The quinazoline-2,4(1H,3H)-diones skeleton: A key intermediate in drug synthesis

Quinazoline-2,4(1H,3H)-dione is a major class of N-fused heterocyclic with a wide range of biological functions, including anti-HIV, anticancer, antifungal, antibacterial, antimutagenic, anticoccidial, anticonvulsant, anti-inflammatory, antidepressant, antimalarial, antioxidant, antileukemic, and antileishmanial activities, and other activities, has attracted high attention in organic and medicinal chemistry. As a consequence, all chemists and pharmaceutical chemists should be familiar with the various procedures for producing quinazoline-2,4(1H,3H)-dione. The main purpose of this paper is to provide an overview of the many manufacturing methods for various biological compounds based on the quinazoline-2,4(1H,3H)-dione and 2,4-dichloroquinazoline cores.     

The outcomes of central hepatectomy versus extended hepatectomy: a systematic review and meta-analysis

Background

Central hepatectomy (CH) is a relatively uncommon liver resection technique. It is generally perceived as a more complex operation than extended hepatectomies (EH), with potentially higher associated morbidity. The outcomes of CH compared with EH is not well defined and there is a need to reassess.

Hyperkalemia and Hypertension Post Organ Transplantation – A Management Challenge

Potassium is the most important intracellular cation and the kidneys play a pivotal role in potassium homeostasis. Potassium disorder is a common electrolyte abnormality and it increases the risk of death from any cause, particularly cardiovascular events. Hyperkalemia is a common electrolyte abnormality encountered post organ transplantation. The etiology is multifactorial, and includes drugs such as calcineurin inhibitors. In certain regards, the clinical picture of post-transplantation hyperkalemia and hypertension resembles that of Gordon syndrome or familial hyperkalemic hypertension, a disorder characterized by over activity of thiazide-sensitive sodium chloride cotransporter. Effective and safe management of chronic hyperkalemia can be challenging in this special patient population. Despite the significant short-term and long-term side effects, fludrocortisone (a potent synthetic oral mineralocorticoid receptor agonist) has emerged as the default drug of choice for treatment of refractory hyperkalemia in many organ transplant recipients. However, the long-term efficacy and safety of fludrocortisone for management of hyperkalemia in organ transplant recipients remains unknown. This review discusses potassium homeostasis, including the role of the kidneys, and focuses on calcineurin inhibitor-induced hyperkalemia and on the under-appreciated role of thiazide-type diuretic use in management of hyperkalemia and hypertension. We present an illustrative case of post-transplantation hyperkalemia and hypertension with relevant literature.     

Leadership Identity Development Through Reflection and Feedback in Team-Based Learning Medical Student Teams

Problem: Studies on leadership identity development through reflection with Team-Based Learning (TBL) in medical student education are rare. We assumed that reflection and feedback on the team leadership process would advance the progression through leadership identity development stages in medical students within the context of classes using TBL. Intervention: This study is a quasi-experimental design with pretest–posttest control group. The pretest and posttest were reflection papers of medical students about their experience of leadership during their TBL sessions. In the intervention group, TBL and a team-based, guided reflection and feedback on the team leadership process were performed at the end of all TBL sessions. In the other group, only TBL was used. The Stata 12 software was used. Leadership Identity was treated both as a categorical and quantitative variable to control for differences in baseline and gender variables. Chi-square, t tests, and linear regression analysis were performed. Context: The population was a cohort of 2015–2016 medical students in a TBL setting at Tehran University of Medical Sciences, School of Medicine. Teams of four to seven students were formed by random sorting at the beginning of the academic year (intervention group n = 20 teams, control group n = 19 teams). Outcome: At baseline, most students in both groups were categorized in the Awareness and Exploration stage of leadership identity: 51 (52%) in the intervention group and 59 (55%) in the control group: uncorrected χ²(3) = 15.6, design-based F(2.83, 108) = 4.87, p = .003. In the posttest intervention group, 36 (36%) were in exploration, 33 (33%) were in L-identified, 20 (20%) were in Leadership Differentiated, and 10 (10%) were in the Generativity. None were in the Awareness or Integration stages. In the control group, 3 (20%) were in Awareness, 56 (53%) were in Exploration, 35 (33%) were in Leader Identified, 13 (12%) were in Leadership Differentiated. None were in the Generativity and Integration stages. Our hypothesis was supported by the data: uncorrected χ²(4) = 18.6, design-based F(3.77, 143) = 4.46, p = .002. The mean of the leadership identity in the pretest, intervention group equaled 1.93 (SD = 0.85) and the pretest, control group mean was 2.36 (SD = 0.86), p = .004. The mean of the posttest, intervention group was 3.04 (SD = 0.98) and posttest, control group mean was 2.54 (SD = 0.74), T = ?4.00, design df = 38, p < .001, and adjusted on baseline and gender T = ?8.97, design df = 38, p < .001. Lessons Learned: Reflection and feedback on the team leadership process in TBL advances the progression in stages of leadership identity development in medical students. Although the TBL strategy itself could have an impact on leadership identity development, this study demonstrates that when a reflection and feedback on leadership intervention are added, there is much greater impact.     

An Investigation of the Effects of Curcumin on Anxiety and Depression in Obese Individuals: A Randomized Controlled Trial

Objective: To investigate the effectiveness of curcumin, a natural polyphenolic compound with antioxidant and anti-inflammatory activities, on the frequency of symptoms of anxiety and depression in obese individuals. Methods: In this double blind, cross-over trial, 30 obese subjects were randomized to receive either curcumin (1 g/day) or placebo for a period of 30 days. Following a wash-out interval of 2 weeks, each subject was crossed over to the alternative regimen for a further 30 days. Severity of anxiety and depression was assessed at baseline and at weeks 4, 6 and 10 of the trial using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scales, respectively. Results: Mean BAI score was found to be significantly reduced following curcumin therapy (P=0.03). However, curcumin supplementation did not exert any significant impact on BDI scores (P=0.7). Conclusion: Curcumin has a potential anti-anxiety effect in individuals with obesity.