Search results for: audit treatment

Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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Authors: Mohammad Javad Zehtab, S. Alireza Mirghasemi, Ali Majlesara, Parvin Tajik, Babak Siavashi

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Objective: There are different modalities proposed for tennis elbow treatment with few randomized trials comparing them. We designed a study to compare the effectiveness of five different modalities and determine the usefulness of recently proposed extensor grip test (EGT) in predicting the response to treatment. Methods: In a randomized controlled clinical trial 92 of 98 tennis elbow patients in Sina hospital of Tehran, Iran between 2006 and 2007 fulfill trial entry criteria, among these patients 56 (60.9%) had positive EGT result. Stratified on EGT result, patients allocated randomly to 5 treatment groups: Brace (B) group, physiotherapy (P), brace + physiotherapy (BP), injection (I) and injection + physiotherapy (IP). Results: Patients who had positive result of EGT had better response to treatments: less SOC (p = 0.06), less PFFQ and patients’ satisfaction scores (p < 0.001). Among the treatment IP was the most successful, then BP, P and B, respectively; injection was the worst treatment modality. Response to treatment was comparable in all groups between EGT positive and negative patients except bracing; in which positive EGT was correlated with a dramatic response to treatment. Conclusion: In all patients IP and then BP is recommended but in EGT negatives, bracing seems to be of no use. Injection alone is not recommended in either group.

Keywords: tennis elbow, extensor grip test, physiotherapy, tennis elbow treatment

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Authors: Nurvita Wijayanti

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The movie titled The King’s Speech is based on a true story telling an English king suffers from stuttering and how he gets the treatment from the therapist, so that he can reduce the high frequency on stuttering. The treatment uses the unique approach implying the linguistic principles. This study shows how the language works significantly in order to treat the stuttering sufferer using psychological approach. Therefore, the linguistic study is done to analyze the treatment activity. Halliday’s Systemic Functional Grammar is used as the main approach in this study along with qualitative descriptive method. The study finds that the therapist though using the orthodox approach applies the psycholinguistic method to overcome the king’s stuttering.

Keywords: psycholinguistics, stuttering, systemic functional grammar, treatment

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Authors: A. Siham Dehmani, B. Djamal Zerrouki

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Domestic wastewater contains high concentrations of nitrogen, which can affect public health and cause harmful ecological impacts. The potential of microalgae as a source of renewable energy based on wastewater has received increasing interest worldwide in recent decades. The microalgae cultivation in wastewater has two advantages: wastewater treatment and algal biomass production. Our work aimed to remove nitrogen from municipal wastewater. Wastewater samples were taken from the wastewater treatment station located in Ouargla and used as a medium for the cultivation of chlorella microalgae strains inside a photobioreactor. Analysis of different parameters was done every 2 days along the period of the cultivation (10 days). The average removal efficiencies of nitrogen were maintained at 95%. Our results show the potential of integrating nutrient removal from wastewater by microalgae as a secondary wastewater treatment processes.

Keywords: biomass, microalgae, treatment, wastewater

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Authors: Schehrazad Selmane

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We present a deterministic model which describes the dynamics of tuberculosis in Algerian population where the vaccination program with BCG is in place since 1969 and where the WHO recommendations regarding the DOTS (directly observed treatment, short course) strategy are in application. The impact of an intervention program, targeting recently infected people among all close contacts of active cases and their treatment to prevent endogenous reactivation, on the incidence of tuberculosis, is investigated. We showed that a widespread treatment of latently infected individuals for some years is recommended to shift from higher to lower equilibrium state and thereafter relaxation is recommended.

Keywords: deterministic model, reproduction number, stability, tuberculosis

Procedia PDF Downloads 329

Authors: Mashayekh Amir Shahriar, Akhlaghi Morteza, Rajaee Hajar, Khani Mohammad Reza, Shokri Babak

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A new and novel approach in medicine is the use of cold plasma for various applications such as sterilization blood coagulation and cancer cell treatment. In this paper a pin-to-hole plasma jet suitable for biological applications is investigated, characterized and the possibility and feasibility of cancer cell treatment is evaluated. The characterization includes power consumption via Lissajous method, thermal behavior of plasma using Infra-red camera as a novel method, Optical Emission Spectroscopy (OES) to determine the species that are generated. Treatment of leukemia cancer cells is also implemented and MTT assay is used to evaluate viability.

