Search results for: surgical removal

Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli

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Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.

Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome

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Authors: S. Melvin Samuel, Jayanta Bhattacharya

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In the present study, a graphene oxide/chitosan (GO-CS) composite material was prepared and used as an adsorbent for the removal of methylene blue (MB) from aqueous solution. The synthesized GO-CS adsorbent was characterized by Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopes (SEM), transmission electron microscopy (TEM), Raman spectroscopy and thermogravimetric analysis (TGA). The removal of MB was conducted in batch mode. The effect of parameters influencing the adsorption of MB such as pH of the solution, initial MB concentration, shaking speed, contact time and adsorbent dosage were studied. The results showed that the GO-CS composite material has high adsorption capacity of 196 mg/g of MB solution at pH 9.0. Further, the adsorption of MB on GO-CS followed pseudo second order kinetics and equilibrium adsorption data well fitted by the Langmuir isotherm model. The study suggests that the GO-CS is a favorable adsorbent for the removal of MB from aqueous solution.

Keywords: Methylene blue, Graphene oxide-chitosan, Isotherms, Kinetics.

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Authors: Rami Jahmani

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Closed femoral-shortening osteotomy over an intramedullary nail for the treatment of leg length discrepancy (LLD) is a demanding surgical technique, classically requiring specialized instrumentation (intramedullary saw and chisel). The paper describes a modified surgical technique of performing femoral shortening percutaneously, using a percutaneous multiple drill-hole osteotomy technique to smash the bone, and then, the bone is fixed using intramedullary locked nail. Paper presents the result of performing nine cases of shortening as well.

Keywords: —Femoral shortening, Leg length discrepancy, Minimal invasive, Percutaneous osteotomy.

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Authors: Fares Almomani, Majeda Khraisheh, Rahul Bhosale, Anand Kumar, Ujjal Gosh

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Septic tanks (STs) are very commonly used wastewater collection systems in the world especially in rural areas. In this study, the use of moving bed biological reactors (MBBR) for the treatment of septic tanks effluents (STE) was studied. The study was included treating septic tank effluent from one house hold using MBBRs. Significant ammonia removal rate was observed in all the reactors throughout the 180 days of operation suggesting that the MBBRs were successful in reducing the concentration of ammonia from septic tank effluent. The average ammonia removal rate at 25◦C for the reactor operated at hydraulic retention time of 5.7 hr (R1) was 0.540 kg-N/m3and for the reactor operated at hydraulic retention time of 13.3hr (R2) was 0.279 kg-N/m3. Ammonia removal rates were decreased to 0.3208 kg-N/m3 for R1 and 0.212 kg-N/m3 for R3 as the temperature of reactor was decreased to 8 ◦C. A strong correlation exists between theta model and the rates of ammonia removal for the reactors operated in continuous flow. The average ϴ values for the continuous flow reactors during the temperature change from 8°C to 20 °C were found to be 1.053±0.051. MBBR technology can be successfully used as a polishing treatment for septic tank effluent.

Keywords: septic tanks, wastewater treatment, morphology, moving biological reactors, nitrification

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Authors: Xincheng Jiang, Yanyan An, Yaoyao Huang, Wei Ding, Manli Sun, Hong Li, Huaili Zheng

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The residual antibiotics in the environment will pose a threat to the environment and human health. Thus, efficient removal and rapid detection of norfloxacin (NOR) in wastewater is very important. The main sources of NOR pollution are the agricultural, pharmaceutical industry and hospital wastewater. The total consumption of NOR in China can reach 5440 tons per year. It is found that neither animals nor humans can totally absorb and metabolize NOR, resulting in the excretion of NOR into the environment. Therefore, residual NOR has been detected in water bodies. The hazards of NOR in wastewater lie in three aspects: (1) the removal capacity of the wastewater treatment plant for NOR is limited (it is reported that the average removal efficiency of NOR in the wastewater treatment plant is only 68%); (2) NOR entering the environment will lead to the emergence of drug-resistant strains; (3) NOR is toxic to many aquatic species. At present, the removal and detection technologies of NOR are applied separately, which leads to a cumbersome operation process. The development of simultaneous adsorption-flocculation removal and FTIR detection of pollutants has three advantages: (1) Adsorption-flocculation technology promotes the detection technology (the enrichment effect on the material surface improves the detection ability); (2) The integration of adsorption-flocculation technology and detection technology reduces the material cost and makes the operation easier; (3) FTIR detection technology endows the water treatment agent with the ability of molecular recognition and semi-quantitative detection for pollutants. Thus, it is of great significance to develop a smart water treatment material with high removal capacity and detection ability for pollutants. This study explored the feasibility of combining NOR removal method with the semi-quantitative detection method. A magnetic Cu-Ni-S/Ni foam was synthesized by in-situ loading Cu-Ni-S nanostructures on the surface of Ni foam. The novelty of this material is the combination of adsorption-flocculation technology and semi-quantitative detection technology. Batch experiments showed that Cu-Ni-S/Ni foam has a high removal rate of NOR (96.92%), wide pH adaptability (pH=4.0-10.0) and strong ion interference resistance (0.1-100 mmol/L). According to the Langmuir fitting model, the removal capacity can reach 417.4 mg/g at 25 °C, which is much higher than that of other water treatment agents reported in most studies. Characterization analysis indicated that the main removal mechanisms are surface complexation, cation bridging, electrostatic attraction, precipitation and flocculation. Transmission FTIR detection experiments showed that NOR on Cu-Ni-S/Ni foam has easily recognizable FTIR fingerprints; the intensity of characteristic peaks roughly reflects the concentration information to some extent. This semi-quantitative detection method has a wide linear range (5-100 mg/L) and a low limit of detection (4.6 mg/L). These results show that Cu-Ni-S/Ni foam has excellent removal performance and semi-quantitative detection ability of NOR molecules. This paper provides a new idea for designing and preparing multi-functional water treatment materials to achieve simultaneous removal and semi-quantitative detection of organic pollutants in water.

