Low-cost Treatment Research Articles

Quantitative Research of Medical Tourism Market in Thailand

Introduction. Recently, the medical tourism industry in Thailand has undergone significant qualitative transformations, with the healthcare sector as the main driver of the development and growth of the country's economy. On a global scale, medical tourism in Thailand demonstrates a significant increase in market value that exceeds the global average, ranking in the top five of the most attractive medical tourism destinations.
 A combination of medical services provided by highly qualified specialists, low-cost treatment, as well as ambitious government initiatives allowed Thailand to become one of the industry leaders and a significant hub for healthcare and tourism development. In general, there is a significant potential for market expansion. In particular, Russian tourists are largely represented in Thailand’s tourism market.
 Purpose. The purpose of the study was to identify the key drivers of medical tourism in Thailand that may help to adjust Russian national strategy to the development of medical tourism and the export of medical services within the framework of the Federal Project ”Export of Medical Services” as part of the National Project “Healthcare” upon the Decree of the President of the Russian Federation No. 204 dated May 7th, 2018.
 Results and conclusion. Despite the fact that modern international medical tourism is relatively new, the entry into the market of both a separate medical organization and a governmental one is associated with a high threshold of entry requiring significant legal, infrastructural, scientific, and educational transformations, as well as ensuring the safety of medical tourism services at different levels, from national to municipal and hospital. Thus, the global scientific society is interested in the experiences of the countries that have achieved significant results in the international medical tourism market. Thailand is a striking example of a leading destination for medical tourists from Southeast Asia. The ecosystem of medical and wellness tourism created and supported by the government includes doctors, patients, medical organizations, international certification companies, assistance agencies, and medical tourism agencies. The creation of appropriate conditions for the essential development of all market participants allowed Thailand to begin its journey as a global medical destination in the Eastern Hemisphere.

Comparison of closed percutaneous screw reduction versus open reduction and internal fixation in the treatment of frontal sinus fractures: A retrospective study

The aim of this study was to compare closed percutaneous screw reduction to traditional open reduction-internal fixation (OR-IF) for the treatment of anterior table fractures. Both groups were evaluated in terms of operative variables, complications, and treatment success. Of 32 patients included, 19 patients underwent OR-IF, while 13 underwent percutaneous screw reduction. The median operative time, length of hospital stays, and treatment cost of the OR-IF group were 100 min (range 60-130), 4 days (range 3-9), and $727 (range $642-$1291), respectively. The same variables for the closed reduction group were 30 min (range 20-40), 2 days (range 1-2), and $303 (range $252-$349), respectively. The closed reduction group exhibited a shorter operative time (p< 0.001), reduced length of hospital stays (p< 0.001), lower treatment cost (p< 0.001), and a lower complication rate (p = 0.025) compared to the OR-IF group. Late-term outcomes in both groups showed no visible contour changes or step deformities. In conclusion, the percutaneous screw reduction technique is a safe and effective option with minimal morbidity in the treatment of frontal sinus anterior table fractures. Therefore, traditional OR-IF should be reserved for fractures that are not suitable for reduction using minimally invasive techniques.

The Impact of Patient Engagement on Healthcare: A Systematic Review of Unveiling the Benefits of Patient Engagement in Healthcare

Background: Recently, a body of evidence has emerged that patients who participate in the healthcare process have better health outcomes and lower treatment costs. Therefore, healthcare institutions have tended to use strategies for better patient engagement in the healthcare process, by educating them about their health conditions and fully involving the patient in making decisions about their healthcare. Objectives: This paper presents a systematic study of the recent literature on determining the outcomes and benefits of patient engagement in the healthcare process, through which we provide a comprehensive review, analysis, and synthesis of research published in the past five years. Methodology: We collected relevant literature published between 2018 and 2023 and reviewed the approved issues, research problems, manuscript scopes, research methodologies, and main findings. 28 studies yielded our final extracted cohort. Conclusions: Using the objective analysis of the extracted studies, we present a research typology that summarizes the major outcomes and the benefits of patient engagement in the healthcare process of relevant recent research in this field.

