comparative study between colonic J-pouch and coloplasty anastomosis after ultra-low anterior resection for middle and low rectal cancer

Rectal cancer is the second common gastrointestinal tumour and its surgical treatment varies according to its distance from anal verge. After low anterior resection and colorectal anastmosis, for upper 1/3 rectal tumour, patients usually have normal habits with minimal affection. However, for middle and lower rectal cancer, they require a pouch to minimize the functional disorders resulting from the rectal pouch and may be also related to the loss of normal anorectal sensation. To compare the functional results of coloplasty pouch [CP] versus the colonic J- pouch [JP], after low anterior resection. Thirty patients diagnosed to have an operable middle and low rectal carcinoma, were randomized into two equal groups, the J-pouch and the coloplasty group. All the patients underwent low anterior resection with temporary ileostomy diversion, after colo-anal asnastmosis with CP or JP formation. The patients had a preoperative and postoperative anal manometric study, at 6 months and 12 months interval after closure of ileostomy. This includes resting anal pressure, maximum squeeze pressure, and maximum tolerable volume, as well as the recto-anal inhibitory reflex. Patients had a questionnaire based on Hida et al. scoring system where different variables [evacuation, continence, urgency, perineal soiling and others] were graded from zero to two to quantify the overall functional results. There was no significant difference between both groups regarding intra-operative or postoperative complications, or hospital stay. Bowel evacuation was better for CP patients, at 6 months, however, it equalized in both groups with no significant difference at 1-year interval. Although, the resting anal pressure and the maximum squeeze pressure were lower than the preoperative values, but there was no significant difference between both groups after six months or one year duration. Finally there was a significant inverse correlation between the total functional score and the anasto-motic distance from the anal verge for both groups, the smaller the distance from the anal verge, the higher was the functional score [poorer function]. Patients with colo-plasty pouches were able to defer their bowel movement better, and had less nocturnal leak, at 6 months, however, bowel function equalized in both groups at 1 year, with no significant difference between both groups

Solidification as low cost technology prior to land filling of industrial hazardous waste sludge

The aim of this study was to stabilize and solidify two different treated industrial hazardous waste sludges which were selected from factories situated close to Alexandria. They were selected to ensure their safe transportation and landfill disposal by reducing their potential leaching of hazardous elements which represent significant threat to the environment, especially the quality of underground water. The selected waste sludges have been characterized. Ordinary Portland cement [OPC] and cement kiln dust [CKD] from Alexandria Portland Cement Company and calcium sulfate as a by-product from the dye industry were used as potential solidification additives to treat the selected treated waste sludges from tanning and dyes industry. Waste sludges as well as the solidified wastes have been leach-tested using the general acid neutralization capacity [GANG] procedure. Concentration of concerning metals in the leachates was determined to assess the changes in the mobility of major contaminants. The main advantages of solidification are being simple and low cost process which includes readily available low cost solidification additives that convert the industrial hazardous waste sludges into inert materials

Solid waste problems in Alexandria city Part II Disposal practice

The disposal of solid wastes in the city of Alexandria was studied during the year 1978. The waste was disposed of by different methods according to the type of the waste. For instance, domestic wastes were disposed of by open dumping, composting, salvage, and hog feeding. The physical characteristics of the solid wastes were studied too. These characteristics differ from one living standard to another. Garbage was found to be high in low standard [78.1%], paper was high in high standard [19.5%], and dust was high in waste generated from low standards [4.8%]. Seasonal variations of the characteristics of wastes were studied. It was observed that during summer much garbage is produced, while in winter more paper is generated, [80.1% and 14.3% respectively]. Rate of generation per capita per day [460 gm] was in agreement with those produced in Middle East countries. For domestic and organic wastes, composting was found to be the optimum method of disposal. Pathological wastes should be incinerated, while sanitary landfill is the method of choice to dispose of solid wastes in Alexandria