A critical review of textile industry wastewater: green technologies for the removal of indigo dyes.

The denim textile industry represents an important productive sector. It generates wastewater with low biodegradability due to the presence of persistent pollutants, which can produce toxic and carcinogenic compounds; therefore, wastewater treatment reduces risks to aquatic life and public health. This paper presents a review of 172 papers regarding textile industry wastewater treatment for the removal of contaminants, especially indigo dyes used in the denim industry, in the context of green technologies. The physicochemical characteristics of textile wastewater, its environmental and health impacts, and the permissible limit regulations in different countries were reviewed. Biological, physicochemical and advanced oxidation processes for the removal of indigo dyes were reviewed. The goal of this study was to analyze the characteristics of green technologies; however, the research does not clearly demonstrate an effect on energy consumption savings, carbon footprint decreases, and/or waste generation. Advanced oxidation processes showed the highest color removal efficiency (95 and 97% in synthetic or real wastewater, respectively). Photocatalysis and Fenton reactions were the most efficient processes. None of the revised works presented results regarding upscaling for industrial application, and the results should be discussed in terms of the guidelines and maximum permissible limits established by international legislation. New technologies need to be developed and evaluated in a sustainable context with real wastewater.

Comparison of two HIV testing strategies in primary care centres: indicator-condition-guided testing vs. testing of those with non-indicator conditions.

OBJECTIVES: The aim of the study was to compare prospectively indicator-condition (IC)-guided testing versus testing of those with non-indicator conditions (NICs) in four primary care centres (PCCs) in Barcelona, Spain. METHODS: From October 2009 to February 2011, patients aged from 18 to 65 years old who attended a PCC for a new herpes zoster infection, seborrhoeic eczema, mononucleosis syndrome or leucopenia/thrombopenia were included in the IC group, and one in every 10 randomly selected patients consulting for other reasons were included in the NIC group. A proportion of patients in each group were offered an HIV test; those who agreed to be tested were given a rapid finger-stick HIV test (€6 per test). Epidemiological and clinical data were collected and analysed. RESULTS: During the study period, 775 patients attended with one of the four selected ICs, while 66,043 patients presented with an NIC. HIV screening was offered to 89 patients with ICs (offer rate 11.5%), of whom 85 agreed to and completed testing (94.4 and 100% acceptance and completion rates, respectively). In the NIC group, an HIV test was offered to 344 persons (offer rate 5.2%), of whom 313 accepted (90.9%) and 304 completed (97.1%) testing. HIV tests were positive in four persons [prevalence 4.7%; 95% confidence interval (CI) 1.3-11.6%] in the IC group and in one person in the NIC group (prevalence 0.3%; 95% CI 0.01-1.82%; P < 0.009). If every eligible person had taken an HIV test, we would have spent €4650 in the IC group and €396,258 in the NIC group, and an estimated 36 (95% CI 25-49) and 198 persons (95% CI 171-227), respectively, would have been diagnosed with HIV infection. The estimated cost per new HIV diagnosis would have been €129 (95% CI €107-153) in the IC group and €2001 (95% CI €1913-2088) in the NIC group. CONCLUSIONS: Although the number of patients included in the study was small and the results should be treated with caution, IC-guided HIV testing, based on four selected ICs, in PCCs seems to be a more feasible and less expensive strategy to improve diagnosis of HIV infection in Spain than a nontargeted HIV testing strategy.

Cardiotocography and perinatal outcome in women with and without meconium stained liquor.

BACKGROUND: There is little evidence linking meconium stained liquor to poor perinatal outcome and clear amniotic fluid is frequently considered a reassuring sign during labour. OBJECTIVE: To determine whether there are any differences in cardiotocography (CTG) tracings and perinatal outcomes in women with meconium stained compared with those with clear liquor in labour. DESIGN: A prospective cohort study. SETTING: The Aga Khan University Hospital, Nairobi. SUBJECTS: Seventy seven women presenting in labour were studied. Thirty six had meconium stained liquor and 41 had clear liquor. MAIN OUTCOME MEASURES: Initial and intrapartum CTG was done. Perinatal and maternal outcomes determined were birth weights, Apgar scores, admission due to foetal indications and puerperal sepsis. CTG interpretation was based on RCOG/NICE guidelines-2001. SPSS 12.0.1 was used for all analyses. RESULTS: Variable decelerations were the most common foetal heart rate patterns. In the initial CTG, suspicious (RR 1.033, 95% CI: 0.515 - 2.073), and pathologic (RR 1.490, 95% CI: 0.928-2.393) patterns were increased in the meconium stained group. In the intrapartum CTG, pathologic pattern was increased in women with meconium stain liquor (RR 1.096, 95% CI: 0.650-1.847). Apgar score of <7 was likely if the initial base line rate was abnormal (RR 1.357, 95% CI: 0.139 -1.009, irrespective of the state of liquor. Meconium staining of liquor was associated with Caesarean delivery (RR = 1.357, 95% CI: 1.010-1.823; P-value 0.042). There was no significant difference in the mean birth weights of the infants born to women in both groups (3359.72 grams and 3260.24 grams respectively, P = 0.282). One minute Apgar score in both groups was not significantly (RR 0.390, 95% CI:0.131-1.1611). CONCLUSION: The suspicious and pathologic tracings were increased in the meconium stained liquor group. There was no significant difference in the Apgar scores in both groups of women. Meconium staining of liquor was significantly associated with Caesarean delivery.

