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1. Constructed wetlands operated as bioelectrochemical systems for the removal of organic micropollutants

Author

Hartl, M., García-Galán, M. J., Matamoros, V., Fernández-Gatell, M., Rousseau, D. P. L., Laing, G. Du, Garfí, M., and Puigagut, J.

Subjects
Quantitative Biology - Quantitative Methods
Abstract

The removal of organic micropollutants (OMPs) has been investigated in constructed wetlands (CWs) operated as bioelectrochemical systems (BES). The operation of CWs as BES (CW-BES), either in the form of microbial fuel cells (MFC) or microbial electrolysis cells (MEC), has only been investigated in recent years. The presented experiment used CW meso-scale systems applying a realistic horizontal flow regime and continuous feeding of real urban wastewater spiked with four OMPs (pharmaceuticals), namely carbamazepine (CBZ), diclofenac (DCF), ibuprofen (IBU) and naproxen (NPX). The study evaluated the removal efficiency of conventional CW systems (CW-control) as well as CW systems operated as closed-circuit MFCs (CW-MFCs) and MECs (CW-MECs). Although a few positive trends were identified for the CW-BES compared to the CW-control (higher average CBZ, DCF and NPX removal by 10-17% in CW-MEC and 5% in CW-MFC), these proved to be not statistically significantly different. Mesoscale experiments with real wastewater could thus not confirm earlier positive effects of CW-BES found under strictly controlled laboratory conditions with synthetic wastewaters., Comment: Chemosphere, 38 pages, 1 figure, 4 tables (2 figures and 6 tables in Supplementary Information)

Published
2021

2. Unravelling the causes of respiratory disease in the working horses of Ethiopia

Author

Laing, G. A., Pinchbeck, G., Christley, R., Radford, A., Newton, R., Stringer, A., and Aklilu, N.

Subjects
636.1
Abstract

Worldwide, respiratory disease is an important contributor to loss in equine industries, limiting performance and disrupting work schedules. In Ethiopia, respiratory disease is a frequent finding in horses presenting to veterinary clinics; coughing and nasal discharge has been identified as a priority concern for users of working horses. Despite the interdependency between human and equid health in low income settings, and the fact that 80% of all global equids reside in developing nations, there is little existing literature for this group. This thesis aims to build understanding of disease epidemiology and begin to unravel the causes of respiratory disease in the working horses of Ethiopia, contributing new research to help inform disease reduction strategies in the future, for the benefit of equine health and human wellbeing. An initial participatory appraisal (February-March 2013) involved focus group discussions with 170 equid users. It explored local experience of respiratory disease, documenting the variety of signs (n=21) and syndromes (n=44) people recognised in their animals. The most common signs represented were coughing, altered respiration, bilateral mucopurulent or serous nasal discharge and epistaxis. Thematic analysis of participants’ ideas on aetiology of disease, and what action could be taken to treat or prevent, revealed concepts of communicable diseases and disease caused by, and responding to, management changes or environmental conditions. Subsequently, a cross-sectional survey (August-December 2013) of 350 horses across 19 sites was conducted to determine the prevalence of both respiratory signs and exposure to major respiratory pathogens. The majority of horses examined were carthorses, with over a third reporting recent coughing and around ten per cent with an active nasal discharge. Antibodies towards Streptococcus equi subspecies equi, the causative agent of strangles, were the most prevalent, with 8% of animals showing prior exposure. Prevalence of antibodies to alpha-herpesviruses, picornaviruses, arteritis virus was uncommon and antibodies to influenza were not detected. Finally 108 horses with respiratory disease (coughing, nasal discharge or dyspnoea) were fully examined using endoscopy, alongside 93 unmatched and randomly selected control horses (September –December 2014). Horses presenting with respiratory signs often had evidence of lower airway disease with significantly increased tracheal mucus and neutrophilia compared to control horses. S equi, equine herpesvirus 4 and equine picornaviruses in the lower respiratory tract were detected occasionally, but showed little association with clinical signs. Equine influenza virus, arteritis virus or Mycoplasma spp were not detected. However, gamma-herepsviruses (EHV-2/-5) were found often but not significantly associated with cases. Streptococcus equi subspecies zooepidemicus was significantly associated with case horses. Whether this is as a primary pathogen or secondary coloniser could not be established in this study. Young and old horses were found to be at higher risk for disease, as were horses performing strenuous work, drinking from stagnant water sources, and those housed on a cobbled floor. Findings suggest that respiratory disease in this population is multifactorial but that endemic S equi is likely a significant contributor and S zooepidemicus also appears to play a role.