Keywords: adsorption-flocculation, antibiotics detection, Cu-Ni-S/Ni foam, norfloxacin

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Authors: Anna Wolowicz, Katarzyna Staszak, Zbigniew Hubicki

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Nowadays heavy metal ions as well as surfactants are widely used throughout the world due to their useful properties. The consequence of such widespread use is their significant production. On the other hand, the increasing demand for surfactants and heavy metal ions results in production of large amounts of wastewaters which are discharged to the environment from mining, metal plating, pharmaceutical, cosmetic, fertilizer, paper, pesticide and electronic industries, pigments producing, petroleum refining and from autocatalyst, fibers, food, polymer industries etc. Heavy metal ions are non-biodegradable in the environment, cable of accumulation in living organisms and organs, toxic and carcinogenic. On the other hand, not only heavy metal ions but also surfactants affect the purity of water and soils. Some of surfactants are also toxic, harmful and dangerous because they are able to penetrate into surface waters causing foaming, blocked diffusion of oxygen from the atmosphere and act as emulsifiers of hydrophobic substances and increase solubility of many the dangerous pollutants. Among surfactants the anionic ones dominate and their share in the global production of surfactants is around 50 ÷ 60%. Due to the negative impact of heavy metals and surfactants on aquatic ecosystems and living organisms, removal and monitoring of their concentration in the environment is extremely important. Surfactants and heavy metal ions removal can be achieved by different biological and physicochemical methods. The adsorption as well as the ion-exchange methods play here a significant role. The aim of this study was heavy metal ions removal from aqueous solutions using different types of ion exchangers in the presence of anionic surfactants. Preliminary studies of copper(II), nickel(II), zinc(II) and cobalt(II) removal from acidic solutions using ion exchangers (Lewatit MonoPlus TP 220, Lewatit MonoPlus SR 7, Purolite A 400 TL, Purolite A 830, Purolite S 984, Dowex PSR 2, Dowex PSR3, Lewatit AF-5) allowed to select the most effective ones for the above mentioned sorbates and then to checking their removal efficiency in the presence of anionic surfactants. As it was found out Lewatit MonoPlus TP 220 of the chelating type, show the highest sorption capacities for copper(II) ions in comparison with the other ion exchangers under discussion, e.g. 9.98 mg/g (0.1 M HCl); 9.12 mg/g (6 M HCl). Moreover, cobalt(II) removal efficiency was the highest in 0.1 M HCl using also Lewatit MonoPlus TP 220 (6.9 mg/g) similar to zinc(II) (9.1 mg/g) and nickiel(II) (6.2 mg/g). As the anionic surfactant sodium dodecyl sulphate (SDS) was used and surfactant parameters such as viscosity (η), density (ρ) and critical micelle concentration (CMC) were obtained: η = 1.13 ± 0,01 mPa·s; ρ = 999.76 mg/cm3; CMC = 2.26 g/cm3. The studies of copper(II) removal from acidic solutions in the presence of SDS of different concentration show negligible effects on copper(II) removal efficiency. The sorption capacity of Cu(II) from 0.1 M acidic solution of 500 mg/L initial concentration was equal to 46.8 mg/g whereas in the presence of SDS 45.3 mg/g (0.1 mg SDS/L), 47.1 mg/g (0.5 mg SDS/L), 46.6 mg/g (1 mg SDS/L).

Keywords: anionic surfactant, heavy metal ions, ion exchanger, removal

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Authors: Andrew Hargreaves, Peter Vale, Jonathan Whelan, Carlos Constantino, Gabriela Dotro, Pablo Campo

