Synthesis and Optical Properties of Near-Infrared (NIR) Absorbing Azo Dyes

This chapter provides a general overview and information on near-infrared (NIR) absorbing azo dyes. In this work, we have developed an efficient and simple protocol for the synthesis of novel A-π-D-π-A NIR azo dyes. The near-infrared absorbing azo dyes were synthesized by using 2-hydroxy-1,4 naphthoquinone (Lawsone) and different substituted aromatic primary amines. Furthermore, author developed push-pull chromophores of A-π-D-π-A type containing an electron-withdrawing azo core, phenazine moieties, and a hydroxyl group as electron donor. The benzo[a]quinoxalino[2,3-i]phenazin-5-ol moiety was introduced to make the system planer as well as to increase the π-conjugation. The optical properties of these dyes were studied in N,N-dimethylformamide (DMF)

CLINICAL OUTCOME OF CHEWING GUM ON BOWEL MOTILITY AMONG PATIENTS UNDERGOING ABDOMINAL SURGERY

Introduction: Postoperative paralytic ileus is one of the commonest causes of morbidity in abdominal surgeries. The aim of the present study was to evaluate efficacy of chewing gum in on bowel motility among patients who have undergone abdominal surgery. Methods: The details of patients along with diagnosis, co-morbidities, duration of anesthesia & surgery and post-operative stay were recorded. Patients that received chewing gum in addition to standard postoperative care were grouped as cases while those that received standard postoperative care were grouped as controls. The patients were observed for Peristaltic Sounds, Flatus passed, Stool Passed, return of appetite and time was recorded. Results: The study was conducted with 200 patients of which 100 each were grouped as cases and controls. Majority of the patients in Cases Group were in the age group of 40-50 years (42%). The mean age of the patients was 47.3 ±12.97 years. 7 (23.3%) patients in Cases Group had hypertension while 5 (16.7%) patients had diabetes mellitus. 8 (26.8%) patients in Control Group had hypertension while 4 (13.4%) patients had diabetes mellitus. 47 (47%) patients in Cases Group had enterocolon diseases while 43 (43%) and 10 (10%) patients had hepatobiliary and pancreatic diseases respectively. 46 (46%) patients in Control Group had enterocolon diseases while 45 (45%) and 9 (9%) patients had hepatobiliary and pancreatic diseases respectively. There was no statistical significance on comparison between the groups with respect to age, sex, co-morbidities and diagnosis. The mean duration of induction of anesthesia was 27.08±0.89 minutes and 28.16±1.14 minutes in Cases and Control Group respectively. The mean duration of surgery was 2.67±0.21 hours and 2.44±0.19 hours in Cases and Control Group respectively. The mean duration of return of Bowel Sound was significantly lesser in Cases Group as compared to Control Group (9.9±1.37 vs. 36.1±6.72 hours). The mean duration of first passage of flatus was significantly lesser in Cases Group as compared to Control Group (14.8±2.13 vs. 81.1±5.47 hours). The mean duration of time to first faeces was significantly lesser in Cases Group as compared to Control Group (36.1±7.28 vs. 107.6±6.87 hours). The mean duration of return of appetite was significantly lesser in Cases Group as compared to Control Group (19.3±2.13 vs. 87.6±5.47 hours). The duration of post-operative hospital stay was significantly lesser in Cases Group as compared to Control Group (72.1±7.28 vs. 155.6±6.87 hours). Conclusion: Gum chewing in patients undergoing abdominal surgery can be an effective intervention to facilitate the passage of flatus and feces, shorten the time to dietary intake, and shorten the length of hospital stay by promoting bowel motility. Key words: Abdominal surgery, Bowel motility, Chewing gum

