Search results for: surgical removal

Authors: Moses Basitere, Marshal Sherene Sheldon, Seteno Karabo Obed Ntwampe, Debbie Dejager

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In South Africa, Poultry slaughterhouses consume largest amount of freshwater and discharges high strength wastewater, which can be treated successfully at low cost using anaerobic digesters. In this study, the performance of bench-scale mesophilic Static Granular Bed Reactor (SGBR) containing fully anaerobic granules coupled with ultra-filtration (UF) membrane as a post-treatment for poultry slaughterhouse wastewater was investigated. The poultry slaughterhouse was characterized by chemical oxygen demand (COD) range between 2000 and 6000 mg/l, average biological oxygen demand (BOD) of 2375 mg/l and average fats, oil and grease (FOG) of 554 mg/l. A continuous SGBR anaerobic reactor was operated for 6 weeks at different hydraulic retention time (HRT) and an Organic loading rate. The results showed an average COD removal was greater than 90% for both the SGBR anaerobic digester and ultrafiltration membrane. The total suspended solids and fats oil and grease (FOG) removal was greater than 95%. The SGBR reactor coupled with UF membrane showed a greater potential to treat poultry slaughterhouse wastewater.

Keywords: chemical oxygen demand, poultry slaughterhouse wastewater, static granular bed reactor, ultrafiltration, wastewater

Procedia PDF Downloads 387

Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

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Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

Procedia PDF Downloads 161

Authors: Reda A. Elkhyat, Mahmoud Nasr, Amel A. Tammam, Mohamed A. Ghazy

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Pharmaceuticals and personal care products (PPCPs) are a unique group of emerging contaminants continuously introduced into the aquatic ecosystem at concentrations capable of inducing adverse effects on humans and aquatic organisms, even at trace levels ranging from ppt to ppm. Amongst the common pharmaceutical emerging pollutants detected in several aquatic environments, acetaminophen has been recognized for its high toxicity. Once released into the aquatic environment, acetaminophen could be degraded by the microbial community and adsorption/ uptake by the plants. Although many studies have investigated the hazard risks of acetaminophen pollutants on aquatic animals, the number of studies demonstrating its removal efficiency and effects on the aquatic plant still needs to be expanded. In this context, this study aims to apply the aquatic plant-based phytoremediation system to eliminate this emerging contaminant from domestic wastewater. The phytoremediation experiment was performed in a hydroponic system containing Eichhornia crassipes and operated under the natural environment at 25°C to 30°C. This system was subjected to synthetic domestic wastewater with the maximum initial chemical oxygen demand (COD) of 390 mg/L and three different acetaminophen concentrations of 25, 50, and 200 mg/L. After 17 d of operation, the phytoremediation system achieved removal efficiencies of about 100% and 85.6±4.2% for acetaminophen and COD, respectively.Moreover, the Eichhornia crassipes could withstand the toxicity associated with increasing the acetaminophen concentrations from 25 to 200 mg/L. This high treatment performance could be assigned to the well-adaptation of the water hyacinth to the phytoremediation factors. Moreover, it has been proposed that this phytoremediation system could be largely supported by phytodegradation and plant uptaking mechanisms; however, detecting the generated intermediates, metabolites, and degradation products are still under investigation. Applying this free-floating plant in wastewater treatment and reducing emerging contaminants would meet the targets of SDGs 3, 6, and. 14. The cost-benefit analysis was performed for the phytoremediation system. The phytoremediation system is financially viable as the net profit was 2921 US $/ y with a payback period of nine years.

Keywords: domestic wastewater, emerging pollutants, hydrophyte Eichhornia crassipes, paracetamol removal efficiency, sustainable development goals (SDGs)

Procedia PDF Downloads 115

Authors: Sarabjeet Singh Sidhu, Ajay Batish, Sanjeev Kumar

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This paper reports the optimal process conditions for machining of three different types of metal matrix composites (MMCs): 65vol%SiC/A356.2; 10vol%SiC-5vol%quartz/Al and 30vol%SiC/A359 using PMEDM process. Metal removal rate (MRR), tool wear rate (TWR), surface roughness (SR) and surface integrity (SI) were evaluated after each trial and contributing process parameters were identified. The four responses were then collectively optimized using the technique for order preference by similarity to ideal solution (TOPSIS) and optimal process conditions were identified for each type of MMCS. The density of reinforced particles shields the matrix material from spark energy hence the high MRR and SR was observed with lowest reinforced particle. TWR was highest with Cu-Gr electrode due to disintegration of the weakly bonded particles in the composite electrode. Each workpiece was examined for surface integrity and ranked as per severity of surface defects observed and their rankings were used for arriving at the most optimal process settings for each workpiece.