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As a consequence of their potential to cause harm, there are strong regulatory drivers that require metals to be removed as part of the wastewater treatment process. Bioavailability-based standards have recently been specified for copper (Cu), lead (Pb), nickel (Ni) and zinc (Zn) and are expected to reduce acceptable metal concentrations. In order to comply with these standards, wastewater treatment works may require new treatment types to enhance metal removal and it is, therefore, important to examine potential treatment options. A substantial proportion of Cu, Pb, Ni and Zn in effluent is adsorbed to and/or complexed with macromolecules (eg. proteins, polysaccharides, aminosugars etc.) that are present in the colloidal size fraction. Therefore, technologies such as coagulation-flocculation (CF) that are capable of removing colloidal particles have good potential to enhance metals removal from wastewater. The present study investigated the effectiveness of CF at removing trace metals from humus effluent using the following coagulants; ferric chloride (FeCl3), the synthetic polymer polyethyleneimine (PEI), and the biopolymers chitosan and Tanfloc. Effluent samples were collected from a trickling filter treatment works operating in the UK. Using jar tests, the influence of coagulant dosage and the velocity and time of the slow mixing stage were studied. Chitosan and PEI had a limited effect on the removal of trace metals (<35%). FeCl3 removed 48% Cu, 56% Pb and 41% Zn at the recommended dose of 0.10 mg/L. At the recommended dose of 0.25 mg/L Tanfloc removed 77% Cu, 68% Pb, 18% Ni and 42% Zn. The dominant mechanism for particle removal by FeCl3 was enmeshment in the precipitates (i.e. sweep flocculation) whereas, for Tanfloc, inter-particle bridging was the dominant removal mechanism. Overall, FeCl3 and Tanfloc were found to be most effective at removing trace metals from wastewater.

Keywords: coagulation-flocculation, jar test, trace metals, wastewater

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Authors: Amina Ramadni, Safia Taleb, André Dératani

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The present study presents, firstly, to characterize the physicochemical quality of brackish groundwater of the Terminal Complex (TC) from the region of Eloued-souf and to investigate the presence of fluoride, and secondly, to study the comparison of adsorbing power of three materials, such as (activated alumina AA, sodium clay SC and hydroxyapatite HAP) against the groundwater in the region of Eloued-souf. To do this, a sampling campaign over 16 wells and consumer taps was undertaken. The results show that the groundwater can be characterized by very high fluoride content and excessive mineralization that require in some cases, specific treatment before supply. The study of adsorption revealed removal efficiencies fluoride by three adsorbents, maximum adsorption is achieved after 45 minutes at 90%, 83.4% and 73.95%, and with an adsorbed fluoride content of 0.22 mg/L, 0.318 mg/L and 0.52 mg/L for AA, HAP and SC, respectively. The acidity of the medium significantly affects the removal fluoride. Results deducted from the adsorption isotherms also showed that the retention follows the Langmuir model. The adsorption tests by adsorbent materials show that the physicochemical characteristics of brackish water are changed after treatment. The adsorption mechanism is an exchange between the OH^- ions and fluoride ions. Three materials are proving to be effective adsorbents for fluoride removal that could be developed into a viable technology to help reduce the salinity of the Saharan hyper-fluorinated waters. Finally, a comparison between the results obtained from the different adsorbents allowed us to conclude that the defluoridation by AA is the process of choice for many waters of the region of Eloued-souf, because it was shown to be a very interesting and promising technique.

Keywords: fluoride removal, hydrochemical characterization of groundwater, natural materials, nanofiltration

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Authors: J. D. Ho, D. M. Dawes, B. Driver

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Introduction: TASER Conducted Electrical Weapons (CEWs) are the dominant CEWs in use and have been used in modern police and military operations since the late 1990s as a form of non-lethal weaponry. The 3rd generation of CEWs has been recently introduced and is known as The TASER 7. This new CEW will be replacing current CEW technology and has a new dart design that is important for emergency medical professionals to be familiar with because it requires a different method of removal and will leave a different marking pattern in human tissue than they may have been previously familiar with. features of this new dart design include: higher velocity impact, larger impact surface area, break away dart body segment, dual back-barb retention, newly designed removal process. As the TASER 7 begins to be deployed by the police and military personnel, these new features make it imperative that emergency medical professionals become familiar with the signature markings that this new dart design will make on human tissue and how to remove them. Methods: Multiple observational studies using high speed photography were used to record impact patterns of the new dart design on fresh tissue and also the newly recommended dart removal process. Both animal and human subjects were used to test this dart design prior to production release. Results: Data presented will include dart design overview, flight pattern accuracy, impact analysis, and dart removal example. Tissue photographs will be presented to demonstrate examples of signature TASER 7 dart markings that emergency medical professionals can expect to see. Conclusion: This work will provide the reader with an understanding of this newest generation CEW dart design, its key features, its signature marking pattern that can be expected and a recommendation of how to remove it from human tissue.

Keywords: TASER 7, conducted electrical weapon, dart mark, dart removal

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Juliet Okoli

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The removal of BTEX (Benzene, toluene, Ethylbenzene and p-Xylene) from water by orange peel and eggshell compared to GAC were investigated. The influence of various factors such as contact time, dosage and pH on BTEX removal by virgin orange peel and egg shell were accessed using the batch adsorption set-up. These were also compared to that of GAC which serves as a benchmark for this study. Further modification (preparation of Activated carbon) of these virgin low-cost adsorbents was also carried out. The batch adsorption result showed that the optimum contact time, dosage and pH for BTEX removal by virgin LCAs were 180 minutes, 0.5g and 7 and that of GAC was 30mintues, 0.2g and 7. The maximum adsorption capacity for total BTEX showed by orange peel and egg shell were 42mg/g and 59mg/g respectively while that of GAC was 864mg/g. The adsorbent preference for adsorbate were in order of X>E>T>B. A comparison of batch and column set-up showed that the batch set-up was more efficient than the column set-up. The isotherm data for the virgin LCA and GAC prove to fit the Freundlich isotherm better than the Langmuir model, which produced n values >1 in case of GAC and n< 1 in case of virgin LCAs; indicating a more appropriate adsorption of BTEX onto the GAC. The adsorption kinetics for the three studied adsorbents were described well by the pseudo-second order, suggesting chemisorption as the rate limiting step. This was further confirmed by desorption study, as low levels of BTEX (<10%) were recovered from the spent adsorbents especially for GAC (<3%). Further activation of the LCAs which was compared to the virgin LCAs, revealed that the virgin LCAs had minor higher adsorption capacity than the activated LCAs. Economic analysis revealed that the total cost required to clean-up 9,600m3 of BTEX contaminated water using LCA was just 2.8% lesser than GAC, a difference which could be considered negligible. However, this area still requires a more detailed cost-benefit analysis, and if similar conclusions are reached; a low-cost adsorbent, easy to obtain are still promising adsorbents for BTEX removal from aqueous solution; however, the GAC are still more superior to these materials.

