Search results for: hospital waste

Authors: Jaroslav Frantík, Jan Najser

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This article deals with increasing the energy efficiency of a plant in terms of optimizing the process. The European Union is striving to achieve the climate-energy package in the area increasing of energy efficiency. The goal of energy efficiency is to reduce primary energy consumption by 20% within the EU until 2020. The objective of saving energy consumption in the Czech Republic was set at 47.84 PJ (13.29 TWh). For reducing electricity consumption, it is possible to choose: a) mandatory increasing of energy efficiency, b) alternative scheme, c) combination of both actions. The Czech Republic has chosen for reducing electricity consumption using-alternative scheme. The presentation is focused on the proposal of a technological unit dealing with the gasification process of processing of biomass with an increase of power in the output. The synthesis gas after gasification of biomass is used as fuel in a cogeneration process of reciprocating internal combustion engine with the classic production of heat and electricity. Subsequently, there is an explanation of the ORC system dealing with the conversion of waste heat to electricity with the using closed cycle of the steam process with organic medium. The arising electricity is distributed to the power grid as a further energy source, or it is used for needs of the partial coverage of the technological unit. Furthermore, there is a presented schematic description of the technology with the identification of energy flows starting from the biomass treatment by drying, through its conversion to gaseous fuel, producing of electricity and utilize of thermal energy with minimizing losses. It has been found that using of ORC system increased the efficiency of the produced electricity by 7.5%.

Keywords: biomass, efficiency, gasification, ORC system

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Aya Belal, Ahmed Maher Eltair, Maggie Ahmed Mashaly

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Geopolymer concrete is gaining recognition as a sustainable alternative to conventional Portland Cement concrete due to its environmentally friendly nature, which is a key goal for Smart City initiatives. It has demonstrated its potential as a reliable material for the design of structural elements. However, the production of Geopolymer concrete is hindered by batch-to-batch variations, which presents a significant challenge to the widespread adoption of Geopolymer concrete. To date, Machine learning has had a profound impact on various fields by enabling models to learn from large datasets and predict outputs accurately. This paper proposes an integration between the current drift to Artificial Intelligence and the composition of Geopolymer mixtures to predict their mechanical properties. This study employs Python software to develop machine learning model in specific Decision Trees. The research uses the percentage oxides and the chemical composition of the Alkali Solution along with the curing conditions as the input independent parameters, irrespective of the waste products used in the mixture yielding the compressive strength of the mix as the output parameter. The results showed 90 % agreement of the predicted values to the actual values having the ratio of the Sodium Silicate to the Sodium Hydroxide solution being the dominant parameter in the mixture.

Keywords: decision trees, geopolymer concrete, machine learning, smart cities, sustainability

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Authors: Saeed Karimi, Ali Behbahaninia

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In this study, the design and optimization of combined cooling, heating, and power system (CCHP) for a sustainable building are dealt with. Sustainable buildings are environmentally responsible and help us to save energy also reducing waste, pollution and environmental degradation. CCHP systems are widely used to save energy sources. In these systems, electricity, cooling, and heating are generating using just one primary energy source. The selection of the size of components based on the maximum demand of users will lead to an increase in the total cost of energy and equipment for the building complex. For this purpose, a system was designed in which the prime mover (gas turbine), heat recovery boiler, and absorption chiller are lower than the needed maximum. The difference in months with peak consumption is supplied with the help of electrical absorption chiller and auxiliary boiler (and the national electricity network). In this study, the optimum capacities of each of the equipment are determined based on Thermo economic method, in a way that the annual capital cost and energy consumption will be the lowest. The design was done for a gas turbine prime mover, and finally, the optimum designs were investigated using exergy analysis and were compared with a traditional energy supply system.

Keywords: sustainable building, CCHP, energy optimization, gas turbine, exergy, thermo-economic

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Authors: Peng Guo

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Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

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Authors: Nazanin Gerami, Shirin Adlparvar

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In the present time in the laboratory, one can create an ionized gas, that is to say, plasma from room temperature up to ten times more than the temperature of the sun center (150,000,000). All these temperature spectrums of plasma have applications in different disciplines, including dentistry, medicine, science, surface treatment, nuclear waste disinfection, nuclear fusion technology, etc. However, for the sick of simplicity, all these plasma temperature spectrums are classified as cold or low-pressure non-thermal plasma and warm or high-pressure equilibrium plasma. The cold plasma, as we are interested in this paper, exists at lower ion and neutral temperatures with respect to electron temperature, but in the equilibrium plasma, the temperatures of ion and electron are fairly equal. The cold plasma is a partially ionized gas comprising ions, electrons, ultraviolet photons and reactive neutrals such as radicals, excited and ground-state molecules. Cold atmospheric pressure plasmas are widely used in diverse fields of dental medicine, such as the titanium surface of dental implants, which helps in reducing contact angle and supporting the spread of osteoblastic cells and is known to aid in osteoblastic proliferation and osseointegration, thus increasing the success rates of implants. This article focuses on the anticipated uses of a newly designed water-cooled adjustable cathode cold atmospheric pressure plasma Jet (CAPPJ) for titanium surface treatment in dental implant placement.

