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Abstract Wastewater can be contaminated with all kinds of microorganisms and small organisms, including bacteria, parasites, fungi and viruses. Therefore, it can be said that biological pollution is one of the most dangerous pollutions. These types of pollution can endanger human health and the environment. In this study, industrial wastewater disinfection has been investigated in a laboratory pilot. In this study, ultraviolet waves have been used for wastewater disinfection. In this research, treatment indicators such as wastewater pH, phosphate, nitrate, biological oxygen and chemical oxygen, organic carbon, and wastewater turbidity have been investigated. The results of this research show that if 4.5 g of dry ice is added to the wastewater entering the disinfection unit, the pH of the wastewater will decrease to about 7.9. The results presented from the disinfection unit show that the amount of chemical oxygen demand and biological oxygen demand have decreased by about 35% and 20.3%, respectively. The results of this unit show that the amount of phosphate and nitrate has decreased by 61.3 and 71.9%, respectively. Laboratory results show that the TDS of wastewater has decreased from 600 to 451 mg/l.

Today, the lack of drinking water has caused severe crises in many countries. One of the ways to deal with water shortages is to treat wastewater. Petrochemical industries are among the factories that produce significant wastewater. These industries cause a lot of damage to the ecosystem. The use of nanomaterials can play a significant role in the removal of wastewater pollutants. The use of nano-packing in the filtration structure has not been investigated in previous literature. In this research, a gravity filtration unit was used to treat the outlet wastewater from the Fajr petrochemical desalination unit. This unit is filled with titanium dioxide nano-packings. The results of this research show that the turbidity of the effluent discharged from the gravity filtration bed is reduced by about 39 %. This research shows that nano-packing has a significant effect on reducing total dissolved solids and organic carbon. This study shows that the amount of total dissolved solids and organic carbon in treated wastewater is equal to 1 % and 17.1 %, respectively. This research shows that the use of a gravity filtration unit has a significant role in reducing petrochemical effluent pollutants.

Using transfer-matrix and stationary phase methods, we study the tunneling time (group delay time) in a ferromagnetic monolayer graphene superlattice. The system we peruse consists of a sequence of rectangular barriers and wells, which can be realized by putting a series of electronic gates on the top of ferromagnetic graphene. The magnetization in the two ferromagnetic layers is aligned parallel. We find out that the tunneling time for normal incident is independent of spin state of electron as well as the barrier height and electron Fermi energy while for the oblique incident angles the tunneling time depends on the spin state of electron and has an oscillatory behavior. Also the effect of barrier width on tunneling time is also investigated and shown that, for normal incident, the Hartman effect disappears in a ferromagnetic graphene superlattice but it appears for oblique incident angles when the x component of the electron wave vector in the barrier is imaginary.

Background: Preconception care (PCC) aims to address health risks before conception for better pregnancy outcomes. Effective PCC starts before pregnancy and involves interventions to improve well-being and prevent adverse outcomes. Unintended pregnancies and pre-existing illnesses increase risks. Early provision of care is crucial, as fetal development can be affected early. Improving women's knowledge and access to PCC is essential for optimal maternal and child health in Saudi Arabia., Methodology: A descriptive, cross-sectional study was conducted in Saudi Arabia to assess knowledge, attitudes, and practices regarding preconception care among women between the ages of 18 and 45 who live in Saudi Arabia, who matched the inclusion criteria. All women working in or studying in the medical field were excluded from the research. Data was collected using Google Forms (Google, Mountain View, CA) via social media apps. Data was cleaned in Microsoft Excel (Microsoft Corporation, Redmond, WA) and analyzed using IBM SPSS, version 29 (IBM Corp., Armonk, NY)., Results: Our study assessed awareness about PCC among 788 women. Age distribution revealed 24.9% (n=196) were 30-35 years old and 23.6% (n=186) were 40-45 years. Most were Saudi nationals (86.9%, n=685) and married (94.4%, n=744). University education was reported by 83.0% (n=654). Among notable findings, 79.1% disagreed or were neutral on PCC's necessity, and 78.6% supported free PCC. Barriers included fear of blood draws (68.7%) and negative family reactions (63.8%). Notably, 44.2% (n=348) demonstrated high knowledge and positive attitude towards PCC. Multivariate analysis indicated that marital status was significantly associated with high PCC knowledge (Exp(B)=1.956, p=0.049), while other sociodemographic factors were not associated with PCC knowledge., Conclusion: Our study showed an adequate level of knowledge about PCC among women. However, there is a need for further improvement in PCC awareness among Saudi women. A significant number of women supported free PCC services. Barriers included fear of procedures and family reactions. Marital status was significantly associated with higher PCC knowledge, emphasizing targeted educational interventions., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. National Committee of Bioethics/Umm Al-Qura University IRB issued approval HAPO-02-K-012. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Edris et al.)