Keywords: Atmospheric Pressure Plasma Jet (APPJ), Plasma Medicine, Cancer cell treatment, leukemia, Optical Emission

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Authors: Marco Correa, Flavio Araujo, Paulo Scalize, Antonio Albuquerque

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The increasing reduction of the volumes of surface water sources which supply most municipalities, as well as the continued rise of demand for treated water, combined with the disposal of effluents from washing of decanters and filters of the water treatment plants, generates a continuous search for correct environmentally solutions to these problems. The effluents generated by the water treatment industry need to be suitably processed for return to the environment or re-use. This article shows an alternative for the dehydration of sludge from the water treatment plants (WTP) and eventual disposal of sludge drained. Using the simple design methodology, we present a case study for a drainage in tanks geotextile, full-scale, which involve five sludge drainage tanks from WTP of the Rio Verde City. Aiming to the reutilization the water drained from the sludge and enabling its reuse both at the beginning of the treatment process at the WTP and in less noble services as for watering the gardens of the local town hall. The sludge will be used to production of building materials.

Keywords: re-use, residue, sustainable, water treatment plants, sludge

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Authors: jihen ayadi sellami

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The rapid evolution of the global financial landscape has led to increased attention to corporate tax policies and the need to understand the factors that influence their tax behavior. In order to mitigate any residual loss for shareholders resulting from tax aggressiveness and resolve the agency problem, appropriate systems that separate the function of management from that of controlling are needed. In this context of growing concerns to limit aggressive corporate taxation practices through governance, this study discusses. Its aims is to examine the influence of six key characteristics of the board of directors (board size, diligence, CEO duality, presence of audit committees, gender diversity and independence of directors), given a governance mechanism, on the tax decisions of non-financial corporations in the United State. In fact, using a sample of 90 non-financial US firms from S&P 500 over a period of 4 years going from 2014 to 2017, the results based on a multivariate linear regression highlight significant associations between these characteristics and corporate tax policy. Notably, larger board, gender diversity, diligence and increased director independence appear to play an important role in reducing aggressive taxation. While duality has a positive and significant correlation with tax aggressiveness, that can be explained by the fact that the manager did properly exploit his specific position within the company. These findings contribute to a deeper understanding of how board characteristics can influence corporate tax management, providing avenues for more effective corporate governance and more responsible tax decision-making

Keywords: tax aggressiveness, board of directors, board size, CEO duality, audit committees, gender diversity, director independence, diligence, corporate governance, united states

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Authors: O. Balamane-Zizi, L. M. Rouidi, A. Boukhrissa, N. Daas, H. Ait-amar

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The objective of this study was to test the possibility of a mixed treatment (physical-chemical and biological) of Ouled Fayet leachates which date of 10 years and has a large fraction of hard COD that can be reduced by coagulation-flocculation. Previous batch tests showed the possibility of applying the physical-chemical and biological treatments separately; the removal efficiencies obtained in this case were not interesting. We propose, therefore, to test the possibility of a combined treatment, in order to improve the quality of the leachates. Estimation of the treatment’s effectiveness was done by analysis of some pollution parameters such as COD, suspended solids, and heavy metals (particularly iron and nickel). The main results obtained after the combination of treatments, show reduction rate of about 63% for COD, 73% for suspended solids and 80% for iron and nickel. We also noted an improvement in the turbidity of treated leachates.

Keywords: landfill leachates, COD, physical-chemical treatment, biological treatment

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Authors: Amir Mahmoudi

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In this investigation, AISI321 steel after welding by Shilded Metal Arc Welding (SMAW) was solution heat treated in various temperatures and times, and then was sensitizied. Results indicated, increasing of temperature in solution heat treatment raises the sensitization and creates the cavity structure in grain boundaries. Besides, in order to examine the effect of time on solution heat treatment, all samples were solution heat treated at different times and fixed temperature (1050°C). By increasing the time, more chrome carbides were created due to dissolution of delta ferrite phase and reproduce titanium carbides. Additionally, the best process for solution heat treatment for this steel was suggested.

