Bromidobis(N,N′-diphenyl­thio­urea-κS)copper(I) monohydrate

In the title compound, [CuBr(C13H12N2S)2]·H2O, the CuI atom adopts a slightly distorted trigonal-planar coordination arising from two S atoms of two diphenyl­thio­urea ligands and a bromide ion. There are two intra­molecular N—H⋯Br hydrogen bonds completing twisted six-membered rings with R(6) motifs. The dihedral angles between the aromatic rings in the ligands are 62.11 (13) and 85.73 (13)°. In the crystal, components are linked by N—H⋯O, O—H⋯S and O—H⋯π inter­actions. There also exist π–π inter­actions with a distance of 3.876 (2) Å between the centroids of benzene rings of two different ligands. Together, the inter­molecular inter­actions lead to a three-dimensional network

Phylogenetic analysis of Artemisia L. (Asteraceae) based on micromorphological traits of pollen grains

The phylogenetic relationships within the genus Artemisia have been very controversial. In order to recognize the systematic inference of pollen grains in this genus, the micromorphological characteristics of pollens from 22 taxa were examined by means of light microscopy (LM) and scanningelectron microscopy (SEM). A phylogenetic analysis of Artemisia based on 9 micromorphological characters of pollens was conducted using Wagner parsimony method. In the resulting phylogenetic tree, relationships among different Artemisia species are shown. This study also presents thephylogenetic associations among 4 sections within the genus Artemisia. The reunion of genus Seriphidum with Artemisia was also confirmed

Primary Soft Tissue Orbital Ewing’s Sarcoma Causing Unilateral Visual Loss: A Case Report

A case of primary Ewing's sarcoma of right orbit causing unilateral visual loss in a 3 year old female child is reported. The child presented with 1 year history of painless unilateral proptosis and loss of vision. Loss of vision due to primary Ewing's sarcoma in orbit is extremely rare and it should be considered as one of the differential diagnoses while dealing the patient with these sorts of clinical presentation

5-Hydr­oxy-2-methyl-4H-pyran-4-one

The title compound, C6H6O3, is a member of the pyrone family. The mol­ecules are planar (r.m.s. deviation of the asymmetric unit is 0.0248 Å, whereas that of the dimer is 0.0360 Å) and they are dimerized due to inter­molecular O—H⋯O hydrogen bonds. The dimers are connected to each other through hydrogen bonds involving the CH3 group and the hydr­oxy O atom. There are π–π inter­actions between the centroids of the pyrone rings at a distance of 3.8552 (13) Å. A C—H⋯π inter­action also exists between the carbonyl group and the centroid CgA of the pyrone ring, with O⋯CgA = 3.65 (1) Å and C⋯CgA = 4.363 (2) Å

Prognostic Indicators in Patients with Severe Head Injury: A 2 Year Retrospective Experience at Mayo Hospital, Lahore

Introduction: Traumatic brain injury (TBI) is an important public health care problem in the western world and equally being pandemic in the developing world. It is one of the most common causes of death in young adults and it can affect people’s lives enormously. Since many years the prognostic indicators of severe head injury had been field of research. Knowing the factors responsible for poor prognosis and preventing them outcome of severe head injury can be improved.Material and Methods: A retrospective study was conducted analyzing past records of the patients in department of Neurosurgery, Mayo Hospital from Nov 2011 to Nov 2013 with diagnosis of severe head injury (Glasgow Come Scale < 9). All patients except the patients with brain death, associated poly trauma, spinal injuries were excluded from the study. Total sample of 236 either managed conservatively or surgical and observed in Intensive care unit were study population. Prognosis was assessed with Glasgow Outcome Score (GOS) on or before (if patient expired before 30 days) 30 post admission day. Age, GCS, CT findings, Pupils were compared with GOS to find probable predictors of prognosis. GOS of less than 4 was regarded as poor prognosis. Categorical variables like GCS, pupils, CT findings were presented in the form of frequency (percentage) whereas continuous variables like age were presented in the form of mean ± SD and median (range). Association between GOS and probable prognostic indictors was seen by chi square test.Results: Out of 236 patients, 188 were male and 48 were female. Mean ± SD age of patient was 32.8 ± 14.6 years. Age group 15 – 45 years had maximum number of patients. Road traffic accident was major cause of severe head injury and majority had GCS 3 after resuscitation. More than half of the patient had bilaterally reactive pupils, 10% patient had post traumatic fits and half of the patients had features of base of skull fracture. 208 (8%) patient had abnormal CT findings. 30% patient on CT scan had closed cisterns and half of the patients has midline shift of 1.5 – 3 mm. More than 35% cases had surgical lesions over CT scan. Patients with age group < 15 years, GCS < 4, with closed cisterns, with surgical lesions and with midline shift of more than 3 mm had 30 day GOS < 4, which is regarded as poor prognostic marker.Conclusion: Prognosis in patient with severe head injury is determined by age, presenting post resuscitation GCS, mode of injury, CT findings and surgical lesions

