Search results for: extra skin removal surgery
3225 Investigation into the Optimum Hydraulic Loading Rate for Selected Filter Media Packed in a Continuous Upflow Filter
Authors: A. Alzeyadi, E. Loffill, R. Alkhaddar
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Continuous upflow filters can combine the nutrient (nitrogen and phosphate) and suspended solid removal in one unit process. The contaminant removal could be achieved chemically or biologically; in both processes the filter removal efficiency depends on the interaction between the packed filter media and the influent. In this paper a residence time distribution (RTD) study was carried out to understand and compare the transfer behaviour of contaminants through a selected filter media packed in a laboratory-scale continuous up flow filter; the selected filter media are limestone and white dolomite. The experimental work was conducted by injecting a tracer (red drain dye tracer –RDD) into the filtration system and then measuring the tracer concentration at the outflow as a function of time; the tracer injection was applied at hydraulic loading rates (HLRs) (3.8 to 15.2 m h-1). The results were analysed according to the cumulative distribution function F(t) to estimate the residence time of the tracer molecules inside the filter media. The mean residence time (MRT) and variance σ2 are two moments of RTD that were calculated to compare the RTD characteristics of limestone with white dolomite. The results showed that the exit-age distribution of the tracer looks better at HLRs (3.8 to 7.6 m h-1) and (3.8 m h-1) for limestone and white dolomite respectively. At these HLRs the cumulative distribution function F(t) revealed that the residence time of the tracer inside the limestone was longer than in the white dolomite; whereas all the tracer took 8 minutes to leave the white dolomite at 3.8 m h-1. On the other hand, the same amount of the tracer took 10 minutes to leave the limestone at the same HLR. In conclusion, the determination of the optimal level of hydraulic loading rate, which achieved the better influent distribution over the filtration system, helps to identify the applicability of the material as filter media. Further work will be applied to examine the efficiency of the limestone and white dolomite for phosphate removal by pumping a phosphate solution into the filter at HLRs (3.8 to 7.6 m h-1).Keywords: filter media, hydraulic loading rate, residence time distribution, tracer
Procedia PDF Downloads 2773224 The Osteocutaneous Distal Tibia Turn-over Fillet Flap: A Novel Spare-parts Orthoplastic Surgery Option for Functional Below-knee Amputation
Authors: Harry Burton, Alexios Dimitrios Iliadis, Neil Jones, Aaron Saini, Nicola Bystrzonowski, Alexandros Vris, Georgios Pafitanis
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This article portrays the authors’ experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of “spares parts” in reconstructive microsurgery. This case describes a successful use of the osteocutaneous distal tibia turn-over fillet flap that allowed ‘lowering the level of the amputation’ from a through knee to the conventional level of a below-knee amputation to preserve the knee joint function. This case demonstrates the value of ‘spare-parts’ surgery principles and how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-over fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.Keywords: osteocutaneous flap, fillet flap, spare-parts surgery, Below knee amputation
Procedia PDF Downloads 1663223 Causes of Jaundice and Skin Rashes Amongst Children in Selected Rural Communities in the Gambia
Authors: Alhage Drammeh
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The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes
Procedia PDF Downloads 643222 Effect of Application of Turmeric Extract Powder Solution on the Color Changes of Non-Vital Teeth (An In-vitro study).
Authors: Haidy N. Salem, Nada O. Kamel, Shahinaz N. Hassan, Sherif M. Elhefnawy
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Aim: to assess the effect of using turmeric powder extract on changes of tooth color with extra-coronal and intra-coronal bleaching methods. Methods: Turmeric powder extract was weighted and mixed with two different hydrogen peroxide concentrations (3% and 6%) to be used as a bleaching agent. Thirty teeth were allocated into three groups (n=10): Group A: Bleaching agent (6%) was applied on the labial surface, Group B: Bleaching agent (3%) was applied inside the pulp chamber and Group C: Extra and intra-coronal bleaching techniques were used (6% and 3% respectively). A standardized access cavity was opened in the palatal surface of each tooth in both Groups B and C. Color parameters were measured using a spectrophotometer. Results: A statistically significant difference in color difference values (∆E*) and enamel brightness (∆L*) was found between Group C and each of Groups A and B. There was no statistically significant difference in (∆E*) and (∆L*) between Group A and Group B. The highest mean value of (∆E*) and (∆L*) was found in Group C, while the least mean value was found in Group B. Conclusion: Bleaching the external and internal tooth structure with low concentrations of hydrogen peroxide solution mixed with turmeric extract has a promising effect in color enhancement.Keywords: bleaching, hydrogen peroxide, spectrophotometer, turmeric
Procedia PDF Downloads 1183221 Comparison between Conventional Bacterial and Algal-Bacterial Aerobic Granular Sludge Systems in the Treatment of Saline Wastewater
Authors: Philip Semaha, Zhongfang Lei, Ziwen Zhao, Sen Liu, Zhenya Zhang, Kazuya Shimizu
