A new model of inexpensive portable homemade PERC Mentor (IPHOM) and its validation

Background Percutaneous nephrolithotomy (PCNL) is a complex surgery and has a flat learning curve. Due to this and the ethical issues, trainees do not get enough hands on exposure. Virtual simulator is very expensive and bulky. Animal model requires legal clearance. This inexpensive portable homemade PERC Mentor (IPHOM) teaches all the major aspects of PCNL surgery. This article has shown the way to make this model and its validation study. Methods IPHOM can be made at home with carton box, ball bearings, LED torch and some hospital wastes. After a short demonstration of IPHOM, 14 residents and 4 urologists were given 8 tasks to perform on it followed by 15-min supervised practice exercise on day 0 and day 1. Their performance was reassessed on day 2 and 3. Response to 17 feedback points was recorded on a seven-point Likert scale. Results There was significant difference between the performance of expert and novice on day 0. Expert completed all the tasks in less time and no. of attempts. The time for tract dilatation and duration of radiation exposure were significantly less in the expert group. The performance of both expert and novice improved on day 2 and 3, but the improvement was significantly more in novice. Response to the feedback points showed no difference between expert and novice (p > .05). Conclusions We have found that training on IPHOM has improved the concept and skills of PCNL in residents. The simplicity and low cost of the model make it constructible at home.

Operative Management and Disposal of Hospital Wastes: A Comprehensive Appraisal

: Health clinics are significant destinations for the creation of risky waste. Every clinic has its own profile for the management and transport of waste contingent upon its area. It is amazingly crucial to guarantee that the waste created in medical clinics is sufficiently kept away from dangers to well-being and the climate. The manuscript describes the control of clinical waste, which incorporates infectious waste, synthetic substances, lapsed medications, radioactive trash, and rough waste are the major ones in hospitals. On the off chance that the administration is not efficient, it becomes perilous, as they are pathogenic and environmentally unsafe. Inability to do so can bring about negative results; for example, genuine well-being chances and the clinic's standing. This article portrays the different ways to deal with the powerful administration of clinic squander. The authors conclude that pretreatment is basic before discarding emergency clinic squander in a hospital to minimize hazardous issues.

Molecular Screening of bla-TEM-68 Gene for TEM-68 ESBLs Resistant K. pneumoniae and C. freundii from Hospital Waste in Adamawa state Specialist Hospital, Yola

Resistant strains of K. pneumoniae and C. freundii due to under use and over use of antibiotics and biocides has contributed to economic burden due to nosocomial infections. This study focuses on screening hospital wastes for antibacterial and biocide resistant K. pneumoniae and C. freundii in Adamawa state specialist hospital, Yola. One hundred and twenty (120) hospital wastes samples were analysed. Samples were cultured on appropriate media and incubated at 37 oC for 24h. Biochemically identified isolates were molecularly confirmed and sequenced. K. pneumoniae being 93% identical to strain KPNIH48 and C. freundii being 99% identical to complex sp CFNH4 were confirmed. Resistant K. pneumonia and C. freundii were subjected to phenotypic ESBLs test, then DDS test was carried out to confirm ESBLs production. Phenotypically ESBLs positive K. pneumoniae were positive for DDST but negative for C. freundii. The DDST positive isolates were then screened for bla-TEM-68 gene. All the DDST positive K. pneumoniae harboured the bla-TEM-68 gene but none in C. freundii. The isolates carrying bla-TEM-68 gene were cured using 10 % SDS and the results showed that the ESBLs genes were plasmid and/or chromosomally encoded. The presence of K. pneumoniae carrying bla-TEM-68 gene indicates a possibility for increased nosocomial infections in Adamawa state and Nigeria at large and so relevant preventive recommendations were made.

