p-Dimethoxy-substituted trans-octahydrobenzo[f]- and -[g]quinolines: synthesis and assessment of dopaminergic agonist effects

The N-n-propyl homologues of the title compounds were prepared for further assessment of the ability of the "p-dimethoxy" moiety to confer dopaminergic agonism upon a variety of ring systems. Both the angularly and the linearly annulated trans-benzoquinoline ring derivatives displayed prominent DA2 dopaminergic effects on the peripheral sympathetic nerve terminal and displayed postjunctional dopamine receptor agonist properties in the striatum. It is speculated that the angular octahydrobenzo[f]quinoline derivative (but not the linear octahydrobenzo[g]quinoline derivative) may owe its dopamine-like effects to metabolic activation phenomena. In contrast, the cis-fused isomer of the angularly annulated benzoquinoline was inactive, as was the simple benzene derivative N,N-di-n-propyl-beta-(2,6-dimethoxyphenyl)ethylamine.     

Copper scavenging efficiency of adsorbents prepared from Raphia hookeri fruit waste

Low cost adsorbents prepared from the epicarp of Raphia hookeri fruit were used for the removal of copper (II) ion from aqueous solution. The effects of operational parameters such as pH, concentration and contact time, dosage as well as interference of other ions were studied. Optimum pH for raw and modified biomass were 5.0 and 5.5 with percentage removal of 75.08% and 95.62% respectively. Concentration of competing ions greatly reduced Cu²⁺ removal with both adsorbents while agitation speed had negligible effect on Cu²⁺ uptake. Adsorbents surfaces were activated as temperature increased thus enhancing adsorbent adsorption capacity at high temperature. Adsorption kinetic data fitted best into the pseudo second order model while the thermodynamics studies confirmed adsorption spontaneity and feasibility. The Freundlich adsorption isotherm best described the adsorption process and the Langmuir maximum monolayer adsorption capacity for the raw (RHE) and acid treated (ARHE) biomass were 81.97 and 103.09 mg/g respectively. Chemisorption predominate the Cu²⁺-ARHE system hence desorption efficiency was obtained to be 72.65% with CH₃COOH as eluent.     

Preoperative embolisation of brain arteriovenous malformations: a systematic review and meta-analysis

Preoperative embolisation is a commonly performed adjunct to microsurgical excision of brain arteriovenous malformations (bAVMs), with aims such as lessening the technical difficulty of the microsurgical procedure, reducing operative time, decreasing blood loss, and improving patient functional outcomes. We aim to perform a systematic review of randomised trials and cohort studies evaluating preoperative embolisation of bAVMs published between 01 January 2000 and 31 March 2021 and appraise its role in clinical practice. A MEDLINE search was performed, and articles reporting on outcomes following preoperative embolisation, as an adjunct to microsurgery, were eligible for inclusion. PRISMA reporting and Cochrane Handbook guidelines were followed. The primary outcome measure was the risk of complications associated with preoperative embolisation. The study was registered with PROSPERO (CRD42021244231). Of the 1661 citations, 8 studies with 588 patients met predefined inclusion criteria. No studies specifically compared outcomes of surgical excision of bAVMs between those with and without preoperative embolisation. Spetzler Martin (SM) grading was available in 301 cases. 123 of 298 (41?28%) patients presented with haemorrhage. Complications related to embolisation occurred in 175/588 patients (29.4%, 95% CI 19.6–40.2). Permanent neurological deficits occurred in 36/541 (6%, 95% CI 3.9–8.5) and mortality in 6/588 (0.41%, 95% CI 0–1.4). This is the first systematic review evaluating preoperative embolisation of bAVMs. Existing studies assessing this intervention are of poor quality. Associated complication rates are significant. Based on published literature, there is currently insufficient evidence to recommend preoperative embolisation of AVMs. Further studies are required to ascertain if there are benefits of this procedure and if so, in which cases.

     

Anti-inflammatory and phytochemical properties of twelve medicinal plants used for treating gastro-intestinal ailments in South Africa

Ethnopharmacological relevance

The investigated medicinal plants are commonly used for the treatment of pains and cramps related to gastro-intestinal tract infections in South African traditional medicine.

Aims of the study

This study aimed to evaluate the ability of the plant extracts to inhibit cyclooxygenase enzymes. Phytochemical analysis was also carried out in the quest to determine some plant metabolites that may be responsible for the observed anti-inflammatory activity.

Materials and methods

The cyclooxygenase assay was used to test for the anti-inflammatory activity of the plant extracts using cyclooxygenase-1 and -2 (COX-1 and COX-2) enzymes. Total phenolic compounds including condensed tannins, gallotannins and flavonoids were quantitatively determined using spectrophotometric methods. Qualitative tests for alkaloids and saponins were also carried out.

Results

Most of the plant extracts evaluated showed dose dependent activity against COX-1 and/or COX-2 enzymes. Agapanthus campanulatus root dichloromethane extract showed the highest COX-2 inhibitory activity (83.7%) at 62.5 μg/ml. The presence and/or amounts of phenolics, condensed tannins, gallotannins, flavonoids, alkaloids and saponins varied with plant parts and species.

Conclusion

The results support the use of the investigated plant in treating pain and cramp related to gastro-intestinal tract infections. To some extent, the observed anti-inflammatory activity could be attributed to the various plant secondary metabolites detected in the plant materials.     

Drug addiction in sickle cell disease: case report

There has been widespread speculation that patients with sickle cell disease (SCD) may become drug dependent if their painful crisis is treated with narcotics. However, there has been no scientific evidence to support this assertion. Paradoxically, individuals suffering from sickle cell disease who are not adequately treated may develop an addiction to narcotics due to self-medication to treat their pain. In this article, we describe a 38-year-old African American woman who became addicted to cocaine due to self-medication of her sickle cell pain with cocaine.     

ECT in the medically ill elderly: a case report

Electroconvulsive therapy (ECT) is well recognized as an effective treatment for depression. However, it is not often used among the elderly due to increased co-morbid medical problems and fear of complications. We present here the case of an 88-year-old man with a history of depression and co-morbid medical illness. This patient was successfully treated with ECT. With the population of individuals above the age of 65 expected to double in the next 40 years, the use of ECT to treat major depression and other psychiatric conditions among the elderly will likely increase.     

An unusual foreign body ingestion in a schizophrenic patient: case report

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine, and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and requires special evaluation and management. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions of this type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid. On further investigation, we found that patient had a proclivity toward this swallowing behavior even prior to his incarceration. Early identification of inmates with this proclivity has important implications for treatment and prevention.     

Genomic detection of a familial 382 Kb 6q27 deletion in a fetus with isolated severe ventriculomegaly and her affected mother

Terminal deletions of the chromosome 6q27 region are rare genomic abnormalities, linked to specific brain malformations and other neurological phenotypes. Reported cases have variable sized genomic deletions that harbor several genes including the DLL1 and TBP. We report on an inherited 0.38 Mb terminal deletion of chromosome 6q27 in a 22‐week fetus with isolated bilateral ventriculomegaly and her affected mother using microarray‐based comparative genomic hybridization and fluorescent in situ hybridization (FISH). The deleted region harbors at least seven genes including DLL1 and TBP. The affected mother had a history of hydrocephalus, developmental delay, and seizures commonly associated with DLL1 and TBP 6q27 deletions. This deletion is one of the smallest reported isolated 6q27 terminal deletions. Our data provides additional evidence that haploinsufficiency of the DLL1 and TBP genes may be sufficient to cause the ventriculomegaly, seizures, and developmental delays associated with terminal 6q27 deletions, indicating a plausible role in the abnormal development of the central nervous system.