Synthesis of pyrazines and imidazoles using lemon juice (Citrus limon) as a recyclable catalyst

1887-1892One-pot four component synthesis of 2,5,6-triaryl pyrazines, 1,2,4,5-tetraaryl imidazoles and 2,2,4,5-tetraaryl imidazoles have been achieved from benzoin, aryl amine, ammonium acetate and aryl ketone /aryl aldehydes using lemon juice (Citrus limon) as an ecofriendly catalyst in good yield under mild conditions. The antibacterial action exhibited by the synthesized compounds against clinical isolates obtained from urinary tract catheters of infected patients is close to the standard drug tetracycline. Recovery of lemon juice after completion of reaction eliminates the need to handle side products, making this process more safe and user friendly

Synthesis of pyrazines and imidazoles using lemon juice (Citrus limon) as a recyclable catalyst

One-pot four component synthesis of 2,5,6-triaryl pyrazines, 1,2,4,5-tetraaryl imidazoles and 2,2,4,5-tetraaryl imidazoles have been achieved from benzoin, aryl amine, ammonium acetate and aryl ketone /aryl aldehydes using lemon juice (Citrus limon) as an ecofriendly catalyst in good yield under mild conditions. The antibacterial action exhibited by the synthesized compounds against clinical isolates obtained from urinary tract catheters of infected patients is close to the standard drug tetracycline. Recovery of lemon juice after completion of reaction eliminates the need to handle side products, making this process more safe and user friendly

Care seeking behaviour and various delays in tuberculosis patients registered under RNTCP in Pune city

Introduction: Case finding in tuberculosis is known to be influenced by factors such as patient motivation, care seeking, the degree of diagnostic suspicion by health care provider which could result in a delayed diagnosis. Objective: To determine care seeking behaviour and delay in diagnosis and treatment of new sputum positive tuberculosis patients registered under RNTCP. Material and Methods: Descriptive cross sectional study. 283 new sputum positive tuberculosis patients (?15 years of age) registered during a period of six months at two randomly selected tuberculosis unit of Pune city. Questionnaire by WHO was modified and used. Interviews were conducted in DOT centres. Statistical analysis: Frequency, mean and standard deviation, chi square test. Results: Mean age of patients was 35 (±15) years18% of patients were unemployed and 77% resided in urban slums. The commonest co morbidity in 7.4% and 3.5 % patients was HIV/ AIDS followed by diabetics respectively. Majority of the patients, for the first and second time visited a general practitioner. Median patient, health care system and total delay were 18, 22 and 47 days with mean of 24±21, 32±30 and 56±33 days respectively. Health care system delay was less (p<0.05) in patients who first visited the public health care facility than patients who first visited a private health care provider. Conclusions: General practitioners are preferred first choice of health care provider for tuberculosis patients. Mean health care system delay is more than patient delay

Systematic Literature Review and Meta-analysis: Real-World Mucosal Healing in Vedolizumab-Treated Patients with Crohn's Disease

Background. Vedolizumab is a gut-selective monoclonal anti-α4β7-integrin antibody approved for the treatment of adults with moderately to severely active Crohn's disease (CD). Aim. To conduct a systematic literature review and meta-analysis of published real-world studies examining mucosal healing (MH) rates in patients with CD treated with vedolizumab in routine clinical practice. Methods. MEDLINE-, Cochrane-, and EMBASE-indexed publications from January 2014 to January 2020 and 2018-2019 conference abstracts were searched for real-world studies reporting MH-related outcomes in vedolizumab-treated adults with CD. A meta-analysis was conducted in R to generate pooled estimates of MH. The primary analysis included studies reporting point estimates of MH/endoscopic remission as absence of ulcers/erosions and/or Simple Endoscopic Score for CD (SES-CD) cut − points < 4 , at 6 and 12 months. Results. The systematic literature review included 36 studies, predominantly of antitumour necrosis factor-experienced patients. MH and endoscopic remission were the most frequently reported endpoints. MH rates were 10.1%-46.0% at 6 months (ten studies) and 21.2%-62.5% at 12 months (eight studies). Fifteen studies defining MH as absence of ulcers/erosions and/or SES-CD cut − points < 4 were included for meta-analysis. Pooled MH rates for the primary analysis were 31.8% at 6 months (95% confidence interval (CI): 25.6-38.3; five studies, N = 223 ) and 33.4% at 12 months (95% CI: 25.9-41.4; three studies, N = 151 ). Conclusion. Approximately one-third of vedolizumab-treated patients with CD achieved MH at both 6 and 12 months in real-world clinical settings, despite utilisation in largely biologic-refractory patients. These findings confirm the effectiveness of vedolizumab for achieving MH in patients with CD

