Design Development of Portable (Mini) Multi-function Incinerator for Dry Medical Waste Handling.

Abstract Medical waste contains biohazard, such as dry medical waste from the Centre of Public Health Services (PUSKESMAS) should be burning out, especially in the pandemic of covid 19. One of the possible solution is burning the waste by using incinerator. Basic concept of incinerator is controlled high temperature combustion, thus it should be perfect condition to burnt out the hazardous waste. Heat energy that exposed while incinerator operated should having high potency to be used for other purposes such as water heater and carbonization process. This research aims to develop an incinerator which can be used not only as high temperature burner (as incinerator’s main function), but also for water heater system and carbonization process, in the same time. The incinerator designed as mini portable incinerator since it will be used in a center of public health services (PUSKESMAS). Both of hot water and charcoal produced while incinerator operation can be used for sanitation purposes in the PUSKESMAS itself. Combustion process temperatures, smoke quality, safety factor, and energy utilities are the parameters which were determined as incinerator performance. Some design improvement has been done to the original design by Pradipta and Agustina [1] in order to improve the incinerator performance. The latest design performance is showing that combustion temperature successfully increased up to 980 °C for combustion rate of 9 kg waste/hour. Utilization of heat energy produced by combustion process inside the chamber has been successfully produce 2-2,5 kg of good quality coconut shell charcoal and hot water of 83 °C at 6 lt/minute flow rate.</jats:p

Caustic ingestion in children: is endoscopy always indicated? The results of an Italian multicente observational study. (I.F.7.367)

Background: The ingestion of caustic substances can represent a serious medical problem in children. Objective: Whether or not an urgent endoscopy should be performed is still a matter of debate, particularly in asymptomatic patients. Design: We conducted a multicenter observational study to investigate the predictive value of signs and symptoms in detecting severe esophageal lesions. Setting and Patients: The records of 162 children who presented with accidental caustic substance ingestion were analyzed. Interventions: Signs and symptoms were divided into minor (oral and/or oropharyngeal lesions and vomiting) and major (dyspnea, dysphagia, drooling, and hematemesis). An endoscopy was performed in all patients within 12 to 24 hours of the substance being ingested. Main Outcome Measurements: The types of substance ingested, signs and symptoms, age, sex, and severity of esophageal injury were correlated. Results: Mild esophageal lesions were identified in 143 of 162 patients (88.3%), and severe (third degree) esophageal lesions in 19 patients (11.7%). The risk of severe esophageal lesions without signs and/or symptoms was very low (odds ratio [OR] 0.13 [95% CI, 0.02-0.62], P Z.002). Indeed, the presence of 3 or more symptoms is an important predictor of severe esophageal lesions (OR 11.97 [95% CI, 3.49-42.04], P Z.0001). Multivariate analysis showed that the presence of symptoms is the most significant predictor of severe esophageal lesions (OR 2.3 [95% CI, 1.57-3.38], P Z.001). Conclusions: The results demonstrated that the incidence of patients with third-degree lesions without any early symptoms and/or signs is very low, and an endoscopy could be avoided. The risk of severe damage increases proportionally with the number of signs and symptoms, and an endoscopy is always mandatory in symptomatic patients. (Gastrointest Endosc 2008;68:434-9.