Introduction: Chronic urinary retention (CUR) is a major problem in elderly patients and leads to high levels of morbidity. CUR can be treated surgically with transurethral resection of the prostate (TURP), but surgery is frequently avoided in elderly patients due to increased perioperative risks and the presence of detrusor underactivity, which can lead to surgical failure. We report on contemporary outcomes for catheterized elderly patients undergoing TURP from a high-volume university teaching hospital. Patients and Methods: Catheterized patients 80 years of age and older undergoing TURP for CUR at a university teaching hospital between 2012 and 2020 (9 years) were eligible. Those with neurogenic bladder, urethral stricture, or prior TURP were excluded. Surgical success was defined as being catheter free at 3- and 12-month follow-up. Statistical analysis was performed using the Chi-squared test for grouped data and logistic regression modeling for continuous data. Results: A total of 147 patients were included and underwent TURP. Of these, 118 (80.3%) were completely catheter free or using intermittent self-catheterization at initial 3-month follow-up. One hundred seventeen (79.6%) remained catheter free at 1-year follow-up. Postvoid residual >1500 mL before TURP ( p  = 0.017); age ≥90 ( p  = 0.0067); and World Health Organization performance status ≥3 ( p  < 0.00001) were all identified as independent risk factors for surgical failure. A selected subset of patients excluding these risk factors showed overall catheter-free rates of 88.8% at 3-month follow-up. Early and late complications were noted in 6.8% and 2.7% of patients. Conclusion: Our contemporary series demonstrate high rates of successful postoperative voiding for selected elderly patients after TURP, with catheter-free rates at 12 months of 88.8%. Overall complication rate was 9.5%, which may be justified given the alternative morbidity of long-term catheterization. TURP remains an efficacious and cost-effective treatment for selected elderly patients who are catheterized for CUR.

