Biotreatment of AL-KARAMA Teaching Hospital Wastewater Using Aerobic Packed Bed

This study is aimed to use the aerobic packed bed in biotreatment of the wastewater which is discharge from AL-KARAMA teaching hospital in Baghdad. The performance of packed-bed treatment method was examined for elimination of the organic compounds from wastewater under aerobic conditions. In this research different parameters were studied. They were: inoculums concentration, circulation rate of wastewater through the bed, packing type and the temperature. Results showed that the system efficiently removed about 82% of the chemical oxygen demand (COD) and 80% of the Biological oxygen demand (BOD). Percent reduction in turbidity was about 92% and reduction in nitrate concentration was about 87%. It was found that best performance of the packed bed method was obtained at temperature of 37 oC, circulation rate of 10 L/min and inoculums concentration of 3%

Video assisted minimally invasive mitral valve replacement in rheumatic valve disease.

Objective: Assessment early outcome of video assisted minimally invasive mitral valve replacement, in rheumatic valve disease. Also, to evaluate early postoperative quality of life by SF 36 questionnaire. Methods: This is a prospective single center study which was conducted on 20 rheumatic heart patients, in Egypt; during the period from October 2015 to June 2018. The main pathological lesion was sever mitral regurgitation (MR), mitral stenosis (MS) or both. Patients underwent video assisted minimally invasive mitral valve replacement, through a right mini thoracotomy. 13 patients (65%) were via infra-mammary incision, 4 patients (20%) were via periareolar incision and 3 patients (15%) were via limited right anterolateral mini-thoracotomy. Results: Mean length of surgical incision was (6.60 ± 1.35 cm). Mean duration of operation, cardiopulmonary bypass, and cross clamp times were (4.32 ± 1.08 hr.), (2.85 ± 0.75 hr.) and (1.78 ± 0.47 hr.) respectively. ICU stay was 2.35 ± 1.14 days and Hospital stay was 6.45 ± 1.43 days. The mean amount of blood loss was 398.50 ± 245.79 ml with two patients of bleeding requiring re-opening. At discharge, all patients had normal mitral prosthetic valve function with no or trivial regurgitation, as shown by echocardiographic studies. The postoperative quality of life revealed faster recovery of usual activities. Conclusions: Video assisted minimally invasive mitral valve surgery in the surgically challenging rheumatic valve disease has less surgical trauma, blood loss and pain, which translates into short hospital stay, rapid return to normal activities, less use of resources

Using locally isolated Chlorella vulgaris in Wastewater Treatment

In this study locally isolated microalgae (Chlorella vulgaris Bejerinck) was used in wastewater treatment to reduce the pollutant parameters. Three parameters were studied to determine the efficiency of Chlorella vulgaris in reducing COD, BOD and PO4 concentration. Samples of wastewater were taken from a primary station in Al-Rustomiya wastewater treatment station. Three different dilutions of wastewater were tested; 100% waste, 75%waste 25%waste with distilled water. Chemical oxygen demand (COD) values started with 370mg/l, 270mg/l and 200mg/l for samples A, B and C respectively, and it reached after 14 days to 112 mg/l, 88 mg/l, and 120 mg/l. Biochemical oxygen demand (BOD) started with 241mg/l, 200mg/l, and 170 mg/l for samples A, B and C respectively, and it declined to 110 mg/l, 61 mg/l, and 112 mg/l. Finally PO4 started with 39.9 mg/l, 30 mg/l, 21 mg/l and it reached to 17.1mg/l, 8mg/l, 11.2mg/l for samples A, B and C respectively. Sample B showed the best removal values for COD, BOD and PO4 which reached to 88 mg/l, 61 mg/l, and 8 mg/l respectively

