Search results for: surgical removal
1761 Antibiotic Prescribing in the Acute Care in Iraq
Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas
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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.Keywords: Acute care, Antibiotic misuse, Iraq, Prescribing
Procedia PDF Downloads 1221760 Biosorption of Chromium (VI) Ions Using Polyaniline Coated Maize Tassels
Authors: F. Chigondo, G. Chitabati
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Hexavalent chromium is toxic and is widely used in many industries hence efficient and economical methods must be explored to remove the chromium(VI) from the environment. The removal of Cr (VI) from aqueous solutions onto polyaniline coated maize tassel was studied in batch mode at varying initial metal concentrations, adsorbent doses, pH and contact times. The residual Cr (VI) concentrations before and after adsorption were analyzed by Ultraviolet–visible spectroscopy. FTIR analysis of the polyaniline coated maize tassel showed the presence of C=C, C=N, C-H, C-N and N-H groups. Adsorption conditions were deduced to be pH of 2, adsorbent dosage 1g/L, Cr(VI) initial concentration of 40mg/L contact time of 150 minutes and agitation speed of 140rpm. Data obtained fitted best to the Langmuir isotherm (R2 = 0.972) compared to the Freundlich isotherm (R2 0.671. The maximum adsorption capacity was found to be 125mg/L. Correlation coefficients for pseudo first order and pseudo second order were 0.952 and 0.971 respectively. The adsorption process followed the pseudo-second order kinetic model. The studied polyaniline coated maize tassel can therefore be used as a promising adsorbent for the removal of Cr (VI) ion from aqueous solution.Keywords: polyaniline-coated, maize tassels, adsorption, hexavalent chromium
Procedia PDF Downloads 2031759 A Comparative Study of Murayya Koenigii Varieties for the Removal of Cr (VI) from Aqueous Solutions
Authors: Mesfin Tsegaw, Sivakumar C. V., Chandrakal Gunturu, Meera Indracanti
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Chromium (VI), a toxic metal ion, is widely used in electroplating, stainless steel production, leather tanning, paint, and textile manufacturing. Cr (VI) is mobile in the environment, acutely toxic and carcinogenic. In the present study, the ability to remove Cr (VI) from aqueous solutions has been compared using leaves of dwarf and gamthi varieties of Murayya koerigii abundantly available in Selaqui region of Dehradun as an adsorbent. Effects of temperature, pH, initial concentration of adsorbate and adsorbent dosage have been studied for effective removal of Cr (VI). The biosorptive ability of biosorbent was reliant on the pH of the biosorbate, with pH 2 being most favorable for both the varieties. The obtained results were analyzed by the Freundlich and Langmuir equation at different temperature and related parameters were determined for each adsorption isotherm. The study also includes results on the kinetic dimensions of adsorption of the Cr (VI) on the derived adsorbent. Gamthi variety has a promising absorption rate of 80% over the dwarf variety. FTIR studies confirmed that carboxyl and hydroxyl groups were the main groups involved in the metal uptake.Keywords: adsorption, cromium, kinetics, variety
Procedia PDF Downloads 1471758 Bio-Mimetic Foam Fractionation Technology for the Treatment of Per- and PolyFluoroAlkyl Substances (PFAS) in Contaminated Water
Authors: Hugo Carronnier, Wassim Almouallem, Eric Branquet
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Per- and polyfluoroalkyl Substances (PFAS) are a group of man-made refractory compounds that have been widely used in a variety of industrial and commercial products since the 1940s, leading to contamination of groundwater and surface water systems. They are persistent, bioaccumulative and toxic chemicals. Foam fractionation is a potential remedial technique for treating PFAS-contaminated water, taking advantage of the high surface activity to remove them from the solution by adsorption onto the surface of the air bubbles. Nevertheless, traditional foam fractionation technology developed for PFAS is challenging and found to be ineffective in treating the less surface-active compounds. Different chemicals were the subject of investigation as amendments to achieve better removal. However, most amendments are toxic, expensive and complicated to use. In this situation, patent-pending PFAS technology overcomes these challenges by using rather biological amendments. Results from the first laboratory trial showed remarkable results using a simple and cheap BioFoam Fractionation (BioFF) process based on biomimetics. The study showed that the BioFF process is effective in removing greater than 99% of PFOA (C8), PFOS (C8), PFHpS (C7) and PFHxS (C6) in PFAS-contaminated water. For other PFAS such as PFDA (C10) and 6:2 FTAB, a slightly less stable removal between 94% and 96% was achieved while between 34% and 73% removal efficiency was observed for PFBA (C4), PFBS (C4), PFHxA (C6), and Gen-X. In sum, the advantages of the BioFF presented as a low-waste production, a cost and energy-efficient operation and the use of a biodegradable amendment requiring no separation step after treatment, coupled with these first findings, suggest that the BioFF process is a highly applicable treatment technology for PFAS contaminated water. Additional investigations are currently carried on in order to optimize the process and establish a promising strategy for on-site PFAS remediation.Keywords: PFAS, treatment, foam fractionation, contaminated amendments
