In Hospital Outcome of Acute Anterior Myocardial Infarction in Diabetic and Non-Diabetic Patients

Background: Patients with acute anterior myocardial infarction and diabetes have a poor prognosis. Objectives: To see the in-hospital outcome of acute anterior myocardial infarction in diabetic and non-diabetic patients. Methodology: This cross-sectional observational study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet over a period of two years from July 2015 to June 2017. A total of 100 acute anterior MI patients (50 diabetic and 50 non diabetic) were included in this study. Acute anterior MI patients admitted after 6 hours of symptom onset or who did not receive streptokinase were excluded. Results: Male predominance was obvious in both groups [40 (80%) versus 42 (84%); p>0.05] in diabetic and non-diabetic group respectively. Mean age was 53.34 ± 11.32 and 54.84 ± 14.12 years in diabetic and non-diabetic groups respectively. Dyslipidemia [6 (12%) versus 6 (12%); p >0.05], Smoking [32 (64%) versus 34 (68%); p >0.05] and Family history of cardiovascular disease [6 (12%) versus 4 (8%); p >0.05] were similar among diabetic and non-diabetic respectively. Hypertension was found more among non-diabetic [27 (54%) versus 19 (38%); p>0.05] but difference was not statistically significant. Diabetic group had more Apical Anterior MI [22 (44%) versus 19 (38%); p<0.05] and Extensive Anterior MI [20 (40%) versus 11 (22%); p<0.05] while non-diabetic group had more Septal MI [10 (20%) versus 3 (6%); p<0.05] and Mid Anterior MI [10 (20%) versus 4 (8%); p<0.05]. LV ejection fraction was found significantly low in diabetic patients [43.96 ± 5.95 versus 53.68 ± 6.36; p<0.01]. Killip Class III was more in diabetic [24 (48%) versus 9 (18%); p<0.01] and Killip Class I was more in non-diabetic group [18 (36%) versus 3 (6%); p<0.01] according to Killip classification of HF which was statistically significant between the two groups. Atrial Fibrillation was more in diabetics [6 (12%) versus 1 (2%); p<0.05] while sinus tachycardia was more among non-diabetics [20 (40%) versus 5 (10%); p<0.05] which are statistically significant. Diabetic group had more acute MR [2 (4%) versus 0 (0%); p>0.05] but was not significant. Death was more in diabetic group than that of non-diabetic group [7 (14%) versus 3 (6%); p>0.05] but it was statistically not significant. Conclusion: It is concluded from the present study that in hospital outcomes of acute anterior myocardial infarction are worse in diabetic patients than in non-diabetic patients

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

Vinylanthracene-Based Compounds as Electron-Rich Sensors for Explosives Recognition

Four new vinylanthracene-based fluorescent molecules were synthesized and characterized. The highly fluorescent vinylanthracene moiety was coupled with the ethynylbenzene group to yield rigid and electron-rich pi systems, which were utilized as selective and sensitive probes for picric acid in both the solution and solid states. In solution, the molecules demonstrated signal amplification by a combined effect of photo-induced electron transfer and resonance energy transfer, whereas in the solid state the enhanced sensitivity was attributed to a collective effect of PET and exciton migration among closely spaced molecules. In direct contact mode experiments, thin films of the molecules demonstrated discernible changes in fluorescent intensity, which shows that the molecules are potential materials for in-the-field applications

N-glycolylneuraminic acid specific lectin from Pila globosa snail

A N-glycolylneuraminic acid-specific lectin (PAL) has been purified from an albumin gland extract of the apple snail, Pila globosa. Purification is conducted on a bovine submaxillary mucin-~$ar~s%-TB affinity matrix followed by gel filtration on a Sepharose 6B column. The lectin agglutinatz; rabbit erythrocytes. The hemagglutination activity is dependent on Ca concentration in a significant manner but with a remark able behaviour. The lectin is a trimeric glycoprotein of native Mr 440 kDa with 25% carbohydrate and is composed of three nonidentical subunits of molecular weights 190, 145. and 105 kDa. It has a p1 of 7.0. The lectin exhibits a unique and strict specificity toward N-glycolylneuraminic acid and this phenomenon discriminates it from other known sialic acid binding lectins. The uniqueness indicates the absolute need for a glycolyl substitution on the amino residue and of a glyceryl side chain on the exocyclic part and an axial-COOH group in neuraminic acid. The presence of an acety

Mechano-fluorochromic Pt-II Luminogen and Its Cysteine Recognition

A new triphenylamine-based organometallic Pt-II luminogen (1) and its analogous organic compound (2) are reported. The molecules are decorated with aldehyde functionality to improve their photophysical properties by utilising donor-acceptor interactions. The single crystal X-ray structure analysis of PtII analogue 1 revealed that the neighbouring molecules were loosely organised by weak intermolecular C-H center dot center dot center dot pi interactions. Because of the twisted nature of the triphenylamine backbone the compounds showed aggregation-induced emission enhancement in THF/water mixture. Due to their loose crystal packing, upon application of external stimuli these luminogens exhibited mechano-fluorochromic behaviour. The crystalline forms of the compounds displayed a more superior emission efficiency than the grinded samples. Moreover, the compounds showed crystallization-induced emission enhancement (CIEE) and exhibited chemodosimetric response towards cysteine under physiological condition

