Search results for: hospital waste

Authors: A. Nurgiartiningsih, G. Ciptadi, S. B. Siswijono

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This research was done to identify the performance and breeding potency of Local Buffalo in Kangean Island, Sumenep, East Java, Indonesia. Materials used were buffalo and farmer in Kangean Island. Method used was survey with purposive sampling method. Qualitative trait and existing breeding system including the type of production system were directly observed. Quantitative trait consisted of chest girth, body weight and wither height were measured and recorded. Data were analyzed using analysis of variance applying software GENSTAT 14. Results showed the purposes of buffalo breeding in Kangean Island were for production of calves, saving, religion tradition, and buffalo racing. The combination between grazing and cut and carry system were applied in Kangean Island. Forage, grass and agricultural waste product were available abundantly especially, during the wet season. Buffalo in Kangean Island was categorized as swamp buffalo with 48 chromosomes. Observation on qualitative trait indicated that there were three skin color types: gray (81.25%), red (10.42%) and white/albino (8.33%). Analysis on quantitative trait showed that there was no significant difference between male and female buffalo. The performance of male buffalo was 132.56 cm, 119.33 cm and 174.11 cm, for the mean of body length, whither height and chest girth, respectively. The performance of female buffalo were 129.8 cm, 114.0 cm and 166.2 cm, for mean of body length, wither height and chest girth (CG), respectively. The performance of local buffalo in Kangean Island was categorized well. Kangean Island could be promoted as center of buffalo breeding and conservation. For optimal improvement of population number and its genetics value, government policy in buffalo breeding program should be implemented.

Keywords: chromosome, qualitative trait, quantitative trait, swamp buffalo

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Authors: Sema Kayapinar, Ismail Karaoglan, Turan Paksoy, Hadi Gokcen

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Green Supply Chain Management is gaining growing interest among researchers and supply chain management. The concept of Green Supply Chain Management is to integrate environmental thinking into the Supply Chain Management. It is the systematic concept emphasis on environmental problems such as reduction of greenhouse gas emissions, energy efficiency, recycling end of life products, generation of solid and hazardous waste. This study is to present a green supply chain network model integrated Internet of Things applications. Internet of Things provides to get precise and accurate information of end-of-life product with sensors and systems devices. The forward direction consists of suppliers, plants, distributions centres and sales and collect centres while, the reverse flow includes the sales and collects centres, disassembled centre, recycling and disposal centre. The sales and collection centre sells the new products are transhipped from factory via distribution centre and also receive the end-of life product according their value level. We describe green logistics activities by presenting specific examples including “recycling of the returned products and “reduction of CO2 gas emissions”. The different transportation choices are illustrated between echelons according to their CO2 gas emissions. This problem is formulated as a mixed integer linear programming model to solve the green supply chain problems which are emerged from the environmental awareness and responsibilities. This model is solved by using Gams package program. Numerical examples are suggested to illustrate the efficiency of the proposed model.

Keywords: green supply chain optimization, internet of things, greenhouse gas emission, recycling

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Authors: Patrick Mueller, Alan Martin, Justin Stockwell, Robert Goldblatt

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Elevated concentrations of inorganic nitrogen (N) compounds (nitrate, nitrite, and ammonia) are a ubiquitous feature to mine-influenced drainages due to the leaching of blasting residues and use of cyanide in the milling of gold ores. For many mines, the management of N is a focus for environmental protection, therefore understanding the factors controlling the speciation and behavior of N is central to effective decision making. In this paper, the passive attenuation of ammonia and nitrite is described for three northern water bodies (two lakes and a tailings pond) influenced by mining activities. In two of the water bodies, inorganic N compounds originate from explosives residues in mine water and waste rock. The third water body is a decommissioned tailings impoundment, with N compounds largely originating from the breakdown of cyanide compounds used in the processing of gold ores. Empirical observations from water quality monitoring indicate nitrification (the oxidation of ammonia to nitrate) occurs in all three waterbodies, where enrichment of nitrate occurs commensurately with ammonia depletion. The N species conversions in these systems occurred more rapidly than chemical oxidation kinetics permit, indicating that microbial mediated conversion was occurring, despite the cool water temperatures. While nitrification of ammonia and nitrite to nitrate was the primary process, in all three waterbodies nitrite was consistently present at approximately 0.5 to 2.0 % of total N, even following ammonia depletion. The persistence of trace amounts of nitrite under these conditions suggests the co-occurrence denitrification processes in the water column and/or underlying substrates. The implications for N management in mine waters are discussed.

