Unleashing synergistic potential of microbially enhanced anaerobic co-digestion of petroleum refinery biosludge and yard waste: Impact of nutrient balance and microbial diversity.

Petroleum refinery sludge, an egregious solid residue generated from the wastewater treatment plants poses an environmental hazard owing to its intricate hydrocarbon composition, necessitating competent treatment for secure disposal. The study proposes a green solution through anaerobic co-digestion of nitrogen-rich petroleum refinery sludge (PS) with carbon-rich yard waste (YW), balancing the nutrients and moisture content for efficient microbial proliferation. Using Central Composite Design-Response Surface Methodology, 1 L batch experiments were conducted with varying carbon/nitrogen (C/N) ratios and pH to achieve maximum biogas yield within 50 days of co-digestion. However, the sluggish biogas recovery (40%) indicated a slow rate-limiting hydrolysis, necessitating pretreatment. Feedstock incubation with Bacillus subtilis IH1 strain, isolated from the microbially-enriched PS, at 108 colony forming units (CFU) per mL for 5 days maximized the soluble chemical oxygen demand and volatile fatty acids by 2.2 and 1.4 folds respectively compared to untreated feedstock. Scale-up Bacillus subtilis aided co-digestion studies further augmented biogas by 76% against untreated monodigestion of PS with significant total petroleum hydrocarbons, emulsions, and lignocellulosic degradation. Further identification of major organic pollutants in the batch digestate revealed significant degradation of the toxic organic hydrocarbon pollutants apotheosizing the efficacy of the synergistic sustainable technique for the management of PS. ENVIRONMENTAL IMPLICATION: The effluent treatment plants (ETPs) of petroleum refining industries generate sludge which is a complex mixture of petroleum hydrocarbons, oil-water (O/W) emulsions and heavy metals. These petroleum hydrocarbon constituents can be linear/cyclic alkanes, polyaromatics, resins and asphaltenes, whose intricate composition is reportedly carcinogenic, cytogenic and mutagenic, classifying it as hazardous waste. Biological treatment of these sludge through anaerobic digestion leads to utilization of petroleum hydrocarbons with subsequent energy recovery. Co-digestion of these sludge with competent co-substrates leads to nutrient balance, diverse microbial proliferation and toxicant dilution. Microbially aided co-digestion further augments methane rendering a digestate with utmost pollutant degradation.

Impact of COVID-19 lockdown on substance availability, accessibility, pricing, and quality: A multicenter study from India.

Background and Aim: Pandemic and consequent lockdowns are likely to affect the drug market by the sudden disruption of the supply chain. We explored the change in the availability, access, purity, and pricing during lockdown from respondents seeking treatment for drugs, alcohol, and tobacco dependence. Materials and Methods: A cross-sectional survey was conducted among 404 respondents from seven treatment centers across India. A structured questionnaire assessed the change in availability, access, quality, and price of substances used during the first phase (March 24-April 14) and the second phase (April 15-May 3) of lockdown. Results: A majority of the respondents in treatment used tobacco (63%) and alcohol (52%). Relatively few respondents used opioids (45%) or cannabis (5%). Heroin (44%) was the most common opioid the respondents were treated for. Seventy-five percent, 65%, and 60% of respondents treated for alcohol, tobacco, and opioid problems, respectively, reported a reduction in the availability and access during the first phase of the lockdown. In the second phase, respondents with alcohol and tobacco dependence reported greater availability than those with opioid and cannabis dependence. The reported price of all substances increased more than 50% during the first phase of lockdown and remained higher throughout the second phase. Deterioration in purity was reported by more than half of the people who used opioid. Conclusion: Lockdown could have affected both licit and illicit drug markets, albeit to a varying degree. The observed changes seemed short-lasting, as suggested by the recovering trends during the second phase of lockdown.

Does Online Newsmedia Portrayal of Substance Use and Persons with Substance Misuse Endorse Stigma? A Qualitative Study from India.