Keywords: metal matrix composites (MMCS), metal removal rate (MRR), surface roughness (SR), surface integrity (SI), tool wear rate (TWR), technique for order preference by similarity to ideal solution (TOPSIS)

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Authors: Larry Hawkins, Scott K. Sakakura, Michael J. Salopek

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The Marshall Space Flight Center is designing and building a next-generation CO₂ removal system, the Four Bed Carbon Dioxide Scrubber (4BCO₂), which will use the International Space Station (ISS) as a testbed. The current ISS CO2 removal system has faced many challenges in both performance and reliability. Given that CO2 removal is an integral Environmental Control and Life Support System (ECLSS) subsystem, the 4BCO2 Scrubber has been designed to eliminate the shortfalls identified in the current ISS system. One of the key required upgrades was to improve the performance and reliability of the blower that provides the airflow through the CO₂ sorbent beds. A magnetically levitated blower, capable of higher airflow and pressure than the previous system, was developed to meet this need. The design and qualification testing of this next-generation blower are described here. The new blower features a high-efficiency permanent magnet motor, a five-axis, active magnetic bearing system, and a compact controller containing both a variable speed drive and a magnetic bearing controller. The blower uses a centrifugal impeller to pull air from the inlet port and drive it through an annular space around the motor and magnetic bearing components to the exhaust port. Technical challenges of the blower and controller development include survival of the blower system under launch random vibration loads, operation in microgravity, packaging under strict size and weight requirements, and successful operation during 4BCO₂ operational changeovers. An ANSYS structural dynamic model of the controller was used to predict response to the NASA defined random vibration spectrum and drive minor design changes. The simulation results are compared to measurements from qualification testing the controller on a vibration table. Predicted blower performance is compared to flow loop testing measurements. Dynamic response of the system to valve changeovers is presented and discussed using high bandwidth measurements from dynamic pressure probes, magnetic bearing position sensors, and actuator coil currents. The results presented in the paper show that the blower controller will survive launch vibration levels, the blower flow meets the requirements, and the magnetic bearings have adequate load capacity and control bandwidth to maintain the desired rotor position during the valve changeover transients.

Keywords: blower, carbon dioxide removal, environmental control and life support system, magnetic bearing, permanent magnet motor, validation testing, vibration

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Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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Authors: Amitesh Goswami, Vishal Gulati, Annu Yadav

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In this paper, WEDM has been used to investigate the machining characteristics of Inconel-625 alloy. The machining characteristics namely material removal rate (MRR) and surface roughness (SR) have been investigated along with surface microstructure analysis using SEM and EDS of the machined surface. Taguchi’s L27 Orthogonal array design has been used by considering six varying input parameters viz. Pulse-on time (Ton), Pulse-off time (Toff), Spark Gap Set Voltage (SV), Peak Current (IP), Wire Feed (WF) and Wire Tension (WT) for the responses of interest. It has been found out that Pulse-on time (Ton) and Spark Gap Set Voltage (SV) are the most significant parameters affecting material removal rate (MRR) and surface roughness (SR) are. Microstructure analysis of workpiece was also done using Scanning Electron Microscope (SEM). It was observed that, variations in pulse-on time and pulse-off time causes varying discharge energy and as a result of which deep craters / micro cracks and large/ small number of debris were formed. These results were helpful in studying the effects of pulse-on time and pulse-off time on MRR and SR. Energy Dispersive Spectrometry (EDS) was also done to check the compositional analysis of the material and it was observed that Copper and Zinc which were initially not present in the Inconel 625, later migrated on the material surface from the brass wire electrode during machining

Keywords: MRR, SEM, SR, taguchi, Wire Electric Discharge Machining

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Authors: Ming-Yeh Lu, Shiao-Shing Chen, Saikat Sinha Ray, Hung-Te Hsu

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Recently, anaerobic membrane bioreactors (AnMBRs) has been widely utilized, which combines anaerobic biological treatment process and membrane filtration, that can be present an attractive option for wastewater treatment and water reuse. Conventional AnMBR is having several advantages, such as improving effluent quality, compact space usage, lower sludge yield, without aeration and production of energy. However, the removal of nitrogen and phosphorus in the AnMBR permeate was negligible which become the biggest disadvantage. In recent years, forward osmosis (FO) is an emerging technology that utilizes osmotic pressure as driving force to extract clean water without additional external pressure. The pore size of FO membrane is kindly mentioned the pore size, so nitrogen or phosphorus could effectively improve removal of nitrogen or phosphorus. Anaerobic bioreactor with FO membrane (AnOMBR) can retain the concentrate organic matters and nutrients. However, phosphorus is a non-renewable resource. Due to the high rejection property of FO membrane, the high amount of phosphorus could be recovered from the combination of AnMBR and FO. In this study, development of novel submerged anaerobic osmotic membrane bioreactor integrated with periodic microfiltration (MF) extraction for simultaneous phosphorus and clean water recovery from wastewater was evaluated. A laboratory-scale AnOMBR utilizes cellulose triacetate (CTA) membranes with effective membrane area of 130 cm² was fully submerged into a 5.5 L bioreactor at 30-35℃. Active layer-facing feed stream orientation was utilized, for minimizing fouling and scaling. Additionally, a peristaltic pump was used to circulate draw solution (DS) at a cross flow velocity of 0.7 cm/s. Magnesium sulphate (MgSO₄) solution was used as DS. Microfiltration membrane periodically extracted about 1 L solution when the TDS reaches to 5 g/L to recover phosphorus and simultaneous control the salt accumulation in the bioreactor. During experiment progressed, the average water flux was achieved around 1.6 LMH. The AnOMBR process show greater than 95% removal of soluble chemical oxygen demand (sCOD), nearly 100% of total phosphorous whereas only partial removal of ammonia, and finally average methane production of 0.22 L/g sCOD was obtained. Therefore, AnOMBR system periodically utilizes MF membrane extracted for phosphorus recovery with simultaneous pH adjustment. The overall performance demonstrates that a novel submerged AnOMBR system is having potential for simultaneous wastewater treatment and resource recovery from wastewater, and hence, the new concept of this system can be used to replace for conventional AnMBR in the future.