Keywords: explosives, mining, nitrification, water

Procedia PDF Downloads 319

Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

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Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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An earthquake hit the Kermanshah province, which is located in the west of Iran, on 12th November 2017 at 18:18 UTC (21:48 Iran Standard Time). This earthquake caused several deaths and injured people. In this disaster, substantial homes were destroyed and many homes were damaged. The Iranian government, local authorities, and several non-governmental organizations responded to affected populations’ needs, such as foods, blanket, water, a tent as a temporary shelter, etc. Considerable national groups, including governmental, non-governmental organizations, and people from non-organized groups, directly and indirectly, tried to bring donated goods to the affected populations. However, some of these aids could not satisfy all the affected populations. Moreover, these impossibilities led to waste extensive resources. In this regard, this research study aims to assess the problems of the Kermanshah disaster responses. At the same time, this project searches possible solutions in order to increase emergency management efficiencies for encountering future events. To this end, this study assesses the problem from all beneficiaries´ point of views. In this regard, a survey and a questionnaire were designed for statistical analyses of the responses of people, who were involved in the Kermanshah earthquake recovery program. Additionally, this research study takes into account diverse strategies, which have been applied in other recovery programs, with the Kermanshah case in order to determine similarities and differences. Finally, this study presents possible solutions taken from other recovery programs that could be applied for the Kermanshah emergency responses. However, the results demonstrate that it is required to customize applied strategies based on local conditions and requirements.

Keywords: disaster response, Kermanshah earthquake, natural disasters, NGOs

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Authors: Karla D. Vazquez-Valdez, Bradley P. Wynne

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In the last decades manufacturing needs have been changing, leading to the study of manufacturing methods that were underdeveloped, such as incremental forming processes like shear forming. These processes use rotating tools in constant local contact with the workpiece, which is often also rotating, to generate shape. This means much lower loads to forge large parts and no need for expensive special tooling. Potential has already been established by demonstrating manufacture of high-value products, e.g., turbine and satellite parts, with high dimensional accuracy from difficult to manufacture materials. Thus, huge opportunities exist for these processes to replace the current method of manufacture for a range of high value components, e.g., eliminating lengthy machining, reducing material waste and process times; or the manufacture of a complicated shape without the development of expensive tooling. However, little is known about the exact deformation conditions during processing and why certain materials are better than others for shear forming, leading to a lot of trial and error before production. Three alloys were used for this study: Ti-54M, Jethete M154, and IN718. General Microscopy and Electron Backscatter Diffraction (EBSD) were used to measure strains and orientation maps during shear forming. A Design of Experiments (DOE) analysis was also made in order to understand the impact of process parameters in the properties of the final workpieces. Such information was the key to develop a reliable Finite Element Method (FEM) model that closely resembles the deformation paths of this process. Finally, the potential of these three materials to be shear spun was studied using the FEM model and their Forming Limit Diagram (FLD) which led to the development of a rough methodology for testing the shear spinnability of various metals.

Keywords: shear forming, damage, principal strains, forming limit diagram

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Authors: Zhala Ahmad, Zainab Lazim, Haider Hamzah

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Bacterial resistance is a pressing global health issue, with multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains to pose a serious threat. In this context, researchers are investigating effective, safe, and affordable metabolites to combat these pathogens. This study focuses on gum essential oil (GEO) extracted from Pistacia atlantica and its activity and the mechanism of action against XDR Gram-negative Acinetobacter baumannii. GEO was extracted by hydrodistillation and analyzed using GC-MS. Eleven A. baumannii isolates were collected from the ward environment of Burn and Plastic Surgery Hospital in Al Sulaymaniyah City, Iraq. They were identified using the VITEK 2 system, 16S rRNA gene, and confirmed with the blaₒₓₐ₋₅₁ gene; A. baumannii ATCC 19606 was used as a reference strain. The isolates were identified as resistant to twelve different antibiotics spanning six distinct antibiotic classes while showing susceptibility to tetracycline and trimethoprim. Over 40 chemical constituents were detected in the gum's essential oils, with α-pinene being the most abundant. GEO was found to inhibit the growth of A. baumannii isolates; the minimum inhibitory concentration (MIC) of GEO was 2.5 µl/ml. GEO induced protein leakage, phosphate, and potassium ion efflux, distorted cell morphology, and cell death in the tested bacteria. GEO exhibited bacterial clearance and anti-adhesion activity using Band-Aids. This study's findings suggest that GEO could be used as a potential alternative treatment for infectious diseases caused by XRD pathogens, shedding further light on the importance of GEO in biomedical applications. Future studies must focus on generating clinically feasible sources of GEO for testing in small animal models before proceeding to human trials, ensuring safe and effective translation from the laboratory to the clinic.