Keywords: stainless steel, solution heat treatment, intergranular corrosion, DLEPR

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

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Authors: Pricillia Priska Sianita

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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems

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Authors: M. Hadji, A. Haddad, Y. Hadji

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The effects of boronizing treatment on the friction coefficient and wear behavior of Ti2AlC were investigated. In order to modify the surface properties of Ti2AlC, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti2AlC. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti2AlC from 6 GPa to 13GPa. In the pin-on-disc test, it was found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti2AlC/Al2O3 tribocouple under 7N load for the non treated and the boronized samples, respectively. The wear resistance of Ti2AlC under Al2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti2AlC.

Keywords: MAX phase, wear, hardness, boronizing

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Authors: Azza Mohsin Al-Hashami, Reginald Victor

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Treatment of wastewater involves physical, chemical, and biological processes to remove the pollutants from wastewater. This study evaluates of the effectiveness of sewage treatment plants (STP) in Samail, Oman. Samail STP has tertiary treatment using conventional activated sludge with surface aeration. The collection of wastewater is through a network with a total length of about 60 km and also by tankers for the areas outside the network. Treated wastewater from this STP is used for the irrigation of vegetation in the STP premises and as a backwash for sand filters. Some treated water is supplied to the Samail municipality, which uses it for the landscaping, road construction, and 'the Million Date Palms' project. In this study, homogenous samples were taken from eight different treatment stages along the treatment continuum for one year, at a frequency of once a month, to evaluate the physical, chemical, and biological parameters. All samples were analyzed using the standard methods for the examination of water and wastewater. The spatial variations in water quality along the continuum are discussed. Despite these variations, the treated wastewater from Samail STP was of good quality, and most of the parameters are within class A category in Oman Standards for wastewater reuse and discharge.

Keywords: wastewater, STP, treatment, processes

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Authors: Mohamed Ben Amar, Henda Barhoumi, Hokia Siala, Foued Elhalouani

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The present contribution consists of a purely experimental investigation on the effect of Squeeze casting on the micro structural and mechanical propriety of Al-Si alloys destined to automotive industry. Accordingly, we have proceeding, by ourselves, to all the thermal treatment consisting of solution treatment at 540°C for 8h and aging at 160°C for 4h. The various thermal treatment, have been carried out in order to monitor the processes of formation and dissolution accompanying the solid state phase transformations as well as the resulting changes in the mechanical proprieties. The examination of the micrographs of the aluminum alloys reveals the dominant presence of dendrite. Concerning the mechanical characteristic the Vickers micro-hardness curve an increase as a function of the pressure. As well as the heat treatment increase mechanical propriety such that pressure and micro hardness. The curves have been explained in terms of structural hardening resulting from the various compounds formation.

Keywords: squeeze casting, process parameters, heat treatment, ductility, microstructure

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Authors: Rizwan Iqbal

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Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

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Authors: Nejib Turki, Karima Kouki Khalfallah

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The effect of six treatments of organic amendments were evaluated on a sandy soil in the region of Soukra in Tunisia. T1: cattle manure 55 t.ha-1, T2: commercial compost from Germany to 1 t.ha-1, T3: a mixture of 27.5 t.ha-1 of T1 with 0.5 t. ha-1 of T2, T4: commercial compost from France 2 t.ha-1, T5: a Tunisian commercial compost to 10 t.ha-1 and T0: control without treatment. The nitrogen in the soil increase to 0.029 g.kg-1 of soil treatment for the T1 and 0.021 g. kg-1 of soil treatment for the T3. The highest content of P2O5 has been registered by the T3 treatment that 0.44 g kg-1 soil with respect to the control (T0), which shows a content of 0.36 g.kg-1 soil. The soil was initially characterized by a potassium content of 0.8 g kg-1 soil, K2O exchangeable rate varied between 0.63 g.Kg-1 and 0.71 g.kg-1 soil respectively T2 and T1.

