Mechanical Prosthetic Valves and Pregnancy : A therapeutic dilemma of anticoagulation

Choosing the best anticoagulant therapy for a pregnant patient with a mechanical prosthetic valve is controversial and the published international guidelines contain no clear-cut consensus on the best approach. This is due to the fact that there is presently no anticoagulant which can reliably decrease thromboembolic events while avoiding damage to the fetus. Current treatments include either continuing oral warfarin or substituting warfarin for subcutaneous unfractionated heparin or low-molecular-weight heparin (LMWH) in the first trimester (6–12 weeks) or at any point throughout the pregnancy. However, LMWH, while widely-prescribed, requires close monitoring of the blood anti-factor Xa levels. Unfortunately, facilities for such monitoring are not universally available, such as within hospitals in developing countries. This review evaluates the leading international guidelines concerning anticoagulant therapy in pregnant patients with mechanical prosthetic valves as well as proposing a simplified guideline which may be more relevant to hospitals in this region

Pyridazine and its related compounds: Part 33. Synthesis of some disperse dyes derived from 3-hydrazinyl-4,5-diphenyl-1H-pyrazolo[3,4-c]pyridazine and their color assessment on polyester fabric

Active methylene compound such as ethyl acetoacetate was coupled with diazotized arylamines to give ethyl arylazoacetoacetates. When the obtained compounds refluxed with 3-hydrazinyl-4,5-diphenyl-1H-pyrazolo[3,4-c]pyridazine in the presence of ethanol yielded 1-(4, 5-Diphenyl-1H-pyrazolo[3, 4-c]pyridazin-3-yl)-3-methyl-4-(2-phenylhydrazono)-1H-pyrazol-5(4H)-one derivatives. The dyes were applied to polyester fabric, and their absorption spectral characteristics, fastness properties and color assessment measured

مدى توافر أبعاد التوجه الإستراتيجي في القطاع المصرفي

هدفت هذه الدِّراسة إلى تحديد مدى توافر أبعاد التوجه الإستراتيجي: التوجه الريادي، التوجه نحو العملاء، التوجه نحو التكنولوجيا في فروع المصارف التجارية الخاصة في الساحل السوري, اعتمد الباحث في هذه الدراسة على المنهج الوصفي، الذي يقوم على وصف الظاهرة وصفا دقيقا وتحليلها للإجابة على أهداف الدراسة ومناقشة فرضياتها. أما بالنسبة لطرائق البحث تم تطوير استبانة من خلال اطلاع الباحث على الأدبيات المنشورة كأداة لجمع البيانات الأولية, وتمّ توزيع الدرجات على بنود الاستبانة وفقاً لمقياس ليكرت الخماسي, وقاد تمثلت عينة البحث بـــ110 مفردة من كادر العاملين في المصارف، ومن ثمَّ أجرى دراسة ميدانيَّة بغرض بيان هذه العلاقة. وقد خلصت الدِّراسة إلى إن إدارة المصارف لا تتقبل ولا تنفذ الأفكار التي لم يتم التفكير فيها مسبقاً، وليس لدى المصارف  استعداداً لتحمل المخاطرة من جراء تقديم خدمات جديدة ، وإن المصارف لا تقوم باستطلاع آراء العملاء لمعرفة رضاهم عن الخدمات المقدمة، وبلغ متوسّط إجابات أفراد العيّنة لمتغيّر التوجه نحو المنافسين2.984 ، وهو يدلّ على عدم توافر بعد التوجه نحو المنافسين كأحد أبعاد التوجه الإستراتيجي في القطاع المصرف

Crystal structures of 4-phenylpiperazin-1-ium 6-chloro-5-ethyl-2,4-dioxopyrimidin-1-ide and 4-phenylpiperazin-1-ium 6-chloro-5-isopropyl-2,4-dioxopyrimidin-1-ide

