Hydrological and Water Quality Characteristics of Rivers Feeding into Small Earth Dams for Rural Water Supply: A Case Study of Traditional Authority Kalolo in Lilongwe District

The obligation to ensure adequate and clean water supply to everyone, has necessitated the development of small earth dams for rural water supply in developing countries. In Malawi, there are approximately 750 small and medium dams most of which are used multiple purposes. However, in most cases, the sustainability of these dams is challenged by gross catchment mismanagement and improper designs and set up. In this study, FDC analysis, in conjunction with water quality assessment, was used to evaluate the reliability of rivers flows that supply small earth dams designed for rural water supply in Malawi, using Kalolo area in Lilongwe district as a case study. FDC analysis showed that over 80% of the time, all rivers in the study area would not meet the target community’s water demand, without the dams in place. Water quality assessments show biological contamination as the major water quality problem. Significant seasonal variation in water quality is evident, with the dry season having generally better biological water quality. Further, the study categorized the catchments areas as moderately to largely modified using rapid ecological assessment method. Therefore, the low biological water quality may be attributed to uncontrolled anthropogenic activities in the catchment, arising from lack of proper catchment management. It is then recommended that construction of such small earth dams should be preceded by thorough scientific design through appropriate engineering and environmental studies, encompassing hydrological, geological, ecological and socio-economic factors, if the small earth dams are to result into long term outputs.Keywords: River flow; small earth dams; flow duration curve; water quality; rural water supply

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Sistem Pakar Mendiagnosa Penyakit Gigi dan Mulut pada Manusia dengan Metode Certainty Factor Berbasis Mobile Web

Pada bidang keshatan sangat di perlukan sebuah sistem untuk menyelesaikan masalah yang biasanya dilakukan oleh tenagah medis serta nantinya dapat mengambil keputusan dengan cepat. seperti contoh penyakit yang umum terjadi di masyarkat yaitu gigi dan mulut, salah satu bagian kesehatan tubuh terpenting yang harus di jaga, karena kesehatan gigi dan mulut dapat mempengaruhi kesehatan tubuh secara menyeluruh. Penelitian ini bertujuan ( 1 ) untuk merancang sistem pakar mendiognasi penyakit gigi dan mulut pada manusia dengan metode certainty factor berbasis mobile web dan ( 2 ) untuk menginplementasikan algoritma certainty factor dalam sistem pakar mendiognosa penyakit gigi dan mulut pada manusia dengan metode certainty factor berbasis mobile web. Desain penelitian yng digunakan adalah UML yang didesain secara terstruktur yang terdiri dari rancangan model use case diagram, activity diagram, sequence diagram dan kelas diagram. sofware yang digunakan dalam membangun sistem ini adalah PHP dan MySqI untuk pengolahan database. algoritma yang digunakan adalah certainty factor. dalam peneitian ini pengumpulan data diperoleh melalui observasi, wawancara dan kepustakaan. Hasil dari penelitian ini adalah sistem mampu membantu pasien dalam mendiagnosa penyakit gigi dan mulut sesuai dengan gejala yang dialami dan memberikan solusi atau penenagangan yang tepat. Berdasarkan hasil pembahasan dan pengujian dengan uji coba 10 kondisi data, menghasilkan tingkat kecocokan 8 dari 28 gejala dan 10 penyakit. Dan nilai tertinggi untuk 10 kasus di peroleh nilai CF 0.8 dengan jenis penyakit karies media dan karies profunda.xiii, 99 hlm.; 29 c