Keywords: anaerobic treatment, forward osmosis, phosphorus recovery, membrane bioreactor

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Authors: Laura Frydel

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Chloroxylenol is a common ingredient in disinfectants. Due to the use of this compound in large amounts, it is more and more often detected in rivers, sewage, and also in human body fluids. In recent years, there have been concerns about the potentially harmful effects of chloroxylenol on human health and the environment. This paper presents the synthesis, a brief characterization and the use of a halloysite-carbon adsorbent for the removal of chloroxylenol from water. The template in the halloysite-carbon adsorbent was acid treated bleached halloysite, and the carbon precursor was cellulose dissolved in zinc (II) chloride, which was dissolved in 37% hydrochloric acid. The FTIR spectra before and after the adsorption process allowed to determine the presence of functional groups, bonds in the halloysite-carbon composite, and the binding mechanism of the adsorbent and adsorbate. The morphology of the bleached halloysite sample and the sample of the halloysite-carbon adsorbent were characterized by scanning electron microscopy (SEM) with surface analysis by X-ray dispersion spectrometry (EDS). The specific surface area, total pore volume and mesopore and micropore volume were determined using the ASAP 2020 volumetric adsorption analyzer. Total carbon and total organic carbon were determined for the halloysite-carbon adsorbent. The halloysite-carbon adsorbent was used to remove chloroxylenol from water. The degree of removal of chloroxylenol from water using the halloysite-carbon adsorbent was about 90%. Adsorption studies show that the halloysite-carbon composite can be used as an effective adsorbent for removing chloroxylenol from water.

Keywords: adsorption, cellulose, chloroxylenol, halloysite

Procedia PDF Downloads 191

Authors: Muhammad Waqar Ashraf

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The influence of magnetic field on the structure of water and aqueous solutions are similar and can alter the physical and chemical properties of water-dispersed systems. With the application of magnetic field, hydration of salt ions and other impurities slides down and improve the possible technological characteristics of the water. Magnetic field can enhance the characteristic of water i.e. better salt solubility, kinetic changes in salt crystallization, accelerated coagulation, etc. Gulf countries are facing critical problem due to depletion of water resources and increasing food demands to cover the human needs; therefore water shortage is being increasingly accepted as a major limitation for increased agricultural production and food security. In arid and semi-arid regions sustainable agricultural development is influenced to a great extent by water quality that might be used economically and effectively in developing agriculture programs. In the present study, the possibility of using magnetized water to desalinate the soil is accounted for the enhanced dissolving capacity of the magnetized water. Magnetic field has been applied to treat brackish water. The study showed that the impact of magnetic field on saline water is sustained up to three hours (with and without shaking). These results suggest that even low magnetic field can decrease the electrical conductivity and total dissolved solids which are good for the removal of salinity from the irrigated land by using magnetized water.

Keywords: magnetic treatment, saline water, hardness of water, removal of salinity

Procedia PDF Downloads 498

Authors: Ivar Zekker, Ergo Rikmann, Anni Mandel, Markus Raudkivi, Kristel Kroon, Liis Loorits, Andrus Seiman, Hannu Fritze, Priit Vabamäe, Toomas Tenno, Taavo Tenno

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The anaerobic ammonium oxidation (anammox) and nitritation-anammox (deammonification) processes are widely used for N-rich wastewater treatment nowadays. A deammonification moving bed biofilm reactor (MBBR) with a high maximum total nitrogen removal rate (TNRR) of 1.5 g N m-2 d-1 was started up and similarly high TNRR was sustained at low temperature of 15°C. During biofilm cultivation, temperature in MBBR was lowered by 0.5° C week-1 sustaining the high TNRR. To study the short-term effect of temperature on the TNRR, a series of batch-scale experiments performed showed sufficient TNRRs even at 9-15° C (4.3-5.4 mg N L-1 h-1, respectively). After biomass was adapted to lower temperature (15°C), the TNRR increase at lower temperature (15°C) was relatively higher (15-20%) than with biomass adapted to higher temperatures (17-18°C). Anammox qPCR showed increase of Candidatus Brocadia quantities from 5×103 to 1×107 anammox gene copies g-1 TSS despite temperature lowered to 15°C. Modeling confirmed causes of stable and unstable periods in the reactor and in batch test high Arrhenius constant of 29.7 kJ mol-1 of the process as high as at 100 mg NO2--N L-1 were determined. 

