Blood Donation Facts - Is the US Blood Supply in Jeopardy?

In recent decades, many operations that once required a blood transfusion using donated blood are now being performed without the use of blood products. In many of these cases, the patients receiving the operation voluntarily elect not to have a transfusion. These patients instead opt for alternative medical procedures, commonly referred to as bloodless surgery.

Patients' reasons for seeking alternatives to blood transfusions vary. Some have strict religious beliefs that do not allow for a transfusion; Jehovah's Witnesses are the most well known group of people who do not receive transfusions for these reasons. Others prefer a bloodless approach to surgery because they are concerned with the risks associated with receiving a blood transfusion with donor blood.

The rise of HIV and AIDS awareness in the mid to late 1980s is partially responsible for patient concerns with the safety of receiving donor blood. In the US, blood used in a transfusion comes from blood banks located throughout the country. According to the U.S. National Blood Data Resource Center, more than 15 million units of blood are donated every year. This volume of donated blood comes from more than eight million blood donors.

U.S. institutions collecting donor blood have strict donation requirements. Potential donors who have recently traveled abroad, received a piercing or tattoo, have certain medical conditions, or have been exposed to sexually transmitted diseases are just a few examples of people who might not qualify to donate blood. In fact, the complete list of health conditions, medications, lifestyle and travel habits that are screened during the blood donation process is exhaustive.

Yet, even with strict screenings, evaluations and testing procedures, there still are patients in the US who contract serious infectious diseases from donor blood received during a transfusion. There are documented cases of patients contracting HIV, Hepatitis (B and C) and West Nile Virus from contaminated blood.

In addition to the danger of virus and disease, the US blood supply may be at risk in other areas. Because of the strict blood donation requirements necessary to obtain the safest possible blood, shortages are not uncommon. This happens often for patients who require a rare blood type. However, even patients with common blood types (such as O and A positive) can encounter blood shortages. In many cases, the availability of a particular type of blood depends more on when and where the patient needs it rather than what blood type is needed.

Although these and other risks are present in the US blood supply, this by no means indicates that blood transfusions are "unsafe." While some patients prefer transfusion alternatives, such as bloodless surgery, the fact remains that millions of blood transfusions are successfully performed every day, and that these transfusions improve the health and survival of the transfusion recipient.

Ventilation Perfusion Abnormalities

Ventilation of unperfused alveoli leads to increase in dead space. Perfusion of unventilated alveoli results in the addition of unoxygenated blood to pulmonary venous blood. Taking effective minute ventilation to be 4 litres and pulmonary blood flow to be 5 litres, the normal ventilation perfusion ration is 0.8. Several conditions lead to imbalance in ventilation.

1. Normal variations

The upper parts of the lungs receive less blood than the bases, the hydrostatic pressure of the blood being higher at the base. Though the perfusion is unequal is the different portions of the lung, ventilation is more or les uniform with only minor differences.

2. Obstruction to pulmonary blood flow

Pulmonary blood flow is obstructed in pulmonary embolism, vascular changes due to chronic inflammation, destructive lesions of the lung, pulmonary hypertension and vasoconstriction due to hypoxia. Since carbondioxide is 20 times more easily diffusible than oxygen, the ventilation perfusion imbalances lead to hypoxia, but not to hypercapnia, except in the advanced cases.

Gas exchange by diffusion across the alveolar membrane

The alveolar membrane is 0.2 to 0.7 micrometer and it consists of a single layer of cells lining the alveoli, a thin basement membrane and the endothelial cells of the capillary. The alveolar capillaries contain mixed venous blood with carbondioxide and low oxygen tensions. Oxygen passes into the capillary and carbondioxide passes into the alveoli within a few milliseconds, when the alveolar membrane is thickened, gas exchanged is impaired. Diffusion of oxygen is affected early and, therefore, hypoxemia occurs first. Retention of Carbondioxide occurs only when the lesion is advanced. Several factors such as the tructures of the abnormalities affect diffusion capacity to a great extent. Hence the term "transfer factor" is used instead of diffusion capacity.