Keywords: CAPPJ, surface modification, osseointegration, plasma medicine, dentistry

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Authors: Arunkumar Thirugnanasambantham, Velraj Ramalingam

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An experimental attempt has been made to study the effect of system integration by two different concentrator assisted desalting systems. The compound parabolic concentrator (CPC) and compound conical concentrator (CCC) are used in this research work. Two solar desalination systems, the single slope solar still (SSSS) and pyramid solar still (PSS), have been integrated with a CCC and compound parabolic concentrator-concentric circular tubular solar still (CPC-CCTSS). To study the effect of system integration, a thick cloth prevents the entry of sunlight into the solar still top. Additionally, the concentrator assisted desalting systems are equipped with phase change material (PCM) for enhancement. In CCC-SSSS, PCM has been filled inside copper balls and placed on the SSSS basin. The PCM is loaded in the specially designed circular trough of the tubular solar still. Here, the used concentrators and distillers are not the same. Two methodologies are followed here to produce the fresh water even while the distillers are blocked from the sunlight. They are (1) thermosyphon effect in CCC-SSSS and (2) waste heat recovery from CPC-CCTSS. The results showed that the productivity of CCC-SSSS, CCC-SSSS with PCM and CCC-SSSS (PCM) top cover shaded were found as 2680 ml / m² / day, 3240 ml / m² / day, and 1646 ml / m² / day. Similarly, the productivity of the CPC-CCTSS-PSS, CPC-CCTSS (PCM)-PSS and CPC-CCTSS (PCM)-PSS top cover shaded were found as 7160 ml / m² / day, 7346 ml / m² / day, and ml / m² / day. The productivity of the CCC-SSSS and CPC-CCTSS-PSS is examined, and conclusions are drawn such as the solar radiation blocked distillers productivity did not drop to zero.

Keywords: compound conical concentrator, compound parabolic concentrator, desalination, system integration

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Authors: Hadi Gholizadeh, Ali Tajdin

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To have effective production planning, it is necessary to control the quality of processes. This paper aims at improving the performance of the disposable essentials process using statistical quality control and goal programming in a vague environment. That is expressed uncertainty because there is always a measurement error in the real world. Therefore, in this study, the conditions are examined in a vague environment that is a distance-based environment. The disposable essentials process in Kach Company was studied. Statistical control tools were used to characterize the existing process for four factor responses including the average of disposable glasses’ weights, heights, crater diameters, and volumes. Goal programming was then utilized to find the combination of optimal factors setting in a vague environment which is measured to apply uncertainty of the initial information when some of the parameters of the models are vague; also, the fuzzy regression model is used to predict the responses of the four described factors. Optimization results show that the process capability index values for disposable glasses’ average of weights, heights, crater diameters and volumes were improved. Such increasing the quality of the products and reducing the waste, which will reduce the cost of the finished product, and ultimately will bring customer satisfaction, and this satisfaction, will mean increased sales.

Keywords: goal programming, quality control, vague environment, disposable glasses’ optimization, fuzzy regression

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Authors: Julius Adebayo John

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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

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Authors: Lubna M. Zakaryia Mahmoud, Mohammed A. Dawood, Doaa A. Heiba

