Background: Fibromyalgia (FM) is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by diffuse pain, many patients with FM were reported to have dizziness which is attributed to hypotension and the autonomic nervous system (ANS) dysfunction. Aim: To improve management of patients with fibromyalgia having dizziness. Objective: to assess peripheral vestibular functions in patients with fibromyalgia. Subjects and Methods: After obtaining approval from the Ethics Committee of the Suez Canal University Hospital (registration number:3646) and written informed patient consent, a Cross-sectional study was conducted at Suez Canal University hospital from June 2018 to December 2019 in the Audio-Vestibular Clinic of the E.N.T department, including 30 female subjects whose age ranged from 22 to 50 years and were divided into Study group that comprised patients diagnosed with fibromyalgia and Control group rather healthy individuals. The vestibular assessment was done using pure tone audiometry, Bedside tests, and video-nystagmography (VNG). Results: There was no statistically significant difference between both groups regarding results of bedside examinations and VNG results as a caloric test (p-value = 0.6) however, there was a trend towards positive results and an increase in vestibular weakness in the fibromyalgia group compared to the control group. Conclusion: Fibromyalgia is unlikely to be a cause of peripheral vestibular dysfunction, so vestibular testing is not routinely recommended for such patients.

In areas without sewer collection infrastructure, decentralized treatment is regarded as being necessary to provide sewage management and sanitation. Organic matter can be degraded anaerobically with Up-flow Anaerobic Sludge Blanket (UASB) digesters resulting in biogas production that is used in a wide range of uses (i.e., for heating, electricity, and fuel). Under decentralized operations, traditional aerated wastewater treatment can be expensive and readily overloaded by high-strength effluent or changes in the environment's temperature. High-strength wastewater can be treated with UASB digesters, which can also produce biofuel and reduce the high costs of aeration. Operations can be stabilized and granule formation improved by adding supporting components such as microbial communities and biochar made from Phragmites Australis to the UASB. The first stage of this study statistically investigates the optimization of anaerobic treatment conditions of cattle wastewater in a batch study. In the second stage, continuous treatment processes will be planned using data obtained as a result of the batch study. The COD concentrations used in the present study ranged between 1850 mg/L to 2050 mg/L while the BOD concentrations range between 450 mg/L to 1250 mg/L. The effects of operating parameters on the chemical oxygen demand (COD) removal efficiency and the methane production rate were evaluated. COD removal efficiencies of 72.43% -92.70% were obtained for the cattle wastewater using a 3-14 d hydraulic retention time. The maximum COD removal was found in batch experiment 7, where the type of bacteria was actinobacteria, biochar dose was 20 g/L, pH was 7.5 and no inoculum dose was added this resulted in 92.70% COD removal efficiency. Hence, the batch study recommended using actinobacteria as a type of bacteria and Phragmites Australis biochar for continuous UASB reactors.