Search results for: extra skin removal surgery

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

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Authors: Farida Eid, Hala Nasseif, Hana Mokhtar, Labib Riachi, Mudhar Hasan

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Bladder Endometriosis is a rare form of endometriosis and is defined as the presence of endometriotic tissue in the detrusor muscle of the bladder, either in full or partial thickness. Women typically present with dysuria, urinary frequency, hematuria, and recurrent urinary tract infections. Bladder endometriosis is typically found at the bladder base and bladder dome. Transvaginal ultrasound is considered first-line imaging, and the condition is typically managed with laparoscopic partial cystectomy. A 33-year-old nulliparous woman presented with chronic pelvic pain, severe dysmenorrhea, and metrorrhagia. The patient was previously diagnosed with bladder endometriomas two years ago with multiple recurrences. MRI revealed urinary bladder endometriosis measuring 3 x 2 x 1.5 cm. Accordingly, the patient underwent a cystoscopy-guided robotic-assisted excision of the endometriotic implant in the bladder with cystotomy and repair of the bladder mucosa. The operation was tolerated well, and the postoperative period was uneventful. Bladder Endometriosis (BE) typically presents with urinary symptoms and can be mistaken for a bladder tumor upon further imaging. The case was successfully managed with cystoscopy-guided, robotic-assisted excision and fulguration of the endometriotic implant in the bladder.

Keywords: endometriosis, bladder endometriosis (BE), urinary tract endometriosis (UTE), robotic-assisted surgery

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Ebtesam Dessouki, Yasaman Mousavi

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Christopher Nolan’s Dunkirk (2017) is not a conventional war film. He invites the audience to see the war from within, from the characters’ experiences, through suspense and fear, with the help of talented sound designers and musicians such as Hans Zimmer for an extra dimension creating those feelings. This experience of being among the surviving soldiers makes room for an interpretation of this film using the concept of the Self and the Other. The Self is the soldiers and the audience who try to make sense of their reality given limited information about the enemy and their situation, and the Other is the faceless enemy. However, this film can be taken under an even more detailed analysis theorizing that the Other also exists on different occasions in the film. Overall, Nolan leaves a lot of cues for the audience to track the Other and sometimes breaks the rules for the Other.

Keywords: film, Dunkirk, other, self

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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

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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

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Authors: Hanish Mohammed, C. H. Muthukumar Muthuchamy

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The advancement in the science and technology has made it possible to convert electrical energy into any desired form. It has given electrical energy a place of pride in the modern world. The survival of industrial undertakings and our social structure depends primarily upon low cost and uninterrupted supply of electrical energy. Microbial fuel cell (MFC) is a promising and emerging technique for sustainable bioelectricity generation and wastewater treatment. MFCs are devices which are capable of converting organic matter to electricity/hydrogen with help of microorganisms. Different kinds of wastewater could be used in this technique, distillery effluent is one of the most troublesome and complex and strong organic effluent with high chemical oxygen demand of 1,53,846 mg/L. A single cell MFC unit was designed and fabricated for the distillery effluent treatment and to generate electricity. Due to the high COD value of the distillery effluent helped in the production of energy for 74 days. The highest voltage got from the fuel cell is 206 mV on the 30th day. A maximum power density obtained from the MFC was 9.8 mW, treatment efficiency was evaluated in terms of COD removal and other parameters. COD removal efficiencies were around 68.5 % and other parameters such as Total Hardness (81.5%), turbidity (70 %), chloride (66%), phosphate (79.5%), Nitrate (77%) and sulphate (71%). MFC using distillery effluent is a promising new unexplored substrate for the power generation and sustainable treatment technique through harnessing of bioelectricity.

Keywords: microbial fuel cell (MFC), bioelectricity, distillery effluent, wastewater treatment

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Authors: V. Ibujes, A. Guevara, P. Barreto