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A prospective double-blind placebo controlled trial carried out on 60 children known to be asthmatic who presented to the emergency department at Alexandria University of Children’s Hospital at El-Shatby with acute asthma exacerbations to assess the efficacy of adding inhaled magnesium sulfate to β-agonist, compared with β-agonist in saline, in the management of acute asthma exacerbations in children. The participants in the study were divided in two groups; Group A (study group) received inhaled salbutamol solution (0.15 ml/kg) plus isotonic magnesium sulfate 2 ml in a nebulizer chamber. Group B (control group): received nebulized salbutamol solution (0.15 ml/kg) diluted with placebo (2 ml normal saline). Both groups received inhaled solution every 20 minutes that was repeated for three doses. They were evaluated using the Pediatric Asthma Severity Score (PASS), oxygen saturation using portable pulse oximetry and peak expiratory flow rate using a portable peak expiratory flow meter at initially recorded as zero-minute assessment and every 20 minutes from the end of each nebulization (nebulization lasts 5-10 minutes) recorded as 20, 40 and 60-minute assessments. Regarding PASS, comparison showed non-significant difference with p-value 0.463, 0.472, 0.0766 at 20, 40 and 60 minutes. Regarding oxygen saturation, improvement was more significant towards group A starting from 40 min with significant p-value=0.000. At 60 min p-value=0.000. Although mean PEFR significantly improved from zero-min in both groups; however, improvement was more significant in group A with significant p-value = 0.015, 0.001, 0.001 at 20 min, 40 min and 60 min, respectively. The conclusion this study suggests is that inhaled magnesium sulfate is an efficient add on drug to standard β- agonist inhalation used in the treatment of moderate to severe asthma exacerbations.

Keywords: nebulized, magnesium sulfate, acute asthma , pediatric

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Authors: Usama Bin Zubair, Syed Azhar Ali

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Introduction: Depression is emerging as a major public health problem in all parts of the world. Developing countries have a unique socioeconomic structure that affects the lives of its inhabitants in several ways. Going abroad for employment is one of the common social problems which have been faced by young males in developing countries. This included both highly qualified individuals as well as the labor class. Objective: To determine the difference in the presence of depressive symptoms among pregnant women with husbands living abroad and those with husbands living with them in Azad Jammu and Kashmir. Methods: The sample population comprised of pregnant women reporting for an antenatal checkup at Amna hospital Rawalakot. Cases constituted the pregnant women with husbands living abroad while controls were the pregnant women with husbands living with them. Patient health questionnaire-9 (PHQ-9) was used to record the presence and severity of depressive symptoms. Age, gestation, parity, rural or urban origin, education, level of family income, daily contact hours on the telephone or what’s app, previous pregnancy loss or complications, number of years abroad and visits to home per year were associated with the presence of depressive symptoms. Findings: The mean age of the study participants was 29.73 ±5.395 years. Sixty-six had significant depression in the case group, while 14 had in the control group (p-value<0.001). Education and rural background had a significant difference between the case and the control group. Less number of visits per year of the husband was strongly linked with the presence of depressive symptoms among the cases. Conclusion: Pregnant women with husbands abroad were found more prone to develop depressive symptoms as compared to those with husbands living with them. Special attention should be paid to the women whose husband had a lesser number of visits to the country.

Keywords: depression, pregnancy, lack of support, war zone

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Authors: Ben Salah Nahla

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The problem of water in Tunisia affects the quality and quantity. Tunisia is in a situation of water shortage. It was estimated that 4.6 Mm3/an. Moreover, the quality of water in Tunisia is also mediocre. In fact, 50% of the water has a high salinity (> 1.5g/l). There are several parameters which affect water quality such as sodium, fluoride. An excess of this parameter may induce some human health. Furthermore, the mining basin area has a problem of industrial waste. This problem may affect the water quality of the groundwater. Therefore, the purpose of this work is to assess the water quality in Basin Mining and the impact of fluorine. For this research, some water samples were done in the field and specific water analysis was implemented in the laboratory. Sampling is carried out on eight drilling in the area of the mining region. In the following, we will look at water view composition, physical and chemical quality. A physical-chemical analysis of water from a survey of the Mining area of Tunisia was performed and showed an excess for the following items: fluorine, sodium, sulfate. So many chemicals may be present in water. However, only a small number of them immediately concern in terms of health in all circumstances. Fluorine (F) is one particular chemical that is considered both necessary for the human body, but an excess of the rate of this chemical causes serious diseases. Sodium fluoride and sodium silicofluoride are more soluble and may spread in animals and plants where their toxicity largest organizations. The more complex particles such as cryolite and fluorite, almost insoluble, are more stable and less toxic. Thereafter, we will study the problem of excess fluorine in the water. The latter intended for human consumption must always comply with the limits for microbiological quality parameters and physical-chemical parameters defined by European standards (1.5 mg/l) and Tunisian (2 mg/l).

