Coagulation and electrocoagulation for co-treatment of stabilized landfill leachate and municipal wastewater

Landfill leachate and municipal wastewater at various ratios (1:20, 1:10, 1:7 and 1:5) were subjected to coagulation and electrocoagulation (EC). Alum was used in conventional coagulation at pH 6 and aluminum plate as electrode was used in EC at a current density of 386 A/m2 with 5 cm inter electrode spacing. Treatment efficiency was assessed from removal of chemical oxygen demand (COD), total suspended solids (TSS), turbidity, ammonia, nitrate and phosphate. At 1:5 ratio of landfill leachate to municipal wastewater, highest COD removal was with 3.8 g/L alum whereas highest turbidity removal was with 3.3 g/L alum during coagulation. EC exhibited almost similar removal efficiency for all the parameters at different ratios tested except for COD which was considerably higher at 1:20 ratio. Aluminum consumption from electrode was 0.7 g/L following EC as compared to 3.8 g/L alum used in coagulation. The amount of sludge produced was found to be higher with EC as compared to coagulation which could be due to the fact that the electrochemical method was performed for a longer duration than conventional coagulation. For minimal sludge generation, EC reaction time should be ∼30 min. Further studies with EC process on costing and sludge generation will help to advance the technology for wastewater treatment

Macrophage Activation Syndrome in Adult Onset Still’s Disease: A Life Threatening Complication

Adult onset Still’s disease (AOSD), a multi-systemic inflammatory disorder, is a rare disorder but an important differential to be considered in patients of Pyrexia of Unknown Origin, especially if patient presents with polyarthritis. Macrophage activation syndrome (MAS), a subset of Secondary Hemophagocytic Lymphohistiocytosis (HLH), considered as the most life threatening complication of AOSD, mostly develops around the onset of disease. Hence, in a previously undiagnosed case of AOSD, recognizing MAS as a presenting feature complicating underlying AOSD is essential for increased patient survival, as in our case.     A 39 year old diabetic female presented with high grade fever with chills and multiple joint pains symmetrically involving proximal shoulder, knees and distal joints (involving MCP, PIP and DIP joints of hand) associated with swelling and early morning stiffness, relieved on activity, since past 6 months. No history of oral ulcers, rash, jaundice, weight loss, loss of appetite, foreign travel or close animal contact.   On examination, Pallor was present, Blood Pressure was 120/70 mm Hg, pulse rate was 102/min and temperature was 100 F. On per abdomen, mild hepatomegaly was present and other system examination was unremarkable.   Routine laboratory findings on day of presentation have been summarised (Table 1.1). Ultrasound Abdomen revealed hepatomegaly and Chest X-ray showed signs of old infective foci. Peripheral smear for Malarial parasite, Ns1Ag and dengue serology, Widal test and Montoux test were negative. Blood cultures and urine cultures were sterile. X-Ray of joints were normal. USG of B/L Knee joints showed mild joint effusion bilaterally with no internal echoes (non tappable). Trans-thoracic echo and Trans-esophageal echo were normal. CT chest, neck and abdomen showed old tubercular changes in lung. Tests for atypical bacterial infections which was normal (RK 39, Chickungunya, Brucella, Leptospirosis  and Scrub typhus). Fever did not respond to Broad Spectrum Antibiotics, Antimalarials or Antitubercular therapy and patient continued to have persistent fever spikes.   Autoimmune profile showed ANA and RA Factor negative but markers of inflammation were raised: CRP- 521, ESR -148, IL-6 – 84.0, Procalcitonin-6.9 and S.Ferritin >2000. During the work up for Anemia, Microcytic hypochromic anemia was found with Elevated NAP SCORE-165. Incidentally, her triglycerides were found to be elevated (356) and a reduced fibrinogen.  With these results, we planned for a bone marrow aspirate and biopsy which showed increased myeloid preponderance (32:1), increased histiocytes and evidence of hemophagocytosis.   The 2004 diagnostic criteria of HLH was fulfilled. After ruling out almost all infectious and malignant causes of secondary HLH, we searched for a rheumatologic cause. Thus diagnosis of AOSD (after fulfilling Yamaguchi’s criteria) with MAS (a subset of 2’ HLH) was made. Patient had dramatic improvement after receiving steroids with her fever episodes and joint pains settling completely thereafter.     Prompt recognition of life threatening complications like MAS which pose diagnostic difficulty due to overlapping features in a patient of AOSD, should be done at the earliest to improve patient prognosis and survival. Serum Ferritin levels can be considered a useful marker to assess the disease activity and to predict MAS occurrence in such patients