CLINICAL OUTCOME OF CHEWING GUM ON BOWEL MOTILITY AMONG PATIENTS UNDERGOING ABDOMINAL SURGERY

Introduction: Postoperative paralytic ileus is one of the commonest causes of morbidity in abdominal surgeries. The aim of the present study was to evaluate efficacy of chewing gum in on bowel motility among patients who have undergone abdominal surgery. Methods: The details of patients along with diagnosis, co-morbidities, duration of anesthesia & surgery and post-operative stay were recorded. Patients that received chewing gum in addition to standard postoperative care were grouped as cases while those that received standard postoperative care were grouped as controls. The patients were observed for Peristaltic Sounds, Flatus passed, Stool Passed, return of appetite and time was recorded. Results: The study was conducted with 200 patients of which 100 each were grouped as cases and controls. Majority of the patients in Cases Group were in the age group of 40-50 years (42%). The mean age of the patients was 47.3 ±12.97 years. 7 (23.3%) patients in Cases Group had hypertension while 5 (16.7%) patients had diabetes mellitus. 8 (26.8%) patients in Control Group had hypertension while 4 (13.4%) patients had diabetes mellitus. 47 (47%) patients in Cases Group had enterocolon diseases while 43 (43%) and 10 (10%) patients had hepatobiliary and pancreatic diseases respectively. 46 (46%) patients in Control Group had enterocolon diseases while 45 (45%) and 9 (9%) patients had hepatobiliary and pancreatic diseases respectively. There was no statistical significance on comparison between the groups with respect to age, sex, co-morbidities and diagnosis. The mean duration of induction of anesthesia was 27.08±0.89 minutes and 28.16±1.14 minutes in Cases and Control Group respectively. The mean duration of surgery was 2.67±0.21 hours and 2.44±0.19 hours in Cases and Control Group respectively. The mean duration of return of Bowel Sound was significantly lesser in Cases Group as compared to Control Group (9.9±1.37 vs. 36.1±6.72 hours). The mean duration of first passage of flatus was significantly lesser in Cases Group as compared to Control Group (14.8±2.13 vs. 81.1±5.47 hours). The mean duration of time to first faeces was significantly lesser in Cases Group as compared to Control Group (36.1±7.28 vs. 107.6±6.87 hours). The mean duration of return of appetite was significantly lesser in Cases Group as compared to Control Group (19.3±2.13 vs. 87.6±5.47 hours). The duration of post-operative hospital stay was significantly lesser in Cases Group as compared to Control Group (72.1±7.28 vs. 155.6±6.87 hours). Conclusion: Gum chewing in patients undergoing abdominal surgery can be an effective intervention to facilitate the passage of flatus and feces, shorten the time to dietary intake, and shorten the length of hospital stay by promoting bowel motility. Key words: Abdominal surgery, Bowel motility, Chewing gum

Clinical profile of dengue patients: A hospital based study

Context: For most of the patients, dengue is a self-limiting viral fever, but in some patients, it results in a life threatening conditioncalled as dengue hemorrhagic fever or dengue shock syndrome. Objective: We attempted to determine the common and atypicalclinical and laboratory features in children suffering from dengue fever, which will help in early diagnosis and management of patientssuffering from dengue infection. Design: Hospital based descriptive, cross-sectional study conducted from January 2014 to December2014. Setting: Tertiary referral teaching hospital. Patients: All patients between 1-month and 12 years admitted in pediatric ward withsymptoms suggestive of dengue and who turn out to be positive for NS1 antigen alone or NS1 and immunoglobulin M antibody againstdengue were included in the study. Data regarding relevant history and clinical examination and outcome and relevant investigationswere collected. Results: Of 250 children included in the study, 145 (58%) were male and 105 (42%) were female. The most commonpresenting complaint was fever (92.8%), followed by abdominal pain (46.4%). The most common clinical sign was pyrexia followedby relative bradycardia (37.6%) and hypotension (26.4%). On laboratory investigation, the most common abnormality detected wasleucopenia (81.6%) followed by thrombocytopenia (69.2%). Conclusion: A high index of suspicion is required on the part of treatingpediatrician to diagnose dengue early and treat accordingly to prevent mortality due to dengue

Magnesium sulphate is it necessary to prevent eclampsia?

