A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

Background: Hysterectomy is the most common performed major gynaecological surgery and the decision depends on indications for operation, surgeon’s training and preference, uterine size, adnexal pathologies and patient choice. To avoid laparotomy either total laparoscopic hysterectomy (TLH) or non-descent vaginal hysterectomy (NDVH) is the recently practised option. Objectives of the present study are to compare duration of operation, blood loss, ambulation time, post-operative pain and complications between TLH and NDVH.Methods: Patients undergoing above operation during January 2014 to December 2014 at N.R.S. Medical College, Kolkata, were included under the study. All patients were thoroughly examined and investigated and malignancies were excluded by Pap smear and or D&C. All patients were observed minutely during pre-operative, intra operative and post-operative period for any complications.Results: NDVH requires less operative time than TLH but intra operative blood loss, post-operative pain and ambulation time are slightly more.Conclusions: TLH requires infrastructural set up, greater surgical expertise, longer operative time and major intraopertive complications as compared to NDVH. In our low resource government hospital NDVH is better choice for removal of uterus in uncomplicated benign conditions

A randomized controlled trial of vaginal misoprostol tablet and intracervical dinoprostone gel in labor induction of women with prolonged pregnancies

Background: Objective of the study was to compare the efficacy of vaginal misoprostol and intracervical dinoprostone gel for induction of labor in women with unfavorable cervix beyond 41 weeks (287 days) of gestation.Methods: This randomized controlled trial was performed at a teaching hospital between January 2011 and December 2012. 192 women with singleton uncomplicated pregnancy with no previous uterine scar not going into spontaneous labor at 288th days of gestation .Misoprostol(25 mcg tablet)in the posterior vaginal fornix, four hourly, maximum six doses or Dinoprostone (0.5 mg gel) intracervical instillation ,six hourly, maximum three doses were given.Oxytocin was administered if needed. Primary outcome: Induction delivery interval (IDI) with incidence of delivery within 12 hours and 24 hours; mode of delivery: vaginal or caesarean section. Secondary outcome: maternal side effects, neonatal outcome. For statistical analysis chi-square test, student t- test and P-value determination were done.Results: The mean IDI was shorter in the misoprostol group compared to the dinoprostone group (p0.05). Adverse neonatal outcome (5-minutes Apgar score0.05).Conclusions: Vaginal misoprostol tablet is a safe and more effective method of induction of labour when compared with intracervical dinoprostone gel in prolonged pregnancies.

Omicron and vaccine booster dose – an update

Mutations in coronavirus is not unheard off. The variant, Omicron B.1.1.529 has overall 50 mutations and is considered as a variant of concern. Though the new variant has shown changes throughout its genome, S gene changes predominate. Significant changes in the S encoding gene, S gene, influences not only the transmissibility properties of SARS-CoV-2 but also the efficacy of existing vaccines. Increased transmissibility and ability of this variant to evade host immune responses conferred either due to past infections or due to vaccination driving increase in number of infections. However, the severity of the infections is low in comparison to its predecessors. A meta-analysis of ten studies analyzing the effect of COVID-19 vaccine booster dose, it was found studies report 10-to-42-fold increase in omicron neutralization. COVID appropriate behaviors, if followed rigidly can bring a meaningful change in the viral spread and resultant health impacts

Reappraisal of the variational anatomy of the vermiform appendix and their possible clinical applicability: a cadaveric analysis

