Treated Municipal Wastes: Are they Contaminating or Enriching the Soil?

Treated municipal wastes could be a mixture of treated sewage biosolids and green wastes (Kala compost) that can be applied for agricultural production. It can improve soil fertility and plant growth. However, long-term application of treated sewage biosolids could result in heavy metal accumulation and some health problems. The objective of this study is to evaluate the effect of different fertilizers, especially Kala compost, on the soil fertility and plant productivity. An open field was divided into nine plots and received either treated municipal wastes (Kala compost) or inorganic fertilizer, or a mixture of both fertilizers. The field was irrigated by drip system, and commercial cucumber, tomato, cabbage, lettuce, carrot, and potato were grown in each plot. Soil and plant were monitored continuously and samples were taken at different stages of the study. No symptoms of physical or chemical problems were observed in the open field and measured soil samples. Moreover, the soil had sufficient amount of different nutrients for plant growth and all measured micronutrients (heavy metals) were within the safe limit and below the allowable safe limit of the international standards. Good growth was observed in all grown crops and no symptoms of element toxicity were observed. Chemical analysis for fruit samples did not show any accumulation of heavy metals and all measured elements were within the safe limit for human consumption. It can be concluded that treated municipal wastes (Kala compost) were good media for plant growth that can enrich the soil with different elements needed for higher yield. However, more monitoring is needed with treated biosolid application and good management could be the key to avoid any adverse effect of any contaminant

Mitigating Environmental Risks of Wastewater Reuse for Agriculture

The study was aimed to maximize and optimize treated wastewater reuse in conjunction with surface and ground waters resources. Moreover, environmental, agronomic and economic components were also considered. The project was funded by USAID and implemented in three countries (Oman, Tunisia and Jordan). In Oman, the study was done at Sultan Qaboos University experimental station field. Four types of waters (A: 50% of treated wastewater with 50% of groundwater, B: 100% of groundwater, C: 25% of groundwater with 75% of treated wastewater, and D: 100% of treated wastewater) were used to grow three different crops (okra, maize and sweet corn). Results showed no significant differences in soil physical and chemical properties with treatments irrigated with treated wastewater as compared to groundwater. On other hand, some chemical properties significantly increased (p<0.05) when treated wastewater was applied such as soil total carbon and some major elements (N, K, Mg). Crop physical analysis showed significant increases in plant productivity when plants were irrigated with treated wastewater and values of chemical properties were within the international standards. Crop biological analysis showed no effect on crop quality and all tested crops were free from any microbial contamination

Field Guide to the Difficult Patient Interview

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Medical Tourism Abroad : A new challenge to Oman’s health system - Al Dakhilya region experience

Objectives: This study aimed to understand why people seek medical advice abroad given the trouble and expense this entails. The types of medical problems for which treatment abroad was sought, preferred destinations and satisfaction with the treatment were explored. A secondary aim was to give feedback to stakeholders in the health care system on how to handle this issue and meet the needs of the community. Methods: 45 patients who had recently travelled abroad for treatment were asked to complete a questionnaire or were interviewed by telephone. Results: 40 questionnaires were received. 68% of the respondents were male. Orthopaedic diseases were the most common conditions leading patients to seek treatment abroad. Thailand was the most popular destination followed by India (50% and 30% respectively). 85% of respondents went abroad for treatment only, 10% for treatment and tourism and 2.5% were healthy, but travelled abroad for a checkup. Interestingly, 15% of the participants went abroad without first seeking medical care locally. Out of those initially treated in Oman, 38.2% had no specific diagnosis and 38.2% had received treatment, but it was not effective. 73% of respondents obtained information on treatment abroad from a friend. The Internet and medical tourism offices were the least used sources of information. 15% of the patients experienced complications after their treatment abroad. Conclusion: Various facts about medical treatment abroad need to be disseminated to the public. This will necessitate greater effort in public health promotion and education. 

Postprocedural Endophthalmitis or Postprocedural Intraocular Inflammation: A Diagnostic Conundrum

We experienced an atypical endophthalmitis occurring post consecutively performed in-office procedures; an intravitreal injection (IVI) of ranibizumab followed by an anterior chamber (AC) paracentesis performed twice in an eye with neovascular glaucoma (NVG). A 52-year-old diabetic male who was asymptomatic developed signs of endophthalmitis and decreased vision without pain in his left eye a few days post-IVI and AC paracentesis. The condition worsened after an initial vitreous tap and injection of antibiotics. Cultures of vitreous and aqueous samples were negative. Complete resolution occurred after a pars plana vitrectomy with IVI of antibiotics and steroid with removal of a dense “yellowish-brown” fibrinous plaque. The absence of pain, presence of a peculiar colored fibrin, mild-to-moderate vitritis without retinitis, negative cultures, and complete recovery despite the fulminant presentation; favor a diagnosis of inflammation over infection. We hypothesize that a micro-leak from a 26-gauge AC tap tract might have served as an entry port for 5% povidone-iodine from the ocular surface thus inciting inflammation. However, an exuberant inflammatory response that can be typically seen in NVG eyes after intraocular procedures cannot be excluded. Various causes of inflammation post-procedures, both toxic and nontoxic should be considered in atypical culture-negative fulminant endophthalmitis cases with good outcome posttreatment. Any minor ocular procedure may carry a risk of such complication. Patient counseling and care must be exercised in performing these procedures