A Prospective study of Modified Triple Assessment in Breast Lumps

INTRODUCTION: “BREAST LUMP” is one of the common complaints in women coming to the surgical outpatient department. Even though most of the lumps were benign, all cases needs to be evaluted properly to rule out malignancy. In India, Breast carcinoma is the 2nd most common malignancy in women. Incidence increasing every year which ranges approximately 19-33%. Incidence of cancer breast shows “AGE SHIFT” over the past twenty years in India that is incidence increased from 7 to 15% in the age group of 30-40 years. Advanced breast cancer stage is associated with high morbidity and mortality. Hence early stage disease should be promptly differentiated from benign disease for proper management at the earliest with proper assessment. Breast lump assessment should be an ordered one. So, sequential evaluation named “TRIPLE TEST” was formalized. This was introduced with an aim to avoid expensive potentially morbid negative biopsy and also to let the clinician to proceed directly for definitive management without further investigations. Triple test proved to be a gold standard diagnostic modality in lump breast. AIM OF THE STUDY: To study .the diagnostic accuracy of modified triple test. Components of .Modified Triple Test: Clinical examination, Imaging .study - ultrasound, Tissue diagnosis .- FNAC/CNB. Scope of this .study: 1. To assess .the individual component diagnostic accuracy of MTT. 2. To assess .overall diagnostic accuracy of MTT. 3. To explore .the results against HPE report of Incisional/ Excisional biopsy. MATERIALS AND METHODOLOGY: Patients attending Department of General Surgery OPD with a palpable breast lump was subjected to the study. Place of study: Department of General Surgery, Government Royapettah Hospital, Kilpauk Medical College, Chennai-14. Inclusion criteria: Female patients with palpable. breast lump, Age group of more than 15 years. Exclusion criteria: Male patients, Female patients with clinically evident. advanced stage. breast disease As per inclusion and exclusion criteria study people.. were selected. Total numbers of 50 patients were included in the study. Duration of Study: March 2018 to August 2018. CONCLUSION: In recent years in India, westernization and increased sedentary life style resulted in increased incidence of breast can.cer. With present knowledge and public awareness about cancer breast, the cancer phobia is increased in among the female. Our study includes assessment of individual and combined diagnostic accuracy of Modified Triple Test in women of more than 30 years of age with palpable breast lump. Study goes on with initial assessment with clinical examination, then imaging with Ultrasound and finally cytological interpretation of FNAC slides. Clinician, Radiologist and pathologist had fine collaboration during the study. Diagnostic accuracy of MTT indirectly indicates the experience and skill of the clinician, radiologist and pathologist. On data analysis the study results showed that clinical examination is least sensitive in diagnosing the malignancy, hence breast lump requires further investigations which on combination with other two component the sensitivity increased to 100%. Advanced technology Ultrasonogram good in characterization of breast lump which had high sensitivity and NPV of 100%. FNAC had a high specificity and positive predictive value of 100% which was highly comparable to previous study results

