Dental antibiotic policies, stewardship, and implementation in India: A policy document analysis

Objectives Dental antibiotic stewardship is crucial in low- and middle-income countries where the burden of antimicrobial resistance (AMR) is high and antibiotic misuse is common. Given that India is the most populous country, the largest antibiotic consumer and has a large dental prescriber population, this study investigated the extent to which current Indian policy and practice for dental antibiotic prescribing and stewardship aligns with the global policy and best practice. Methods The READ approach was used to identify and extract data and synthesize the findings. Policy documents on dental antimicrobial stewardship were identified using a systematic search strategy involving nine medical and grey literature databases (Medline, Global Health, Web of Science, Cochrane, CINAHL, Eldis, Global Index Medicus, Proquest and Opengrey), targeted websites (government organizations and dental regulatory bodies) and contact with experts. Framework analysis was used to code extracted data into themes related to dental antimicrobial stewardship. Results Of the 3039 records screened, 25 documents were included in the final analysis. The analysis showed a lack of guidelines or toolkits for appropriate antibiotic prescribing in dentistry in India. The treatment guidelines for antimicrobial use in common syndromes published by the Indian Council of Medical Research had no section or content for dental practitioners. Furthermore, the undergraduate dental curriculum developed by the Dental Council of India (DCI), included little content on appropriate antibiotic prescribing and no mention of AMR or stewardship. There were no educational resources either for dental practitioners or patients in the documents. Conclusion This document analysis showed that there was little or no mention of dental antibiotic prescribing guidelines in key policy documents such as the National Action Plan on AMR. In addition, contradictory and subjective information provided in some policy documents could encourage dentists and other health professionals such as general practitioners to prescribe antibiotics for common dental conditions for which they are contra-indicated. There is an urgent need to develop relevant guidelines and include these in Indian policy documents on AMR particularly the National Action Plan on AMR

Assessment of Arthrobacter viscosus as reactive medium for forming permeable reactive biobarrier applied to PAHs remediation

Polycyclic aromatic hydrocarbons (PAHs) are significant environmental contaminants as they are present naturally as well as anthropogenically in soil, air and water. In spite of their low solubility, PAHs are spread to the environment, and they are present in surface water, industrial effluent or groundwater. Amongst all remediation technologies for treating groundwater contaminated with PAHs, the use of a permeable reactive biobarrier (PRBB) appears to be the most cost-effective, energy efficient, and environmentally sound approach. In this technology, the microorganisms are used as reactive medium to degrade or stabilize the contaminants. The main limits of this approach are that the microorganisms or consortium used for forming the PRBB should show adequate characteristics. They must be retained in the barrier-forming biofilm, and they should also have degradative ability for the target pollutants. The aim of the present work is to evaluate the viability of Arthrobacter viscosus as bioreactive medium for forming PRBB. Initially, the ability of A. viscosus to remove PAHs, benzo[a]anthracene 100 μM and phenanthrene 100 μM was evaluated operating in a batch bench-scale bioreactor. In both cases, total benzo[a]anthracene and phenanthrene removals were obtained after 7 and 3 days, respectively. Furthermore, the viability of the microorganisms was evaluated in the presence of chromium in a continuous mode. As a final point, the adhesion of A. viscosus to sepiolite forming a bioreactive material to build PRBB was demonstrated. In view of the attained results, it can be concluded that A. viscosus could be a suitable microorganism to form a bioreactive medium for PAHs remediation.This work has been supported by the Spanish Ministry of Economy and Competitiveness and FEDER Funds (Project CTM 2011-25389). Marta Pazos received financial support under the Ramon y Cajal programme and Marta Cobas under the final project master grant "Campus do Mar Knowledge in depth"

Permeable reactive barrier for groundwater remediation

This article aims to provide an overview of the upcoming technology of permeable reactive barriers for groundwater remediation. A comprehensive list of references and web-links are also provided for further in-depth understanding. A brief discussion on the Australian perspective on this emerging technology is also included. © 2008

A review on UV/TiO<inf>2</inf> photocatalytic oxidation process

Advanced oxidation processes (AOPs) with UV irradiation and photocatalyst titanium dioxide (TiO2) are gaining growing acceptance as an effective wastewater treatment method. A comprehensive review of the UV-TiO 2 photocatalytic oxidation process was conducted with an insight into the mechanism involved, catalyst TiO2, irradiation sources, types of reactors, comparison between effective modes of TiO2 application as immobilized on surface or as suspension, and photocatalytic hybrid membrane system. Photocatalytic degradation technique with titanium dioxide is generally applied for treating wastewater containing organic contaminants due to its ability to achieve complete mineralization of the organic contaminants under mild conditions such as ambient temperature and ambient pressure. Recently, photocatalysis studies using TiO2 have been gaining attention for the degradation of persistent organic pollutants and other organic chemicals which are known to be endocrine disruptors. Treatment of wastewater in a titanium dioxide-suspended slurry reactor has been widely utilized due to its simplicity and enhanced degradation efficiency. However, this system requires separation of TiO2 from water after the photocatalytic process. The final section of the manuscript focuses on the removal of TiO2 using a membrane hybrid system. A two-stage coagulation and sedimentation process coupled with microfiltration hollow-fibre membrane process was found to achieve complete removal of TiO2, and the recovered TiO2 can be reused for a photocatalytic process after regeneration. © 2008 Springer

Integrated Forward and Reverse Osmosis for Coal Mine Wastewater Desalination

Water management is an integral part of coal mining operations. Due to the constraints on releasing saline water, coal mines require additional water storage facilities and therefore seek to minimise their inventory of saline water. Adopting efficient treatment technologies on-site would minimise the risk of wet season run-offs, freshwater contamination and allow segregation of different qualities of water to enable greater water recycling. This study aims to evaluate the application of an integrated forward osmosis (FO) and reverse osmosis (RO) system with three different actual coal mine waters, containing various concentrations of sulphates and silica that are generally associated with scaling and fouling of membrane systems. Three different FO draw solutions, di-sodium hydrogen phosphate (DHSP), sodium hexametaphosphate (SHMP) and sodium lignosulphonate (SLS) were evaluated. Two different modes of integrating the FO and RO systems were identified. The integrated system was able to concentrate the brackish mine waters, recovering more than 80% of the volume of mine water and obtaining dischargeable quality treated water. Simple physical cleaning with clean water circulation was found to be effective in restoring the FO water flux. The osmotic gradient between two mine waters was also utilised to adopt mine water as a draw solution. The effect of solution temperature on stand-alone and integrated FO and RO systems was also evaluated. The combination of FO with RO provided a better performance than individual FO or RO in treating coal mine wastewater. The FO unit served as an effective pre-treatment system prior to RO and the integrated FO–RO systems has a strong potential to successfully eliminate conventional pre-treatment processes for RO

Forward Osmosis Hybrid Processes for Mining Wastewater Treatment

This chapter examines the integration of forward osmosis (FO) with other water treatment methods with a particular focus on integrating FO and reverse osmosis (RO) technologies. It discusses the limitations of RO in relation to the quality of the feed water, in particular for the treatment of mining wastewater. In dry conditions, water management must focus on minimizing dependence on high-quality water. Adapting coal handling and preparation plants and dust suppression to use highly saline water reduces the volume of raw water that needs treatment at mine sites. The chapter presents different modes of integration and examines the advantages and limitations of different hybrid configurations. The hybrid system could potentially eliminate the extensive pretreatment required for conventional RO processes and thereby the overall cost of desalination. The mine site application of hybrid FO-RO technology has yet to be investigated