Blood Gases

Both oxygen and carbondioxide are carried by blood. Diffusion across the alveolar membrane depends upon the partial pressure of these gases on either side, of the diffusing capacity of these gases. Since carbondioxide is much more readily diffusible than oxygen, the level of carbondioxide in blood closely follows the partial pressure of carbondioxide in alveolar air. The pattern of oxygen dissociation curve of hemoglobin is such that partial pressure of oxygen in arterial blood does not fall significantly even when the partial pressure of oxygen in the alveoli falls from 100millimeters Mercury to 80 millimeter Mercury. But when the alveolar Oxygen falls below 80 millimeters Mercury, arterial Oxygen falls steeply. The arterial Oxygen concentration does not closely follow the alveolar oxygen concentration due to this phenomenon. Oxygen is carried by blood mainly in combination with hemoglobin (1.34ml/g of Hb) and a small quantity as the dissolved form (0.003ml/100 ml blood/mm Hg of oxygen tension). The oxygen content in blood can be expressed either as the percentage saturation or the partial pressure. Arterial carbondioxide level is expressed in terms of its partial pressure. Alveolar gas concentrations are expressed in terms of their partial pressures.

Normal blood gas values

Arterial oxygen concentration (95-98)%; Partial pressure of arterial oxygen (80-100 mm Hg [11-14KPa]); Partial pressure of arterial carbondioxide (35-45 mm Hg [4.5-6.0KPa]).

Pulmonary mechanics- Work of breathing:

The total work involved in moving the thoracic cage, expanding the lungs and moving the gases in and out is known as the work of breathing.

Pulmonary compliance:

The elastic property of the lung is expressed in terms of pulmonary compliance. It is the distensibility of the lung per unit change in intrapleural pressure. Normal pulmonary compliance is about 0.2L per cm of water. In conditions like emphysema where there is loss of elastic tissue, lung is more distensible and in conditions like pulmonary fibrosis and pulmonary edema compliance is diminished.

Airway resistance:

About 90% of resistance to flow of air is contributed by the larger air passages and 10% by smaller airways. Airway resistance is expressed as H2O/liter/second. Resistance to air flow offered by the air passages depends upon several factors like the caliber of the passage, driving pressure, rate of flow, type of flow (laminar or turbulent), density of the gas, and its viscosity. Airway resistance is calculated from values for atmospheric and alveolar pressures and the rate of air flow.

Airway resistance = atmospheric pressure - alveolar pressure

Rate of flow

In general, airway resistance is measured at a flow rate of 0.5 litres/sec. In normal, during quiet breathing the airflow resistance varies between 1.5 to 3cm water/litre sec. It reaches, high values (above 10cm of water/litres/sec) in obstructive airway disease.

1. The lung volumes: Several parameters are used to determine the ventilatory capacity of the lung.

• Tidal Volume (VT) is the volume of gas inspired or expired during each respiratory cycle. Normally it is 0.5 liters.

• Inspiratory reserve volume (IRV) is the maximal volume of gas that can be inspired from the end of tidal inspiration. Normal value is 2 liters..

• Expiratory reserve volume (ERV) is the maximal volume of gas that can be expired from the end of tidal expiration. Normal value is 1.3 liters.

• Residual Volume (RV) is the volume of gas still remaining in the lungs after maximal expiration. Normal value is 1.6 liters.

2. The Lung Capacities

Total lung capacity (TLC) is the volume of gas contained in the lung at the end of maximal inspiration. Normal value is 5.4 liters.

Vital Capacity (VC) is the maximal volume of gas that can be expelled from the lung by forceful effort after maximal inspiration. In health, vital capacity is influenced by factors such as age, sex, position, body frame and state of physical conditioning. Average normal value is 3.8 liters.

Inspiratory Capacity (IC) is the maximal volume of gas that can be inspired from the resting expiratory level. Normal value is 2.5 liters.

Functional residual capacity (FRC) is the volume of gas remaining in the lung at the end of tidal expiration. Normal value is 2.9 liters.

Forced expiratory volume in one second (FEV1) [timed vital capacity]: The volume of air expelled in the first one second of a forcible expiration following a full inspiration is called forced expiratory volume in one second (FEV1). Normally FEV1 is above 75% of the total vital capacity, FEV2 is above 85%, and FEV3 is above 95%. Airways obstruction is indicated by FEV1 below 70% of normal.

Forced expiratory time (FET) is the total time taken for completing a forced expiration. Normally it is less than 4s.

Peak expiratory flow rate (PEFR) is the maximum rate than can be sustained during the first 10 millisecs, of a sudden forced expiration after a full inspiration. The PEFR depends up on the height and surface area of the individual. Nomogras are available for reference.

