Is Leishmaniasis donovani elimination feasible in Bhutan? A review of current prevention and control mechanisms in Bhutan

Leishmaniasis is a neglected tropical disease with an annual estimated 700,000 to 1 million new cases globally. The diseases affect the rural community and people living in poverty. It is transmitted by female phlebotomine sand-fly; a tiny 2–3 mm long insect vector. Along with the regional countries, Bhutan has embarked on the elimination goal. However, several challenges lies ahead on its path to elimination. There is no elimination strategy and actions. The reporting, surveillance system, control and prevention mechanisms are inadequate. Further, there is lack of knowledge among the health care providers that impedes elimination goals. Therefore, if Bhutan is serious about its elimination goal, all the gaps and current challenges needs to be addressed appropriately. Keywords: Bhutan; Elimination; Leishmaniasis.

Influence of functional abilities on the quality of refereeing in handball

Background: Several factors contributed to the evolution of handball, and one of the most important changes for faster, more dynamic and aggressive game is the change of rules which increase physical demands of players and especially referees. The aim of this study is to determine whether functional abilities have an influence on the quality of refereeing. Material and methods: 31 subjects were involved in the research, all of them top-level referees with an average age of 34.66±6.44, height 184.02±5.87 cm and body mass 91.14±10.61 kg. Testing was divided into two parts: the first part was spiroergometric progressive test on a treadmill to diagnose functional abilities, and the second part was the official handball matches. Results: Results show an average relative maximum oxygen uptake of 45.35±6.12 ml/min/kg. No statistically significant correlation was found between better functional abilities of handball referees and a better quality of refereeing. Conclusions: Referees have a lower anaerobic capacity, which could lead to errors in their judgment during the highest physiological loads in a match. Referees are a homogeneous group due to elimination criteria on tests at official seminars. If there were no elimination criteria, there would be greater variability among referees, and it would be possible to confirm the hypothesis that better functional abilities would lead to a better quality of refereeing.

Behavior of UV Filters, UV Blockers and Pharmaceuticals in High Rate Algal Ponds Treating Urban Wastewater

The present study evaluated the efficiency of a high rate algal pond (HRAP) at pilot scale to remove pharmaceuticals and personal care products (PPCPs) from urban wastewater, including UV-filters and parabens (10), benzotriazoles (4), antibiotics (15), anti-inflammatories (3) and other pharmaceuticals (3). A total of 35 compounds were targeted, of which 21 were detected in the influent wastewater to the HRAP. Removals (RE%) for pharmaceuticals were variable, with efficient eliminations for atenolol (84%) and sulfathiazole (100%), whereas the anti-inflammatories naproxen and ketoprofen were only partially removed <50%. Benzotriazoles showed elimination rates similar to those of conventional WWTPs, with RE% ranging from no elimination to 51% for the UV filter benzophenone-3 (BP3) and 100% for 4-methylbenzilidenecamphor (4MBC). Hazard quotients (HQs) were estimated for those compounds not fully eliminated in the HRAP, as well as the cumulative ecotoxicity in the resulting effluent. The majority of the compounds yielded HQs < 0.1, meaning that no environmental risk would be derived from their discharge. Overall, these results clearly indicate that HRAPs are a reliable, green and cost-effective alternative to intensive wastewater treatment, yielding promising results removing these contaminants.

Simple Thin-Layer Chromatographic and UV-Spectrophotometric Analysis of Promethazine and its N-Demethylation Metabolites from Biological Fluids

Several Ultra-Violet spectrophotometric analytical method has been made available in the analysis of phenothiazine group of drugs but Thin-Layer Chromatographic techniques are not fully utilized. Hence, we were able to develop a succinct, simple and cost-effective TLC and UV-spectrophotometric quantification method for the analysis promethazine and metabolites from biological fluids, validating previous studies. The proposed method was found to be precise, accurate and phenotypic determination and categorization were successfully estimated among the test samples. From the chromatogram intensities, 33.3% of the study population were classified as poor metabolizers, 40% were intermediate metabolizers, and 26.67% extensive metabolizers. Little or no elimination of N-desmethylpromethazine was observed for subjects with poor metabolism in correlation with the severity. Therefore, the phenotypic knowledge will help in the clinical choices as an individual from the same family may likely metabolize a giving drug in the same manner due to their genetic similarities. Keywords : Promethazine, Metabolites, Thin-Layer Chromatography, cytochrome P450.

Performance of Ozonation Process as Advanced Treatment for Antibiotics Removal in Membrane Permeate

There was an investigation into the removal of 6 types of antibiotics from hospital wastewater through membrane bioreactor (MBR) treatment and ozonation processes. Six types of antibiotics, namely, Sulfamethoxazole (SMZ), Norfloxacin (NOR), Ciprofloxacin (CIP), Ofloxacin (OFL), Erythromycin (ERY), and Vancomycin (VAN) which had high detection frequencies in collected samples from hospital wastewater treatment plant (HWTPs). After MBR treatment, the removal efficiencies of SMZ, NOR, OFL, and ERY were 45%, 25%, 30%, and 16%, respectively. Among of them, almost no elimination was observed for CIP and VAN since their concentrations increased by 0.24 ± 0.18 (μg·l-1) and 0.83 ± 0.20 (μg·l-1), respectively. Then, residues of the antibiotics were removed from the MBR effluent by the ozonation process. The overall removal efficiencies of SMZ, NOR, CIP, OFL, ERY, and VAN were approximately 66 %, 88 %, 83 %, 80 %, 93 %, and 92 %, respectively. The reason might be depended on different ozone consumption of those antibiotics (ABS) in a range of 313 to 1681 μg ABS·gO--1. Consequently, the ozonation process performed better in the antibiotics removal (e.g. CIP and VAN) so ozonation could be considered as important support for the MBR treatment to reduce the risk of antibiotic residues.