Keywords: water, minier basin, fluorine, silicofluoride

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Authors: Donatella Cimini, Sergio D’ambrosio, Saba Sadiq, Chiara Schiraldi

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Chondroitin sulfate (CS), as well as modified CS, and unsulfated chondroitin, are largely applied in research today. CS is a linear glycosaminoglycan normally present in cartilage-rich tissues and bones in the form of proteoglycans decorated with sulfate groups in different positions. CS is used as an effective non-pharmacological alternative for the treatment of osteoarthritis, and other potential applications in the biomedical field are being investigated. Some bacteria, such as E. coli K4, produce a polysaccharide that is a precursor of CS (unsulfated chondroitin). This work focused on the construction of integrative E. coli K4 recombinant strains overexpressing genes (kfoA, kfoF, pgm and galU in different combinations) involved in the biosynthesis of the nucleotide sugars necessary for polysaccharide synthesis. Strain growth and polymer production were evaluated using renewable waste materials as substrates in shake flasks and small-scale batch fermentation processes. Results demonstrated the potential to replace pure sugars with cheaper medium components to establish environmentally sustainable and cost-effective production routes for potential industrial development. In fact, although excellent fermentation results have been described so far by employing strains that naturally produce chondroitin-like polysaccharides on semi-defined media, there is still the need to reduce manufacturing costs by providing a cost-effective biotechnological alternative to currently used animal-based extraction procedures.

Keywords: E. coli K4, chondroitin, microbial cell factories, glycosaminoglycans, renewable resources

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Authors: F. Javier Benitez, Francisco J. Real, Juan Luis Acero, Francisco Casas

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Three emerging contaminants (amitriptyline hydrochloride, methyl salicylate and 2-phenoxyethanol) frequently found in waste-waters were selected to be individually degraded in ultra-pure water by the combined advanced oxidation process constituted by UV radiation and chlorine. The influence of pH, initial chlorine concentration and nature of the contaminants was firstly explored. The trend for the reactivity of the selected compounds was deduced: amitriptyline hydrochloride > methyl salicylate > 2-phenoxyethanol. A later kinetic study was carried out and focused on the specific evaluation of the first-order rate constants and the determination of the partial contribution to the global reaction of the direct photochemical pathway and the radical pathway. A comparison between the rate constant values among photochemical experiments without and with the presence of Cl₂ reveals a clear increase in the oxidation efficiency of the combined process with respect to the photochemical reaction alone. In a second stage, the simultaneous oxidation of mixtures of the selected contaminants in several types of water (ultrapure water, surface water from a reservoir, and two secondary effluents) was also performed by the same combination UV/Cl₂ under more realistic operating conditions. The efficiency of this combined system UV/Cl₂ was compared to other oxidants such as the UV/S₂O₈^2- and UV/H₂O₂ AOPs. Results confirmed that the UV/Cl₂ system provides higher elimination efficiencies among the AOPs tested.

Keywords: emerging contaminants, UV/chlorine advanced oxidation process, amitriptyline, methyl salicylate, 2-phenoxyethanol, chlorination, photolysis

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Authors: Angga Pratama Herman, Muhammad Shahbaz, Suzana Yusup

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Bottom ash is a solid waste from thermal power plant and it is usually disposed of into landfills and ash ponds. These disposal methods are not sustainable since new lands need to be acquired as the landfills and ash ponds are fill to its capacity. Bottom ash also classified as hazardous material that makes the disposal methods may have contributed to the environmental effect to the area. Hence, more research needs to be done to explore the potential of recycling the bottom ash as more useful product. The objective of this research is to explore the potential of utilizing bottom ash as catalyst in biomass steam gasification. In this research, bottom ash was used as catalyst in gasification of Palm Kernel Shell (PKS) using Thermo Gravimetric Analyzer coupled with mass spectrometry (TGA/MS). The effects of temperature (650 – 750 °C), particle size (0.5 – 1.0 mm) and bottom ash percentage (2 % - 10 %) were studied with and without steam. The experimental arrays were designed using expert method of Central Composite Design (CCD). Results show maximum yield of hydrogen gas was 34.3 mole % for gasification without steam and 61.4 Mole % with steam. Similar trend was observed for syngas production. The maximum syngas yield was 59.5 mole % for without steam and it reached up to 81.5 mole% with the use of steam. The optimal condition for both product gases was temperature 700 °C, particle size 0.75 mm and cool bottom ash % 0.06. In conclusion, the use of bottom ash as catalyst is possible for biomass steam gasification and the product gases composition are comparable with previous researches, however the results need to be validated for bench or pilot scale study.