Maximal expiratory flow rate (MEFR): This is the flow rate at a specified portion of a forced expiration after a maximal inspiration, e.g MEFR 300-1300 denoted flow rates for 1 liter of expired gas after the first 300 ml has been breathed out.

Maximal inspiratory flow rate (MIFR) This is the flow rate at a specified portion of a forced inspiration.

Maximal mid-expiratory flow rate (MMFR): This is the velocity of air expressed as liters per second during the middle third of the total expired volume. It is also denoted as forced expiratory flow (FEF 25-75%). In normal the values vary with age and height of the individuals. Average values lie between 1.5 and 5.5 liters/sec in men. Determination of MMFR helps in detecting borderline cases of airways obstruction.

Maximal voluntary ventilation (MVV), or maximal breathing capacity is the total volume of air breathes by a subject using maximum effort over a period of 1 min.

Air velocity index (AVI): The ratio of the percentage of predicted MVV to the percentage of the predicted vital capacity is called air velocity index. The normal range is from 0.8 to 1.2.

Diffusing capacity: This is the volume of a gas transported across the alveolo-capillary membrane in 1 min for one unit of pressure gradient. It is expressed as ml/min/mm of Hg difference in partial pressure.

Closing capacity: During inspiration the air centers different portions of the lung in a definite order. The upper portions fill first and then the middle and lower parts in order. During expiration air escapes in the reverse order, the basal portions emptying first and the apical regions being the last. As a result, the smaller airways at the bases start to close even while air from apices is escaping. The volume of air contained in the lungs at the point where the airways first start to close is called closing capacity.

Closing Volume (CV): The difference between the closing capacity and the residual volume is termed closing volume. This is often expressed as a percentage of the vital capacity. In normal subjects below 40 years it is less than 20%. The CV increases with age. In many cases increase in closing volume may be the only detectable abnormality in impending airway obstructions.

Assessment of Pulmonary function:

Different aspects of respiratory functions can be subjected to investigational study, these include:

1. Gas transport down the airways,

2. Gas mixing within alveoli

3. Gas transfer across the alveolocapillary membrane, and

4. Lung perfusion.

Entry of air down the airways and its return can be measured using static and dynamic spirometry. Body plethysmography is employed to measure lung compliance and airways resistance. FEV1 and VC which are the most important parameters to assess the ventilatory capacity, are estimated by spirometry.

Peak expiratory flow rate:

It is measured using Wright's peak flow meter. This is an easy and convenient method to assess airways obstruction. Other methods to assess PEFR employ the peak flow gauge and the De Bono Whistle, Distribution of inspired air in different parts of the lungs is studied by single breath oxygen test.

General Considerations of the Respiratory System

The main function of the respiratory organs is to provide a constant supply of oxygen to the tissues and to remove carbondioxide from them through the lungs. Ultimately this gas exchange occurs between the alveolar air and mixed venous blood in the capillaries across the alveolo-capillary membrane.

The alveolocapillary membrane has a total area of 75 meter square in an adult. Air is taken in through the air passages comprising the nose, pharynx, larynx, trachea, bronchi, and the bronchioles. The terminal portions of the air passages- the respiratory bronchioles and alveolar ducts- sub-serve the function of gas exchange. The part above the vocal cords is termed the upper respiratory tract and the parts below are called the lower respiratory tract.

The trachea which is 11cm long is kept permanently open by the presence of C-shaped cartilages on its wall. Several mucous glands present in the mucous membrane provide mucus which moistens the surface and takes part in ciliary action. The trachea divides into the right and left bronchi. The bronchi are similar to the trachea in structure. The right main bronchus is 1-2.5cm in length and it is in direct line with the trachea. This fact makes it more vulnerable for obstruction by foreign bodies entering through the trachea. The right main bronchus divides into branches which supply the right upper lobe, middle lobe, and lower lobe. The left main bronchus is longer (5cm) and it forms an angle of 50-100 degrees with the right main bronchus. It divides into two branches which supply the upper and lower lobes. Further division of the lobar bronchi gives rise to segmental bronchi which supply bronchopulmonary segments.

Bronchopulmonary segments
The bronchopulmonary segment is a wedge of lung tissue supplied by each segmental bronchus along with the corresponding branches of the pulmonary artery and vein. The bronchopulmonary segments act as independent units and are separated by fibrous septa.