Keywords: antibiotic resistance, Acinetobacter baumannii, essential oils, Pistacia atlantica, alpha-pinene

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Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

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Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

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Authors: Yogi Sirodz Gaos, Irvan Wiradinata

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In the 500 kW Organic Rankine Cycle (ORC) power plant in Indonesia, an AFT (according to the Tubular Exchanger Manufacturers Association – TEMA) type shell and tube heat exchanger device is used as a pre-heating system for the ORC’s hot water circulation system. The pre-heating source is a waste heat recovery of the brine water, which is tapped from a geothermal power plant. The brine water itself has 5 MWₜₕ capacities, with average temperature of 170ᵒC, and 7 barg working pressure. The aim of this research is to examine the performance of the heat exchanger in the ORC system in a 500 kW ORC power plant. The data for this research were collected during the commissioning on the middle of December 2016. During the commissioning, the inlet temperature and working pressure of the brine water to the shell and tube type heat exchanger was 149ᵒC, and 4.4 barg respectively. Furthermore, the ΔT for the hot water circulation of the ORC system to the heat exchanger was 27ᵒC, with the inlet temperature of 140ᵒC. The pressure in the hot circulation system was dropped slightly from 7.4ᵒC to 7.1ᵒC. The flow rate of the hot water circulation was 80.5 m³/h. The presentation and discussion of a case study on the performance of the heat exchanger on the 500 kW ORC system is presented as follows: (1) the heat exchange duty is 2,572 kW; (2) log mean temperature of the heat exchanger is 13.2ᵒC; (3) the actual overall thermal conductivity is 1,020.6 W/m².K (4) the required overall thermal conductivity is 316.76 W/m².K; and (5) the over design for this heat exchange performance is 222.2%. An analysis of the heat exchanger detailed engineering design (DED) is briefly discussed. To sum up, this research concludes that the shell and tube heat exchangers technology demonstrated a good performance as pre-heating system for the ORC’s hot water circulation system. Further research need to be conducted to examine the performance of heat exchanger system on the ORC’s hot water circulation system.

Keywords: shell and tube, heat exchanger, organic Rankine cycle, performance, commissioning

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Authors: Zainab Idrees Ahmad, Mahjabeen Qureshi, Zainab Hussain

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Standard precautions are a set of infection control practices used to prevent the transmission of diseases that can be acquired by contact with body fluids, non-intact skin, and mucous membranes. Lack of practice of SPs can result in a considerable increase in morbidity and mortality rates. Medical students (the future physicians) should have the highest knowledge of standard precautions to prevent the spread of nosocomial infections and ensure their safety as well. This study was designed. To assess the knowledge of medical students regarding standard precautions. And explore the attitude of medical students of MBBS in the third, fourth and final year towards standard precautions.: A descriptive cross-sectional study was conducted in the setting of Rawalpindi Medical University, Pakistan including the students of MBBS in their 3rd, 4th and final years. The study duration was from October 2022 to February 2023. The sample size calculated was 282 with a confidence interval of 95%. A questionnaire was structured utilizing the WHO guidelines on SPs assessing knowledge and attitude regarding hand hygiene, needle stick injury, use of gloves and mask, and sharp disposal. A total of 300 responses were received utilizing the technique of non-random convenience sampling. Data was analyzed using the latest version of SPSS.:Knowledge score regarding components of SPs, hand hygiene, and moments of hand hygiene was satisfactory. However, score regarding the use of PPE, needle stick injury, and sharp disposal was low. Almost all the students were compliant with the proper washing of hands but the observation of recommended time length was lacking. Compliance with the use of correct PPE and informing the supervisor upon getting a needle stick injury was low. This study signifies that medical students lack knowledge regarding standard precautions. This is alarming as this can be the vehicle for the spread of nosocomial infections. Proper training should be given to medical students to prevent the spread of hospital-acquired infections.

Keywords: attitude, knowledge, medical students, standard precautions

Procedia PDF Downloads 127

Authors: D. Osborn, L. Easthope

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The increasing threat of ‘marauding terror,' utilising improvised explosive devices and firearms, has focused the attention of policy makers and emergency responders once again on the treatment of the critically injured patient in a highly volatile scenario. Whilst there have been significant improvements made in the response and lessons learned from recent disasters in the international disaster community there still remain areas of uncertainty and a lack of clarity in the care of the critically injured. This innovative, longitudinal study has at its heart the aim of using ethnographic methods to ‘slow down’ the journey such patients will take and make visible the ethical complexities that 2017 technologies, expectations and over a decade of improved combat medicine techniques have brought. The primary researcher, previously employed in the hospital emergency management environment, has closely followed responders as they managed casualties with life-threatening injuries. Ethnographic observation of Exercise Unified Response in March 2016, exposed the ethical and legal 'vacuums' within a mass casualty and fatality setting, specifically the extrication, treatment and care of critically injured patients from crushed and overturned train carriages. This article highlights a gap in the debate, evaluation, planning and response to an incident of this nature specifically the incapacitated, unidentified patients and the ethics of submitting them to the invasive ‘Disaster Victim Identification’ process. Using a qualitative ethnographic analysis, triangulating observation, interviews and documentation, this analysis explores the gaps and highlights the next stages in the researcher’s pathway as she continues to explore with emergency practitioners some of this century’s most difficult questions in relation to the medico-legal and ethical challenges faced by emergency services in the wake of new and emerging threats and medical treatment expectations.

Keywords: ethics, disaster, Disaster Victim Identification (DVI), legality, unidentified

Procedia PDF Downloads 192

Authors: M. I. Nicolas, J. C. Cruz, Ysmael Verde, A.Yeladaqui-Tello

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The manufacture of Portland cement has revolutionized the construction industry since the nineteenth century; however, the high cost and large amount of energy required on its manufacturing encouraged, from the seventies, the search of alternative materials to replace it partially or completely. Among the materials studied to replace the cement are the ashes. In the city of Chetumal, south of the Yucatan Peninsula in Mexico, there are no natural sources of pozzolanic ash. In the present study, the cementitious properties of artificial ash resulting from the combustion of waste pine wood were analyzed. The ash obtained was sieved through the screen and No.200 a fraction was analyzed using the technique of X-ray diffraction; with the aim of identifying the crystalline phases and particle sizes of pozzolanic material by the Debye-Scherrer equation. From the characterization of materials, mixtures for a concrete of f'c = 250 kg / cm2 were designed with the method ACI 211.1; for the pattern mixture and for partial replacements of Portland cement by 5%, 10% and 12% pine wood ash mixture. Simple resistance to axial compression of specimens prepared with each concrete mixture, at 3, 14 and 28 days of curing was evaluated. Pozzolanic activity was observed in the ash obtained, checking the presence of crystalline silica (SiO2 of 40.24 nm) and alumina (Al2O3 of 35.08 nm). At 28 days of curing, the specimens prepared with a 5% ash, reached a compression resistance 63% higher than design; for specimens with 10% ash, was 45%; and for specimens with 12% ash, only 36%. Compared to Pattern mixture, which after 28 days showed a f'c = 423.13 kg/cm2, the specimens reached only 97%, 86% and 82% of the compression resistance, for mixtures containing 5%, 10% ash and 12% respectively. The pozzolanic activity of pine wood ash influences the compression resistance, which indicates that it can replace up to 12% of Portland cement by ash without compromising its design strength, however, there is a decrease in strength compared to the pattern concrete.

Keywords: concrete, pine wood ash, pozzolanic activity, X-ray

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Authors: Asmaa Ahmed Nasr El-Din

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The Egyptian countryside faces many environmental problems in the field of environmental pollution in a wide range due to the current bad behavior patterns towards the environment, where the rural people continued to follow unconscious environmental practices in addition to the lack of environmental awareness among the rural people in terms of legislation, and the damages resulting from those practices. Rural women play an important and vital role that cannot be neglected in the field of reducing environmental pollution and rationalizing environmental resources, and it is their responsibility to maintain the safety of environmental elements such as water, air, food, and soil from pollution, either through limiting their personal practice that leads to the pollution of these elements or from During the upbringing of her children on the right behaviors towards these elements to protect them from pollution and thus avoid the infection of family members with diseases arising from environmental pollution that may affect their health and production capacity. Therefore, the research aimed to identify the level of rural women’s implementation of environmental practices (land, water, air, public health, and food waste), as well as determining the nature of the relationship between the studied independent variables (demographic, social and economic characteristics) and the level of rural women’s implementation of their role in preserving the environment and identifying some women’s information sources rural environment to preserve the environment. The research was conducted in the villages of Tarout and Qam al-Arous in the governorates of Sharkia and BeniSuef, respectively, and a random sample of 333 rural women was selected using the Yamani equation. Statistical ratio analysis, arithmetic mean, Pearson simple correlation coefficient value, and T-test.

