Diversity oriented one-pot three-component sequential synthesis of annulated benzothiazoloquinazolines

Annulated benzothiazoloquinazolines have been synthesized by a diversity oriented simple and convenient synthesis involving one-pot three-component reaction of substituted 2-aminobenzothiazoles with α-tetralone and aromatic/heteroaromatic aldehydes in ethanol in the presence of catalytic amount of triethylamine. The synthesized compounds have been characterized by their elemental analyses and spectral data

Pulmonary embolism as presenting feature of membranous nephropathy induced nephrotic syndrome

Severe pulmonary embolism as first-time presentation of Nephrotic syndrome is rare but Nephrotic syndrome secondary to membranous nephropathy (MN) may impose a greater thrombotic risk for unclear reasons. Here, we report the case of a 36-year-old female patient presented with complaints of sudden onset of shortness of breath since 4-5 days and features of right-sided heart failure. There was no preceding history of any chronic disease or renal disease. She was diagnosed as having a bilateral severe pulmonary embolism. Extensive workup and renal biopsy were done which was suggestive of primary membranous nephropathy

Rheumatoid arthritis 1st time presenting with bilateral pleural effusion- A rare presentation

Rheumatoid arthritis is the most common chronic autoimmune disorder involving joints and extra-axial system. Varied presentations have been described in the literature. Pulmonary involvement is also common. Inflammatory pleural effusions are an uncommon complication and are rarely seen in about 2% to 5% of patients with rheumatoid arthritis. Here, we present an interesting case where the patient presented with bilateral pleural effusion early in the disease. On further evaluation of the patient and the pleural fluid, it was found to be consistent with pleural effusion secondary to rheumatoid arthritis. The patient responded to oral non-steroidal antiinflammatory drugs along with disease-modifying agents

A REVIEW ON PSYCHOSIS AND ANTI-PSYCHOTIC PLANTS

ABSTRACTPsychosis (schizophrenic, schizoaffective, and affective illnesses) is a group of serious illnesses that affect the mind. About 1% of the population suffersfrom psychosis worldwide and increases for those, whose closer family member have suffered with the disorder. Common symptoms of psychosisare hallucinations, delusions, flat affect, forgetfulness, alogia, avolition, and anhedonia. Currently available marketed drugs like chlorpromazine,haloperidol, clozapine, risperidone, and olanzapine have some serious adverse effects such as dizziness, diabetes, weight gain, tardive dyskinesia,neuroleptic malignant syndrome, sexual dysfunction, agitation, and sedation. There is no satisfactory remedy available for prevention and managementof psychosis. Therefore, the demand for herbal medicine is increasing. This article collects the information about the possible plants and dietarysupplements to improve symptoms of psychosis with no side effect. The present review discusses about anti-psychotic plants, its biological source,common name, and other biological activities, which are helpful for researchers to development new anti-psychotic herbal formulations.Keywords: Psychosis, Anti-psychotic drugs, Dietary supplements, Anti-psychotic plants

Liver cirrhosis first time presented with delirium unveiled as accidental secondary hypothermia

Liver cirrhosis is a condition which is defined histopathologically but cannot be diagnosed clinically without any non-invasive tests. There are various etiologies of cirrhosis such as alcoholic liver disease, chronic viral hepatitis B, C, and non-alcoholic fatty liver diseases. Liver, not only function as an organ for detoxification, conjugation, and synthesis but also it regulates body heat. Cirrhosis patients thus are prone to body heat loss and hyperthermia. We present a case with undiagnosed liver cirrhosis patient, 1st time presenting with altered sensorium, revealed as accidental secondary hypothermia with ECG changes of hypothermia. The patient treated for hypothermia only after which she recovered

Evaluation of efficacy of priming dose of propofol in reducing induction dose requirements in patients undergoing elective surgeries under general anaesthesia