Microbial load of healthcare wastes in Aba Metropolis, Abia State

Introduction: Healthcare waste is the total waste both solid and liquid from healthcare establishment and laboratories. A hospital produces waste by giving their services to the patients. Purpose: This study examined the microbial load of waste from selected healthcare facilities in Aba metropolis, Abia State. Methodology: Tenfold serial dilution was used for processing of all the samples. After the dilutions, exactly 0.5ml of each the sample was planted on the media using the spread plate method and evaluated using the standard microbiological techniques. Results: The viable count (TVC) ranged from 1.0×103cfu/g to 0.3×108cfu/g, coliform count (TCC) ranged from 0.4×102 cfu/g to 4.2×104 cfu/g, staphylococcal count (TSC) ranged from 1.0×101 cfu/g to 1.4×102 and fungal counts ranged from 2.0×102 cfu/g to 0.8×103cfu/g in the microbial count of various waste samples within the Aba metropolis, Abia State. The laboratory waste had the highest microbial counts, followed by the Out-patient department waste and the least was the pharmaceutical waste. The microorganisms isolated from the hospital wastes were Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Aspergillus niger, A. Fumigatus, Candida albicans and among others. Unique contribution to theory, practice and policy: This research has revealed that healthcare waste contained pathogens with high microbial load densities, suggesting that the hospital wastes may pose a major health and environmental threat, if not properly managed. The study recommends that, the government should ensure that there is a policy on hospital waste management in line with recommended international best practices, which should be monitored and enforced.

Nanophotocatalysis for the Removal of Pharmaceutical Residues from Water Bodies: State of Art and Recent Trends

Background: The occurrence of pharmaceuticals in surface and drinking water is ubiquitous and is a major concern of researchers. These compounds cause a destructive impact on aquatic and terrestrial life forms and the removal of these compounds from the environment is a challenging issue. Existent conventional wastewater treatment processes are generally inefficacious because of their low degradation efficiency and inadequate techniques associated with the disposal of adsorbed pollutants during comparatively effective methods like the adsorption process. Remediation method: Semiconductor mediated photocatalysis is an attractive technology for the efficient removal of pharmaceutical compounds. Among various semiconductors, TiO2 and ZnO based photocatalysts gained much interest during the last years because of their efficiency in decomposing and mineralizing the lethal organic pollutants with the utilization of UV-visible light. Incessant efforts are being undertaken for tuning the physicochemical, optical and electronic properties of these photocatalysts to strengthen their overall photocatalytic performance with good recycling efficiency. Results: This review attempts to showcase the recent progress in the rational design and fabrication of nanosized TiO2 and ZnO photocatalysts for the removal of pollutants derived from the pharmaceutical industry and hospital wastes. Conclusion: Photocatalysis involving TiO2 and ZnO provides a positive impact on pollution management and could be successfully applied to remove pharmaceuticals from wastewater streams. Structure modifications, introduction of heteroatoms and integration of polymers with these nanophotocatalysts offer leapfrogging opportunities for broader applications in the field of photocatalysis.

Eco-Environmental Aspects of COVID-19 Pandemic and Potential Control Strategies

A new coronavirus-strain from a zoonotic reservoir (probably bat)—termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—has recently claimed more than two million deaths worldwide. Consequently, a burst of scientific reports on epidemiology, symptoms, and diagnosis came out. However, a comprehensive understanding of eco-environmental aspects that may contribute to coronavirus disease 2019 (COVID-19) spread is still missing, and we therefore aim to focus here on these aspects. In addition to human–human direct SARS-CoV-2 transmission, eco-environmental sources, such as air aerosols, different public use objects, hospital wastes, livestock/pet animals, municipal wastes, ventilation facilities, soil and groundwater potentially contribute to SARS-CoV-2 transmission. Further, high temperature and humidity were found to limit the spread of COVID-19. Although the COVID-19 pandemic led to decrease air and noise pollution during the period of lockdown, increased use of masks and gloves is threatening the environment by water and soil pollutions. COVID-19 badly impacted all the socio-economic groups in different capacities, where women, slum dwellers, and the people lacking social protections are the most vulnerable. Finally, sustainable strategies, waste management, biodiversity reclaim, eco-friendly lifestyle, improved health infrastructure and public awareness, were proposed to minimize the COVID-19 impact on our society and environment. These strategies will seemingly be equally effective against any future outbreak.

