Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh

<p>Abstract</p> <p>Background</p> <p>Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal) along with the types and amount of wastes generated by Health Care Establishments (HCE). A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information.</p> <p>Methods</p> <p>The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form.</p> <p>Results</p> <p>The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse.</p> <p>Conclusion</p> <p>The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City.</p

Effects of different designs of implant supported fixed partial dentures on peri-implant bone stress distribution during mandibular-flexture

Statement of Problem: In the treatment of edentulous patients with implant supported fixed partial dentures several factors such as implant numbers, implant position, superstructure pattern and cantilever length must be considered. Mandibular flexture in function exerts forces in peri-implant bone, however; this phenomenon has received little attention. Purpose: The goal of this finite element analysis (FEA) study was to evaluate the effect of mandibular dimensional changes on peri-implant bone stress in different prosthesis and implant treatment plans. Materials and Methods: In this experimental study, three dimensional finite element computer model of mandible was simulated according to data from CT-Scan in 0.5 mm sections. The model of 4.1&amp;#61620;10 mm ITI implant, measured by profile projector, was simulated in solid works 2003 software. Implant models were inserted, in two different patterns, on mandible and three different superstructures were placed on implants. Two clenching tasks were modeled (incisal clench and right molar clench). Results: Analysis of Von Misses stress for peri-implant bone revealed the lowest stress values in three-piece superstructure. Conclusion: According to this study, additional placement of implants in order to fabricate independent prostheses and to achieve the freedom of mandibular flexture are recommended

Robust Primary Control of Microgrids for Parametric and Topological Uncertainties: A Quest for Resilience

In this paper, a robust droop-based control structure is developed in primary level of a hierarchical control scheme for robust performance and robust stability against parametric and topological uncertainties to 1) improve the robust stability and robust performance 2) resolve drawbacks of previously reported methods. Considering droop control scheme, the conventional hierarchical control structure is developed and the effectiveness of the proposed control scheme is investigated considering parametric and topological uncertainties. For the sake of drawing a picture to address how we can realize a resilient microgrid including a hierarchical control structure and providing enough robustness against mentioned uncertainties, signal disturbances, and different types of nonlinearity, some special recommendations are also provided. Finally, to prove the usefulness of the proposed controller, simulation studies are done on a microgrid which includes several distributed generation units with local loads