Crystal structure, Hirshfeld surface analysis and computational study of bis(2-{[(2,6-dichlorobenzylidene)hydrazinylidene]methyl}phenolato)cobalt(II) and of the copper(II) analogue

The title homoleptic Schiff base complexes, [M(C14H9Cl2N2O)2], for M = CoII,(I), and CuII, (II), present distinct coordination geometries despite the Schiff base dianion coordinating via the phenolato-O and imine-N atoms in each case. For (I), the coordination geometry is based on a trigonal bipyramid whereas for (II), a square-planar geometry is found (Cu site symmetry 1). In the crystal of (I), discernible supramolecular layers in the ac plane are sustained by chlorobenzene-C—HO(coordinated), chlorobenzene-C—H(fusedbenzene ring) as well as (fused-benzene, chlorobenzene)–(chlorobenzene) interactions [inter-centroid separations = 3.6460 (17) and 3.6580 (16) A˚ , respectively]. The layers inter-digitate along the b-axis direction and are linked by dichlorobenzene-C—H(fused-benzene ring) and – interactions between fused-benzene rings and between chlorobenzene rings [inter-centroid separations = 3.6916 (16) and 3.7968 (19) A˚ , respectively] . Flat, supramolecular layers are also found in the crystal of (II), being stabilized by – interactions formed between fused-benzene rings and between chlorobenzene rings [intercentroid separations = 3.8889 (15) and 3.8889 (15) A˚ , respectively]; these stack parallel to [101] without directional interactions between them. The analysis of the respective calculated Hirshfeld surfaces indicate diminished roles for HH contacts [26.2% (I) and 30.5% (II)] owing to significant contributions by ClH/HCl contacts [25.8% (I) and 24.9% (II)]. Minor contributions by ClCl [2.2%] and CuCl [1.9%] contacts are indicated in the crystals of (I) and (II), respectively. The interaction energies largely arise from dispersion terms; the aforementioned CuCl contact in (II) gives rise to the most stabilizing interaction in the crystal of (II)

Pregnancy Outcomes in HIV-Infected Women: Our Experience at a Tertiary Health-Care Center, Ahmedabad, Western India

Background: HIV prevalence has been increasing among pregnant women in many regions within the country. Illiteracy, early marriage, violence and sexual abuse against women are the major socioeconomic reasons for their vulnerability to HIV infection. Estimating the HIV seroprevalence in a low risk population such as pregnant women provide essential information for monitoring trend of HIV in general population and assist in prevention from mother to child transmission.  Methods: This study is a retrospective computer based data analysis, conducted at Sheth V.S. General and Sheth C.M. Hospital, Smt. N.H.L Municipal Medical College, Ahmedabad, a tertiary health care center in Gujarat, India between January 2012 to December 2019. This study includes 68330 pregnant women who attended antenatal clinic or directly admitted in labor room in emergency. Blood sample collected after pretest counselling and informed consent, tested for HIV antibodies as per NACO guidelines. HIV sero-positive mothers and babies were managed at ART center of our institute according to latest guidelines of the same. Results: Out of 68330 pregnant women, 166 found to be HIV-positive with seroprevalence rate of 0.24%. Majority of seropositive women (49.4%) were in the age group of 25-30 Years. Out of 150 live births, 3 babies were found to be HIV sero-positive result at 18 months and were managed with ART according to latest NACO guidelines. Conclusions: Mother to child transmission of HIV infection during pregnancy, delivery or breast feeding is responsible for more than 90% of pediatrics AIDS. Proper antenatal screening, interventions and preventive strategies during pregnancy, delivery and breastfeeding will bring down the mother to child transmission of HIV. A multidisplinary team approach to management involving an HIV physician, experienced obstetrician, and neonatologist are essential to optimize maternal and fetal outcome

Strategies to improve spinal cord ischemia in endovascular thoracic aortic repair: Outcomes of a prospective cerebrospinal fluid drainage protocol

