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Knowing how, when, and what types of antibiotics should be used before and after an appendectomy is a very important subject for this very common intra-abdominal procedure that is performed in an emergency setting. This subject reflects the positive results of the procedure on the reduction of infectious complications, such as surgical site infection or intra-abdominal abcess. Post-operatively, we divided patients who had a non-perforated appendix into two groups: group A received pre-operative antibiotics half an hour before surgery with a single dose of 3rd generation cephalosporin (ceftriaxone)1g and metronidazole 500mg, and group B received antibiotics half an hour pre-operatively and continued antibiotics post-operatively within 24 hours. Both groups received antibiotics post-operatively. 240 patients were randomly selected and separated into two groups with an identical number in each. Of the 120 patients in group A, eight of them developed a wound infection (6.67%), and the same number of patients in group B also became infected. The 30-day follow-up period came and went without anyone developing an intra-abdominal infection. The use of a single dosage of antibiotic will be sufficient to prevent infection at the surgical site, and the advantage of post-operative antibiotic treatment in non-perforated appendix will be imperceptible.

The benefits of using mathematical modeling of the flow are obvious, the final objective being the elimination of as many inclusions as possible during the flow of steel through the tundish, and thus, obtaining steel with superior quality.In this work, a simulation of the movement of the liquid alloy in the tundish was carried out, in order to highlight the erosion of its refractory lining. For this, we used SolidWorks, RealFlow, and ABAQUS programs.Using these simulation programs, the filling method of the tundish, the contact area of the alloy jet with the tundish wall, and the "dead" areas are highlighted, as well as the turbulences that can appear during the flow, which have a negative impact on the quality of the steel.

Abstract In recent years, there has been a surge in interest in developing new polymeric materials with high performance and low cost. With increased environmental awareness, research has focused on eco-friendly materials, with terms like “renewable,” “recyclable,” “sustainable,” and “biodegradable” becoming important features of the materials, Polymer blends can provide products with a wider range of useful qualities than single polymer equivalents. In this study, Polymer blend films were prepared using dextrin at different compositions of (PVA- PMMA-PAAm) by solvent casting method. The prepared blend films were flexible and transparent and characterized using was examined by scanning electron microscopy to examine the surface morphology of the samples that show the good distribution of starch in the blend, while FT-IR was used to identify the active groups, which refer to the interaction among the materials. Also, we have studied the optical properties and recording the absorption spectrum with a visible ultraviolet spectrophotometer. Absorption spectra were recorded in the wavelength range of 200–1100 nm. The absorbance and optical conductivity were increased by dextrin additive, while the transmittance and energy gap decreased. Based on the overall results, the prepared films can be used in drug delivery and optical devices.

Protozoa parasites of the genus Leishmania have a great ability to avoid damage in the hostile environments they encounter throughout their life cycle within the host’s body. Parasites have developed many virulence factors to ensure their persistence and replication within the host, and the first role of these factors is to attenuate the host’s defenses against them through innate and adaptive immunity, as evidence indicates that the determinants of parasite virulence are responsible for evading the host’s defenses, allowing these organisms to survive on Alive in the host’s hostile immune environment. Understanding the molecular details of how these pathogens persist with impunity under extreme conditions is beginning to begin. The fact that Leishmania parasites have adapted not only to survive but are likely to reproduce is due to the protection afforded by specialized molecules on the parasite’s cell surface. Although recent years have seen clear and significant progress in the research on Leishmania in different directions, many issues have yet to be clarified. The surface of all parasites, especially protozoa, usually undergoes pronounced changes during their life cycle. It is of particular interest in the case of protozoan parasites of the genus Leishmania whose surface is exposed to different and hostile environments within vertebrate and invertebrate organisms. Because of the importance that the cell surface of pathogenic parasites plays in their interaction with the host for survival, some efforts have been devoted to their characterization. This review aims to give an overview of the main virulence factors that contribute to parasite survival and survival. We have attempted to provide a brief picture of the factors that influence the interaction of the parasite in its host, further highlighting GP63 as a critical virulence factor affecting macrophage physiology as well as the functioning of the immune system.