Improving household water treatment: using zeolite to remove lead, fluoride and arsenic following optimized turbidity reduction in slow sand filtration

Despite the United Nations 2030 agenda, large number of both urban and rural dwellers in low-income countries continue to lack access to improved water. Thus, increased effort is required towards enhancing low-cost drinking water treatment technologies especially for developing countries. Slow sand filter (SSF) is one of the most commonly used low-cost and efficient technologies for treating household drinking water. However, effectiveness of SSF is substantially affected by very high turbidity and relatively large amounts of dissolved heavy metals. To enhance removal of both turbidity and heavy metals, this study optimized sand bed depth (SBD) of SSF and investigated the potential of natural zeolite from Uganda for removal of lead, arsenite (As(III)) and fluoride ions from water. To remove lead ions, the zeolite was used in its natural form. However, to remove As(III) and fluoride, the natural zeolite was modified using hexadecyltrimethylammonium bromide solution. Removal of high turbidity was found to require a large optimal SBD. Furthermore, efficiency of treating synthetic turbid water increased with increasing initial turbidity. Variation of final turbidity with SBD was found to be best described by an exponential function. Optimal SBDs on top of an underdrain gravel layer of 0.2 m were 453, 522, 561, and 580 mm for turbidity of 60, 80, 100, and 120 NTU, respectively. Optimized SBD used achieve at least 95% efficiency in removing suspended particles from water with turbidity 120 NTU was found to save up to 35% of the total cost for acquiring sand volume required by a conventional SSF. For a particular zeolite mass, removal efficiencies of lead, As(III) and fluoride generally increased with increasing contact time. Removal efficiencies of lead, As(III), and fluorides were also shown to increase with increasing zeolite mass. Lead removal efficiencies using natural zeolite were 75 and 98% under 20 and 40 min, respectively. Removal of As(III) using modified zeolite mass was 91% within contact time of 10 min. Adsorption of fluoride on modified zeolite was 80% within 5 min. Adsorption of lead, As(III), and fluorides indicated promising potential of natural zeolites from Uganda for treating polluted water.

Photo-thermal activation of persulfate for the efficient degradation of synthetic and real industrial wastewaters: System optimization and cost estimation

The photo-thermal activation of persulfate (PS) was carried out to degrade various pollutants such as reactive blue-222 (RB-222) dye, sulfamethazine, and atrazine. Optimizing the operating parameters showed that using 0.90 g/L of PS at pH 7, temperature of 90 °C, initial dye concentration of 21.60 mg/L, and reaction time of 120 min could attain a removal efficiency of 99.30%. The degradation mechanism was explored indicating that hydroxyl and sulfate radicals were the prevailing reactive species. The degradation percentages of 10 mg/L of sulfamethazine and atrazine were 83.30% and 70.60%, respectively, whereas the mineralization ratio was 63.50% in the case of real textile wastewater under the optimal conditions at a reaction time of 120 min. The treatment cost per 1 m3 of real wastewater was appraised to be 1.13 $/m3 which assured the inexpensiveness of the proposed treatment system. This study presents an effective and low-cost treatment system that can be implemented on an industrial scale.

Continuous flow combined with in situ self-assembly fabrication of high permselective ZIF-8@GO composite membrane in ceramic tube for organic dye nanofiltration

Nanofiltration holds promise for treating dyeing and printing wastewater on account of its key merits: low consumption, easy manipulation, and absence of secondary contamination. In this study, the fabrication of a uniform permselective ZIF-8@GO composite membrane in the alumina ceramic tube by the continuous flow combined with in situ self-assembly way was investigated. Subsequently, the properties of ZIF-8@GO membrane were examined in relation to reaction time, reaction temperature, flow rate, and GO concentration. Furthermore, the durability of the membrane was tested. It was observed that under optimal conditions, the rejection rate and permeation flux of methyl blue solutions remained essentially constant during 24 hours of continuous operation, with values of 98.39% and 38.27 L/(m2·h·bar), respectively. This work aims to simplify and smoothly implement the industrialized production of MOF-based composite membranes and offers a potential solution for the low-cost and efficient treatment of organic dye wastewater in the printing and dyeing industry.

