Metabolic risk factors in first acute coronary syndrome (MERIFACS) Study.

OBJECTIVES: In acute coronary syndrome (ACS) patients the focus is on major conventional risk factors - CRF [diabetes, hypertension, elevated low-density cholesterol (LDL-C) and smoking] whereas others - specific metabolic risk factors - MRF [high-density lipoprotein cholesterol (HDL-C), body-mass index (BMI), waist-hip ratio (WHR), and triglycerides, and HbA1c get less attention. METHODS: This is a prospective case-control observational study from 15 tertiary care hospitals in India. CRF and MRF in patients presenting with first incidence of ACS (n = 2153) were compared with matched controls (n = 1210). RESULTS: Propensity score matching (PSM) yielded 1193 cases and matched 1210 controls. Risk factor prevalence in cases vs. controls were CRF: hypertension - 39.4% vs 16.4% (p < 0.0001), diabetes - 42.6% vs 12.7% (p < 0.0001), smoking - 28.3% vs 9.3% (p < 0.0001) and elevated LDL-C - 70.2% vs 57.9% (p < 0.0001). MRF: High BMI - 54.7% vs 55.1% (p = 0.84), increased waist: hip ratio 79.5% vs 63.6% (p < 0.0001), high HbA1c - 37.8% vs 14.9% (p < 0.0001), low HDL-C - 56.2% vs 42.8% (p < 0.0001) and elevated triglycerides - 49.7% vs 44.2% (p = 0.007). Adjusted Odds ratios by multivariate analysis were CRF: hypertension - 2.3 (p < 0.001), diabetes - 4.7 (p < 0.001), high LDL-C - 3.3 (p < 0.001) and smoking- 6.3 (p < 0.001). MRF: High waist: hip ratio - 2.4 (p < 0.001) high HbA1c - 3.2 (p < 0.001), low HDL-C 2.2 (p < 0.001) and elevated triglycerides - 0.878 p = 0.17. CONCLUSION: In India, the risk of ACS conferred by specific metabolic risk factors (High waist: hip ratio, Low HDL-C and High HbA1c) is comparable to that caused by CRF.

Treatment of greywater using waste biomass derived activated carbons and integrated sand column.

Utilization of greywater can reduce water stress if, it is used as an alternative source of water for non-potable use, but it requires careful treatment to remove the contaminants including micropollutants associated with the use of a large number of personal care products. The present paper deals with the batch as well as continuous adsorption study for the treatment of greywater using activated carbons prepared from sawdust, sugarcane bagasse and pine needles. Characterization of adsorbents were done through sophisticated instruments such as FE-SEM, FTIR and BET. The optimum conditions in batch mode for the removal of contaminants are found as pH 7, contact time 240 min. and adsorbent dose 8 g/L with initial COD of greywater as 554 mg/L and BOD as 120 mg/L. For isotherms study, models such as Langmuir, Freundlich and Temkin were used whereas for kinetic study pseudo-first-order, pseudo-second-order and Elovich models were investigated to validate the experimental data. The column adsorption study has been performed to carry out breakthrough analysis of the column bed with respect to COD and BOD removal. To understand the behaviour of breakthrough curves three models viz. Bohart-Adams, Yoon-Nelson and Thomas models have been tested. Out of these adsorbents, the sawdust activated carbon is found to be more efficient. To maintain the concentration of pollutants in treated water below the permissible limit as per CPCB (Central pollution control board), India, a coupled unit of sand and the adsorbent column was investigated in continuous mode. The present investigation appears to be highly competitive to the published literature.

Isolated tubercular liver abscess in an elderly diabetic successfully treated with systemic antitubercular drugs.

Tubercular liver abscess is a rare extrapulmonary manifestation of tuberculosis. We are presenting a case of isolated tubercular liver abscess in a 70 year old diabetic male without any evidence of tuberculosis in the lungs or abdomen. Diagnosis was made on the basis of radiological findings along with PCR for Mycobacterium tuberculosis in pus aspirated from abscess under CT guidance. Systemic antitubercular drugs were given for 6 months. On follow up patient improved clinically with radiological evidence of resolution of abscess.