Background: Priming principle refers to administration of a subanaestheic dose of an agent prior to its actual anaesthetic dose. Propofol is an effective substitute to thiopentone for intravenous induction. The objectives of the study were to evaluate whether priming with propofol would reduce induction of dose, reduce the peri-intubation haemodynamic changes, influence the severity of side effects and influence recall phenomenon.Methods: Sixty patients of ASA Grade 1 and 2, between 18-55 years of age group, of both sexes, were selected on the basis of eligibility criteria and scheduled for elective surgery under general anaesthesia were divided into study and control groups of 30 patients each. The total dose of propofol including the priming (25% of total) dose of propofol, heart rate and blood pressure, baseline (before induction), immediately after intubation, 1 min, 3 min, 5 min after induction, SPO2 (% of oxygen saturation), recall phenomenon and other side effects post operatively were studied.Results: The demographic data were comparable for age, weight and sex in both the groups. Total patients were divided into two groups with 30 patients each. It was observed that total induction dose of propofol was significantly decreased in the study group 72.33±9.53mg compared to control group 115.83±9.00mg. Heart rate was better maintained in study group with minimal post-intubation response. The values of systolic, diastolic and mean blood pressure observed at 1 min after induction also showed significant decrease in control group compared to study group.Conclusions: Propofol produces smooth, rapid, pleasant and safe induction. Priming with propofol can be practiced due to its cost effectiveness and better haemodynamic profile and safety

Thyrotoxic neuropathy - a case report

Thyrotoxic neuropathy is a rare entity in literature. The association between thyrotoxicosis and neuropathy is under-recognized. We here present a rare case report in which patient was presented with ascending sensory-motor paralysis coupled with respiratory muscle weakness which closely resembles Guillain–Barré syndrome (GBS). But relevant history suggested thyrotoxic features, thus a timely focused investigation revealed the diagnosis. It was confirmed in nerve conduction studies (NCS) and other necessary investigations ruled out other differential diagnosis. Patient was treated with anti-thyroid drugs. On follow up patient’s power improved and NCS after 6 months came out to be normal which established the diagnosis. Thyrotoxic neuropathy is a close differential diagnosis of LGBS and other commonly encountered neuroparalytic illnesses. So high degree of suspicion is needed to diagnose this potentially treatable neuropathy

Proximally migrated Double J stent in hydronephrotic kidneys: Etiological factors and management

Double J stents have become an essential tool in urologist’s armamentarium but are never without potential complications. Migration of DJ stent is a recognized complication, though its proximal migration into the upper ureter, pelvicalyceal system is reported rarely. This can add to the cost of patients and increases hospital stay if another general/ regional anesthesia session is required for its repositioning/removal. We successfully repositioned or removed proximally migrated DJ stents ureteroscopically under local anesthesia and analgesia in all of our case series patients on a daycare basis. We emphasize the importance of recordkeeping and follow up of stented patients particularly with those with hydronephrotic systems. In the event of proximal migration of the DJ stent, it can be successfully repositioned or removed under local anesthesia and analgesia. Keywords: Double J stent, proximal migration, ESWL-Extracorporeal shockwave lithotrips

Xanthogranulomatous pyelonephritis in a child: A rare entity

Xanthogranulomatous pyelonephritis (XGP) is chronic pyelonephritis uncommonly described in adults and is rare in children. It ischaracterized by the replacement of renal parenchymal tissue by lipomatous cells making it nonfunctional and may be mistaken forpyonephrosis, cystic or solid tumor, and the most commonly, Wilms tumor. It often presents as abdominal mass in children and morecommonly involves left kidney. Imaging by computed tomography (CT) scan is characteristic, and histology is diagnostic. We arereporting a case of a child who presented with prolonged febrile illness and documented urinary tract infection with nephrolithiasiswithout any abdominal lump and received antibiotics for multiple times without any improvement. Ultrasonography was suggestiveof pyonephrosis and multiple abscesses. However, on CT scan, was diagnosed as XGP of the right kidney which was confirmed onhistology. After documenting, no function in affected kidney with other being normal, unilateral nephrectomy was done resultingin rapid symptomatic improvement