Procedia PDF Downloads 781757 MIL-88b(Fe)-MOF Grafted Carbon Dot Nanocomposites as Effective Photocatalysts for Fenton-Like Photodegradation of Amphotericin B and Naproxen Under Visible Light Irradiation
Authors: Payam Hayati, Fateme Firoozbakht, Gholamhassan Azimi, Shahram Tangestaninejad
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The synthesis of a photocatalytic adsorbent involved the integration of carbon dots (CD) into a metal-organic framework (MOF) of MIL-88B(Fe) using the solvothermal technique. Characterization of the resulting CD@MIL-88B(Fe) was conducted using various analytical methods, including X-ray-based microscopic and spectroscopic techniques, electrochemical impedance spectroscopy, UV–Vis, FT-IR, DRS, TGA, and photoluminescence (PL) analysis. The adsorbent demonstrated significant photocatalytic activity, achieving up to 92% and 90% removal of amphotericin B (AmB) and naproxen (Nap) from aqueous solutions under visible light, with an RSD value of around 5%. The study explored the factors influencing the degradation of pharmaceuticals and determined the optimal conditions for the process, including pH values of 3 and 4 for AmB and Nap, a photocatalyst concentration of 0.2 g L-1, and an H2O2 concentration ranging from 40 to 50 mM. Reactive oxidative species such as ⋅OH and ⋅O2 were identified through the examination of different scavengers. Additionally, the adsorption isotherm and kinetic studies revealed that the synthesized photocatalyst functions as an effective adsorbent, with maximum adsorption capacities of 42.5 and 121.5 mg g-1 for AmB and Nap, while also serving as a photocatalytic agent for removal purposes.Keywords: fenton-like degradation, metal-organic frameworks, heterogenous photocatalysts, naproxen
Procedia PDF Downloads 761756 Improvement of Brain Tumors Detection Using Markers and Boundaries Transform
Authors: Yousif Mohamed Y. Abdallah, Mommen A. Alkhir, Amel S. Algaddal
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This was experimental study conducted to study segmentation of brain in MRI images using edge detection and morphology filters. For brain MRI images each film scanned using digitizer scanner then treated by using image processing program (MatLab), where the segmentation was studied. The scanned image was saved in a TIFF file format to preserve the quality of the image. Brain tissue can be easily detected in MRI image if the object has sufficient contrast from the background. We use edge detection and basic morphology tools to detect a brain. The segmentation of MRI images steps using detection and morphology filters were image reading, detection entire brain, dilation of the image, filling interior gaps inside the image, removal connected objects on borders and smoothen the object (brain). The results of this study were that it showed an alternate method for displaying the segmented object would be to place an outline around the segmented brain. Those filters approaches can help in removal of unwanted background information and increase diagnostic information of Brain MRI.Keywords: improvement, brain, matlab, markers, boundaries
Procedia PDF Downloads 5161755 A Comparative Study on the Dimensional Error of 3D CAD Model and SLS RP Model for Reconstruction of Cranial Defect
Authors: L. Siva Rama Krishna, Sriram Venkatesh, M. Sastish Kumar, M. Uma Maheswara Chary
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Rapid Prototyping (RP) is a technology that produces models and prototype parts from 3D CAD model data, CT/MRI scan data, and model data created from 3D object digitizing systems. There are several RP process like Stereolithography (SLA), Solid Ground Curing (SGC), Selective Laser Sintering (SLS), Fused Deposition Modelling (FDM), 3D Printing (3DP) among them SLS and FDM RP processes are used to fabricate pattern of custom cranial implant. RP technology is useful in engineering and biomedical application. This is helpful in engineering for product design, tooling and manufacture etc. RP biomedical applications are design and development of medical devices, instruments, prosthetics and implantation; it is also helpful in planning complex surgical operation. The traditional approach limits the full appreciation of various bony structure movements and therefore the custom implants produced are difficult to measure the anatomy of parts and analyse the changes in facial appearances accurately. Cranioplasty surgery is a surgical correction of a defect in cranial bone by implanting a metal or plastic replacement to restore the missing part. This paper aims to do a comparative study on the dimensional error of CAD and SLS RP Models for reconstruction of cranial defect by comparing the virtual CAD with the physical RP model of a cranial defect.Keywords: rapid prototyping, selective laser sintering, cranial defect, dimensional error