Keywords: environment, rural women, EL-sharkia, banuef

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Authors: Gwo-Hwa Wan, Tai-Ho Hung, Fen-Fang Chung, Wan-Ying Lee, Hui-Ching Yang

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Air pollutant exposure results in elevated concentrations of oxidative stress and inflammatory biomarkers in general populations. Increased concentrations of inflammatory biomarkers in pregnant women would be associated with preterm labor and low birth weight. To our best knowledge, the associations between air pollutants exposure and inflammation in pregnant women and fetuses are unknown, as well as their effects on fetal growth. This study aimed to evaluate the influences of outdoor air pollutants in northern Taiwan areas on the inflammatory biomarker (high sensitivity C-reactive protein, hs-CRP) concentration in the blood of healthy pregnant women and how the biomarker impacts fetal growth. In this study, 38 healthy pregnant women who are in their first trimester and live in northern Taiwan area were recruited from the Taipei Chang Gung Memorial Hospital. Personal characteristics and prenatal examination data (e.g., blood pressure) were obtained from recruited subjects. The concentrations of inflammatory mediators, hs-CRP, in the blood of healthy pregnant women were analyzed. Additionally, hourly data of air pollutants (PM10, SO2, NO2, O3, CO) concentrations were obtained from air quality monitoring stations in Taipei area, established by the Taiwan Environmental Protection Administration. The definition of lag 0 and lag 01 are the exposure to air pollutants on the day of blood withdrawal, and the average exposure to air pollutants one day before and on the day of blood withdrawal, respectively. The statistical analyses were conducted using SPSS software version 22.0 (SPSS, Inc., Chicago, IL, USA). This analytical result indicates that the healthy pregnant women aged between 28 and 42 years old. The body mass index before pregnancy averaged 21.51 (sd = 2.51) kg/m2. Around 90% of the pregnant women had never smoking habit, and 28.95% of them had allergic diseases. Approximately around 84% and 5.26% of the pregnant women worked at indoor and outdoor environments, respectively. The mean hematocrit level of the pregnant women was 37.10%, and the hemoglobin levels were ranged between 10.1 and 14.7 g/dL with 12.47 g/dL of mean value. The blood hs-CRP concentrations of healthy pregnant women in the first trimester ranged between 0.32 and 32.5 mg/L with 2.83 (sd = 5.69) mg/L of mean value. The blood hs-CRP concentrations were positively associated with ozone concentrations at lag 0-14 (r = 0.481, p = 0.017) in healthy pregnant women. Significant lag effects were identified in ozone at lag 0-14 with a positive excess concentration of blood hs-CRP.

Keywords: air pollutant, hs-CRP, pregnant woman, ozone, first trimester

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Authors: Siva Kumar Bathina, Sudheer Siddapureddy

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Fires accident becomes even worse when the hazardous equipment like reactors or radioactive waste packages are engulfed in fire. In this work, large-eddy numerical fire simulations are performed using fire dynamic simulator to predict the thermal behavior of such bodies engulfed in hydrocarbon pool fires. A radiatively dominated 0.3 m circular burner with n-heptane as the fuel is considered in this work. The fire numerical simulation results without anybody inside the fire are validated with the reported experimental data. The comparison is in good agreement for different flame properties like predicted mass burning rate, flame height, time-averaged center-line temperature, time-averaged center-line velocity, puffing frequency, the irradiance at the surroundings, and the radiative heat feedback to the pool surface. Cask of different sizes is simulated with SS304L material. The results are independent of the material of the cask simulated as the adiabatic surface temperature concept is employed in this study. It is observed that the mass burning rate increases with the blockage ratio (3% ≤ B ≤ 32%). However, the change in this increment is reduced at higher blockage ratios (B > 14%). This is because the radiative heat feedback to the fuel surface is not only from the flame but also from the cask volume. As B increases, the volume of the cask increases and thereby increases the radiative contribution to the fuel surface. The radiative heat feedback in the case of the cask engulfed in the fire is increased by 2.5% to 31% compared to the fire without cask.