Divisions of the bronchial tree:
After 8-13 successive divisions the segmental bronchi break up into the smallest bronchi. They continue further as bronchioles. The bronchioles have no cartilage and mucous glands on their walls. The bronchioles divide further and the terminal bronchioles divide further and the terminal bronchioles are formed after the fourth division. The terminal bronchioles give rise to respiratory bronchioles. Alveoli begin to appear on the walls of the respiratory bronchioles. As the respiratory bronchioles divide further, the number of alveoli arising from them progressively increases. Normal adult lung contains about 300 million alveoli. Rapid division of the respiratory bronchioles results in enormous increase in surface area. The terminal portions of the respiratory bronchioles divide into alveolar ducts and sacs. Alveoli sacs. Alveoli are 0.1-0.2mm in diameter. Up to the respiratory bronchioles the airways only conduct air passively, but beyond this they, also take part in gaseous exchange. The part supplied by a single terminal bronchiole is called an "acinus". An alveolar duct with its distal connections is called a "primary lobule". A group of primary lobules separated by connective tissue septa form a "secondary lobule".

Pores of Kohn and Canals of Lembert:
Pores of Kohn are openings connecting alveoli, which allow communication between them and sometimes even between adjacent segments. Canals of Lembert are short communications lines by epithelium which exist between distal bronchioles and some of the neighboring alveoli. These take part in collateral ventilation between different regions of the lung.

The Lining of the trachea, bronchi, and bronchioles consists of ciliated columnar epithelium containing goblet cells. The respiratory bronchioles are lined by non-ciliated cuboidal epithelium. The lining epithelium of the alveoli is flattened and it comprises of two types of cells- type I and type II pneumonocytes-arranged on a basement membrane. Type I pneumonocytes are numerous and they cover most of the inner surface of the alveoli. Gas exchange occurs mainly across these cells. Type II pneumonocytes are smaller in number. They contain lamelleated osmiophilic inclusion bodies which are thought to be of lysosomal nature. Surfactant is produced or stored in them.

Secretions of the airways and ciliary action:
Mucus is secreted by the mucous glands and goblet cells. Mucous glands are seen all along from the trachea to the smallest bronchi. They are most numerous in the medium-sized bronchi and are absent from bronchioles. In the bronchioles there are only a few goblet cells. Vagus is secretomotor for the mucous glands. The goblet cells respond to direct irritation. The mucous contains acid and neutral polysaccharides mainly, and variable quantities of sodium, potassium, albumin, globulin, specific antibodies, lysozyme and transferring. In addition to its antibacterial action, the mucus provides a milieu for the cilia to function. Ciliary action helps in removing particulate matter. Each cell contains about 200 cilia, each being 6-7 micrometer long. By successive rhythmic movement, they produce a wave motion passing regularly from cell to cell. As optimum amount of mucus of the correct thickness (5 micrometer) and optimum viscosity is essential for proper ciliary function. Drying up of tracheal secretions, increase in thickness, and viscosity of the mucous layer, inhalation of irritants, excessive intake of alcohol and certain drugs like cocaine impair ciliary function and predispose infection of the respiratory tract. Ciliary function is impaired in inherited disorders such as Kartagener's syndrome.

Surfactant
This is a substance produced by type II pneumonocytes from the 30th week of intrauterine life. It lines the alveoli. It contains an insoluble lipoprotein (dipalmitoyl lecithin) which forms a thin layer at the air-fluid interface and lowers surface tension. Surfactant prevents the alveoli from collapsing by reducing surface tension within the alveoli. Absence of surfactant results in the collapse of small alveoli during expiration and hyperinflation of the larger alveoli during inspiration. In addition, increase in surface tension leads to transudation of fluid from capillaries into the alveoli. Absence of surfactant leads to the formation of hyaline membrane disease in the newborn and adult respiratory distress syndrome in adults. Impairment of pulmonary blood flow and prolonged administration of dry oxygen or air leads to reduction in surfactant.

The Pleura:
The Lung is covered by visceral pleura on its surface and the thoracic cavity is lined by the parietal pleura. The space between them contains 10-20 ml of serous fluid having a protein content of 1.77g/dl. Pleural cavity is only a potential space. During inspiration the lung fills the pleural space. The pleural space is under negative pressure so that the lung is kept in apposition with the parietal pleura. At the end of a quiet expiration the pleural pressure is about 5cm of water. The pressure inside the pleural cavity is not uniform throughout. The negative pressure is higher at the apices than at the bases. The pleural fluid is formed at the parietal pleura and absorbed at the visceral pleura.