Media provides and shapes public knowledge, perceptions, and attitude towards people with substance misuse. We aimed to explore the content and specific themes of Indian online news articles on substance use or persons with substance misuse. We followed an exploratory qualitative design to analyze online news media reports published between July 1 2020 and June 30 2021. Hundred articles met the selection criteria. Our content analysis was based on a checklist. Thematic analysis was done by the coding, categorization, and theme generation after meticulous data immersion and triangulation. Sixty percent of articles had pessimistic headlines and portrayed substance use or persons with substance use negatively. Fifty-one percent articles were on alcohol. Twenty-seven percent articles focussed supply reduction, whereas only 5% positively discussed the role of treatment. We identified seven themes. Most frequent themes were legal-criminal aspects of substance use (n = 39), psychosocial and health hazards of substance use (n = 30), and propagation of public stigma (n = 25). Two other prevalent themes were the business and marketing of alcohol (n = 20) and sociocultural aspects of substance use (n = 9). The theme, treatment strategy, appeared in only five articles. There is an urgent need for media guidelines for responsible reporting of substance misuse. We suggested a set of recommendations for media reporting.

A Case of Premenopausal Uterine Leiomyoma, Non-cirrhotic Portal Fibrosis, Hepatic Koch's, a PET Gone Astray-Morphology Antidotes a Confounding Concoction.

Uterine leiomyoma with hepatic vasculopathy, specifically non-cirrhotic portal fibrosis (NCPF), has hitherto been undescribed. NCPF is characterized by elevated portal pressure sans cirrhosis and has previously not been described in association with a gynecological pathology. We report the case of a female under evaluation for a heterogeneously enhancing intrauterine mass with multiple hepatic lesions with increased uptake of fluorodeoxyglucose on positron emission analysis. Fibroscan values were increased. Histopathologic evaluations revealed a leiomyoma with liver tissue showing tubercular granulomas, thin wispy fibrotic strands, and rounded portal tracts pointed to NCPF. No evidence of malignancy was seen. Metabolic imaging may be unreliable to distinguish between benign and malignant uterine pathology and granulomatous and malignant hepatic lesions. Elastography may also be ineffective in diagnosing the etiology of liver fibrosis. Histopathological analysis hence remains essential despite noninvasive tests. Further research is required on females afflicted with NCPF to exclude a hormonal link.

A multicentric survey among patients with substance use disorders during the COVID-19 lockdown in India.

Background: The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions. Materials and Methods: We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June-September) of the pandemic. Results: An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ2 = 20.408, P = 0.000), make attempts (χ2 = 12.436, P = 0.000), seek treatment (χ 2 = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ2 = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ2 = 35.143, P = 0.000) and experience stigma by family members (χ2 = 29.951, P = 0.000) and neighbors (χ2 = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others. Conclusion: COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions.

Enhanced methane production and hydrocarbon removal from petroleum refinery sludge after Pseudomonas putida pretreatment and process scale-up.

The influence of Pseudomonas putida 7525 strain on the pretreatment of petroleum refinery sludge was optimized at different dosages to maximize solubilization for improved biodegradability. Laccase-producing P. putida strain at a dosage of 108 CFU/mL resulted in 249% and 121.57% increments in soluble chemical oxygen demand and volatile fatty acids production respectively as compared to untreated within 6 days of incubation. 1L biochemical methane potential test conducted for optimization of different inoculum and pretreated substrate ratios (0.3, 0.4, 0.5, 0.7 and 1.0) revealed maximum methane augmentation (62%) and volatile solids degradation (66.7%) at ratio 0.5. Scaled-up study (20L) for ratio 0.5 resulted in 57.07% total petroleum hydrocarbon, 62.98% oil and grease and 91.9% phenol removal within 50 days of digestion of pretreated PS. Kinetic modelling of cumulative methane yield indicated that modified Gompertz model showed the best fit thereby, evincing the potency of bacterial species for bioremediation of PS.

Optimization of electrokinetic pretreatment for enhanced methane production and toxicity reduction from petroleum refinery sludge.

