A hybrid electrocoagulation-biocomposite adsorption system for the decolourization of dye wastewater.

Among the various methods for the removal of azo dye, electrocoagulation is recognized to be highly efficient. However, the process is associated with high operation and maintenance cost, which demands the need for reducing the electrolysis time without compromising the performance efficiency. This can be achieved by adopting hybrid electrocoagulation process with a low-cost but effective process, such as adsorption. The study investigated the performance of a hybrid electrocoagulation-biocomposite system (H-EC-BC) for removing methyl orange dye. Firstly, the operating parameters of electrocoagulation process were optimized and a removal efficiency of 99% has been attained using Fe-SS electrodes at a pH of 6 for a reaction time of 30 min. The performance of EC process was found to be decreasing with increase in dye concentration. Secondly, biocomposite was synthesized from Psidium guajava leaves and characterized using SEM, FTIR, EDAX, and XRD analyses. The results suggested that it is having a porous nature and cellulose crystal structure and confirmed the presence of chemical elements such as carbon (65.2%), oxygen (29.1%) as primary with Fe, Cl, Na and Ca as secondary elements. The performance of the biocomposite was evaluated for the dye adsorption using spectrophotometric methods. Various operating parameters were optimized using experimental methods and a maximum removal efficiency of 65% was achieved at a pH of 6, dosage of 5 g/L and an adsorption contact time of 120 min. The maximum efficiency (92.78%) was obtained with Fe-SS electrodes and KCl as a sustaining electrolyte under acidic circumstances (pH 6). The biocomposite was observed to be more efficient for higher dye concentration. Langmuir and Freundlich adsorption isotherms were fitted with the experimental results with R2 values as 0.926 and 0.980 respectively. The adsorption kinetics were described using Pseudo-first and Pseudo-second order models, wherein Pseudo-second order model fits the experimental results with R2 value of 0.999. The energy consumption of electrocoagulation (EC) process in the hybrid H-EC-BC system was compared to that of a standard EC process. The results demonstrated that the hybrid system is approximately 7 times more energy efficient than the conventional process, thereby implicating its adaptability for field application.

Sadyovamana - An effective therapy in the management of Bell's palsy - A case report.

Bell's palsy or Facial nerve palsy is a condition that causes temporary weakness or paralysis of the muscles in the face. In Ayurveda, Ardita is a disease with functional disturbances affecting the Uthamanga (head) and stands close with the symptoms of Bell's palsy. This crippling disease has been elaborated by Ayurveda Acharyas Charaka, Susrutha and Vagbhata in their respective samhithas. It is narrated as one among the Asheeti Vata Vikaras (80 types of typical vata predominant diseases). This report is on a case study of 44 year old male patient who approached the Panchakarma OPD presenting with complaints of deviated face towards left side, difficulty in closing right eye and feeling of heaviness and swelling over right side of face for about 3 days. After relevant examinations and screening it was diagnosed as Bell's palsy. This disease though self-resolving some cases remain partially recovered and some may be left with major facial dysfunction. This patient was admitted at Govt. Ayurveda College, Tripunithura, Kerala, India for speedy recovery and complete resolution of this disease. Fourteen days of treatment primarily Sadyovamana followed with oral medications, pratimarsha nasya and physiotherapy were administered. The patient got complete recovery from all the symptoms of Ardita without any residual weakness or deformity within two weeks which is much early than the self-resolving period of 6 months. Being one among the aseetivatavikaras, Sadyovamana is the least practiced treatment for this condition. So in this report the scope of Sadyovamana in Bell's palsy management is discussed.

Challenges and opportunities in current vaccine technology and administration: A comprehensive survey examining oral vaccine potential in the United States.

This study provides a snapshot of the current vaccine business ecosystem, including practices, challenges, beliefs, and expectations of vaccine providers. Our team focused on providers' firsthand experience with administering vaccines to determine if an oral vaccine (e.g. pill or oral-drop) would be well-received. We interviewed 135 healthcare providers and vaccine specialists across the US, focusing questions on routine vaccinations, not COVID-19 vaccines. Improving workflow efficiency is a top concern among vaccine providers due to shrinking reimbursement rates-determined by pharmacy benefit managers (PBMs)-and the time-intensiveness of injectable vaccines. Administering injectable vaccines takes 23 minutes/patient on average, while dispensing pills takes only 5 minutes/patient. An average of 24% of patients express needle-fear, which further lengthens the processing time. Misaligned incentives between providers and PBMs could reduce the quality and availability of vaccine-related care. The unavailability of single-dose orders prevents some rural providers from offering certain vaccines. Most interviewees (74%) believe an oral vaccine would improve patient-provider experience, patient-compliance, and workflow efficiency, while detractors (26%) worry about the taste, vaccine absorption, and efficacy. Additional research could investigate whether currently non-vaccinating pharmacies would be willing to offer oral vaccines, and the impact of oral vaccines on vaccine acceptance.

