Nutrient removal by root zone treatment systems: a review.

The Root Zone Treatment System (RZTS) has been used widely for nutrient removal in European countries. In spite of having its more adaptability in tropical region like India its use to address nutrient induced issues in the country is very less. The lack of widely accepted data, non consensus of scientists over nutrient removal mechanism and inability to apply performance standards observed in other countries directly might have hampered the acceptance of this technology in India. A few technology assessment programs are being conducted in collaboration with other countries to engineer this technology but nutrient removal aspects are not essentially focused. In this context, there is need to direct lab scale research to identify potential wetland plants, bed media and comparative study of their combination specific performance under similar conditions. The field application of the data will help to understand variability in performance and disparities in the mechanism. The systems would be amended based on these studies to establish combination specific performance standards for typical Indian conditions. Maintenance strategy and optimization of design will help to foster the technology. The development strategy should give due consideration to the contributions of other countries so as to avoid repetition of work which will save time, money and efforts, and help for the real acceptance of RZTS in Indian conditions.

Release of oral submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft--a new technique.

Long standing oral submucous fibrosis is associated with involvement of the oral submucosa and the muscles of mastication leading to difficulty in mouth opening. Various surgical modalities are mentioned for release but each has its own limitations. This article introduces a new technique of release of submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft. The surgical technique involves a pre-auricular incision extending into the temporal region with dissection carried out in the sub follicular plane to develop the superficial temporal fascia flap to its maximum extent. The masseter muscle origin is released from the zygomatic arch and the temporalis muscle insertion is released from the coronoid process through an external approach. The entire fibrosed mucosa is released intraorally to create a mucomuscular defect thus achieving full mouth opening. The superficial temporal fascia flap is then brought in and sutured to the intraoral defect, which is then covered with a split thickness skin graft. This procedure is performed bilaterally. A total of five patients were treated with this new technique and all of them showed good mouth opening in long term follow up. There was no donor site morbidity. The incision line is well hidden in the hair bearing area. A well vascularised superficial temporal fascia flap brings in good blood supply to the area of affected muscle and mucosa to improve its function.