PurposeAlthough endovascular repair of thoracic aortic aneurysm has been shown to reduce the morbidity and mortality rates, spinal cord ischemia remains a persistent problem. We evaluated our experience with spinal cord protective measures using a standardized cerebrospinal fluid (CSF) drainage protocol in patients undergoing endovascular thoracic aortic repair.MethodsFrom 2004 to 2006, 121 patients underwent elective (n = 52, 43%) and emergent (n = 69, 57%) endovascular thoracic aortic stent graft placement for thoracic aortic aneurysm (TAA) (n = 94, 78%), symptomatic penetrating ulceration (n = 11, 9%), pseudoaneurysms (n = 5, 4%) and traumatic aortic transactions (n = 11, 9%). In 2005, routine use of a CSF drainage protocol was established to minimize the risks of spinal cord ischemia. The CSF was actively drained to maintain pressures <15 mm Hg and the mean arterial blood pressures were maintained at ≥90 mm Hg. Data was prospectively collected in our vascular registry for elective and emergent endovascular thoracic aortic repair and the patients were divided into 2 groups (+CSF drainage protocol, −CSF drainage protocol). A χ2 statistical analysis was performed and significance was assumed for P < .05.ResultsOf the 121 patients with thoracic stent graft placement, the mean age was 72 years, 62 (51%) were male, and 56 (46%) underwent preoperative placement of a CSF drain, while 65 (54%) did not. Both groups had similar comorbidities of coronary artery disease (24 [43%] vs 27 [41%]), hypertension (44 [79%] vs 50 [77%]), chronic obstructive pulmonary disease (18 [32%] vs 22 [34%]), and chronic renal insufficiency (10 [17%] vs 12 [18%]). None of the patients with CSF drainage developed spinal cord ischemia (SCI), and 5 (8%) of the patients without CSF drainage developed SCI within 24 hours of endovascular repair (P< .05). All patients with clinical symptoms of SCI had CSF drain placement and augmentation of systemic blood pressures to ≥90 mm Hg, and 60% (3 of 5 patients) demonstrated marked clinical improvement.ConclusionPerioperative CSF drainage with augmentation of systemic blood pressures may have a beneficial role in reducing the risk of paraplegia in patients undergoing endovascular thoracic aortic stent graft placement. However, selective CSF drainage may offer the same benefit as mandatory drainage

Carotid-carotid crossover bypass: Is it a durable procedure?

AbstractPurpose: Reconstruction of a diseased common carotid artery may necessitate direct repair via aortic artery-based revascularization. However, carotid-carotid artery crossover grafting is an alternative extra-anatomic option that obviates the need for median sternotomy. We analyzed our results with carotid-carotid artery crossover bypass surgery. Methods: Data were analyzed for all patients undergoing carotid-carotid crossover bypass surgery from 1995 to 2000. Data on patient demographics, indications for surgery, perioperative morbidity and mortality, and graft patency were retrieved from a vascular surgery data base and hospital records. Stroke-free survival and graft patency were determined with life table methods. Results: Over 5 years, 24 carotid-carotid artery crossover bypass procedures were performed to treat both symptomatic (n = 19, 79%) and asymptomatic (n = 5, 17%) disease. Nine procedures (38%) were performed in men, 3 (13%) in patients with diabetes, 12 (50%) in active smokers, and 2 in patients with a history of Takayasu arteritis. Patient mean age was 63 years (range, 38-79 years). Twenty-three patients (96%) received polytetrafluoroethylene conduit grafts, and the remaining patients received vein grafts. Ten (42%) patients underwent concomitant endarterectomy. There were no perioperative deaths. One patient (4%) had asymptomatic early occlusion, one had transient neurologic deficit (4%), one (4%) required additional surgery because of bleeding, and one (4%) had a perioperative cerebrovascular accident (stroke). Three (17%) asymptomatic late occlusions were identified at 11, 57, and 64 months, respectively. Mean follow-up was 30 months (range, 1-70 months). Primary patency was 88%, and secondary patency was 92% at 3 years. Stroke-free survival was 94% at 4 years. Conclusion: Carotid-carotid artery crossover bypass surgery is a safe and durable procedure. Its use precludes the need for median sternotomy and provides acceptable stroke-free survival. (J Vasc Surg 2003;37:582-5.

2-{(1E)-[(E)-2-(2,6-Dichlorobenzylidene)hydrazin-1-ylidene]methyl}phenol: crystal structure, Hirshfeld surface analysis and computational study

The title Schiff base compound, C14H10Cl2N2O, features an E configuration about each of the C N imine bonds. Overall, the molecule is approximately planar with the dihedral angle between the central C2N2 residue (r.m.s. deviation = 0.0371 A˚ ) and the peripheral hydroxybenzene and chlorobenzene rings being 4.9 (3) and 7.5 (3), respectively. Nevertheless, a small twist is evident about the central N—N bond [the C—N—N—C torsion angle = 172.7 (2)]. An intramolecular hydroxy-O—H���N(imine) hydrogen bond closes an S(6) loop. In the crystal, – stacking interactions between hydroxy- and chlorobenzene rings [inter-centroid separation = 3.6939 (13) A˚ ] lead to a helical supramolecular chain propagating along the b-axis direction; the chains pack without directional interactions between them. The calculated Hirshfeld surfaces point to the importance of H���H and Cl...H/H...Cl contacts to the overall surface, each contributing approximately 29% of all contacts. However, of these only Cl...H contacts occur at separations less than the sum of the van der Waals radii. The aforementioned – stacking interactions contribute 12.0% to the overall surface contacts. The calculation of the interaction energies in the crystal indicates significant contributions from the dispersion term