Diabetic Muscle Infarction

A 58-year-old male with past medical history of diabetes mellitus presented with pain to the bilateral groin for six weeks. Magnetic resonance imaging of the patient’s lower extremities revealed acute myoedema, and he was diagnosed with myositis secondary to diabetic muscle infarction

Social class inequalities in perinatal outcomes: Scotland 1980–2000

Objective: To examine social class inequalities in adverse perinatal events in Scotland between 1980 and 2000 and how these were influenced by other maternal risk factors. Design: Population based study using routine maternity discharge data. Setting: Scotland. Participants: All women who gave birth to a live singleton baby in Scottish hospitals between 1980 and 2000 (n = 1 282 172). Main outcome measures: Low birth weight (LBW), preterm birth, and small for gestational age (SGA). Results: The distribution of social class changed over time, with the proportion of mothers with undetermined social class increasing from 3.9% in 1980–84 to 14.8% in 1995–2000. The relative index of inequality (RII) decreased during the 1980s for all outcomes. The RII then increased between the early and late 1990s (LBW from 2.09 (95%CI 1.97, 2.22) to 2.43 (2.29, 2.58), preterm from 1.52 (1.44, 1.61) to 1.75 (1.65, 1.86), and SGA from 2.28 (2.14, 2.42) to 2.49 (2.34, 2.66) respectively). Inequalities were greatest in married mothers, mothers aged over 35, mothers taller than 164 cm, and mothers with a parity of one or more. Inequalities were also greater by the end of the 1990s than at the start of the 1980s for women of parity one or more and for mothers who were not married. Conclusion: Despite decreasing during the 1980s, inequalities in adverse perinatal outcomes increased during the 1990s in all strata defined by maternal characteristics

Five-country Study on Service and Volunteering in Southern Africa Malawi Country Report

This study on the nature and form of civic service and volunteering in Malawi followed a qualitative, descriptive research approach, drawing on information from an extensive document search, interviews with key informants responsible for supporting and/or implementing service and volunteering programmes and a focus group discussion with representatives of national and international organisations running structured service programmes, as well as those involved in district and community-based activities

Synthesis of (2R,6R)-Hydroxy-norketamine for Evaluation of Antidepressant Effects

Major Depressive Disorder, colloquially known as depression, is a devastating mental illness that affects a large portion of today\u27s population. Following a drug side-effect that caused depression, the monoamine theory of depression was created, stating that depressive symptoms were caused by a decrease in concentrations of vital monoamine neurotransmitters at the synaptic cleft. Pharmaceutical remedies to combat depression were first introduced in the 1950s and to this date, most available drugs follow the monoamine theory. These drugs have a large loading dose lag time, numerous negative side effects, and still many patients do not experience relief from symptoms. In 2000, the Stress-neurogenic theory was proposed, suggesting depressive symptoms decreased neurogenesis and dendritic retraction, induced by excess cortisol from chronic stress. This new theory opened the door for further studies to be conducted on possible pharmacotherapies for MDD. Ketamine had shown some antidepressant effects, but was not a sufficient option due to the dissociative effects and history of abuse. Further studies were done to indicate that ketamine\u27s antidepressant effects were caused by the metabolite (2R,6R)-hydroxynorketamine and that the mechanism of action seems to be NMDA receptor independent. The goal of this thesis was to construct an efficient complete synthesis pathway of (2R,6R)- hydroxynorketamine from commercially available chemicals. This was done by evaluating chemically and structurally similar reactions that had been previously published to piece together a new synthesis of (2R,6R)-HNK. The product of this research will be sent to a partnering lab for further studies to be completed on the NMDA-independent and possibly AMPA receptor-dependent mechanism by which ketamine exhibits such promising antidepressant effects. Further understanding of this mechanism brings us one step closer to better future pharmacotherapies for MDD