In Vivo Validation of a Nanostructured Electrospun Polycaprolactone Membrane Loaded with Gentamicin and Nano-Hydroxyapatite for the Treatment of Periodontitis.

The aim of this research was to validate the use of a gentamicin (GEN) and nano-hydroxiapatite (nHAP)-loaded polycaprolactone nanostructured membrane (NM) as an innovative, highly efficient, low-cost treatment for periodontitis. We conducted an in vivo study on Wistar rats, in which we induced periodontitis by placing silk ligatures around the first right and left upper molars. The subjects were divided into three groups; the first group received no periodontal treatment, the second group received open flap debridement, and the third group received open flap debridement, together with the positioning of the GEN and nHAP-loaded nanostructured membrane as a treatment. The extent of periodontal regeneration was assessed by the periodontal pocket depth, bleeding on probing, tooth mobility, dental plaque, microbiological analysis, concentration of MMP-8 in saliva, plasma levels of CRP, and histological analysis. The results showed that using open flap debridement with the NM is more efficient, and it significantly reduces the probing depth, extent of bleeding on probing, dental mobility, bacterial plaque, and pathogenic flora. The concentrations of MMP-8 and CRP decrease. The histological analysis demonstrated that NM leads to bone regeneration. Our study indicates that gentamicin and nano-hydroxyapatite embedded in the fiber of the biodegradable membranes might be a promising therapeutic option for periodontitis treatment.

Fabrication and characterization of CuO–SiO2/PVA polymer nanocomposite for effective wastewater treatment and prospective biological applications

ABSTRACT The quality of water significantly affects the health and walefare of all orginisms, highlighting the importance to develop low-cost and efficient wastewater treatment methods. Herein, we report the fabrication, characterization, and utilization of a polymer-based ternary nanocomposite (CuO–SiO2/PVA) for the removal of Nile Blue (NB) and Methylene Blue (MB) contaminants from wastewater, along with exploring its potential biological activities. We have successfully employed the cost-effective sol–gel and in-situ polymerization approaches to fabricate the CuO–SiO2/PVA based ternary composite, utilizing Cu(NO3)2·3H2O:Glycerol:TEOS:PVA in a ratio of 8:2:3:4. The desired fabrication of nanocomposite was confirmed through UV-Visible spectroscopy, SEM (scanning electron microscope), TEM (transmission electron microscope), EDX (energy dispersive X-ray diffraction), FTIR (Fourier transform infrared), DSC (differential scanning calorimetry), and TGA (thermogravimetric analysis). In addition to its biological potentialthe performance of the nanocomposite in catalytic / photocatalytic removal of NB and MB dyes is investigated and compared. The higher photodegradation performance of the composite for NB (85%) dye than for MB (76%) dye indicates that variables such as chemical structure, charge, molecular mass, and pH sensitivity of the dyes can influence the catalyst's removal potential. This composite is considered to have a higher capability for removing pollutants and microorganisms from wastewater.