Ayurveda panchakarma treatment success in a case of chronic spontaneous urticaria non-responding to conventional medicine-A case study.

This is a case study of a 34-year-old male patient of Chronic Spontaneous Urticaria (CSU) with severe generalised itching and rashes all over the body since 17 years. The patient has no significant relief with conventional antihistamine therapies, AST (Autologous serum therapy) and Omalizumab (OMA). He was clinically assessed and managed with Ayurvedic Panchakarma procedures like Snehapana(therapeutic administration of unctuous formulation like ghee, oil), Vamana, Virechana and internal medication in line of Seethapitta Chikitsa. The patient was asked to monitor hives and itching daily for one week using a validated weekly Urticaria Activity Score (UAS7) at the baseline, after Vamana, after Virechana and after follow up. The Quality of life was assessed at the baseline and after follow-up using Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). The assessment showed complete remission in disease activity and improvement in Quality of life as per the scores. The hematological and biochemical investigations reflect the safety and efficacy of Ayurveda in management of CSU.

Perioperative point-of-care ultrasound for diagnosis of acute lower extremity arterial thrombosis after total hip arthroplasty revision: a case report.

PURPOSE: Acute arterial thrombosis after hip arthroplasty is a rare event associated with potentially catastrophic complications. Early clinical diagnosis of progressive limb ischemia is often difficult in the immediate postoperative period because of residual neuraxial blockade and the nonspecific nature of signs. We describe the use of point-of-care ultrasound (POCUS) in the postanesthesia care unit (PACU) to diagnose this complication early and facilitate timely intervention. CLINICAL FEATURES: A 78-yr-old female patient underwent elective right hip revision arthroplasty under spinal anesthesia and postoperatively had an absent dorsalis pedis pulse on her operative leg as screened by an audible-only Doppler. No obvious clinical symptoms were present as the patient was still under subarachnoidal blockade. A bedside POCUS vascular evaluation was performed in the PACU and showed an absence of blood flow in the superficial femoral artery, expediting the confirmation of a surgical emergency. The patient underwent a successful open thrombectomy and made an uneventful postoperative recovery. CONCLUSION: Our case report highlights the novel use and impact of bedside POCUS to assess the presence or absence of distal limb arterial blood flow and, in this case, the level of arterial occlusion.

RéSUMé: OBJECTIF: La thrombose artérielle aiguë après arthroplastie de la hanche est un événement rare associé à des complications potentiellement catastrophiques. Le diagnostic clinique précoce de l'ischémie progressive du membre est souvent difficile à poser dans la période postopératoire immédiate en raison du bloc neuraxial résiduel et de la nature non spécifique des signes. Nous décrivons l'utilisation de l'échographie ciblée (POCUS) en salle de réveil (SDR) pour diagnostiquer cette complication rapidement et faciliter une intervention rapide. CARACTéRISTIQUES CLINIQUES: Une patiente de 78 ans a bénéficié d'une arthroplastie non urgente de révision de la hanche droite sous rachianesthésie; après l'intervention, le pouls pédieux, tel que dépisté par un Doppler uniquement sonore, était absent au niveau de la jambe opérée. Aucun symptôme clinique évident n'était présent alors que la patiente était toujours sous bloc sous-arachnoïdien. Une évaluation vasculaire d'échographie ciblée a été réalisée en salle de réveil et montrait l'absence de circulation sanguine dans l'artère fémorale superficielle, confirmant l'urgence chirurgicale. La patiente a bénéficié d'une thrombectomie ouverte réussie et s'est rétablie sans incident après l'opération. CONCLUSION: Notre présentation de cas met en évidence l'utilisation innovante et l'impact de l'échographie ciblée pour évaluer la présence ou l'absence du flux sanguin artériel distal et, dans ce cas, le niveau de l'occlusion artérielle.

Protective effect of Yemeni green coffee powder against the oxidative stress induced by Ochratoxin A.

