41 research outputs found

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

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    Abstract 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‚Äďmiddle-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 ‚Äėsingle-use‚Äô 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‚Äďmiddle-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‚Äď and low‚Äďmiddle‚Äďincome countries

    Nasogastric tube insertion using conventional versus bubble technique for its confirmation in anesthetized patients: a prospective randomized study

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    Background: Nasogastric tube insertion and confirmation of its position can be difficult in the anesthetized patient. The purpose of the present study was to compare the bubble technique with the conventional method for confirmation of nasogastric tube placement in these patients. Methods: Two hundred sixty adult patients, aged between 20...70 years, posted for surgeries requiring general anesthesia, tracheal intubation, and a nasogastric tube were enrolled in this study. Patients were randomized into 2 groups: Group B (Bubble group) and Group C (Control group). In Group C, a conventional technique using a lubricated nasogastric tube was positioned through the nostril with head remained neutral. In Group B, 2% lidocaine jelly was added to the proximal end to form a single bubble. The correct placement of the nasogastric tube in the stomach was confirmed by fluoroscopy by an independent observer intraoperatively. Results: The duration of nasogastric tube insertion was 57.2 .. 13.3 seconds in Group B and 59.8 .. 11.9 seconds in Group C (p = 0.111). The confirmation rate of the bubble technique was 76.8% (95% CI: 68.7...83.3), which was significantly better than the conventional method where the confirmation rate was 59.7% (95% CI 50.9...67.9), p < 0.001. When compared to fluoroscopy, bubble technique was found to have a sensitivity of 92.3% (95% CI: 85.6...96.1) with specificity of 81.0% (95% CI: 60.0...92.3), positive predictive value of 96.0% (95% CI: 90.2...98.4), and a moderate negative predictive value of 68.0% (95% CI: 48.4...82.8). Conclusions: The bubble technique of nasogastric tube insertion has a higher confirmation rate in comparison to the conventional technique. Trial Registry Number: Clinical Trial Registry of India (CTRI/2018/09/015864)

    Evaluation of Lipase from an Indigenous Isolated Bacillus Strain for Biodiesel Production

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    Lipases are utilized in biodiesel production utilizing various types of substrates. The use of lipase in bioenergy production aims to reduce energy crises and environmental pollution. Lipase-producing indigenous bacteria Bacillus licheniformis (Accession no. OP56979) and Bacillus rugosus (Accession no. OP56980) were isolated from various oil-contaminated sites. The isolated potential lipolytic bacteria were screened for maximum lipase production. Then, the bacteria showing the highest lipolytic activity were subjected to identification using the 16s rRNA technique while other isolated were identified biochemically. Lipase [LipBL-WII(c)] from Bacillus licheniformis having the highest lipolytic activity expressed various characteristics. Characterization of crude LipBL-WII(c) expressed that it showed stability in a wide range of pH (4 to 10) with optimum lipolytic activity observed at pH 8. It was then found to be active at a temperature range from 20¬įC to 80¬įC with optimal at 50¬įC. Lipase activity was also stimulated in metal ions such as Ca+1, Mg2+, and Zn2+ the most. Furthermore, LipBL-WII(c) retained lipolytic activity in the presence of various organic solvents and surfactants. The kinetic parameters (Km and Vmax) for LipBL-WII(c) were ascertained using Lineweaver- Burk plot. LipBL-WII(c) showed a potential for biodiesel production using olive oil as a source. Lipase gave 84% yield of biodiesel production from olive oil. Thus, it could be employed as a potential candidate for green biodiesel production using oil sources

    Effect of yogic intervention on urinary melondialdehyde levels, autonomic functions and quality of life among buffing polishing workers of an automobile industry

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    Background: Oxidative stress at industry setting poses a threat to autonomic functions and quality of life deterioration of the workers in automobile industry. Yogic intervention may improve the stress levels and autonomic functions thereby improves their quality of life. Aims and Objectives: This study was aimed to see the effect of 12 weeks of yogic regimen on urinary melondialdehyde levels (MDA), autonomic functions and quality of life in workers exposed to buffing polishing work in an automobile industry. Materials and Methods: 35 male subjects of age group 25-40 years working on buffing polishing machine for 4-6 hours/day, 6 days in a week for the last 2 years were selected as subjects from an automobile industry. Same number of age and sex matched controls not involved in buffing polishing work were also selected from the same socioeconomic background. Urinary MDA levels, autonomic functions and health related quality of life parameters were recorded before and after 12 weeks of practicing yogic regimen. All the parameters were analyzed intergroup as well as intra-group by 2 way ANOVA followed by the Tukey’s Test. Results: Significant improvement was found in MDA levels, weight, BMI, E:I ratio &amp; cold pressor test of autonomic function tests and all the physical and psychological domains of quality of life after practicing 12 weeks of yoga regimen. Conclusions: Integrated yogic regimen in buffing polishing workers can improve stress markers thereby improving their autonomic functions and health related quality of life. Thus yoga and pranayama can be encouraged and incorporated as a part of their routine schedule