An open trial of biofeedback for long COVID

ObjectiveBiofeedback is a therapeutic treatment model that teaches self-regulation of autonomic functions to alleviate stress-related symptoms. “Long COVID” refers to chronic physical and cognitive sequelae post-SARS-CoV-2 infection. This study examined the efficacy of a six-week intervention, consisting of weekly one-hour sessions combining heart rate variability and temperature biofeedback, for alleviating mood symptoms, somatic symptoms and sleep disturbance of patients diagnosed with long COVID. MethodsData were collected from 20 adult participants aged 22–63 (Mage = 44.1, SDage = 12.2) with varying long COVID symptoms. Within this single arm design, 16 of the 20 participants completed all six sessions of biofeedback; 14 completed an assessment at the three-month post-treatment time point. ResultsParticipants self-reported significant improvements in somatic, anxiety, and depressive symptoms, sleep quality, quality of life, and number of “bad days” immediately after the intervention and three months later (Cohen's d effect size (ES) = 1.09–0.46). Reduced number of medical doctor visits (ES = 0.85) and prescription drug use over the last month (odds ratio = 0.33), as well as improved emotional wellbeing (ES = 0.97) were observed at the three-month time point only. ConclusionResults suggest that this short, readily scalable intervention can be potentially efficacious in alleviating symptoms of long COVID. Despite notable improvements, the major limitation of this study is its lack of control group. While a randomized trial merits study, biofeedback appears to be a brief, effective, non-invasive, and low-cost treatment option for patients with chronic somatic symptoms secondary to SARS-CoV-2 infection.Clinicaltrials.govID: NCT05120648

Web-based guided self-help cognitive behavioral therapy-enhanced versus treatment as usual for binge-eating disorder: a randomized controlled trial protocol.

Binge-eating disorder (BED) is a psychiatric disorder characterized by recurrent episodes of eating a large amount of food in a discrete period of time while experiencing a loss of control. Cognitive behavioral therapy-enhanced (CBT-E) is a recommended treatment for binge-eating disorder and is typically offered through 20 sessions. Although binge-eating disorder is highly responsive to CBT-E, the cost of treating these patients is high. Therefore, it is crucial to evaluate the efficacy of low-intensity and low-cost treatments for binge-eating disorder that can be offered as a first line of treatment and be widely disseminated. The proposed noninferiority randomized controlled trial aims to determine the efficacy of web-based guided self-help CBT-E compared to treatment-as-usual CBT-E. Guided self-help will be based on a self-help program to stop binge eating, will be shorter in duration and lower intensity, and will require fewer therapist hours. Patients with binge-eating disorder (N = 180) will be randomly assigned to receive guided self-help or treatment-as-usual. Assessments will take place at baseline, mid-treatment, at the end of treatment, and at 20- and 40-weeks post-treatment. Treatment efficacy will be measured by examining the reduction in binge-eating days in the previous 28 days between baseline and the end of treatment between groups, with a noninferiority margin (Δ) of 1 binge-eating day. Secondary outcomes will include full remission, body shape dissatisfaction, therapeutic alliance, clinical impairment, health-related quality of life, attrition, and an economic evaluation to assess cost-effectiveness and cost-utility. The moderators examined will be baseline scores, demographic variables, and body mass index. It is expected that guided self-help is noninferior in efficacy compared to treatment-as-usual. The proposed study will be the first to directly compare the efficacy and economically evaluate a low-intensity and low-cost binge-eating disorder treatment compared to treatment-as-usual. If guided self-help is noninferior to treatment-as-usual in efficacy, it can be widely disseminated and used as a first line of treatment for patients with binge-eating disorder. The Dutch trial register number is R21.016. The study has been approved by the Medical Research Ethics Committees United on May 25th, 2021, case number NL76368.100.21.

A Digital Intervention to Improve Skin Self-Examination Among Survivors of Melanoma: Protocol for a Type-1 Hybrid Effectiveness-Implementation Randomized Trial.