Background: Preeclampsia was reported to account for 15 % of all antenatal hospitalization for pregnancy complications. It causes maternal as well as fetal death by developing eclampsia Since the turn of the century, obstetrician have to decrease the incidence of eclampsia i.e hypertension complicated with seizures in pregnant women by treating them magnesium sulfate in preeclampsia. In our study we tried to find out Magnesium sulphate really helpful in prevention of eclampsia or not.Methods: This prospective study was carried out by the department of Pharmacology with the help from department of obstetrics and gynecology, in rural hospital and medical college i.e Mahatma Gandhi Institute of Medical sciences Sewagram, Wardha, Maharashtra, India during January 2007 to January 2008. A total of 100 subjects registered in inpatient department were included in this study. Patients were divided in to two group one group receiving nifedipine (calcium channel blockers) and other group receive combination of nifedipine and magnesium sulfate. We compared the delivery outcome of both the group.Results: Patients receiving nifedipine had good pregnancy outcome with less side effects than the patients receiving combination of nifedipine and magnesium sulphate.Conclusions: Magnesium sulphate is not necessary drug for prophylaxis of eclampsia

Ki67 Labelling Index predicts clinical outcome and survival in oral squamous cell carcinoma

Objective: To investigate the Ki 67 expression and its correlation with clinicopathological features and 3 years as well as 5 years survival rate in oral squamous cell carcinoma (OSCC). Methodology: Total 217cases of OSCC primarily treated with surgery with or without radiation were included. All patients were followed up for 3 years and 150 were followed up of 5 years for disease free survival. The immunohistochemistry was carried out on neutral buffered formalin fixed paraffin embedded tissue to evaluate the expression of Ki67. Results: The Ki67 labeling index (LI) was significantly higher with respect to adverse clinicopathological parameters such as histopathological grading (p<0.001), clinical TNM staging (p<0.001) and nodal metastasis (p<0.001). The OSCC patients survived for less than 3 and 5 years were showed significantly higher Ki67 LI as compared to diseases free survived more than 3 and 5 years(p<0.001). The three years survival rate of OSCC patient significantly higher with low Ki67 LI (≤45) 96.2%, followed by moderate Ki67 LI (46 to 60) 60.7% and high Ki67 LI (≥61) 37.7% (p<0.001). The five years survival rate of OSCC patient statistically significantly higher with low Ki67 LI (≤45)93.3%, followed by moderate Ki67 LI (46 to 60) 46.8% and Ki67 LI (≥61) 23.3% (p<0.001). Conclusion: The measurement of cell proliferative activity by using Ki67 antigen expression in individual OSCC might provide unique, predictive information on clinical outcome, prognosis and deciding treatment modalities in OSCC

Undifferentiated Nasopharyngeal Carcinoma with Oral Manifestation: A Case Report

Nazofaringealni karcinom (NPC) rijetka je maligna bolest u većem dijelu svijeta, pa se zato često pogrešno dijagnosticira. Ta se vrsta raka teško pronađe među karcinomima glave i vrata zbog predilekcijskog mjesta, malignih karakteristika rasta, posebnih teškoća u otkrivanju i određivanju stupnja proširenosti te visoke stope neuspjeha u liječenju, iako je osjetljiv na radioterapiju. O toj bolesti malo se zna i obično na godinu oboli jedna osoba u populaciji od 100 tisuća. Uobičajen je u južnoj Kini i sjevernoj Africi, gdje se njegova etiologija povezuje s prehrambenim navikama. Kako bismo bolje razumjeli etiološku patogenezu i mogli prepoznati klinička obilježja te postaviti ranu dijagnozu i prognozu NPC-a, izvještavamo o rijetkom slučaju nazofaringealnog karcinoma u srednjoj Indiji. Pacijentica je bila u dobi od 19 godina i došla je na liječenje zbog tkivne mase u sklopu vrata intraoralno uključene u meko nepce.Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world and is one of the most confusing, commonly misdiagnosed, and poorly understood diseases. It is unusual among all the head and neck cancers due to its marked geographical predilection, highly malignant tumor growth characteristics, special difficulties in detection and staging and a high rate of treatment failure despite of its radiosensitivity. This carcinoma is rare in most parts of the world with reported incidence of around 1 case per 100,000 population per year. Nasopharyngeal carcinoma is common in Southern China and North Africa, where the etiology is related to dietary habits but it is rare in other parts of the world. Therefore, for better understanding of etiopathogenesis, clinical pathological features, early diagnosis and prognosis of NPC, we report a rare case of a nasopharyngeal carcinoma in Central India, of a 19 year old female patient who presented with a mass in her neck and intraoral involvement of the soft palate

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions