Novel heteroleptic complexes of titanium(IV) derived from 2-hydroxyacetophenone: synthesis, characterization, antibacterial and molecular docking studies

A few new and versatile complexes of titanium(IV) derived from 2-hydroxyacetophenone of the types {[(Ap)Ti(OPr ⁱ )_2?n (L₂) _n ] (2a, 2e and 2f)}, {[(Ap)Ti(L₁OR)(L₂)] (2b–2d, 2g–2i)} have been synthesized by the reaction of the precursor [(Ap)Ti(OPr ⁱ )₂] with different 2-heteroaryl methyl ketone oximes and alkoxyalkanols in various molar ratios in refluxing toluene yielded mono nuclear heteroleptic derivatives, {where, n = 1–2, HAp = 2-hydroxyacetophenone, Pr ⁱ  = isopropyl, L₁ = O–CH₂–CH₂?, R = CH₃, C₂H₅, C₄H₉ and HL₂=HONC(Me)py-2, HONC(Me)fu-2}. All these newly synthesized complexes were characterized by elemental analysis, mass, UV, FT-IR and NMR (¹H, ¹³C) spectral studies. The mass spectra of the newly synthesized molecules indicate their monomeric state. Spectral studies suggest the bonding between metal and ligands in a tetra coordinated fashion. Thermogravimetric analyses indicate the multistep decomposition of complexes resulting TiO₂ as the end product at 600 °C. Antibacterial activities of these complexes were also exercised. Complex 2e is equipotent to the standard drug against Pseudomonas aeruginosa and Escherichia coli. A keen molecular docking study revealed lesser docking scores of some of these complexes than that of the standard drug gentamicin.     

Improvement of Sleep Disturbance and Insomnia Following Parathyroidectomy for Primary Hyperparathyroidism

Background

The aim of the present study was to investigate the incidence of sleep disturbance and insomnia in patients with primary hyperparathyroidism (PHPT), and to evaluate the effect of parathyroidectomy.

Methods

A questionnaire was prospectively administered to adult patients with PHPT who underwent curative parathyroidectomy over an 11-month period. The questionnaire, administered preoperatively and 6 months postoperatively, included the Insomnia Severity Index (ISI) and eight additional questions regarding sleep pattern. Total ISI scores range from 0 to 28, with >7 signifying sleep difficulties and scores >14 indicating clinical insomnia.

Results

Of 197 eligible patients undergoing parathyroidectomy for PHPT, 115 (58.3 %) completed the preoperative and postoperative questionnaires. The mean age was 60.0 ± 1.2 years and 80.0 % were women. Preoperatively, 72 patients (62.6 %) had sleep difficulties, and 29 patients (25.2 %) met the criteria for clinical insomnia. Clinicopathologic variables were not predictive of clinical insomnia. There was a significant reduction in mean ISI score after parathyroidectomy (10.3 ± 0.6 vs 6.2 ± 0.5, p < 0.0001). Postoperatively, 79 patients (68.7 %) had an improved ISI score. Of the 29 patients with preoperative clinical insomnia, 21 (72.4 %) had resolution after parathyroidectomy. Preoperative insomnia patients had an increase in total hours slept after parathyroidectomy (5.4 ± 0.3 vs 6.1 ± 0.3 h, p = 0.02), whereas both insomnia patients and non-insomnia patients had a decrease in the number of awakenings (3.7 ± 0.4 vs 1.9 ± 0.2 times, p = 0.0001).

Conclusions

Sleep disturbances and insomnia are common in patients with PHPT, and the majority of patients will improve after curative parathyroidectomy.     

Evaluating the Potential Impact of Pharmacist Counseling on Medication Adherence Using a Simulation Activity

Objective. To evaluate the impact of counseling in a simulated medication adherence activity.Design. Students were randomized into 2 groups: patient medication monograph only (PMMO) and patient medication monograph with counseling (PMMC). Both groups received a fictitious medication and monograph. Additionally, the PMMC group received brief counseling. A multiple-choice, paper-based survey instrument was used to evaluate simulated food-drug interactions, adherence, and perceptions regarding the activity’s value and impact on understanding adherence challenges.Assessment. Ninety-two students participated (PMMC, n=45; and PMMO, n=47). Overall, a significantly higher incidence of simulated food-drug interactions occurred in the PMMO group (30%) vs the PMMC group (22%) (p=0.02). Doses taken without simulated food-drug interactions were comparable: 46.2% (PMCC) vs 41.9% (PMMO) (p=0.19). The average number of missed doses were 3.2 (PMMC) vs 2.8 (PMMO) (p=0.55). Approximately 70% of the students found the activity to be valuable and 89% believed it helped them better understand adherence challenges.Conclusion. This activity demonstrated the challenges and important role of counseling in medication adherence.     

Nocturnal variant of benign myoclonic epilepsy of infancy: a case series

Myoclonus is a brief, rapid, involuntary muscle jerk originating in the central nervous system that can be physiological or a symptom of disease. We report a group of five children with excessive myoclonic jerks, only during sleep, and abnormal EEG during the events. Although only one third of the events had EEG epileptiform correlate, the presence of myoclonus without epileptiform EEG correlate has been described in patients with benign myoclonic epilepsy of infancy. We hypothesize that these findings may represent a variant of benign myoclonic epilepsy of infancy.     

Single-stage earlobe reconstruction: a simple method with promising results

Various methods have been described in the literature for earlobe reconstruction in one or many stages. Authors describe here a simple, single-stage technique to reconstruct the loss of the earlobe. The technique is clearly illustrated in a step-by-step manner and produces a natural-looking earlobe without an unpleasant secondary deformity with desirable texture and color match. Level of Evidence: Level IV, therapeutic study.