OPTIMAL MAINTENANCE PROGRAM OF A WASTE-TO-ENERGY PLANT : Case Study: wasteWOIMA®

Waste-to-energy (WtE) plant is a complex system which requires different maintenances to be reliable and available in its full functionalities. Maintenance has a crucial impact on the performance, availability and reliability of the WTE plant. The inadequacies of WTE plant lifetime maintenance may increase the production costs, and more it negatively affects the competitiveness, makes the downtime longer and the Mean-Time-Failure is bigger. The thesis focuses on the maintenance of WtE plant and it reviews the existing literature about Waste-to-Energy maintenance program and then find the best combination that better suits a Waste-to-Energy plant. This thesis has into two parts: the first part identifies the critical factors that enable high availability of Waste-to-Energy plant and the second addresses the identification of the right criteria for spare part selection. Both parts are aimed at enhancing the availability of Waste-to-Energy plant. A survey was sent to Waste-to-Energy professionals to collect data and compare that data to the findings in literature. DEMATEL method is chosen over the other methods for the pragmatic methodology used to construct and analyze the structural model involving causal relationship between multiple factors. It also integrates different expert knowledge that helps to investigate internal relationship and significance degrees of all the chosen factors. One advantage is that it can present a derived relationship through a cause-effect diagram. Critical factors through a visual structural model can be found, as well as the interdependent relationship amount factors are identified and evaluated while using DEMTEL. Key findings of the study revealed that human, economic, equipment and tools, management and environment factors have important impact of the effectiveness of the maintenance and the availability of the WtE plant, whatever the maintenance strategies from preventive to corrective maintenance through the condition maintenance. Quality, Lead time, Price and severity of spare part failure are keys criteria to consider while selecting spare part for WtE plant. The main limitation is that, the sample was a bit small since only few responds to the survey. Limitation of the thesis is related to the amount of the data collected. The findings cannot be generalized as it is affected by the limitation. The survey encounters probably the lack of cooperation from respondents as the study was not directly requested and done from their companies. It would be interesting to do further research of the topic by using data from different plants operated by the case company, to make the research more objective. This will help the case company knowing real issues their plants face. It could be interesting to do further research by focusing for instance on different locations and population because different climatic and environment factors may influence the failure rate of the plants items; dust, humidity, cultural factors

Criteres Du Traitement Non Operatoire Des Contusions Abdominales En Milieu Sous Equipe

The criteria of non-operative operative management (NOM) of blunt abdominal trauma remains poorly defined in the context of low-income countries. Purpose: To validate a protocol for blunt abdominal trauma by specifying indications for NOM in a resource-limited setting. Material and Method: The study was prospective, carried out over a period of 12 months at Sylvanus Olympio Teaching Hospital Lomé (Togo). It included all patients over 15 years admitted for abdominal blunt trauma. Patients were subjected to NOM or surgery according to systolic blood pressure, response to resuscitation measures, clinical examination, peritoneal tap, abdominal plain radiograph and ultrasound. Results: Sixty-four patients, including 53 men and 11 women, were admitted in the study. The mean age was 27.8 years. Road traffic accidents were the circumstance of the occurrence in all cases. Pneumopéritoneum was found in 3 patients (5.45%). Abdominal ultrasound identified a solid organ injury in 24 patients (43.6%). Spleen lesions were the most frequent injuries. An extra-abdominal lesion was present in 23 patients (35.9%). NOM was initiated in 52 patients (81.25%) and effective in 46 patients (88.4%). The failure of the NOM was due to small intestine perforation in 2 patients, a bladder injury in 1 patient, active bleeding in 1 patient and hemodynamic instability resulting in nontherapeutic laparotomy in 2 patients. Death was observed in 8 patients (12.5%), 2 of whom were in the NOM group. Conclusion: criteria for the NOM of blunt abdominal trauma can be defined according to the local possibilities. Early diagnosis of digestive perforation should remain a priority during clinical monitoring

La Chirurgie Foraine : Une Solution Aux Problemes D’acces Aux Soins Chirurgicaux Des Populations Rurales

Assessment of the quality of care in surgical outreach programs is necessary to improve their reliability. Purpose: The purpose of this study is to evaluate the clinical results of a surgical outreach program involving large numbers of patients. Material and Method: Retrospective study of clinical data and outcomes of patients operated on within a surgical outreach held in Togo's Central Region was carried out. Data was collected from patient’s files with a follow-up, of 2 years. Results: Two hundred and seventy seven patients (277) underwent 304 surgical procedures within the surgical outreach. The conditions were essentially made of hernias of the abdominal wall (89%). Cases of hydroceles, endemic goiter and uterine myo-fibroids were also managed. Spinal anesthesia was the most common procedure of anesthesia (75%). Day case surgery involved 165 patients (59.5%). A post operative morbidity was observed in 31 patients (11%) essentially made of hematoma 28 cases (9.2%) and parietal abscesses 20 cases (6.5%).There were no postoperative deaths. Conclusion: outcomes in this study encourage surgical outreach programs as reliable means to address surgery accessibility issues of rural populations in low incomes countries

DEVELOPING AN ONLINE SHOP WITH OPEN SOURCE TECHNOLOGIES

The aim of the thesis was to develop an online shop website using open source technologies (PHP, HTML5, CSS3, JavaScript, MySQL and Apache Web Server) for electronics products in Togo where customers will be able to buy products online. The application provides two separate views; public view and admin view. The public view is meant for users and customers where they can view and order products. The admin view is meant for application manager who can maintain products and customers. The administrator will be able to see all the orders made by all the customers. The administrator will also be able to view, add, update and delete the product and customer information. The user will be able to view, search and buy products. The application allows the users to register and login. The registered users will have their own accounts where they can see all their personal information as well as their orders. Registered customers will also be able to update their personal information, manage their orders and accounts

Unusual Complication following a Myomectomy: Colic Migration of a Forgotten Abdominal Swab

Surgical sponges are the most common retained foreign bodies following surgery. The morbidity of this condition is illustrated herein with the case of a 36-year-old female patient with a history of myomectomy 5 months before her admission into our unit for enterocutaneous fistula. Although imaging and etiological investigations were made, diagnosis was carried out only by laparotomy. The foreign body found was an abdominal swab that migrated from abdominal cavity to the colon causing several intestinal injuries. The lack of specific clinical signs and the death of the patient raise the necessity of preventing these complications that involve the surgeon liability