The title molecular salts, C10H15N2+·C6H6ClN2O2−, (I), and C10H15N2+·C7H8ClN2O2−, (II), consist of 4-phenylpiperazin-1-ium cations with a 6-chloro-5-ethyl-2,4-dioxopyrimidin-1-ide anion in (I) and a 6-chloro-5-isopropyl-2,4-dioxopyrimidin-1-ide anion in (II). Salt (I) crystallizes with two independent cations and anions in the asymmetric unit. In the crystal structures of both salts, the ions are linked via N—H...O and N—H...N hydrogen bonds, forming sheets which are parallel to (100) in (I) and to (001) in (II). In (I), the sheets are linked via C—H...Cl hydrogen bonds, forming a three-dimensional framework

Comparing monolithic and fused core HPLC columns for fast chromatographic analysis of fat soluble vitamins

HPLC stationary phases of monolithic and fused core type can be used to achieve fast chromatographic separation as an alternative to UPLC. In this study, monolithic and fused core stationary phases are compared for fast separation of four fat-soluble vitamins. Three new methods on the first and second generation monolithic silica RP-18e columns and a fused core pentafluoro-phenyl propyl column were developed. Application of three fused core columns offered comparable separations of retinyl palmitate, DL-α-tocopheryl acetate, cholecalciferol and menadione in terms of elution speed and separation efficiency. Separation was achieved in approx. 5 min with good resolution (Rs >5) and precision (RSD ≤ 0.6 %). Monolithic columns showed, however, a higher number of theoretical plates, better precision and lower column backpressure than the fused core column. The three developed methods were successfully applied to separate and quantitate fat-soluble vitamins in commercial products

(E)-1-(1,3-Benzodioxol-5-yl)-4,4-di­methyl­pent-1-en-3-one

In the mol­ecule of the title compound, C14H16O3, all non-H atoms except for one methyl C atom lie on a crystallographic mirror plane. The conformation with respect to the C=C bond [1.3465 (12) Å] is trans. In the crystal, mol­ecules are linked via C—H⋯O hydrogen bonds into C(5) chains propagating along [100]

PATHOLOGICAL MONITORING OF VISCERAL LESIONS INDUCED BY VELOGENIC NEWCASTLE DISEASE IN EXPERIMENTALLY INFECTED BROILER CHICKENS AT DIFFERENT AGES WITH SPECIAL REFERENCE TO PULMONARY INFLAMMATORY CYTOKINES EXPRESSION

The present work aimed to study the impact of infection with a locally isolated vNDV genotype VII in commercial broiler chickens of different ages from a histopathological point of view with related changes in pulmonary cytokine expression. 100 commercial broiler chickens were allocated into 4 groups as follows; group 1 served as control non-infected group and three infected groups, were infected with 106 EID50 NDV at ages of 10,20, and 30 days. Tissue samples from different organs were collected at the 1st, 3rd, 5th, and 7th days post-inoculation for histopathological and immunohistochemical examination. Quantitative real-time RT-PCR for virus re-isolation as well as expression of IL-6 and IFN-γ genes estimation were performed on lung tissue collected at 3 dpi. RT-PCR for virus revealed increased virus load in the lungs of older birds and cytokines profiling revealed significant up-regulation of both IL-6 and IFN-γ genes in the groups that received infection at older ages. The severity and distribution of pathological lesions were directly proportioned to the age of infection and the time interval post-infection. Immunostaining of the viral antigen in the different tissues confirmed the pantropic nature of the virus

Eradication Of Endodontic Infection By Instrumentation Role Of Nursing In The Management

There are a number of various working processes that are involved in endodontic therapy. These procedures include the isolation of the operating field, access to the pulp chamber, cleaning and shaping stages, and finally, the necessity for a three-dimensional filling of the canals. During each stage, a set of instruments that are either single-use or sterilizable is required. Nursing has a very essential part in the management of endodontic infection eradication because they will be the first line of defense in recognizing the symptoms being experienced by the patient. When it comes to reusable tools, it is essential to pay attention to the removal of material that has been deposited on the blades, which is not easy to remove manually. This review demonstrated that the use of single-use or first-use instruments necessitates the implementation of procedures associated with presterilization or sterilization