ABSTRACT
Antimicrobial stewardship programmes have been introduced worldwide in response to the rise in antimicrobial resistance. The World Health Organization has mandated each Member State to produce a plan to address this problem. We report on the organic development of an antibiotic stewardship programme in a rural regional hospital in a resource-limited setting in South Africa. This has resulted in organisational change with increased awareness, participation, monitoring and education in antibiotic stewardship throughout the hospital.
Subject(s)
Antimicrobial Stewardship/organization & administration , Hospitals, Rural , Antimicrobial Stewardship/statistics & numerical data , Humans , South AfricaABSTRACT
An infant presented with clinical signs and symptoms suggestive of a pyloric stenosis. On abdominal ultrasound, pyloric stenosis was excluded, and other causes for proximal duodenal obstruction, such as a duodenal web or annular pancreas, were suspected. At surgery, the cause was found to be due to an anterior portal vein or preduodenal portal vein, compressing the duodenum. There were no associated findings such as midgut malrotation, duodenal web and congenital anomalies. The treatment was a diamond-shaped duodeno-duodenostomy anterior to the portal vein. The patient improved after surgery.
Subject(s)
Duodenal Obstruction/congenital , Duodenal Obstruction/surgery , Portal Vein/abnormalities , Diagnosis, Differential , Female , Humans , InfantABSTRACT
This study investigated Fe(II) oxidation during acid mine drainage (AMD) neutralization using CaCO3 in a pilot-scale Sequencing Batch Reactor (SBR) of hydraulic retention time (HRT) of 90 min and sludge retention time (SRT) of 360 min in the presence of air. The removal kinetics of Fe(II), of initial concentration 1,033 ± 0 mg/L, from AMD through oxidation to Fe(III) was observed to depend on both pH and suspended solids, resulting in Fe(II) levels of 679 ± 32, 242 ± 64, 46 ± 16 and 28 ± 0 mg/L recorded after cycles 1, 2, 3 and 4 respectively, with complete Fe(II) oxidation only achieved after complete neutralization of AMD. Generally, it takes 30 min to completely oxidize Fe(II) during cycle 4, suggesting that further optimization of SBR operation based on both pH and suspended solids manipulation can result in significant reduction of the number of cycles required to achieve acceptable Fe(II) oxidation for removal as ferric hydroxide. Overall, complete removal of Fe(II) during AMD neutralization is attractive as it promotes recovery of better quality waste gypsum, key to downstream gypsum beneficiation for recovery of valuables, thereby enabling some treatment-cost recovery and prevention of environmental pollution from dumping of sludge into landfills.
Subject(s)
Bioreactors , Iron/chemistry , Waste Disposal, Fluid/methods , Calcium Carbonate/chemistry , Gold , Hydrogen-Ion Concentration , Industrial Waste , Kinetics , Mining , Oxidation-Reduction , Sewage , South AfricaABSTRACT
Batch regeneration of barium carbonate (BaCO(3)) from barium sulphide (BaS) slurries by passing CO(2) gas into a pilot-scale bubbling column reactor under ambient conditions was used to assess the technical feasibility of BaCO(3) recovery in the Alkali Barium Calcium (ABC) desalination process and its use for sulphate removal from high sulphate Acid Mine Drainage (AMD). The effect of key process parameters, such as BaS slurry concentration and CO(2) flow rate on the carbonation, as well as the extent of sulphate removal from AMD using the recovered BaCO(3) were investigated. It was observed that the carbonation reaction rate for BaCO(3) regeneration in a bubbling column reactor significantly increased with increase in carbon dioxide (CO(2)) flow rate whereas the BaS slurry content within the range 5-10% slurry content did not significantly affect the carbonation rate. The CO(2) flow rate also had an impact on the BaCO(3) morphology. The BaCO(3) recovered from the pilot-scale bubbling column reactor demonstrated effective sulphate removal ability during AMD treatment compared with commercial BaCO(3).
Subject(s)
Barium Compounds/chemistry , Barium/chemistry , Carbon Dioxide/chemistry , Carbonates/chemistry , Coal Mining , Industrial Waste , Sulfides/chemistry , Waste Disposal, Fluid/methods , Pilot Projects , Sulfates/chemistryABSTRACT
A patient presented with typical features of ankylosing spondylitis, as well as some of the biochemical abnormalities expected in this disease. In addition the patient had symptoms and signs of biventricular heart failure (dilated cardiomyopathy) with conduction defect. No valve lesions were demonstrated. A non-reducible head tilt, seldom described in ankylosing spondylitis, was also present. A short review of the possible mechanisms in the development of dilated cardiomyopathy in ankylosing spondylitis is given.
Subject(s)
Cardiomyopathy, Dilated/complications , Spondylitis, Ankylosing/complications , Electrocardiography , Humans , Male , Middle AgedABSTRACT
Cervical spine injuries are often overlooked in young children with multiple injuries while diagnostic accuracy is reduced by difficulties in clinical and radiological investigation. Misinterpretation of normal radiographic appearances of vertebrae at different stages of maturity may lead to diagnostic confusion and inappropriate treatment. Two case histories are presented to illustrate these difficulties and guidelines are suggested to help establish the nature and extent of such injuries in young children.