Published
2016
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12. An audit of trauma laparotomy in children and adolescents highlights the role of damage control surgery and the need for a trauma systems approach to injury in this vulnerable population

Author

Reíd, B, Kong, V, Xu, W, Thirayan, V, Cheung, C, Rajaretnam, Ν, Manchev, V, Bekker, W, Bruce, JL, Laing, G, and Clarke, DL

Subjects
children, vulnerable population, trauma laparotomy, children, adolescents, damage control surgery, trauma systems approach, vulnerable population, Surgery, trauma laparotomy, adolescents, damage control surgery, trauma systems approach
Abstract

BACKGROUND: This study reviews the indications and outcome of emergency laparotomy for paediatric trauma in a South African trauma centre. METHODS: This was a retrospective study of all children less than 18 years of age who underwent an emergency laparotomy for trauma between December 2012 and October 2020 at Grey's Hospital in Pietermaritzburg. RESULTS: During the eight-year period under review, a total of136 children of which 107 were male underwent a laparotomy for trauma. The median age was 14 years. There were 80 (57.1%) blunt mechanisms, and the rest were penetrating mechanisms. A total of 46 (33%) patients required ICU admission. Thirty-four patients developed a complication. These included nine cases of pneumonia, one case of renal failure, two patients developed abdominal collections, three wound-related complications, three neurological complications and one miscellaneous complication. There were seven (5%) deaths. The penetrating cohort were older than the blunt cohort. Solid viscera were more likely to be injured in the blunt cohort and hollow viscera more likely in the penetrating cohort. A total of 16 (11%) patients underwent damage control surgery (DCS). Of this cohort, there were three female children. Six sustained blunt trauma and ten penetrating trauma. A total of six (37%) of these children died. CONCLUSION: Emergency laparotomy for trauma in children is not infrequent in Pietermaritzburg and there is a high incidence of penetrating trauma in this cohort. The response to increased degrees of physiological derangement is the application of DCS. Ongoing efforts to develop and strengthen a paediatric trauma service appear to be justified.