Keywords: activated carbon, BTEX removal, low cost adsorbents, water treatment

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Authors: Amina Ramdani, Abdelkader Kadeche, Zoubida Taleb, Safia Taleb

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The aim of this present study is to evaluate the adsorption capacity of a dye, Malachite green, on a local Algerian montmorillonite clay mineral (raw, purified and Cr-pillared). Various parameters influencing the dye adsorption process ie contact time, adsorbent dose, initial concentration of dye, pH of the solution and temperature. Cr pillared clay has been obtained with a better surface character than purified and natural clay. An increase in basal spacing from 12.45 Å (Mont-Na) to 22.88 Å (Mont-PLCr), surface area from 67 m2 /g (Mont-Na) to 102 m2 /g (Mont-PLCr). The experimental results show that the dye adsorption kinetic were fast: 5 min for Cr-pillared clay mineral, and 30 min for raw and purified clay mineral (RC and Mont-Na). The removal efficiency on Mont-PLCr (98.64%) is greater than that of Mont-Na (86.20%) and RC (82.09%). The acidity and basicity of the medium considerably affect the adsorption of the dye. It attained its maximum at pH 4.8. The equilibrium and kinetic data were found to fit well the Langmuir model and the pseudo-second-order model.

Keywords: Dye removal, pillared clay, isotherm, kinetic

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Authors: Archana G. Lamdande, Shyam R. Garud, K. S. M. S. Raghavarao

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Coconut has two edible parts, that is, a white kernel (solid endosperm) and coconut water (liquid endosperm). The white kernel is generally used in fresh or dried form for culinary purposes. Coconut testa, is the brown skin, covering the coconut kernel. It is removed by paring of wet coconut and obtained as a by-product in coconut processing industries during the production of products such as desiccated coconut, coconut milk, whole coconut milk powder and virgin coconut oil. At present, it is used as animal feed component after drying and recovering the residual oil (by expelling). Experiments were carried out on expelling of coconut milk for shredded coconut with and without testa removal, in order to explore the possibility of increasing the milk yield and value addition in terms of increased polyphenol content. The color characteristics of coconut milk obtained from the grating without removal of testa were observed to be L* 82.79, a* 0.0125, b* 6.245, while that obtained from grating with removal of testa were L* 83.24, a* -0.7925, b* 3.1. A significant increase was observed in total phenol content of coconut milk obtained from the grating with testa (833.8 µl/ml) when compared to that from without testa (521.3 µl/ml). However, significant difference was not observed in protein content of coconut milk obtained from the grating with and without testa (4.9 and 5.0% w/w, respectively). Coconut milk obtained from grating without removal of testa showed higher milk yield (62% w/w) when compared to that obtained from grating with removal of testa (60% w/w). The fat content in coconut milk was observed to be 32% (w/w), and it is unstable due to such a high fat content. Therefore, several experiments were carried out for examining its stability by adjusting the fat content at different levels (32, 28, 24, and 20% w/w). It was found that the coconut milk was more stable with a fat content of 24 % (w/w). Homogenization and ultrasonication and their combinations were used for exploring the possibility of increasing the stability of coconut milk. The microscopic study was carried out for analyzing the size of fat globules and the degree of their uniform distribution.

Keywords: coconut milk, homogenization, stability, testa, ultrasonication

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Authors: Albert Suryaprawira

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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.

Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement

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Authors: Tooba Aslam, Efthalia Chatzisymeon

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Untreated Municipal Wastewater (MWW) is renowned as the utmost harmful pollution caused to environmental water due to the high presence of nutrients and organic contaminants. Removal of Chemical Oxygen Demand (COD) from synthetic as well as municipal wastewater is investigated by using acid mine drainage as a source of iron to initiate the solar photo-Fenton treatment of municipal wastewater. In this study, Acid Mine Drainage (AMD) and different minerals enriched in iron, such as goethite, hematite, magnetite, and magnesite, have been used as the source of iron to initiate the photo-Fenton process. Co-treatment of real municipal wastewater and acid mine drainage /minerals is widely examined. The effects of different parameters such as minerals recovery from AMD, AMD as a source of iron, H₂O₂ concentration, and COD concentrations on the COD percentage removal of the process are studied. The results show that, out of all the four minerals, only hematite (1g/L) could remove 30% of the pollutants at about 100 minutes and 1000 ppm of H₂O₂. The addition of AMD as a source of iron is performed and compared with both synthetic as well as real wastewater from South Africa under the same conditions, i.e., 1000 ppm of H₂O₂, ambient temperature, 2.8 pH, and solar simulator. In the case of synthetic wastewater, the maximum removal (56%) is achieved with 50 ppm of iron (AMD source) at 160 minutes. On the other hand, in real wastewater, the removal efficiency is 99% with 30 ppm of iron at 90 minutes and 96% with 50 ppm of iron at 120 minutes. In conclusion, overall, the co-treatment of AMD and MWW by solar photo-Fenton treatment appears to be an effective and promising method to remove organic materials from Municipal wastewater.