Procedia PDF Downloads 3251754 A Prospective Randomised Observational Study of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients
Authors: Sanjeev Singh
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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection
Procedia PDF Downloads 221753 Adherence Induced Formwork Removal in Small-Scale Pull-Off Tensile Tests
Authors: Nicolas Spitz, Nicolas Coniglio, Mohamed El Mansori, Alex Montagne, Sabeur Mezghani
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Nowadays buildings' construction is performed by pouring concrete into molds referred to as formworks that are usually prefabricated metallic modules. Defects such as stripping may possibly form during the removal of the formwork if the interfacial bonding between the concrete and the formwork is high. A new pull-off tensile test was developed in our laboratory to simulate small-scale formwork removals. The concrete-to-formwork adherence force was measured on bare and coated formworks with different surface signatures. The used concrete was a mixture largely used on building sites and contains CEM I Portland cement and calcareous filler. The concrete surface appearance and the type of failures at the concrete-formwork interface have been investigated. The originality of this near-to-surface test was to compare the laboratory-measured adherence forces to the on-site observations. Based upon the small-scale laboratory test results, functional formwork specifications with low adherence to concrete was proposed in terms of superficial signature characteristics.Keywords: concrete-formwork adherence, interfacial bonding, skin formwork functionality, small-scale pull-off tensile test
Procedia PDF Downloads 2461752 Synthesis of Magnetic Chitosan Beads and Its Cross-Linked Derivatives for Sorption of Zinc Ions from Water Samples of Yamuna and Hindon Rivers in India
Authors: Priti Rani, Rajni Johar, P. S. Jassal
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The magnetic chitosan beads (MCB) were synthesized using co-precipitation method and made to react with epichlorohydrin (ECH) to get the cross-linked derivative (ECH-MCB). The beads were characterized by FTIR, SEM, EDX, and TGA. It is found that zinc metal ion sorption efficiency of ECH-MCB is significantly higher than MCB. Various factors affecting the uptake behavior of metal ions, such as pH, adsorbent dosage, contact time, and temperature effects, were investigated. The adsorption parameters fitted well with Langmuir and Freundlich isotherms. The equilibrium parameter RL values support that the adsorption (0 < RL < 1) is favorable and spontaneous process. The thermodynamic parameters confirm that it is an endothermic reaction, which results in an increase in the randomness of adsorption process. The beads were regenerated using ethylene diamine tetraacetic acid (EDTA) for further use. These beads prove as promising materials for the removal of pollutants from industrial wastewater. Water samples from Yamuna and Hindon rivers were analysed for the detection of Zn (II) ions.Keywords: chitosan magnetic beads, EDTA, epichlorohydrin, removal efficiency
Procedia PDF Downloads 1501751 Effect of Scaling and Root Planing on Improvement of Glycemic Control in Periodontitis Patients with Type-2 Diabetes Mellitus
Authors: Shivalal Sharma, Sanjib K. Sharma, Madhab Lamsal
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Background: The aim of this study was to evaluate the clinical and laboratory changes three months after full-mouth scaling and root planing (SRP) in periodontitis patients with type 2 diabetes mellitus (DM). Methods: Forty-seven type 2 DM subjects with moderate to severe periodontitis were randomly divided into two groups. Treatment group (TG), 25 subjects, received full-mouth scaling and root planning; control group (CG), 22 subjects, received no treatment. At baseline and at the end of three months, glycated hemoglobin (HbA1c) values, fasting glucose, and clinical parameters like plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded in all the patients. Following SRP, the patients were enrolled in a monthly interval maintenance program for 3 months. Results: A statistically significant effect could be demonstrated for PI, GI, PPD, and CAL for the treatment group. HbA1c levels in the treatment group decreased significantly whereas the control group showed a slight but insignificant increase for these parameters. Conclusions: The results of this study showed that non-surgical periodontal treatment (SRP) is associated with improved glycemic control in type 2 DM patients and could be undertaken along with the standard measures for the diabetic patient care.Keywords: periodontitis, type 2 diabetes mellitus, non-surgical periodontal therapy, SRP