Background: The anatomical variations in the position, length, arterial supply and extension of mesoappendix of the vermiform appendix (VA) are pivotal to establishing a standard pattern in the study population of known ethnicity and their clinical applicability. Materials and methods: The present study was conducted on 47 adult human cadavers, thirty-five males and twelve female subjects of North Indian ethnicity. Results: Retrocaecal appendix was found in 23 cases (48.9%) followed by pelvic in 13 (27.7%), three cases each of pre-ileal, post-ileal, and promontoric (6.4%), one case (2.1%) each of paracaecal and subcaecal reported. The length of VA varied from three to ten centimetres, averaging about 7.37±1.67 cm, both the shortest (2.9 cm) (female) and longest (10 cm) (male) were of retrocaecal type. The main appendicular artery (MAA) showed a widely varied branching pattern within the mesoappendix, ranging from three to seven. Fourteen cases (29.78%) showed the accessory appendicular artery (AAA) or dual arterial supply, arising from the ileocolic artery in ten (21%) and in four from the post-caecal (9%). In the specimens with dual arterial supply, the estimated portions of the VA supplied by the MAA also vary with distal ¾th being supplied in 57.14%. In ten cases (21%), the mesoappendix failed to reach the tip of the VF. Conclusions: Knowledge of anatomical diversities in position, length, course, arterial supply, branching pattern, and mesoappendix is potentially crucial in avoiding surgical catastrophes. Atypical positions of the organ can cause diagnostic confusion and result in delayed treatment. VF supplied by an end artery is one of the causes of the occurrence of appendicitis and mesoappendix not reaching the tip making the organ more vulnerable to necrosis. Vascular variations and anomalies involving the main or accessory appendicular artery are critical to prevent haemorrhage or faulty ligatures

Efficacy of pre- and post-emergence herbicide combinations on weed control in no-till mechanically transplanted rice

No-till mechanized-transplanted rice was evaluated for different combinations of pre- and post-emergence herbicides to determine feasible, economically viable weed management options to control complex weed flora in rice fields. All pre-emergence herbicides significantly reduced the population of grassy weeds; of these, pendimethalin resulted in the greatest reductions (83%) at 15 days after transplanting (DAT). Among five post-emergence herbicide treatments, the combination of bispyribac-sodium (10%SP) + pyrazosulfuron (10%WP) was found to be the most effective in controlling all weed flora at both 35 and 55 DAT. The sequential application of pendimethalin (pre-emergence) followed bispyribac-sodium + pyrazosulfuron (post-emergence) resulted in significantly higher rice grain yield (4.4 t-ha−1) and relative gross-margin (417 USD-ha−1) than all other treatments. A strong negative correlation was observed between rice grain yield and weed biomass, and a strong positive correlation between rice grain yield and weed control efficiency. Our findings demonstrate the potential to combine pre- and post-emergence herbicides in no-till mechanized-transplanted rice; these findings have applications globally in regions where rice is established by no-till or mechanized transplanting

Bivalent, trivalent, and tetravalent nickel complexes with a common tridentate deprotonated pyridine bis-amide ligand. Molecular structures of nickel(II) and nickel(IV) and redox activity

Using a tridentate bis-amide ligand 2,6-bis[N-(phenyl)carbamoyl]pyridine (H2L), in its deprotonated form, nickel complexes in three consecutive oxidation states [Et4N]2[NiIIL2]·H2O (1), [Et4N][NiIIIL2]·H2O (2), and [NiIVL2]·0.75H2O (3) have been prepared, and 1 and 3 structurally characterized. These X-ray structures represent first crystallographically characterized NiN6 coordination sphere, with a common pyridine bis-amide ligand. Complex 1 crystallizes in the orthorhombic space group Pccn, α = 10.175(2) Å, b = 20.834(3) Å, c = 23.765(4) Å, Z = 4, and 3 crystallizes in the monoclinic space group P21/a, a = 14.874(7) Å, b = 13.300(4) Å, c = 16.604(5) Å, β = 99.678(3)°, Z = 4. Considerable distortion is observed with the average distances being Ni-Namide 2.131(8) Å and Ni-Npy 1.994(7) Å for 1 and Ni-Namide 1.946(8) Å and Ni-Npy 1.846(8) Å for 3. The observation of short axial M-Npy and long equatorial M-Namide bonds (tetragonally compressed octahedral geometry) is caused by the steric requirement of the ligand. Magnetic susceptibility measurements (63-300 K) reveal that the spin states of nickel centers in 1 and 2 are S = 1 and S =½, respectively. Complex 3 is diamagnetic. In their absorption spectra (MeCN), 1 exhibits a d-d transition at 854 nm; 2 and 3 display LMCT transitions at 449 nm with a shoulder at 636 nm and at 480 nm with a shoulder at 730 nm, respectively. The nickel(III) complex 2 exhibits a rhombic EPR signal (g values: 2.149, 2.115, and 2.034), showing that the metal center is the primary residence site of the unpaired electron. Cyclic voltammetric measurements of 1 in MeCN solution at a glassy carbon electrode exhibit two chemically reversible (ip,a/ip,c ≈ 1) and electrochemically quasireversible (ΔEp = 100 mV) oxidative responses: a NiIII-NiII couple (E½ = 0.05 V vs SCE) and a NiIV-NiIII couple (E½ = 0.51 V vs SCE). A one-electron chemical oxidation of yellowish brown 1 was achieved in a two-phase solvent mixture H2O-CH2Cl2 with [Fe(η5-C5H5)2][PF6], which led to the isolation of reddish brown 2. A two-electron chemical oxidation of 1 was readily achieved in MeCN with ceric ammonium nitrate to afford dark violet crystals of 3. For 1 a linear correlation between the NiIII-NiII reduction potentials and the reciprocal of solvent dielectric constants is obtained