Keywords: compost, organic amendement, Ntot, P2O5, K2O

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Authors: Kolawole Oyekan

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Torture, cruel, inhuman and degrading treatment is one of the issues dealt with by the United Nations in its development of human rights standard. Torture and other ill -treatments is banned at all times in all places including in times of war. There is no justification for torture, cruel, inhuman and degrading treatment under any law in Nigeria. All statutes; local, regional and international on human rights prohibits all forms of degrading treatment. This paper examines the definition of torture, inhuman and degrading treatment and the prevalence of confessional statements obtain through torture by security agencies during the interrogation of crime suspects and are mostly relied upon during trial even in cases involving capital punishment. The paper further reviews the Violence against Persons Prohibition Act 2015 which prohibits torture and other forms of ill-treatment. Presently, the Act is applicable only to the federal Federal Capital Territory, Abuja. Consequently, the paper concludes that the Act should be adopted as a matter of urgency by the 36 states of the Federation of Nigeria and in addition, cogent steps must be taken to ensure that the provisions of the Act are strictly complied with in order to eliminate torture, cruel and inhuman degrading treatment in Nigeria.

Keywords: confessional statement, human rights, torture, United Nations

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Authors: Hen Friman

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Various categories of aqueous solutions are discharged within residential, institutional, commercial, and industrial structures. To safeguard public health and preserve the environment, it is imperative to subject wastewater to treatment processes that eliminate pathogens (such as bacteria and viruses), nutrients (such as nitrogen and phosphorus), and other compounds. Failure to address untreated sewage accumulation can result in an array of adverse consequences. Israel exemplifies a special case in wastewater management. Appropriate wastewater treatment significantly benefits sectors such as agriculture, tourism, horticulture, and industry. Nevertheless, untreated sewage in settlements lacking proper sewage collection or transportation networks remains an ongoing and substantial threat. Notably, the process of wastewater treatment entails substantial energy consumption. Consequently, this study explores the integration of solar energy as a renewable power source within the wastewater treatment framework. By incorporating renewable energy sources into the process, costs can be minimized, and decentralized facilities can be established even in areas lacking adequate infrastructure for traditional treatment methods.

Keywords: renewable energy, solar energy, innovative, wastewater treatment

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Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum

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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.

Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Ouahiba Taamallah, Tarek Litim

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This work relates to the physico-geometrical aspect of the surface layers of 100C6 steel having undergone the burnishing treatment by hard steel ball. The application of tip diamond burnishing promotes better roughness compared to turning. In addition, it allows the surface layers to be consolidated by work hardening phenomena. The optimal effects are closely related to the parameters of the treatment and the active part of the device. With an 80% improvement in roughness resulting from the treatment, burnishing can be defined as a finishing operation within the machining range. With a 40% gain in consolidation rate, this treatment is an efficient process for material consolidation.

Keywords: 100C6 steel, burnishing, hardening, roughness

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Young-Kwan Choi, Gang-Wook Shin, Sung-Taek Hong

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Water supply system consumes large amount of power load during water treatment and transportation of purified water. Many energy conserving high efficiency materials such as DC motor and LED light have recently been introduced to water supply system for energy conservation. This paper performed empirical analysis on BLDC, AC motors, and comparatively analyzed the change in power according to DC power supply ratio in order to conserve energy of a next-generation water treatment system called vertical water treatment system. In addition, a DC distribution system linked with photovoltaic generation was simulated to analyze the energy conserving effect of DC load.

Keywords: vertical water treatment system, DC power supply, energy efficiency, BLDC

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: Ujwal Kishor Zore, Shankar Balajirao Kausley, Aniruddha Bhalchandra Pandit

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There are some important design parameters of activated sludge process (ASP) for wastewater treatment and they must be optimally defined to have the optimized plant working. To know them, developing a mathematical model is a way out as it is nearly commensurate the real world works. In this study, a mathematical model was developed for ASP, solved under activated sludge model no 1 (ASM 1) conditions and MATLAB tool was used to solve the mathematical equations. For its real-life validation, the developed model was tested for the inputs from the municipal wastewater treatment plant and the results were quite promising. Additionally, the most cardinal assumptions required to design the treatment plant are discussed in this paper. With the need for computerization and digitalization surging in every aspect of engineering, this mathematical model developed might prove to be a boon to many biological wastewater treatment plants as now they can in no time know the design parameters which are required for a particular type of wastewater treatment.

Keywords: waste water treatment, activated sludge process, mathematical modeling, optimization

Procedia PDF Downloads 144

Authors: M. Hadji, A. Haddad, Y. Hadji

Abstract:

The effects of boronizing treatment on the friction coefficient and wear behavior of 0.35 Vf TiC- Ti3 SiC2 composite were investigated. In order to modify the surface properties of Ti3SiC2, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti3SiC2. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti3SiC2 from 6 GPa to 13 GPa. In the pin-on-disc test, i twas found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti3SiC2/Al2O3 tribocouple under 7 N load for the non treated and the boronized samples, respectively. The wear resistance of Ti3SiC2 under Al2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti3SiC2.

Keywords: MAX phase, boronizing, hardness, wear

Procedia PDF Downloads 349

Authors: Boy Subirosa Sabarguna, Aria Kekalih, Irzan Nurman

Abstract:

Introduction: Software in the form of Clinical Decision Support System could help students in understanding the mind set of decision-making in diagnosis and treatment at the stage of general practitioners. This could accelerate and ease the learning process which previously took place by using books and experience. Method: Gather 1000 members of the National Medical Multimedia Digital Community (NM2DC) who use the “flowchart of diagnosis and treatment” software, and analyse factors related to: display, speed in learning, convenience in learning, helpfulness and usefulness in the learning process, by using the Likert Scale through online questionnaire which will further be processed using percentage. Results and Discussions: Out of the 1000 members of NM2DC, apparently: 97.0% of the members use the software and 87.5% of them are students. In terms of the analysed factors related to: display, speed in learning, convenience in learning, helpfulness and usefulness of the software’s usage, the results indicate a 90.7% of fairly good performance. Therefore, the “Flowchart of Diagnosis and Treatment” software has helped students in understanding the decision-making of diagnosis and treatment. Conclusion: the use of “Flowchart of Diagnosis and Treatment” software indicates a positive role in helping students understand decision-making of diagnosis and treatment.

Keywords: usage, software, diagnosis and treatment, medical education

Procedia PDF Downloads 359

Authors: Medhat Gad

Abstract:

Wastewater treatment became a big issue in this decade due to shortage of water resources, growth of population and modern live requirements. Reuse of treated wastewater in industrial and agriculture sectors has a big demand to substitute the shortage of clean water supply as well as to save the eco system from dangerous pollutants in insufficient treated wastewater In last decades, most of wastewater treatment plants are built using primary or secondary biological treatment technology which almost does not provide enough treatment and removal of phosphorus and nitrogen. those plants which built ten to 15 years ago also now suffering from overflow which decrease the treatment efficiency of the plant. Discharging treated wastewater which contains phosphorus and nitrogen to water reservoirs and irrigation canals destroy ecosystem and aquatic life. Using chemical material to enhance treatment efficiency for domestic wastewater but it leads to huge amount of sludge which cost a lot of money. To enhance wastewater treatment, we used INNPT nano material which consists of calcium, aluminum and iron oxides and compounds plus silica, sodium and magnesium. INNPT nano material used with a dose of 100 mg/l to upgrade SBR treatment plant in Cairo Egypt -which has three treatment tanks each with a capacity of 2500 cubic meters per day - to tertiary treatment level by removing Phosphorus, Nitrogen and increase dissolved oxygen in final effluent. The results showed that the treatment retention time decreased from 9 hours in SBR system to one hour using INNPT nano material with improvement in effluent quality while increasing plant capacity to 20 k cubic meters per day. Nitrogen removal efficiency achieved 77%, while phosphorus removal efficiency achieved 90% and COD removal efficiency was 93% which all comply with tertiary treatment limits according to Egyptian law.

Keywords: INNPT technology, nanomaterial, tertiary wastewater treatment, capacity extending

Procedia PDF Downloads 165

Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

Abstract:

For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

Procedia PDF Downloads 177