Concurrent Stimulant and Atypical Antipsychotic Drug Use in Children and Adolescents Diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD)

Background: Multiple psychotropic drug use is highly prevalent in children and adolescents despite the lack of sufficient safety and efficacy data for such use. Few studies evaluated the concurrent use of stimulant and atypical antipsychotic agents in children and adolescents diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). Objectives: The goals of this study were 1) to examine the prevalence of and factors associated with concurrent use of long acting stimulant (LAS) and atypical antipsychotic agents, 2) to examine the impact of addition of atypical antipsychotic agents on the persistence of LAS treatment, and 3) to examine the risk of cardiovascular adverse events due to addition of the atypical antipsychotic agents already on the regimen of LAS in children and adolescents diagnosed with ADHD. Methods: The study involved retrospective longitudinal analysis of 2003-2007 Medicaid Analytical eXtract (MAX) data of four US states. The study mainly focused on children and adolescents aged 6 to 17 years who were diagnosed with ADHD and initiated ADHD treatment by using long acting stimulant (LAS) medications from July 2003 to December 2006. The continuous eligibility 6 months before and 12 months after the index LAS date was ensured for the study cohort. The study cohort was uniformly followed for one year after the initiation of LAS. Concurrent use of LAS and atypical antipsychotic medications were defined as receipt of both medications together at least for 14 days. The persistence of LAS was defined as number of days to discontinuation of index LAS treatment. The cardiovascular events were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from inpatient and outpatient files. Descriptive analysis was performed to examine the utilization of LAS and atypical antipsychotic agents and compare the study groups. Multiple logistic regression analysis within the conceptual framework of Andersen behavioral model was used to examine the factors associated with concurrent use with LAS use only as reference group. Multivariate analysis was conducted by using accelerated failure time regression to examine the determinants of persistence of LAS. In order to examine cardiovascular safety typical antipsychotic use was further classified as current use (active atypical antipsychotic use), former use (days after the periods of current use), and nonuse (time before the first atypical antipsychotic use including the follow up of patients who were never exposed to atypical antipsychotics). The cardiovascular risks were compared among the study groups using time dependent Cox regression analysis. Results: Among the 61, 793 children and adolescents who were diagnosed with ADHD and initiated their ADHD treatment with LAS 11, 866 (19.20%) received LAS and atypical antipsychotic concurrently at least for 14 days. Risperidone was highly used concurrently and clozapine was least used (0.03%) among atypical antipsychotic users. The results of multiple logistic regression revealed that children and adolescents with male gender, black race, and foster care benefit recipients were more likely to receive LAS and atypical antipsychotic agents concurrently than their counterparts. Moreover, FDA approved indications such as schizophrenia, bipolar disorder, and psychosis and FDA non-approved indications such as oppositional defiant disorder, pervasive developmental disorder, tic disorder, and personality disorder determined the concurrent use of LAS and atypical antipsychotic agents. The mean duration of LAS treatment was longer (200 days; 95% Confidence Interval (CI), 197.6-202.9 days) among concurrent LAS and atypical antipsychotic recipients than only LAS users (143 days; 95% CI, 141.8-144 days). The accelerated failure time regression analysis found that concurrent users of LAS and atypical antipsychotic agents had 45% longer (Survival Time Ratio (STR), 1.45; 95% CI, 1.41-1.49) LAS treatment persistence than only LAS recipients. Similarly, adolescents and non-whites had shorter LAS treatment persistence than their counterparts. The numbers of cardiac events were 840, 202, and 45 during periods of atypical non-use, current use and former use, respectively. After controlling for demographic, service related, and clinical characteristics, the study found that current users and former users of atypical antipsychotics among the LAS users were not associated with cardiovascular events compared to no atypical users (Current use: (Hazard ratio (HR), 1.17; 95% CI, 0.98-1.40; Former use: HR, 1.24; 95% CI, 0.91-1.69). Patient characteristics obesity (HR, 1.63; 95% CI, 1.21-2.20), diabetes (HR, 1.94; 95% CI, 1.27-2.96) and receipt of mood stabilizers increased the risk of cardiovascular events (HR, 1.87; 95% CI, 1.08-3.24) in the study population. Conclusions: This study found that almost 1 in 5 children and adolescents received LAS and atypical antipsychotics concurrently. In addition to FDA approved indications such as schizophrenia, bipolar disorder, and psychosis, FDA non-approved indications such as oppositional defiant disorder, pervasive developmental disorder, tic disorder, and personality disorder determined the concurrent use of LAS and atypical antipsychotics. The recipients of LAS and atypical antipsychotic agents concurrently had longer LAS treatment continuity than recipients of only LAS. The study did not find any increased cardiovascular risk with addition of the atypical antipsychotics to LAS regimen in children and adolescents diagnosed with ADHD. The addition of the atypical antipsychotic agents along with LAS in ADHD patients may be beneficial in controlling ADHD symptoms. There is need to conduct head to head clinical trials of the 2 treatment groups in order to examine the efficacy of atypical antipsychotic agents and mechanism in the treatment of ADHD. Therefore there is urgent need of conducting head to head long term trials in order to examine the safety and efficacy of concurrent use of LAS and atypical antipsychotic agents in children and adolescents with ADHD and several other psychiatric disorders. Future studies with long term follow up are required to evaluate the long term effects of concurrent use of long acting stimulants and atypical antipsychotic agents.Pharmacy, College o