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The increasing generation of saline wastewater through various industrial activities is becoming a global concern for activated sludge (AS) based biological treatment which is widely applied in wastewater treatment plants (WWTPs). As for the AS process, an increase in wastewater salinity has negative impact on its overall performance. The advent of conventional aerobic granular sludge (AGS) or bacterial AGS biotechnology has gained much attention because of its superior performance. The development of algal-bacterial AGS could enhance better nutrients removal, potentially reduce aeration cost through symbiotic algae-bacterial activity, and thus, can also reduce overall treatment cost. Nonetheless, the potential of salt stress to decrease biomass growth, microbial activity and nutrient removal exist. Up to the present, little information is available on saline wastewater treatment by algal-bacterial AGS. To the authors’ best knowledge, a comparison of the two AGS systems has not been done to evaluate nutrients removal capacity in the context of salinity increase. This study sought to figure out the impact of salinity on the algal-bacterial AGS system in comparison to bacterial AGS one, contributing to the application of AGS technology in the real world of saline wastewater treatment. In this study, the salt concentrations tested were 0 g/L, 1 g/L, 5 g/L, 10 g/L and 15 g/L of NaCl with 24-hr artificial illuminance of approximately 97.2 µmol m¯²s¯¹, and mature bacterial and algal-bacterial AGS were used for the operation of two identical sequencing batch reactors (SBRs) with a working volume of 0.9 L each, respectively. The results showed that salinity increase caused no apparent change in the color of bacterial AGS; while for algal-bacterial AGS, its color was progressively changed from green to dark green. A consequent increase in granule diameter and fluffiness was observed in the bacterial AGS reactor with the increase of salinity in comparison to a decrease in algal-bacterial AGS diameter. However, nitrite accumulation peaked from 1.0 mg/L and 0.4 mg/L at 1 g/L NaCl in the bacterial and algal-bacterial AGS systems, respectively to 9.8 mg/L in both systems when NaCl concentration varied from 5 g/L to 15 g/L. Almost no ammonia nitrogen was detected in the effluent except at 10 g/L NaCl concentration, where it averaged 4.2 mg/L and 2.4 mg/L, respectively, in the bacterial and algal-bacterial AGS systems. Nutrients removal in the algal-bacterial system was relatively higher than the bacterial AGS in terms of nitrogen and phosphorus removals. Nonetheless, the nutrient removal rate was almost 50% or lower. Results show that algal-bacterial AGS is more adaptable to salinity increase and could be more suitable for saline wastewater treatment. Optimization of operation conditions for algal-bacterial AGS system would be important to ensure its stably high efficiency in practice.Keywords: algal-bacterial aerobic granular sludge, bacterial aerobic granular sludge, Nutrients removal, saline wastewater, sequencing batch reactor
Procedia PDF Downloads 1483220 Measurement of Sarcopenia Associated with the Extent of Gastrointestinal Oncological Disease
Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh
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Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology
Procedia PDF Downloads 853219 Simulation Analysis and Control of the Temperature Field in an Induction Furnace Based on Various Parameters
Authors: Sohaibullah Zarghoon, Syed Yousaf, Cyril Belavy, Stanislav Duris, Samuel Emebu, Radek Matusu
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Induction heating is extensively employed in industrial furnaces due to its swift response and high energy efficiency. Designing and optimising these furnaces necessitates the use of computer-aided simulations. This study aims to develop an accurate temperature field model for a rectangular steel billet in an induction furnace by leveraging various parameters in COMSOL Multiphysics software. The simulation analysis incorporated temperature dynamics, considering skin depth, temperature-dependent, and constant parameters of the steel billet. The resulting data-driven model was transformed into a state-space model using MATLAB's System Identification Toolbox for the purpose of designing a linear quadratic regulator (LQR). This controller was successfully implemented to regulate the core temperature of the billet from 1000°C to 1200°C, utilizing the distributed parameter system circuit.Keywords: induction heating, LQR controller, skin depth, temperature field
Procedia PDF Downloads 413218 Animal Modes of Surgical or Other External Causes of Trauma Wound Infection
Authors: Ojoniyi Oluwafeyekikunmi Okiki
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Notwithstanding advances in disturbing wound care and control, infections remain a main motive of mortality, morbidity, and financial disruption in tens of millions of wound sufferers around the sector. Animal models have become popular gear for analyzing a big selection of outside worrying wound infections and trying out new antimicrobial techniques. This evaluation covers experimental infections in animal models of surgical wounds, pores and skin abrasions, burns, lacerations, excisional wounds, and open fractures. Animal modes of external stressful wound infections stated via extraordinary investigators vary in animal species used, microorganism traces, the quantity of microorganisms carried out, the dimensions of the wounds, and, for burn infections, the period of time the heated object or liquid is in contact with the skin. As antibiotic resistance continues to grow, new antimicrobial procedures are urgently needed. Those have to be examined using popular protocols for infections in external stressful wounds in animal models.Keywords: surgical wounds, animals, wound infections, burns, wound models, colony-forming gadgets, lacerated wounds
Procedia PDF Downloads 83217 Developing Biocompatible Iridium Oxide Electrodes for Bone-Guided Extra-Cochlear Implant
Authors: Yung-Shan Lu, Chia-Fone Lee, Shang-Hsuan Li, Chien-Hao Liu