Keywords: adiabatic surface temperature, fire accidents, fire dynamic simulator, radiative heat feedback

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Authors: Sadeq Al Yaari, Nassr Almaflehi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background: Assessment of language-related functional activities (ALFA) is of vital importance in assessing aphasics’ performance of both sexes. However, the validity and reliability of this language therapeutic test has never been validated in the Arabic medical literature. Purpose: The aim of this study was to validate the test by assessing the language-related functional activities of 100 gender aphasics based in a medical faculty. Design: ALFA Pre-and-posttest was administered twice in three weeks to test the language-related functional activities of 100 gender aphasics. Settings: Al Khars hospital in Al Ahsa’a, Kingdom of Saudi Arabia (KSA). Participants: Sixteen to eight-year-old participants (N = 100 men and women) were enrolled in this experiment. Again, the purpose was to assess their language-related functional activities using ALFA. Procedures: The first step was to translate the English version of ALFA test into the mother tongue of the patients (Arabic). Secondly, the translated text is reviewed and edited by three specialists of Arabic language. Having the test standardized, the third step was to assess language-related functional activities of the participants in natural environment. Assessment took place in three weeks. In the first week, a pre-test was administered to the participants at hand and after two weeks, a post-test was administered to identify whether or not significant differences between the two tests (pre-and-posttest) could be observed. Interventions: Outcomes of the results obtained from the analyses were broadly discussed. Linguistic and statistical comparisons were held to illustrate the findings of this study. Main outcomes and Results: The analysis of the obtained results indicated that the performance of the aphasic participants in the post-test did not differ from that of the pre-test (, respectively). Conclusions & Implications: ALFA was proved to be a valid and reliable test. Moreover, outlined results pointed out the importance of assessing not only gender aphasics’ language, but also their language-related functional activities. Further research is needed to explore how gender aphasics’ verbal and non-verbal performances interact.

Keywords: ALFA, language test, Arab aphasics, validity, reliability, psychoneurolinguistics.

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Authors: Marinos Xagoraris, Iliada K. Lappa, Charalambos Kanakis, Dimitra Daferera, Christina Papadopoulou, Georgios Sourounis, Charilaos Giotis, Pavlos Bouchagier, Christos S. Pappas, Petros A. Tarantilis, Efstathia Skotti

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The aim of this work was to recover phenolic compounds from grape skins produced in Greek varieties of the Ionian Islands in order to form the basis of calculations for their further utilization in the context of the circular economy. Isolation and further utilization of phenolic compounds is an important issue in winery by-products. For this purpose, 37 samples were collected, extracted, and analyzed in an attempt to provide the appropriate basis for their sustainable exploitation. Extraction of the bioactive compounds was held using an eco-friendly, non-toxic, and highly effective water-glycerol solvent system. Then, extracts were analyzed using UV-Vis, liquid chromatography-mass spectrometry (LC-MS), FTIR, and Raman spectroscopy. Also, total phenolic content and antioxidant activity were measured. LC-MS chromatography showed qualitative differences between different varieties. Peaks were attributed to monomeric 3-flavanols as well as monomeric, dimeric, and trimeric proanthocyanidins. The FT-IR and Raman spectra agreed with the chromatographic data and contributed to identifying phenolic compounds. Grape skins exhibited high total phenolic content (TPC), and it was proved that during vinification, a large number of polyphenols remained in the pomace. This study confirmed that grape skins from Ionian Islands are a promising source of bioactive compounds, suggesting their utilization under a bio-economic and environmental strategic framework.

Keywords: antioxidant activity, grape skin, phenolic compounds, waste recovery

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Authors: Vinh Duy Cao, Shima Pilehvar, Anna M. Szczotok, Anna-Lena Kjøniksen

