Improvements in vortex flow control design to increase sewer network flood resistance

Copyright © 2013 IWA7th International Conference on Sewer Processes and Networks (SPN7), Sheffield, UK, 28-30 August 2013Flow controls are used within the water industry to manage the flow through sewer networks by attenuating flows at convenient or critical locations. Many sewer networks, regardless whether the systems have a flow control installed, are predicted to become stressed in the future due to the effects of climate change, population growth and urbanisation. This issue is compounded by the age of the Britain’s sewerage infrastructure as well as the cost and difficulty of replacing and upgrading the infrastructure. Statutory ‘Catchment Flood Management Plans’ have been introduced within the United Kingdom to tackle this issue by better understanding the flow path of flood water on a catchment scale. This paper discusses a method to maximise the use of the current sewerage infrastructure by installing flow controls, meaning a greater volume of the sewer network can be used for stormwater storage. This paper continues by describing a method of increasing a sewer network’s flood resistance by using vortex flow controls with a lower design flow-rate compared to an orifice plate. This paper then concludes by describing three case studies demonstrating the use vortex flow controls when retrofitting sewer networks as well as the impact of implementing the retrofit design method.EPSRCSTREAM IDCHydro Internationa

A comparison of WHO guidelines issued in 1997 and 2009 for dengue fever - single centre experience.

Objective: To compare the original (1997) and revised (2009) versions of World Health Organization guidelines for dengue patientsMethods: Adult patients with a positive dengue Immunoglobulin M serology, and a diagnosis of dengue were included in the study at Aga Khan University Hospital during a three-year period from January 2005 to December 2007. Data related to these dengue patients was collected from their medical records. Guidelines were then applied by the research assistant and correlation among these guidelines was computed. SPSS 19 was used for statistical analysis.Results: A total of 612 patients were found with a diagnosis of dengue, but only 439 (71.73%) had a positive IgM. The median age of these 439 patients was 28 (interquartile range: 18) years and majority of them were males, 295 (67%). According to the 1997 guidelines, 383 (87%) patients were classified as having dengue, while according to the 2009 guidelines, all the 439 (100%) patients were classified with a dengue infection. Under WHO 1997, 21 (5.5%) cases were classified as dengue shock syndrome, while 2009 guidelines labelled 88 (20%) cases as severe dengue. There was a consensus on only 11 severe cases by both the guidelines, showing different results between the two.Conclusion: By using 2009 guidelines, a physician would classify more dengue patients as having severe disease

Mantle cell lymphoma with in situ or mantle zone growth pattern: a study of five cases and review of literature

We present two rare cases of in situ mantle cell lymphoma ( in situ MCL ) and three cases of MCL with mantle zone growth pattern (MCL-MZGP). The patients include four males and one female, with a median age of 66 years (range, 52 to 86 years). Two present with isolated lymphadenopathy and three with multiple lymphadenopathy. At presentation, the complete blood count (CBC) and serum lactate dehydrogenase (LDH) are normal in all cases. Histologic examination reveals an in situ pattern in two cases and a mantle zone growth pattern in three cases. The staging bone marrow biopsies show minimal involvement by lymphoma in one case and no morphologic evidence of lymphoma in four cases. All cases are positive for cyclin D1, including two with typical MCL phenotype and three with CD5-negativity. Four out of five cases express kappa light chain. FISH study for t(11;14) is performed in three cases, of which one is positive and two are inconclusive. For four patients with a median follow-up of 38 months, three are in clinical remission and one has persistent disease. In conclusion, the in situ MCL is associated with incidental finding, indolent clinical course and lower tumor burden. The predominant usage of kappa light chain and frequent CD5-negativity observed in our cases are unusual. We review the clinical and laboratory features of in situ MCL cases in the literature

Cystathione gamma lyase/hydrogen sulphide pathway up regulation enhances the responsiveness of ?1A and ?1B-adrenoreceptors in the kidney of rats with left ventricular hypertrophy

The purpose of the present study was to investigate the interaction between H2S and NO (nitric oxide) in the kidney and to evaluate its impact on the functional contribution of ?1A and ?1B-adrenoreceptors subtypes mediating the renal vasoconstriction in the kidney of rats with left ventricular hypertrophy (LVH). In rats the LVH induction was by isoprenaline administration and caffeine in the drinking water together with intraperitoneal administration of H2S. The responsiveness of ?1A and ?1B to exogenous noradrenaline, phenylephrine and methoxaminein the absence and presence of 5-methylurapidil (5-MeU) and chloroethylclonidine (CEC) was studied. Cystathione gamma lyase (CSE), cystathione ? synthase (CBS), 3-mercaptopyruvate sulphar transferase (3-MST) and endothelial nitric oxide synthase (eNOS) were quantified. There was significant up regulation of CSE and eNOS in the LVH-H2S compared to the LVH group (P<0.05). Baseline renal cortical blood perfusion (RCBP) was increased (P<0.05) in the LVH-H2S compared to the LVH group. The responsiveness of ?1A-adrenergic receptors to adrenergic agonists was increased (P<0.05) after administration of low dose 5-Methylurapidil in the LVH-H2S group while ?1B-adrenergic receptors responsiveness to adrenergic agonists were increased (P<0.05) by both low and high dose chloroethylclonidine in the LVH-H2S group. Treatment of LVH with H2S resulted in up-regulation of CSE/H2S, CBS, and 3-MST and eNOS/NO/cGMP pathways in the kidney. These up regulation of CSE/H2S, CBS, and 3-MST and eNOS/NO/cGMP pathways enhanced the responsiveness of ?1A and ?1B-adrenoreceptors subtypes to adrenergic agonists in LVH-H2S. These findings indicate an important role for H2S in modulating deranged signalling in the renal vasculature resulting from LVH development

The pediatric disease spectrum in emergency departments across Pakistan: data from a pilot surveillance system

Background: There is an increasing number of urgently ill and injured children being seen in emergency departments (ED) of developing countries. The pediatric disease burden in EDs across Pakistan is generally unknown. Our main objective was to determine the spectrum of disease and injury among children seen in EDs in Pakistan through a nationwide ED-based surveillance system. Methods: Through the Pakistan National Emergency Department Surveillance (Pak-NEDS), data were collected from November 2010 to March 2011 in seven major tertiary care centers representing all provinces of Pakistan. These included five public and two private hospitals, with a collective annual census of over one million ED encounters. Results: Of 25,052 children registered in Pak-NEDS (10% of all patients seen): 61% were male, 13% under 5 years,while almost 65% were between 10 to \u3c 16 years. The majority (90%) were seen in public hospital EDs. About half the patients were discharged from the EDs, 9% admitted to hospitals and only 1.3% died in the EDs. Injury (39%) was the most common presenting complaint, followed by fever/malaise (19%) and gastrointestinal symptoms (18%). Injury was more likely in males vs. females (43% vs. 33%; p \u3c 0.001), with a peak presentation in the 5-12 year age group (45%). Conclusions: Pediatric patients constitute a smaller proportion among general ED users in Pakistan. Injury is the most common presenting complaint for children seen in the ED. These data will help in resource allocation for cost effective pediatric ED service delivery systems. Prospective longer duration surveillance is needed in more representative pediatric EDs across Pakistan