• Environmental Engineering Research
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• v.23 no.3
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• pp.323-329
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• 2018

The municipal solid waste (MSW) management system in one of the Class II Indian cities i.e. Rishikesh was studied and analysed to identify the key issues in solid waste management in the city. A total of 329 solid waste samples from 47 households were collected to characterize the household solid waste (HSW). The average (HSW) generation rate was 0.26 kg/c/d and it was composed of organic waste (57.3%), plastics (14%), paper (10.9%), and glass and ceramic (1.3%) and other materials (16.5%). There was an inverse relationship between household waste generation rate and family size (p < 0.05). The MSW management system practiced in Rishikesh is unsound. There is no waste segregation at source, no provisions of composting and no recycling by formal sector. The collection and transportation of waste is inadequate and inappropriate. Collected waste is dumped in open dumping site without scientific management. Following are some recommendations for developing a sustainable solid waste management system in Rishikesh city: (1) sensitize people for segregation at source; (2) promote reduction, reuse and recycling of wastes; (3) promote community based composting; (4) provision for 100% door to door collection and; (5) formalize the informal sectors such as rag pickers and recycling industries.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.45-51
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• 2021

Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.8-14
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• 2024

Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

• Parasites, Hosts and Diseases
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• v.54 no.6
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• pp.733-742
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• 2016

Acquaintance is scanty on primaquine (PQ) efficacy and Plasmodium vivax recurrence in Udupi district, Karnataka, India. We assessed the efficacy of 14 days PQ regimen (0.25 mg/kg/day) to prevent P. vivax recurrence. Microscopically, aparasitemic adults (${\geq}18years$) after acute vivax malaria on day 28 were re-enrolled into 15 months' long follow-up study. A peripheral blood smear examination was performed with participants at every 1-2 month interval. A nested PCR test was performed to confirm the mono-infection with P. vivax. Of 114 participants, 28 (24.6%) recurred subsequently. The median (IQR) duration of the first recurrence was 3.1 (2.2-5.8) months which ranged from 1.2 to 15.1 months, including initial 28 days. Participants with history of vivax malaria had significantly higher risk of recurrence, with hazard ratio (HR) (95% CI) of 2.62 (1.24-5.54) (P=0.012). Severity of disease (11.4%, 13/114) was not associated (P=1.00) with recurrence. Of 28 recurrence cases, the nPCR proved that P. vivax mono-infection recurrence rate was at least 72.7% (16/22) at first recurrence. In Udupi district, PQ dose of 0.25 mg/kg/day over 14 days seems inadequate to prevent recurrence in substantial proportion of vivax malaria. Patients with a history of vivax malaria are at high risk of recurrences.

• Journal of Microbiology and Biotechnology
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• v.22 no.9
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• pp.1230-1236
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• 2012

Fish meal grades SL1 and SL2 from Sardine (Sardinella longiceps) and NJ from Pink Perch (Nemipterus japonicas) were evaluated as a sole source of carbon and nitrogen in the medium for alkaline protease production by Bacillus pumilus MTCC 7514. The analysis of the fish meal suggests that the carbon and nitrogen contents in fish meal are sufficient to justify its choice as replacement for other nutrients. Protease production increased significantly (4,914 U/ml) in medium containing only fish meal, compared with the basal medium (2,646 U/ml). However, the elimination of inorganic salts from media reduced the protease productivity. In addition, all the three grades of fish meal yielded almost the same amounts of protease when employed as the sole source of carbon and nitrogen. Nevertheless, the best results were observed in fish meal SL1 medium. Furthermore, protease production was enhanced to 6,966 U/ml and 7,047 U/ml on scaling up from flask (4,914 U/ml) to 3.7 and 20 L fermenters, respectively, using fish meal (10 g/l). Similarly, the corresponding improvement in productivities over flask (102.38 U/ml/h) was 193.5 and 195.75 U/ml/h in 3.7 and 20 L fermenters, respectively. The crude protease was found to have dehairing ability in leather processing, which is bound to have great environmental benefits.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.153-159
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• 2020

Background Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. Methods All patients operated for BCS and partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps from January 2015 to October 2018 were included in the analysis. Oncoplastic breast surgeons with appropriate level of training performed all tumor excisions and reconstructions as a single-stage procedure. Patient characteristics, treatment details and surgical outcomes were noted. Specific outcomes recorded were margin re-excision and complication rates. Results One hundred and twelve patients underwent the procedure in the given study period. The median age was 54 years. Median specimen weight was 62.5 g and median volume of excision was 121.4 mL. Fifteen patients (13.39%) underwent a margin re-excision for close or positive margins without additional morbidity. One patient required a completion mastectomy. Eight patients (7.14%) had an early complication. None of the patients required a contralateral symmetrization procedure. The results were comparable across the participating centers. Conclusions Chest wall artery perforator-based flaps are an excellent option for lateral and inferior quadrant partial breast reconstructions. The short and long-term surgical outcomes are comparable across sites and can be performed with minimal morbidity. Patient-reported outcome measures need to be studied.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.306-310
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• 2009

Mass mortality was occurred in adult koi carp(Cyprinus carpio) at a private pond near Samchunpo city in the early November, 2007. Its water temperature was $11^{\circ}C$ and turbidity was very high. The fishes diseased were shown widely distributed hemorrhages, deep ulcerations on the whole body surface and severe erosions in the all fins. In necropsy, excess ascitic fluid was observed and spleen and kidney affected were enlarged. In microscopic observation, it was examined widely distributed severe dermal ulceration, multifocal gill lamella hyperplasia, severe fibrinous pericarditis, multifocal nephritis and hepatitis. The bacteria suspected were isolated using tryptone soya agar and identified as motile Aeromonas hydrophila as results of biochemical tests using API 20E and 20NE. According to previous reports, A. hydrophila infection were mainly occurred in fingerling at high temperature. However, this case exhibited that A. hydrophila infection can develop on adult koi carp even in the winter season.

• Environmental Engineering Research
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• v.25 no.3
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• pp.290-298
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• 2020

A large residual fraction of aliphatic components of diesel prevails in soil, which has adverse effects on the environment. This study identified the most bio-recalcitrant aliphatic residual fraction of diesel through total petroleum-hydrocarbon fractional analysis. For this, the strain Acinetobacter sp. K-6 was isolated, identified, and characterized and investigated its ability to degrade diesel and n-alkanes (C₁₈, C₂₀, and C₂₂). The removal efficiency was analysed after treatment with bacteria and nutrients in various soil microcosms. The fractional analysis of diesel degradation after treatment with the bacterial strains identified C₁₈-C₂₂ hydrocarbons as the most bio-recalcitrant aliphatic fraction of diesel oil. Acinetobacter sp. K-6 degraded 59.2% of diesel oil and 56.4% of C₁₈-C₂₂ hydrocarbons in the contaminated soil. The degradation efficiency was further improved using a combinatorial approach of biostimulation and bioaugmentation, which resulted in 76.7% and 73.7% higher degradation of diesel oil and C₁₈-C₂₂ hydrocarbons, respectively. The findings of this study suggest that the removal of mid-length, non-volatile hydrocarbons is affected by the population of bio-degraders and the nutrients used in the process of remediation. A combinatorial approach, including biostimulation and bioaugmentation, could be used to effectively remove large quantities of aliphatic hydrocarbons persisting for a longer period in the soil.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.40-47
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• 2020

Background: Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. Methods: In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. Results: Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. Conclusions: Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.239-248
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• 2021

The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.