Experiences of Participants practicing Anapan sati (Progressive Relaxation via Breathing Technique) prior to Counselling session

Abstract The fabric of mental health in India is susceptible to several difficulties and obstacles. In the middle class and lower middle class, particularly among the Indian people, there are still many negative stereotypes about psychotherapy and counseling. Ironically, this group is also the one that experiences the most mental health problems. To comprehend the type, severity, and typology of barriers to counseling, extensive research has been done on poor mental health literacy and the stigma associated with counseling. This study attempts to comprehend the variance in counseling experiences and the impact of Anapan sati (often used in Vippashana meditation using Anapan's progressive breathing technique) before counseling sessions. The sample is split into two groups for the investigation. Age (18–30 years), socioeconomic level (lower middle class), and medical history are used to match the groups. Prior to the counseling session, members of Group 1 (N=10) participated in the breathing exercise, but members of Group 2 (N=10) did not. To comprehend the experiences of counseling and the anguish it causes, semi-structured interviews were done. Cathartic, relaxing, and investigative were the typical themes that surfaced, but the themes from people who did not use breathing techniques were similar but intense. Future research should concentrate on examining the counseling experiences of people with a history of psychopathology. There were limitations and suggestions offered

EXPERIMENTAL STUDY OF HEAT TRANSFER FROM PLATE FIN ARRAY IN MIXED CONVECTION MODE

The work summarized in this paper presents an experimental study of heat transfer from plate fin in mixed convection mode enhancement by the use of plate fins is presented. After a brief review of the basic methods used to enhance the heat transfer by simultaneous increase of heat transfer surface area as well as the heat transfer coefficient, a simple experimental method to assess the heat transfer enhancement is presented. The method is demonstrated on plate fins as elements for the heat transfer enhancement, but it can in principle be applied also to other fin forms

COMPARATIVE STUDY OF EDGE BASED LSB MATCHING STEGANOGRAPHY FOR COLOR IMAGES

Steganography is a very pivotal technique mainly used for covert transfer of information over a covert communication channel. This paper proposes a significant comparative study of the spatial LSB domain technique that focuses on sharper edges of the color as well as gray scale images for the purpose of data hiding and hides secret message first in sharper edge regions and then in smooth regions of the image. Message embedding depends on content of the image and message size. The experimental results illustrate that, for low embedding rate the method hides the message in sharp edges of cover image to get better stego image visualization quality. For high embedding rate, smooth regions and edges of the cover image are used for the purpose of data hiding. In this steganography method, color image and textured kind of image preserves better visual quality of stego image. The novelty of the comparative study is that, it helps to analyze the efficiency and performance of the method as it gives better results because it directly works on color images instead of converting to gray scale image