Keywords: deammonification, reject water, intermittent aeration, nitrite inhibition

Procedia PDF Downloads 417

Authors: A. Zare Javid, H. Babaee, E. Ashrafzadeh, H. Yousefimanesh, M. Zakerkish, K. Ahmadi Angali, M. Ravanbakhsh

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Introduction: Type 2 diabetes mellitus and periodontal disease hold a physiologically relationship. Periodontal disease, a common widespread chronic disease, is considered as an important complication in diabetes mellitus. The prevalence and severity of periodontal disease are increased among diabetic patients. A balanced nutrition may improve either diabetes or periodontal disease by controlling one of them. The aim of this study was to evaluate the effects of cranberry juice enriched with n-3 PUFA and their individual consumption on glycemic control and antioxidant status in diabetic patients with periodontal disease. Methods: In this randomized clinical trial 41 diabetic patients (35 – 65 y) with chronic adult periodontal disease were recruited from Endocrinology Clinic of Golestan Hospital in Ahvaz city, Iran. Subjects were randomly assigned to four groups as follow: one control group (n=12) and three intervention groups as receiving 1 g n-3 PUFA capsule (n=10), 400 ml cranberry juice (n=9), 400 ml cranberry juice enriched with 1g n-3 PUFA (n=10) for 8 weeks. Non-surgical periodontal therapy was provided for all patients during study. Fasting blood glucose, glycated hemoglobin, plasma and saliva TAOC and MDA, pocket depth and bleeding on probing were measured at baseline and post intervention. Results: There was a significant reduction in glycated hemoglobin observed in intervention groups of receiving n-3 PUFA and cranberry enriched with n-3 PUFA (11 %, P = 0.01 and 7 %, P = 0.01, respectively). The intervention group receiving n-3 PUFA had significantly lower glycated hemoglobin compared with control group. There was no significant difference found in FBS between and within groups. Furthermore, there was a significant increase in plasma TAOC only in cranberry enriched with n-3 PUFA group. Moreover, plasma MDA significantly decreased in intervention groups of receiving cranberry and cranberry enriched with n-3 PUFA. A significant increase was observed in TAOC of salvia in cranberry enriched with n-3 PUFA group compared to control group .The intervention group receiving cranberry enriched with n-3 PUFA had significantly lower MDA of salvia compared with control group. Pocket depth were significantly decreased in all groups, however, bleeding on probing didn’t significantly changed in patients post intervention. Conclusion: It is suggested that consumption of cranberry juice enriched with n-3 PUFA as a nutritional approach in adjunct with non-surgical periodontal therapy may help to improve glycosylated hemogolobin and TAOC in salvia and plasma in diabetic patients with periodontal disease.

Keywords: antioxidant, cranberry, oxidant status, periodontal disease, type 2 diabetes mellitus

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: Nona Mirzamohammadi, Bahram Nasernejad

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This work mainly focuses on studying the mechanism governing the adsorption of tetraethylammonium bromide, a short-chain quaternary ammonium salt, on the surface of natural zeolite and to characterize modified and raw zeolites in order to study the removal of nitrate anions from water. Natural clinoptilolite, as the most common zeolite, was chosen and modified in an ultrasonication process using tetraethylammonium bromide, subsequent to being contacted with NaCl solutions. FT-IR studies indicated a peak attributed to the stretching vibrations of the –CH₂ group in the molecule of tetraethylammonium bromide in the spectrum of the modified sample. Moreover, the SEM images showed some obvious changes in the surface morphology and crystallinity of clinoptilolite after being modified. Batch adsorption experiments show that the modified zeolite is capable of removing nitrate anions, and the predominant removal mechanism is suggested to be a combination of electrostatic attraction and ion exchange since the results from the zeta potential analysis showed a decrease in the net negative charge of clinoptilolite after modification, while bromide ions were detected in the modified sample in the µXRF analysis.

Keywords: adsorption, clinoptilolite, short-chain quaternary ammonium salt, tetraethylammoniumbromide, ultrasonication

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Authors: Moatlhodi Wise Letshwenyo, Lesedi Lebogang

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Botswana is an arid country that needs to start reusing wastewater as part of its water security plan. Pilot scale slow sand filtration in combination with roughing filter was investigated for the treatment of effluent from Botswana International University of Science and Technology to meet Botswana irrigation standards. The system was operated at hydraulic loading rates of 0.04 m/hr and 0.12 m/hr. The results show that the system was able to reduce turbidity from 262 Nephelometric Turbidity Units to a range between 18 and 0 Nephelometric Turbidity Units which was below 30 Nephelometric Turbidity Units threshold limit. The overall efficacy ranged between 61% and 100%. Suspended solids, Biochemical Oxygen Demand, and Chemical Oxygen Demand removal efficiency averaged 42.6%, 45.5%, and 77% respectively and all within irrigation standards. Other physio-chemical parameters were within irrigation standards except for bicarbonate ion which averaged 297.7±44 mg L^-1 in the influent and 196.22±50 mg L^-1 in the effluent which was above the limit of 92 mg L^-1, therefore averaging a reduction of 34.1% by the system. Total coliforms, fecal coliforms, and Escherichia coli in the effluent were initially averaging 1.1 log counts, 0.5 log counts, and 1.3 log counts respectively compared to corresponding influent log counts of 3.4, 2.7 and 4.1, respectively. As time passed, it was observed that only roughing filter was able to reach reductions of 97.5%, 86% and 100% respectively for faecal coliforms, Escherichia coli, and total coliforms. These organism numbers were observed to have increased in slow sand filter effluent suggesting multiplication in the tank. Water quality index value of 22.79 for the physio-chemical parameters suggests that the effluent is of excellent quality and can be used for irrigation purposes. However, the water quality index value for the microbial parameters (1820) renders the quality unsuitable for irrigation. It is concluded that slow sand filtration in combination with roughing filter is a viable option for the treatment of secondary effluent for reuse purposes. However, further studies should be conducted especially for the removal of microbial parameters using the system.