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Recently, various bioelectronic devices have been developed for neurologic disease treatments via electro-stimulations such as cochlear implants and retinal prosthesis. Since the electric signal needs electrodes to be transmitted to an organism, electrodes play an important role of stimulations. The materials of stimulation electrodes affect the efficiency of the delivered currents. The higher the efficiency of the electrodes, the lower the threshold current can be used to stimulate the organism which minimizes the potential damages to the adjacent tissues. In this study, we proposed a biocompatible composite electrode composed of high-charge-capacity iridium oxide (IrOₓ) film for a bone-guide extra-cochlear implant. IrOₓ was exploited to decrease the threshold current due to its high capacitance and low impedance. The IrOₓ electrode was fabricated via microelectromechanical systems (MEMS) photolithography and examined with in-vivo tests with guinea pigs. Based on the measured responses of brain waves to sound, the results demonstrated that IrOₓ electrodes have a lower threshold current compared with the Platinum (Pt) electrodes. The research results are expected to be beneficial for implantable and biocompatible electrodes for electrical stimulations.Keywords: cochlear implants, electrode, electrical stimulation, iridium oxide
Procedia PDF Downloads 1893216 Support Provided by Teachers to Learners With Special Education Needs in Selected Amathole West District Primary Schools South Africa
Authors: Toyin Mary Adewumi, Cina Mosito
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Part of enabling learners with special education needs (SEN) to succeed is providing them with adequate support. Support is all activities in a school that enhance its capacity to respond to diversity by making learning contexts and lessons accessible to all learners. The paper reports findings of support provided by teachers to learners with SEN and the pockets of good practice found in the support provided by teachers to these learners in schools in the Amathole West District, Eastern Cape. A purposeful sample, comprising eight teachers, eight principals in eight schools, including one provincial and two district education officials, was selected. Thematic analysis was used for analyzing data gathered through semi-structured interviews. The results established that despite the challenges such as lack of qualifications and training in special education needs, learners with SEN received varied support from teachers which include extra exercises, extra time, special attention during break times or after school hours and homework. The study reveals pockets of good practice in some selected primary schools particularly in the poverty-stricken locations in the Amathole West District. This paper recommends adequate training for teachers for the support of learners with SEN.Keywords: good practice, learner, special education needs, inclusion, support
Procedia PDF Downloads 1343215 Post-Anesthetic Recovery: The Best Moment to Apply Positive Pressure in Airway in Postoperative Bariatric Surgery
Authors: Eli Maria Pazzianotto-Forti, Patrícia Brigatto, Letícia Baltieri, Carolina Moraes Da Costa, Maura Rigoldi Simoes Da Rocha, Irineu Rasera Jr
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The application of positive pressure in airway can contribute to the restoration of lung volumes, capacities and prevent respiratory complications. The aim was to investigate the use of Bilevel Positive Airway Pressure (BIPAP) in morbidly obese in two moments in postoperative bariatric surgery: In the post-anesthetic recovery (PAR) and on the 1st postoperative day (1stPO). Twenty morbidly obese, aged between 25 and 55 years, underwent pulmonary function test and chest X-ray preoperatively and on the day of discharge (2nd day after surgery). They were randomly allocated in groups. GPAR: received BIPAP treatment in PAR, for an hour and G1stPO: received BIPAP for one hour, on the 1stPO. There were significant reductions in slow vital capacity (SVC) (p=0.0007), inspiratory reserve volume (IRV) (p=0.0016) and forced vital capacity (FVC) (p=0.0013) in the postoperative in GPAR and the expiratory reserve volume (ERV) remained (p=0.4446). In the G1stPO, there were significant reductions for: SVC p=<0.0001, ERV p=0.0191, IRV p= 0.0026 and FVC p=<0.0001. Comparing between groups, the SVC (p=0.0027) and FVC (p=0.0028) showed significant difference between the treatments. However, the GPAR showed fewer declines of these capacities. To the ERV (p= 0.1646) and IRV (p=0.3973) there was no significant difference between groups. The atelectasis prevalence was 10% for the GPAR and 30% for G1stPO, with significant difference between the proportions (p = 0.0027). The lowest reduction in SVC and FVC happens when positive pressure is applied in PAR. Thus, the use of BIPAP in the PAR can promote a restoration of ERV and contribute to the reduction of atelectasis. FAPESP 2013/06334-8.Keywords: atelectasis, bariatric surgery, physiotherapy, pulmonary function, positive pressure
Procedia PDF Downloads 4043214 Fire Smoke Removal over Cu-Mn-Ce Oxide Catalyst with CO₂ Sorbent Addition: Co Oxidation and in-situ CO₂ Sorption
Authors: Jin Lin, Shouxiang Lu, Kim Meow Liew
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In a fire accident, fire smoke often poses a serious threat to human safety especially in the enclosed space such as submarine and space-crafts environment. Efficient removal of the hazardous gas products particularly a large amount of CO and CO₂ gases from these confined space is critical for the security of the staff and necessary for the post-fire environment recovery. In this work, Cu-Mn-Ce composite oxide catalysts coupled with CO₂ sorbents were prepared using wet impregnation method, solid-state impregnation method and wet/solid-state impregnation method. The as-prepared samples were tested dynamically and isothermally for CO oxidation and CO₂ sorption and further characterized by the X-ray diffraction (XRD), nitrogen adsorption and desorption, and field emission scanning electron microscopy (FE-SEM). The results showed that all the samples were able to catalyze CO into CO₂ and capture CO₂ in situ by chemisorption. Among all the samples, the sample synthesized by the wet/solid-state impregnation method showed the highest catalytic activity toward CO oxidation and the fine ability of CO₂ sorption. The sample prepared by the solid-state impregnation method showed the second CO oxidation performance, while the coupled sample using the wet impregnation method exhibited much poor CO oxidation activity. The various CO oxidation and CO₂ sorption properties of the samples might arise from the different dispersed states of the CO₂ sorbent in the CO catalyst, owing to the different preparation methods. XRD results confirmed the high-dispersed sorbent phase in the samples prepared by the wet and solid impregnation method, while that of the sample prepared by wet/solid-state impregnation method showed the larger bulk phase as indicated by the high-intensity diffraction peaks. Nitrogen adsorption and desorption results further revealed that the latter sample had a higher surface area and pore volume, which were beneficial for the CO oxidation over the catalyst. Hence, the Cu-Mn-Ce oxide catalyst coupled with CO₂ sorbent using wet/solid-state impregnation method could be a good choice for fire smoke removal in the enclosed space.Keywords: CO oxidation, CO₂ sorption, preparation methods, smoke removal