In the last few decades, environmental contaminants (ECs) have been introduced into the environment at an alarming rate. There is a risk to human health and aquatic ecosystems from trace levels of emerging contaminants, including hospital wastewater (HPWW), cosmetics, personal care products, endocrine system disruptors, and their transformation products. Despite the fact that these pollutants have been introduced or detected relatively recently, information about their characteristics, actions, and impacts is limited, as are the technologies to eliminate them efficiently. A wastewater recycling system is capable of providing irrigation water for crops and municipal sewage treatment, so removing ECs before wastewater reuse is essential. Water treatment processes containing advanced ions of biotic origin and ECs of biotic origin are highly recommended for contaminants. This study introduces the fundamentals of the treatment of tertiary wastewater, including membranes, filtration, UV (ultraviolet) irradiation, ozonation, chlorination, advanced oxidation processes, activated carbon (AC), and algae. Next, a detailed description of recent developments and innovations in each component of the emerging contaminant removal process is provided.

The present study aimed to investigate the renoprotective effect of therapeutic hypothermia (TH) on renal ischemia-reperfusion injury (RI/RI) induced by asphyxial cardiac arrest (CA) in rats. A total of 48 male rats were randomly divided into five groups: i) Sham (n=6); ii) Normothermia + CA (Normo.) (n=14); iii) Normo. and 2 h of TH after return of spontaneous circulation (ROSC) (n=12); iv) Normo. and 4 h of TH after ROSC (n=9); and v) Normo. and 6 h of TH after ROSC (n=7). All rats except the Sham group underwent asphyxia CA and were sacrificed 1 day after ROSC. The survival rate increased from 42.8% in the Normo. group to 50, 66.6 and 85.7% in the groups with 2, 4 and 6 h of TH after CA, respectively. TH attenuated the histopathological changes of the renal tissues following ROSC and the levels of blood urea nitrogen, serum creatinine and malondialdehyde in renal tissues. On immunohistochemistry, the relative optical density of nuclear erythroid-related factor-2 (Nrf2) and heme oxygenase (HO-1) expression in renal tissues increased in the Normo. group compared with that in the Sham group and exhibited further significant increases at 6 h of TH after ROSC. In conclusion, TH attenuated renal injury and increased the expression of Nrf2 and HO-1 in a TH treatment time-dependent manner.

Recently, covalent organic frameworks (COFs) have gained significant attention as a promising material for the elimination of various organic pollutants due to their distinctive characteristics such as high surface area, adjustable porosity, high removal efficiency, and recyclability. The efficiency and selectivity of COFs depend on the decorated functional group and the pore size of the chemical structure. Hence, this review highlights the adsorption removal mechanism of different organic contaminants such as (pharmaceutical and personal care products, pesticides, dyes, and industrial by-products) by COFs from an aqueous solution. Spectroscopic techniques and theoretical calculation methods are introduced to understand the mechanism of the adsorption process. Also, a comparison between the performance of COFs and other adsorbents was discussed. Furthermore, future research directions and challenges encountered in the removal of organic contaminants by COFs are discussed.

Highly efficient magnetic sewage sludge biochar (MSSBC) discloses feasible fabrication process with lower production cost, superior adsorption capacity, usage of waste sewage sludge as resource, selected by external magnetic field and exceptional regeneration property. 2 g L−1 MSSBC exhibited a high adsorption capacity of 249.00 mg g−1 in 200 ppm Pb(II) and the lead-MSSBC equilibrium was achieved within one hour, owing to the existence of the copious active sites. The adsorption kinetics was well described by the pseudo-second-order model while the adsorption isotherm could be fitted by Langmuir model. Mechanism study demonstrated the adsorption involved electrostatic attraction, ion exchange, inner-sphere complexation and formation of co-precipitates at the surface of MSSBC. Additionally, adsorption performance maintained remarkable in a broad pH window. These outcomes demonstrated the promising waste resource utilization by a feasible approach that turns the solid waste of sewage sludge into biochar adsorbent with auspicious applications in elimination of Pb(II) from wastewater.

Background Burn scar treatment persists as an unsolved problem, involving thousands of affected patients disfigured for life. Objectives We sought to present our experience with the use of combined treatments for patients with burn scars. Methods This was a case series report of the senior author’s experience during 8 years utilizing the combined treatments of Fraxel Restore (fractional laser) and microfat graft injection for 288 patients with burn scars. Results Laser treatment reduced scar intensity and attenuated skin irregularities and hyperpigmentation. All patients demonstrated marked improvement of skin texture and an increase in scar softness after 3 sessions of microfat grafting. However, the degree of improvement varied between patients and was related to the severity of the scar and the type of tissue. Overall, a 40% to 80% improvement was noted in our patients. All patients and their families expressed satisfaction with the results. Conclusions The combined treatment of Fraxel and microfat grafting is an effective technique for improving the appearance of a hypertrophic scar or keloid on burn patients. Fat tissue stem cells may have helped to repair the damaged skin. Level of Evidence: 4

