The Yolk Sac Abnormalities, Maternal Serum Level of Cancer Antigen 125 (CA-125) and Beta Human Chorionic Gonadotropin (B-HCG) as an Early Predictors of First Trimester Pregnancy Loss in Patients with Threatened Miscarriage

Background: Pregnancy loss before 20 weeks is considered a miscarriage, as is the loss of a fetus weighing less than 500 grams before viability. A medical emergency, threatened miscarriage affects 15–25% of pregnancies. Aim and objectives: The goal of this study was to assess the predictive value of maternal blood levels of Cancer Antigen 125 (CA-125) and beta-human chorionic gonadotropin (B- HCG) in individuals at risk of miscarriage during the first trimester. Subjects and methods: This study was a prospective cohort study. This study included 120 pregnant women with threatened abortion between (6-11 weeks) and followed up till end of 14th week. Results: 36(30%) of pregnant women aborted, while 84(70%) of women continued till 14th weeks of pregnancy. At a cut-off value of 45 U/ml, the CA125 test was shown to have a sensitivity of 88.9% and a specificity of 77.5%, respectively, while also having a positive predictive value of 79.8% and a negative predictive value of 87.5%. At a cut-off value of 18.501 mlIU/ml, the B-HCG test's sensitivity and specificity were determined to be 96.3 and 88.9, respectively, with a positive predictive value of 89.7% and a negative predictive value of 96%. Conclusion: Even before fetal morphology can be investigated sonographically, abnormalities in the size of the yolk sac can be utilized as a good prognostic sign of early pregnancy loss. Pregnancy viability can be estimated from first trimester serum CA 125 and Beta HCG measurements

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Synthesis and DFT study of novel pyrazole, thiophene, 1,3-thiazole and 1,3,4-thiadiazole derivatives

Regioselective facile synthesis of innovative heterocycles from the reaction of 2-cyano-N-cyclohexylacetamide (3) with hydrazonoyl chloride (4) in basic condition afforded amino pyrazole derivative 6. The behavior of acetamide 3 with phenylisothiocyanate in DMF/KOH surveyed by addition of the α-halo ketones to yeild the corresponding thiophene derivative 13a, 13b, 16, 18 and 1,3-thiazoles 21. Reaction of intermediate potassium salt 9 with hydrazonoyl chloride 22a-e furnished the corresponding 1,2,4-thiadiazoles 24a-e. Density functional theory (DFT) calculations at the B3LYP and HF techniques combined with 6-31G(d) basis set to investigate the equilibrium geometry of the innovative compound pyrazoles 6 and the stability affording of HOMO/LUMO molecular orbitals

ZnO Nanoparticles-Chitosan Composite as Antibacterial Finish for Textiles

The antibacterial performance of sol-gel-derived inorganic-organic hybrid polymers filled with ZnO nanoparticles-chitosan against a gram-negative bacterium Escherichia coli and a gram-positive Micrococcus luteus has been investigated. Three different molecular weights (MW) of chitosan (CTS) 1.36 · 105, 2.2 · 105, and 3.0 · 105 Da with equal degree of deacetylation (DD, 85%) (coded as S 85-60, He 85-250, and He 85-500) with equal degree of deacetylation (DD, 85%) were examined. ZnO was prepared by the base hydrolysis of zinc acetate in isopropanol using lithium hydroxide (LiOH · H2O) to hydrolyze the precursor. Sol-gel-based inorganic-organic hybrid polymers were modified with these oxides and were applied to cellulosic cotton (100%) and cotton/polyester (65/35%) fabrics. Inorganic-organic hybrids polymers were based on 3-glycidyloxypropyltrimethoxysilane (GPTMS). Bacteriological tests were performed in nutrient agar media on solid agar plates and in liquid broth systems using ZnO nanoparticles with average particle size of (40 nm). Our study showed the enhanced antibacterial activity of ZnO nanoparticles chitosan (different MW) of against a gram-negative bacterium Escherichia coli DSMZ 498 and a gram-positive Micrococcus luteus ATCC 9341 in repeated experiments. The antibacterial activity of textile treated with ZnO nanoparticles chitosan increases with decreasing the molecular weight of chitosan