Keywords: irrigation, slow sand filter, turbidity, wastewater reuse

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Authors: Asim Laeeq Khan, Mazhar Amjad Gilani, Tayub Raza

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The use of fossil fuels for energy generation leads to the emission of greenhouse gases particularly CO2 into the atmosphere. To date, several techniques have been proposed for the efficient removal of CO2 from flue gas mixtures. Membrane technology is a promising choice due to its several inherent advantages such as low capital cost, high energy efficiency, and low ecological footprint. One of the goals in the development of membranes is to achieve high permeability and selectivity. Mixed matrix membranes comprising of inorganic fillers embedded in polymer matrix are a class of membranes that have showed improved separation properties. One of the biggest challenges in the commercialization if mixed matrix membranes are the removal of non-selective voids existing at the polymer-filler interface. In this work, mixed matrix membranes were prepared using polysulfone as polymer matrix and ordered mesoporous MCM-41 as filler materials. A new approach to removing the interfacial voids was developed by introducing room temperature ionic (RTIL) at the polymer-filler interface. The results showed that the imidazolium based RTIL not only provided wettability characteristics but also helped in further improving the separation properties. The removal of interfacial voids and good contact between polymer and filler was verified by SEM measurement. The synthesized membranes were tested in a custom built gas permeation set-up for the measurement of gas permeability and ideal gas selectivity. The results showed that the mixed matrix membranes showed significantly higher CO2 permeability in comparison to the pristine membrane. In order to have further insight into the role of fillers, diffusion and solubility measurements were carried out. The results showed that the presence of highly porous fillers resulted in increasing the diffusion coefficient while the solubility showed a slight drop. The RTIL filled membranes showed higher CO2/CH4 and CO2/N2 selectivity than unfilled membranes while the permeability dropped slightly. The increase in selectivity was due to the highly selective RTIL used in this work. The study revealed that RTIL filled mixed matrix membranes are an interesting candidate for gas separation membranes.

Keywords: ionic liquids, CO2 separation, membranes, mixed matrix membranes

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Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

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Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

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Authors: Ahmed O. Babaleye, Rafet E. Kurt

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The global oil and gas industry is beginning to witness an increase in the number of installations moving towards decommissioning. Decommissioning of offshore installations is a complex, costly and hazardous activity, making safety one of the major concerns. Among existing removal options, complete and partial removal options pose the highest risks. Therefore, a dynamic risk model of the accidents from the two options is important to assess the risks on an overall basis. In this study, a risk-based safety model is developed to conduct quantitative risk analysis (QRA) for jacket structure systems failure. Firstly, bow-tie (BT) technique is utilised to model the causal relationship between the system failure and potential accident scenarios. Subsequently, to relax the shortcomings of BT, Bayesian Belief Networks (BBNs) were established to dynamically assess associated uncertainties and conditional dependencies. The BBN is developed through a similitude mapping of the developed bow-tie. The BBN is used to update the failure probabilities of the contributing elements through diagnostic analysis, thus, providing a case-specific and realistic safety analysis method when compared to a bow-tie. This paper presents the application of dynamic safety analysis to guide the allocation of risk control measures and consequently, drive down the avoidable cost of remediation.

Keywords: Bayesian belief network, offshore decommissioning, dynamic safety model, quantitative risk analysis

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Authors: Tânia F. C. V. Silva, Eloísa S. S. Vieira, João Pinto da Costa, Rui A. R. Boaventura, Vitor J. P. Vilar

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Sanitary landfill leachates are characterized as a complex mixture of diverse organic and inorganic contaminants, which are usually removed by combining different treatment processes. Due to its simplicity, reliability, high cost-effectiveness and high nitrogen content (mostly under the ammonium form) inherent in this type of effluent, the activated sludge biological process is almost always applied in leachate treatment plants (LTPs). The purpose of this work is to assess the effect of the main nitrification and denitrification variables on the nitrogen's biological removal, from mature leachates. The leachate samples were collected after an aerated lagoon, at a LTP nearby Porto, presenting a high amount of dissolved organic carbon (1.0-1.3 g DOC/L) and ammonium nitrogen (1.1-1.7 g NH4+-N/L). The experiments were carried out in a 1-L lab-scale batch reactor, equipped with a pH, temperature and dissolved oxygen (DO) control system, in order to determine the reaction kinetic constants at unchanging conditions. The nitrification reaction rate was evaluated while varying the (i) operating temperature (15, 20, 25 and 30ºC), (ii) DO concentration interval (0.5-1.0, 1.0-2.0 and 2.0-4.0 mg/L) and (iii) solution pH (not controlled, 7.5-8.5 and 6.5-7.5). At the beginning of most assays, it was verified that the ammonium stripping occurred simultaneously to the nitrification, reaching up to 37% removal of total dissolved nitrogen. The denitrification kinetic constants and the methanol consumptions were calculated for different values of (i) volatile suspended solids (VSS) content (25, 50 and 100 mL of centrifuged sludge in 1 L solution), (ii) pH interval (6.5-7.0, 7.5-8.0 and 8.5-9.0) and (iii) temperature (15, 20, 25 and 30ºC), using effluent previously nitrified. The maximum nitrification rate obtained was 38±2 mg NH4+-N/h/g VSS (25ºC, 0.5-1.0 mg O2/L, pH not controlled), consuming 4.4±0.3 mg CaCO3/mg NH4+-N. The highest denitrification rate achieved was 19±1 mg (NO2--N+NO3--N)/h/g VSS (30ºC, 50 mL of sludge and pH between 7.5 and 8.0), with a C/N consumption ratio of 1.1±0.1 mg CH3OH/mg (NO2--N+NO3--N) and an overall alkalinity production of 3.7±0.3 mg CaCO3/mg (NO2--N+NO3--N). The denitrification process showed to be sensitive to all studied parameters, while the nitrification reaction did not suffered significant change when DO content was changed.