    Imprints of lockdown and treatment processes on the wastewater surveillance of SARS-CoV-2 : a curious case of fourteen plants in Northern India

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    The present study investigated the detection of severe acute respiratory syndrome‚Äď coronavirus 2 (SARS-CoV-2) genomes at each treatment stage of 14 aerobic wastewater treatment plants (WWTPs) serving the major municipalities in two states of Rajasthan and Uttarakhand in Northern India. The untreated, primary, secondary and tertiary treated wastewater samples were collected over a time frame ranging from under-lockdown to post-lockdown conditions. The results showed that SARS-CoV-2 RNA was detected in 13 out of 40 wastewater samples in Jaipur district, Rajasthan and in 5 out of 14 wastewater samples in the Haridwar District, Uttarakhand with the E gene predominantly observed as compared to the N and RdRp target genes in later time-points of sampling. The Ct values of genes present in wastewater samples were correlated with the incidence of patient and community cases of COVID-19. This study further indicates that the viral RNA could be detected after the primary treatment but was not present in secondary or tertiary treated samples. This study implies that aerobic biological wastewater treatment systems such as moving bed biofilm reactor (MBBR) technology and sequencing batch reactor (SBR) are effective in virus removal from the wastewater. This work might present a new indication that there is little to no risk in relation to SARS-CoV-2 while reusing the treated wastewater for non-potable applications. In contrast, untreated wastewater might present a potential route of viral transmission through WWTPs to sanitation workers and the public. However, there is a need to investigate the survival and infection rates of SARS-CoV-2 in wastewater.Published versionThis research was funded by research grants from the Department of Biotechnology-GoI [Grant No. BT/RLF/Re-entry/12/2016]

    Status of lung functions in buffing polishing workers and the impact of yogic regimen on their pulmonary health

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    Background: The metal buffers &amp; polishers in automobile industry are exposed to inhalation of air borne metal dust. Deposition of this metal dust in respiratory tract, in due course of time, can cause obstructive, restrictive or combined respiratory disease. Aims and Objectives: Yoga and pranayama may play an impressive role in improving the pulmonary functions and facilitating gas diffusion at the alveolo-capillary membrane. This study was aimed to record the pulmonary function tests (PFTs) in buffing polishing workers of an automobile industry before and after 12 weeks of yoga regimen. Materials and Methods: 35 male subjects of the age group of 25-40 years working on buffing polishing machine for 4-6 hours/day, 6 days in a week for more than 2 years were selected as subjects from an automobile industry. PFTs were carried out on all the subjects at the onset of the study and after12 weeks of subjecting them to a standardized yogic regimen. PFT parameters were analysed between group and with controls by ANOVA followed by Tukey’s Test. Results: Significant improvement was seen in slow vital capacity, forced vital capacity, peak expiratory flow rate, maximum voluntary ventilation, and DLCO after following yogic regimen. FEV1, and FEV1% also showed a trend towards improvement in buffing polishing workers. Conclusions: Yoga and pranayama breathing exercises can improve the lung functions of the industrial workers. These can be encouraged as a part of their routine schedule as it can reduce absenteeism by improving their health

    Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India

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    Aim. We assessed neonatal resuscitation practices among paediatricians in Gujarat. Methods. Cross-sectional survey of 23 questions based on guidelines of Neonatal Resuscitation Program (NRP) and Navjaat Shishu Suraksha Karyakram (NSSK) was conducted using web-based tool. Questionnaire was developed and consensually validated by three neonatologists. Results. Total of 142 (21.2%) of 669 paediatricians of Gujarat, India, whose e-mail addresses were available, attempted the survey and, from them, 126 were eligible. Of these, 74 (58.7%) were trained in neonatal resuscitation. Neonatal Intensive Care Unit with mechanical ventilation facilities was available for 54% of respondents. Eighty-eight (69.8%) reported correct knowledge and practice regarding effective bag and mask ventilation (BMV) and chest compressions. Knowledge and practice about continuous positive airway pressure use in delivery room were reported in 18.3% and 30.2% reported use of room air for BMV during resuscitation. Suctioning oral cavity before delivery in meconium stained liquor was reported by 27.8% and 38.1% cut the cord after a minute of birth. Paediatricians with NRP training used appropriate method of tracheal suction in cases of nonvigorous newborns than those who were not trained. Conclusions. Contemporary knowledge about neonatal resuscitative practices in paediatricians is lacking and requires improvement. Web-based tools provided low response in this survey
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