Procedia PDF Downloads 1393213 Characterization of Hyaluronic Acid-Based Injections Used on Rejuvenation Skin Treatments
Authors: Lucas Kurth de Azambuja, Loise Silveira da Silva, Gean Vitor Salmoria, Darlan Dallacosta, Carlos Rodrigo de Mello Roesler
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This work provides a physicochemical and thermal characterization assessment of three different hyaluronic acid (HA)-based injections used for rejuvenation skin treatments. The three products analyzed are manufactured by the same manufacturer and commercialized for application on different skin levels. According to the manufacturer, all three HA-based injections are crosslinked and have a concentration of 23 mg/mL of HA, and 0.3% of lidocaine. Samples were characterized by Fourier-transformed infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and scanning electron microscope (SEM) techniques. FTIR analysis resulted in a similar spectrum when comparing the different products. DSC analysis demonstrated that the fusion points differ in each product, with a higher fusion temperature observed in specimen A, which is used for subcutaneous applications, when compared with B and C, which are used for the middle dermis and deep dermis, respectively. TGA data demonstrated a considerable mass loss at 100°C, which means that the product has more than 50% of water in its composition. TGA analysis also showed that Specimen A had a lower mass loss at 100°C when compared to Specimen C. A mass loss of around 220°C was observed on all samples, characterizing the presence of hyaluronic acid. SEM images displayed a similar structure on all samples analyzed, with a thicker layer for Specimen A when compared with B and C. This series of analyses demonstrated that, as expected, the physicochemical and thermal properties of the products differ according to their application. Furthermore, to better characterize the crosslinking degree of each product and their mechanical properties, a set of different techniques should be applied in parallel to correlate the results and, thereby, relate injection application with material properties.Keywords: hyaluronic acid, characterization, soft-tissue fillers, injectable gels
Procedia PDF Downloads 883212 Thermophilic Anaerobic Granular Membrane Distillation Bioreactor for Wastewater Reuse
Authors: Duong Cong Chinh, Shiao-Shing Chen, Le Quang Huy
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Membrane distillation (MD) is actually claimed to be a cost-effective separation process when waste heat, alternative energy sources, or wastewater are used. To the best of our knowledge, this is the first study that a thermophilic anaerobic granular bioreactor is integrated with membrane distillation (ThAnMDB) was investigated. In this study, the laboratory scale anaerobic bioreactor (1.2 litter) was set-up. The bioreactor was maintained at temperature 55 ± 2°C, hydraulic retention time = 0.5 days, organic loading rates of 7 and 10 kg chemical oxygen demand (COD) m³/day. Side-stream direct contact membrane distillation with the polytetrafluoroethylene membrane area was 150 cm². The temperature of the distillate was kept at 25°C. Results show that distillate flux was 19.6 LMH (Liters per square meter per hour) on the first day and gradually decreased to 6.9 LMH after 10 days, and the membrane was not wet. Notably, by directly using the heat from the thermophilic anaerobic for MD separation process, all distilled water from wastewater was reuse as fresh water (electrical conductivity < 120 µs/cm). The ThAnMDB system showed its high pollutant removal performance: chemical oxygen demand (COD) from 99.6 to 99.9%, NH₄⁺ from 60 to 95%, and PO₄³⁻ complete removal. In addition, methane yield was from 0.28 to 0.34 lit CH₄/gram COD removal (80 – 97% of the theoretical) demonstrated that the ThAnMDB system was quite stable. The achievement of the ThAnMDB is not only in removing pollutants and reusing wastewater but also in absolutely unnecessarily adding alkaline to the anaerobic bioreactor system.Keywords: high rate anaerobic digestion, membrane distillation, thermophilic anaerobic, wastewater reuse
Procedia PDF Downloads 1273211 Appearance and Magnitude of Dynamic Pressure in Micro-Scale of Subsonic Airflow around Symmetric Objects
Authors: Shehret Tilvaldyev, Jorge Flores-Garay, Alfredo Villanueva, Erwin Martinez, Lazaro Rico
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The efficiency of modern transportation is severely compromised by the prevalence of turbulent drag. The high level of turbulent skin-friction occurring, e.g., on the surface of an aircraft, automobiles or the carriage of a high-speed train, is responsible for excess fuel consumption and increased carbon emissions. The environmental, political, and economic pressure to improve fuel efficiency and reduce carbon emissions associated with transportation means that reducing turbulent skin-friction drag is a pressing engineering problem. The dynamic pressure of subsonic airflow around solid objects creates lift, but also induces drag force. This paper is presenting the results of laboratory experiments, investigating appearance and magnitude of dynamic pressure in micro scale of subsonic air flow around right cylinder and symmetrical airfoil.Keywords: airflow, dynamic pressure, micro scale, symmetric object
Procedia PDF Downloads 3823210 Removal of Nutrients from Sewage Using Algal Photo-Bioreactor
Authors: Purnendu Bose, Jyoti Kainthola
