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Zaheer Amin Virani ¹, Amol Bhagat ¹, Satish Gaitonde ², Prashant Rajput ¹, Prashant Rao ³, Bharat Shah ⁴

Affiliations
1 Institute of Renal Sciences, Global Hospitals, Mumbai, IN
2 Department of Radiology, Global Hospitals, Mumbai, IN
3 Department of Surgery, Global Hospitals, Mumbai, IN
4 Director of Nephrology, Institute of Renal Sciences, Global Hospitals, Mumbai, IN

Abstract

No Abstract.

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Zaheer Amin Virani ¹, Amol Bhagat ¹, Satish Gaitonde ², Prashant Rajput ¹, Prashant Rao ³, Bharat Shah ¹

Affiliations
1 Institute of Renal Sciences, Global Hospitals Mumbai, IN
2 Department of Radiology, Global Hospitals Mumbai, IN
3 Department of Surgery, Global Hospitals, Mumbai, IN

Abstract

A 29 year-old man with history of living donor renal transplant in 2004 (donor mother), new onset diabetes post-transplant, chronic allograft nephropathy and type 1 renal tubular acidosis was admitted with bilateral loin pain and backache. On the basis of the Chest X-ray (CXR) Emphysematous Cholecystitis (E.C) was suspected and an Abdominal CT was done. He was started on antibiotics and underwent laparoscopic cholecystectomy. Postoperatively he developed biliary leak requiring ERCP and laparoscopic peritoneal lavage. He was discharged 11 days later on oral antibiotics. We report a case of E.C a relatively rare and virulent variant of A.C in a post renal transplant patient who presented with insidious symptoms and never developed the classical symptoms of Acute Cholecystitis (A.C). There was no right upper quadrant pain, nausea or vomiting. He was diagnosed accidentally on a CXR and early initiation of antibiotics and surgical intervention prevented morbidity and mortality. His imaging and histopathology showed all the classical features of E.C.

Keywords

Emphysematous Cholecystitis, Living Donor Renal Transplant, Acute Cholecystitis, Chronic Follicular Cholecystitis.

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Hitesh Patel ¹, Jhanvi Patel ¹, Bhavana Raval ¹, Bharat Shah ¹

Affiliations
1 B.J.Medical College, Ahmedabad, Gujarat, IN

Abstract

Airway management of an adult patient with palatal defect is a challenging case to Anesthesiologist. We report an adult patient who is an operated case of nasopharyngeal Angiofibroma posted for palatal defect (3.5*4.5 cm) repair. It was a major surgery lasted for 10 hours involving free flap from radial aspect of forearm along with radial artery and repositioning on palatal defect and anastomosis with facial artery. Challenges involved in this case management were airway, analgesia and fluid electrolytes . Intraoperative period was uneventful. Patient was electively shifted to ICU for prophylactic ventilatory support with ETTube in situ post procedure because it being a major surgery with compromised airway with poor pharyngeal reflexes, copious secretions, bite block. Patient was postoperatively managed with adequate analgesia, sedation and relaxation and was extubated on 3rd postoperative day. The details would be discussed later.

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Kinjal Patel ¹, Bharat Shah ¹

Affiliations
1 L.D.College of Engineering, Ahmedabad 05, IN

Abstract

The common indicators of economic welfare, such as national product and income have reflected the growth of the industry as a major indicator for the development of the nation. But the other angle of industrialization has been the serious damage to the surrounding environment so there is keen need of “Cleaner Production” to sustain against waste from industries and pollution. In this paper Cleaner Production(CP) methodology for a dye intermediate Pamino azo benzene 4-sulfonic acid(PAAB4SA) is described. The literature review on cleaner production tools is described. The paper discussed reactor design and simulation of it in the production of PAAB4SA. This modified design is cost saving and it also gives cleaner and easy operation. The paper describe COD reduction options for the case study of dye intermediate sulfotobias acid. Different methods are evaluated and compared to give cost effective method of COD reduction for the process. Experiments were performed for Sulfotobias acid with Advance oxidation process(AOP) of fenton reagent and adsorption using low cost adsorbent neem leaves powder. The detail process and experimental data are discussed in the paper.

Keywords

Advance Oxidation Process(AOP),Cleaner Production, COD Reduction, Fenton Process, Dye Intermediate, Reactor Design, Reactor Simulation.

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