The current study focusses on knowing the antioxidant effects of green Yemeni coffee powder on reducing the oxidative stress that was induced by Ochratoxin A in kidney, liver and brain of rats. The grouping of female albino Wistar rats was into 5 groups (5 rats/group). Rats of Group 1 designated Vehicle Control (only water), Group2 (10 mg/kg Ochratoxin A); Group 3 designated Low dose (2000 mg/kg Coffee+10 mg/kg Ochratoxin A); Group 4 designated High dose (4000 mg/kg Coffee+10 mg/kg Ochratoxin A); Group 5 designated Coffee Control (1000 mg/kg Coffee) and orally administered with the above test materials repeatedly every day for 28 days. On termination of the study, liver, brain and kidney tissues were collected after dissection, oxidative stress biomarkers (Levels of Lipid Peroxidation and Reduced Glutathione, activities Superoxide Dismutase, Catalase and Glutathione Reductase enzymes) and histopathological studies were carried out. Treatment of Ochratoxin A alone (group 2 rats) significantly increased malondialdehyde content, catalase, and glutathione reductase activities with a decrease in the activity of superoxide dismutase enzyme and reduced glutathione level and in brain, kidney and liver. Whereas, low dose coffee (group 3) and high dose coffee (group 4) rats showed dose-dependent increase in antioxidant and less histopathological alterations. Concomitant treatment of Yemeni green coffee powder and Ochratoxin A brought dose-dependent protective effects against oxidative stress which was induced using Ochratoxin A in liver, brain, and kidney tissues of female rats.

Preprocedural ultrasound assessment does not improve trainee performance of spinal anesthesia for obstetrical patients: a randomized controlled trial.

STUDY OBJECTIVE: This randomized controlled trial was designed to evaluate the efficacy of additional information from preprocedure ultrasound examination to aid anesthesiology trainees performing spinal anesthesia for obstetric patients. DESIGN: Trainee residents were randomly allocated to landmark technique and anatomy demonstration via ultrasound examination or landmark technique only for spinal anesthetic placement. SETTING: Obstetric delivery suite. PATIENTS: Eighty healthy obstetric patients undergoing elective cesarean delivery. INTERVENTION: Ultrasound examination prior to spinal anesthetic placement. MEASUREMENTS: The primary outcome was the number of attempts for the spinal anesthetic. Secondary outcomes included placement duration; block height; and the incidence of need for staff intervention, paresthesia, and bloody tap. Subjective ease of placement was rated on a 100-mm visual analog scale. MAIN RESULTS: Baseline demographic data were similar between the patient groups. The median number of attempts with preprocedure ultrasound and landmark was 3 (interquartile range, 2-7). This was not significantly different from the number of attempts with landmark technique only of 3 (1-60) (P=.69). The median duration of spinal placement with ultrasound and landmark was 92 (51-140) seconds vs 75 (53-126) seconds with landmark only (P=.57). There was no statistical difference between the groups in spinal placement duration, need for staff intervention, paresthesia, bloody tap, lumbar interspace, or block height. There was no difference in subjective ease of spinal placement by the resident. CONCLUSIONS: In this study of junior anesthesia trainees performing obstetrical spinal anesthesia with preprocedure ultrasound and landmark technique or landmark technique only, no significant difference was observed in the number of attempts, duration of spinal placement, subjective ease of spinal placement, or any other measured secondary outcome.

Biomarkers of oxidative stress in rat for assessing toxicological effects of heavy metal pollution in river water.

Increasing use of heavy metals in various fields, their environmental persistency, and poor regulatory efforts have significantly increased their fraction in river water. We studied the effect of Musi river water pollution on oxidative stress biomarkers and histopathology in rat after 28 days repeated oral treatment. River water analysis showed the presence of Zn and Pb at mg/l concentration and Ag, As, Ba, Cd, Co, Cr, Cu, Mn, Mo, Ni, Sn, and Sb at µg/l concentration. River water treatment resulted in a dose-dependent accumulation of metals in rat organs, being more in liver followed by kidney and brain. Metal content in both control and low-dose group rat organs was below limit of detection. However, metal bioaccumulation in high- and medium-dose group organs as follows: liver-Zn (21.4 & 14.5 µg/g), Cu (8.3 & 3.6 µg/g), and Pb (8.2 & 0.4 µg/g); kidney-Zn (16.2 & 7.9 µg/g), Cu (3.5 & 1.4 µg/g), Mn (2.9 & 0.5 µg/g), and Pb (2.6 & 0.5 µg/g); and brain-Zn (2.4 & 1.1 µg/g), and Ni (1 & 0.3 µg/g). These metals were present at high concentrations in respective organs than other metals. The increased heavy metal concentration in treated rat resulted significant increase in superoxide dismutase, glutathione peroxidase, glutathione reductase, glutathione S transferase enzymes activity, and lipid peroxidation in a dose-dependent manner. However, glutathione content and catalase activity were significantly decreased in treated rat organs. Histopathological examination also confirmed morphological changes in rat organs due to polluted river water treatment. In conclusion, the findings of this study clearly indicate the oxidative stress condition in rat organs due to repeated oral treatment of polluted Musi river water.