This study examined the effect of electrokinetic pretreatment on petroleum sludge (PS) released from the wastewater treatment plants of petrochemical industries for enhanced biodegradation and contaminant removal. The application of electric field on PS through direct current is optimized with the combined variation of applied voltage (40-80 V), exposure duration (20-120 min) and distance between graphite electrodes (8-16 cm) using central composite design-response surface methodology (CCD-RSM). The optimization study revealed significant interaction among the response variables to obtain an optimum condition (60 V, 83.5 min, 11.6 spacing) for maximization of solubilization in terms of soluble chemical oxygen demand (230% increment against untreated) and volatile fatty acids (172% increment against untreated) concentrations for accelerated hydrolysis of complex PS. BMP batch assays were performed at different inoculum and sludge ratios (0.3, 0.4, 0.5 and 0.7) based on volatile solids content after pretreatment at the optimized condition which resulted in accumulated methane ranging from 5.16 to 6.61 L/gVSadded (untreated - 3.9 L/gVSadded). The mixing ratio of 0.4 showed the maximum methane enhancement of 69.2% compared to untreated. The maximum removal of organic content (62.8%), oil and grease (71.74%), and total petroleum hydrocarbon (52.9%) were also observed for the mixing ratio of 0.4. The FTIR study showed the efficacy in hydrocarbon dissociation and decomposition after pretreatment of PS. The net energy gain (3508 kJ) and phytotoxicity reduction of batch digestate after the anaerobic digestion suggest the economic feasibility and decontamination efficiency of the electrokinetic pretreatment technique respectively. Further research could be performed to evaluate the viability of this pretreatment for enhanced methane recovery at field-scale levels to relate to these lab-scale postulations.

A comparative study evaluating insight in different phase of illness among patients with bipolar disorder by using multiple scales.

AIM: This cross-sectional study aimed to evaluate insight and its correlates among patients with bipolar disorder (BD). METHODOLOGY: 180 patients with BD were evaluated on Scale to Assess Unawareness of Mental Disorders (SUMD), Insight scale for affective disorders (ISAD), Mood Disorders Insight Scale (MDIS), and Beck Cognitive Insight Scale (BCIS). RESULTS: About half of the patients were in clinical remission (N = 94; 52.2%), one-fifth (N = 37; 20.55%) were in the phase of mania and one-fourth (N = 49; 27.2%) were in a depression. There was no significant difference in the level of insight between those in clinical remission and those in depression except for one of the domains of BCIS. Patients with mania had poorer insight compared to those in remission and depression. In terms of association of insight as assessed by different scales, in the whole sample and all the three subgroups, SUMD current and past scores had a significant positive correlation with the ISAD total score. In the whole sample, among patients currently in remission and those currently in depression, ISAD total score had significant negative correlation with MDIS total score. Poorer insight as assessed on SUMD (current and past), ISAD and MDIS was associated with poorer medication adherence. CONCLUSION: The present study demonstrates that patients with mania have poor insight when compared to the patients in clinical remission and depression. The present study also demonstrates that the assessment of clinical insight is not affected much by the type of scale used.

The Effectiveness of Non-Benzodiazepine, Non-Barbiturate Medications for Alcohol Withdrawal Syndrome: A Rapid Systematic Review.