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Due to recent advances in illumination technology, artificially illuminated algal-bacterial photo bioreactors are now a potentially feasible option for simultaneous and comprehensive organic carbon and nutrients removal from secondary treated domestic sewage. The experiments described herein were designed to determine the extent of nutrient uptake in photo bioreactors through algal assimilation. Accordingly, quasi steady state data on algal photo bioreactor performance was obtained under 20 different conditions. Results indicated that irrespective of influent N and P levels, algal biomass recycling resulted in superior performance of algal photo bioreactors in terms of both N and P removals. Further, both N and P removals were positively related to the growth of algal biomass in the reactor. Conditions in the reactor favouring greater algal growth also resulted in greater N and P removals. N and P removals were adversely impacted in reactors with low algal concentrations due to the inability of the algae to grow fast enough under the conditions provided. Increasing algal concentrations in reactors over a certain threshold value through higher algal biomass recycling was also not fruitful, since algal growth slowed under such conditions due to reduced light availability due to algal ‘self-shading’. It was concluded that N removals greater than 80% at high influent N concentrations is not possible with the present reactor configuration. Greater than 80% N removals may however be possible in similar reactors if higher light intensity is provided. High P removal is possible only if the influent N: P ratio in the reactor is aligned closely with the algal stoichiometric requirements for P.Keywords: nutrients, algae, photo, bioreactor
Procedia PDF Downloads 2133209 Sulfur Removal of Hydrocarbon Fuels Using Oxidative Desulfurization Enhanced by Fenton Process
Authors: Mahsa Ja’fari, Mohammad R. Khosravi-Nikou, Mohsen Motavassel
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A comprehensive development towards the production of ultra-clean fuels as a feed stoke is getting to raise due to the increasing use of diesel fuels and global air pollution. Production of environmental-friendly fuels can be achievable by some limited single methods and most integrated ones. Oxidative desulfurization (ODS) presents vast ranges of technologies possessing suitable characteristics with regard to the Fenton process. Using toluene as a model fuel feed with dibenzothiophene (DBT) as a sulfur compound under various operating conditions is the attempt of this study. The results showed that this oxidative process followed a pseudo-first order kinetics. Removal efficiency of 77.43% is attained under reaction time of 40 minutes with (Fe+2/H2O2) molar ratio of 0.05 in acidic pH environment. In this research, temperature of 50 °C represented the most influential role in proceeding the reaction.Keywords: design of experiment (DOE), dibenzothiophene (DBT), optimization, oxidative desulfurization (ODS)
Procedia PDF Downloads 2173208 Multi-Temporal Cloud Detection and Removal in Satellite Imagery for Land Resources Investigation
Authors: Feng Yin
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Clouds are inevitable contaminants in optical satellite imagery, and prevent the satellite imaging systems from acquiring clear view of the earth surface. The presence of clouds in satellite imagery bring negative influences for remote sensing land resources investigation. As a consequence, detecting the locations of clouds in satellite imagery is an essential preprocessing step, and further remove the existing clouds is crucial for the application of imagery. In this paper, a multi-temporal based satellite imagery cloud detection and removal method is proposed, which will be used for large-scale land resource investigation. The proposed method is mainly composed of four steps. First, cloud masks are generated for cloud contaminated images by single temporal cloud detection based on multiple spectral features. Then, a cloud-free reference image of target areas is synthesized by weighted averaging time-series images in which cloud pixels are ignored. Thirdly, the refined cloud detection results are acquired by multi-temporal analysis based on the reference image. Finally, detected clouds are removed via multi-temporal linear regression. The results of a case application in Hubei province indicate that the proposed multi-temporal cloud detection and removal method is effective and promising for large-scale land resource investigation.Keywords: cloud detection, cloud remove, multi-temporal imagery, land resources investigation
Procedia PDF Downloads 2783207 Adsorption of Toluene from Aqueous Solutions by Porous Clay Hetero-Structures
Authors: F. Asadi, M. M. Zerafat, S. Sabbaghi
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Among water pollutants, volatile organic compounds can cause severe long lasting effects not only on biotic organism but also on human health. As a result, this material group has attracted more attention in recent years. Adsorption is one of the common processes for remediation of aromatic compounds. In this study, porous clay hetrostructers (PCHs) are synthesized through gallery template approach and cetyltrimethylammonium bromide and dodecylamine used as template and co-template, respectively. Porous clay is characterized by XRD and FTIR. Batch adsorption experiments were carried out to investigate the effect of various adsorption parameters like adsorbent dosage, pH, initial concentration and contact time. It was found that by increasing adsorbent dosage from 0.5gr/lit to 4gr/lit, toluene removal is increased from 34% to 88.1%. Increasing contact time and decreasing the pH of aqueous solution increases toluene removal efficiency.Keywords: adsorption, clay, nano-porous, toluene
Procedia PDF Downloads 3383206 Craniopharyngiomas: Surgical Techniques: The Combined Interhemispheric Sub-Commissural Translaminaterminalis Approach to Tumors in and Around the Third Ventricle: Neurological and Functional Outcome
Authors: Pietro Mortini, Marco Losa
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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),
Procedia PDF Downloads 2933205 A Development of Practice Guidelines for Surgical Safety Management to Reduce Undesirable Incidents from Surgical Services in the Operating Room of Songkhla Hospital, Thailand
