Efficacy of Glucose-Insulin-Potassium Infusion on Left Ventricular Performance in Type II Diabetic Patients Undergoing Elective Coronary Artery Bypass Graft.Dy

BACKGROUND: Glucose-insulin-potassium (GIK) may improve cardiovascular performance after coronary artery bypass graft surgery (CABG). Our study investigated whether an infusion of GIK during elective CABG surgery in type II diabetic patient improved left ventricular performance.    METHODS: We measured left ventricular ejection fraction and troponin (Tn), a myofibrillar structural protein. In this research, after ethics committee approval, 50 patients with type 2 diabetes mellitus (DM) were enrolled into a randomized simple sampling, prospective, double-blind clinical trial study. In the case group, 500 cc dextrose water 5% plus 80 IU regular insulin and 40 mEq KCL were infused at the rate of 30 cc/hr. Patients in control group received 5% dextrose solution at the rate of 30cc/hr. Venous blood samples were taken before induction of anesthesia, after removal of the aortic clamp and before discharging from hospital. The Mann-Whitney-test was used to test for differences in Tn concentration between the groups. Fisher’s exact test was used to determine whether there was a difference in the proportion of patients with a low ejection fraction (<45%) in the case group compared with that in the control group. Changes in potassium and glucose concentrations over time within the groups were examined by ANOVA and paired t-tests. P<0.05 was regarded as significant level for all tests.    RESULTS: In this study, 50 patients with type 2 DM were evaluated in case and control groups. The mean age ± SD in the case group was 57.7 ±9.9 years and in the other group was 61.2 ± 8.4 years. The groups were well-matched for age, sex and number of bypass grafts. Randomization did not give an equal distribution of male and female patients. There wasn’t any significant difference in ejection fraction between the case and control groups before and after CABG (P>0.05). Tn concentration in the case group was 3.3 ± 5.0 and in the control group was 3.9 ± 5.1. There was no significant difference in Tn between the two groups before and after CABG (P>0.05). There was not any significant difference in hospitalization time between the two groups.     CONCLUSION: The results suggested that GIK can’t improve left ventricular performance in routine CABG surgery.      Keywords: Cardiovascular surgery, Glucose-Insulin-Potassium, Cardiac troponin

High Loaded Synthetic Hazardous Wastewater Treatment Using Lab-Scale Submerged Ceramic Membrane Bioreactor

Submerged ceramic membrane bioreactors (SCMBRs) are more efficient combinations of traditional activated hazardous sludge and new membrane separation processes in wastewater treatment. Suspended solids are separated from hazardous effluent using microfilter ceramic membranes in SCMBRs. A high loaded wastewater was treated using an SCMBR employing a homemade tubular ceramic membrane in laboratory scale. Hydraulic Retention Time (HRT) was 32 h and COD range was varied from 2000 to 5000 mg/l. COD removal was evaluated to be more than 90% after a week and the lab scale SCMBR showed desired performance for the wastewater treatment. Mixed Liquor Suspended Solid (MLSS) was increased from 2000 to 4000 mg/L during the SCMBR operation time

Wastewaters treatment containing phenol and ammonium using aerobic submerged membrane bioreactor

Abstract Phenolic wastewater was treated using anaerobic submerged membrane bioreactor (ASMBR). Effect of different solids retention times on MBR performance was studied. Various ratios of carbon to nitrogen were used in the synthetic wastewaters. During the operation, phenol concentration of feed was changed from 100 to 1000 mg L−1. Phenol concentration was increased stepwise over the first 30 days and kept constant at 1000 mg L−1, thereafter. For the first 100 days, a chemical oxygen demand (COD) to N ratio of 100:5.0 was used and this resulted in phenol and COD removal more than 99 and 95%, respectively. However, the ammonium removal decreased from 95 to 40% by increasing the phenol concentration of feed, from 100 to 1000 mg L−1. For the last 25 days, a COD to N ratio of 100:2.1 was used due to the ammonium accumulation in the ASMBR. This led to the complete ammonium removal and no ammonium was detected in the ASMBR permeate. These results suggest that in the ASMBR at high phenol loading of 1000 mg L−1, COD to N ratio of the phenolic wastewater must be 100:2.1 for ammonium removal, while at low phenol loading, COD to N ratio of 100:5.0 can be used

First report on self-rated health in a nationally-representative sample of Iranian adolescents: the Caspian-iii study

Objective: To evaluate predictive factors of adolescents′ appraisal of their health. Methods: The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases (CASPIAN) study," was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self-rated health (SRH) and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. Results: 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH (β = 0.08, P value = 0.003). Smoking, violence, and family history of disease associated to SRH non-linearly (P value < 0.05). Family smoking (β = -0.01) and hygienic habits (β = 0.27) related to SRH both linearly and non-linearly. Conclusions: Physical health and high risk behavior, either of linear or non-linear effect, are factors, which seem to shape the adolescents′ perception of health