Polyvascular Disease in Patients Presenting with Acute Coronary Syndrome: Its Predictors and Outcomes

We evaluated prevalence and clinical outcome of polyvascular disease (PolyVD) in patients presenting with acute coronary syndrome (ACS). Data for 7689 consecutive ACS patients were collected from the 2nd Gulf Registry of Acute Coronary Events between October 2008 and June 2009. Patients were divided into 2 groups (ACS with versus without PolyVD). All-cause mortality was assessed at 1 and 12 months. Patients with PolyVD were older and more likely to have cardiovascular risk factors. On presentation, those patients were more likely to have atypical angina, high resting heart rate, high Killip class, and GRACE risk scoring. They were less likely to receive evidence-based therapies. Diabetes mellitus, renal failure, and hypertension were independent predictors for presence of PolyVD. PolyVD was associated with worse in-hospital outcomes (except for major bleedings) and all-cause mortality even after adjusting for baseline covariates. Great efforts should be directed toward primary and secondary preventive measures

Extraction and Analysis of Carbamate and Pyrethroid Pesticides in Tomatoes and Rice by Gas Chromatography Mass Spectrometry

This work aimed to explore common methods for the extraction of pesticide and to perform qualitative and quantitative analysis by gas chromatography coupled with electron impact mass spectrometry (GC-EI-MS). Extraction was conducted using QuEChERS and Liquid-Liquid (L-L). Calibration curve and standard addition curve were both plotted for different concentration of mixtures. Additionally, the efficiency of the QuEChERS extraction methods was examined by spiking the organic rice and tomato with standard mixture of pyrethroid and carbamate and applying the extraction. Results showed that, in general, carbamate species (especially the aliphatic types) were eluted at earlier times compared to pyrethroids species. Carbamates were more susceptible to degradation during GC separation compared to pyrethroids. A chromatographic resolution of 3.24 was obtained for the two permethrin isomers. Good linearity of the three quantitative methods (R2 > 0.99) were obtained for most compounds. Based on using the standard addition curve, the recovery for the different pyrethroid and carbamate compounds were determined.qscienc

Non-Communicable Disease Risk Factors among Employees and Their Families of a Saudi University: An Epidemiological Study

Objectives:To assess the prevalence of non-communicable disease (NCD) risk factors among Saudi university employees and their families; to estimate the cardiovascular risk (CVR) amongst the study population in the following 10years. Methods:The NCD risk factors prevalence was estimated using a cross-sectional approach for a sample of employees and their families aged ≥ 18 years old, in a Saudi university (Riyadh in Kingdom of Saudi Arabia; KSA). WHO STEPwise standardized tools were used to estimate NCD risk factors and the Framingham Coronary Heart Risk Score calculator was used to calculate the CVR. Results:Five thousand and two hundred subjects were invited, of whom 4,500 participated in the study, providing a response rate of 87%. The mean age of participants was 39.3±13.4 years. The majority of participants reported low fruit/vegetables consumption (88%), and physically inactive (77%). More than two thirds of the cohort was found to be either overweight or obese (72%), where 36% were obese, and 59% had abdominal obesity. Of the total cohort, 22–37% were found to suffer from dyslipidaemia, 22% either diabetes or hypertension, with rather low reported current tobacco use (12%). One quarter of participants was estimated to have >10% risk to develop cardiovascular disease within the following 10-years. Conclusion:The prevalence of NCD risk factors was found to be substantially high among the university employees and their families in this study

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. Methods: This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). Results: Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19–15.76], p < 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79–3.73]; p < 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71–1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90–1.39], p = 0.312). Conclusions: PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function

Feasibility and Cost Optimization Study of Osmotic Assisted Reverse Osmosis Process for Brine Management

Due to the excessive demand to desalinate seawater to satisfy the domestic need in Qatar. This targeted the need to develop safe and cost effective desalination processes with the consideration of stringent regulation for water quality production and wastewater/brine discharge quality. The direct disposal of brines to the environment raised potential negative impact to the aquatic system and therefore the best practice is to minimize the volume of brine production and reuse it for beneficiary application. Several brine-dewatering techniques include both evaporative and non-evaporative approach are capable to dewater high salinity brines with 50-350 g/L of total dissolved solids (TDS). The commonly adopted technology for dewatering brine is mechanical vapor compression , that is known for its significant energy consumption up to 25 kWh/m3 of produced water for 50% of water recovery1. Non-evaporative membrane base technologies are a promising approach to dewater brines with minimum energy usage. Osmotically assisted reverse osmosis (OARO) is an advance membrane based technology for energy efficient and high recovery desalination of saline brine. OARO differ from reverse osmosis (RO) by adding saline sweep on permeate side to reduce osmotic pressure difference across the membrane to generate more water flux. The ongoing research work are based on mathematical/numerical approach that focuses on finding the optimum OARO configuration, inlet hydraulic pressure to avoid membrane burst and cost analysis. However, most of these studies conducted by considering ideal conditions. In this study, an algorithm for simulating OARO process based on MATLAB and Aspen Plus to model membrane calculation and to design process configuration considering the effect of concentration polarization (CP) and reverse solute flux (RSF). The objective is to study the effect of inlet feed concentration and flowrate, sweep concentration and flowrate, inlet hydraulic pressure, number of stages, membrane size and characteristic and module configuration flow. In addition, technical economic analysis to evaluate the economic feasibility of OARO process. The stopping criteria of this model is the quality of water permeate at the feasible operating conditions and the cost. This model demonstrated high potential simulating OARO process to be used as a palate form for the user to predict the behavior of the process by varying operating conditions to desired outcomes

Characteristics and predictors of out-of-hospital cardiac arrest in young adults hospitalized with acute coronary syndrome: A retrospective cohort study of 30,000 patients in the Gulf region.

IntroductionThe characteristics of young adults with out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome (ACS) has not been well described. The mean age of gulf citizens in ACS registries is 10-15 years younger than their western counterparts, which provided us with a unique opportunity to investigate the characteristics and predictors of OHCA in young adults presenting with ACS.MethodologyThis was a retrospective cohort study using data from 7 prospective ACS registries in the Gulf region. In brief, all registries included consecutive adults who were admitted with ACS. OHCA was defined as cardiac arrest upon presentation (i.e., before admission to the hospital). We described the characteristics of young adults (ResultsA total of 31,620 ACS patients were included in the study. There were 611 (1.93%) OHCA cases in the whole cohort [188/10,848 (1.73%) in young adults vs 423/20,772 (2.04%) in older adults, p = 0.06]. Young adults were predominantly males presenting with ST-elevation myocardial infarction (STEMI) [182/188 (96.8%) and 172/188 (91.49%), respectively]. OHCA was the sentinel event of coronary artery disease (CAD) in 70% of young adults. STEMI, male sex, and non-smoking status were found to be independent predictors of OHCA [OR = 5.862 (95% CI 2.623-13.096), OR: 4.515 (95% CI 1.085-18.786), and OR = 2.27 (95% CI 1.335-3.86), respectively].ConclusionWe observed a lower prevalence of OHCA in ACS patients in our region as compared to previous literature from other regions. Moreover, OHCA was the sentinel event of CAD in the majority of young adults, who were predominantly males with STEMIs. These findings should help risk-stratify patients with ACS and inform further research into the characteristics of OHCA in young adults