Avaliação temporal e espacial da qualidade das águas superficiais da bacia hidrográfica do rio Desquite, Santa Catarina / Temporal and spatial evaluation of the surface water quality of the river Desquite watershed, Santa Catarina

RESUMO Objetivou-se, com este estudo, avaliar o impacto ambiental do uso e da ocupação da terra na qualidade da água da bacia hidrográfica do rio Desquite, utilizando a Resolução nº 357/2005, do Conselho Nacional do Meio Ambiente (CONAMA), como legislação balizadora. Foram realizadas coletas de água e determinados os parâmetros físico-químicos: temperatura, pH, condutividade elétrica, oxigênio dissolvido (OD) e sólidos totais dissolvidos (STD), com uma sonda multiparâmetro; demanda química de oxigênio (DQO), fenóis totais, fósforo total e amônia (NH3), com um fotocolorímetro; e os metais cádmio (Cd), chumbo (Pb), cromo (Cr), níquel (Ni) e cobre (Cu), por meio de Espectrometria de Absorção Atômica de Alta Resolução com Fonte Contínua (AR-FC EAA). Para efeitos comparativos, tomando-se como base o ordenamento jurídico, as amostras apresentaram valores acima dos valores máximos permitidos (VMP) para os parâmetros fósforo total, NH3 e Cr. Também foram observadas alterações nos parâmetros: OD, fenóis totais, DQO e Cd. Ao final de um ano de acompanhamento e campanhas amostrais, conclui-se que o rio Desquite seria classificado de acordo com os limites estabelecidos para a classe IV da Resolução CONAMA nº 357/2005, e verificou-se que as principais alterações na qualidade da água ocorrem nas áreas de preservação permanente com ausência de cobertura vegetal ou nos lançamentos de efluentes domésticos e resíduos sólidos nesses locais ou diretamente nos corpos d'água.

ABSTRACT The objective of this study was to evaluate the environmental impact of land use and occupation on the water quality of the Desquite river basin, using CONAMA Resolution no 357/2005, as beacon legislation. Water samples were collected and the physical-chemical parameters were determined: temperature, pH, electrical conductivity, DO and TDS, with a multiparameter probe; COD, total phenols, total phosphorus and ammonia (NH3) with a Photocolorimeter; and the metals Cd, Pb, Cr, Ni and Cu were determined by Continuous Source High Resolution Atomic Absorption Spectrometry (HR-FC EAA). Based on the comparative legal order, the samples presented values above the maximum permitted values for the parameters total phosphorus, ammonia (NH3) and Cr. Changes were also observed in the parameters: OD, total phenols, COD and Cd. At the end of a year of follow-up and sampling campaigns, it was concluded that the Desquite river would be classified according to the limits established for class IV of CONAMA Resolution no 357/2005, the main changes in water quality occur in the areas of permanent preservation with absence of vegetal cover or in the releases of domestic effluents and solid residues in these places or directly in the bodies of water.

Study of socio-demographic determinants and body mass index of female class IV employees (Aayas and Mehatranis) at a municipal tertiary care teaching hospital in Mumbai, India

Background: Health care professionals (including class IV employees) are the most ignorant as far as their own health is concerned. Problems encountered at the workplace affect not only a worker’s health but also adversely affects the workplace environment. Today is an era of women who have diverse role to play in the society and often they handle multiple tasks simultaneously. They are therefore prone to suffer from work related diseases, which are further complicated by various social (responsibilities at home), psychological and physiological (e.g., pregnancy) issues.Methods: A cross-sectional study was carried out amongst 287 female class IV employees of municipal tertiary care teaching hospital in Mumbai during the period of April 2017 to December 2018. A semi-structured interview schedule was prepared comprising of socio-demographic determinants and BMI. Data was entered in MS Excel sheet and were analyzed in the form of percentage and proportions whenever necessary.Results: Out of total 287 participants, 101 (35.2%) belonged to age group of 41-50 years, more than half 168 (58.5%) were widows and majority 231 (80.5%) were Hindu by religion, 124 (43.2%) belonged to upper middle class, 158 (55.0%) belonged to a nuclear family and 44 (15.3%) had to travel more than 60 kms daily to reach at workplace.Conclusions: Study concluded that 35.2% participants were 41-50 years age group and 80.5% were Hindu by religion and 43.2% belonged to the upper middle class. Only 2.1% respondents had completed their graduation. More than half i.e. 55.1% of the participants were having normal body mass index and 10.5% were obese.

Assessment of feasibility and efficacy of Class IV laser therapy for postoperative pain relief in off-pump coronary artery bypass surgery patients: A pilot study.