Authors: Thitima Plejai
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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room
Procedia PDF Downloads 2973204 Texturing of Tool Insert Using Femtosecond Laser
Authors: Ashfaq Khan, Aftab Khan, Mushtaq Khan, Sarem Sattar, Mohammad A Sheikh, Lin Li
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Chip removal processes are one of key processes of the manufacturing industry where chip removal is conducted by tool inserts of exceptionally hard materials. Tungsten carbide has been extensively used as tool insert for machining processes involving chip removal processes. These hard materials are generally fabricated by single step sintering process as further modification after fabrication in these materials cannot be done easily. Advances in tool surface modification have revealed that advantages such as improved tribological properties and extended tool life can be harnessed from the same tool by texturing the tool rake surface. Moreover, it has been observed that the shape and location of the texture also influences the behavior. Although texturing offers plentiful advantages the challenge lies in the generation of textures on the tool surface. Extremely hard material such as diamond is required to process tungsten carbide. Laser is unique processing tool that does not have a physical contact with the material and thus does not wear. In this research the potential of utilizing laser for texturing of tungsten carbide to develop custom features would be studied. A parametric study of texturing of Tungsten Carbide with a femtosecond laser would be conducted to investigate the process parameters and establish the feasible processing window. The effect of fluence, scan speed and number of repetition would be viewed in detail. Moreover, the mechanism for the generation of features would also be reviewed.Keywords: laser, texturing, femtosecond, tungsten carbide
Procedia PDF Downloads 6583203 Photocatalytic Oxidation of Gaseous Formaldehyde Using the TiO2 Coated SF Filter
Authors: Janjira Triped, Wipada Sanongraj, Wipawee Khamwichit
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The research work covered in this study includes the morphological structure and optical properties of TiO2-coated silk fibroin (SF) filters at 2.5% wt. TiO2/vol. PVA solution. SEM micrographs revealed the fibrous morphology of the TiO2-coated SF filters. An average diameter of the SF fiber was estimated to be approximately 10µm. Also, it was confirmed that TiO2 can be adhered more on SF filter surface at higher TiO2 dosages. The activity of semiconductor materials was studied by UV-VIS spectrophotometer method. The spectral data recorded shows the strong cut off at 390 nm. The calculated band-gap energy was about 3.19 eV. The photocatalytic activity of the filter was tested for gaseous formaldehyde removal in a modeling room with the total volume of 2.66 m3. The highest removal efficiency (54.72 ± 1.75%) was obtained at the initial formaldehyde concentration of about 5.00 ± 0.50ppm.Keywords: photocatalytic oxidation process, formaldehyde (HCHO), silk fibroin (SF), titanium dioxide (TiO2)
Procedia PDF Downloads 4693202 A One-Dimensional Model for Contraction in Burn Wounds: A Sensitivity Analysis and a Feasibility Study
Authors: Ginger Egberts, Fred Vermolen, Paul van Zuijlen
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One of the common complications in post-burn scars is contractions. Depending on the extent of contraction and the wound dimensions, the contracture can cause a limited range-of-motion of joints. A one-dimensional morphoelastic continuum hypothesis-based model describing post-burn scar contractions is considered. The beauty of the one-dimensional model is the speed; hence it quickly yields new results and, therefore, insight. This model describes the movement of the skin and the development of the strain present. Besides these mechanical components, the model also contains chemical components that play a major role in the wound healing process. These components are fibroblasts, myofibroblasts, the so-called signaling molecules, and collagen. The dermal layer is modeled as an isotropic morphoelastic solid, and pulling forces are generated by myofibroblasts. The solution to the model equations is approximated by the finite-element method using linear basis functions. One of the major challenges in biomechanical modeling is the estimation of parameter values. Therefore, this study provides a comprehensive description of skin mechanical parameter values and a sensitivity analysis. Further, since skin mechanical properties change with aging, it is important that the model is feasible for predicting the development of contraction in burn patients of different ages, and hence this study provides a feasibility study. The variability in the solutions is caused by varying the values for some parameters simultaneously over the domain of computation, for which the results of the sensitivity analysis are used. The sensitivity analysis shows that the most sensitive parameters are the equilibrium concentration of collagen, the apoptosis rate of fibroblasts and myofibroblasts, and the secretion rate of signaling molecules. This suggests that most of the variability in the evolution of contraction in burns in patients of different ages might be caused mostly by the decreasing equilibrium of collagen concentration. As expected, the feasibility study shows this model can be used to show distinct extents of contractions in burns in patients of different ages. Nevertheless, contraction formation in children differs from contraction formation in adults because of the growth. This factor has not been incorporated in the model yet, and therefore the feasibility results for children differ from what is seen in the clinic.Keywords: biomechanics, burns, feasibility, fibroblasts, morphoelasticity, sensitivity analysis, skin mechanics, wound contraction
Procedia PDF Downloads 1603201 Statistical Analysis for Overdispersed Medical Count Data
Authors: Y. N. Phang, E. F. Loh