Procedia PDF Downloads 3011750 Removal of Rhodamine B from Aqueous Solution Using Natural Clay by Fixed Bed Column Method
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The discharge of dye in industrial effluents is of great concern because their presence and accumulation have a toxic or carcinogenic effect on living species. The removal of such compounds at such low levels is a difficult problem. The adsorption process is an effective and attractive proposition for the treatment of dye contaminated wastewater. Activated carbon adsorption in fixed beds is a very common technology in the treatment of water and especially in processes of decolouration. However, it is expensive and the powdered one is difficult to be separated from aquatic system when it becomes exhausted or the effluent reaches the maximum allowable discharge level. The regeneration of exhausted activated carbon by chemical and thermal procedure is also expensive and results in loss of the sorbent. The focus of this research was to evaluate the adsorption potential of the raw clay in removing rhodamine B from aqueous solutions using a laboratory fixed-bed column. The continuous sorption process was conducted in this study in order to simulate industrial conditions. The effect of process parameters, such as inlet flow rate, adsorbent bed height, and initial adsorbate concentration on the shape of breakthrough curves was investigated. A glass column with an internal diameter of 1.5 cm and height of 30 cm was used as a fixed-bed column. The pH of feed solution was set at 8.5. Experiments were carried out at different bed heights (5 - 20 cm), influent flow rates (1.6- 8 mL/min) and influent rhodamine B concentrations (20 - 80 mg/L). The obtained results showed that the adsorption capacity increases with the bed depth and the initial concentration and it decreases at higher flow rate. The column regeneration was possible for four adsorption–desorption cycles. The clay column study states the value of the excellent adsorption capacity for the removal of rhodamine B from aqueous solution. Uptake of rhodamine B through a fixed-bed column was dependent on the bed depth, influent rhodamine B concentration, and flow rate.Keywords: adsorption, breakthrough curve, clay, fixed bed column, rhodamine b, regeneration
Procedia PDF Downloads 2751749 The Incidence of Inferior Alveolar Nerve Dysfunction Following Bilateral Sagittal Split Osteotomies: A Single Centre Retrospective Audit in the United Kingdom
Authors: Krupali Mukeshkumar, Jinesh Shah
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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction
Procedia PDF Downloads 2371748 Electrochemical Coagulation of Synthetic Textile Dye Wastewater
Authors: H. B. Rekha, Usha N. Murthy, Prashanth, Ashoka
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Dyes are manufactured to have high chemical resistance because they are normally species, very difficult to degrade (reactive dyes). It damages flora and fauna. Furthermore, coloured components are highly hazardous. So removal of dyes becomes a challenge for both textile industry and water treatment facility. Dyeing wastewater is usually treated by conventional methods such as biological oxidation and adsorption but nowadays them becoming in-adequate because of large variability of composition of waste water. In the present investigation, mild steel electrodes of varying surface area were used for treatment of synthetic textile dye. It appears that electro-chemical coagulation could be very effective in removing coloured from wastewater; it could also be used to remove other parameters like chlorides, COD, and solids to some extent. In the present study, coloured removal up to 99% was obtained for surface area of mild steel electrode of 80 cm2 and 96% of surface area of mild steel electrode of 50 cm2. The findings from this study could be used to improve the design of electro-chemical treatment systems and modify existing systems to improve efficiency.Keywords: electrochemical coagulation, mild steel, colour, environmental engineering
Procedia PDF Downloads 3071747 Study of Synergetic Effect by Combining Dielectric Barrier Discharge (DBD) Plasma and Photocatalysis for Abatement of Pollutants in Air Mixture System: Influence of Some Operating Conditions and Identification of Byproducts
Authors: Wala Abou Saoud, Aymen Amine Assadi, Monia Guiza, Abdelkrim Bouzaza, Wael Aboussaoud, Abdelmottaleb Ouederni, Dominique Wolbert