What We Should Know About the Physiology of the Pulmonary System

Gas exchange between the blood and the alveoli is brought about by different processes which include:
• Ventilation of the alveoli;
• Mixing of inspired air and alveoli air and
• Diffusion of gases across the alveolar membrane.

Under resting conditions, 5 litres of blood perfuse the pulmonary capillaries, and 6 litres of air enter and leave the lungs every minute. 250-300ml of oxygen is taken by the pulmonary capillary blood to the tissues and 200-250ml of carbondioxide is left out into the alveolar air. With exercise these values go up considerably.

The nervous control of breathing
Respiration is controlled by the respiratory centre situated in the medulla and pons. The respiratory centre consists of inspiratory center, expiratory center and pneumotaxic enter which control the rhythm, depth, and rate of respiration. Principal muscles of respiration are the diaphragm and intercostals muscles. When there is demand for increasing the ventilation, the accessory muscles of respiration come into play.

Chemical control of breathing
Rise in carbon-dioxide tension in the arterial blood is the strongest direct stimulus to the respiratory centre to increase ventilation. Next in importance is hypoxia. Hypoxia stimulates the chemoreceptors of the carotid and aortic bodies attached to external carotid artery and ascending aorta respectively. A fall in pH stimulates breathing directly by its action on the respiratory center.

Cheyne-Stokes breathing
In this type of abnormal rhythm of respiration, there is increase in the rate and depth of respiration, which reach a maximum and then they come down to reach a period of apnea. These cycles repeat. Cheyne-Stokes respiration is indicative of serious functional impairment of the respiratory centre. It is seen in Cardiac failure, metabolic acidosis, increased intracranial tension, narcotic poisoning, and sometimes even during sleep.

Biot's breathing
This is a type of irregular breathing in which 3-4 respirations occur in clusters with apneic pauses. The respiration resembles sighs. This is commonly seen in meningitis and brain damage.

Gas exchange in the alveoli

Air in the conducting airways is functionally inert and its volume is called the "anatomical dead space". Functionally effective ventilation that the alveoli receive is called "alveolar ventilation". When the alveoli are not perfused with blood, ventilation becomes ineffective. Ventilation occurring in alveoli which are not properly perfused with blood is called "dead space ventilation". Gas exchange in the alveoli is adversely affected by uneven ventilation, uneven perfusion or defective diffusion.

Causes of alveolar hypoventilation
• Obstructive airway disease which produces uneven distribution of ventilation.
• Thoracic deformities and neuromuscular disease like myasthenia and poliomyelitis.
• Conditions causing central respiratory failure
• Reduction in functional lung volume as in atelectasis, fibrosis etc.

Hyperventilation
This occurs commonly in major pulmonary embolism, anxiety, neurocirculatory asthenia, meningitis, encephalitis, therapy with drugs like epinephrine, poisoning with salicylates of aspirin, hyperthyroidism, hypoxia, and acidosis. Hyperventilation results in excessive removal of Carbondioxide and consequent alkalosis.

Implementation of Safety Programs for Safe Handling of Hazardous Drugs

Innumerable reports have exposed the destructive affects of exposures to hazardous drugs to the healthcare workers indulged in all sorts of drug related activities. All the work places where drug activities are carried out are found to be contaminated by the noxious chemicals used for the manufacture of drugs. From the urine tests of various workers, it has become clear that they have significant amounts of these noxious chemicals in their body. These chemicals can induce various health disorders. Hence, safe handling of hazardous drugs is very essential to prevent these workers. All the healthcare workers and other professionals of the healthcare organizations must actively participate in controlling the exposures to perilous drugs. This article is all about the numerous safety guidelines and measures that should be implemented in all the workplaces for the safe handling of perilous drugs.

There are numerous workers that are engaged in drug development industries and other pharmaceutical manufacturing industries. These workers could be the victim of aerosols, vapors and harmful emissions that are produced during the different stages of the drug development procedures. There are various chances of exposure to these toxic emissions through the dermal contact. These exposures can also affect through the contaminated food stuffs and other food products.