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Many researchers have suggested the use of zero inflated Poisson (ZIP) and zero inflated negative binomial (ZINB) models in modeling over-dispersed medical count data with extra variations caused by extra zeros and unobserved heterogeneity. The studies indicate that ZIP and ZINB always provide better fit than using the normal Poisson and negative binomial models in modeling over-dispersed medical count data. In this study, we proposed the use of Zero Inflated Inverse Trinomial (ZIIT), Zero Inflated Poisson Inverse Gaussian (ZIPIG) and zero inflated strict arcsine models in modeling over-dispersed medical count data. These proposed models are not widely used by many researchers especially in the medical field. The results show that these three suggested models can serve as alternative models in modeling over-dispersed medical count data. This is supported by the application of these suggested models to a real life medical data set. Inverse trinomial, Poisson inverse Gaussian, and strict arcsine are discrete distributions with cubic variance function of mean. Therefore, ZIIT, ZIPIG and ZISA are able to accommodate data with excess zeros and very heavy tailed. They are recommended to be used in modeling over-dispersed medical count data when ZIP and ZINB are inadequate.Keywords: zero inflated, inverse trinomial distribution, Poisson inverse Gaussian distribution, strict arcsine distribution, Pearson’s goodness of fit
Procedia PDF Downloads 5423200 A Comparative Study of Simple and Pre-polymerized Fe Coagulants for Surface Water Treatment
Authors: Petros Gkotsis, Giorgos Stratidis, Manassis Mitrakas, Anastasios Zouboulis
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This study investigates the use of original and pre-polymerized iron (Fe) reagents compared to the commonly applied polyaluminum chloride (PACl) coagulant for surface water treatment. Applicable coagulants included both ferric chloride (FeCl₃) and ferric sulfate (Fe₂(SO₄)₃) and their pre-polymerized Fe reagents, such as polyferric sulfate (PFS) and polyferric chloride (PFCl). The efficiency of coagulants was evaluated by the removal of natural organic matter (NOM) and suspended solids (SS), which were determined in terms of reducing the UV absorption at 254 nm and turbidity, respectively. The residual metal concentration (Fe and Al) was also measured. Coagulants were added at five concentrations (1, 2, 3, 4 and 5 mg/L) and three pH values (7.0, 7.3 and 7.6). Experiments were conducted in a jar-test device, with two types of synthetic surface water (i.e., of high and low organic strength) which consisted of humic acid (HA) and kaolin at different concentrations (5 mg/L and 50 mg/L). After the coagulation/flocculation process, clean water was separated with filters of pore size 0.45 μm. Filtration was also conducted before the addition of coagulants in order to compare the ‘net’ effect of the coagulation/flocculation process on the examined parameters (UV at 254 nm, turbidity, and residual metal concentration). Results showed that the use of PACl resulted in the highest removal of humics for both types of surface water. For the surface water of high organic strength (humic acid-kaolin, 50 mg/L-50 mg/L), the highest removal of humics was observed at the highest coagulant dosage of 5 mg/L and at pH=7. On the contrary, turbidity was not significantly affected by the coagulant dosage. However, the use of PACl decreased turbidity the most, especially when the surface water of high organic strength was employed. As expected, the application of coagulation/flocculation prior to filtration improved NOM removal but slightly affected turbidity. Finally, the residual Fe concentration (0.01-0.1 mg/L) was much lower than the residual Al concentration (0.1-0.25 mg/L).Keywords: coagulation/flocculation, iron and aluminum coagulants, metal salts, pre-polymerized coagulants, surface water treatment
Procedia PDF Downloads 1543199 Investigating the Process Kinetics and Nitrogen Gas Production in Anammox Hybrid Reactor with Special Emphasis on the Role of Filter Media
Authors: Swati Tomar, Sunil Kumar Gupta
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Anammox is a novel and promising technology that has changed the traditional concept of biological nitrogen removal. The process facilitates direct oxidation of ammonical nitrogen under anaerobic conditions with nitrite as an electron acceptor without the addition of external carbon sources. The present study investigated the feasibility of anammox hybrid reactor (AHR) combining the dual advantages of suspended and attached growth media for biodegradation of ammonical nitrogen in wastewater. The experimental unit consisted of 4 nos. of 5L capacity AHR inoculated with mixed seed culture containing anoxic and activated sludge (1:1). The process was established by feeding the reactors with synthetic wastewater containing NH4-H and NO2-N in the ratio 1:1 at HRT (hydraulic retention time) of 1 day. The reactors were gradually acclimated to higher ammonium concentration till it attained pseudo steady state removal at a total nitrogen concentration of 1200 mg/l. During this period, the performance of the AHR was monitored at twelve different HRTs varying from 0.25-3.0 d with increasing NLR from 0.4 to 4.8 kg N/m3d. AHR demonstrated significantly higher nitrogen removal (95.1%) at optimal HRT of 1 day. Filter media in AHR contributed an additional 27.2% ammonium removal in addition to 72% reduction in the sludge washout rate. This may be attributed to the functional mechanism of filter media which acts as a mechanical sieve and reduces the sludge washout rate many folds. This enhances the biomass retention capacity of the reactor by 25%, which is the key parameter for successful operation of high rate bioreactors. The effluent nitrate concentration, which is one of the bottlenecks of anammox process was also minimised significantly (42.3-52.3 mg/L). Process kinetics was evaluated using first order and Grau-second order models. The first-order substrate removal rate constant was found as 13.0 d-1. Model validation revealed that Grau second order model was more precise and predicted effluent nitrogen concentration with least error (1.84±10%). A new mathematical model based on mass balance was developed to predict N2 gas in AHR. The mass balance model derived from total nitrogen dictated significantly higher correlation (R2=0.986) and predicted N2 gas with least error of precision (0.12±8.49%). SEM study of biomass indicated the presence of the heterogeneous population of cocci and rod shaped bacteria of average diameter varying from 1.2-1.5 mm. Owing to enhanced NRE coupled with meagre production of effluent nitrate and its ability to retain high biomass, AHR proved to be the most competitive reactor configuration for dealing with nitrogen laden wastewater.Keywords: anammox, filter media, kinetics, nitrogen removal