Potentials of enhancing the physicochemical and functional characteristics of Nigella sativa oil by using the screw pressing technique for extraction

Mejoras potenciales de las características físico-químicas y funcionales del aceite de Nigella sativa mediante extracción con prensa de tornillo. En la presente investigación se extrajo el aceite crudo de Nigella sativa de las semillas utilizando técnicas hidráulicas y de prensado de tornillo. Se evaluaron diferentes parámetros para conocer la técnica apropiada que potencie las características fisicoquímicas y funcionales del aceite extraído. Los resultados mostraron que los valores de ácido y peróxido fueron significativamente más bajos en el aceite de presión con tornillo (SPO) que en el aceite prensado hidráulico (HPO). El contenido fenólico total del SPO fue significativamente mayor que el de HPO. La evaluación de la estabilidad oxidativa mediante Rancimat demostró que el aceite SPO tiene un índice de estabilidad oxidativa mucho más alto (40,07 h) que el HPO (0,51 h). El rendimiento de la fracción volátil y su contenido de timoquinona aislada del aceite SPO fueron superiores a los del HPO. La evaluación biológica reveló que el aceite SPO tenía una actividad antimicrobiana significativamente mayor que el HPO contra Listeria monocitogenes y Staphylococcus aureus a 40 μL/pocillo.In the current investigation the crude oil of Nigella sativa was extracted from seeds using hydraulic and screw pressing techniques. Different parameters were evaluated in order to find out the appropriate technique to enhance the physicochemical and functional-related characteristics of the extracted crude oil. Results showed that the acid and peroxide values were significantly lower in the screw pressed oil (SPO) than in the hydraulic pressed oil (HPO). The total phenolic content of the SPO was significantly higher than that of HPO. Evaluation of the oxidative stability using the Rancimat test showed that SPO recorded a much higher oxidative stability index (40.07 h) than HPO (0.51 h). The yield of the volatile oil fraction and its contents of thymoquinone isolated from the SPO were higher than that from the HPO. Biological evaluation revealed that the SPO had significantly higher antimicrobial activity than HPO against Listeria monocytogenes and Staphylococcus aureus at 40 μL/well

Crystal structure of ethyl 2-[9-(5-bromo-2-hydroxyphenyl)-1,8-dioxo-1,2,3,4,5,6,7,8,9,10-decahydroacridin-10-yl]-acetate

In the title compound, C23H24BrNO5, the central 1,4-di-hydro-pyridine ring of the 1,2,3,4,5,6,7,8,9,10-deca-hydro-acridine ring system adopts a half-chair conformation. The two cyclo-hexene rings fused to the central ring both have a twisted-boat conformation. The mean planes of the bromo-hydroxy-phenyl ring and the major and minor components of the disordered ethyl amino-acetate moiety make dihedral angles of 78.99 (12), 85.9 (2) and 88.3 (9)degrees, respectively, with the 1,4-di-hydro-pyridine ring. The terminal ethyl group of the ethyl amino-acetate moiety is disordered over two sets of sites with refined occupancies of 0.768 (17) and 0.232 (17). The mol-ecular conformation is stabilized by an intra-molecular O-H center dot center dot center dot O hydrogen bond, forming an S(8) ring motif. In the crystal, C-H center dot center dot center dot O hydrogen bonds connect the mol-ecules into layers parallel to (001), enclosing R-1(2)(7) ring motifs

2-Amino-4-(4-meth­oxy­phen­yl)-1-(4-methyl­phen­yl)-5-oxo-1,4,5,6,7,8-hexa­hydro­quinoline-3-carbo­nitrile

In the title compound, C24H23N3O2, the cyclohexene and 1,4-dihydropyridine rings of the 1,4,5,6,7,8-hexahydroquinoline ring system each adopt a twisted-boat conformation. The dihedral angle between the benzene rings is 13.89 (10)°. In the crystal, molecules are linked through pairs of amino–nitrile N—H...N hydrogen bonds, forming inversion dimers. Weak C—H...O and C—H...π interactions connect the dimers, forming a three-dimensional network

Crystal structure of 2-[9-(2-hydroxyphenyl)-1,8-dioxo-1,2,3,4,5,6,7,8,9,10-decahydroacridin-10-yl]acetic acid