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Concentration of arsenic represents a serious threat to human health. It is a bioaccumulable toxic element and is transferred through the food chain. In Ecuador, values of 0.0423 mg/kg As are registered in potatoes of the skirts of the Tungurahua volcano. The increase of arsenic contamination in Ecuador is mainly due to mining activity, since the process of gold extraction generates toxic tailings with mercury. In the Province of Azuay, due to the mining activity, the soil reaches concentrations of 2,500 to 6,420 mg/kg As whereas in the province of Tungurahua it can be found arsenic concentrations of 6.9 to 198.7 mg/kg due to volcanic eruptions. Since the contamination by arsenic, the present investigation is directed to the remediation of the soils in the provinces of Azuay and Tungurahua by phytoremediation technique and the definition of a methodology of extraction by means of analysis of arsenic in the system soil-plant. The methodology consists in selection of two types of plants that have the best arsenic removal capacity in synthetic solutions 60 μM As, a lower percentage of mortality and hydroponics resistance. The arsenic concentrations in each plant were obtained from taking 10 ml aliquots and the subsequent analysis of the ICP-OES (inductively coupled plasma-optical emission spectrometry) equipment. Soils were contaminated with synthetic solutions of arsenic with the capillarity method to achieve arsenic concentration of 13 and 15 mg/kg. Subsequently, two types of plants were evaluated to reduce the concentration of arsenic in soils for 7 weeks. The global variance for soil types was obtained with the InfoStat program. To measure the changes in arsenic concentration in the soil-plant system, the Rhizo and Wenzel arsenic extraction methodology was used and subsequently analyzed with the ICP-OES (optima 8000 Pekin Elmer). As a result, the selected plants were bluegrass and llanten, due to the high percentages of arsenic removal of 55% and 67% and low mortality rates of 9% and 8% respectively. In conclusion, Azuay soil with an initial concentration of 13 mg/kg As reached the concentrations of 11.49 and 11.04 mg/kg As for bluegrass and llanten respectively, and for the initial concentration of 15 mg/kg As reached 11.79 and 11.10 mg/kg As for blue grass and llanten after 7 weeks. For the Tungurahua soil with an initial concentration of 13 mg/kg As it reached the concentrations of 11.56 and 12.16 mg/kg As for the bluegrass and llanten respectively, and for the initial concentration of 15 mg/kg As reached 11.97 and 12.27 mg/kg Ace for bluegrass and llanten after 7 weeks. The best arsenic extraction methodology of soil-plant system is Wenzel.

Keywords: blue grass, llanten, phytoremediation, soil of Azuay, soil of Tungurahua, synthetic arsenic solution

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Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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Authors: Nixon Kuruvila, H. V. Ravindra

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Wire-cut Electro Discharge Machining (WEDM) is a special form of conventional EDM process in which electrode is a continuously moving conductive wire. The present study aims at determining parametric influence and optimum process parameters of Wire-EDM using Taguchi’s Technique and Genetic algorithm. The variation of the performance parameters with machining parameters was mathematically modeled by Regression analysis method. The objective functions are Dimensional Accuracy (DA) and Material Removal Rate (MRR). Experiments were designed as per Taguchi’s L16 Orthogonal Array (OA) where in Pulse-on duration, Pulse-off duration, Current, Bed-speed and Flushing rate have been considered as the important input parameters. The matrix experiments were conducted for the material Oil Hardened Non Shrinking Steel (OHNS) having the thickness of 40 mm. The results of the study reveals that among the machining parameters it is preferable to go in for lower pulse-off duration for achieving over all good performance. Regarding MRR, OHNS is to be eroded with medium pulse-off duration and higher flush rate. Finally, the validation exercise performed with the optimum levels of the process parameters. The results confirm the efficiency of the approach employed for optimization of process parameters in this study.

Keywords: dimensional accuracy (DA), regression analysis (RA), Taguchi method (TM), volumetric material removal rate (VMRR)

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Authors: Sahar Abbaszadeh, Sharifah Rafidah Wan Alwi, Colin Webb, Nahid Ghasemi, Ida Idayu Muhamad

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Toxic heavy metal discharges into environment due to rapid industrialization is a serious pollution problem that has drawn global attention towards their adverse impacts on both the structure of ecological systems as well as human health. Lead as toxic and bio-accumulating elements through the food chain, is regularly entering to water bodies from discharges of industries such as plating, mining activities, battery manufacture, paint manufacture, etc. The application of conventional methods to degrease and remove Pb(II) ion from wastewater is often restricted due to technical and economic constrains. Therefore, the use of various agro-wastes as low-cost bioadsorbent is found to be attractive since they are abundantly available and cheap. In this study, activated carbon of papaya peel (AC-PP) (as locally available agricultural waste) was employed to evaluate its Pb(II) uptake capacity from single-solute solutions in sets of batch mode experiments. To assess the surface characteristics of the adsorbents, the scanning electron microscope (SEM) coupled with energy disperse X-ray (EDX), and Fourier transform infrared spectroscopy (FT-IR) analysis were utilized. The removal amount of Pb(II) was determined by atomic adsorption spectrometry (AAS). The effects of pH, contact time, the initial concentration of Pb(II) and adsorbent dosage were investigated. The pH value = 5 was observed as optimum solution pH. The optimum initial concentration of Pb(II) in the solution for AC-PP was found to be 200 mg/l where the amount of Pb(II) removed was 36.42 mg/g. At the agitating time of 2 h, the adsorption processes using 100 mg dosage of AC-PP reached equilibrium. The experimental results exhibit high capability and metal affinity of modified papaya peel waste with removal efficiency of 93.22 %. The evaluation results show that the equilibrium adsorption of Pb(II) was best expressed by Freundlich isotherm model (R2 > 0.93). The experimental results confirmed that AC-PP potentially can be employed as an alternative adsorbent for Pb(II) uptake from industrial wastewater for the design of an environmentally friendly yet economical wastewater treatment process.