Keywords: bottom ash, biomass steam gasification, catalyst, lab scale

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Authors: Rene Davids

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Urban undergrounds spaces such as parking garages or metro stations are perceived as interludes before reaching desired destinations, as commodities devoid of aesthetic value. Within the encoded space of the city, commercial underground spaces are the closest expression to pure to structures of consumption and commodity. Even in the house, the cellar is associated with castoffs and waste or, as scholar Mircea Eliade has pointed out at best, with a place to store abandoned household and childhood objects, which lie forgotten and on rediscovery evoke a nostalgic and uncanny sense of the past. Despite a growing body of evidence presented by an increasing number of buildings situated entirely below or semi underground that feature exemplary spatial and sensuous qualities, critics and scholars see them largely as efforts to produce efforts in producing low consumption non-renewable energy. Buildings that also free space above ground. This critical approach neglects to mention and highlight other project drivers such as the notion that the ground and sky can be considered a building’s fundamental context, that underground spaces are conducive to the exploration of pure space, namely an architecture that doesn’t have to deal with facades and or external volumes and that digging into geology can inspire the textural and spatial richness. This paper will argue that while the assessment about the reduced energy consumption of underground construction is important, it does not do justice to the qualities underground buildings can contribute to a city’s expanded urban and or landscape experiences.

Keywords: low non-renewable energy consumption, pure space, underground buildings, urban and landscape experience

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Authors: Kulwinder Singh Mann, Manmohan Singh Heer, Asha Rani

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The safe storage of radioactive materials has become an important issue. Nuclear engineering necessitates the safe handling of radioactive materials emitting high energy gamma-rays. Hazards involved in handling radioactive materials insist suitable shielded enclosures. With overgrowing use of nuclear energy for meeting the increasing demand of power, there is a need to investigate the shielding behavior of cost effective shielded enclosure (CESE) made from clay-bricks (CB) and fire-bricks (FB). In comparison to the lead-bricks (conventional-shielding), the CESE are the preferred choice in nuclear waste management. The objective behind the present investigation is to evaluate the double layered transmission exposure buildup factors (DLEBF) for gamma-rays for CESE in energy range 0.5-3MeV. For necessary computations of shielding parameters, using existing huge data regarding gamma-rays interaction parameters of all periodic table elements, two computer programs (GRIC-toolkit and BUF-toolkit) have been designed. It has been found that two-layered slabs show effective shielding for gamma-rays in orientation CB followed by FB than the reverse. It has been concluded that the arrangement, FB followed by CB reduces the leakage of scattered gamma-rays from the radioactive source.

Keywords: buildup factor, clay bricks, fire bricks, nuclear wastage management, radiation protective double layered slabs

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Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum

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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.

Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids

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Authors: Priyal Motwani

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The current market for bamboo products in India is about Rs. 21000 crores and is highly unorganised and fragmented. In this study, we have closely analysed the structure and functions of a major bamboo craft based organisation in Kerela, India and elaborated about its value chain, product mix, pricing strategy and supply chain, collaborations and competitive landscape. We have identified six major bottlenecks that are prevalent in such organisations, based on the Indian context, in relation to their product mix, asset management, and supply chain- corresponding waste management and retail network. The study has identified that the target customers for the bamboo based products and alternative revenue streams (eco-tourism, microenterprises, training), by carrying out secondary and primary research (5000 sample space), that can boost the existing revenue by 150%. We have then recommended an optimum product mix-covering premium, medium and low valued processing, for medium sized bamboo based organisations, in accordance with their capacity to maximize their revenue potential. After studying such organisations and their counter parts, the study has established an optimum retail network, considering B2B, B2C physical and online retail, to maximize their sales to their target groups. On the basis of the results obtained from the analysis of the future and present trends, our study gives recommendations to improve the revenue potential of bamboo based organisation in India and promote sustainability.

Keywords: bamboo, bottlenecks, optimization, product mix, retail network, value chain

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Authors: Ndarusanze Berchmans

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This research work focused on the analysis of the observations of tuberculous meningitis in HIV-positive patients who were treated by the Prince Regent Charles Hospital in Bujumbura. A number of 246 seropositive patients were examined by the laboratory of Prince Regent Charles in the period between 2010 and 2015. We did a retrospective study; we used data from the registers of the laboratories mentioned above; the objective was to approach the epidemiological, biological, clinical, and therapeutic characteristics of tuberculosis meningitis infection: 124 women (50.40% of AIDS patients) and 122 men (49.59% of AIDS patients) were subject to the diagnosis by identification of cerebrospinal fluid (CSF). The average age of the patients was 30 years for this period. The population at risk has an average age of between 34 and 42 years for the years between 2010-2015. From 2010 to 2012, cases of opportunistic diseases (e.g., tuberculous meningitis and Cryptococcus neoformans meningitis), often found in immunocompromised, were observed at a high rate; in this period, there was a disturbance of the rhythm providing antiretroviral drugs to people with AIDS. The rate of the two meningitis (tuberculous meningitis and Cryptococcus neoformans meningitis) remained above 10% to gradually decrease until 2015, with the gradual return of antiretrovirals. This period records an overall average of 25 cases of tuberculous meningitis, or a percentage of 10.16%. For the year 2015, there were 4 cases of tuberculous meningitis out of a total of 35 seropositive examined (11.42%). This year's percentage shows that the number of tuberculous meningitis cases has fallen from the rate in previous years. This is the result of the care given by associations against HIV/AIDS to HIV-positive people. This decrease in cases of tuberculous meningitis is due to the acquisition of antiretrovirals by all HIV-positive people treated by hospitals. For the moment, these hospitals are taking care of many AIDS patients by providing them permanently with antiretrovirals; Besides that, there are many patients who are supported by associations whose activities are directed against HIV/AIDS.

