Cardio-Protective Effects of Multiport Antegrade Cold Blood Cardioplegia Versus Antegrade Cold Blood Cardioplegia in Patients With Left Ventricular Systolic Dysfunction Undergoing Conventional Coronary Artery Bypass Grafting.

Introduction The aim of this study was to compare the in-hospital outcomes of multiport antegrade cold blood cardioplegia through vein grafts versus conventional antegrade cold blood cardioplegia in patients with left ventricle systolic dysfunction who underwent coronary artery bypass grafting (CABG). Methods This prospective, randomized clinical study was comprised of patients undergoing on-pump CABG at the Ch. Pervaiz Elahi Institute of Cardiology in Multan, Pakistan from November 18, 2018 to December 17, 2019. Patients with multivessel coronary artery disease and left ventricular systolic dysfunction (ejection fraction < 50%) were included. In Group A (N = 73), multiport antegrade cold blood vein graft cardioplegia was given after every distal anastomosis completed for myocardial preservation. In Group B (N = 73), conventional antegrade cold blood cardioplegia was given for myocardial preservation. Results Spontaneous rhythm (without defibrillation applied) after cross-clamp removal was higher in Group A than in Group B (93.3% vs. 85.2%, p < 0.05). Duration of support, ventilation time, and hospital stay were also significantly lower in Group A than in Group B with p = 0.00001, p = 0.03, and p = 0.002, respectively. Intra-aortic balloon pump insertion (4.1% vs. 23.0%, p = 0.02) and operative mortality (0.5% vs. 4.0%, p = 0.35) were also lower in Group A than in Group B. Postoperative left ventricular ejection fraction (LVEF) increased more in Group A than in Group B, and the postoperative LVEF mean value was 44.68% in Group A versus 41.26% in Group B (p = 0.02). Conclusion Multiport vein graft blood cardioplegia provides superior myocardial protection in patients with left ventricular systolic dysfunction who underwent CABG. It is also easy to administer, so this technique can be adopted as a routine method for myocardial protection in patients with left ventricular dysfunction planned for on-pump CABG.

Facile Synthesis of Cauliflower Leaves Biochar at Low Temperature in the Air Atmosphere for Cu(II) and Pb(II) Removal from Water.

In this study, a facile and low-cost method for biochar (CLB) preparation from vegetable waste (cauliflower leaves) was developed at a low temperature (120 °C) in the air atmosphere. The prepared mechanism, adsorption mechanism, and performance of CLB for Cu(II) and Pb(II) sorption were investigated using Scanning electron microscopy- energy dispersive X-ray spectroscopy(SEM-EDS), X-ray diffraction(XRD), Fourier transform infrared spectroscopy(FTIR), and a series of sorption experiments. Then the CLB was subjected to single and double element sorption studies to examine the effect of pH value on the Cu(II)/Pb(II) sorption capacities and then competitive sorption priority. There are both more hydroxyl (-OH) and carboxyl (-COOH) functional groups on the surface of CLB compared to those from control (without H3PO4 impregnation), resulting in more ion exchanges and complexation reaction for CLB with Cu(II) and Pb(II). Besides, the phosphorus-containing groups (e.g., P = OOH, P = O.), which newly formed with H3PO4 impregnation, could also enhance sorption, especially for Pb(II), this way leaded to its adsorption and precipitation as Pb5(PO4)3OH crystals. The performance of maximum adsorption capacities of CLB toward Cu(II) and Pb(II) were 81.43 and 224.60 mg/g, respectively. This sorption was slightly pH-dependent, except that the sorption capacity improved significantly as the pH value of the solution increased from 2 to 4. Competitive sorption experiment confirmed that Pb(II) had a higher sorption priority than Cu(II).

Highly effective removal of Pb2+ in aqueous solution by Na-X zeolite derived from coal gangue.

The present study aimed to synthesize Na-X zeolite from coal gangue powder (CGP) via the alkali fusion hydrothermal method. The optimal synthetic conditions were investigated, the mass ratio of CGP/NaOH(s) was 1:1.25, and crystallization reaction time was 12 h. X-ray powder diffraction, scanning electron microscopy energy-dispersive X-ray spectrum, and Fourier transform infrared spectrometer techniques were used to test the properties of resultant zeolite product, which was highly identical to that of commercial zeolite. The efficiencies of the synthetic zeolite for Pb2+ adsorption were analyzed on factors including solution pH, adsorbent dosage, temperature, and contact time. Compared with the pseudo-first-order, Elovich, Freundlich, and Temkin models, the pseudo-second-order and Langmuir models were fitted more satisfactorily with the dynamic data and adsorption equilibrium data, respectively. The maximum Pb2+ adsorption capacity of synthetic zeolite (457 mg/g) could be reached when the pH, contact time, temperature, and initial Pb2+ concentration was 6, 40 min, 45 °C, and 200 mg/L. The adsorption capacity was higher than many of the natural and synthetic zeolites reported in previous literature.

Early outcome of coronary artery bypass grafting in patients with unstable angina.

BACKGROUND: Unstable angina is a common cause of admission to hospitals. There is conflicting evidence on the need and success of urgent coronary revascularization in such cases. This study was conducted to evaluate the early post-operative morbidity and mortality of Coronary Artery Bypass Grafting (CABG) in patients with unstable angina. METHODS: This cross sectional descriptive study was conducted at Choudry Pervaiz Elahi Institute of Cardiology, Multan. The data of the all the patients who had undergone CABG for unstable angina, between February 2009 and March 2010, was collected and analysed. RESULTS: Total 35 patients of unstable angina had undergone CABG (M=29, F=6). Mean age was 58.25±9.62. Sixty five percent of the patients were from New York Heart Association (NYHA) class-IV. Regarding pre-operative risk factors, 35% had diabetes mellitus (DM), 22% had previous Myocardial infarction (MI), 3% had pulmonary Hypertension, 3% had uncontrolled hyperlipidemia, 40% had positive history of smoking, 17% had positive family history of IHD and 82% had triple vessel disease. None of the patients died. Mild ionotropic support was required in 48% of the patients. Two patients had acute confusional state; none of the patients had stroke or renal failure requiring dialysis. However 4 patients had disturbed renal profile. Pulmonary complications occurred in one patient. CONCLUSION: Coronary artery bypass surgery in patients with unstable angina has comparable morbidity and mortality in our setup and should be performed where indicated