Objectives : To study a modification to the conventional retrograde ureteroscopic approach for treating proximal ureteric stones of 1-2 cm; we intentionally push the stone from the proximal ureter into a favourable calyx then the flexible ureteroscope is used to fragment the trapped stone using laser lithotripsy ('boxing in the corner'). Patients and methods : The study was conducted in a randomised prospective manner and included 100 patients who presented with a single proximal ureteric stone of 1-2 cm. We randomised the patients into two equal groups: Group A (50 patients) underwent the conventional retrograde technique (CRT) and Group B (50 patients) underwent the modified retrograde technique (MRT) with the primary intention of relocating the stone into a favourable calyx. Intended relocation of the proximal ureteric stone in the MRT group was achieved in a stepwise manner. All intraoperative parameters and postoperative outcomes were recorded and compared between the two groups. Results : There was no statistical significant difference in terms of the patients' demographics and stone criteria between the two groups. The stone-free rate (SFR) was significantly higher in Group B (92%) compared to Group A (78%) ( P = 0.049). Fluoroscopy time was significantly longer in Group B ( P < 0.001), while operative time, lithotripsy time and hospital stay were comparable. There was no difference between the groups regarding complications. Conclusion : The MRT was found to be safe and more effective than the CRT for treating proximal ureteric stones of 1-2 cm, with a significantly higher SFR. Abbreviations CONSORT: Consolidated Standards of Reporting Trials; ESWL: extracorporeal shockwave lithotripsy; fURS: flexible ureteroscope; NCCT: non-contrast CT; SFR: stone-free rate; YAG: yttrium-aluminium-garnet., Competing Interests: No potential conflict of interest was reported by the authors., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Study Objective: To determine the feasibility, efficacy, and long-term clinical outcomes of resectoscopic endometrial ablation as primary treatment of simple endometrial hyperplasia (SH) and complex endometrial hyperplasia (CH) without atypia in women with abnormal uterine bleeding (AUB)., Design: Prospective follow-up study (Canadian Task Force classification II-2)., Setting: Teaching hospital., Patients: One hundred sixty-one women with hyperplasia, either SH (n = 107) or CH (n = 54)., Interventions: From January 1990 through December 2012, one of us performed 4729 primary resectoscopic endometrial ablation procedures in women with AUB. This group included 161 women with endometrial hyperplasia, identified either at office biopsy (n = 62) or incidentally during routine hysteroscopic endometrial ablation (n = 99). Endometrial tissue obtained at dilation and curettage and/or resected during resectoscopic surgery enabled identification of atypical hyperplasia in 6 patients (4 CH, 2 SH) and 1 patient with adenosarcoma. One patient with atypical CH and the patient with adenosarcoma underwent hysterectomy. The remaining 159 women, including 5 with atypical hyperplasia (3 CH, 2 SH), underwent resectoscopic endometrial ablation (102 SH, 52 CH) as primary treatment. Patient median age was 50 years (range, 30-87 years), and body mass index was 32 (range, 17-59). Comorbidities included hypertension in 25 patients, diabetes in 14, cerebrovascular disease in 3, cardiovascular disease in 7, and hypothyroidism in 8. Office biopsy demonstrated proliferative endometrium in 68 patients, SH in 43, CH in 19, and inadequate findings in 13. In 18 women, we were unable to perform biopsy because of cervical stenosis, morbid obesity, or patient intolerance. Endometrium was resected in 120 patients, electrocoagulated in 34, and a combination of procedures in 5, using a 9-mm (26F) resectoscope, 1.5% glycine, and 120W power. Patients were followed up annually. Three patients were lost to follow-up, and 1 died of an unrelated cause 5 years after surgery., Measurements and Main Results: One uterine perforation occurred, which required no additional treatment. After endometrial ablation, SH was identified in 70 patients, and CH in 35 patients. At a median follow-up of 7 years (range, 1.5-18), 12 patients underwent hysterectomy to treat persistent bleeding (n = 6), benign ovarian cyst (n = 2), pelvic organ prolapse (n = 1), chronic pelvic pain (n = 2), or myomas (n = 1). Uterine histopathology in 11 patients demonstrated no residual endometrial hyperplasia. We were unable to obtain a pathology report for 1 patient. The remaining 138 women were satisfied with the treatment, with no further bleeding or pain in 132 (95.7%). Six patients (4.3%) had monthly spotting., Conclusion: When performed by surgeons experienced in hysteroscopy, resectoscopic endometrial ablation is feasible, safe, and effective for treatment of SH and CH without atypia in women with AUB., (Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.)

Study Objective: To compare efficacy of rollerball endometrial ablation with low-voltage (cut) versus high-voltage (coag) waveforms., Design: Pilot comparative clinical study (Canadian Task Force Classification II-1)., Setting: University-affiliated teaching hospital., Patients: Fifty premenopausal women with menorrhagia., Intervention: Women with menorrhagia were allocated randomly to thermal destruction of the endometrium by a 5-mm rollerball with unmodulated cutting current or modulated coagulating current. Complication rate, clinical outcomes, and need for reintervention were evaluated., Measurements and Main Results: At 2 years of follow-up, the reintervention rate was 26.3% in the cutting waveform group versus 31.4% in the coagulating waveform group. This difference was not statistically significant. Hysterectomy was performed in 3 (14%) women in the cutting waveform group and 5 (20%) women in the coagulating waveform group. There were no complications in either group., Conclusion: Both cutting and coagulating waveforms are equally effective for hysteroscopic endometrial ablation with the rollerball.

