Foreign body ingestion is one of the most frequently encountered cases in otorhinolaryngology and most of the cases can be managed non-operatively. If left untreated, migration of foreign bodies can occur and presents a significant challenge in patient management. We hereby describe the case of an elderly gentleman who had a preceding history of fish bone ingestion and complained of dysphagia for two days. Clinical examination revealed swelling of the right vallecula with minimal pus discharge. Computed tomography (CT) of the neck confirmed the diagnosis of a migratory foreign body in the neck. He underwent open neck exploration and foreign body removal under intraoperative fluoroscopy guidance. A high index of suspicion of a migratory foreign body is warranted in cases of persistent, unresolved symptoms with the failure of endoscopic evaluation to detect the foreign body. Migratory foreign body of the neck may cause life-threatening complications and requires early surgical intervention.
The recurrence of nasopharyngeal carcinoma (NPC) is either at the local primary site or at regional or distant metastases. However, an axillary metastasis is a rare entity in NPC. We highlighted a case of recurrent NPC that presented with axillary swelling as the main initial complaint. Clinical examinations showed enlarged left axillary lymph nodes and left cervical lymph nodes. Histopathological examination of the axillary lymph node biopsy confirmed the recurrence of NPC. The patient underwent palliative chemotherapy in view of the advanced stage of recurrent disease. A thorough clinical history and examination during surveillance are crucial for early diagnosis and better survival outcomes.
In this study, the performance of a laboratory scale upflow anaerobic sludge blanket (UASB) reactor operating at mesophilic temperature (35 °C) was examined. Cattle slaughterhouse wastewater (CSWW) was used as the main substrate. The total and effective volumes of the reactor were 8 L and 6 L, respectively. Twelve different organic loading rates (OLR) were applied and the performance was evaluated. The chemical oxygen demand (COD) removal efficiency was more than 90% during batch study. In the continuous study, COD removal was also approximately 90% at OLR 0.4 g/L d-1 which subsequently dropped to below 50% when the loading rate increased to 15 g/L d-1. Approximately 5 L/d of biogas was obtained with high methane concentration at stages VI and XI corresponding to OLR of 2 and 10 g/L d-1, respectively. It was observed that the concentration of volatile fatty acids was low and that the alkalinity of the wastewater was sufficient to avoid acidification. Specific methane yields of 0.36 and 0.38 LCH₄/g COD added were achieved at OLR 7 and 10 g/L d-1. A hydraulic retention time (HRT) of 1 day was sufficient to remove greater than 70% of COD which correspond to 89% methane concentration. Parameters like soluble COD, NH₃-N, pH, alkalinity, total suspended solid (TSS), fats, oil, and grease were also investigated. The results show that the UASB reactor could serve as a good alternative for anaerobic treatment of CSWW and methane production.
Cattle slaughterhouses generate wastewater that is rich in organic contaminant and nutrients, which is considered as high strength wastewater with a high potential for energy recovery. Work was undertaken to evaluate the efficiency of the 12 L laboratory scale conventional and a modified upflow anaerobic sludge blanket (UASB) reactors (conventional, R1 and modified, R2), for treatment of cattle slaughterhouse wastewater (CSWW) under mesophilic condition (35 ± 1 °C). Both reactors were acclimated with synthetic wastewater for 30 days, then continuous study with real CSWW proceeds. The reactors were subjected to the same loading condition of OLR, starting from 1.75, 3, 5 10, 14, and 16 g L-1d-1, corresponding to 3.5, 6, 10, 20, 28, and 32 g COD/L at constant hydraulic retention time (HRT) of 24 h. The performance of the R1 reactor drastically dropped at OLR 10 g L-1d-1, and this significantly affected the subsequent stages. The steady-state performance of the R2 reactor under the same loading condition as the R1 reactor revealed a high COD removal efficiency of 94% and biogas and methane productions were 27 L/d and 89%. The SMP was 0.21 LCH4/gCOD added, whereas the NH3-N alkalinity ratio stood at 651 mg/L and 0.2. SEM showed that the R2 reactor was dominated by Methanosarcina bacterial species, while the R1 reactor revealed a disturb sludge with insufficient microbial biomass.
Lack of good management practice of chicken slaughterhouse wastewater (CSWW) has caused pollution into water bodies. In this study, the potential of seed sludge acclimatised modified synthetic wastewater (MSWW) on bioreactor performance and energy recovery of CSWW treatment was investigated. Two sets of upflow anaerobic sludge blanket (UASB) reactors were employed. The seed sludge in UASB 2 was acclimatised with MSWW for 30 days. In UASB 1, no acclimatisation process was undertaken on seed sludge for control purposes. After the acclimatisation process of UASB 2, both reactors were supplied with CSWW under the same condition of organic loading rate (OLR = 0.5 to 6 gCOD/L/d) and mesophilic condition (37 °C). COD removal efficiencies of UASB 2 were >80% all through the steady-state of the OLR applied. Meanwhile, a drastic decrease in overall performance was observed in UASB 1 when the OLR was increased to 3, 4, 5, and 6 gCOD/L/d. Energy recovery from laboratory scale and projected value from commercial-scale bioreactor were 0.056 kWh and 790.49 kWh per day, respectively. Preliminary design of an on-site commercial-scale anaerobic reactor was proposed at a capacity of 60 m3.