Keywords: Cryptococcus neoformans meningitis, tuberculosis meningitis, neurological complications, epidemiology of meningitis

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Authors: Sujana T, Kurniasari MD, Ayakeding AM

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Background: Sexual violence is one of the violence with high incidence in Indonesia. Purpose: This research aims to describe the implementation of sexual violence victim assessment in Semarang Regency. Method: This research is a qualitative research with embeded single case study design. Data is analized with two units of analysis. The first unit of analysis is victim’s examiner with minimum one year of work experience. Semi-structured interview method is used to obtain the data. The second unit of analysis is document related. The data is taken by observing the pathway and description of every document and how it supported each implementation of assessment. Results: This study is resulted with three themes, which are: The first theme is assessments of sexual violence in Semarang regency has been standardized. The laws of the Republic of Indonesia have regulated the handling of victims of sexual violence in outline. Victims of sexual violence can be dealt with by the police, the Integrated Service Center for Women and Children Empowerment and the Regional General Hospital. Each examination site has different operational procedures standards for dealing with victims of sexual violence. Cooperation with family and witnesses is also required in the review process to obtain accurate results and evidence; The second idea that resulted from this study is there are inhibits factors in the assessments process. Victims sometimes feel embarrassed and reluctant to recount the chronological events during reporting. The examining officer should be able to approach and build a trust to convince the victim to be able to cooperate. The third theme is there are other things to consider in the process of assessing victims of sexual violence. Ensuring implementation in accordance with applicable operational procedures standards, providing exclusive examination rooms, counseling and safeguarding the privacy of victims are important to be considered in the assessment.

Keywords: assessment, case study, Semarang regency, sexual violence

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Authors: Florge Francis A. Sy

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Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman

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Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome

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Authors: Mahmoud Reza Tahamtan, Mohammad Saleh Bahreini

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Background and Purpose: Cystic echinococcosis, caused by the larval stage of Echinococcus granulosus, is a common parasitic infection of humans and is endemic in many parts of the world, including Iran. So that, one percent of those admitted to surgery departments are hydatid cyst patients, and using the ELISA method, the infection rate has been reported in different regions of Iran from 1.2% to 21.4%. Therefore, the aim of this study was to investigate the seroepidemiology of human hydatid cysts in Fars province, southern Iran, by ELISA method. Methods: In this cross-sectional study, 600 serum samples of persons who were referred to the laboratory of Nemazi Hospital in Shiraz for normal tests were examined for the presence of specific Anti-IgG antibodies to hydatid cysts by ELISA method. During the sampling, a structured questionnaire was used to obtain social data of individuals with determinants of risk factors for Cystic echinococcosis. Finally, the results of the ELISA test, along with demographic information completed by individuals, were analyzed using SPSS software. Results: The average age of the subjects in this study was 40.01 ± 9.166. The prevalence of hydatidosis was reported as 5.66% (34/600). The disease was more in the age group of 21-30, people living in villages, working in rural areas, and people with a history of other parasitic diseases. Statistically, a significant difference was observed between the prevalence of the disease and two risk factors, contact with dogs (OR= 0.042; 95%CI: 0.014-0.12; P= 0.001) and washing vegetables with water (OR= 0.08; 95%CI: 0.011-0.56; P= 0.012). Conclusion: The present study showed that hydatid cyst disease has a significant prevalence in this area. Also, based on the results, contact with dogs and not properly washing vegetables are two important factors of disease transmission.