Published
2022

37. Impact of postoperative non-steroidal anti-inflammatory drugs on adverse events after gastrointestinal surgery

Author

Chapman, S. J., Glasbey, J., Kelly, M., Khatri, C., Nepogodiev, D., Fitzgerald, J. E. F., Bhangu, A., Harrison, E. M., Adams, R., Patel, K., Retchless, A. R., Elsaddig, M., Curtis, A. E., McMahon, R., Mittapalli, D., Ferguson, L. A., Gentry, S. V., Kong, C. Y. N., Naqvi, Z., Amin, H., Chaudhry, B., Burke, J., Henderson, I., Trecarten, S., Clements, J. M., Drake, T. M., Wild, J. R. L., Venkatesh, H., Butters, N., Ahmeidat, H., Goergen, N., Black, D., Robertson, K., Jama, G. M., McGuire, S. A., Ahl, R., Suri, T. S., Kuo, R., Fadhlillah, M., Mills, H., Mitchell, R., Goodship, J., Tan, M., Barker, T., Wright, T., Mohamad, W., Hanna, N., Laing, G., Warnock, M. W. C., Baird-Fraser, P. R., Logan, T., Young, F. M., Fane De Salis, A. C., McHugh, R., Hickson, C., Paszkiewicz, J., Anderson, L. B., Neeson, D., Mohan, M., Narang, Y., Brophy, T., Punj, R., Majumdar, S., Kauser, S., Jong, G., Palkhi, E., Finch, D., Mitchell, H., Carter, N., Viyasar, T., Sammut, T., Cook, N., Powell, M. M., Horne, S., Allen, J. L. Y., Marshall, D., McIntyre, C., S Koh, D. T., Shi, J., Reid, T., Armugam, N. P., Luck, J., Fozard, T., OʼCallaghan, J., Copley, P. C., Tilliriou, V., Aiyer, R., Yazdi, A., Wiltshire, A., Blower, E., Jewitt, C., Cheung, L. K., Fourali, S., Rahimi, Y., Velho, R., Taylor, C., Satterthwaite, L., Eze, N. V., Johnston, J. P. M., McCain, R. S., Hess, E. C. F., Thumbadoo, R. P., Turner, E. J. H., Wookey, R., Morris, R., Gasteratos, K., Heywood, E., Simpson, S. J., Rai, Z., Kazzazi, D., Ducey, J., Livesey, M. J., Finan, C., Staunton, E., Haddad, S. D., Karanjia, R., Bokobza, I., Ahmed, M., Howell, J., Grainger, C., Woo, A., McDowall, M., Bulley, F., Keating, R., Tan, B., Sng, S., Brown, C., Aidoo-Micah, G., Champsi, A., Ellis, R., Darwazeh, S., Polson, R., Chan, J. Z., Chong, B. F. H. K., Park, J. H., Kong, C. Y., Mogan, Y. P., Stevens, S., Sekhon, H. K., McIntosh, R., Ochiltree, D. W., Jamieson, P. D., Naumann, D. N., Bowley, D. M., Howell, G., Clark, T., Dear, K., James, L., Upchurch, E., Wilson, H., Hughes, M., Modayur, S. M., Datta, U., Chen, J. H. C., Williams, L. J. L., Selby, J., Prabhudesai, A., Mahomed, K., Shah, H. A., Kong, K., Chandramoorthy, S., Marshall, L., De Kauwe, C., Rana, R., Patel, J., Pezas, T., Ma, J., Stohlner, V., Kinsella, M. S., Gardiner, S. N., Smith, R. A., Glover, M., Akinfala, M., Lee, J. Z. C., Aggarwal, V., Waters, S., Atif, M., Hill, M., Ramasubramoni, A., Jaffry, Z., Sagoo, H., Jeyakumar, J., Kosasih, S., Davis, J., Stanley, G. H. M., Nijran, J., Tang, I., Mehta, K., Fillery, A., Watson, N. F., Shah, D., Naidu, S., Grewal, T. K., Singh, P., Reissis, D., Marusza, C., Pettit, W., Timbrell, S., Woods, R., Phillips, J., Vaughan, R., Dean, S., Gibby, R., Jones, T. F., Rao, R., Torrance, H. D. T., Thirumal, V., McMahon, R. K., Yap, D., Shaw, A., Claireaux, H. A., Pang, Y. L., Narramore, R., Holmes, C., Caldwell, A., Daoub, A., Bibby, L., Hague, A. G., Sykes, M. C., Morar, P., Downes, G., Shah, S., Walimohamed, S., Alsulaimi, A., Biswas, V., Gnaneswaran, B., Davies, N., Narwani, V., Hernon, J., Jumbu, A., Ilyas, M., Johal, G., Atia, F., Williams, A., Chan, C., McAnelly, S., Evans, A., Chan, K. Y., Flegg, K., Carter, S., Coley, J., Khaw, R., Jayakody, N., Jones, B., Fawcett, N., Ghali, C., Jalundhwala, K., Ariyaratnam, P., Colville, H., Walls, M., Lindsay, J., Keane, M., Ban, V. S., Kambasha, C., Sait, S., Tahir, M., Tharakan, R., Voll, J., Shiwani, H., Al-Omran, Y., Hawash, A., McCaughan, V., Shatkar, V., Gohil, K., Greenhalgh, A., Higgins, E., Moody, T., Booth, M. B., Chan, W. H., Shanthakumaran, S., Maple, N., McNish, D., Shahin, B., Nicholas, J., McDermid, R., Narayan, P., Brodie, C., Hurrey, S., Panayi, V., Turner, B., Kopala, K., Winfield, Clayton S. A., Mohamud, A., Venkatesh, A., Hosein, S., Olimpio, C., Gkiousias, V., Kilgour, J. M., Cogbill, E., Ramcham, M., Carr, G., Bannerman, A., Grundy, L., White, S., Beamish, A., Neo, Y. N., Cragg, A. R., Perkins, A., Wynn-Hebden, A., Khan, T., Ali, M., Battersby, C. L. F., Pinto, R. S., Poon, S. S., Patel, M., Patel, P., Shafi, A. M. A., Vedage, D., Ghorbhanian, S., Klimach, S., Bradley, J., de Sausmarez, E., Hayward, P., Naqib, S., Flanigan, C., Shuttleworth, R. H. A., McElvanna, K., Shelton, B., Westbrook, N., Weir, A., Webb, P., Alam, M., Bhanderi, S., Roberts, C., Al-Shakarchi, J., Lu, M., Harvey, J., Chowdhury, M. U., McGow, C., Antoniou, I., Good, D. F., Gerasimova, N., Eragat, M., Pressler, N., Santos, C. R. D., Arshad, W., Patel, H. R., Kassim, Y., Jayaratne, N., Perera, A., Chandramoorthy, L., Quan, V., Ponweera, A., Tadjkarimi, J., Moyes, L., Metcalfe, C., Napier-Hemy, T, Bull, A., Jaffer, Y., Mushtaq, J., Warren, M., Jarrar, Z., Wickenden, R., Kang, M., Holohan, G., Isbister, T., Strachan, E., Varma, R., Simpson, R., Rajasekar, N., Panayiotou, H., Walsh, E., Thacoor, A., Willson, J. M. H., Mustafa, A., Barai, I., Menon, A., Soon, W. C., Thakrar, C., McCurdie, S., Carr, E. C. F., Westwood, K. J., Wardell, H., Weinberg, D., Craig, A. R. J., Khan, F. A. S., Mulla, A., Dann, P., Saleh, M., Pignatelli, I. C., Igbagiri, K. V., Panagoulas, E. V., Tilston, T. W., Thayaparan, A. J., Navaratnam, J., Aryasomayajula, S., Joji, N., Screen, R., Quinn, C., Harrison, R., Arnaout, A., McCartan, N., Allen, W., Gabriel, R., Hartelius, C. F., Makinde, M. L., Sivasubramaniam, S., Spreadborough, P., Lobo, R., Surendran, H., Couch, L., Butters, T., Beale, K., Markiewicz, O., Kennedy, E. D., Neely, D. M., Martin, A., Al-Moasseb, Z. H., Ong, K. K., Letchumanan, S., Lam, W. L., Yapp, L., Skelly, B. L., Stallard, S., Westhuizen, P. V. D., Rafferty, A. R., Lambert, A., Tay, Y. Z., Koshnow, Z., Elamin, O., Shah, A., Kim, E., English, W., Farrell, A., Sharma, J., Rowan, Chudek. D. K., Mullan, B., Brown, R. J., McCarter, J. A., Johnston, D., Symonds, C., Gatfield, W., Messenger, D., Knox, J. D., Jani, P., Trinquet, J., Naqvi, Z. B., Hussain, K., Jaffer, A., McAleer, E., Joshi, H., Cecil, E., Lochrane, A., Woolley, T., Marriott, P., Bolton, W., Balian, V., Scott, A. J., and Tan, Y. H.