Synthesis and characterization of pyridine amide cation radical complexes of iron: stabilization due to coordination with low-spin iron(III) center

We reported the synthesis and characterization of peptide complexes of low-spin iron(III) [Fe(bpb)(py)2][ClO4] (1) and Na[Fe(bpb)(CN)2] (2) [H2bpb = 1,2-bis(pyridine-2-carboxamido)benzene; py = pyridine], where iron is coordinated to four nitrogen donors in the equatorial plane with two amide nitrogen anions and two pyridine nitrogen donors (Ray, M.; Mukherjee, R.; Richardson, J. F.; Buchanan, R. M. J. Chem. Soc., Dalton Trans. 1993, 2451). Chemical oxidation of 2 and a new low-spin iron(III) complex Na[Fe(Me6bpb)(CN)2]·H2O (4) [synthesized from a new iron(III) complex [Fe(Me6bpb)(py)2][ClO4] (3) (S =½)] [H2Me6bpb = 1,2-bis(3,5-dimethylpyridine-2-carboxamido)-4,5-dimethylbenzene) by (NH4)2Ce(NO3)6 afforded isolation of two novel complexes [Fe(bpb)(CN)2] (5) and [Fe(Me6bpb)(CN)2]·H2O (6). All the complexes have been characterized by physicochemical techniques. While 1-4 are brown/green, 5 and 6 are violet/bluish violet. The collective evidence from infrared, electronic, Mossbauer, and 1H NMR spectroscopies, from temperature-dependent magnetic susceptibility data, and from cyclic voltammetric studies provides unambiguous evidence that 5 and 6 are low-spin iron(III) ligand cation radical complexes rather than iron(IV) complexes. Cyclic voltammetric studies on isolated oxidized complexes 5 and 6 display identical behavior (a metal-centered reduction and a ligand-centered oxidation) to that observed for complexes 2 and 4, respectively. The Mossbauer data for 6 are almost identical with those of the parent compound 4, providing compelling evidence that oxidation has occurred at the ligand in a site remote from the iron atom. Strong antiferromagnetic coupling (|-2J| ≥ 450 cm-1) of the S = ½ iron atom with the S = ½ ligand π-cation radical leads to an effectively S = 0 ground state of 5 and 6. The oxidized complexes display 1H NMR spectra (in CDCl3 solution), characteristic of diamagnetic species

Synthesis, crystal structure and properties of trigonal bipyramidal [M(L<SUP>5</SUP>)<SUB>2</SUB>(H<SUB>2</SUB>O)]&#183;H<SUB>2</SUB>O complexes [M = cobalt(II) (S = 3/2) or copper(II) (S =&#189;); HL<SUP>5</SUP> = N-(2-chloro-6-methylphenyl)pyridine-2-carboxamide]