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The total energy consumption is dramatically increasing on over the world, especially for building energy consumption where a significant proportion of energy is used for heating and cooling purposes. One of the solutions to reduce the energy consumption for the building is to improve construction techniques and enhance material technology. Recently, microcapsulated phase change materials (MPCM) with high energy storage capacity within the phase transition temperature of the materials is a potential method to conserve and save energy. A new composite materials with high energy storage capacity by mixing MPCM into concrete for passive building technology is the promising candidate to reduce the energy consumption. One of the most untilized building materials for mixing with MPCM is Portland cement concrete. However, the emission of carbon dioxide (CO2) due to producing cement which plays the important role in the global warming is the main drawback of PCC. Accordingly, an environmentally friendly building material, geopolymer, which is synthesized by the reaction between the industrial waste material (aluminosilicate) and a strong alkali activator, is a potential materials to mixing with MPCM. Especially, the effect of MPCM on the thermal and mechanical properties of geopolymer concrete (GPC) is very limited. In this study, high thermal energy storage capacity materials were fabricated by mixing MPCM into geopolymer concrete. This article would investigate the effect of MPCM concentration on thermal and mechanical properties of GPC. The target is to balance the effect of MPCM on improving the thermal performance and maintaining the compressive strength of the geopolymer concrete at an acceptable level for building application.

Keywords: microencapsulated phase change materials, geopolymer concrete, energy storage capacity, thermal performance

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Authors: Adepoju Abiola Lydia, Adeyanju James Abiodun, Abioye A. O.

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Spray drying, an innovative and sustainable preservation method, is increasingly gaining recognition for its potential to enhance food security by extending the shelf life of fruits. This technique involves the atomization of fruit pulp into fine droplets, followed by rapid drying with hot air, resulting in a powdered product that retains much of the original fruit's nutritional value, flavor, and color. By encapsulating sensitive bioactive compounds within a dry matrix, spray drying mitigates nutrient degradation and extends product usability. This technology aligns with sustainability goals by reducing post-harvest losses, minimizing the need for preservatives, and lowering energy consumption compared to conventional drying methods. Furthermore, spray drying enables the use of imperfect or surplus fruits, contributing to waste reduction and providing a continuous supply of nutritious fruit-based ingredients regardless of seasonal variations. The powdered form enhances versatility, allowing incorporation into various food products, thus broadening the scope of fruit utilization. Innovations in spray drying, such as the use of novel carrier agents and optimization of processing parameters, enhance the quality and functionality of the final product. Moreover, the scalability of spray drying makes it suitable for both industrial applications and smaller-scale operations, supporting local economies and food systems. In conclusion, spray drying stands out as a key technology in enhancing food security by ensuring a stable supply of high-quality, nutritious food ingredients while fostering sustainable agricultural practices.

Keywords: spray drying, sustainable, process parameters, carrier agents, fruits

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Authors: P. Larpsomboonchai

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Agro-industry is one of major industries that has strong impacts on national economic incomes, growth, stability, and sustainable development. Moreover, this industry also has strong influences on social, cultural and political issues. Furthermore, this industry, as producing primary and secondary products, is facing challenges from such diverse factors such as demand inconsistency, intense international competition, technological advancements and new competitors. In order to maintain and to improve industry’s competitiveness in both domestics and international markets, science and technology are key factors. Besides hard sciences and technologies, modern industrial engineering concepts such as Just in Time (JIT) Total Quality Management (TQM), Quick Response (QR), Supply Chain Management (SCM) and Lean can be very effective to supportant to increase efficiency and effectiveness of these agricultural products on world stage. Onion is one of Thailand’s major export products which brings back national incomes. But, it also facing challenges in many ways. This paper focused its interests in onion packing process and its related activities such as storage and shipment from one of major packing plant and storage in Mae Wang District, Chiang Mai, Thailand, by applying Toyota Production System (TPS) or Lean concepts, to improve process capability throughout the entire packing and distribution process which will be profitable for the whole onion supply chain. And it will be beneficial to other related agricultural products in Thailand and other ASEAN countries.

Keywords: packing process, Toyota Production System (TPS), lean concepts, waste reduction, lean in agro-industries activities

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Authors: Shady S. Hassan, Brijesh K. Tiwari, Gwilym A. Williams, Amit K. Jaiswal