Acute puerperal uterine inversion: case report.

Acute puerperal uterine inversion is a rare but potentially fatal obstetric emergency in which the uterine fundus collapses into the uterine cavity. Maternal mortality is high unless the condition is recognised and quickly corrected. The duration of time elapsed from moment of diagnosis to that of correction, along with rapid resuscitation measures are of utmost importance in its prognosis. A recent case managed successfully is described followed by a short review of the literature.

Caesarian section rates and perinatal outcome at the Aga Khan University Hospital, Nairobi.

BACKGROUND: There has been a persistent rise in the rate of Caesarean sections over the years. Whether this rise is the cause of the decline in infant mortality and improved neonatal outcome still remains debatable. OBJECTIVE: To compare the Caesarian section rate and the perinatal outcome at the Aga Khan University Hospital for the years 2001 and 2004. DESIGN: Retrospective study. SETTING: The Aga Khan University Hospital, Nairobi. MAIN OUTCOME MEASURES: The total Caesarian section rates, their indication and the perinatal outcome. RESULTS: The overall Caesarian section rate was 20.4% in 1996, 25.9% in 2001 and 38.1% in 2004. The rate among patients managed by their private obstetricians was 27.1% in 1996, 30.8% in 2001 and 41.7% in 2004. Whilst among general patients, it was 14.7%, 21.5% and 34.5% over the same period. The main indication for emergency Caesarian section was foetal distress, while that for elective Caesarian section was a previous uterine scar. The overall perinatal mortality rate improved from 25.2 per 1,000 births in 2001 to 14.0 per 1,000 births in 2004 (P< 0.001, 95%CL 8.58-30.62). The early neonatal mortality rate was 12.8 per 1,000 live births in 2001 compared to 10.8 per 1,000 live births in 2004 (p=0.08, 95%CI 9.84-13.76). CONCLUSION: There has been a significant increase in Caesarian section rate over the years. Being a referral unit dealing with many high-risk patients some of whom are supervised elsewhere and with a significant ratio of private patients, the high rate of Caesarean section at the Aga Khan University Hospital is expected. The rise could also be due to early detection of foetal compromise and improved diagnostic facilities leading to timely intervention. However, there has been a significant improvement in the neonatal outcome over the same period of time. Whether this is an effect of the high Caesarean section rate is debatable and calls for further research to correlate the two.

Effects of fluoride on the histoarchitecture of reproductive organs of the male mouse.

The effects of sodium fluoride (NaF) ingestion in two doses (10 and 20 mg/kg body weight) for 30 days on histology and histocytometry of reproductive organs of the adult male mouse were investigated. In order to study reversibility, treatment was withdrawn for one and two months. The testes, epididymides, vas deferens, prostate, and seminal vesicle were utilized for the study by standard hematoxylin-eosin staining and an ocular eye piece and micrometer scale. NaF treatment caused severe disorganization and denudation of germinal epithelial cells of seminiferous tubules with absence of sperm in the lumina. The Leydig cell and nucleus diameters were not affected. The caput epididymis showed fewer changes than the cauda. However, epithelial cell nuclear pyknosis and absence of luminal sperm were observed. A reduction in epithelial cell height, nuclear pyknosis, denudation of cells, and absence of sperm occurred in the cauda epididymis. The vas deferens epithelium showed nuclear pyknosis, clumped stereocilia, and cell debris but no sperm in the lumen and an increase in the lamina propria. The prostate and seminal vesicles were not affected by treatment. Withdrawal of treatment caused marked recovery in the histoarchitecture of these organs. The effects of NaF treatment are therefore transient and reversible.

Grateful Med on an institutional local area network.

Grateful Med version 6.0 provides new features very desirable to network users. These include: a single copy of the application resident on a server providing access to many users; a new communications architecture which provides access to Medline via the Internet or local network modems; additional scripting capabilities allowing local customization. These new features reduce the overhead in installing and maintaining Grateful Med (GM), allow much quicker downloading of citations and abstracts from Medline, and remove the requirement of a local modem for each PC accessing Medline.

Serum cholesterol changes during pregnancy and puerperium in African and Asian women.