Microvascular Decompression for Trigeminal Neuralgia

Background: The majority of patients with trigeminal neuralgia can be managed by medical treatment. Those patients who are not relieved with medicines can be offered some surgical treatment. Microvascular decompress-ion (MVD) of the trigeminal nerve in the root entry zone is the most suitable surgical procedure.Methods: This study included 80 patients who underwent MVD for trigeminal neuralgia from January 2002 to December 2005.Results: Out of the total 80 patients, 48 (60%) were males and 32 (40%) were females with male: female ratio of 3:2. The maximum number of patients was in the 6th decade of life (30%) followed by 7th and 5th decades (over 18%). Peroperatively, an arterial loop was found compressing the 5th nerve in the root entry zone in 60 (75%) patients, only veins in 10 (12.5%) and an artery and a vein (combined) in 6 (7.5%) patients.Conclusion: An arterial loop compressing the trigeminal nerve at root entry zone is the commonest finding at microvascular decompression (75%), followed by veins (12.5%).Keywords: Trigeminal neuralgia, Microvascular decompression, Root entry zon

Spinal Tumours: - Experience at Mayo Hospital

Objective: Spinal tumours are mostly benign, having devastating effects on patients in terms of patient’s dis-ability, morbidity and mortality. Depending upon their site, size and growth potential, they have different clinical effects on the patients. We are presenting a case series of 138 patients managed in neurosurgery department Mayo hospital from Nov 2011 to Sept 2014.metastatic bony spinal lesions were not included in this study . The objectives of my study are to determine: Types of spinal tumours treated in this setting. Common and differenti-ating clinical features among subjects, different locations of the same types and the role of microsurgery. Materials and Methods: It is a retrospective study. 55 Schawanomas, 34 Menengiomas, 15 Ependimomas, 06 Dermoids, 17 Astrocytomas, 07 Plasmacytomas, 02 Aneurysm bone cyst and 02 Teratomas were managed surgi-cally. Schwanoma and meningioma’s prevalence was more in cervical and dorsal areas. plasmacytomas mainly affected dorsal spine, astrocytomas and ependymomas hade different locations. Teratomas occupied conus medu-llaris. Multiple laminectomies and laminotomies were performed according to situation. Radical resections for intradural extramedullary and gross total debulking for intramedullary lesions, under high resolution Microscope was done. Post operative improvements and complications were noted. Results: A radical resection of these tumors results in a good long-term outcome, since the majority is histolo-gically benign. For intradural intramedullary tumours gross total debulking is more appropriate. Adjuvant radi-ation therapy should only be administered for the high grade or malignant tumor. Malignant tumors have a dismal outcome and surgery in these patients should be a conservative debulking. Open door laminotomies are preferable in intradural extramedulary lesions and does not cause post op spinal deformity. Conclusion: Radical surgery for spinal tumors with laminotomies gives good results in terms of patient’s func-tionality and spinal stability

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London