Although melanoma survival rates have improved in recent years, survivors remain at risk of recurrence, second primary cancers, and keratinocyte carcinomas. The National Comprehensive Cancer Network recommends skin examinations by a physician every 3 to 12 months. Regular thorough skin self-examinations (SSEs) are recommended for survivors of melanoma to promote the detection of earlier-stage, thinner melanomas, which are associated with improved survival and lower treatment costs. Despite their importance, less than a quarter of survivors of melanoma engage in SSEs. Previously, our team developed and evaluated a web-based, fully automated intervention called mySmartSkin (MSS) that successfully improved SSE among survivors of melanoma. Enhancements were proposed to improve engagement with and outcomes of MSS. The purpose of this paper is to describe the rationale and methodology for a type-1 hybrid effectiveness-implementation randomized trial evaluating the enhanced MSS versus control and exploring implementation outcomes and contextual factors. This study will recruit from state cancer registries and social media 300 individuals diagnosed with cutaneous malignant melanoma between 3 months and 5 years after surgery who are currently cancer free. Participants will be randomly assigned to either enhanced MSS or a noninteractive educational web page. Surveys will be collected from both arms at baseline and at 3, 6, 12, and 18 months to assess measures of intervention engagement, barriers, self-efficacy, habit, and SSE. The primary outcome is thorough SSE. The secondary outcomes are the diagnosis of new or recurrent melanomas and sun protection practices. Multilevel modeling will be used to examine whether there are significant differences in survivor outcomes between MSS and the noninteractive web page over time. Mixed methods will evaluate reach, adoption, implementation (including costs), and potential for maintenance of MSS, as well as contextual factors relevant to those outcomes and future scale-up. This trial has the potential to improve outcomes in survivors of melanoma. If MSS is effective, the results could guide its implementation in oncology care and nonprofit organizations focused on skin cancers. RR1-10.2196/52689.

Effectiveness of oseltamivir in reducing COVID-19-related in-hospital deaths: A pharmacoepidemiological study

BackgroundOseltamivir is a low-cost antiviral agent that could support or complement treatment of COVID-19. This study assessed whether oseltamivir is effective in reducing COVID-19-related mortality. MethodsThis retrospective cohort study evaluated real-world data from a nationwide database of hospitalisation due to severe acute respiratory syndrome in Brazil. Propensity score matching was used to mimic a randomised controlled trial with ‘oseltamivir’ and ‘no antivirals at all’ as the intervention and control groups, respectively. ResultsA total of 21 480 and 268 486 patients admitted between February 2020 and January 2023 were included in the intervention and control groups, respectively. After matching, the odds ratio (OR) for death was 0.901 (95% confidence interval [CI] 0.873-0.930). The OR (95% CI) for death in patients who were admitted to the ICU, and on non-invasive or invasive ventilation was 0.868 (0.821-0.917), 0.935 (0.893-0.980), and 0.883 (0.814-0.958), respectively. ConclusionsOverall, the use of oseltamivir was associated with an attributable risk reduction of 2.50% (95% CI 1.77-3.29). Similar results were observed in patients who were admitted to the ICU, and on non-invasive or invasive ventilation. Oseltamivir is a low-cost potential antiviral treatment for COVID-19.

Effectiveness and economic evaluation of rhTPO and rhIL-11 in the treatment of cancer therapy induced thrombocytopenia based on real-world research.

Objective: Based on real-world research, we aimed to evaluate the effectiveness and economy of recombinant human thrombopoietin (rhTPO) and recombinant human interleukin 11 (rhIL-11) in the treatment of cancer therapy induced thrombocytopenia (CTIT). Methods: We retrospectively collected clinical data of patients with CTIT who were treated with rhTPO or rhIL-11 in a single cancer hospital from January 2020 to December 2021. Propensity score matching (PSM) was applied to eliminate confounding factors. The measurements of effectiveness analysis were the platelet compliance rate, days of medication, days of compliance, highest platelet count after medication, platelet count elevation before and after medication, and the lowest platelet count after next-cycle cancer therapy. The economic evaluation was performed according to the results of the effectiveness evaluation. At the same time, patients were stratified according to type of tumor and grade of thrombocytopenia for subgroup analysis. Results: A total of 262 patients were collected and 174 patients were enrolled after PSM, 87 in the rhTPO group and 87 in the rhIL-11 group. In all patients, there were no significant differences in the platelet compliance rate, mean days of medication, median days of compliance, median highest platelet count after medication, and the median platelet count elevation before and after medication between the two groups (p > 0.05), but the median lowest platelet count after next-cycle cancer therapy in the rhTPO group was lower than that in the rhIL-11 group (p = 0.014). The subgroup analysis showed that the rhTPO group had longer mean days of medication than the rhIL-11 group in patients with hematological malignancies (p = 0.042), and a lower median lowest platelet count after next-cycle cancer therapy in patients with grade I/II thrombocytopenia than rhIL-11 group (p = 0.022), with no significant difference in other outcome indicators (p > 0.05). As there was no statistically significant difference in platelet compliance rate between the two groups, the cost-minimization analysis showed that the rhIL-11 group had lower treatment costs than the rhTPO group. Conclusion: RhTPO and rhIL-11 showed similar effectiveness in the treatment of CTIT, but rhIL-11 was more advantageous in economic cost.