Keywords: mature sanitary landfill leachate, nitrogen removal, nitrification and denitrification parameters, lab-scale activated sludge biological reactor

Procedia PDF Downloads 277

Authors: Naghmeh Zamani, Ashkan Pourkand, David Grow

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This paper presents the design and mechanical model of a hybrid impedance/admittance haptic device optimized for applications, like bone drilling, spinal awl probe use, and other surgical techniques were high force is required in the tool-axial direction, and low impedance is needed in all other directions. The performance levels required cannot be satisfied by existing, off-the-shelf haptic devices. This design may allow critical improvements in simulator fidelity for surgery training. The device consists primarily of two low-mass (carbon fiber) plates with a rod passing through them. Collectively, the device provides 6 DOF. The rod slides through a bushing in the top plate and it is connected to the bottom plate with a universal joint, constrained to move in only 2 DOF, allowing axial torque display the user’s hand. The two parallel plates are actuated and located by means of four cables pulled by motors. The forward kinematic equations are derived to ensure that the plates orientation remains constant. The corresponding equations are solved using the Newton-Raphson method. The static force/torque equations are also presented. Finally, we present the predicted distribution of location error, cables velocity, cable tension, force and torque for the device. These results and preliminary hardware fabrication indicate that this design may provide a revolutionary approach for haptic display of many surgical procedures by means of an architecture that allows arbitrary workspace scaling. Scaling of the height and width can be scaled arbitrarily.

Keywords: cable direct driven robot, haptics, parallel plates, bone drilling

Procedia PDF Downloads 258

Authors: E. D. Paul, A. D. Adams, O. Sunmonu, U. S. Ishiaku

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Activated tamarind kernel powder (ATKP) was prepared from tamarind fruit (Tamarindus indica), and utilized for the removal of Reactive Blue 29 (RB29) from its aqueous solution. The powder was activated using 4N nitric acid (HNO₃). The adsorbent was characterised using infrared spectroscopy, bulk density, ash content, pH, moisture content and dry matter content measurements. The effect of various parameters which include; temperature, pH, adsorbent dosage, ion concentration, and contact time were studied. Four different equilibrium isotherm models were tested on the experimental data, but the Temkin isotherm model was best-fitted into the experimental data. The pseudo-first order and pseudo-second-order kinetic models were also fitted into the graphs, but pseudo-second order was best fitted to the experimental data. The thermodynamic parameters showed that the adsorption of Reactive Blue 29 onto activated tamarind kernel powder is a physical process, feasible and spontaneous, exothermic in nature and there is decreased randomness at the solid/solution interphase during the adsorption process. Therefore, activated tamarind kernel powder has proven to be a very good adsorbent for the removal of Reactive Blue 29 dyes from industrial waste water.

Keywords: tamarind kernel powder, reactive blue 29, isotherms, kinetics

Procedia PDF Downloads 248

Authors: Afzal Hussain, Mohammad A. Altamimi, Syed Sarim Imam, Mudassar Shahid, Osamah Abdulrahman Alnemer

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Exhaustive application of sulfamethoxazole (SUX) became as a global threat for human health due to water contamination through diverse sources. The addressed combined application of Hansen solubility (HSPiP software) parameters and Quality by Design tool for developing various green nanoemulsions. HSPiP program assisted to screen suitable excipients based on Hansen solubility parameters and experimental solubility data. Various green nanoemulsions were prepared and characterized for globular size, size distribution, zeta potential, and removal efficiency. Design Expert (DoE) software further helped to identify critical factors responsible to have direct impact on percent removal efficiency, size, and viscosity. Morphological investigation was visualized under transmission electron microscopy (TEM). Finally, the treated was studied to negate the presence of the tested drug employing ICP-OES (inductively coupled plasma optical emission microscopy) technique and HPLC (high performance liquid chromatography). Results showed that HSPiP predicted biocompatible lipid, safe surfactant (lecithin), and propylene glycol (PG). Experimental solubility of the drug in the predicted excipients were quite convincing and vindicated. Various green nanoemulsions were fabricated, and these were evaluated for in vitro findings. Globular size (100-300 nm), PDI (0.1-0.5), zeta potential (~ 25 mV), and removal efficiency (%RE = 70-98%) were found to be in acceptable range for deciding input factors with level in DoE. Experimental design tool assisted to identify the most critical variables controlling %RE and optimized content of nanoemulsion under set constraints. Dispersion time was varied from 5-30 min. Finally, ICP-OES and HPLC techniques corroborated the absence of SUX in the treated water. Thus, the strategy is simple, economic, selective, and efficient.