Keywords: activated carbon, bioadsorption, lead removal, papaya peel, wastewater treatment

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Authors: H. Mokaddem, D. Miroud, N. Azouaou, F. Si-Ahmed, Z. Sadaoui

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The synthesis and characterization of activated carbon from local lignocellulosic precursor (Algerian alfa) was carried out for the removal of cationic dyes from aqueous solutions. The effect of the production variables such as impregnation chemical agents, impregnation ratio, activation temperature and activation time were investigated. Carbon obtained using the optimum conditions (CaCl2/ 1:1/ 500°C/2H) was characterized by various analytical techniques scanning electron microscopy (SEM), infrared spectroscopic analysis (FTIR) and zero-point-of-charge (pHpzc). Adsorption tests of methylene blue on the optimal activated carbon were conducted. The effects of contact time, amount of adsorbent, initial dye concentration and pH were studied. The adsorption equilibrium examined using Langmuir, Freundlich, Temkin and Redlich–Peterson models reveals that the Langmuir model is most appropriate to describe the adsorption process. The kinetics of MB sorption onto activated carbon follows the pseudo-second order rate expression. The examination of the thermodynamic analysis indicates that the adsorption process is spontaneous (ΔG ° < 0) and endothermic (ΔH ° > 0), the positive value of the standard entropy shows the affinity between the activated carbon and the dye. The present study showed that the produced optimal activated carbon prepared from Algerian alfa is an effective low-cost adsorbent and can be employed as alternative to commercial activated carbon for removal of MB dye from aqueous solution.

Keywords: activated carbon, adsorption, cationic dyes, Algerian alfa

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Authors: Kishor Prasad Bhatta, Suman Ghimire, Durga Prasad Joshi

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Invasive Alien Species (IAS) are considered waste forest resources in Nepal. The rapid expansion of IAS is one of the nine main drivers of forest degradation, though the extent and distribution of this species are not well known. Further, the knowledge of the impact of IAS removal on forest plant diversity is hardly known, and the possibilities of income generation from them at the grass-root communities are rarely documented. Systematic sampling of 1% with nested circular plots of 500 square meters was performed in IAS removed and non-removed area, each of 30 hectares in Udayapur Community Forest User Group (CFUG), Chitwan, central Nepal to observe whether the removal of IAS contributed to an increase in plant diversity. In addition, ten entrepreneurs of Udaypur CFUG, involved in the charcoal production, briquette making and marketing were interviewed and interacted as well as their record keeping booklets were reviewed to understand if the charcoal production contributed to their income and employment. The average annual precipitation and temperature of the study area is 2100 mm and 34 degree Celsius respectively with Shorea robusta as main tree species and Eupatorium odoratum as dominant IAS. All the interviewed households were from the ̔below-poverty-line’ category as per Community Forestry Guidelines. A higher Shannon-Weiner plant diversity index at regeneration level was observed in IAS removed areas (2.43) than in control site (1.95). Furthermore, the number of tree seedlings and saplings in the IAS harvested blocks were significantly higher (p < 0.005) compared to the unharvested one. The sale of charcoal produced through the pyrolysis of IAS in ̔ Bio-energy kilns’ contributed for an average increased income of 30.95 % (Nepalese rupees 31,000) of the involved households. Despite above factors, some operational policy hurdles related to charcoal transport and taxation existed at field level. This study suggests that plant diversity could be increased through the removal of IAS, and considerable economic benefits could be achieved if charcoal is substantially produced and utilized.

Keywords: briquette, economic benefits, pyrolysis, regeneration

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Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

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The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

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Authors: E. Fabre, C. Vale, E. Pereira, C. M. Silva

