Role of methotrexate in ectopic pregnancy

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention

Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients

Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (≥65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria

Polymer supported sulphanilic acid – A novel green heterogeneous catalyst for synthesis of benzimidazole derivatives

Polymer supported sulphanilic acid was synthesized and used as green, reusable and heterogeneous catalyst and duly characterized using chemical methods like determination of free hydroxyl content, epoxy equivalent weight and free sulphonic acid content as well as infrared spectroscopy and thermogravimetric analysis. The prepared catalyst was applied for one-pot synthesis of 2-substituted benzimidazoles from o-phenylenediamine and various aromatic aldehydes in absolute ethanol under thermal condition. Catalyst was separated from the product by simple filtration and could be reused for at least five times with almost retention in its efficiency. Due to three dimensional network structures, it shows high thermal stability and can be reused without any further purification

A Study of Bacterial pathogens causing Surgical site infection and their antimicrobial susceptibility in tertiary care hospital

Aim: Surgical site infections (SSIs) remain a common and global problem that contributes to significant morbidity and mortality, prolongs hospital stay and consequently increasing health care cost. Bacterial resistances pose a challenge and complicated the SSI treatment. The aim of this study was to evaluate the bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection. Methods: Patients who underwent either elective or emergency surgical procedure were enrolled in this study. From those who developed surgical site infections, Specimen from surgical site were collected and processed at Microbiologylaboratory at tertiary healthcare Centre, Ahmedabad. Results: out of the 5003 patients 34 developed SSI. In our study, 37 bacteria were isolated from 34 samples subjected to culture.32 samples showed monomicrobial growth and 2 showed polymicrobial growth. Among them, 14 (38%) were gram positive cocci out of which 12(85.7%) were Staphylococcus aureus and 2 (14.3%) were Enterococci spp. and 23 (62%) were gram negative bacilli, there were 21(91.3%) Enterobacteriaceae out of which 05(23.8%) were E. coli, 01(4.8%) were Proteus mirabilis, 15(71.4%) Klebsiella spp. and 02 (8.7%) non-fermenters of which Pseudomonas aeruginosa and Acinetobacter baumannii. Conclusions: Gram-negative bacteria were the most dominant isolates from surgical sites in the study area. Among the Gram-negative bacilli, klebsiella spp. were the most common bacteria causing surgical site infection. In our study there is high antibiotic resistance observed which raise serious concerns and mandates strict antibiotic policy as well as antimicrobial stewardship

Oxidative cyanide-free cyanation on arylboronic acid derivatives using aryl/heteroaryl thiocyanate using novel IL-PdCl₄ catalyst under mild condition

<p>An efficient and simple method is reported for the cyanation on arylboronic acid using various simple/indole thiocyanates using a new IL-PdCl₄ catalyst. The cascade process involves a coupling reaction without any additive to give a wide range of cyanide derivatives. Cyanation on various arylboronic acids underwent smoothly affording the corresponding arylnitriles in good to high yields.</p