Study Objectives: To estimate the incidence of incidental miscellaneous uterine malignant neoplasms other than endometrioid adenocarcinoma detected during routine resectoscopic surgery in women with abnormal uterine bleeding (AUB) and to examine the effect of hysteroscopic surgery on long-term clinical outcome., Design: Prospective cohort study (Canadian Task Force classification II-3)., Setting: University-affiliated teaching hospital., Patients: Women with AUB., Intervention: From January 1, 1990, through December 31, 2008, one of the authors (G.A.V.) and several fellows performed primary hysteroscopic surgery at St. Joseph's Health Care in 3892 women with AUB. Of the 7 with malignant disease, one underwent hysteroscopic partial (n = 1) or complete (n = 6) rollerball electrocoagulation or endomyometrial resection. After diagnosis of uterine cancer, the women were counseled about the disease and management in accord with established clinical practice guidelines. Follow-up with office visits and telephone interviews ranged from 2 to 8 years (median, 6 years)., Measurements and Main Results: Of the 3892 women, 4 had undiagnosed and 3 had suspected miscellaneous uterine malignant neoplasms including 1 endometrial stromal sarcoma, 2 carcinosarcomas, 2 atypical polypoid adenomyomas of the endometrium, 1 minimal deviation adenocarcinoma of the cervix, and 1 smooth-muscle tumor of uncertain malignant potential. At 2 to 8 years of follow-up, 1 patient died accidentally after 1 year, 1 died of carcinomatosis of either coexisting breast cancer or a carcinosarcoma (postmortem examination was declined) after 1 year, and 5 were alive and well., Conclusion: Resectoscopic surgery in women with miscellaneous uterine malignant lesions not adversely affect 5-year survival and long-term prognosis.

Objectives: To describe three steps: (1) the initial Veress pressure (VIP-Pressure), (2) transient high-pressure pneumoperitoneum (HIP-Entry) prior to trocar/cannula insertion, and (3) visual entry with a trocarless cannula during closed laparoscopic entry, which may reduce major injuries., Design: Prospective observational cohort study (Canadian Task Force Classification II-2)., Setting: University-affiliated teaching hospital., Interventions: VIP-Pressure. During laparoscopic entry, the initial VIP pressure was measured and correlated against the body habitus and parity of 365 consecutive women. HIP-Entry was performed in 2,498 consecutive cases. In 100 women, the CO(2) volume, heart rate, blood pressure, oxygen saturation, and pulmonary compliance were recorded at pressures of 10, 15, 20, 25, and 30 mmHg. Visual entry with a trocarless blunt cannula was performed in 776 women. The cannula, housing a 0 degrees laparoscope, was rotated clockwise applying minimal downward force., Measurements and Results: VIP-Pressure. Pneumoperitoneum was established after one, two or three Veress needle attempts at the umbilicus in 82.4%, 10.9%, and 4.0% of women, respectively. In seven (2.2%), pneumoperitoneum was established at the left upper quadrant (LUQ) during the fourth attempt, and in two (0.6%) entry was abandoned. Median initial Veress pressure was 4 mmHg (range 2-10 mmHg). The VIP pressure correlated positively with women's weight (r = 0.518, p < 0.001) and body mass index (BMI) (r=0.545, p<0.001), and negatively with parity (r= -0.179, p<0.001). HIP-Entry. The abdomen was insufflated to 25-30 mmHg prior to primary trocar/cannula insertion. There were no changes in cardiovascular parameters between 15 and 30 mmHg. A 21% decrease in pulmonary compliance from 15 to 30 mmHg was of no clinical significance. No injury has been experienced with the visual cannula in 776 cases., Conclusions: (1) A VIP-Pressure (<10 mmHg) indicates intraperitoneal placement of the Veress needle. (2) The use of transient HIP-Entry does not adversely affect cardiopulmonary function in healthy women. (3) Visual cannula offers an additional step towards safer entry.

