Synthesis and analgesic activity of some novel 2-substituted 1,3,4-thiadiazolo

An ecofriendly synthesis for 1,2,3,4,5,6,8-octahydro- 3-amino-2-thioxo-benzothieno[2,3-d]pyrimidin-4-one (7A, B) has been developed. A series of hitherto unreported compounds (2a-i, 3a-c) have been synthesized by treating 3-Amino-2-mercaptopyrimidinones (7A, B) with one carbon donors like chloroacetyl chloride or chloroacetic acid and subsequently replacing the chloro group by various nucleophiles. Compound 2f was successfully synthesized by an alternate route. All the new compounds were characterized by elemental and spectral analyses. They were screened for analgesic activity in mice. Compounds 2a, b, 3a, b, and 2e, showed very good activity.     

Systolic time intervals in anemic children with or without congestive heart failure

Systolic time intervals (STI) were measured from simultaneous high speed recordings of electrocardiogram, phonocardiogram, and carotid artery trace in 47 children of anemia with or without congestive heart failure (CHF), and in 20 healthy normal children. Group I comprised 20 healthy controls with a mean Hb level of 13.65±0.73 gm percent, group II of 37 anemic children with a mean Hb level of 7.3±1.01 gm percent, without any evidence of CHF: Group III of 10 severely anaemic children with a mean Hb level of 2.75±0.82 gm percent with overt CHF. Electromechanical systole (QS2) pre-ejection period (PEP), left ventricular ejection time (LVET) and the ratio of PEP/LVET were studied and compared in various groups. PEP/LVET ratio was found to be 0.265±0.04, 0.363±0.07 and 0.407±0.06 in groups I, II, III cases respectively. The mean PEP/LVET ratio was significantly prolonged in groups II and III when compared with group I (p<.001). Further mean PEP/LVET ratio was significantly greater in group III subjects when compared with group II patients (p<.001). Thus it seems that LV dysfunction sets in early in cases of anemic children and as the severity of anemia increases. left ventricular dysfunction proportionately increases, ultimately resulting in congestive heart failure.     

Calculus anuria in a 20 months old child

Calculus obstruction of the solitary kidney presenting as anuria in small children is unusual. We record the youngest such patient reported in the literature with a congenital single kidney.     

Perceived barriers to medical-error reporting: an exploratory investigation

Medical-error reporting is an essential component for patient safety enhancement. Unfortunately, medical errors are largely underreported across healthcare institutions. This problem can be attributed to different factors and barriers present at organizational and individual levels that ultimately prevent individuals from generating the report. This study explored the factors that affect medical-error reporting among physicians and nurses at a large academic medical center located in the midwest United States. A nominal group session was conducted to identify the most relevant factors that act as barriers for error reporting. These factors were then used to design a questionnaire that explored the likelihood of the factors to act as barriers and their likelihood to be modified. Using these two parameters, the results were analyzed and combined into a Factor Relevance Matrix. The matrix identifies the factors for which immediate actions should be undertaken to improve medical-error reporting (immediate action factors). It also identifies factors that require long-term strategies (long-term strategy factors) as well as factors that the organization should be aware of but that are of lower priority (awareness factors). The strategies outlined in this study may assist healthcare organizations in improving medical-error reporting, as part of the efforts toward patient-safety enhancement. Although factors affecting medical-error reporting may vary between different organizations, the process used in identifying the factors and the Factor Relevance Matrix developed in this study are easily adaptable to any organizational setting.     

Ultrasonography and fluoroscopic fusion for prostate brachytherapy dosimetry

: To investigate the feasibility of performing postimplant and intraoperative dosimetry for prostate brachytherapy by fusing transrectal ultrasound (TRUS) and fluoroscopic data.

: Registration of ultrasound (prostate boundary) and fluoroscopic (seed) data requires spatial markers that are detectable by both imaging modalities. In this study, the needle tips were considered as such fiducials. Prostate phantoms were implanted with the seeds, and four localization needles were inserted. In the TRUS frame of reference, the longitudinal coordinate of the needle tip was determined by advancing the needle until the echo from its tip just registered at a known probe depth. The tip’s transverse coordinates were determined from the associated TRUS slice. The three-dimensional needle tip positions were also calculated in the fluoroscopic coordinate system using a seed reconstruction method. The transformation between the TRUS and fluoroscopy coordinate systems was established by the least-squares solution using the singular value decomposition.

: With three of four needle tips as fiducials and the one remaining needle as a test target, the mean fiducial registration error was 0.8 mm and the test target registration error was 2.5 mm. When all four points were used for registration, the errors decreased to 1.1 mm. A comparison between the proposed method and CT-based dosimetry yielded a percentage of prostate volume receiving 100% and 150% of the prescribed minimal peripheral dose and minimal dose received by 90% of the prostate gland that agreed within 0.4%, 2.7%, and 4.2%, respectively.