The serious limitations of available technologies for decontamination of wastewater have compelled researchers to search for alternative solutions. Catalytic treatment with hydrogen peroxide, which appears to be one of the most efficient treatment systems, is able to degrade various organics with the help of powerful ·OH radicals. This review focuses on recent progress in the use of bicarbonate activated hydrogen peroxide for wastewater treatment. The introduction of bicarbonate to pollutant treatment has led to appreciable improvements, not only in process efficiency, but also in process stability. This review describes in detail the applications of this process in homogeneous and heterogeneous systems. The enhanced degradation, limited or lack of leaching during heterogeneous degradation, and prolonged catalysts stability during degradation are salient features of this system. This review provides readers with new knowledge regarding bicarbonate, including the fact that it does not always harm pollutant degradation, and can significantly benefit degradation under some conditions.

Black liquor (BL) is an agro-industrial residue with high number of lignocellulosic components which could be recognized as a biomass feedstock. In this work, BL coupled with red mud (RM), were applied to prepare cost-effective zero-valent iron (ZVI) embedded in biochar. The oligomers in BL acted as reductants for RM to generate ZVI, while the organic components could be converted into biochar during pyrolysis. The RM/BL demonstrated excellent performance in the removal of Cr(VI) (349.5 mg/g), as the mechanisms were reduction and adsorption. The fixed-bed column study was conducted and 1.7 L simulated wastewater could be treated by 1.0 g RM/BL. After reaction, 95.5% ± 0.8% and 82.5%±3.2% Cr-loaded adsorbents could be recovered by an external magnet for batch and fixed-bed experiments, respectively. All these results shed light on valorizing these two widespread agro-industrial byproducts, and bridged the knowledge gap between magnetic bio-adsorbent preparation and its industrial practicality on wastewater purification.

After qualifying, Jacob Plange-Rhule came to the UK to study renal physiology in Manchester. Soon after he obtained his PhD, he returned to Ghana to train in internal medicine. He became consultant physician in the Department of Medicine, Komfo Anokye Teaching Hospital (KATH), where he started hypertension and renal clinics. Later on, he became head of nephrology services at KATH …

In this paper, sewage sludge, a solid waste from wastewater treatment plant, which eagerly requires proper treatment was reused as solid support in the form of sewage sludge biochar, then modified with carboxymethyl chitosan to form a bio-adsorbent. Further, carboxymethyl chitosan coating on sewage sludge biochar improved carboxymethyl chitosan's stability in water. The prepared bio-adsorbent revealed a shorter equilibrium time (60 min) for Pb(II) adsorption and a superior capacity of 594.17 mg g

Phenylurea herbicide residuals in soil may continuously contaminate surface water and groundwater due to unregulated and improper use. Herein, we reported a stable and active oxidation system including heterogeneous Fe-based layered double hydroxide materials as persulfate (PS) activators. Under mild conditions, 1% LDH in weight and 70 mM PS can completely degrade 500 mg/kg isoproturon in soil within 10 h, during which less than 0.1 ppm heavy metal leaching was detected. This remarkable performance was consistent in a broad pH range (3~11) and was resistant to various inorganic anions (Cl−, Br−, NO3−, HCO3−) and humic acid. Mechanism studies from scavenging tests, EPR, and fluorescence spectra collectively proved that besides •OH and •SO4−, singlet oxygen (1O2) and superoxide (•O2−) were also generated and were accounted for the oxidative degradation. This unique mechanism of generating diverse radicals was clearly distinguished from classic Fe(II)/PS system, significantly reduced the influence of varying parameters in water and soil matrix, and was suggestive to chemical oxidation system in soil remediation to avoid scavenging effects by background electrolytes or other components in water/soil matrix.