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Introduction: Mercury is one of the most troublesome toxic metals responsible for the contamination of the aquatic systems due to its accumulation and bioamplification along the food chain. The 2030 agenda for sustainable development of United Nations promotes the improving of water quality by reducing water pollution and foments an enhance in wastewater treatment, encouraging their recycling and safe water reuse globally. Sorption processes are widely used in wastewater treatments due to their many advantages such as high efficiency and low operational costs. In these processes the target contaminant is removed from the solution by a solid sorbent. The more selective and low cost is the biosorbent the more attractive becomes the process. Agricultural wastes are especially attractive approaches for sorption. They are largely available, have no commercial value and require little or no processing. In this work, banana peels were tested for mercury removal from low concentrated solutions. In order to investigate the applicability of this solid, six water matrices were used increasing the complexity from natural waters to a real wastewater. Studies of kinetics and equilibrium were also performed using the most known models to evaluate the viability of the process In line with the concept of circular economy, this study adds value to this by-product as well as contributes to liquid waste management. Experimental: The solutions were prepared with Hg(II) initial concentration of 50 µg L-1 in natural waters, at 22 ± 1 ºC, pH 6, magnetically stirring at 650 rpm and biosorbent mass of 0.5 g L-1. NaCl was added to obtain the salt solutions, seawater was collected from the Portuguese coast and the real wastewater was kindly provided by ISQ - Instituto de Soldadura e qualidade (Welding and Quality Institute) and diluted until the same concentration of 50 µg L-1. Banana peels were previously freeze-drying, milled, sieved and the particles < 1 mm were used. Results: Banana peels removed more than 90% of Hg(II) from all the synthetic solutions studied. In these cases, the enhance in the complexity of the water type promoted a higher mercury removal. In salt waters, the biosorbent showed removals of 96%, 95% and 98 % for 3, 15 and 30 g L-1 of NaCl, respectively. The residual concentration of Hg(II) in solution achieved the level of drinking water regulation (1 µg L-1). For real matrices, the lower Hg(II) elimination (93 % for seawater and 81 % for the real wastewaters), can be explained by the competition between the Hg(II) ions and the other elements present in these solutions for the sorption sites. Regarding the equilibrium study, the experimental data are better described by the Freundlich isotherm (R ^ 2=0.991). The Elovich equation provided the best fit to the kinetic points. Conclusions: The results exhibited the great ability of the banana peels to remove mercury. The environmental realist conditions studied in this work, highlight their potential usage as biosorbents in water remediation processes.

Keywords: banana peels, mercury removal, sorption, water treatment

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

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Authors: Vidya Pratap, Seena Biju, Keshavdev A.

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In the educational town of Manipal (located in southern India) households dispose their wastes without segregation. Mixed wastes (organic, inorganic and hazardous items) are collected either by private collectors or by the local municipal body in trucks and taken to dump yards. These collectors select certain recyclables from the collected trash and sell them to scrap merchants to earn some extra money. Rag pickers play a major role in picking up card board boxes, glass bottles and milk sachets from dump yards and public areas and scrap iron from construction sites for recycling. In keeping with the Indian Prime Minister’s mission of Swachh Bharat (A Clean India), the local municipal administration is taking efforts to ensure segregation of domestic waste at source. With this in mind, each household in a residential area in Manipal was given two buckets – for wet and dry wastes (wet waste referred to organic waste while dry waste included recyclable and hazardous items). A study was conducted in this locality covering a cluster of 145 households to assess the residents’ knowledge of recyclable, organic and hazardous items commonly disposed by households. Another objective of this research was to evaluate the extent to which the residents actually dispose their wastes appropriately. Questionnaires were self-administered to a member of each household with the assistance of individuals speaking the local language whenever needed. Respondents’ knowledge of whether an item was organic, inorganic or hazardous was captured through a questionnaire containing a list of 50 common items. Their behaviour was captured by asking how they disposed these items. Results show that more than 70% of respondents are aware that banana and orange peels, potato skin, egg shells and dried leaves are organic; similarly, more than 70% of them consider newspapers, notebook and printed paper are recyclable. Less than 65% of respondents are aware that plastic bags and covers and plastic bottles are recyclable. However, the results of the respondents’ recycling behaviour is less impressive. Fewer than 35% of respondents recycle card board boxes, milk sachets and glass bottles. Unfortunately, since plastic items like plastic bags and covers and plastic bottles are not accepted by scrap merchants, they are not recycled. This study shows that the local municipal authorities must find ways to recycle plastic into products, alternate fuel etc.

Keywords: behaviour, knowledge, plastic waste management, recyclables

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Authors: Tobias Schmithuesen, Johannes Henrich Schleifenbaum

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The additive manufacturing process laser powder bed fusion offers many advantages over conventional manufacturing processes. For example, almost any complex part can be produced, such as topologically optimized lightweight parts, which would be inconceivable with conventional manufacturing processes. A major challenge posed by the LPBF process, however, is, in most cases, the need to use and remove support structures on critically inclined part surfaces (α < 45 ° regarding substrate plate). These are mainly used for dimensionally accurate mapping of part contours and to reduce distortion by absorbing process-related internal stresses. Furthermore, they serve to transfer the process heat to the substrate plate and are, therefore, indispensable for the LPBF process. A major challenge for the economical use of the LPBF process in industrial process chains is currently still the high manual effort involved in removing support structures. According to the state of the art (SoA), the parts are usually treated by simple hand tools (e.g., pliers, chisels) or by machining (e.g., milling, turning). New automatable approaches are the removal of support structures by means of wet chemical ablation and thermal deburring. According to the state of the art, the support structures are essentially adapted to the LPBF process and not to potential post-processing steps. The aim of this study is the determination of support structure designs that are adapted to the mentioned post-processing approaches. In the first step, the essential boundary conditions for complete removal by means of the respective approaches are identified. Afterward, a representative demonstrator part with various macroscopic support structure designs will be LPBF-manufactured and tested with regard to a complete powder and support removability. Finally, based on the results, potentially suitable support structure designs for the respective approaches will be derived. The investigations are carried out on the example of the aluminum alloy AlSi10Mg.

Keywords: additive manufacturing, laser powder bed fusion, laser beam melting, selective laser melting, post processing, tool-free, wet chemical ablation, thermal deburring, aluminum alloy, AlSi10Mg

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Authors: D. M. Cocârță, I. A. Istrate, C. Streche, D. M. Dumitru

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Soil contamination phenomena are a wide world issue that has received the important attention in the last decades. The main pollutants that have affected soils are especially those resulted from the oil extraction, transport and processing. This paper presents results obtained in the framework of a research project focused on the management of contaminated sites with petroleum products/ REMPET. One of the specific objectives of the REMPET project was to assess the electrochemical treatment (improved with polarity change respect to the typical approach) as a treatment option for the remediation of total petroleum hydrocarbons (TPHs) from contaminated soils. Petroleum hydrocarbon compounds attach to soil components and are difficult to remove and degrade. Electrochemical treatment is a physicochemical treatment that has gained acceptance as an alternative method, for the remediation of organic contaminated soils comparing with the traditional methods as bioremediation and chemical oxidation. This type of treatment need short time and have high removal efficiency, being usually applied in heterogeneous soils with low permeability. During the experimental tests, the following parameters were monitored: pH, redox potential, humidity, current intensity, energy consumption. The electrochemical method was applied in an experimental setup with the next dimensions: 450 mm x 150 mm x 150 mm (L x l x h). The setup length was devised in three electrochemical cells that were connected at two power supplies. The power supplies configuration was provided in such manner that each cell has a cathode and an anode without overlapping. The initial value of TPH concentration in soil was of 1420.28 mg/kg_dw. The remediation method has been applied for only 21 days, when it was already noticed an average removal efficiency of 31 %, with better results in the anode area respect to the cathode one (33% respect to 27%). The energy consumption registered after the development of the experiment was 10.6 kWh for exterior power supply and 16.1 kWh for the interior one. Taking into account that at national level, the most used methods for soil remediation are bioremediation (which needs too much time to be implemented and depends on many factors) and thermal desorption (which involves high costs in order to be implemented), the study of electrochemical treatment will give an alternative to these two methods (and their limitations).

Keywords: electrochemical remediation, pollution, total petroleum hydrocarbons, soil contamination

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Authors: Chao Ding, Jun Shi, Huiping Deng

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This study reports the preparation of a new type yeast-chitosan bio-microcapsule coating sodium alginate and chitosan, with good biocompatibility and mechanical strength. Focusing on the optimum preparation conditions of bio-microcapsule, a dynamic test of yeast-chitosan bio-microcapsule combined with ultrafiltration membrane was established to evaluate both the removal efficiency of major pollutants from raw water and the applicability of this system. The results of orthogonal experiments showed that the optimum preparation procedure are as follows: mix sodium alginate solution (3%) with bacteria liquid in specific proportion, drop in calcium chloride solution (4%) and solidify for 30 min; put the plastic beads into chitosan liquid (1.8%) to overlay film for 10 min and then into glutaraldehyde solution (1%) to get cross-linked for 5 min. In dynamic test, the microcapsules were effective as soon as were added in the system, without any start-up time. The removal efficiency of turbidity, ammonia nitrogen and organic matter was 60%, 80%, and 40%. Besides, the bio-microcapsules were prospective adsorbent for heavy metal; they adsorb Pb and Cr⁶⁺ in water while maintaining high biological activity to degrade ammonia nitrogen and small molecular organics through assimilation. With the presence of bio-microcapsules, the internal yeast strains’ adaptability on the external environment and resistance ability on toxic pollutants will be increased.