Numerous safe handling guidelines have been formulated by different healthcare units. The workers and other employers must follow all these safety guidelines to prevent the surroundings from getting contaminated. Precautionary measures should be properly implemented for the safe handling of hazardous drugs. Safety devices such as personal protective equipments, biological cabinets and closed system drug transfer devices must be used for reducing the risks of exposures.

Strict adherence to all the safety guidelines and proper implementation of all the safety measures can minimize the risks of exposures to hazardous drugs to a maximum extent.

Cures For Yeast Infections in Women - Causes and the Ultimate Prevention

Yeast infection affects most women of any age and for varied reasons and causes, this is one of the most common vaginal disease women suffers. Though, yeast infection may not be a very critical disease in its nature, it causes serious discomfort, itching and restlessness in the person. It will be a very good idea, to get it treated as soon as one noticed that she has acquired this slow but harmful infection. A qualified medical professional should be contacted after you should have try home remedy which most time is very effective.

These yeast infections also exist in other forms such as mouth thrush which changes the color of the mouth and cause white substances to be deposited on the tongue and the mouth too. Another kind of yeast infection is the Esophagitisare, this makes swallowing to be very painful. Other forms cause rashes and itching on the surface of the skin. There is one form which stay in the blood stream and this seems to be much feared because any illness in the blood system can be poisonous and deadly too to the body system.

The signs and symptoms of these kinds of candidiasis may not be comfortable or pleasing to the sufferer. Most times there may be pains, irritation, and burning sensation, itching in the vagina, swelling of the vagina's vulva and offensive odor from the vagina too. There may be discharge from the vagina if the yeast infection has stayed long untreated; this discharge can be whitish or yellowish in color. The discharge is use by the medical professional to diagnose the type of yeast infection the patient, is having so that proper treatment can be administered.

Treating yeast infection properly is important in order to cure this illness. A qualified medical professional should be consulted and the prescribed treatment should be taken as directed by the physician. The anti-fungal drugs may be given by the medical expert which will destroy the organisms which are fungus in nature but it must be noted that the fungus is very stubborn in nature and tends to return after treatment, when the patient goes back to the initial condition before the treatment, so care must taken as to guard against the reoccur of the yeast infections by properly disinfecting any material used prior to the treatment and abstaining from contact with any infected person again.

After the treatment, you should reduce your antibiotics intake because they decrease your pH value making it to be more acidic thereby encouraging the growth the yeast organisms. A high personal hygiene should be maintained too as the fungi thrive in dirty and moist environment. Abstinence from sugar or foods with high sugar content is a must as to discourage the increase of the fungus too. You should eat a lot of fruits and vegetables and keep your underwear clean and wear cotton materials, not silk that allows the free flow of air within your system. More books and literatures about the Yeast infections and Candida Albicans should be read so as to know how to stay protected from this infection. The treatment should be continued for one week after the symptoms have completely disappeared as to prevent a relapse of the infection.

Pharmaceutical Plants Focusing More on Waste-Treatment

Pharmaceutical manufacturing is the most important part of pharmaceutical engineering. The manufacturing process undergoes numerous steps for the manufacturing of common as well as crucial diseases. The manufacturing process starts from the identification of appropriate raw drug materials and ends with the conversion of these raw materials into important medicines. Waste management is mandatory for all the pharmaceutical manufacturing plants as there are great chances for the production of various waste materials including liquid and solid wastes. There are various chances of hazardous air emissions during each step of the drug manufacture.

To protect all the workers engaged in different steps of drug manufacture from being exposed to the hazardous air emissions, various Environmental Assessment (EA) programs are highly efficient. This EA program mainly includes the study of various biodegradable, chemical and physical aspects of several noxious drug byproducts. This program mainly takes into account the parent drugs. Numerous tests based on the photolysis process and aqueous toxicity is also done by this program. The Pharmaceutical engineers mainly focus on the waste treatment and management to provide a secure and reliable working environment.

Numerous reports have been published by several drug development industries for the entire knowledge on the characteristics of the wastes and their byproducts. The main components of the drug pollutants are the particulate matters. Volatile organic compounds also form a major part of it. When all the equipments used in the drug manufacturing industries are cleaned, various highly noxious aqueous exhausts are produced.

Finding the substitutes for the fatal drug ingredients is one of the major areas of concern for all the pharmaceutical engineers. Thus, we can say that pharmaceutical engineering is one of the most important branches that have contributed a lot to the medical world for the betterment of the mankind.