تجتهد هذه الورقة المكثفة في التركيز على دور الانتقال الديمقراطي أو عملية الدمقرطة السياسية في إثارة قضية اللامركزية أو الحكم المحلي في العراق (إدارية كانت أم سياسية)، فعلى العكس مما يظهر في الديمقراطيات الراسخة حيث يشكل الاستقرار السياسي والإداري سمةً بارزة فيه، ففي المجتمعات الانتقالية تشكل الصراعات الإثنية والدينية والطائفية مركز الثقل في عملية الانتقال. وعلى الرغم من أن قضية إدارة الأقاليم في العراق قد نالت حظها الوافر من السجال السياسي والإعلامي وحتى الشعبي، غير أنها لم تجد مستوًى مثيلاً من الاهتمام الأكاديمي، فلم يعد ممكناً التعامل معها كقضية ثانوية، فهي تمثل جوهر عملية التحول الديمقراطي في العراق. إن الأزمة الراهنة بين حكومتي المركز والإقليم تشكل توقيتاً مناسباً لعرض قضية اللامركزية في العراق على طاولة البحث والنقاش، ليس لأن هذا التوقيت هو فترة اجترار تأريخي لصراع المركز والإقليم فحسب، ولكن لأنه يمكن أن يكون مرحلة تفكيك إشكاليات النماذج القديمة للثقافة السياسية التي تعاملت مع القضية، ومحاولة بناء براديغمات جديدة، فضلاً عن كونها مرحلة ضغوط شعبية متزايدة، وحراك مدني متزايد من أجل حلّ المسائل العالقة، بين المركز ومدن بعينها تشكو الغبن، كما أن هناك مشاريع لمحاولة المطالبة بإقليم طائفي (سنّي هذه المرة). ولأجل ذلك تحاول الورقة الحالية عرض أهم المسائل المتعلقة بقضية اللامركزية، وتتمثل بوقفاتٍ خمس، هي: اللامركزية... في المفهوم وتداولاته، واللامركزية في الدولة العراقية الحديثة.. الدواعي والمتطلبات، وإشكالية اللامركزية في الدستور، واللامركزية والانتقال الديمقراطي في العراق، وإقليم كوردستان... التحديات وآفاق الحل الممكنة، وانتهت الورقة أخيراً بخاتمة. مدخل أولي تجتهد هذه الورقة المكثفة في التركيز على دور الانتقال الديمقراطي أو عملية الدمقرطة السياسية في إثارة موضوعة اللامركزية أو الحكم المحلي في العراق (إدارية كانت أم سياسية)، فعلى العكس مما يظهر في الديمقراطيات الراسخة حيث يشكل الاستقرار السياسي والإداري سمةً بارزة فيه، ففي المجتمعات الانتقالية تشكل الصراعات الإثنية والدينية والطائفية مركز الثقل في عملية الانتقال. وعلى الرغم من قضية إدارة الأقاليم في العراق قد نالت حظها الوافر من السجال السياسي والإعلامي وحتى الشعبي، غير أنها لم تجد مستوىً مثيلاً من الاهتمام الأكاديمي، فلم يعد ممكناً التعامل معها كقضية ثانوية، فهي تمثل جوهر عملية التحول الديمقراطي في العراق

Introduction Gitelman syndrome is an inherited autosomal recessive renal salt-wasting disorder. It presents with variable clinical symptoms including muscle weakness and fatigue, and the diagnosis is based on metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. It is usually diagnosed incidentally in early adulthood. There are rare cases of Gitelman syndrome presenting in early childhood; however, to the best of our knowledge it has not previously been associated with delayed puberty. Case presentation A 17-year-old South Asian man with recurrent episodes of generalized muscle weakness, fatigue and cramps from the age of two years was admitted for further workup. Before the age of 12 years, the episodes had been mild, but they then got progressively worse. Other symptoms include polyuria, polydipsia, nocturia, paresthesia and occasional watery diarrhea. He also had a history of short stature, poor weight gain and delayed developmental landmarks. His family history was unremarkable except for the consanguineous marriage of his parents. An examination revealed a thin and lean man with blood pressure of 95/60mmHg. His height and weight were below the third percentile and his sexual development was at Tanner Stage II. Laboratory work revealed serum sodium of 124mmol/L, potassium 2.4mmol/L, calcium 6.5mmol/L and magnesium of 1.2mg/dL. His testosterone level was low (0.85ng/mL, normal for his age 2.67 to 10.12ng/mL) with normal levels of luteinizing hormone and follicle-stimulating hormone. The sex hormone findings were attributed to delayed puberty. A 24-hour urinary analysis revealed decreased excretion of calcium (25.9mg/24 hours). Based on the findings of hypokalemic metabolic alkalosis without hypertension, severe hypomagnesemia and hypocalciuria, a diagnosis of Gitelman syndrome was made. Treatment was started with oral supplementation of potassium, magnesium and calcium along with spironolactone and liberal salt intake. Conclusion Diagnosis of Gitelman syndrome is usually made incidentally during adolescence or early adulthood based on clinical and biochemical findings. We report that Gitelman syndrome can present during the early childhood years. If undiagnosed and untreated, it can lead to growth retardation and delayed puberty.