Experimental and kinetic study on pyrolysis and combustion characteristics of pesticide waste liquid

Waste liquid treatment is widely concerned with the deepening of people's awareness of environmental protection, especially for the waste liquid with a high chemical oxygen demand (COD), which also has a high calorific value and makes it possible for the incineration treatment. In this study, the pyrolysis and combustion characteristics of pesticide waste liquid (PWL) are investigated by using thermogravimetric experiment and kinetic analysis, and the effects of different water and salt contents on its pyrolysis and combustion are discussed. The results show that both pyrolysis and combustion processes of the simulated pesticide waste liquid (sPWL) could be divided into two stages. As the water content increases from 0% to 18.5%, the volatilization characteristic index of stage Ⅰ (low temperature) increases by 263.31%, while that of stage Ⅱ (high temperature) decreases by 28.32%, and the water content could promote the pyrolysis and comprehensive combustion performance of the sPWL. As the sodium chloride contents increase from 0% to 1.5%, both the pyrolysis and combustion process of the PWL are enhanced, and the volatile release characteristic index, the ignition temperature and burnout characteristic index increase by 60.77%, 18.74% and 47.95%, respectively. By the means of the Coats-Redfern integral method, the kinetics of the pyrolysis and combustion of the PWL are analyzed, with a linear correlation coefficient of more than 95%. In a whole, a suitable water and sodium chloride content in the pretreatment process is crucial for efficient and low-cost treatment of waste liquid, which can promote the pyrolysis and combustion processes. These results are expected to provide several insightful guidance for the efficient treatment of the waste liquid.

Advancing rainwater treatment technologies for irrigation of urban agriculture: A pathway toward innovation

Urban agriculture (UA) has emerged for local food security since the 1960s. However, the access to sufficient and safe irrigation water remains a significant constraint. Municipal water supply, though commonly used in UA practices, proves unsustainable due to high costs, intensive energy consumption, and limited availability in many vacant urban spaces. In contrast, rainwater harvesting (RWH) exhibits a potential as a non-traditional water supply for urban farming. This article aims to provide insights into the advantages and challenges associated with RWH for UA irrigation, analyze existing low-cost RWH treatment technologies, and identify a visionary way toward innovative, new-generation RWH treatment processes in UA practices. Despite a promising water source, harvested rainwater is challenged for crop irrigation owing to the presence of various contaminants (e.g., waterborne pathogens, potentially toxic metals and metalloids, and synthetic organic chemicals). While established RWH treatment processes (e.g., first flush diversion, sedimentation, solar disinfection, chlorination, UV irradiation, granular filtration, and bio-sand filtration) can remove certain pollutants, they cannot offer viable treatment solutions for UA irrigation due to different technical, economic, and social restrictions. Particularly, their capacity to reliably remove contaminants of emerging concern in runoff remains limited or uncertain. Consequently, it is essential to develop next-generation RWH treatment technologies tailored specifically for UA irrigation. To this end, three fundamental principles are recommended. First, the focus should be on technically viable, low-cost, simple-operation, and easy-maintenance treatment technologies capable of simultaneously addressing traditional and emerging runoff contaminants, while minimizing the production of undesirable treatment byproducts. Second, advancing the understanding of the water, soil, and crop interactions enables the development of “right” RWH treatment processes for irrigation of “right” crops at a “right” place. Last, crop nutrients, if possible, are retained in rainwater to reduce the nutrient demand for crop production. The insights and perspectives have far-reaching implications for water conservation, stormwater management, and the integration of water, food, and energy systems within the urban environment.