Association of ABO blood groups with Chikungunya virus

Chikungunya virus (CHIKV) an emerging arboviral infection of public health concern belongs to the genus Alphavirus, family Togaviridae. Blood group antigens are generally known to act as receptors for various etiological agents. The studies defining the relationship between blood groups and CHIKV is limited and hence it is necessary to study these parameters in detail. In the present study 1500 subjects were enrolled and demographic data (Age, Gender, Blood group, CHIKV infection status, and CHIKV infection confirmation mode) was collected from them. The risk of acquiring CHIKV disease and its association with factors such as blood group, age and gender was analyzed statistically. The data of this study showed a possible association between blood group, age and gender of the study population with CHIKV infection. It is observed that CHIKV infections were higher in individuals with Rh positive blood group when compared to their Rh negative counterparts.CHIKV infections were found to be higher in Rh positive individuals of AB and A blood groups than that of Rh negative counterparts. Results also indicated that infections were higher in adults belonging to the age group > 30 years and also higher in males as compared to females enrolled in this study. These data present further evidence for the association of the blood groups, age and gender to susceptibility to CHIKV infection. Further studies are needed to confirm these findings. This is the second study showing the possible association of blood groups with chikungunya

Two new species of Dulcicalothrix (Nostocales, Cyanobacteria) from India and erection of Brunnivagina gen. nov., with observations on the problem of using multiple ribosomal operons in cyanobacterial taxonomy

Two new species of Dulcicalothrix, D.adhikaryi sp. nov. and D.iyengarii sp. nov., were discovered in India and are characterized and described in accord- ance with the rules of the International Code of Nomenclature for algae, fungi, and plants (ICN). As a result of phylogenetic analysis, Calothrix elsteri is reas- signed to Brunnivagina gen. nov. During comparison with all Dulcicalothrix for which sequence data were available, we observed that the genus has six ribosomal operons in three orthologous types. Each of the three orthologs could be identified based upon indels occurring in the D1–D1′ helix sequence in the ITS rRNA region between the 16S and 23S rRNA genes, and in these three types, there were operons containing ITS rRNA regions with and without tRNA genes. Examination of complete genomes in Dulcicalothrix revealed that, at least in the three strains for which complete genomes are available, there are five ribosomal operons, two with tRNA genes and three with no tRNA genes in the ITS rRNA region. Internal transcribed spacer rRNA regions have been consistently used to differentiate species, both on the basis of secondary structure and percent dissimilarity. Our findings call into ques- tion the use of ITS rRNA regions to differentiate species in the absence of efforts to obtain multiple operons of the ITS rRNA region through cloning or targeted PCR amplicons. The ITS rRNA region data for Dulcicalothrix is woe- fully incomplete, but we provide herein a means for dealing with incomplete data using the polyphasic approach to analyze diverse molecular character sets. Caution is urged in using ITS rRNA data, but a way forward through the complexity is also proposed

Luminosity distance in Swiss cheese cosmology with randomized voids. II. Magnification probability distributions

We study the fluctuations in luminosity distances due to gravitational lensing by large scale (> 35 Mpc) structures, specifically voids and sheets. We use a simplified "Swiss cheese" model consisting of a \Lambda -CDM Friedman-Robertson-Walker background in which a number of randomly distributed non-overlapping spherical regions are replaced by mass compensating comoving voids, each with a uniform density interior and a thin shell of matter on the surface. We compute the distribution of magnitude shifts using a variant of the method of Holz & Wald (1998), which includes the effect of lensing shear. The standard deviation of this distribution is ~ 0.027 magnitudes and the mean is ~ 0.003 magnitudes for voids of radius 35 Mpc, sources at redshift z_s=1.0, with the voids chosen so that 90% of the mass is on the shell today. The standard deviation varies from 0.005 to 0.06 magnitudes as we vary the void size, source redshift, and fraction of mass on the shells today. If the shell walls are given a finite thickness of ~ 1 Mpc, the standard deviation is reduced to ~ 0.013 magnitudes. This standard deviation due to voids is a factor ~ 3 smaller than that due to galaxy scale structures. We summarize our results in terms of a fitting formula that is accurate to ~ 20%, and also build a simplified analytic model that reproduces our results to within ~ 30%. Our model also allows us to explore the domain of validity of weak lensing theory for voids. We find that for 35 Mpc voids, corrections to the dispersion due to lens-lens coupling are of order ~ 4%, and corrections to due shear are ~ 3%. Finally, we estimate the bias due to source-lens clustering in our model to be negligible