Keywords: Echinococcus granulosus, Cystic echinococcosis, hydatid cyst, Fars province

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Authors: Preethi Grace Theva Neethi Dhas

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A healthy human gut microbiome has commensal and symbiotic functions in digestion and is a decisive factor for human health. The soil microbiome is a crucial component in the ecosystem of soils and their health and resilience. Changes in soil microbiome are linked to human health. Ever since the industrial era, the human and the soil microbiome have been going through drastic changes. The soil microbiome has changed due to industrialization and extensive agricultural practices, whereas humans have less contact with soil and increased intake of highly processed foods, leading to changes in the human gut microbiome. Regenerating the soil becomes crucial in maintaining a healthy ecosystem. The nutrients, once obtained from the soil, need to be given back to the soil. Soil degradation needs to be addressed in effective ways, like adding organic nutrients back to the soil. Manure from animals and humans needs to be returned to the soil, which can complete the nutrient cycle in the soil. On the other hand, fecal sludge management (FSM) is a growing concern in many parts of the developing world. Hence, it becomes crucial to treat and reuse fecal sludge in a safe manner, i.e., low in risk to human health. Co-composting fecal sludge with organic wastes is a practice that allows the safe management of fecal sludge and the safe application of nutrients to the soil. This paper will discuss the possible impact of co-composting fecal sludge with coconut choir waste on the soil, water, and ecosystem at large. Impact parameters like nitrogen, phosphorus, and fecal coliforms will be analyzed. The overall impact of fecal sludge application on the soil will be researched and presented in this study.

Keywords: fecal sludge management, nutrient cycle, soil health, composting

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Authors: Oladipo Oluwaseun Peter

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Daily consumption of crude oil is alarming as a result of increasing demand for energy. Waste generation tends to rise with the level of economic advancement of a nation. Hence, this project work researches how wastes which could pose toxic if left unattended to can be processed through biodigestion in order to generate biofuel which could serve as a good substitute for petroleum, a non renewable energy source, so as to reduce over-dependence on petroleum and to prevent environmental pollution. Anaerobic digestion was carried out on organic wastes comprising brewery spent grains, rice husks and poultry droppings in a plastic biodigester of 1000 liters volume using the poultry droppings as a natural inoculums source. The feed composition in ratio 5:3:2, spent grain, rice husks and poultry droppings were mixed with water in the ratio 1:6. Thus, 600 Kg of water was used to prepare the slurry with 100 Kg of feed materials. A plastic biodigester was successfully constructed, and the problem of corrosion and rusting were completely overcome as a result of the use of non-corroding materials of construction. A reasonable quantity of biogas, 33.63m3, was generated over a period of 60 days of biodigestion. The bioslurry was processed through two different process routes; evaporation and filteration. Evaporation process of analysis shows high values of 0.64%, 2.11% and 0.034% for nitrogen, phosphorous and potassium respectively, while filteration process gives 00.61%, 1.93% and 0.026% for nitrogen, phosphorous and potassium respectively.

Keywords: biodigestion, biofuel, digestion, slurry, biogas

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Authors: N. Ali, S. Nakayama, H. Yamaguchi, M. Nadeem

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Traffic congestion is a matter of prime concern in developing countries. This can be primarily attributed due to poor design practices and biased allocation of resources based on political will neglecting the technical feasibilities in infrastructure design. During the last decade, Lahore has expanded at an unprecedented rate as compared to surrounding cities due to more funding and resource allocation by the previous governments. As a result of this, people from surrounding cities and areas moved to the Lahore city for better opportunities and quality of life. This migration inflow inherited the city with an increased population yielding the inefficiency of the existing infrastructure to accommodate enhanced traffic demand. This leads to traffic congestion on major arterial roads of the city. In this simulation study, a major arterial road was selected to evaluate the performance of the five intersections by changing the geometry of the intersections or signal control type. Simulations were done in two software; Highway Capacity Software (HCS) and Synchro Studio and Sim Traffic Software. Some of the traffic management strategies that were employed include actuated-signal control, semi-actuated signal control, fixed-time signal control, and roundabout. The most feasible solution for each intersection in the above-mentioned traffic management techniques was selected with the least delay time (seconds) and improved Level of Service (LOS). The results showed that Jinnah Hospital Intersection and Akbar Chowk Intersection improved 92.97% and 92.67% in delay time reduction, respectively. These results can be used by traffic planners and policy makers for decision making for the expansion of these intersections keeping in mind the traffic demand in future years.