Using aged oil to produce drilling-fluid lubricants

Aged oil is a product of oil and gas treatment and contains components such as oil, water, mud, sand, polymers, and surfactants. Normally, aged oil is mixed back into a crude-oil dehydration and separation treatment system to extract crude oil or treated separately using methods such as electric field dehydration, centrifugal separation, thermochemical dehydration, or biological treatment, amongst others. These methods all require the removal of water, mud, sand, etc. from the aged oil, which can be difficult and costly to treat, making a low-cost treatment method highly desirable. In this study, a resource utilization and treatment method for aged oil was proposed wherein aged oil was used as the base oil to produce lubricants for drilling fluids. This method exploits the emulsifying stability of aged oil and avoids the difficulties of removing mud, sand, and water from it. Through experiments, the components and concentration of the lubricant were optimized, and its performance was evaluated. The emulsifier used for developing lubricants based on aged oil was alkylphenol polyoxyethylene ether (OP-4), the wetting agent was sodium dodecylbenzenesulfonate (ABS), and the stabilizer was sodium carboxymethyl cellulose (Na-CMC). The optimal formula was determined to be 100 mL drilling fluid, 3 mL aged oil, 1.5 g OP-4, 0.15 g of ABS, and 0.015 g Na-CMC. The density, apparent viscosity, and sticking coefficient of the system mud cake satisfied the requirements of enterprise standards after the lubricant was added to the bentonite-based slurry. Consequently, using aged oil as a base oil to develop lubricants for drilling fluids was shown to be a feasible resource-utilization scheme and a viable processing method for achieving value-added aged oil.

High phenanthrene degrading efficiency by different microbial compositions construction.

Microbial remediation has become the most promising technical means for the remediation of polycyclic aromatic hydrocarbons (PAHs) non-point source contaminated soil due to its low cost of treatment, complete degradation of pollutants, and in-situ remediation. In this study, in order to demonstrate the phenanthrene degrading microbial diversity, phenanthrene was chosen as the representative of PAHs and strains capable of degrading phenanthrene were isolated and screened from the sedimentation sludge and the bottom sludge of oil tank trucks, and high throughput sequencing was used to check the dominant strains with a good degrading effect on phenanthrene. Results showed even more than 50% of phenanthrene was degraded in all samples, the composition of PAH-degrading bacteria was diverse, and different environments constructed different functional microbial groups, which resulted in the microbial adapting to the diversity of the environment. Finally, a series of bacterial species with phenanthrene-degrading functions such as Achromobacter, Pseudomonas, Pseudochelatococcus, Bosea was enriched after nine transferring process. Overall, our study offers value information for the enrichment of functional degrading microbes of phenanthrene or other pollutants that more concern should be paid in not only the degradation rate, but also the diversity variation of microbial community composition.

Lokalno radikalno lečenje patoloških lezija rektuma minimalno invazivnim hirurškim pristupima