Green synthesis of nickle oxide nanoparticles for adsorption of dyes

The green synthesis of nickel oxide nanoparticles (NiO-NP) was investigated using Ni(NO3)2 as a precursor, olive tree leaves as a reducing agent, and D-sorbitol as a capping agent. The structural, optical, and morphology of the synthesized NiO-NP have been characterized using ultraviolet–visible spectroscopy (UV-Vis), X-ray crystallography (XRD) pattern, Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM) analysis. The SEM analysis showed that the nanoparticles have a spherical shape and highly crystalline as well as highly agglomerated and appear as cluster of nanoparticles with a size range of (30 to 65 nm). The Scherrer relation has been used to estimate the crystallite size of NiO-NP which has been found about 42 nm. The NiO-NPs have subsequently used as adsorbents for adsorption of two types of dyes; methylene blue (MB) as cation dye and methyl orange (MO) as anion dye. The removal efficiency of dyes from contaminated water was investigated during various key parameters at room temperature; initial dye concentration (Co), pH, contact time (t), agitation speed, and adsorbent dosage. The maximum removal of MB dye was found to be 96% (Co=25 mg/l, pH=10, contact time=100 min, agitation speed=300 rpm and adsorbent dosage=6 g/l), while for MO the maximum removal reached 88% at (Co=20 mg/L, pH=2, t =160 min, agitation speed=300 rpm and adsorbent dosage=6 g/L). The experimental adsorption data were found to well obey Freundlich isotherm. The kinetic investigation showed that the adsorption process for both dyes followed a pseudo-second-order model with rate constants 0.0109 and 0.0079 (mg/g min) for MB and MO, respectively

Preparation, Characterization, and Tetracycline Adsorption Efficiency of Tea Residue-Derived Activated Carbon

The process for preparing activated carbon (AC) made from tea residue was described in this paper. Investigated were the physicochemical characteristics and adsorption efficiency of the produced AC. Activation with potassium hydroxide (KOH) and carbonization at 350 °C are the two key steps in the manufacturing of AC. The activated carbon was used to adsorb Tetracycline (TC). Different parameters were studied at room temperature to show their effects on the adsorption efficiency of TC. These parameters are the initial concentration of adsorbate TC, solution acidity pH, time of adsorption, and adsorbent dosage. The prepared active carbon was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD), and Brunauer-Emmett-Teller (BET). The equilibrium of TC adsorption on the tea-activated carbon TAC is effectively represented by the Langmuir model. Tetracycline could be adsorbed onto the prepared activated carbon with a maximum capacity of 45.662 mg g-1. Adsorption kinetics are well represented by pseudo-second-order. The investigation of adsorption thermodynamics demonstrates that TC adsorption on TAC is endothermic and spontaneou

Ternary glycerol-based deep eutectic solvents: physicochemical properties and enzymatic activity

The present study investigates deep eutectic solvents (DESs) as potential media for enzymatic hydrolysis. A series of ternary ammonium and phosphonium-based DESs were prepared at different molar ratios by mixing with aqueous glycerol (85%). The physicochemical properties including surface tension, conductivity, density, and viscosity were measured at a temperature range of 298.15 K – 363.15 K. The eutectic points were highly influenced by the variation of temperature. The eutectic point of the choline chloride: glycerol: water (ratio of 1: 2.55: 2.28) and methyl triphenylphosphonium bromide:glycerol: water (ratio of 1: 4.25:3.75) is 213.4 K and 255.8 K, respectively. The stability of the lipase enzyme isolated from the porcine pancreas (PPL) and Rhizopus niveus (RNL) toward hydrolysis in ternary DESs medium was investigated. The PPL showed higher activity compared to the RNL in DESs. Molecular docking simulation of the selected DES with the substrate (p-nitrophenyl palmitate) towardPPL was also reported. It is worth noting that ternary DES systems would be viable lipaseactivators in hydrolysis reactions

The fight against the COVID-19 pandemic: Vaccination challenges in Sudan.

The first COVID-19 case in Sudan was announced on March 13th, 2020. 1835 deaths were recorded as of February 7th, 2021. 800,000 doses of the Oxford-AstraZeneca vaccine were allocated to Sudan through COVAX in March 2021. However, multiple challenges exist in vaccinating the Sudanese population, ranging from an inadequate cold chain system to low acceptance rates of COVID-19 vaccination among the Sudanese population. Economic crises, high inflation rates and long-standing economic sanctions have also negatively impacted the healthcare system in Sudan as a result of deprivation of access to research and development funding

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030