Keywords: quality by design, sulfamethoxazole, green nanoemulsion, water treatment, icp-oes, hansen program (hspip software

Procedia PDF Downloads 82

Authors: Saad Mohamed Elsaid Abdelrahman

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The adsorption method is one of the best modern techniques used in removing pollutants, especially organic hydrocarbon compounds, from polluted water. Through this research, bentonite clay can be used to remove organic hydrocarbon compounds, such as heptane and octane, resulting from oil spills in seawater. Bentonite clay can be obtained from the Kholayaz area, located north of Jeddah, at a distance of 80 km. Chemical analysis shows that bentonite clay consists of a mixture of silica, alumina and oxides of some elements. Bentonite clay can be activated in order to raise its adsorption efficiency and to make it suitable for removing pollutants using an ionic organic solvent. It is necessary to study some of the factors that could be in the efficiency of bentonite clay in removing oily organic compounds, such as the time of contact of the clay with heptane and octane solutions, pH and temperature, in order to reach the highest adsorption capacity of bentonite clay. The temperature can be a few degrees Celsius higher. The adsorption capacity of the clay decreases when the temperature is raised more than 4°C to reach its lowest value at the temperature of 50°C. The results show that the friction time of 30 minutes and the pH of 6.8 is the best conditions to obtain the highest adsorption capacity of the clay, 467 mg in the case of heptane and 385 mg in the case of octane compound. Experiments conducted on bentonite clay were encouraging to select it to remove heavy molecular weight pollutants such as petroleum compounds under study.

Keywords: adsorbent, bentonite clay, oil spills, removal

Procedia PDF Downloads 89

Authors: Mustafa M. Bob, Siti Izaidah Azmi, Mohd Hakim Ab Halim, Nur Syahida Abdul Jamal, Aznah Nor-Anuar, Zaini Ujang

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In this research, the formation and development of aerobic granular sludge (AGS) for domestic wastewater treatment application in hot climate conditions was studied using a sequencing batch reactor (SBR). The performance of the developed AGS in the removal of organic matter and nutrients from wastewater was also investigated. The operation of the reactor was based on the sequencing batch system with a complete cycle time of 3 hours that included feeding, aeration, settling, discharging and idling. The reactor was seeded with sludge collected from the municipal wastewater treatment plant in Madinah city, Saudi Arabia and operated at a temperature of 40ºC using synthetic wastewater as influent. Results showed that granular sludge was developed after an operation period of 30 days. The developed granular sludge had a good settling ability with the average size of the granules ranging from 1.03 to 2.42 mm. The removal efficiency of chemical oxygen demand (COD), ammonia nitrogen (NH3-N) and total phosphorus (TP) were 87.31%, 91.93% and 61.25% respectively. These results show that AGS can be developed at elevated temperatures and it is a promising technique to treat domestic wastewater in hot and low humidity climate conditions such as those encountered in Saudi Arabia.

Keywords: aerobic granular sludge, hot climate, sequencing batch reactor, domestic wastewater treatment

Procedia PDF Downloads 359

Authors: Chaimaan Benhsinat, Amal Tazi, Mohammed Azzi

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Synthetic azo-dyes are widely used in food industry, they product intense coloration, high toxicity and mutagenicity for wastewater; Causing serious damage to aquatic biota and risk factors for humans. The treatment of these effluents remains a major challenge especially for third world countries that have not yet all possibilities to integrate the concept of sustainable development. These aqueous effluents require specific treatment to preserve natural environments. For these reasons and in order to contribute to the fight against this danger, we were interested in this study to the degradation of the dye Ponceau Red E124 'C20H11N2Na3O10S3' 'used in a food industry Casablanca-Morocco, by the super iron ferrate (VI) K3FexMnyO8; Synthesized in our laboratory and known for its high oxidizing and flocculants. The degradation of Ponceau red is evaluated with the objectives of chemical oxygen demand (COD), total organic carbon (TOC) and discoloration reductions. The results are very satisfying. In fact, we achieved 90% reduction of COD and 99% of discoloration. The recovered floc are subject to various techniques for spectroscopic analysis (UV-visible and IR) to identify by-products formed after the degradation. Moreover, the results will then be compared with those obtained by the application of ferrous sulfate (FeSO4, 7H2O) used by the food industry for the degradation of P4R. The results will be later compared with those obtained by the application of ferrous sulfate (FeSO4, 7H2O) used by the food industry, in the degradation of the P4R.

Keywords: COD removal, color removal, dye ponceau 4R, oxydation by ferrate (VI)

Procedia PDF Downloads 343

Authors: Martyna Ekiert, Andrzej Mlyniec

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Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.

Keywords: freezing, soft tissue, tendon, bovine fascicles

Procedia PDF Downloads 219

Authors: Taghreed Al-Khalid, Muftah El-Naas

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As an economical and environmentally friendly technology, biological treatment has been shown to be one of the most promising approaches for the removal of numerous types of organic water pollutants such as Chlorophenols, which are hazardous pollutants commonly encountered in wastewater generated by the petroleum and petrochemical industries. This study aimed at evaluating the performance of a spouted bed bioreactor (SBBR) for aerobic biodegradation of 2, 4 dichlorophenol (DCP) by a commercial strain of Pseudomonas putida immobilized in polyvinyl alcohol (PVA) gel particles. The SBBR is characterized by systematic intense mixing, resulting in improvement of the biodegradation rates through reducing the mass transfer limitations. The reactor was evaluated in both batch and continuous mode in order to evaluate its hydrodynamics in terms of stability and response to shock loads. The SBBR was able to maintain a stable operation and recovered quickly to its normal operating mode once the shock load had been removed. In comparison to a packed bed reactor bioreactor, the SBBR proved to be more efficient and more stable, achieving a removal percentage and throughput of 80% and 1414 g/m3day, respectively. In addition, the biodegradation of chlorophenols was mathematically modeled using a dynamic modeling approach in order to assess reaction and mass transfer limitations. The results confirmed the effectiveness of the use of the PVA immobilization technique for the biodegradation of phenols.

