Background/Aims: Antituberculosis drug-induced liver injury (TB DILI) is a frequent medical problem in Pakistan. Critical understanding of various aspects of TB DILI is not only important to manage liver injury but may also prevent unnecessary discontinuation of antituberculosis treatment. The study is aimed to determine the frequency, types, severity and patterns of TB DILI. Study further evaluates various risk factors of TB DILI. Materials and Methods: This is a prospective cohort study of two seventy-eight patients with the diagnosis of tuberculosis, where patients were followed during tuberculosis treatment. TB DILI was defined in accordance to international DILI expert working group. Results: Out of two seventy eight-patients, ninety-five (34.14%) had TB DILI. The most common pattern of TB DILI was hepatocellular (63.15%) followed by mixed (23.15%) and Cholestatic (13.68%). Most of the patients had mild DILI (43.15%) followed by moderate (30.52%), severe (20.01%) and very severe (5.26%). Age > 35 years, concomitant hepatotoxic drugs, extrapulmonary TB and malnutrition are important risk factors for TB DILI. Conclusion: All patterns of TB DILI with varying severity were present. Age > 35 years, malnutrition, extrapulmonary TB and concomitant use of hepatotoxic drugs were risk factors for TB DILI.
Polymer-laminated metals are widely used in the packaging industries due to their flexibility of applications, superior properties, and relatively lower cost. Despite the advantages accomplished by the polymer-metal multilayer packaging materials, the recycling is a very difficult task due to the complexities of multimaterial intrinsic behaviors during the processing of cast-off materials. This study represents an innovative and sustainable way of recycling polymerlaminated aluminum packaging (PLAP) materials (postconsumer food packaging) into high-quality aluminum and a potential source of high-energy hydrocarbon gases and particulate carbon coproducts. Both sides of the aluminum foil of the packaging were laminated by two different polymers (polyethylene terephthalate, and polypropylene). Volatiles from the PLAP materials were eliminated by the thermal disengagement technology at 400-650 °C (5-30 min) with and without an inert gas supply. The volatiles evaporated from the PLAP materials were about 32%, and the rest 68% were aluminum (~ 65%) and carbon (~ 3%) from the decomposition of the polymers. The oxidation behavior of the surface of the recycled aluminum was studied by XRD, XPS, and elementary mapping, and a nanoscale oxidized surface was found in both inert and air atmospheric TD. The purity of the aluminum was measured above 98% by two different methods (LIBS and ICP-MS). The gaseous products released in TD were detected as high energy-carrying hydrocarbon, CO 2 , CO, H 2 , H 2 O, and few other gases observed by real-time monitoring. The clean gases released in TD might be utilized upon reforming into CH 4 or H 2 by further processing or as it turns out might be utilized as a source of heat energy for other applications. Carbon found from the decomposition of the hydrocarbons can be another useful element of this study. This recycling process offers an economically and environmentally feasible recycling strategy for a complex multilayer polymer-metal packaging waste.
Malaysia is a country that has recorded a phenomenal economic development success story. One of the most important problems is solid waste due to inadequate management practices. This resulted in an increase in the amount of waste generated. The national average in at 0.5-0.8 kg/person/day, but in the cities the figures have escalated to 1.7 kg/person/day. This paper addresses the current practice of solid waste management and its disposal in Malaysia. Currently, the waste management approach being employed is landfill, but due to rapid development and lack of space for new landfills, Malaysian states are switching to incineration. The conclusion of this paper is that the earlier practice of solid waste management in Malaysia is not clearly documented and this conclusion can be confirmed by the word of Malaysia Prime Minister once he said that the Ministry of Housing and Local government must study any policy or legislation which could help enhance the practice. On the other hand, it appears that the current policy and system are more resulting from reacting to the problem of increasing waste, in particular in urban areas, and less from taking a practical stand in respect of tackling the problem at its root. Setting clear guidelines about the objectives of waste management and adopting certain principles would allow for such a practical stand. Above all, there should be a target on what to achieve before any program is set up.
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