Biomedical Waste Management (BMW) Assessment at the RHC Regional Hospital in Tangier, Morocco

Biomedical waste is a real danger to public health and the environment. The quantity of this waste, mainly from hospitals, is constantly increasing, leading to various forms of pollution. This is a cross-sectional, observational study that took place in 2017. A questionnaire was submitted to nurses, doctors and those responsible for hospital hygiene and the operation of waste incinerators to assess the mechanisms and knowledge of medical staff in terms of biomedical waste management. It was confirmed that the hospital wastes are still poorly managed due to the absence of a plan or program for MPSD in all the structures studied, which attests to the non-application of the regulations in force and an inadequate internal management system in most laboratories. Due to the non-availability of health technicians and the lack of material resources in quality and quantity, a staff that is poorly informed about the regulations that apply to BMW, and a poorly recognized and disrespected BMW process that breaks even the clearest instructions regarding incineration and landfill disposal. It has become very urgent to adopt new strategies to be planned for an adequate training to be included for better medical waste management.

Statistics and Forecasting Analysis on Hospital Garbage Data

For a long time, China's medical problem is very serious. There are very few researches on medical waste data, which can not provide enough evidence for managers. Therefore, combining some methods of data analysis and data mining to analyze the medical waste data.In this study, based on the collection of the hospital garbage data of over five years from some area in China, the hospital garbage data are analyzed with consideration of the location, the hospital level, hospital beds and number of doctors and staff members, by using some data analysis and data mining methods. The time series analysis of garbage data proves that the medical wastes so produced are on the rise and the sharing of the burden of medical missions is unbalanced with regard to the hospital location and levels. By establishing an auto regressive integrated moving average（ARIMA） (0,1,1) model, the prediction and analysis for the every-day production of the hospital wastes in the area are made.The research results of the K-Means clustering analysis and the PARETO contribution analysis provide some empirical evidences for the future planning and development of the hospitals in this area

Inadequacies in Hospital Waste and Sewerage Management in Chattogram, Bangladesh: Exploring Environmental and Occupational Health Hazards

Bangladesh has been grappling with the issues of improper hospital waste management. To reflect the inadequacies in existing management practices and the potential implications on the environment and health, this study evaluated the Knowledge, Attitude, and Practice (KAP) of doctors and nurses in a private and a public hospital in Chattogram city via a structured questionnaire survey. At the public hospital, 20.4% of the doctors and 6% of the nurses had occupational illnesses, compared to 36% of the doctors and 26.5% of the nurses at the private hospital. At the public hospital, 67.8% of the nurses wore PPE during waste collection, compared to 17.7% in the private hospital. Hospital wastes and occupational safety are not properly dealt with in both hospitals. An inadequacy was observed in the knowledge of hospital waste management among healthcare workers. The route of hospital wastes from the sources to the end destination was also traced via interviews and focus group discussions, which revealed that disposal practices of the hospital solid waste were environmentally unsustainable. In attempts to show opportunities for environmental and health risks from the hospital wastewater, this study also investigated the quality of the wastewater and tested it for the presence of resistant enteric pathogens. E. coli and S. aureus from both hospitals showed resistance against some common antibiotics used in Bangladesh. The physicochemical properties of the samples were nearly compliant with the Bangladesh Water Quality Standards for hospital wastewater. While more robust sampling and water quality analysis are required, this study provides basic water quality indicators and scope for future research to understand the apparent significant negative impact on the environment and health.

Hospital Wastes Handlers’ Understanding of Medical Waste in Selected Hospitals in Ota, Nigeria

The study assessed waste handlers’ understanding of hospital waste components, in order to provide information that would inform policy intervention. Data was collected through questionnaire administration. There were thirty-eight (38) hospitals distributed across five (5) political wards in Ota Township. Twenty-five per cent of the hospitals were sampled, two hospitals in each ward, making ten altogether. Questionnaires were administered to all forty-nine waste handlers in the surveyed hospitals. Data were analysed using descriptive and inferential statistics. The study established that only 8.2% and 14.3% of waste handlers were informed on colour-coded storage receptacles for pharmaceutical and sharp materials respectively. Though 46.9% of waste handlers knew that pathological, pharmaceutical, sharps and infectious wastes were harmful. However, 53.1% was not aware of the harmful nature of radioactive waste. The use of protective materials by the waste handlers was noted to be inadequate. Training of cleaners on proper management of medical waste was insufficient. It was found that there is a strong relationship between educational status and monthly income of the cleaners (r =.67, p > .05), though not significant. It could be concluded that waste handlers in the selected hospitals did not fully understand the hazardous nature of medical waste components.