Future of Sludge Management

Managing sludge is a crucial component of wastewater treatment plants. As the amount of sludge produced continues to grow, it is necessary to explore future strategies and technologies for sustainable sludge management. This chapter aims to provide an overview of the future of sludge management, with an emphasis on emerging technologies and sustainable practices. The chapter stresses the significance of environmentally sustainable and cost-effective sludge management and extensively evaluates the technological, economic, and environmental criteria for assessing sludge management strategies. The chapter explores innovative methods for handling sewage sludge and its reuse, as well as emerging technologies for sustainable sludge management. It assesses the economic feasibility of advanced treatment technologies and sludge-based products, considering beneficial sludge utilization such as land application, energy recovery, alternative fuel sources, construction materials, and resource recovery. Lastly, the chapter discusses future developments in sludge management, including issues and trends. Recent research findings are utilized to provide insights into the future of sludge management that can guide decision-making and policy development in the field

The Roles of Vitamin D in Increasing the Body's Immunity and Reducing Injuries due to Viral Infections: With an Emphasis on its Possible Role in SARS-CoV-2 (COVID-19)

Background: It is known that vitamin D can increase the body's immunity against some viral infections. Many people worldwide have vitamin D deficiency; therefore, this has become a public concern whether vitamin D is an important factor protecting against COVID-19 infection. In this paper, the data about the roles of vitamin D in immunity and recovery from viral infections, especially novel Coronavirus disease (COVID19), are reviewed. Methods: The electronic databases of Pubmed, Google Scholar, Research Gate, Excerpta Media Database (EMBASE), and Medical and Health Education (Medrix) were searched. Results: Vitamin D is considered an important factor in immune homeostasis. Various effects have been considered for this nutrient on the immune system, particularly because of vitamin D receptor (VDR) and Cytochrome P450 Family 27 Subfamily B Member 1 (CYP27B1) expression in most of the immune cells. Vitamin D can increase cellular immunity, reduce cytokine storm, and enhance antioxidants production. It also has modulatory effects on Angiotensin-converting enzyme 2 (ACE2) receptors and might have protective functions against acute lung injuries, including COVID-19 infection. However, there are some articles against this positive effect. Conclusion: Vitamin D supplementation is reported to be effective in the enhancement of the immune system and might be effective in the treatment and prevention of COVID-19 infection, especially in those with its deficiency. However, it should be considered that vitamin D deficiency shows the overall health status of the patients and cannot be considered specific for COVID-19 infectio

Delay in Regular Visits of Chronic Disease Patients and Its Associated Factors during the COVID-19 Pandemic

Background: Chronic patients need regular follow-ups. During the COVID-19 pandemic, these regular visits can be affected. The delay of chronic patients and its contributing factors in their periodic visits during the COVID-19 pandemic are examined here.Methods: This cross-sectional study was conducted between February and June 2021, in Fars, Iran. Two hundred and eighty-six households with at least one chronic patient were recruited. Then, several trained questioners called the studied households and asked about the studied variables. The dependent variable was the number of delays in regular visits during the COVID-19 pandemic. The results were analyzed through Poisson regression by SPSS Statistics version 22 and GraphPad Prism software version 9. A significance level of 0.05 was considered for this study.Results: Out of 286 households 113 (73.4%) fathers, 138 (70.1%) mothers, and 17 (58.6%) children in the households reported delayed referral. In fathers, referring to the health center was significantly associated with a decrease in the number of delays (P=0.033). The higher age of the householder (P=0.005), the higher number of children (P=0.043), and having a family physician (P=0.007) in the mothers' group, also the number of children in households P=0.001 in the children group were significantly associated with increasing the number of delays.Conclusion: COVID-19 pandemic not only creates direct harmful effects but also adversely affects people in danger of chronic diseases. Delays in follow-ups are taken into account as a major challenge during the COVID-19 pandemic. This issue is not limited to rural or urban residency

Autophagy and treatment of patients with COVID-19; which drugs target the autophagy pathway?