Published
2014
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43. Hanging-related injury in Pietermaritzburg, South Africa

Author

Buitendag, J J P, Ras, A, Kong, V Y, Weale, R D, Blodgett, J, Bruce, J L, Clarke, D L, and Laing, G L

Abstract

BACKGROUND. Hanging is a common form of self-harm, and emergency care physicians will not infrequently be called upon to manage a survivor. Despite the relative frequency of the injury, there is a paucity of literature on the topic and the spectrum and incidence of associated injuries are poorly described.OBJECTIVES. To review experience with management of victims of hanging at a major trauma centre in South Africa.METHODS. All patients treated by the Pietermaritzburg Metropolitan Trauma Service following a hanging incident between December 2012 and December 2018 were identified from the Hybrid Electronic Medical Registry. Basic demographics were recorded, and the management and outcome of each patient were noted.RESULTS. During the 6-year period under review, a total of 154 patients were seen following a hanging incident. The mean age was 29.4 years. There were 24 females (15.6%) and 130 males (84.4%). The vast majority (n=150; 97.5%) had attempted suicide, and only 4 hangings (2.5%) were accidental. A total of 92 patients (60.9%) had consumed alcohol prior to the incident. There were 23 patients with a Glasgow Coma Score (GCS) 12 (mild TBI). A total of 7 patients (4.5%) required intensive care unit admission, and 25 (16.2%) required intubation. The following extracranial injuries were documented on computed tomography scans: hyoid bone fractures (n=2), cervical spine fracture (n=10), mandible fracture (n=4) and oesophageal injury (n=1). Intracranial pathology was evident on 27.0% of scans, with the most common finding being global cerebral ischaemia. The mortality rate was 2.5% (4/154).CONCLUSIONS. Hanging is a common mechanism of self-harm. It is associated with significant injuries and mortality. The acute management of hanging should focus on airway protection followed by detailed imaging of the head and neck. Further work must attempt to include mortuary data on hanging.