Keywords: ammonia nitrogen, bio-microcapsules, ultrafiltration membrane, yeast-chitosan

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Authors: Victor R. Thulari, John Akach, Haleden Chiririwa, Aoyi Ochieng

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Solar-light activated titanium dioxide photocatalysts were prepared by hydrolysis of titanium (IV) isopropoxide with thiourea, followed by calcinations at 450 °C. The experiments demonstrated that methyl orange in aqueous solutions were successfully degraded under solar light using doped TiO₂. The photocatalytic oxidation of a mono azo methyl-orange dye has been investigated in multi ion doped TiO₂ and solar light. Solutions were irradiated by solar-light until high removal was achieved. It was found that there was no degradation of methyl orange in the dark and in the absence of TiO₂. Varieties of laboratory prepared TiO₂ catalysts both un-doped and doped using titanium (IV) isopropoxide and thiourea as a dopant were tested in order to compare their photoreactivity. As a result, it was found that the efficiency of the process strongly depends on the working conditions. The highest degradation rate of methyl orange was obtained at optimum dosage using commercially produced TiO₂. Our work focused on laboratory synthesized catalyst and the maximum methyl orange removal was achieved at 81% with catalyst loading of 0.04 g/L, initial pH of 3 and methyl orange concentration of 0.005 g/L using multi-ion doped catalyst. The kinetics of photocatalytic methyl orange dye stuff degradation was found to follow a pseudo-first-order rate law. The presence of the multi-ion dopant (thiourea) enhanced the photoefficiency of the titanium dioxide catalyst.

Keywords: degradation, kinetics, methyl orange, photocatalysis

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Authors: Farid Risheq, M. Zaid Alrisheq, Shuaa Al-Sadoon, Karim Al-Faqih, Mays Abdulazeez

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Breast cancer is the most frequently diagnosed cancer worldwide, and a common cause of death among women. Various conventional anatomical imaging tools are utilized for diagnosis, histological assessment and TNM (Tumor, Node, Metastases) staging of breast cancer. Biopsy of sentinel lymph node is becoming an alternative to the axillary lymph node dissection. Advances in 18-Fluoro-Deoxi-Glucose Positron Emission Tomography/Computed Tomography (18FDG-PET/CT) imaging have facilitated breast cancer diagnosis utilizing biological trapping of 18FDG inside lesion cells, expressed as Standardized Uptake Value (SUVmax). Objective: To present the utility of 18FDG uptake PET/CT scans in detecting active extra lymph nodes and distant occult metastases for breast cancer staging. Subjects and Methods: Four female patients were presented with initially classified TNM stages of breast cancer based on conventional anatomical diagnostic techniques. 18FDG-PET/CT scans were performed one hour post 18FDG intra-venous injection of (300-370) MBq, and (7-8) bed/130sec. Transverse, sagittal, and coronal views; fused PET/CT and MIP modality were reconstructed for each patient. Results: A total of twenty four lesions in breast, extended lesions to lung, liver, bone and active extra lymph nodes were detected among patients. The initial TNM stage was significantly changed post 18FDG-PET/CT scan for each patient, as follows: Patient-1: Initial TNM-stage: T1N1M0-(stage I). Finding: Two lesions in right breast (3.2cm2, SUVmax=10.2), (1.8cm2, SUVmax=6.7), associated with metastases to two right axillary lymph nodes. Final TNM-stage: T1N2M0-(stage II). Patient-2: Initial TNM-stage: T2N2M0-(stage III). Finding: Right breast lesion (6.1cm2, SUVmax=15.2), associated with metastases to right internal mammary lymph node, two right axillary lymph nodes, and sclerotic lesions in right scapula. Final TNM-stage: T2N3M1-(stage IV). Patient-3: Initial TNM-stage: T2N0M1-(stage III). Finding: Left breast lesion (11.1cm2, SUVmax=18.8), associated with metastases to two lymph nodes in left hilum, and three lesions in both lungs. Final TNM-stage: T2N2M1-(stage IV). Patient-4: Initial TNM-stage: T4N1M1-(stage III). Finding: Four lesions in upper outer quadrant area of right breast (largest: 12.7cm2, SUVmax=18.6), in addition to one lesion in left breast (4.8cm2, SUVmax=7.1), associated with metastases to multiple lesions in liver (largest: 11.4cm2, SUV=8.0), and two bony-lytic lesions in left scapula and cervicle-1. No evidence of regional or distant lymph node involvement. Final TNM-stage: T4N0M2-(stage IV). Conclusions: Our results demonstrated that 18FDG-PET/CT scans had significantly changed the TNM stages of breast cancer patients. While the T factor was unchanged, N and M factors showed significant variations. A single session of PET/CT scan was effective in detecting active extra lymph nodes and distant occult metastases, which were not identified by conventional diagnostic techniques, and might advantageously replace bone scan, and contrast enhanced CT of chest, abdomen and pelvis. Applying 18FDG-PET/CT scan early in the investigation, might shorten diagnosis time, helps deciding adequate treatment protocol, and could improve patients’ quality of life and survival. Trapping of 18FDG in malignant lesion cells, after a PET/CT scan, increases the retention index (RI%) for a considerable time, which might help localize sentinel lymph node for biopsy using a hand held gamma probe detector. Future work is required to demonstrate its utility.