: The combination of TRUS and fluoroscopy is a feasible alternative to the currently used CT-based postimplant dosimetry. Furthermore, because of online imaging capability, the method lends itself to real-time intraoperative applications.     

Smokeless tobacco impairs the antioxidant defense in liver, lung, and kidney of rats.

The present study was designed to evaluate the effects of long-term use of aqueous extract of gutkha (a form of smokeless tobacco) on the antioxidant defense status and histopathological changes in liver, lung, and kidney of male Wistar rats. Animals were orally administered aqueous extract of smokeless tobacco (AEST) at a low dose (96 mg/kg body weight per day) for 2 and 32 weeks, and at a high dose (960 mg/kg body weight per day) for 2 weeks. High-dose AEST for 2 weeks decreased the hepatic glutathione (GSH) and glutathione peroxidase (GPx), and increased lipid peroxidation (Lpx) by 17%, 19%, and 20%, respectively. Low-dose AEST for 32 weeks significantly decreased (p < 0.05) the antioxidant status in these organs. In liver, AEST decreased GSH levels and the activities of superoxide dismutase (SOD), catalase (CAT), and GPx by 34.6%, 29%, 17.1%, and 17.4%, respectively, but it increased Lpx by 64%. In kidney, GSH, SOD, CAT, and GPx were decreased by 26.6%, 23%, 33%, and 18%, respectively, with an increase of Lpx by 65%. AEST decreased the lung GSH, SOD, CAT, and GPx, and increased lung Lpx by 43%, 28.5%, 37%, 40%, and 24%, respectively. However, no change in the plasma levels of vitamins A, C, and E were observed with AEST treatment. Histopathological findings suggest that administration of AEST at the high dose for 2 weeks or at the low dose for 32 weeks could cause mild to moderate inflammation in liver and lungs. In conclusion, a decrease in the antioxidant defense system and long-term inflammation caused by smokeless tobacco may be risk factors for gutkha-induced pathogenesis.     

Ideal ward round making in neurosurgical practice

The success of a perfect ward round lies in the role of the consultant leading the 'round making group' (RMG) as well as the hallmark of effective questioning and participation of each member. Twelve senior consultants with more than 10 years' experience in neurosurgical practice at three different university hospitals were observed during round making by a participant observer. Observations were made on the group climate of the RMG, the leadership pattern and language expressed by the clinician conducting the round and the effectiveness in his performance as a leader during clinical discussions. The group climate showed evidence of good productivity and flexibility with 92% and 75% consultants, pleasantness of climate was above average with only 50% (6/12) and poor objectivity with 42% (5/12) consultants. Forty two percent of the consultants were not always very well comprehensible, while only 50% (6/12) spoke exactly fitting the occasion. Only 33% (4/12) of the consultants used humour effectively, while 42% (5/12) spoke unnecessarily in between discussion and were poor in introducing the problems of patient to the round making group. Ward round making in neurosurgical practice needs a holistic approach with motivation, planning, leadership skills and structured curriculum to fulfill its objectives.     

Human sperm immobilization effect of Carica papaya seed extracts： an in vitro study

AIM: To examine if the seed extracts of Carica papaya, which showed antispermatogenic/sperm immobilization properties in animal models, could cause human sperm immobilization in vitro. METHODS: Chloroform extract, benzene chromatographic fraction of the chloroform extract, its methanol and ethyl acetate sub-fractions and the isolated compounds from the sub-fractions i.e., ECP 1 & 2 and MCP 1 &2, of the seeds of Carica papaya were used at concentrations of 0.1%, 0.5%, 1% and 2%. Sperm motility was assessed immediately after addition of extracts and every 5 minutes thereafter for 30 minutes. RESULTS: There were dose-dependent spermicidal effects showing an instant fall in the sperm motility to less than 20% at 2% concentration. Isolated compounds ECP 1 & 2 were more effective inducing a motility of less than 10%. Many of the spermatozoa became vibratory on the spot. Total inhibition of motility was observed within 20-25 min at all concentrations of all products. Scanning and transmission electron microscopy revealed deleterious changes in the plasma membrane of the head and mid-piece of spermatozoa. Sperm viability test and the number of abnormal spermatozoa after completion of incubation suggested that the spermatozoa were infertile. The effects were spermicidal but not spermiostatic as revealed by the sperm revival test. CONCLUSION: The results reveal spermicidal activity in vitro of the seed extracts of Carica papaya.