Published
2020

44. A review of geriatric injuries at a major trauma centre in South Africa

Author

Da Costa, J-P, Laing, J, Kong, V Y, Bruce, J L, Laing, G L, and Clarke, D L

Abstract

BACKGROUND. Trauma in South Africa (SA) has been referred to as a malignant epidemic, but the impact of trauma on the elderly has tended to be overlooked.OBJECTIVES. To address this deficit by focusing on trauma victims aged >65 years.METHODS. All patients aged >65 years who were admitted to Grey's Hospital, Pietermaritzburg, SA, following trauma between December 2012 and January 2019 were reviewed.RESULTS. Over the 6-year study period, a total of 281 patients aged >65 years were admitted to Grey's Hospital following trauma. There were 150 males (53.4%) and 97 females (34.5%). The sex of 34 patients was unknown. The average age was 72 years (range 65 - 97). There were 226 cases of blunt trauma, 42 cases of penetrating trauma (including two incidents of impalement following blunt trauma) and 15 cases of other types of trauma. The most common causes of blunt trauma were accidental falls (n=76), motor vehicle accidents (n=46), pedestrian vehicle accidents (n=32) and falls from a height (n=23). Gunshot wounds (n=22) and knife wounds (n=14) were the most common forms of penetrating trauma. Other trauma mainly comprised dog bites (n=6) and snakebites (n=6). There were 72 incidents of assault (25.6% of total cases). The majority of assaults were committed by a single perpetrator, and the perpetrator was frequently known to the victim. There were no significant differences in the proportions of penetrating, blunt and other trauma injuries between males and females. A total of 44 patients (15.7%) required surgical intervention, and 41 patients (14.6%) experienced complications during their hospitalisation. Respiratory, renal and cardiac complications were most frequent, and 5 patients had a cardiac arrest. Seven experienced acute kidney injury. Seventeen patients (6.0%) required intensive care unit admission and 5 (1.8%) required ventilation. Patients stayed in hospital for an average of 2.96 days (range 0 - 39). Of the patients, 241 (85.8%) survived, 32 (11.4%) died and 8 (2.9%) had an unknown outcome.CONCLUSIONS. Geriatric trauma in SA is relatively rare, but will increase as the population ages. There is a high incidence of assault as a mechanism, highlighting the fact that elderly people are a vulnerable group. Managing these patients is challenging and is associated with significant morbidity and mortality.

Published
2020

46. Green remediation of saline–sodic Pb-factored soil by growing salt-tolerant rice cultivar along with soil applied inorganic amendments

Author

Iqbal, M.M., Naz, T., Zafar, M.I., Imtiaz, M., Farooq, O., ur Rehman, A., Ali, S., Rizwan, M., Hussain, S., Javed, W., Murtaza, G., Afzal, M., Mahmood, A., Mehdi, S.M., Sarwar, M.A., Du Laing, G., Iqbal, M.M., Naz, T., Zafar, M.I., Imtiaz, M., Farooq, O., ur Rehman, A., Ali, S., Rizwan, M., Hussain, S., Javed, W., Murtaza, G., Afzal, M., Mahmood, A., Mehdi, S.M., Sarwar, M.A., and Du Laing, G.

Abstract

In Pb-factored soils, soil application of appropriate inorganic amendment along with cultivation of salt-tolerant crop species/genotypes for Pb immobilization can be a good choice. Hence, in saline-sodic and non-saline/sodic Pb-factored soils, Pb immobilization was observed as influenced by exogeneously applied inorganic amendments. Salt-tolerant rice cultivar Shaheen basmati was grown in present study. The current pot study consists of two factors: three inorganic amendments (i.e., gypsum, rock phosphate and di-ammonium phosphate) each with their three increasing rates along with uncontaminated and contaminated controls, and two types of Pb-factored soils (non-saline/sodic and saline–sodic). At harvest maturity, crop was reaped and straw, paddy yields and height of plant were noted. The results showed that Pb induced decrease in rice growth and physiological attributes (i.e., transpiration rate, photosynthetic rate, stomatal conductance, chlorophyll a, b and carotenoids) were significantly (p ≤ 0.05) counteracted by exogeneously applied inorganic amendments. Among the tested amendments, the highest gypsum application rate of 9 me Ca 100 g−1 soil was proved the most effective to improve rice growth, yield, physiological functions, and to reduce Pb concentration in rice both in saline-sodic and non-saline/sodic Pb-factored soils.

Published
2020

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