Implication for health policy/practice/research/medical education: Autophagy is a way to create new cellular structures, clear cells invaded by microbes, and block accumulating proteins that can cause disease. Moreover, it can destroy all cellular organs and pathogens, including fungi, parasites, bacteria, and viruses, either randomly or selectively. Many research groups are examining a strategy to combat COVID-19. In particular, research is underway to identify drugs that can target autophagy in COVID-19 virus infection. Several known drugs are currently under clinical evaluation for the autophagy process, given that regulating autophagy is a way to combat COVID-19. This study introduces drugs that target the autophagy pathway.publishedVersio

The Association of Vitamin D Deficiency with COVID- 19 Severity and Mortality

Background & Aims: There are few studies showing the association between vitamin D deficiency and COVID-19 severity and mortality. This study designed to investigate the relationship between vitamin D deficiency and the severity and mortality of COVID-19. Materials & Methods: The present cross-sectional study was conducted on 48 COVID-19 patients with positive PCR test results. Patients were divided into three groups according to their serum 25-OH vitamin D3 levels: group 1 <20 ng/mL, group 2. 20-50 ng/mL, and group 3, ≥50 ng/ml. The relationship of the levels of vitamin D3, as well as the history of diabetes, hypertension, Ischemic Heart Disease (IHD), Glomerular Filtration Rate (GFR) ≤60 mL/min, LDH ≥500 U/L, and Lymphocyte count ≤1500 with the severity of the disease and its mortality were investigated. Results: A significant relationship was observed between vitamin D ≤20 ng/mL and the severity (P<0.001) and mortality (P=0.001, adjusted OR=2.4) of the disease in COVID-19 patients. It was also shown that GFR ≤60 mL/min (P=0.02, adjusted OR=3.6), IHD (P=0.04, adjusted OR=2.8), LDH ≥500 U/L (P=0.027, adjusted OR=1.8), and lymphocyte count ≤1500 (P=0.002, adjusted OR=2.2) significantly affected the mortality. Conclusion: The present study showed a significant relationship between vitamin D deficiency and the severity of the disease and mortality in COVID-19 patients. These results suggest the need for appropriate health policies during the COVID-19 pandemic

The Efficacy of Famotidine in Improvement of Outcomes in Hospitalized COVID-19 Patients: A Phase III Randomized Clinical Trial

Background & Aims:  As the first randomized clinical trial, this study evaluated the effect of Famotidine on the improvement of outcomes of hospitalized patients with COVID-19. Materials & Methods: This phase III randomized clinical trial which was designed with two parallel arms, is a placebo-controlled, single-blind, and concealed allocation study, and recruited 20 patients (10 of them received Famotidine as treatment group and 10 received Placebo as control group). Oral Famotidine 160 mg four times a day was given to the COVID-19 patients until the discharge day or for a maximum of 14 days. Patients’ temperature, respiration rate, oxygen saturation, lung infiltration, lactate dehydrogenase (LDH) level, and complete blood count (CBC) were measured at the baseline (before the intervention) and on day 14 after the intervention or on discharge day. Length of stay in the hospital and length of stay in the ICU were also measured as secondary outcomes of the study. Results: The results showed a significant decrease in LDH (P=0.01), mean WBC (P=0.04) and length of stay (P=0.04) of patients with COVID-19 in the group treated with Famotidine compared to the control group. There was also a significant increase in oxygen saturation (P=0.01) in the group treated with Famotidine compared to the control group. Cough improvement was also higher in the oral Famotidine group compared to the control group (P=0.02). Conclusion: This was the first clinical trial on the effect of Famotidine on the improvement of hospitalized COVID-19 patients, which indicated that high-dose Famotidine improves patients’ clinical signs and reduces the severity of the disease and duration of hospitalization

Autophagy and treatment of patients with COVID-19; which drugs target the autophagy pathway?

Autophagy is a way to create new cellular structures, clear cells invaded by microbes, and block accumulating proteins that can cause disease. Moreover, it can destroy all cellular organs and pathogens, including fungi, parasites, bacteria, and viruses, either randomly or selectively. Many research groups are examining a strategy to combat COVID-19. In particular, research is underway to identify drugs that can target autophagy in COVID-19 virus infection. Several known drugs are currently under clinical evaluation for the autophagy process, given that regulating autophagy is a way to combat COVID-19. This study introduces drugs that target the autophagy pathway