Background: Laser therapy, for its established analgesic properties with minimal side effects, has been used for the treatment of chronic pain. However, it has not been used for the treatment of acute postoperative pain. This pilot study was designed to assess the feasibility and efficacy of Class IV laser on postoperative pain relief following off-pump coronary artery bypass graft (OPCABG) surgery, as a component of multimodal analgesia (MMA) technique. Methods: This open observational prospective study comprised of 100 adult patients (84 male, 16 female) who underwent OPCABG through sternotomy. For postoperative analgesia, they were subjected to laser therapy subjected to laser therapy in addition to the standard institutional pain management protocol comprising of IV infusion/bolus of tramadol and paracetamol and fentanyl bolus as rescue analgesic. Pain intensity was measured by Verbal Rating Scale (VRS). The laser therapy was scheduled as once a day regime for three consecutive postoperative days (PODs) starting on POD 1, 30 min following tracheal extubation. The subsequent laser applications were also scheduled at the same time of the day as on day 1 if VRS was ≥5. 10 W Class IV laser was applied over 150 cm2 sternal wound area for 150 s. VRS was used to assess pain severity and was recorded for statistical analysis using Friedman Test. Results: The mean (standard deviation [SD]) VRS of all the 100 patients just before application of the first dose of laser was 7.31 (0.94) while on MMT; the same fell to 4.0 (1.279) and 3.40 (2.697) at 1 h and 24 h respectively following first dose of laser. The change of VRS over first 24 h among all the 100 patients was statistically significant (P = 0.000). Laser was re-applied in 40 patients whose VRS was ≥5 (mean [SD] – 6.38 [0.868]) at 24th h. After receiving the 2nd dose of laser the VRS scores fell significantly (P = 0.000) and became 0 at 54th h. No patients required 3rd dose of the laser. No patient required rescue analgesic while on laser therapy. Conclusion: Class IV laser can be an effective technique for postoperative analgesia following OPCABG surgery through sternotomy when included as a component of MMA technique.

Use of temporary filling material for index fabrication in Class IV resin composite restoration

When a patient with a fractured anterior tooth visits the clinic, clinician has to restore the tooth esthetically and quickly. For esthetic resin restoration, clinician can use 'Natural Layering technique' and an index for palatal wall may be needed. In this case report, we introduce pre-restoration index technique on a Class IV defect, in which a temporary filling material is used for easy restoration. Chair-side index fabrication for Class IV restoration is convenient and makes a single-visit treatment possible.

Clinical Manifestation and Treatment Outcome of Lupus Nephritis in Children

PURPOSE: Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. METHODS: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. RESULTS: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1 (2-18) years old. FANA(95.0%), anti-ds DNA antibody (87.5%), malar rash (80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria (75.0%), nephrotic syndrome (55.0%), and microscopic hematuria alone (15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was 51.8 40.5 months. During 51.8+/-40.5 months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. CONCLUSION: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

The Effect of Modified Anterior Transposition of the Inferior Oblique Muscle

Anterior transposition of inferior oblique muscle(ATIO) is known to an effective procedure for correcting marked overaction of inferior oblique muscle. However, depression in abduction and elevation deficiency in primary and abduction positions have occurred without adherence syndrome after this procedure. To avoid these complications, the author modiffied ATIO by transposing only the anterior portion of inferior oblique muscle at 2mm anterior to the temporal insertion site of inferior rectus, and placing the posterior portion of muscle just posterior to the insertion site of inferior rectus. Modified ATIO was performed in 4 cases of inferior oblique overaction(IOOA) with dissociated vertical deviation(DVD), 2 cases of unilateral IOOA withcontralateral superior oblique overaction(SOOA) and 5 cases of superior oblique palsy(SOP) Knapp class IV. They were observed for over 6 months (6~18 months). Three of 4 cases of IOOA with DVD were improved but adherence syndrome occurred in one case and depression in abduction occurred in another case. In 2 cases of unilateral IOOA with contralateral SOOA, hypertropia was decreased from 20delta and 2delta respectively, after the procedure. In 5 cases of SOP Knapp class IV, preoperative hypertropia was 20delta-40delta in primary position. After modified ATIO, hypertropia was 0delta-20delta . The correction effect was 12delta-35delta , with an average of 18.4delta in primary position. In 4 of 5 cases, hypertropia was corrected within 10delta in primary position. Modified ATIO is an effective procedure for unilateral IOOA with contralateral SOOA and SOP Knapp class IV as a single muscle surgery.