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Volatile organic compounds (VOCs) constitute one of the most important families of chemicals involved in atmospheric pollution, causing damage to the environment and human health, and need, consequently, to be eliminated. Among the promising technologies, dielectric barrier discharge (DBD) plasma - photocatalysis coupling reveals very interesting prospects in terms of process synergy of compounds mineralization’s, with low energy consumption. In this study, the removal of organic compounds such butyraldehyde (BUTY) and dimethyl disulfide (DMDS) (exhaust gasses from animal quartering centers.) in air mixture using DBD plasma coupled with photocatalysis was tested, in order to determine whether or not synergy effect was present. The removal efficiency of these pollutants, a selectivity of CO₂ and CO, and byproducts formation such as ozone formation were investigated in order to evaluate the performance of the combined process. For this purpose, a series of experiments were carried out in a continuous reactor. Many operating parameters were also investigated such as the specific energy of discharge, the inlet concentration of pollutant and the flowrate. It appears from this study that, the performance of the process has enhanced and a synergetic effect is observed. In fact, we note an enhancement of 10 % on removal efficiency. It is interesting to note that the combined system leads to better CO₂ selectivity than for plasma. Consequently, intermediates by-products have been reduced due to various other species (O•, N, OH•, O₂•-, O₃, NO₂, NOx, etc.). Additionally, the behavior of combining DBD plasma and photocatalysis has shown that the ozone can be easily also decomposed in presence of photocatalyst.Keywords: combined process, DBD plasma, photocatalysis, pilot scale, synergetic effect, VOCs
Procedia PDF Downloads 3301746 The Nursing Experience in a Stroke Patient after Lumbar Surgery at Surgical Intensive Care Unit
Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao
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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery
Procedia PDF Downloads 1201745 Integrating Reactive Chlorine Species Generation with H2 Evolution in a Multifunctional Photoelectrochemical System for Low Operational Carbon Emissions Saline Sewage Treatment
Authors: Zexiao Zheng, Irene M. C. Lo
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Organic pollutants, ammonia, and bacteria are major contaminants in sewage, which may adversely impact ecosystems without proper treatment. Conventional wastewater treatment plants (WWTPs) are operated to remove these contaminants from sewage but suffer from high carbon emissions and are powerless to remove emerging organic pollutants (EOPs). Herein, we have developed a low operational carbon emissions multifunctional photoelectrochemical (PEC) system for saline sewage treatment to simultaneously remove organic compounds, ammonia, and bacteria, coupled with H2 evolution. A reduced BiVO4 (r-BiVO4) with improved PEC properties due to the construction of oxygen vacancies and V4+ species was developed for the multifunctional PEC system. The PEC/r-BiVO4 process could treat saline sewage to meet local WWTPs’ discharge standard in 40 minutes at 2.0 V vs. Ag/AgCl and completely degrade carbamazepine (one of the EOPs), coupled with significant evolution of H2. A remarkable reduction in operational carbon emissions was achieved by the PEC/r-BiVO4 process compared with large-scale WWTPs, attributed to the restrained direct carbon emissions from the generation of greenhouse gases. Mechanistic investigation revealed that the PEC system could activate chloride ions in sewage to generate reactive chlorine species and facilitate •OH production, promoting contaminants removal. The PEC system exhibited operational feasibility at different pH and total suspended solids concentrations and has outstanding reusability and stability, confirming its promising practical potential. The study combined the simultaneous removal of three major contaminants from saline sewage and H2 evolution in a single PEC process, demonstrating a viable approach to supplementing and extending the existing wastewater treatment technologies. The study generated profound insights into the in-situ activation of existing chloride ions in sewage for contaminants removal and offered fundamental theories for applying the PEC system in sewage remediation with low operational carbon emissions. The developed PEC system can fit well with the future needs of wastewater treatment because of the following features: (i) low operational carbon emissions, benefiting the carbon neutrality process; (ii) higher quality of the effluent due to the elimination of EOPs; (iii) chemical-free in the operation of sewage treatment; (iv) easy reuse and recycling without secondary pollution.Keywords: contaminants removal, H2 evolution, multifunctional PEC system, operational carbon emissions, saline sewage treatment, r-BiVO4 photoanodes
Procedia PDF Downloads 1591744 Engineered Bio-Coal from Pressed Seed Cake for Removal of 2, 4, 6-Trichlorophenol with Parametric Optimization Using Box–Behnken Method
Authors: Harsha Nagar, Vineet Aniya, Alka Kumari, Satyavathi B.