Keywords: axillary lymph nodes, breast cancer staging, fluorodeoxyglucose positron emission tomography/computed tomography, lymph nodes

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Authors: Jia Yin Tan, Daniel Rambei, Kate Mann, Samuel price, Ahmed Aboelela

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Introduction: Breastfeeding is a complex process, influenced by various factors. Tongue-tie may lead to breastfeeding difficulties due to an inability to suck effectively, causing sore nipples and poor infant weight gain. In the UK, most frenotomies on infants are performed by doctors, nurses, health visitors or midwives. Objectives: Evaluation of safety and efficacy of a multispecialty nurse-led rapid access tongue-tie service at Sheffield Children’s Hospital, run jointly by the ENT and paediatric surgery departments. Methodology: A retrospective observational study, including all patients attending the ENT and paediatric surgery nurse-led tongue tie clinics between 1/10/2021 and 30/09/2022. Results: During the study period there were 1135 referrals for frenotomy, with a mean of 15 days between referral to clinic episode. 86.8% of referred patients underwent frenotomy, with a complication rate of 0.1% and revision rate of 5.4%. Conclusions: Our findings suggest that our rapid access nurse-led outpatient tongue tie service is safe and efficacious, with low complication and revision rates. This suggests a potential for developing a community-based service, allowing safe and effective care closer to home.

Keywords: tongue tie, frenotomy, cost, nurse-led

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Authors: Onur Karaman, Ceren Karaman

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In this study, the adsorption of Methylene Blue (MB), a cationic dye, onto Orange Peel Derived Activated Carbon (OPAC) and chitosan(OPAC/Chitosan composite) composite (a low-cost absorbent) was carried out using a batch system. The composite was characterised using IR spectra, XRD, FESEM and Pore size studies. The effects of initial pH, adsorbent dose rate and initial dye concentration on the initial adsorption rate, capacity and dye removal efficiency were investigated. The Langmuir and Freundlich adsorption models were used to define the adsorption equilibrium of dye-adsorbent system mathematically and it was decided that the Langmuir model was more suitable to describe the adsorption equilibrium for the system. In addition, first order, second order and saturation type kinetic models were applied to kinetic data of adsorption and kinetic constants were calculated. It was concluded that the second order and the saturation type kinetic models defined the adsorption data more accurately. Finally, the evaluated thermodynamic parameters of adsorption show a spontaneous and exothermic behavior. Overall, this study indicates OPAC/Chitosan composite as an effective and low-cost adsorbent for the removal of MB dye from aqueous solutions.

Keywords: activated carbon, adsorption, chitosan, methylene blue, orange peel

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Authors: Pei-Shan Liang

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Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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Authors: Arundhuti Devi, Gitumani Devi, Krishna G. Bhattacharyya

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The goal of this study was to assess the characteristics of the airborne dust created by opencast coal mining and its relation to population hospitalization risk for skin and lung diseases in Margherita Coalfield, Assam, India. Air samples were collected for 24 h in three 8-h periods. For the collection of particulate matter (PM10) and total suspended particulate matter (SPM) samples, respiratory dust samplers with glass microfiber filter papers were used. PM10 was analyzed for Cu, Cd, Cr, Mn, Zn, Ni, Fe and Pb with Flame Atomic Absorption Spectrophotometer (FAAS). SPM and PM10 concentrations were respectively found to be as high as 1,035 and 265.85 μg/m³ in work zone air. The concentration of metals associated with PM10 showed values higher than the permissible limits. It was observed that the average concentrations of the metals Fe, Pb, Ni, Zn, and Cu were very high during the winter month of December, those of Cd and Cr were high during the month of May and Mn was high during February. The morphology of the particles studied with scanning electron microscopy (SEM) gave significant results. Due to opencast coal mining, the air in the work zone, as well as the general ambient air, was found to be highly polluted with respect to dust. More than 8000 patient records maintained by the hospital authority were collected from three hospitals in the area. The highest percentage of people suffering from lung diseases are found in Margherita Civil Hospital (~26.77%) whereas most people suffering from skin diseases reported for treatment in the ESIC hospital (47.47%). Both PM10 and SPM were alarmingly high, and the results were in conformity with the high incidence of lung and other respiratory diseases in the study area.