Hysteroscopic endometrial ablation (HEA) was introduced in the 1980s to treat menorrhagia. Its use required additional training, surgical expertise and specialized equipment to minimize emergent complications such as uterine perforations, thermal injuries and excessive fluid absorption. To overcome these difficulties and concerns, thermal balloon endometrial ablation (TBEA) was introduced in the 1990s. Four hot liquid balloons have been introduced into clinical practice. All systems consist of a catheter (4-10mm diameter), a silicone balloon and a control unit. Liquids used to inflate the balloons include internally heated dextrose in water (ThermaChoice, 87 degrees C), and externally heated glycine (Cavaterm, 78 degrees C), saline (Menotreat, 85 degrees ) and glycerine (Thermablate, 173 degrees C). All balloons require pressurization from 160 to 240 mmHg for treatment cycles of 2 to 10 minutes. Prior to TBEA, preoperative endometrial thinning, including suction curettage, is optional. Several RCTs and cohort studies indicate that the advantages of TBEA include portability, ease of use and short learning curve. In addition, small diameter catheters requiring minimal cervical dilatation (5-7 mm) and short duration of treatment cycles (2-8 min) allow treatment under minimal analgesia/anesthesia requirements in a clinic setting. Following TBEA serious adverse events, including thermal injuries to viscera have been experienced. To minimize such injuries some surgeons advocate the use of routine post-dilatation hysteroscopy and/or ultrasonography to confirm correct intrauterine placement of the balloon prior to initiating the treatment cycle. After 10 years of clinical practice, TBEA is thought to be the preferred first-line surgical treatment of menorrhagia in appropriately selected candidates. Economic modeling also suggested that TBEA may be more cost-effective than HEA.

Objective: To report a successfully managed case of extensive intracranial sinus thrombosis that occurred during an IVF cycle, and to review the literature., Design: Case report and review of literature., Setting: University-affiliated teaching hospital., Patient(s): A 38-year-old nulliparous woman who developed severe ovarian hyperstimulation syndrome on luteal day (LD) 5 during an IVF cycle. Hemoconcentration was corrected, ascitis drained, and heparin prophylaxis started. On LD7, the patient complained of severe headache and neck pain. A magnetic resonance imaging (MRI) study of the head showed extensive cortical vein and dural sinus thrombosis, including the superior sagittal sinus and transverse sinuses., Intervention(s): The patient was fully heparinized using low-molecular-weight heparin. On LD15 she was discharged home on warfarin, after confirming a negative pregnancy test. Complete thrombophilia work-up was negative., Main Outcome Measure(s): Clinical outcome., Result(s): Repeat MRI 2 months later revealed patent superior sagittal sinus and transverse sinuses, unremarkable cortical veins, and no evidence of flow obstruction. The patient was asymptomatic, with no neurologic sequelae., Conclusion(s): Extensive intracranial sinus thrombosis in women undergoing IVF may present with minimal symptoms and can occur in the absence of pregnancy and thrombophilia and despite heparin prophylaxis and correction of hemoconcentration. Medical management was successful and left the patient with no neurologic sequelae.

Study Objective: To determine the effect of hysteroscopic surgery on the long-term clinical outcome of women diagnosed with endometrial cancer., Design: Prospective cohort study (Canadian Task Force classification II-3)., Setting: University-affiliated teaching hospital., Patients: From January 1990 through December 2005, the principal author (GAV) performed primary hysteroscopic surgery in 3401 women with abnormal uterine bleeding. Among these women, there were 16 occult and 3 known endometrial cancers., Interventions: All women underwent hysteroscopic evaluation and partial (n = 8) or complete (n = 11) rollerball electrocoagulation and/or endomyometrial resection. After diagnosis of endometrial malignancy, women were counseled regarding their disease and management, in accordance with established clinical practice guidelines. Follow-up ranged from 1 to 14 years and was conducted by office visits and telephone interviews., Measurements and Main Results: Among the 3401 women, there were 19 women with endometrial adenocarcinoma, 3 of whom were known to harbor cancer before hysteroscopic surgery. One woman refused hysterectomy and remains alive and well 5 years after total hysteroscopic endomyometrial resection. Two women wished to maintain fertility; 1 consented to hysterectomy after incomplete resection of her lesion. The other was treated with progestins. Her cancer reverted to complex hyperplasia, and she requested hysterectomy 4 years later. No residual cancer was found. After 5 years of follow-up, 1 patient died from carcinoma of the gallbladder (2 years), and 2 died at 4 years; 1 at the age of 87 years of natural causes and the other at the age of 86 years from acute renal failure unrelated to her cancer. Fourteen women remain alive and well at 5 to 14 years of follow-up. Two additional women remain alive and well at 1 and 4 years of follow-up., Conclusion: Resectoscopic surgery did not adversely affect the 5-year survival and the long-term prognosis in 14 women with endometrial cancer.