AIM: There are potential clinical, ethical and legal concerns with overdosing benzodiazepines (or barbiturates) for the treatment of moderate to severe alcohol withdrawal symptoms (AWS) through telemedicine or ambulatory outpatients. A rapid systematic review to (a) qualitatively summarize the non-benzodiazepine treatment alternatives, (b) evaluate the quality of evidence for the same to effectively manage moderate to severe AWS. METHODS: We conducted searches on PubMed (January 1990 to 31 March 2020), Cochrane Central Register of Controlled Trials, and Google Scholar. We selected the English language randomized controlled trials (RCTs) assessing the efficacy and adverse effects of non-benzodiazepine and non-barbiturate medications among adults with a diagnosis of AWS. Data extraction was done in a predefined format. Risk of bias (RoB) assessment and qualitative synthesis of evidence was done with the RoB2 tool and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) proGDT. RESULTS: Thirty-four RCTs were included. Gabapentin (n = 6), carbamazepine (n = 5), baclofen (n = 5), valproate (n = 3), clonidine/lofexidine (n = 3) and acamprosate (n = 2) had more than one trial with a particular comparison group. Four studies were found to have a low ROB. The GRADE evidence summary showed gabapentin had a 'moderate' level of evidence against standard benzodiazepine treatments for reducing the severity of AWS. The level of certainty was 'low' for carbamazepine, baclofen and valproate and 'very low' for acamprosate and clonidine/lofexidine. Reported adverse events between these alternative medications and benzodiazepines or placebo were generally unremarkable. CONCLUSIONS: Although benzodiazepines remain the treatment of choice for AWS, during particular circumstances, gabapentin could be an alternative although like benzodiazepines is not without risk when used in the community. Future RCTs must aim to improve upon the quality of evidence.

Can google trends search inform us about the population response and public health impact of abrupt change in alcohol policy? A case study from India during the covid-19 pandemic.

BACKGROUND: Sudden alcohol prohibition in India during the COVID-19 pandemic presented an opportunity to test whether Google Trends data could indicate population responses and the public health impact of alcohol policy. We hypothesized, following prohibition: there would be a significant change in the relative search volumes (RSV) of alcohol-related queries; that temporal analysis of the trends would reflect a public response to policy changes; and that geospatial analysis of RSV would correlate with the prevalence of alcohol use. METHODS: Three different search periods were used to test the hypotheses. The search inputs were based on potential public response to alcohol prohibition, as evidenced by the literature, newspaper articles, and consensus. We used RSV as the unit of analysis. Mean RSV of search queries, pre-post implementation of prohibition, were compared. Smoothing of scatter plots examined the temporal association of trends with policy measures. Multiple linear regression tested the relationship of state-wise RSV and alcohol use prevalence. RESULTS: Post-implementation of prohibition, a significant increase in the RSV was observed for searches related to alcohol withdrawal (p<0.001), how to extract alcohol from sanitizer (p = 0.002), alcohol home delivery online (p<0.001), alcohol home delivery (p<0.001), and sleeping pills (p = 0.006). The trends suggested a decrease in general interest in alcohol but increased demand, and a possible connection with changes in policy measures. State-level RSV and alcohol use prevalence did not reveal a significant relationship. CONCLUSION: Google trend is a potential source of rapid feedback to policymakers about population responses to an abrupt change in alcohol policies.

Extended lockdown and India's alcohol policy: a qualitative analysis of newspaper articles.

OBJECTIVES: Since 25th March 2020 India went into a complete and extended lockdown. Alcohol production, sales, and purchase were barred with this overnight prohibition order. We conducted a qualitative analysis of the media reports published within the first month of the nationwide lockdown with the objectives (a) using the media reports as indications of possible public health impact and population response of a sudden alcohol prohibition in India, (b) suggesting areas for future research. METHODS: We performed thematic and content analysis of 350 articles published online in national newspapers between the 26th March, 2020 and 25th April, 2020. Initial inductive, followed by deductive coding was done in this exploratory thematic analysis. RESULTS: The thematic analysis revealed four main themes: the beneficial aspects of the policy, the harmful aspects of the policy, non-compliance and attempts to change and / or subvert the policy, popularity and level of public buy-in of the policy. We generated relevant sub-themes under main themes. Two additional themes, not directly related to the sudden prohibition, were use of stigmatizing language and ethical concerns. The content analysis showed the frequency of the appearance of the main themes and proportions of sub-themes and codes under those main themes. CONCLUSION: The harms, perceived from the media reports, should be balanced against the potential benefits. Absence of a national-level alcohol policy was made apparent by the reflexive, disconnected, and conflictual measures. Future research could systematically examine the potential ramifications of alcohol prohibition on public health, social, and economic aspects.