Electron-Rich Triphenylamine-Based Sensors for Picric Acid Detection

This paper demonstrates the role of solvent in selectivity and sensitivity of a series of electron-rich compounds for the detection of trace amounts of picric acid. Two new electron-rich fluorescent esters (<b>6</b>, <b>7</b>) containing a triphenylamine backbone as well as their analogous carboxylic acids (<b>8</b>, <b>9</b>) have been synthesized and characterized. Fluorescent triphenylamine coupled with an ethynyl moiety constitutes π-electron-rich selective and sensitive probes for electron-deficient picric acid (PA). In solution, the high sensitivity of all the sensors toward PA can be attributed to a combined effect of the ground-state charge-transfer complex formation and resonance energy transfer between the sensor and analyte. The acids <b>8</b> and <b>9</b> also showed enhanced sensitivity for nitroaromatics in the solid state, and their enhanced sensitivity could be attributed to exciton migration due to close proximity of the neighboring acid molecules, as evident from the X-ray diffraction study. The compounds were found to be quite sensitive for the detection of trace amount of nitroaromatics in solution, solid, and contact mode

Electron-Rich Triphenylamine-Based Sensors for Picric Acid Detection

This paper demonstrates the role of solvent in selectivity and sensitivity of a series of electron-rich compounds for the detection of trace amounts of picric acid. Two new electron-rich fluorescent esters (<b>6</b>, <b>7</b>) containing a triphenylamine backbone as well as their analogous carboxylic acids (<b>8</b>, <b>9</b>) have been synthesized and characterized. Fluorescent triphenylamine coupled with an ethynyl moiety constitutes π-electron-rich selective and sensitive probes for electron-deficient picric acid (PA). In solution, the high sensitivity of all the sensors toward PA can be attributed to a combined effect of the ground-state charge-transfer complex formation and resonance energy transfer between the sensor and analyte. The acids <b>8</b> and <b>9</b> also showed enhanced sensitivity for nitroaromatics in the solid state, and their enhanced sensitivity could be attributed to exciton migration due to close proximity of the neighboring acid molecules, as evident from the X-ray diffraction study. The compounds were found to be quite sensitive for the detection of trace amount of nitroaromatics in solution, solid, and contact mode

Binding of carboxylatopillar5]arene with alkyl and aryl ammonium salts in aqueous medium

The complex formation of alkyl ammonium salts by water-soluble carboxylatopillar5] arene (CP5A) in aqueous medium is reported. p-Xylene diammonium salt and a series of secondary alkyl ammonium salts with various alkyl groups have been prepared and investigated for complex formation. All the ammonium salts exhibit strong host-guest complexation with CP5A under neutral aqueous conditions. H-1 NMR, H-1 DOSY and 2D NOESY NMR experiments have been performed to characterize these inclusion complexes. In this study, the hydrophobic and electrostatic interactions govern the complex formation leading to the formation of pseudorotaxane species. Five pseudo2] rotaxanes and one pseudo3] rotaxane were obtained whose association constant values and stoichiometry were evaluated by an NMR titration method. The results indicate the use of ammonium salts as new complimentary synthons for CP5A in aqueous medium, adding to the repertoire of existing recognition motifs such as paraquat and 1,4-bis(pyridinium) derivatives

Electron-Rich Triphenylamine-Based Sensors for Picric Acid Detection

This paper demonstrates the role of solvent in selectivity and sensitivity of a series of electron-rich compounds for the detection of trace amounts of picric acid. Two new electron-rich fluorescent esters (<b>6</b>, <b>7</b>) containing a triphenylamine backbone as well as their analogous carboxylic acids (<b>8</b>, <b>9</b>) have been synthesized and characterized. Fluorescent triphenylamine coupled with an ethynyl moiety constitutes π-electron-rich selective and sensitive probes for electron-deficient picric acid (PA). In solution, the high sensitivity of all the sensors toward PA can be attributed to a combined effect of the ground-state charge-transfer complex formation and resonance energy transfer between the sensor and analyte. The acids <b>8</b> and <b>9</b> also showed enhanced sensitivity for nitroaromatics in the solid state, and their enhanced sensitivity could be attributed to exciton migration due to close proximity of the neighboring acid molecules, as evident from the X-ray diffraction study. The compounds were found to be quite sensitive for the detection of trace amount of nitroaromatics in solution, solid, and contact mode

Aggregation-Induced Emission of Platinum(II) Metallacycles and Their Ability to Detect Nitroaromatics

Two new acceptors containing platinum-carbazole (1) and platinum-triphenylamine (2) backbones with bite angles of 908 and 1208, respectively, have been synthesised and characterised. Reactions of the rigid acceptor 1 with linear dipyridyl-based donors (3 and 4) generated 4+4] self-assembled molecular squares (5 and 6), and similar treatments with acceptor 2 instead of 1 yielded 6+6] self-assembled molecular hexagons (7 and 8). The metallacycles were characterised by multinuclear NMR spectroscopy (H-1 and P-31) and ESI-MS. The geometries of the metallacycles were optimised by using the PM6 method. When aggregates of the metallacycles were formed by adding hexane solutions in dichloromethane, aggregation-induced emission was observed for metallacycles 5 and 7, and aggregation-caused quenching was observed for metallacycles 6 and 8. The formation of aggregates was verified by dynamic light scattering and TEM analyses. Macrocycles 5 and 7 are white-light emitters in THF. Moreover, their high luminescence in both solution and the solid state was utilised for the recognition of nitroaromatic explosives