Procedia PDF Downloads 3823198 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study
Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker
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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation
Procedia PDF Downloads 1383197 Fabrication of Electrospun Carbon Nanofibers-Reinforced Chitosan-Based Hydrogel for Environmental Applications
Authors: Badr M. Thamer
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The use of hydrogels as adsorbents for pollutants removal from wastewater is limited due to their high swelling properties and the difficulty in recovering them after the adsorption process. To overcome these problems, a new hydrogel nanocomposite based on chitosan-g-polyacrylic acid/oxidized electrospun carbon nanofibers (CT-g-PAA/O-ECNFs) was prepared by in-situ grafting polymerization process. The prepared hydrogel nanocomposite was used as a novel effective and highly reusable adsorbent for the removal of methylene blue (MB) from polluted water with low cost. The morphology and the structure of CT-g-PAA/O-ECNFs were investigated by numerous techniques. The effect of incorporating O-ECNFs on the swelling capability of the prepared hydrogel was explored in distillated water and MB solution at normal pH. The effect of parameters including the ratio of O-ECNFs, contact time, pH, initial concentration, and temperature on the adsorption process were explored. The adsorption isotherm and kinetic were studied by numerous non-linear models. The obtained results confirmed that the incorporation of O-ECNFs into the hydrogel network improved its ability towards MB dye removal with decreasing their swelling capacity. The adsorption process depends on the pH value of the dye solution. Additionally, the adsorption and kinetic results were fitted using the Freundlich isotherm model and pseudo second order model (PSO), respectively. Moreover, the new adsorbents can be recycled for at least five cycles keeping its adsorption capacity and can be easily recovered without loss in its initial weight.Keywords: carbon nanofibers, hydrogels, nanocomposites, water treatment
Procedia PDF Downloads 1473196 Comparative Study of Outcome of Patients with Wilms Tumor Treated with Upfront Chemotherapy and Upfront Surgery in Alexandria University Hospitals
Authors: Golson Mohamed, Yasmine Gamasy, Khaled EL-Khatib, Anas Al-Natour, Shady Fadel, Haytham Rashwan, Haytham Badawy, Nadia Farghaly
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Introduction: Wilm's tumor is the most common malignant renal tumor in children. Much progress has been made in the management of patients with this malignancy over the last 3 decades. Today treatments are based on several trials and studies conducted by the International Society of Pediatric Oncology (SIOP) in Europe and National Wilm's Tumor Study Group (NWTS) in the USA. It is necessary for us to understand why do we follow either of the protocols, NWTS which follows the upfront surgery principle or the SIOP which follows the upfront chemotherapy principle in all stages of the disease. Objective: The aim of is to assess outcome in patients treated with preoperative chemotherapy and patients treated with upfront surgery to compare their effect on overall survival. Study design: to decide which protocol to follow, study was carried out on records for patients aged 1 day to 18 years old suffering from Wilm's tumor who were admitted to Alexandria University Hospital, pediatric oncology, pediatric urology and pediatric surgery departments, with a retrospective survey records from 2010 to 2015, Design and editing of the transfer sheet with a (PRISMA flow study) Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (11) Qualitative data were described using number and percent. Quantitative data were described using Range (minimum and maximum), mean, standard deviation and median. Comparison between different groups regarding categorical variables was tested using Chi-square test. When more than 20% of the cells have expected count less than 5, correction for chi-square was conducted using Fisher’s Exact test or Monte Carlo correction. The distributions of quantitative variables were tested for normality using Kolmogorov-Smirnov test, Shapiro-Wilk test, and D'Agstino test, if it reveals normal data distribution, parametric tests were applied. If the data were abnormally distributed, non-parametric tests were used. For normally distributed data, a comparison between two independent populations was done using independent t-test. For abnormally distributed data, comparison between two independent populations was done using Mann-Whitney test. Significance of the obtained results was judged at the 5% level. Results: A significantly statistical difference was observed for survival between the two studied groups favoring the upfront chemotherapy(86.4%)as compared to the upfront surgery group (59.3%) where P=0.009. As regard complication, 20 cases (74.1%) out of 27 were complicated in the group of patients treated with upfront surgery. Meanwhile, 30 cases (68.2%) out of 44 had complications in patients treated with upfront chemotherapy. Also, the incidence of intraoperative complication (rupture) was less in upfront chemotherapy group as compared to upfront surgery group. Conclusion: Upfront chemotherapy has superiority over upfront surgery.As the patient who started with upfront chemotherapy shown, higher survival rate, less percent in complication, less percent needed for radiotherapy, and less rate in recurrence.Keywords: Wilm's tumor, renal tumor, chemotherapy, surgery
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