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In the present study, engineered bio-coal was produced from pressed seed cake, which otherwise is non-edible in origin. The production process involves a slow pyrolysis wherein, based on the optimization of process parameters; a substantial reduction in H/C and O/C of 77% was achieved with respect to the original ratio of 1.67 and 0.8, respectively. The bio-coal, so the product was found to have a higher heating value of 29899 kJ/kg with surface area 17 m²/g and pore volume of 0.002 cc/g. The functional characterization of bio-coal and its subsequent modification was carried out to enhance its active sites, which were further used as an adsorbent material for removal of 2,4,6-Trichlorophenol (2,4,6-TCP) herbicide from the aqueous stream. The point of zero charge for the bio-coal was found to be pH < 3 where its surface is positively charged and attracts anions resulting in the maximum 2, 4, 6-TCP adsorption at pH 2.0. The parametric optimization of the adsorption process was studied based on the Box-Behken design with the desirability approach. The results showed optimum values of adsorption efficiency of 74.04% and uptake capacity of 118.336 mg/g for an initial metal concentration of 250 mg/l and particle size of 0.12 mm at pH 2.0 and 1 g/L of bio-coal loading. Negative Gibbs free energy change values indicated the feasibility of 2,4,6-TCP adsorption on biochar. Decreasing the ΔG values with the rise in temperature indicated high favourability at low temperatures. The equilibrium modeling results showed that both isotherms (Langmuir and Freundlich) accurately predicted the equilibrium data, which may be attributed to the different affinity of the functional groups of bio-coal for 2,4,6-TCP removal. The possible mechanism for 2,4,6-TCP adsorption is found to be physisorption (pore diffusion, p*_p electron donor-acceptor interaction, H-bonding, and van der Waals dispersion forces) and chemisorption (phenolic and amine groups chemical bonding) based on the kinetics data modeling.Keywords: engineered biocoal, 2, 4, 6-trichlorophenol, box behnken design, biosorption
Procedia PDF Downloads 1171743 Phytoremediation of Textile Wastewater Laden with 1,4-Dioxane Using Eichhornia crassipes: A Sustainable Development Approach
Authors: Hadeer Ibrahiem, Mahmoud Nasr, Masarrat M. M. Migahid, Mohamed A. Ghazy
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The release of textile wastewater loaded with 1,4 dioxane into aquatic ecosystems has been associated with various human health risks and adverse environmental impacts. In parallel, phytoremediation has been recently employed to treat highly polluted wastewater because various plant species tend to produce certain enzymes as a defense mechanism against a toxic environment. To our best knowledge, this study is the first to investigate the ability of phytoremediation using Eichhornia crassipes for the removal of various pollutants, including 1,4 dioxane, from textile wastewater. A phytoremediation system composed of Eichhornia crassipes was acclimatized for 10 d, and then operated in four lab-scale hydroponic systems, viz., negative control, positive control, and two different 1,4 dioxane concentration (400 and 500 mg/L). After 11 d of operation, the phytoremediation system achieved removal efficiencies of 67.5±3.4%, 89.4±4.4%, 83.6±3.8% for 1,4 dioxane (at initial concentration 400 mg/L), chemical oxygen demand (COD) (at initial concentration 679 mg/L), and cumulative heavy metals, respectively. The removal of these pollutants was mainly supported by the phyto-sorption and phytodegradation mechanisms. The economic feasibility of this phytoremediation system was validated by estimating the capital and operating costs, requiring 4.6 USD for the treatment of 1 m3 textile wastewater. The study concluded that the phytoremediation process could be used as a practical and economical approach to treat textile wastewater laden with various organic and inorganic pollutants. Due to the observed pollution reduction and human health protection, the study objectives would fulfill the targets of SDG 3 “Good Health and Well-being” and SDG 6 “Clean Water and Sanitation”. Further studies are required to (i) investigate the ability of plant species to withstand higher concentrations of 1,4 dioxane for an extended operation time and (ii) understand the biochemical pathways for the degradation of 1,4 dioxane via the action of plant enzymes and the associated microbial community.Keywords: 1, 4 dioxane concentrations, hydrophytes, Eichhornia crassipes, phytoremediation effectiveness, SDGs, textile industrial effluent
Procedia PDF Downloads 1011742 Food Safety in Wine: Removal of Ochratoxin a in Contaminated White Wine Using Commercial Fining Agents
Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme
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The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.Keywords: wine, ota removal, food safety, fining
Procedia PDF Downloads 5381741 Pre-Operative Tool for Facial-Post-Surgical Estimation and Detection
Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary
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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.Keywords: k-nearest neighbor (knn), face detection, vitiligo, bone deformity
Procedia PDF Downloads 1641740 Wrong Site Surgery Should Not Occur In This Day And Age!
Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong
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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.Keywords: wrong side surgery, never events, checklist, workload, communication
Procedia PDF Downloads 1841739 Monitoring the Phenomenon of Black Sand in Hurghada’s Artificial Lakes from Sources of Groundwater and Removal Techniques
Authors: Ahmed M. Noureldin, Khaled M. Naguib
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This experimental investigation tries to identify the root cause of the black sand issue in one of the man-made lakes in a well-known Hurghada resort. The lake is nourished by the underground wells' source, which continuously empties into the Red Sea. Chemical testing was done by looking at spots of stinky black sand beneath the sandy lake surface. The findings on samples taken from several locations (wells, lake bottom sand samples, and clean sand with exact specifications as bottom sand) indicated the existence of organic sulfur bacteria that are responsible for the phenomena of black sand. Approximately 39.139 mg/kg of sulfide in the form of hydrogen sulfide was present in the lake bottom sand, while 1.145 mg/kg, before usage, was in the bare sand. The study also involved modeling with the GPS-X program for cleaning bottom sand that uses hydro cyclones as a physical-mechanical treatment method. The modeling findings indicated a Total Organic Carbon (TOC) removal effectiveness of 0.65%. The research recommended using hydro cyclones to routinely mechanically clear the sand from lake bottoms.Keywords: man-made lakes, organic sulfur bacteria, total organic carbon, hydro cyclone
Procedia PDF Downloads 731738 Adsorptive Desulfurization of Using Cu(I) – Y Zeolite via π-Complexation
Authors: Moshe Mello, Hilary Rutto, Tumisang Seodigeng, Itumeleng Kohitlhetse
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The accelerating requirement to reach 0% sulfur content in liquid fuels demand researchers to seek efficient alternative technologies to challenge the predicament. In this current study, the adsorption capabilities of modified Cu(I)-Y zeolite were tested for the removal of organosulfur compounds (OSC) present in tire pyrolytic oil (TPO). The π-complexation-based adsorbent was obtained by ion exchanging Y-zeolite with Cu+ cation using liquid phase ion exchange (LPIE). Preparation of the adsorbent involved firstly ion exchange between Na-Y zeolite with a Cu(NO₃)₂ aqueous solution of 0.5M for 48 hours followed by reduction of Cu²⁺ to Cu+. Fixed-bed breakthrough studies for TPO in comparison with model diesel comprising of sulfur compounds such as thiophene, benzothiophenes (BT), and dibenzothiophenes (DBT) showed that modified Cu(I)-Y zeolite is an effective adsorbent for removal of OSC in liquid fuels. The effect of operating conditions such as adsorbent dosage and reaction time were studied to optimize the adsorptive desulfurization process. For model diesel fuel, the selectivity for adsorption of sulfur compounds followed the order DBT> BT> Thiophene. The Cu(I)-Y zeolite is fully regeneratable and this is achieved by a simple procedure of blowing the adsorbent with air at 350 °C, followed by reactivation at 450 °C in a rich helium surrounding.Keywords: adsorption, desulfurization, TPO, zeolite
Procedia PDF Downloads 1151737 Osteitis in the Diabetic Foot in Algeria
Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda
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— Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.Keywords: diabetic foot, bone biopsy, osteitis, algeria
Procedia PDF Downloads 1041736 Performance Evaluation and Dear Based Optimization on Machining Leather Specimens to Reduce Carbonization
Authors: Khaja Moiduddin, Tamer Khalaf, Muthuramalingam Thangaraj
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Due to the variety of benefits over traditional cutting techniques, the usage of laser cutting technology has risen substantially in recent years. Hot wire machining can cut the leather in the required shape by controlling the wire by generating thermal energy. In the present study, an attempt has been made to investigate the effects of performance measures in the hot wire machining process on cutting leather specimens. Carbonization and material removal rates were considered as quality indicators. Burning leather during machining might cause carbon particles, reducing product quality. Minimizing the effect of carbon particles is crucial for assuring operator and environmental safety, health, and product quality. Hot wire machining can efficiently cut the specimens by controlling the current through it. Taguchi- DEAR-based optimization was also performed in the process, which resulted in a required Carbonization and material removal rate. Using the DEAR approach, the optimal parameters of the present study were found with 3.7% prediction error accuracy.Keywords: cabronization, leather, MRR, current
