[ estimation of water consumption, waste water generation and its biodegradability per capita based on social income and meteorological temperature in Kermanshah]

The aim of this study is to investigate water consumption, domestic wastewater generation and organic matter concentration, based on both, economical income and meteorological temperature. The method of this study is descriptive and analytical. A checklist was used to collect data on economical income. Water consumption was obtained based on water bills. Wastewater generation and organic matter such as biochemical oxygen demand [BOD] per capita/ day were measured every four hours, during a day in three regions of Kermanshah city: Kasra, Ellaheiah and Taavon. Comparing water consumption in winter and summer showed significant difference in three regions, mentioned above. The water consumption was [398 +/- 75, 291 +/- 48 and 188 +/- 50] for warm climate and [200 +/- 25, 188 +/- 35 and 140 +/- 41] for three regions respectively in cold weather. In spite of an apparent difference in BOD in three regions, it was not significant statistically. Water consumption has strongly considerable relationship with economical income [r=0.988, P-value<0.001], while the generated wastewater in these regions were not different, statistically for warm climate [220 +/- 60, 204 +/- 15 and 170 +/- 34], and in cold weather [170 +/- 21, 158 +/- 31 and 112 +/- 29], also the generated wastewater did not have considerable difference in cold climate. This study confirms that, the effects of these two parameters, i.e.monthly economical income and environmental temperature on water consumption, generated wastewater and biodegradable organic loading per capita/day is considerable. It was concluded that water consumption and wastewater generations were much more in warm climate than in cold weather. Finally through this study the estimation of water consumption, wastewater generation and BOD concentration becomes possible, which is beneficial for establishment of water consumption

In-hospital course of early invasive strategy in acute coronary syndromes

Unstable angina is emerging as a major public health problem worldwide. Two approaches - an early invasive strategy or a conservative strategy - are used of the management of non-ST elevation acute coronary syndrome [MSTE-ACS]. An early invasive strategy involves the use of early coronary angiography and revascularization with percutaneous coronary intervention [PCI] or coronary artery bypass graft surgery [CABG]. A conservative strategy involves initial treatment with aggressive pharmacologic treatment, and coronary angiography with revascularization is used if there is evidence of spontaneous or provoked ischemia within the hospital stay. Two hundred sixty-one patients coronary syndrome were enrolled in this study for early invasive strategy. Patients received aspirin, heparin, clopidogrel, and lipid-lowering therapy. The primary endpoint was a composite of death, non-fatal myocardial infarction, cerebrivascular accident, and recurrent chest pain. Angiograms were assessed qualitatively by two expert invasive cardiologists. Sixty-seven percent of the patients underwent percutaneous [33%] or surgical [34%] revascularization. The overall death rate was 1.1%. In-hospital major adverse cardiac event [MACE] rate was 3.2% in the revascularization groups. According to the favorable in-hospital course in patients referred for PCI or CABG, it seems that accurate selection of patients who may be candidates for early invasive strategies is of paramount importance. We found that diabetes, cardiac enzyme elevations [Troponin T], ST/T changes, and the presence of two or more risk factors besides diabetes are powerful predictors of the patients who will undergo revascularization. Proper selection of patients admitted with ACS for invasive strategy is warranted. Positive cardiac enzymes [Troponin T], diabetes mellitus, and presence of two or more major CAD risk factors are helpful for patient selection

Ventilator-associated pneumonia among ICU patients receiving mechanical ventilation and prophylaxis of gastrointestinal bleeding

Pneumonia in ventilated intensive care unit [ICU] patients is one of the most serious nosocomial infections with a frequently fatal outcome. Retrograde colonization of the oropharynx from the stomach by micro-aspiration of gastric fluid was shown to be associated with pneumonia. The purpose of the present study was to compare the frequency of ventilator-associated pneumonia [VAP] between two groups of ICU patients taking gastrointestinal bleeding prophylaxis including ranitidine or omeprazole. This double-blind randomized clinical trial was achieved on 129 subjects receiving at least 48 hours mechanical ventilation. They were assigned in 2 groups of ranitidine and omeprazole as the prophylactic regimen of stress-related gastrointestinal bleeding. In ranitidine group, 6 patients [9.7%] developed VAP compared to 8 subjects [13.1%] in the other group, however, chi square analysis failed to show a significant difference [P=0.4]. The incidence of VAP in ICU patients receiving either ranitidine or omeprazole did not differ significantly, however, further studies with greater sample size are required to draw a firm decision

Atorvastatin effect on activity disease of ankylosing spondylitis

In addition to changing the fat metabolism, Statins may also possess anti-inflammatory properties. The aim of the present study was to assess the effect of Atorvastatin on controlling the activity of Ankylosing Spondylitis [AS] in the out-patients who had active disease and referred to Imam Hossein Hospital in Tehran, between 2007-2008. At a before and after experimental study, 20 patients with active AS were treated with Atorvastatin [20 mg/day] for 12 weeks. At the beginning and the end of the study, plasma concentrations of ESR, CRP, total cholesterol, triglyceride, HDL, LDL and the following clinical measures, BASDAI, BASFI, patient global assessment, spinal pain, morning stiffness, BASMI, chest expansion, modified schober test and occiput to wall distant were determined and their changes were statistically analyzed. The clinical measures, BASDAI [p < 0.001], pain score [p < 0.006], morning stiffness [p < 0.003], modified schober test [p < 0.04], patient global assessment of disease activity [p < 0.05] and BASMI [p < 0.04] improved after treatment with Atorvastatin. 45% of patients had ASAS-20 improvement criteria.Treatment with Atorvastatin in patients with active AS despite previous medication can lead to significant improvement in patients' symptoms and reduction of disease activity. As this study doesn't have a following period after stopping Atorvastatin; supplementary studies are proposed with following period after stopping Atorvastatin in patients with active AS