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EU is known as the destination with the highest rate of the coffee consumption per capita in the world. Spent coffee grounds (SCG) are the main by-product of coffee brewing. SCG is either disposed as a solid waste or employed as compost, although the polysaccharides from such lignocellulosic biomass might be used as feedstock for fermentation processes. However, SCG as a lignocellulose have a complex structure and pretreatment process is required to facilitate an efficient enzymatic hydrolysis of carbohydrates. However, commonly used pretreatment methods, such as chemical, physico-chemical and biological techniques are still insufficient to meet optimal industrial production requirements in a sustainable way. Ultrasound is a promising candidate as a sustainable green pretreatment solution for lignocellulosic biomass utilization in a large scale biorefinery. Thus, ultrasound pretreatment of SCG without adding harsh chemicals investigated as a green technology to enhance enzyme hydrolysis. In the present work, ultrasound pretreatment experiments were conducted on SCG using different ultrasound frequencies (25, 35, 45, 130, and 950 kHz) for 60 min. Regardless of ultrasound power, low ultrasound frequency is more effective than high ultrasound frequency in pretreatment of biomass. Ultrasound pretreatment of SCG (at ultrasound frequency of 25 kHz for 60 min) followed by enzymatic hydrolysis resulted in total reducing sugars of 56.1 ± 2.8 mg/g of biomass. Fourier transform Infrared Spectroscopy (FTIR) was employed to investigate changes in functional groups of biomass after pretreatment, while high-performance liquid chromatography (HPLC) was employed for determination of glucose. Pretreatment of lignocellulose by low frequency ultrasound in water only was found to be an effective green approach for SCG to improve saccharification and glucose yield compared to native biomass. Pretreatment conditions will be optimized, and the enzyme hydrolysate will be used as media component substitute for the production of ethanol.

Keywords: lignocellulose, ultrasound, pretreatment, spent coffee grounds

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Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

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Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Jun-Lun Jiang, Bing-Sheng Yu

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Processing of flat-panel displays generates huge amount of wasted glass polishing powder, with high concentration of cerium and other elements such as lanthanum. According to the current statistics, consumption of polishing powder was approximately ten thousand tons per year in the world. Nevertheless, wasted polishing powder was usually buried or burned. If the lanthanum and cerium compounds in the wasted polishing powder could be recycled, that will greatly reduce enterprise cost and implement waste circulation. Cathodes of SOFCs are the principal consisting of rare earth elements such as lanthanum and cerium. In this study, we recycled the lanthanum and cerium from wasted glass polishing powder by acid-solution method, and synthesized La0.8Sr0.05Ca0.15Fe0.8Co0.8O3-δ and Gd0.1Ce0.9O2 (LSCCF-GDC) composite cathode material for SOFCs by glycinenitrate combustion (GNP) method. The results show that the recovery rates of lanthanum and cerium could accomplish up to 80% and 100% under 10N nitric acid solution within one hour. Comparing with the XRD data of the commercial LSCCF-GDC powder and the LSCCF-GDC product synthesized with chemicals, we find that the LSCCF-GDC was successfully synthesized with the recycled La & Ce solution by GNP method. The effect of adding ammonia to the product was also discussed, the grain size is finer and recovery rate of the product is higher without the addition of ammonia to the solution.

Keywords: glass polishing powder, acid solution, recycling, composite cathodes of solid oxide fuel, cell (SOFC), perovskite, glycine-nitrate combustion(GNP) method

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Authors: Constantin Haita

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The chalcolithic tell settlements from south-eastern Romania, attributed to Gumelnița culture, are characterised by a well-defined surface, marked often by delimitation structures, a succession of many layers of construction, destruction, and rebuilding, and a well-structured area of occupation: built spaces, passage areas, waste zones. Settlements of tell type are located in the river valleys –on erosion remnants, alluvial bars or small islands, at the border of the valleys– on edges or prominences of Pleistocene terraces, lower Holocene terraces, and banks of lakes. This study integrates data on the geographical position, the morphological background, and the general stratigraphy of these important settlements. The correlation of the spatial distribution with the geomorphological units of each area of evolution creates an image of the natural landscape in which they occurred. The sedimentological researches achieved in the floodplain area of Balta Ialomiței showed important changes in the alluvial activity of Danube, after the Chalcolithic period (ca. 6500 - 6000 BP), to Iron Age and Middle Ages. The micromorphological analysis, consisting in thin section interpretation, at the microscopic scale, of sediments and soils in an undisturbed state, allowed the interpretation of the identified sedimentary facies, in terms of mode of formation and anthropic activities. Our studied cases reflect some distinct situations, correlating either with the geomorphological background or with the vertical development, the presence of delimiting structures and the internal organization. The characteristics of tells from this area bring significant information about the human habitation of Lower Danube in Prehistory.

Keywords: chalcolithic, micromorphology, Romania, sedimentology, tell settlements

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Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

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Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: additive manufacturing, internal topologies, porosity, rapid prototyping, selective laser melting

Procedia PDF Downloads 331

Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

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