Methamphetamine causes anorexia in Drosophila melanogaster, exhausting metabolic reserves and contributing to mortality.

Methamphetamine (MA) appears to produce neurotoxic effects, in part, through disruptions of energy metabolism. A recent study of the whole-body proteome of Drosophila melanogaster showed many changes in energy metabolism-related proteins, leading us to hypothesize that MA toxicity may cause whole-body disruptions of energy metabolism. To test this, we monitored the response of energy reserves and other metabolites to MA-exposure with and without the addition of dietary glucose. We also monitored changes in feeding behavior, locomotor activity and respiration rates associated with MA-exposure to investigate how MA affects energy balance. We observed that glycogen and triglyceride levels decreased dramatically within 48 hr of MA-exposure, indicating a strongly negative caloric balance. Behavioral assays revealed that MA-treated flies decreased food consumption by 60-80% and exhibited a 2-fold increase in locomotion. Caloric expenditure decreased with MA-exposure, apparently due to a compensatory decrease in resting metabolism, showing that anorexia was the primary driver of the negative caloric balance. Additionally, we observed that glucose supplementation of MA-containing diet increased glycogen reserves by 44% at 48 hr, leading to a commensurate increase in survivorship. We conclude that dietary sugar supplementation enhances survivorship by partially compensating for decreased caloric intake resulting from MA-induced anorexia. The observation that MA produces similar behavioral changes in Drosophila and humans, i.e. increased locomotor activity and anorexia, further supports the use of Drosophila as a model organism for the study of the effects of MA.

Leucine or carbohydrate supplementation reduces AMPK and eEF2 phosphorylation and extends postprandial muscle protein synthesis in rats.

Muscle protein synthesis (MPS) increases after consumption of a protein-containing meal but returns to baseline values within 3 h despite continued elevations of plasma amino acids and mammalian target of rapamycin (mTORC1) signaling. This study evaluated the potential for supplemental leucine (Leu), carbohydrates (CHO), or both to prolong elevated MPS after a meal. Male Sprague-Dawley rats (∼270 g) trained to consume three meals daily were food deprived for 12 h, and then blood and gastrocnemius muscle were collected 0, 90, or 180 min after a standard 4-g test meal (20% whey protein). At 135 min postmeal, rats were orally administered 2.63 g of CHO, 270 mg of Leu, both, or water (sham control). Following test meal consumption, MPS peaked at 90 min and then returned to basal (time 0) rates at 180 min, although ribosomal protein S6 kinase and eIF4E-binding protein-1 phosphorylation remained elevated. In contrast, rats administered Leu and/or CHO supplements at 135 min postmeal maintained peak MPS through 180 min. MPS was inversely associated with the phosphorylation states of translation elongation factor 2, the "cellular energy sensor" adenosine monophosphate-activated protein kinase-α (AMPKα) and its substrate acetyl-CoA carboxylase, and increases in the ratio of AMP/ATP. We conclude that the incongruity between MPS and mTORC1 at 180 min reflects a block in translation elongation due to reduced cellular energy. Administering Leu or CHO supplements ∼2 h after a meal maintains cellular energy status and extends the postprandial duration of MPS.

The sum of the parts detracts from the intended whole: competencies and in-training assessments.

OBJECTIVES: Despite the fact that Canadian residency programmes are required to assess trainees' performance within the context of the CanMEDS Roles Framework, there has been no inquiry into the potential relationship between residents' perceptions of the framework and their in-training assessments (ITA). Using data collected during the study of ITA, we explored residents' perceptions of these competencies. METHODS: From May 2006-07, a purposive sample of 20 resident doctors from internal medicine, paediatrics, and surgery were interviewed about their ITA experiences. Data collection and analysis proceeded in an iterative fashion consistent with grounded theory. In April 2008, a summary of recurrent themes was presented during a focus group interview of another five residents to afford further elaboration and refinement of thematic findings. RESULTS: The in-training assessment report (ITAR) was perceived as a primary source of residents' information on CanMEDS. Residents' familiarity with the set of competencies appeared to be quite limited and they possessed narrow definitions of the roles. Several trainees questioned the framework's relevance and some appeared confused about the overlapping nature of the roles. Although residents viewed the central Medical Expert role as the most relevant and important competency, they incorrectly perceived it as only involving the acquisition of medical and scientific knowledge. A visual rhetorical analysis of a typical ITAR suggests that the visual features found within this assessment tool may be misrepresenting the framework and the centrality of the Medical Expert role. CONCLUSIONS: Resident doctors' knowledge of CanMEDS was found to be limited. The visual structure of the ITAR appears to be a factor in residents' apparent distortion of the CanMEDS construct from its original holistic philosophy.