Congenital factor VII deficiency in children at tertiary health care facility in Pakistan

This study presents the demographics, clinical spectrum, and outcome of patients with congenital factor VII (FVII) deficiency at a tertiary care center over a period of 12 years. Of the 49 patients, 27 (55%) patients were males. Consanguinity was found in 92% of the patients. The median age of symptom onset was 2.4 (interquartile range [IQR]: 1.1-6.5) years with a median age of 5.8 (IQR: 3.1-10) years at diagnosis. Life-threatening complications like intracranial bleeding (ICB) and intra-abdominal bleeding (IAB) were observed in 8 (16.4%) patients. We found that 11 (55%) of the 20 patients with FVII coagulant activity (FVIIc) 5% were affected by severe symptoms. Age (P = .042; odds ratio 6.46). Overall, 4 (8.2%) died as a consequence of ICB (3 patients) and IAB (1 patient)

2-(3,4-Dimethyl-5,5-dioxo-2H,4H-pyrazolo­[4,3-c][1,2]benzothia­zin-2-yl)acetic acid

In the title mol­ecule, C13H13N3O4S, the heterocyclic thia­zine ring adopts a half-chair conformation in which the S and an adjacent C atom are displaced by 0.919 (3) and 0.300 (4) Å, respectively, on the same side of the mean plane formed by the remaining ring atoms. The mean planes of the benzene and pyrazole rings are inclined at a dihedral angle of 18.32 (12)° with respect to each other. The acetate group is oriented at 80.75 (8)° with respect to the pyrazole ring. The crystal structure is stabilized by O—H⋯N and C—H⋯O hydrogen bonds, resulting in fused eight- and seven-membered rings with R 2 2(8) and R 2 2(7) graph-set motifs, respectively

Methyl 2-acetonyl-4-hydr­oxy-2H-1,2-benzothia­zine-3-carboxyl­ate 1,1-dioxide

In the mol­ecule of the title compound, C13H13NO6S, the thia­zine ring adopts a distorted sofa conformation. The enolic H atom is involved in intra­molecular O—H⋯O hydrogen bonding besides the weaker C—H⋯O=S and C—H⋯O=C inter­actions

Healthcare providers versus patients\u27 understanding of health beliefs and values

This study examined how well healthcare providers perceive and understand their patients’ health beliefs and values compared to patients’ actual beliefs, and to determine if communication relationships maybe improved as a result of healthcare providers’ understanding of their patients’ illness from their perspective. A total of 61 participants (7 healthcare providers and 54 patients) were enrolled in the study. Healthcare providers and patients individually completed survey instruments and each participated in a structured focus group. Healthcare provider and patient differences revealed that patients perceived greater meaning of their illness (p = 0.038), and a greater preference for partnership (p = 0.026) compared to providers. The three qualitative themes most important for understanding patients’ health beliefs and values as perceived by healthcare providers were education, trust, and culture. Educating patients was perceived as having the greatest impact and also the easiest method to implement to foster providers’ understanding, with at least one patient focus group in agreement of same. Likewise, three themes were derived from patients’ perspectives as relatively more important in understanding providers’ beliefs and values; bidirectional communication, comprehensive treatment, and discipline. Overwhelmingly, bidirectional communication was perceived as a critical factor as having the greatest impact and may also be easiest to implement according to these patients. When patients and healthcare providers listen and communicate with each other, they are likely to develop a shared understanding that may improve future decision making and quality of care patients receive

Methyl 4-acet­oxy-2-methyl-2H-1,2-benzothia­zine-3-carboxyl­ate 1,1-dioxide

In the title compound, C13H13NO6S, the thia­zine ring adopts a distorted half-chair conformation. Each mol­ecule is linked to its neighbour through inter­molecular C—H⋯O hydrogen bonds

1-(4-Hydr­oxy-2-methyl-1,1-dioxo-2H-1,2-benzothia­zin-3-yl)ethanone

In the title compound, C11H11NO4S, the thia­zine ring adopts a distorted half-chair conformation. The enolic H atom is involved in an intra­molecular O—H⋯O hydrogen bond, forming a six-membered ring. Mol­ecules are linked through weak inter­molecular C—H⋯O hydrogen bonds, resulting in chains lying along the b axis

Methyl 2-methyl-4-(oxiran-2-ylmeth­oxy)-2H-1,2-benzothia­zine-3-carboxyl­ate 1,1-dioxide

In the title compound, C14H15NO6S, the thia­zine ring adopts a distorted half-chair conformation. The structure displays several cooperative weak inter­molecular C—H⋯O hydrogen-bonding inter­actions, giving rise to a two-dimensional sheet packing motif. The CH2 group in the meth­oxy linker to the oxirane ring, and the CH group in that ring, exhibit twofold positional disorder. The three-membered oxirane ring is twisted approximately perpendicular with respect to thia­zine ring (dihedral angle = 60/86° for the major/minor disorder components). 1,2-Benzothia­zines of this kind have a wide range of biological activities and are mainly used as medicines in the treatment of inflammation and rheumatoid arthritis

2-(3,4-Dimethyl-5,5-dioxo-2H,4H-pyrazolo[4,3-c][1,2]benzothia­zin-2-yl)-N′-(2-thienylmethyl­idene)acetohydrazide

In the title mol­ecule, C18H17N5O3S2, the heterocyclic thia­zine ring adopts a twist boat conformation, with the S and N atoms displaced by 0.480 (7) and 0.205 (8) Å, respectively, on opposite sides of the mean plane formed by the remaining ring atoms. The pyrazole and benzene rings are tilted at an angle of 10.9 (2)° with respect to one another. The crystal structure is stabilized by inter­molecular N—H⋯O and C—H⋯N hydrogen bonds, resulting in dimers forming nine-membered rings of graph-set motif R 2 2(9). In addition, inter­molecular C—H⋯O inter­actions result in chains of mol­ecules along the c axis, further consolidating the crystal packing

2-(2-Oxo-2-phenyl­ethyl)-1,2-benziso­thia­zol-3(2H)-one 1,1-dioxide

In the title compound, C15H11NO4S, the benzothia­zole unit is essentially planar [maximum deviation = 0.0644 (14) Å for the N atom] and forms a dihedral angle 54.43 (6)° with the phenyl ring. In the crystal structure, weak bifurcated C—H⋯O hydrogen bonds involving the carbonyl O atoms as acceptors result in R 2 2(7) ring motifs