Procedia PDF Downloads 641735 Modeling and Optimizing of Sinker Electric Discharge Machine Process Parameters on AISI 4140 Alloy Steel by Central Composite Rotatable Design Method
Authors: J. Satya Eswari, J. Sekhar Babub, Meena Murmu, Govardhan Bhat
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Electrical Discharge Machining (EDM) is an unconventional manufacturing process based on removal of material from a part by means of a series of repeated electrical sparks created by electric pulse generators at short intervals between a electrode tool and the part to be machined emmersed in dielectric fluid. In this paper, a study will be performed on the influence of the factors of peak current, pulse on time, interval time and power supply voltage. The output responses measured were material removal rate (MRR) and surface roughness. Finally, the parameters were optimized for maximum MRR with the desired surface roughness. RSM involves establishing mathematical relations between the design variables and the resulting responses and optimizing the process conditions. RSM is not free from problems when it is applied to multi-factor and multi-response situations. Design of experiments (DOE) technique to select the optimum machining conditions for machining AISI 4140 using EDM. The purpose of this paper is to determine the optimal factors of the electro-discharge machining (EDM) process investigate feasibility of design of experiment techniques. The work pieces used were rectangular plates of AISI 4140 grade steel alloy. The study of optimized settings of key machining factors like pulse on time, gap voltage, flushing pressure, input current and duty cycle on the material removal, surface roughness is been carried out using central composite design. The objective is to maximize the Material removal rate (MRR). Central composite design data is used to develop second order polynomial models with interaction terms. The insignificant coefficients’ are eliminated with these models by using student t test and F test for the goodness of fit. CCD is first used to establish the determine the optimal factors of the electro-discharge machining (EDM) for maximizing the MRR. The responses are further treated through a objective function to establish the same set of key machining factors to satisfy the optimization problem of the electro-discharge machining (EDM) process. The results demonstrate the better performance of CCD data based RSM for optimizing the electro-discharge machining (EDM) process.Keywords: electric discharge machining (EDM), modeling, optimization, CCRD
Procedia PDF Downloads 3411734 Physiopathology of Osteitis in the Diabetic Foot
Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda
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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot
Procedia PDF Downloads 821733 Central Composite Design for the Optimization of Fenton Process Parameters in Treatment of Hydrocarbon Contaminated Soil using Nanoscale Zero-Valent Iron
Authors: Ali Gharaee, Mohammad Reza Khosravi Nikou, Bagher Anvaripour, Ali Asghar Mahjoobi
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Soil contamination by petroleum hydrocarbon (PHC) is a major concern facing the oil and gas industry. Particularly, condensate liquids have been found to contaminate soil at gas production sites. The remediation of PHCs is a difficult challenge due to the complex interaction between contaminant and soil. A study has been conducted to enhance degradation of PHCs by Fenton oxidation and using Nanoscale Zero-Valent Iron as catalyst. The various operating conditions such as initial H2O2 concentration, nZVI dosage, reaction time, and initial contamination dose were investigated. Central composite design was employed to optimize and analyze the effect of operational parameters on the PHC removal efficiency. It was found that optimal molar ratio of H2O2/Fe0 was 58 with maximum TPH removal of 84% and 3hr reaction time and initial contaminant concentration was 15g oil /kg soil. Based on the results, combination of Nanoscale ZVI and Fenton has proved to be a promising remedy for contaminated soil.Keywords: oil contaminated Soil, fenton oxidation, zero valent iron nano-particles
Procedia PDF Downloads 2901732 Osteitis in the Diabetic Foot and the Risk Factor on the Population
Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda
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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.Keywords: osteitis, antibiotic, biopsy, diabetic foot
Procedia PDF Downloads 99