Study Objective: Endometrial hyperplasia is found in 2% to 10% of women with abnormal uterine bleeding (AUB). Up to 43% of patients with cytologic atypia harbor coexisting adenocarcinoma, and approximately 20% to 52% of atypical hyperplasias, if untreated, progress to cancer. The objective of this study was to estimate the incidence of atypical endometrial hyperplasia encountered during routine resectoscopic surgery in women with AUB and to evaluate the role of resectoscopic surgery in the management of women with AUB and atypical endometrial hyperplasia who refused and/or were at high risk for hysterectomy., Design: Prospective cohort study (Canadian Task Force classification II-3)., Setting: University-affiliated teaching hospital., Patients: From January 1990 through December 2005, the senior author (GAV) performed primary resectoscopic surgery in 3401 women with AUB. Among these, there were 22 women with atypical (17 complex, 5 simple) endometrial hyperplasia., Interventions: All women underwent hysteroscopic evaluation and partial (n = 3) or complete (n = 19) endometrial electrocoagulation and/or resection. Subsequently, 6 women had hysterectomy and bilateral salpingo-oophorectomy (BSO)., Measurements and Main Results: The median (range) for age, parity, and body mass index were 55 years (24-78 years), 2 (0-4), and 30.1 kg/m2 (22.5-52.2 kg/m2), respectively. Among the 3401 women, there were 22 cases of atypical endometrial hyperplasia, 12 of which were incidentally diagnosed at the time of hysteroscopy (complex 10, simple 2, incidence 0.35%). After hysteroscopic diagnosis or confirmation of diagnosis, 6 women underwent hysterectomy and BSO. Of the remaining 16 women, followed for a median of 5 years (range 1.5-12 years), 1 was lost to follow-up, 1 had only a biopsy to preserve fertility, 1 died from lung cancer after 4 years, and 1 died from colon cancer after 5 years. One patient developed endometrial cancer after 10.5 years with postmenopausal bleeding. She remains alive and well 3.5 years after hysterectomy and BSO. The remaining 11 patients are amenorrheic at a median follow-up of 6 years (range 1.5-12 years)., Conclusions: Resectoscopic surgery in 3391 women with AUB detected 12 incidental cases of atypical endometrial hyperplasia (incidence 0.35%). Skillful resectoscopic surgery may be an alternative to hysterectomy in women with AUB and atypical endometrial hyperplasia, who refuse or are at high-risk for hysterectomy and who are compliant with regular and long-term follow-up.

A 53-year-old multiparous woman, with no identifiable risk factor for endometrial cancer, presented with menorrhagia. She had been treated with oral contraceptives for 3 years. Office endometrial biopsy indicated well-differentiated villoglandular adenocarcinoma of the endometrium. The patient refused hysterectomy and would consent only to hysteroscopic resection. She remains alive and well, with no clinical evidence of recurrence 5 years after resection. We propose that skillful resectoscopic surgery, under specific circumstance, may be an appropriate alternative treatment to hysterectomy for some early uterine malignancies.

Background: Schizencephaly is a brain anomaly that can be associated with severe neonatal morbidity and mortality. Precise antenatal diagnosis is critical to help families make a decision regarding the continuation of pregnancy. A sequence of magnetic resonance imaging (MRI) called HASTE (Half-Fourier Acquisition Single-Shot Turbo Spin-Echo) has been used prenatally for this purpose., Case: We used an additional MRI sequence called true-FISP (True Fast Imaging with Steady-State Precession) to diagnose schizencephaly in a 15-year-old primigravid woman. This sequence has not been previously described in prenatal MRI., Conclusion: HASTE sequence provides the grey-white matter differentiation that is necessary to make the diagnosis of grey-matter-lined schizencephaly clefts. True-FISP sequence has potentially higher resolution images because it is not prone to blurring of edges and is less sensitive to flowing fluid movement. Using these two MRI sequences is essential for confirming the diagnosis of schizencephaly and can provide information regarding other commonly associated anatomic anomalies.