The title compound, C21H21NO5, crystallizes with two molecules in the asymmetric unit. In each molecule, the central 1,4-dihydropyridine ring adopts a shallow sofa conformations (with the C atom bearing the phenol ring as the flap), whereas the pendant cyclohexene rings both have twisted-boat conformations. Each molecule features an intramolecular O-H center dot center dot center dot O hydrogen bond, which closes an S(8) ring. In the crystal, the molecules are linked by O-H center dot center dot center dot O, C-H center dot center dot center dot O and C-H center dot center dot center dot pi interactions, forming a three-dimensional network

Crystal structures of 1-(4-chlorophenyl)-4-(4-methlphenyl)-2,5-dioxo-1,2,5,6,7,8-hexahydro-quinoline-3-carboxylic acid and 4-(4-methoxyphenyl)-1-(4-methylphenyl)-2,5-dioxo-1,2,5,6,7,8-hexahydroquinoline-3-carbonitrile

In the title compounds C23H21ClN2O3 [I, namely 1-(4-chlorophenyl)-4-(4-methylphenyl)-3,8-dioxo-1,2,5,6,7,8-hexahydroquine-3-carboxylic acid] and C24H22N2O3 [II, namely 4-(4-methoxyphenyl)-1-(4-methylpheny1)-2,5-dioxo-1,2,5,6,7,8-hexahydroquinoline-3-carbonitrile], each of the cyclohexene and dihydropyridine rings of the 1,2,5,6,7,8-hexahydroquinoline moieties adopts a twisted-boat conformation. The asymmetric units of both compounds I and II consist of two independent molecules (A and B). In IIA, three carbon atoms of the cyclohexene ring are disordered over two sets of sites in a 0.670 (11):0.330 (11) occupancy ratio. In the crystal of I, molecules are linked through classical N -H center dot center dot center dot O hydrogen bonds, forming inversion dimers with an R-2(2)(8) ring motif and with their molecular planes parallel to the crystallographic (020) plane. Non-classical C-H center dot center dot center dot O hydrogen-bonding interactions connect the dimers, resulting in a three-dimensional network. In the crystal of II, molecules are linked by C-H center dot center dot center dot N, C-H center dot center dot center dot O and C-H center dot center dot center dot pi interactions, forming a three-dimensional network

Soluble and membranous endothelial protein C receptor in systemic lupus erythematosus patients: Relation to nephritis

Aim of the work: To investigate the role of endothelial protein C receptor (EPCR) (membrane and soluble forms) as a biomarker of lupus nephritis (LN) in systemic lupus erythematosus (SLE) patients and to study its relation to the prognosis and response to treatment. Patients and methods: The study included 30 SLE patients and 30 matched healthy volunteers as well as 10 renal biopsies from surgical nephrectomy as a control for membranous (mEPCR) examination. SLE disease activity index-2000 and damage index were assessed. Serum sEPCR was measured. Renal expression of mEPCR was analyzed. All patients were reassessed after 3 months. Results: Patients were 26 females and 4 males with a mean age of 29.6 ± 10.04 years and disease duration of 4.4 ± 3.5 years. Their mean SLEDAI was 13.9 ± 9.9 and damage index 1 ± 1.5. Serum levels of sEPCR were significantly higher in patients with LN (19.9 ± 5.7 ng/ml) than those without (8.95 ± 4.2 ng/ml) and controls (5.3 ± 2.6 ng/ml)(p < 0.001). SLE patients with cutaneous vasculitis (n = 9) had significantly higher sEPCR levels than those without (18.1 ± 7.8 vs 10.2 ± 5.2 ng/ml)(p = 0.02). There was a significant correlation between sEPCR percentage of change and of SLEDAI-2k with and without LN (p < 0.01 and p < 0.05). A significant difference was observed in sEPCR according to the prognosis and treatment response after 3 months. mEPCR stained positively in glomeruli and tubules of LN patients with no relation to histopathological grading. Conclusion: sEPCR plays a role in the pathogenesis, is related to a bad prognosis and poor response to treatment in LN. mEPCR was not related to LN grading. Keywords: Lupus nephritis, Systemic lupus erythematosus, Soluble and membranous EPCR, ELIS, AImmunohistochemistr