Keywords: municipal wastewater treatment, acid mine drainage, co-treatment, COD removal, solar photo-Fenton, circular economy

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Authors: Retno A. S. Lestari, Wahyudi B. Sediawan, Siti Syamsiah, Sarto

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Sulfur-oxidizing bacteria were isolated and then grown on salak fruit seeds forming a biofilm on the surface. Their performances in sulfide removal were experimentally observed. In doing so, the salak fruit seeds containing biofilm were then used as packing material in a cylinder. Biogas obtained from biological treatment, which contains 27.95 ppm of hydrogen sulfide was flown through the packed bed. The hydrogen sulfide from the biogas was absorbed in the biofilm and then degraded by the microbes in the biofilm. The hydrogen sulfide concentrations at a various axial position and various times were analyzed. A set of simple kinetics model for the rate of the sulfide removal and the bacterial growth was proposed. Since the biofilm is very thin, the sulfide concentration in the Biofilm at a certain axial position is assumed to be uniform. The simultaneous ordinary differential equations obtained were then solved numerically using Runge-Kutta method. The values of the parameters were also obtained by curve-fitting. The accuracy of the model proposed was tested by comparing the calculation results using the model with the experimental data obtained. It turned out that the model proposed can describe the removal of sulfide liquid using bio-filter in the packed bed. The biofilter could remove 89,83 % of the hydrogen sulfide in the feed at 2.5 hr of operation and biogas flow rate of 30 L/hr.

Keywords: sulfur-oxidizing bacteria, salak fruit seeds, biofilm, packing material, biogas

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Authors: Thampi Rawther, Sean O’Brien, Kamala Kanta Das

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Background: Intussusception in the adult is rarely from a benign cause and is almost always pathological. Causes include carcinomas, polyps, Meckel's diverticulum, or colonic diverticulum. Common symptoms include abdominal pain, intestinal obstruction, palpable abdominal mass, GI bleeding, and anemia. Sarcomatoid carcinoma is a rare type of small intestinal malignancy exhibiting carcinomatous and sarcomatous features. It primarily affects older patients, mean age 57, and is 1.5 times more prevalent in men. Method: This is an interesting case report of a patient presenting with intussusception secondary to a sarcomatoid tumor of the small bowel. Conclusion: Surgery is the treatment of choice in adults with intussusception due to the high malignancy potential. Furthermore, surgical resection of the affected bowel is the definitive form of therapy as small bowel sarcomatoid tumors are not responsive to chemotherapy and radiotherapy. Early surgical intervention helps reduce mortality as it allows for early staging, treatment, and monitoring of the tumor. The patient was fortunate to have presented with intussusception, facilitating early surgical intervention, and was found to have a low disease stage.

Keywords: general surgery, small bowel tumour, imaging, unique

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Authors: Manisha Bal, Amit Verma, B. C. Meikap

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Carbon dioxide (CO₂) is the most abundant waste produced by human activities. It is estimated to be one of the major contributors of greenhouse effect and also considered as a major air pollutant formed by burning of fossil fuels. The main sources of emissions are flue gas from thermal power plants and process industries. It is also a contributor of acid rain. Its exposure through inhalation can lead to health risks. Therefore, control of CO₂ emission in the environment is very necessary. The main focus of this study is on the removal of carbon dioxide from off gases using a self-priming venturi scrubber in submerged conditions using sodium hydroxide as the scrubbing liquid. A self-priming submerged venturi scrubber is an efficient device to remove gaseous pollutants. In submerged condition, venturi scrubber remains submerged in the liquid tank and the liquid enters at the throat section of venturi scrubber due to the pressure difference which includes the hydrostatic pressure of the liquid and static pressure of the gas. The inlet polluted air stream enters through converging section which moves at very high velocity in the throat section and atomizes the liquid droplets. This leads to absorption of CO₂ from the off gases in scrubbing liquid which resulted in removal of CO₂ gas from the off gases. Detailed investigation on the scrubbing of carbon dioxide has been done in this literature. Experiments were conducted at different throat gas velocities, liquid levels in outer cylinder and CO₂ inlet concentrations to study the carbon dioxide removal efficiency. Experimental results give more than 95% removal efficiency of CO₂ in the self priming venturi scrubber which can meet the environmental emission limit of CO₂ to save the human life.

Keywords: carbon dioxide, scrubbing, pollution control, self-priming venturi scrubber

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Authors: R. Sonda, F. Pellini, A. Invento, S. Mirandola, F. Riolfatti, D. Grigolato, G. P. Pollini

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The purpose of study is to assess utility of 18F-FDG PET/CT in patients with breast heteroplasia and possibility of changing the surgery/therapeutic treatment. Among these "under fourty-five" candidated for NAC, the prevalence of change in therapeutic approach in comparison with first and second level exams has been: 43.75%, while by 22% among the "over forty-five". The surgical timing according to first-level exams have been deferred in 31.46% cases; PET/CT has led to a change in therapeutic treatment of 48.31% on the previous given; then the addition of MRI has led to a similar variation. For all the total patients, the prevalent choice was found to the debulking approach by increasing from a prevalence of 12.92% to 15.17%, resulting in a reduction of conservative one.The present study set itself the objective to demonstrate how the FDG PET/CT could improve on breast imaging according to a more appropriate surgery.

Keywords: breast cancer, FGD PET/CT, preoperative staging, surgical approach

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Authors: Shahrukh Ahmad, Purnendu Bose

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Algal-Bacterial photobioreactors (ABPBRs) have emerged as a promising technology for sustainable biomass production and wastewater treatment. Nutrient removal is seldom done in sewage treatment plants and large volumes of wastewater which still have nutrients are being discharged and that can lead to eutrophication. That is why ABPBR plays a vital role in wastewater treatment. However, improving the efficiency of ABPBR remains a significant challenge. This study aims to enhance ABPBR efficiency by focusing on two key aspects: nutrient removal and cost-effective optimization of the light source. By integrating nutrient removal and cost analysis for light source optimization, this study proposes practical strategies for improving ABPBR efficiency. To reduce organic carbon and convert ammonia to nitrates, domestic wastewater from a 130 MLD sewage treatment plant (STP) was aerated with a hydraulic retention time (HRT) of 2 days. The treated supernatant had an approximate nitrate and phosphate values of 16 ppm as N and 6 ppm as P, respectively. This supernatant was then fed into the ABPBR, and the removal of nutrients (nitrate as N and phosphate as P) was observed using different colored LED bulbs, namely white, blue, red, yellow, and green. The ABPBR operated with a 9-hour light and 3-hour dark cycle, using only one color of bulbs per cycle. The study found that the white LED bulb, with a photosynthetic photon flux density (PPFD) value of 82.61 µmol.m-2 .sec-1 , exhibited the highest removal efficiency. It achieved a removal rate of 91.56% for nitrate and 86.44% for phosphate, surpassing the other colored bulbs. Conversely, the green LED bulbs showed the lowest removal efficiencies, with 58.08% for nitrate and 47.48% for phosphate at an HRT of 5 days. The quantum PAR (Photosynthetic Active Radiation) meter measured the photosynthetic photon flux density for each colored bulb setting inside the photo chamber, confirming that white LED bulbs operated at a wider wavelength band than the others. Furthermore, a cost comparison was conducted for each colored bulb setting. The study revealed that the white LED bulb had the lowest average cost (Indian Rupee)/light intensity (µmol.m-2 .sec-1 ) value at 19.40, while the green LED bulbs had the highest average cost (INR)/light intensity (µmol.m-2 .sec-1 ) value at 115.11. Based on these comparative tests, it was concluded that the white LED bulbs were the most efficient and costeffective light source for an algal photobioreactor. They can be effectively utilized for nutrient removal from secondary treated wastewater which helps in improving the overall wastewater quality before it is discharged back into the environment.

Keywords: algal bacterial photobioreactor, domestic wastewater, nutrient removal, led bulbs

Procedia PDF Downloads 79

Authors: Nathaniel Deboever, Malcolm Breeze, Adrian Sheen

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Basic surgical and suturing techniques are a fundamental requirement for all doctors. In order to gain confidence and competence, doctors in training need to obtain sufficient teaching and just as importantly: practice. Young doctors with an apt level of expertise on these simple surgical skills, which are often used in the Emergency Department, can help alleviate some pressure during a busy evening. Unfortunately, learning these skills can be quite difficult during medical school or even during junior doctor years. The aim of this project was to adequately train medical students attending University of Sydney’s Nepean Clinical School through a series of workshops highlighting practical skills, with hopes to further extend this program to junior doctors in the hospital. The sessions instructed basic skills via tutorials, demonstrations, and lastly, the sessions cemented these proficiencies with practical sessions. During such an endeavor, it is fundamental to employ models that appropriately resemble what students will encounter in the clinical setting. The sustainability of workshops is similarly important to the continuity of such a program. To address both these challenges, the authors have developed models including suturing platforms, knot tying, and vessel ligation stations, as well as a shave and punch biopsy models and ophthalmologic foreign body device. The unique aspect of this work is that we utilized hands-on teaching sessions, to address a gap in doctors-in-training and junior doctor curriculum. Presented to you through this poster are our approaches to creating models that do not employ animal products and therefore do not necessitate particular facilities or discarding requirements. Covering numerous skills that would be beneficial to all young doctors, these models are easily replicable and affordable. This exciting work allows for countless sessions at low cost, providing enough practice for students to perform these skills confidently as it has been shown through attendee questionnaires.

