Optimization of electrocoagulation process for efficient removal of ciprofloxacin antibiotic using iron electrode; kinetic and isotherm studies of adsorption

TL;DR: In this paper, the authors focused on the removal of ciprofloxacin from hospital wastewater using electrocoagulation (EC) process by iron electrode and the kinetic and isotherms of adsorption were investigated.

About: This article is published in Journal of Molecular Liquids.The article was published on 2017-01-01 and is currently open access. It has received 130 citations till now. The article focuses on the topics: Adsorption & Langmuir adsorption model.

Summary

Introduction

• The diabetes pandemic will increase from 175 million patients with diabetes in 2000 to 353 million in 2030.
• According to the national coronary artery disease (CAD) risk factors surveillance report, the overall prevalence of diabetes in Iran is estimated to be 8.7% in adults aged 15-64 years, of whom half (4.1%) were the newly diagnosed cases.
• It is not clear how many are at pre-diabetes stage and are prone to suffer from diabetes, or vice versa, with timely interventions, the disease can be prevented.
• 5 Using fasting plasma glucose (FPG) ≥7.2 mmol/L the criteria for poor management of diabetes, about 57% of individuals with diagnosed diabetes had high level of plasma glucose.
• The authors reported the age-sex standardized prevalence of diabetes at all stages including pre-diabetes (pre DM) and diabetes (DM).

Methods

• The Kerman Coronary Artery Disease Risk Factors.
• Study is a population based cohort study with repeated surveys.
• The methodology of KERCADR study has been explained in detail elsewhere.
• Only those who were able and provided written informed consent were recruited into the study.
• The study protocol was approved by the Ethical committee of Kerman University of Medical Sciences, Iran (Permission No. 88/110KA).

Interview and measurements

• All details of the measurement are presented elsewhere.
• Part of the questionnaire that the authors used in this study included demographic information, cigarette smoking (yes/no), opium addiction (no/occasional/ dependent), the level of physical activity (low/moderate/ high), and the level of depression and anxiety (related BECK questionnaires).
• Subjects who had no previous history of diabetes or anti-diabetic medication, but turned out to have FPG ≥7 mmol/L at the recruitment were considered as undiagnosed diabetic cases.
• In the old definition, uncontrolled diabetes was specified as HbA1c >53 mmol/mol (>7%) for all individuals.
• The authors found that diabetes and susceptibility in to diabetes was very common in Kerman.

Laboratory measurements

• All participants were asked not to eat for 12-14 h before coming to the clinic.
• Subjects who had FPG more than 5.6 mmol/L were recalled for another FPG test and HbA1c test (NYCOCARD Kit, Code 1042184, Austria).
• To measure serum lipid profiles, total cholesterol (KIMIA Kit, Code 890303, Iran) and triglycerides (KIMIA Kit, Code 890201, Iran) were also measured for all individuals.

Statistical analysis

• All statistical analyses were conducted under survey data analysis using STATAv.12 (StataCorp, 2011 College Station, TX, USA).
• For age-sex direct standardizations, the authors used Kerman population reported in census 2006.
• All prevalence rates were weighted according to the sampling weight (reciprocal of the probability of selection) and individual response rate.
• The data were presented as absolute and relative frequencies as well as 95% confidence intervals (95% CI).
• Univariate and multivariate logistic regression models were applied to determine the predictors of diabetes (both diagnosed and undiagnosed DM).

Undiagnosed and diagnosed diabetes

• There was nearly an equal prevalence of undiagnosed-DM in subpopulations regarding depression and physical activity.
• The prevalence of DM was diagnosed in 7.0% of occasional opium users, while it was 4.0% among dependent users.
• Seven percent of overweight and 7.6% of obese people had diagnosed-DM.

Diabetes mismanagement: old definition

• The uncontrolled-DM increased from 60% in young adults to 77.8% in elderly people.
• The frequency of uncontrolled-DM among people without and with (both insulin and non-insulin) treatment was 57.9% and 92.9%, respectively.
• The frequency of uncontrolled-DM varied from 76.1% among non opium users to 81.3% in dependent opium users.
• People with low physical activity had a higher frequency of uncontrolled-DM (79.4%), which decreased to 66.7% in people with high level of physical activity.

Predictors of diabetes

• In crude analysis, sex (male vs female), age, education, opium addiction, depression, increased BMI category, lower physical activity, and DM familial history turned to be potential significant predictors for DM (Table 3 ).
• While in the multivariate model, after removing confounding effects, it was shown that the odds diabetes increased significantly only by age group (AOR 5.0 to 18.2), depression (AOR 1.2), overweight and obesity (AOR 1.6, and 1.5), moderate and low physical activity, (AOR 1.5, and 1.4) and the positive familial history of DM (AOR 2.2).
• The other variables did not have a statistically significant association with diabetes.

Diabetes-related co-morbidities

• The maximum prevalence of co-morbidities among patients with diagnosed DM were anxiety (87.5%), depression (57.9%) and overweight/obesity (47.1%); among people with undiagnosed DM, most frequent co-morbidities were again anxiety (73.2%) and overweight/obesity (55.6%) while hypercholesterolemia (54.3%) also become very common, too (Table 4 ).
• Among individuals with pre-diabetes, again anxiety (76.2%), overweight/obesity (50.5%) and hypercholesterolemia (35.4%) were the most frequent co-morbidities.

Discussion

• In their analysis, the authors found one out of four individuals living in an urban area in Iran either had impaired glucose level (pre-diabetes) or diabetes.
• In several studies, it has been reported that the prevalence of diabetes (diagnosed and undiagnosed), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) increased by age [13] [14] [15] is not similar between men and women.
• Regarding the effect of cigarette smoking and opium consumption, the results of this study showed almost no statistically significant effects on control of diabetes or odds ratio of predictors of diabetes (Tables 2,3 ).
• In rural areas, Iran has a well-developed primary health-care system, having Behvarz workers responsible for population-based prevention and control services.