Introduction: The most common pathological changes treated in the rectum are neoplastic polyps (villous, tubular, and tubulovillous adenomas) and rectal adenocarcinomas. Until now, precancerous lesions of the type of neoplastic polyps have been treated with a local approach, and patients with advanced cancers have been operated on with a radical surgical intervention, either classically or laparoscopically. Aim: In this paper, we will show the advantages and disadvantages of certain local surgical approaches to pathological changes in the rectum. Material and methods: Our research analyzed two groups of patients. In the first group, patients with pathological lesions of the rectum were treated with local transanal excision (TAE), and the second group of patients were treated with the newly introduced technique of transanal minimally invasive surgery (TAMIS). In the period from September 2021 to March 2023. at the CHC Zemun in Surgery Clinic, a total of 12 patients were operated on with the TAMIS procedure and 15 patients with the TAE technique for various pathological changes in the rectum. In all patients, the changes were localized in the rectum from 5 to 15 cm from the anocutaneous line in the TAMIS group and from 0 to 6 cm in the TAE group. Pathological changes could not be resected by endoscopic polypectomy. Results: The average duration of the operations was longer in the TAMIS group and amounted to 45 minutes, while the operations lasted an average of 20 minutes in the TAE group. During the surgical procedure, mucosectomy is most often performed, followed by resection of the full thickness of the rectal wall, and resection of the rectal wall with part of the mesorectal tissue was performed the least frequently in both analyzed groups. In 3 patients we had preparation fragmentation, and in 1 case we had positive margins by histopathological postoperative analysis in the TAMIS group. In the TAE group, we had one patient with preparation fragmentation and a positive margin. Patients with a positive margin in both the TAE and TAMIS groups belonged to villous adenomas with a high degree of dysplasia. The final HP finding in both groups most often spoke in favor of tubulovillous adenoma with a low to medium degree of dysplasia. In both groups, we had 2 cases of early intramucosal carcinoma T1 stage. Discussion: The postoperative period of hospitalization is shorter in TAE compared to TAMIS (1.3 days compared to 1.8 days). We had no serious postoperative complications in any of the observed groups. In one case, we had postoperative bleeding, which was treated with endoscopic hemostasis. Such low percentages of postoperative complications, even in our small series of patients, justify the introduction of the TAMIS procedure into daily practice for the surgical treatment of large endoscopically unresectable rectal polyps of high rectal localization. Conclusion: Based on our work and the available literature, we can conclude that radical local resections of TAE and TAMIS are a viable alternative to surgical radical rectal resection in polypoid changes and early T1 rectal cancers with less morbidity, faster recovery, and lower treatment costs. These techniques are safe, effective, and reproducible.

An Effluent Treatment Plant’s Procedure Improved by Employing the Kaizen Approach

Industrial waste management, environmental compliance, and public health depend on ETPs. Though vital, many such institutions fail to operate efficiently and effectively. The study of Kaizen techniques implementation is done in Effluent Treatment Plant (ETP) in a SSI unit in Nagpur city, in INDIA. Here, the working of this process is done over Effluent Treatment Plant of the filtration unit in the industry. Here kaizen process is implemented in filtration of sludgy water. To overcome this problem the kaizen process was implemented in the filtration unit. Now in newer process air cylinder is placed in the process. The pump partially fills the air cylinder with sludgy water. The sluggish water is then pumped to the ETP unit. Earlier the process was not manually controlled it totally depended over the pressure of pump which was manually operated. To avoid all the mishaps happening in the industry new process was implemented. After application of kaizen technique all the problems which were a rising during filtration of sludgy water were overcome. Kaizen improves industrial wastewater management by lowering treatment costs and increasing plant capacity. This article describes Kaizen implementation and offers practical suggestions for optimizing wastewater treatment in other facilities.

Treatment of domestic effluents using sustainable biofilter methods

The discharge of effluents is a permanent environmental and sanitation concern. Efficient water management must include water treatment and reuse. It is therefore necessary to study treatment systems to improve their performance throughout the entire chain, from drinking water to wastewater or, more specifically, waste effluent. Currently, technologies using bio-filtration processes have proven to be an effective and low-cost method for treating industrial effluents and domestic sewage. In this study, a low-cost domestic sewage treatment system made up of biofilters and pipes was built on a bench model as a means of teaching practical classes, and its efficiency was also studied. The results showed that the equipment can be made from recyclable material and is low-cost, easy to detail technically and easy to handle and operate. The students involved can easily replicate the technology in their communities, thus spreading low-cost sanitation treatment technologies to low-income populations without access to conventional sanitation systems. The parameters pH, turbidity, chlorination, temperature, and electrical conductivity were all at acceptable levels for discharge into receiving bodies and domestic use.