Using a bidentate ligand N-(2-chloro-6-methylphenyl)pyridine-2-carboxamide (HL5), in its deprotonated form, two new five-co-ordinate complexes of composition [M(L5)2(H2O)]&#183;H2O (M = CoII 1 or CuII 2) have been prepared and characterized including X-ray crystallography. The co-ordination geometry at CoII and CuII is approximately trigonal bipyramidal (two deprotonated amide nitrogens and a water molecule in the equatorial plane and two pyridines in the axial positions), being more distorted in the case of CuII. The observed distortion is caused by (i) a small bite angle of the chelating ligand and (ii) the presence of two ortho substituents, a chloro and a methyl group, on the phenyl ring (steric effect). To the best of our knowledge, 1 represents the first structurally characterized mononuclear high-spin cobalt(II) complex with a pyridine amide ligand. The magnetic moments of 1 and 2 at 300 K reveal that the compounds are paramagnetic (1 has S = 3/2 and 2 has S =&#189;), both as solids and in dmf solution. Temperature dependent magnetic susceptibility measurements confirmed their spin state. The stereochemistry of the cobalt(II) centre in 1 does not change to any measureable extent on dissolution in dmf (cf. solid and solution state absorption spectra). The geometry of the copper(II) centre in 2 observed in the solid state is not retained in dmf solution (absorption spectra), changing to a tetragonal stereochemistry. Cyclic voltammetric measurements (dmf solution; glassy carbon electrode) on 1 reveal an oxidative response at 0.48 V vs. saturated calomel electrode (SCE) and a reductive response at -1.66 V corresponding to CoIII-CoII and CoII-CoI redox couples, respectively. For 2 the CuII-CuI process was observed at -0.53 V vs. SCE

Relative stability of half-sandwich &#951;<SUP>6</SUP>-benzene Ru(II) complexes of tridentate (2-pyridyl)alkylamine ligands of varying chelate ring-size: nucleophilic addition of hydride ion onto the benzene ring

A full account of half-sandwich complexes of ruthenium(II) having three-legged "piano-stool" geometry supported by tridentate (2-pyridyl)alkylamine ligands is presented. Reaction of the dimer [{(&#951;6-C6H6)RuCl(&#956;-Cl)}2] with N-methyl-N,N-bis(2-pyridylmethyl)amine (MeL) in CH3OH in the presence of NH4PF6 affords the complex [(&#951;6-C6H6)Ru(MeL)][PF6]2 (1). A similar reaction with N-methyl-N,N-bis(2-pyridylethyl)amine (MeL), however, affords a non-organometallic Ru(III)-dimeric complex [(MeL)2Ru2III(&#956;-O)(&#956;-Cl)Cl2][PF6](5) (the composition of this complex has been established by physicochemical method). Nucleophilic addition reaction on 1 with NaBH4 leads to the isolation of a cyclohexadienyl complex [(&#951;5-C6H7)Ru(MeL)][PF6] (3). The molecular structure of 1&#183;2CH3CN, 3, and previously reported cyclohexadienyl complex [(&#951;5-C6H7)Ru(MeL)][PF6] (4) [MeL = N-methyl-[(2-pyridyl)ethyl(2-pyridyl)-methyl]amine], obtained from the reaction between NaBH4 and previously reported "piano-stool" complex [(&#951;6-C6H6)Ru(MeL)][PF6]2 (2), has been confirmed by X-ray crystallography. Solution-state structure of new complexes 1 and 3 has been elucidated by their 1H NMR spectra in CD3CN. The behavior of complex 3 has been investigated with the aid of two-dimensional 1H NMR spectroscopy, as well. An attempt has been made to provide a rationale for the effect of supporting tridentate N-donor ligand [MeL, MeL, and MeL], varying in the chelate ring-size on (i) the relative stability of half-sandwich &#951;6-benzene Ru(II) complexes and (ii) the electrophilicity of Ru(II)-coordinated benzene ring on the nucleophilic addition reactions