Keywords: traffic congestion, traffic simulation, traffic management, congestion problems

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Authors: Lai Gwen Chan, Yining Ong, Audrey Yoke Poh Wong

Abstract:

Background. The efficacy of electroconvulsive therapy (ECT) as a form of treatment to a range of mental disorders is well-established. However, ECT is often associated with either temporary or persistent cognitive side-effects, resulting in the failure of wider prescription. Of which, retrograde amnesia is the most commonly reported cognitive side-effect. Most studies found a recalling deficit in autobiographical memories to be short-term, although a few have reported more persistent amnesic effects. Little is known about ECT-related amnesic effects in Asian population. Hence, this study aims to resolve conflicting findings, as well as to better elucidate the effects of ECT on cognitive functioning in a local sample. Method: 12 patients underwent bilateral ECT under the care of Psychological Medicine Department, Tan Tock Seng Hospital, Singapore. Participants’ cognition and level of functioning were assessed at four time-points: before ECT, between the third and fourth induced seizure, at the end of the whole course of ECT, and two months after the index course of ECT. Results: It was found that Global Assessment of Functioning scores increased significantly at the completion of ECT. Case-by-case analyses also revealed an overall improvement in Personal Semantic and Autobiographical memory two months after the index course of ECT. A transient dip in both personal semantic and autobiographical memory scores was observed in one participant between the third and fourth induced seizure, but subsequently resolved and showed better performance than at baseline. Conclusions: The findings of this study suggest that ECT is an effective form of treatment to alleviate the severity of symptoms of the diagnosis. ECT does not affect attention, language, executive functioning, personal semantic and autobiographical memory adversely. The findings suggest that Asian patients may respond to bilateral ECT differently from Western samples.

Keywords: electroconvulsive therapy (ECT), autobiographical memory, cognitive impairment, psychiatric disorder

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Authors: Abimbola M. Enitan, J. Adeyemo

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Anaerobic modeling is a useful tool to describe and simulate the condition and behaviour of anaerobic treatment units for better effluent quality and biogas generation. The present investigation deals with the anaerobic treatment of brewery wastewater with varying organic loads. The chemical oxygen demand (COD) and total suspended solids (TSS) of the influent and effluent of the bioreactor were determined at various retention times to generate data for kinetic coefficients. The bio-kinetic coefficients in the modified Stover–Kincannon kinetic and methane generation models were determined to study the performance of anaerobic digestion process. At steady-state, the determination of the kinetic coefficient (K), the endogenous decay coefficient (Kd), the maximum growth rate of microorganisms (µmax), the growth yield coefficient (Y), ultimate methane yield (Bo), maximum utilization rate constant Umax and the saturation constant (KB) in the model were calculated to be 0.046 g/g COD, 0.083 (dˉ¹), 0.117 (d-¹), 0.357 g/g, 0.516 (L CH4/gCODadded), 18.51 (g/L/day) and 13.64 (g/L/day) respectively. The outcome of this study will help in simulation of anaerobic model to predict usable methane and good effluent quality during the treatment of industrial wastewater. Thus, this will protect the environment, conserve natural resources, saves time and reduce cost incur by the industries for the discharge of untreated or partially treated wastewater. It will also contribute to a sustainable long-term clean development mechanism for the optimization of the methane produced from anaerobic degradation of waste in a close system.

Keywords: brewery wastewater, methane generation model, environment, anaerobic modeling

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Authors: W. Ketren, J. Wannapeera, Z. Heishun, A. Ryuichi, K. Toshiteru, M. Kouichi, O. Hideaki

Abstract:

Degradative solvent extraction is the method developed for biomass upgrading by dewatering and fractionation of biomass under the mild condition. However, the conversion mechanism of the degradative solvent extraction method has not been fully understood so far. The rice straw was treated in 1-methylnaphthalene (1-MN) at a different solvent-treatment temperature varied from 250 to 350 ^oC with the residence time for 60 min. The liquid membrane-Fourier Transform Infrared Spectroscopy (FTIR) technique is applied to study the processing mechanism in-depth without separation of the solvent. It has been found that the strength of the oxygen-hydrogen stretching  (3600-3100 cm^-1) decreased slightly with increasing temperature in the range of 300-350 ^oC. The decrease of the hydroxyl group in the solvent soluble suggested dehydration reaction taking place between 300 and 350 ^oC. FTIR spectra in the carbonyl stretching region (1800-1600 cm^-1) revealed the presence of esters groups, carboxylic acid and ketonic groups in the solvent-soluble of biomass. The carboxylic acid increased in the range of 200 to 250 ^oC and then decreased. The prevailing of aromatic groups showed that the aromatization took place during extraction at above 250 ^oC. From 300 to 350 ^oC, the carbonyl functional groups in the solvent-soluble noticeably decreased. The removal of the carboxylic acid and the decrease of esters into the form of carbon dioxide indicated that the decarboxylation reaction occurred during the extraction process.

Keywords: biomass waste, degradative solvent extraction, mechanism, upgrading

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