Keywords: heavy metals, open cast coal mining, PM10, respiratory diseases

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Authors: Özgür Bahadir, Meltem Kurtuncu

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The study was designed as quasi-experimental and conducted to determine the effect of music therapy on anxiety, fear and pain management in 6-12-year-old children undergoing surgery. The present study was carried out between 01.01.2016 and 19.08.2016 in BEU. Application and Research Center. The children aged 6 -12 who applied for surgery between the mentioned dates constituted the universe of the study. In the quasi-experimental study that was conducted in the clinics where children received operational treatment, two groups were formed: experimental group (the children who received musical therapy before the surgery) and control group (the children who were administered surveys and the surgery service routines only). Each group consisted of 30 children, and the participants of the study were 60 children in total. Necessary permissions were obtained from the parents of the children hospitalized before the beginning of the implementation. The data was collected through Child Anxiety Sensitivity Index (CASI), “Fear In Medical Treatment Scale”, Face, Legs, Activity, Cry, Consolability Scale (FLACC), Visual Analog Scale (VAS) and Participant Information Form. In the analysis of the data, Kolmogorov-Smirnov distribution scale was used to examine the normality of the distribution along with descriptive statistics methods (Frequency, Percentage, Mean, Standard Deviation). Data was presented in the tables in numbers and percentages. Means were demonstrated along with the standard deviations. The research compared children received; case and control groups include socio-demographic perspective, non-significant difference statistically among similar groups are intertwined. The general level of fear regarding the medical processes before returning to service after the operation and 30 minutes before getting discharged was found to be significantly low in the experimental group compared to control group (p<0.05). No statistically significant difference was found between experimental and control groups in terms of general level of fear regarding the medical processes before the operation, during the operation day and in the recovery room after the operation (p>0.05). Total CASI AD (anxiety sensitivity) levels before the operation, day of the operation and 30 minutes before the discharge for patients in experimental group was found to be significantly higher than the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in the total CASI AD levels for the post-operative recovery room and for returning to the service room after the operation (p>0.05). VAS levels for patients in the experimental group in the post-operative recovery room was significantly higher than the control group (p>0.05). There was no statistically significant difference between the groups in terms of VAS findings in returning to service room after the operation and in 30 minutes before the discharge (p>0.05). As a result of the research; applied children music therapy in the experimental group anxiety, fear, and pain of the scales, their scores average, is lower than the control group children in this situation an increase in the satisfaction of children and parents was observed. In line with this, music therapy preoperative anxiety, fear, and can be used as an effective method of decreasing postoperative pain clinics is suggested.

Keywords: anxiety, children, fear, music therapy, pain

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Authors: T. R. Sreekrishnan, Mukesh Khare, Dinesh Upadhyay

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In a Rotating Biological Contactor (RBC), the biological film responsible for removal of pollutants is formed on the surface of discs. Evaluation studies of a pilot RBC designed to treat sewage of 150 persons with BOD Loading Rate: 8.2–26.7 g/m2/d, Discharge: 57.6 – 115.2 m3/day, HRT 1.25 – 2.5 hrs, at STP Yamuna Vihar Delhi. Removal of organic materials through use of fixed film reactors such as RBC is accomplished by means of a biological film on the fixed media. May and June in Delhi are dry summer months where the ambient temperature is in the range of 35oC to 45oC. July is a wet monsoon month that receives occasional precipitation, cloud cover, high humidity, with ambient temperature in the range of 30oC to 35oC. The organic and inorganic loads to the RBC employed in this study are actual city sewage conditions. Average in fluent BOD concentrations have been 330 mg/l, 245 mg/l and 160 mg/l and the average COD concentrations have been 670 mg/l, 500 mg/l, and 275 mg/l. The city sewage also has high concentration of ammonia, phosphorous, total suspended solids (TSS). pH of the city sewage is near neutral. Overall, the substrate conditions of city sewage are conducive for biological treatment though aerobic process. The presentation is a part of the ongoing collaborative research initiative between IIT Delhi and Karlsruhe Institute of Technology, Germany which is going on for last 15 years or so in the treatment of sewage waste of Delhi using semi-decentralized treatment system based on Rotating Biological Contactor.

Keywords: Rotating Biological Contactor (RBC), COD, BOD, HRT, STP

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Authors: Ilirian Laçi, Alketa Spahiu

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Ageing causes an increase in the number of patients with spinal canal stenosis. Most of the patients have back pain, leg pain, numbness of the legs, as well as urinary incontinence as a very common symptoms. Urinary incontinence impairs the quality of life. Correction of the symptom of urinary incontinence is possible in the early and adequate treatment of spinal stenosis. Methods: This study observed patients with urinary incontinence and spinal canal stenosis. These patients underwent mechanical decompression of the spinal stenosis through surgery. At the same time, these patients were observed clinically with clinical consultations. Cystoscopy and urodynamic tests were conducted at intervals of 2 and 6 months. As a result of treatment, 60% of patients did recover. The patients in this group who benefit from treatment were the patients who were early diagnosed and treated. Conclusions: An important factor in the prognosis of this pathology is the early diagnosis and treatment. The proper treatment of this pathology makes it curable in most cases. An important role in this pathology is played by the neurosurgeon. Surgery accompanied by laminotomy and mechanical decompression is the best way of treatment. Other factors that played a role in this pathology are also a large number of childbirths for women, obesity, etc.

Keywords: urinary incontinence, quality of life, spinal canal stenosis, early diagnosis, treatment

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