PIP: This study investigated the levels of serum total cholesterol among urban African and Asian vegetarian and Asian nonvegetarian women ranging in age from 18 to 35. All were before 26 weeks of gestation. A group of nonpregnant, nonlactating women of the same ethnic origins was included as control. Venous blood samples were collected at 26 weeks and 37 weeks of gestation and within 24 hours after delivery. Levels in cord blood samples were also analysed. All blood samples collected were nonfasting. African women when compared with Asian nonvegetarians were found to have a significantly lower serum cholesterol level (p.02). No difference was observed between African and Asian vegetarians. Asian vegetarians had a lower level than Asian nonvegetarians (p.05). No statistical differences were observed among the 3 groups at 26 weeks of gestation. All 3 groups showed a progressive increase in serum total cholesterol levels as pregnancy advanced. From 26 to 37 weeks of gestation an increase was found of 18%, 4% and 6% for the Asian nonvegetarian, Asian vegetarian and African women, respectively. On average, a drop in cholesterol levels was observed within 24 hours after delivery: 11% decrease for Asian nonvegetarians, 9% for Asian vegetarians, and 3% for Africans. No statistical differences were found in the serum total cholesterol levels measured in the cord blood samples of the 3 groups. Lower levels of cholesterol among vegetarians may be due to higher intake of leafy vegetables and cereals.^ieng

Rubella immunity in pregnant women in Nairobi, Kenya.

PIP: Blood samples collected from 136 pregnant women (40 Asians and 96 Africans) receiving antenatal care at the Aga Khan Hospital, Nairobi, Kenya, and 302 at the Kenyatta National Hospital at the time of delivery were tested by hemagglutination inhibition (HI) method to determine number of susceptible women. It was found that 7.3% of Africans and 15% of Asians from the Aga Khan Hospital were susceptible to Rubella, compared with 3.6% at the Kenyatta National Hospital. The ethnic difference in Rubella antibody tire among the Asians and Africans could have been generated by chance due to the small size of the study sample. The outcome of pregnancies for all study groups was studied in terms of birth weight, apgar score at 1 minute after birth and a clinical assessment of the newborn by a pediatrician. The mean birth weight was found to be 2.968 gms among the Aga Khan Hospital Asian group, 3.191 gms among the African group, and 3.057 gms among the Kenyatta National Hospital group. An examination of the birth weight of babies born to mothers with high titres, i.e. 1:640 and 1:1280 in the Aga Khan Hospital group showed that the mean birth weight among the Asian babies was 3.153 gms, and among the African babies it was 3.147 gms.^ieng

Paraspinal arteriovenous shunts in children.

Arteriovenous shunts within the spinal canal and in the paraspinal region are unusual. Spinal cord and dural arteriovenous communications have been the subject of numerous reports but paraspinal shunts causing venous congestion in the spinal canal are rarer and may present special problems in diagnosis and management. We describe three children with paraspinal arteriovenous malformations, associated with overt or potential venous congestion in the spinal canal. In each case, the lesion was successfully obliterated by endovascular therapy. Embolisation with permanent occlusive agents is an effective treatment for these rare but potentially debilitating lesions.

Anthropometric changes during pregnancy of urban Indian women related to birthweight.

PIP: Vegetarian and nonvegetarian women of Asian Indian origin living in Nairobi, Kenya, and attending the antenatal clinic at the Aga Khan Hospital were followed up from 26 weeks of pregnancy to term. The objective was to observe these pregnant women in relation to pregnancy performance and outcome. The mean gestational age for both groups was 39.0 weeks. There is a progressive increase in weight from the 26th week of pregnancy up to the time of delivery among both groups. 65.4% of the women gained between 90 and 150% of the expected value. Women who gained less than 90% of the expected value (34.6%) did not produce smaller babies. The mean birth weight of the newborns was 2,869 gms in the vegetarian group and 3,026 gms in the nonvegetarian group. There was no significant difference in the outcome of pregnancy between the 2 groups. Mean birth weight, mean length and mean head circumference of the babies in both the groups fell within the 10th and 25th percentiles of the Harvard standards. The mean chest circumference of the babies in the vegetarian group fell within the 25th and 50th percentiles, while that of the babies in the nonvegetarian group fell between 50th and 75th percentiles. The pattern of weight gain in the study population corresponds favorably with that observed among British women . Other anthropometric parameters studied were height, mid-upper arm circumference and 4 skinfold thickness. Changes in muscle mass and fat area were also calculated. Tables show quantitative data.^ieng

A modified method for the differential staining of spermatozoa using alcoholic acidic silver nitrate.

Differential silver staining patterns have been demonstrated in mammalian spermatozoa, using an aqueous silver nitrate reagent. In the present study, mouse, rabbit, and human spermatozoa were stained using a modification of the earlier method. In the modified method, an alcoholic acidic silver nitrate stain, with subsequent differentiation in alcoholic ammonia, was used. This method enhanced the intensity of staining of the head, mid-piece, and tail. In particular, marked differentiation of the acrosomal, subacrosomal, and postacrosomal regions was obtained, which facilitated determination of acrosomal integrity. Moreover, background interference was reduced, yielding better clarity of the stained smears. The staining was carried out in the cold. This modified technique offers an advantage in the assessment of sperm morphological anomalies and membrane and acrosomal integrity, and is a simple, reliable, and useful method for the evaluation of sperm function.