Keywords: medical education, surgical models, surgical simulation, surgical skills education

Procedia PDF Downloads 157

Authors: Mercedeh Malekzadeh

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Scrap tires are the source of wastes that cause the environmental problems. The major components of these tires are rubber and carbon black. These components can be used again for different applications by utilizing physical and chemical processes. Pyrolysis is a way that converts rubber portion of scrap tires to oil and gas and the carbon black recovers to pyrolytic carbon black. This pyrolytic carbon black can be used to reinforce rubber and metal, coating preparation, electronic thermal manager and so on. The porous structure of this carbon black also makes it as a suitable choice for heavy metals removal from water. In this work, the application of base treated pyrolytic carbon black was studied as an adsorbent for chromium (III) removal from water in a batch process. Pyrolytic carbon blacks in two natural and base treated forms were characterized by scanning electron microscopy and energy dispersive analysis x-ray. The effects of adsorbent dosage, contact time, initial concentration of chromium (III) and pH were considered on the adsorption process. The adsorption capacity was 19.76 mg/g. Maximum adsorption was seen after 120 min at pH=3. The equilibrium data were considered and better fitted to Langmuir model. The adsorption kinetic was evaluated and confirmed with the pseudo second order kinetic. Results have shown that the base treated pyrolytic carbon black obtained from scrap tires can be used as a cheap adsorbent for removal of chromium (III) from the water.

Keywords: chromium (III), pyrolytic carbon, scrap tire, water

Procedia PDF Downloads 200

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

Procedia PDF Downloads 84

Authors: Fatiha Atmani, Lamia Djellab, Nacera Yeddou Mezenner, Zohra Bensaadi

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Generally, bilge waters can be briefly defined as saline and greasy wastewaters. The oil and grease are mixed with the sea water, which affects many marine species. Bilge water is a complex mixture of various compounds such as solvents, surfactants, fuel, lubricating oils, and hydraulic oils. It is resulted mainly by the leakage from the machinery and fresh water washdowns,which are allowed to drain to the lowest inner part of the ship's hull. There are several physicochemical methods used for bilge water treatment such as biodegradation electrochemical and electro-coagulation/flotation.The research herein presented discusses adsorption as a method to treat bilge water and eggshells were studied as an adsorbent. The influence of operating parameters as contact time, temperature and adsorbent dose (0,2 - 2g/l) on the removal efficiency of Chemical oxygen demand, COD, and turbidity was analyzed. The bilge wastewater used for this study was supplied by Harbour Bouharoune. Chemical oxygen demand removal increased from 26.7% to 68.7% as the adsorbent dose increased from 0.2 to 2 g. The kinetics of adsorption by eggshells were fast, reaching 55 % of the total adsorption capacity in ten minutes (T= 20°C, pH =7.66, m=2g/L). It was found that the turbidity removal efficiency decreased and 95% were achieved at the end of 90 min reaction. The adsorption process was found to be effective for the purification of bilge water and pseudo-second-order kinetic model was fitted for COD removal.

Keywords: adsorption, bilge water, eggshells and kinetics, equilibrium and kinetics

Procedia PDF Downloads 355

Authors: Nora Yusma Bte Mohamed Yusoff, Hussain Ali Bekhet

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The rationalization of a gradual subsidies reforms plan has been set out by the Malaysian government to achieve the high-income nation target. This paper attempts to analyze the impacts of energy subsidy reform policy on fiscal deficit and macroeconomics variables in Malaysia. The Computable General Equilibrium (CGE) Model is employed. Three simulations based on different groups of scenarios have been developed. Importantly, the overall results indicate that removal of fuel subsidy has significantly improved the real GDP and reduced the government fiscal deficit. On the other hand, the removal of the fuel subsidy has increased most of the local commodity prices, especially energy commodities. The findings of the study could provide some imperative inputs for policy makers, especially to identify the right policy mechanism. This is especially ensures the subsidy savings from subsidy removal could be transferred back into the domestic economy in the form of infrastructure development, compensation and increases in others sector output contributions towards a sustainable economic growth.

Keywords: CGE, deficit, energy, reform, subsidy

Procedia PDF Downloads 265

Authors: P. Lestinsky, D. Jecha, V. Brummer, P. Stehlik

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Scrubbing by a liquid spraying is one of the most effective processes used for removal of fine particles and soluble gas pollutants (such as SO2, HCl, HF) from the flue gas. There are many configurations of scrubbers designed to provide contact between the liquid and gas stream for effectively capturing particles or soluble gas pollutants, such as spray plates, packed bed towers, jet scrubbers, cyclones, vortex and venturi scrubbers. The primary function of venturi scrubber is the capture of fine particles as well as HCl, HF or SO2 removal with effect of the flue gas temperature decrease before input to the absorption column. In this paper, sulfur dioxide (SO2) from flue gas was captured using new design replacing venturi scrubber (1st degree of wet scrubbing). The flue gas was prepared by the combustion of the carbon disulfide solution in toluene (1:1 vol.) in the flame in the reactor. Such prepared flue gas with temperature around 150 °C was processed in designed laboratory O-element scrubber. Water was used as absorbent liquid. The efficiency of SO2 removal, pressure drop and temperature drop were measured on our experimental device. The dependence of these variables on liquid-gas ratio was observed. The average temperature drop was in the range from 150 °C to 40 °C. The pressure drop was increased with increasing of a liquid-gas ratio, but not as much as for the common venturi scrubber designs. The efficiency of SO2 removal was up to 70 %. The pressure drop of our new designed wet scrubber is similar to commonly used venturi scrubbers; nevertheless the influence of amount of the liquid on pressure drop is not so significant.

