Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Moulding characteristics of Quartzite sand sample from Dhanji Hill

The investigation was undertaken on behalf of Directorate of Mining and Geology, Patna, to study the suitability of quartzite sample, from Dhanji Hill near Dhanbad as a foundry sand for Hatia Project. About 2 cwts of the sample was received. The sample was in the form of lumps, 4 to 6 inches in size and white to pale brown in colour. The sand was crushed to suitable size for assessment of its characteristics for specific purpose

Moulding characteristics of Silica sand from Yadgiri

The investigation was undertaken to study the moulding characteristics of silica sand from Yadgiri which is at a distance of about 400 miles from Hyderabad. The sand was supplied to us by M/s Ruston and Hornsby (India) Private Ltd., Poona

Moulding characteristics of sand from Bhawanagar (Supplied by Rustom and Hornsby)

This investigation was undertaken to study the suitability of Bhawanagar sand for moulding purposes in foundries. This sand was supplied by M/s Rustom and Hornsby (India) Private Ltd., in response to our questionnaire in respect of foundry sands