Keywords: biodegradation, 2, 4 dichlorophenol, immobilization, polyvinyl alcohol (PVA) gel

Procedia PDF Downloads 181

Authors: Glemarie C. Hermosa, Sheng-Jie You, Chien Chih Hu

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Efficient separation technologies are required for the removal of carbon dioxide from natural gas streams. Membrane-based natural gas separation has emerged as one of the fastest growing technologies, due to the compactness, higher energy efficiency and economic advantages which can be reaped. The removal of Carbon dioxide from gas streams using membrane technology will also give the advantage like environmental friendly process compared to the other technologies used in gas separation. In this study, Polyimide membranes, which are mostly used in the separation of gases, are blended with a new kind of solvent: Deep Eutectic Solvents or simply DES. The three types of DES are used are choline chloride based mixed with three different hydrogen bond donors: Lactic acid, N-methylurea and Urea. The blending of the DESs to Polyimide gave out high permeability performance. The Gas Separation performance for all the membranes involving CO2/CH4 showed low performance while for CO2/N2 surpassed the performance of some studies. Among the three types of DES used the solvent Choline Chloride/Lactic acid exhibited the highest performance for both Gas Separation applications. The values are 10.5 for CO2/CH4 selectivity and 60.5 for CO2/N2. The separation results for CO2/CH4 may be due to the viscosity of the DESs affecting the morphology of the fabricated membrane thus also impacts the performance. DES/blended Polyimide membranes fabricated are novel and have the potential of a low-cost and environmental friendly application for gas separation.

Keywords: deep eutectic solvents, gas separation, polyimide blends, polyimide membranes

Procedia PDF Downloads 310

Authors: Aura Alejandra Burbano Patino, Mariela Agotegaray, Veronica Lassalle, Fernanda Horst

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Water pollution is of worldwide concern due to its importance as an essential resource for life. Industrial and urbanistic growth are anthropogenic activities that have caused an increase of undesirable compounds in water. In the last decade, emerging pollutants have become of great interest since, at very low concentrations (µg/L and ng/L), they exhibit a hazardous effect on wildlife, aquatic ecosystems, and human organisms. One group of emerging pollutants that are a matter of study are pharmaceuticals. Their high consumption rate and their inappropriate disposal have led to their detection in wastewater treatment plant influent, effluent, surface water, and drinking water. In consequence, numerous technologies have been developed to efficiently treat these pollutants. Adsorption appears like an easy and cost-effective technology. One of the most used adsorbents of emerging pollutants removal is carbon-based materials such as hydrochars. This study aims to use a magnetic hydrochar nanocomposite to be employed as an adsorbent for diclofenac removal. Kinetics models and the adsorption efficiency in real water samples were analyzed. For this purpose, a magnetic hydrochar nanocomposite was synthesized through the hydrothermal carbonization (HTC) technique hybridized to co-precipitation to add the magnetic component into the hydrochar, based on iron oxide nanoparticles. The hydrochar was obtained from sunflower husk residue as the precursor. TEM, TGA, FTIR, Zeta potential as a function of pH, DLS, BET technique, and elemental analysis were employed to characterize the material in terms of composition and chemical structure. Adsorption kinetics were carried out in distilled water and real water at room temperature, pH of 5.5 for distilled water and natural pH for real water samples, 1:1 adsorbent: adsorbate dosage ratio, contact times from 10-120 minutes, and 50% dosage concentration of DCF. Results have demonstrated that magnetic hydrochar presents superparamagnetic properties with a saturation magnetization value of 55.28 emu/g. Besides, it is mesoporous with a surface area of 55.52 m²/g. It is composed of magnetite nanoparticles incorporated into the hydrochar matrix, as can be proven by TEM micrographs, FTIR spectra, and zeta potential. On the other hand, kinetic studies were carried out using DCF models, finding percent removal efficiencies up to 85.34% after 80 minutes of contact time. In addition, after 120 minutes of contact time, desorption of emerging pollutants from active sites took place, which indicated that the material got saturated after that t time. In real water samples, percent removal efficiencies decrease up to 57.39%, ascribable to a possible mechanism of competitive adsorption of organic or inorganic compounds, ions for active sites of the magnetic hydrochar. The main suggested adsorption mechanism between the magnetic hydrochar and diclofenac include hydrophobic and electrostatic interactions as well as hydrogen bonds. It can be concluded that the magnetic hydrochar nanocomposite could be valorized into a by-product which appears as an efficient adsorbent for DCF removal as a model emerging pollutant. These results are being complemented by modifying experimental variables such as pollutant’s initial concentration, adsorbent: adsorbate dosage ratio, and temperature. Currently, adsorption assays of other emerging pollutants are being been carried out.

Keywords: environmental remediation, emerging pollutants, hydrochar, magnetite nanoparticles

Procedia PDF Downloads 189

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

Procedia PDF Downloads 315