Keywords: desulphurization, absorption, flue gas, modeling

Procedia PDF Downloads 399

Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

Procedia PDF Downloads 49

Authors: Gurinder Singh Brar, Sarbjeet Singh, Harry Garg

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Wire Electric Discharge Machining (WEDM) is thermal machining process capable of machining very hard electrically conductive material irrespective of their hardness. WEDM is being widely used to machine micro-scale parts with the high dimensional accuracy and surface finish. The objective of this paper is to optimize the process parameters of wire EDM to fabricate the microchannels and to calculate the surface finish and material removal rate of microchannels fabricated using wire EDM. The material used is aluminum 6061 alloy. The experiments were performed using CNC wire cut electric discharge machine. The effect of various parameters of WEDM like pulse on time (TON) with the levels (100, 150, 200), pulse off time (TOFF) with the levels (25, 35, 45) and current (IP) with the levels (105, 110, 115) were investigated to study the effect on output parameter i.e. Surface Roughness and Material Removal Rate (MRR). Each experiment was conducted under different conditions of a pulse on time, pulse off time and peak current. For material removal rate, TON and Ip were the most significant process parameter. MRR increases with the increase in TON and Ip and decreases with the increase in TOFF. For surface roughness, TON and Ip have the maximum effect and TOFF was found out to be less effective.

Keywords: microchannels, Wire Electric Discharge Machining (WEDM), Metal Removal Rate (MRR), surface finish

Procedia PDF Downloads 498

Authors: Yaling Gou, Sucai Yang, Pengwei Qiao

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Integrated chemical-biological treatment is an attractive alternative to remove polycyclic aromatic hydrocarbons (PAHs) from contaminated soil; wherein indigenous bacteria is the key factor for the biodegradation of residual PAHs concentrations after the application of chemical oxidation. However, the systematical study on the impact of persulfate (PS) oxidation on indigenous bacteria as well as PAHs removal is still scarce. In this study, the influences of different PS dosages (1%, 3%, 6%, and 10% [w/w]), as well as various activation methods (native iron, H2O2, alkaline, ferrous iron, and heat) on PAHs removal and indigenous bacteria in highly contaminated aged soil were investigated. Apparent degradation of PAHs in the soil treated with PS oxidation was observed, and the removal efficiency of total PAHs in the soil ranged from 38.28% to 79.97%. The removal efficiency of total PAHs in the soil increased with increasing consumption of PS. However, the bacterial abundance in soil was negatively affected following oxidation for all of the treatments added with PS, with bacterial abundance in the soil decreased by 0.89~2.88 orders of magnitude compared to the untreated soil. Moreover, the number of total bacteria in the soil decreased as PS consumption increased. Different PS activation methods and PS dosages exhibited different influences on the bacterial community composition. Bacteria capable of degrading PAHs under anoxic conditions were composed predominantly by Proteobacteria and Firmicutes. The total amount of Proteobacteria and Firmicutes also decreased with increasing consumption of PS. The results of this study provide important insight into the design of PAHs contaminated soil remediation projects.

Keywords: activation method, chemical oxidation, indigenous bacteria, polycyclic aromatic hydrocarbon

Procedia PDF Downloads 115

Authors: Anurakti Shukla, Sudhakar Srivastava

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Cyanobacteria are known for rapid growth rates, high biomass, and the ability to accumulate potentially toxic elements and contaminants. The present work was planned to develop a low-cost, feasible prototype, CyanoClean, for the growth of a cyanobacterial consortium for the removal of arsenic (As) from water. The cyanobacterial consortium consisting of Oscillatoria, Phormidiumand Gloeotrichiawas used, and the conditions for optimal growth of the consortium were standardized. A pH of 7.6, initial cyanobacterial biomass of 10 g/L, and arsenite [As(III)] and arsenate [As(V)] concentration of 400 μΜand 600 μM, respectively, were found to be suitable. The CyanoClean prototype was designed with acrylic sheet and had arrangements for optimal cyanobacterial growth in natural sunlight and also in artificial light. The As removal experiments in concentration- and duration-dependent manner demonstrated removal of up to 39-69% and 9-33% As respectively from As(III) and As(V)-contaminated water. In field testing of CyanoClean, natural As-contaminated groundwater was used, and As reduction was monitored when a flow rate of 3 L/h was maintained. In a field experiment, As concentration in groundwater was found to reduce from 102.43 μg L⁻¹ to <10 μg L⁻¹ after 6 h in natural sunlight. However, in shaded conditions under artificial light, the same result was achieved after 9 h. The CyanoClean prototype is of simple design and can be easily up-scaled for application at a small- to medium-size land and shall be affordable even for a low- to middle-income group farmer.

Keywords: cyanoclean, gloeotrichia, oscillatoria, phormidium, phycoremediation

Procedia PDF Downloads 142