Synthesis and biological evaluation of some novel pyrazolopyrimidines incorporating a benzothiazole ring system

In the present study, a series of benzothiazol derivatives 3a-l containing pyrazolo[3,4-d]pyrimidine moiety at the second position were synthesized and characterized by analytical and spectral data. The compounds were tested for their in vitro antimicrobial activity. Compounds 1-(1,3-benzothiazol-2-yl)-3-methyl-4-phenyl-1H-pyrazolo[3,4-d]pyrimidine (3a), 1-(1,3-benzothiazol-2-yl)-4-(4-chlorophenyl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidine (3d) and 1-(1,3-benzothiazol-2-yl)-3-methyl-4-substituted phenyl-1H-pyrazolo[3,4-d]pyrimidines (3h-j) showed significant inhibitory activity against P. aeruginosa whereas compounds 1-(1,3-benzothiazol-2-yl)-4-(2-chlorophenyl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidine (3b), 2-[1-(1,3-benzothiazol-2-yl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidin-4-yl]phenol (3e), 1-(1,3-benzothiazol-2-yl)-4-(3,4-dimethoxyphenyl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidine (3h), 4-[1-(1,3-benzothiazol-2-yl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidin-4-yl]-N,N-dimethylaniline (3j) and 1-(1,3-benzothiazol-2-yl)-3-methyl-4-[2-phenylvinyl]-1H-pyrazolo[3,4-d]pyrimidine (3k) were found to be active against C. albicans. Some of these synthesized compounds were evaluated for their in vivo acute toxicity, analgesic, anti-inflammatory, and ulcerogenic actions. The tested compound 4-[1-(1,3-benzothiazol-2-yl)-3-methyl-1H-pyrazolo[3,4-d]pyrimidin-4-yl]-N,N-dimethylaniline (3j) exhibited maximum analgesic and anti-inflammatory activities. Compounds 1-(1,3-benzothiazol-2-yl)-3-methyl-4-(3-nitrophenyl)-1H-pyrazolo[3,4-d]pyrimidine (3i) and 3j showed a significant gastrointestinal protection compared to the standard drug diclofenac sodium

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Knowledge, attitudes, and practices regarding sterilization protocol among undergraduate dental students in Faridabad City: A questionnaire-based study

Aim: To assess the level of knowledge, attitudes, and practices regarding sterilization/infection control measures among undergraduate dental students. Materials and Methods: A total of 300 dental students from Manav Rachna Dental College, Faridabad, Haryana participated in this study. A questionnaire survey comprising 24 questions regarding knowledge, attitudes, and practices was completed by the participants. Results: It was observed that a majority of the students were highly concerned regarding the sterilization and infection control protocol. 96.9% students dispose of their gloves after use. About 89% are aware of the exact specifications of sterilization via autoclave. Use of mouth masks and head caps as effective infection control measures was practiced among 82.4% students. A large fraction of students comprising about 85% believed that proper sterilization could not be achieved by simple boiling of instruments. Conclusion: The level of knowledge and attitude of sterilization measures were acceptable, although compliance and practice of the same needs to be more worked upon

Hypertension in pregnancy: A community-based study

Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ΃25 years, gestational period ͳ20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications

Comparison of Corneal Endothelial Cell Loss during Manual Small-incision Cataract Surgery using Visco-expression versus Irrigating Wire Vectis-assisted Nucleus Removal: A Prospective Randomised Study

Introduction: Age-related cataract is the leading cause of curable blindness in India, and Manual Small-Incision Cataract Surgery (MSICS) is a machine-independent and cost-effective alternative to phacoemulsification for handling this significant burden. In every cataract surgery, some endothelial cell loss is inevitable. Therefore, the present study was conducted to compare endothelial cell loss in the two most commonly practiced methods of nucleus delivery in MSICS. Aim: To compare and analyse endothelial cell loss during MSICS using viscoelastic/viscoexpression-assisted nucleus removal versus irrigating wire vectis-assisted nucleus removal. Materials and Methods: A prospective randomised interventional study was conducted at the Regional Institute of Ophthalmology, Postgraduate Institute of Medical Sciences (PGIMS) Rohtak, Haryana, India. The study duration was three years, from May 2018 to May 2021. A total of 250 patients with uncomplicated senile cataract over 40 years of age, with nuclear sclerosis of grade 2 or higher and “with the rule” astigmatism, were included in the study. The patients were randomly divided into Group A and Group B (125 each), who underwent MSICS using visco-expression (Group A) versus irrigating wire vectis-assisted (Group B) nucleus removal. Visual Acuity (VA), keratometry, astigmatism, pachymetry, and Endothelial Cell Density (ECD) were recorded in every patient preoperatively and postoperatively on day 1 and day 40. The Shapiro-wilk test was used to assess the normality of the data, and student’s t-test was performed to identify significant differences in continuous factors between the two groups. Chi-square test was used to find the association between factors and techniques, with a p-value <0.05 considered statistically significant. Results: The mean age of the patients was 68.5±9.4 years (range 52-89 years) with a significant male preponderance. The mean LogMAR visual acuity on Postoperative Day (POD)-1 was 0.3±0.1 for Group A, while for Group B, it was 0.5±0.2, showing a statistically significant difference (p=0.004). However, on day 40, visual acuity was comparable in both groups, with Group A (0.1±0.2) and Group B (0.1±0.1), and no significant difference (p=0.09). On POD-1, the percentage change in Endothelial Cell Density (ECD) was 4.2% in Group A and 10.6% in Group B, with a statistically significant difference (p=0.0017). On day 40, it was 2.1% and 4.8% in Group A and Group B, respectively, also showing a statistically significant difference (p=0.003). On postoperative day 40, the mean Surgically Induced Astigmatism (SIA) in Group A and Group B was 0.67±0.24 and 0.74±0.41, respectively, but this difference was statistically insignificant (p=0.074). Intra and postoperative complications such as hyphema, iridodialysis, and corneal oedema were more common in Group B than Group A. Conclusion: The study concludes that there was a statistically significant endothelial cell loss in the irrigating wire vectisassisted nucleus delivery method compared to the viscoexpression of the nucleus during MSICS. The present method also showed delayed visual rehabilitation and a higher risk of intra and postoperative complications. Therefore, viscoexpression of the nucleus should be the preferred method of nucleus delivery in every MSICS where feasible

Recent trends: Medical management of infectious keratitis

This review article highlights the newer diagnostic modalities and approaches in the medical management of infectious keratitis. A Medline literature search conducted to March 2014 has been included. Recent studies or publications were selected from international indexed journals using suitable key words. Development of specular microscopy and polymerase chain reaction (PCR) has a promising role as diagnostic modalities in infectious keratitis, especially in refractory cases. Previously fortified antibiotics have been the mainstay of treatment for bacterial keratitis. Recently, the advent of fourth-generation fluoroquinolones monotherapy has shown promising results in the management of bacterial keratitis. Corneal collagen cross-linking is being considered in the refractory cases. Topical natamycin and amphotericin B should be considered as the first choice anti-fungal agents in suspected filamentous or yeast infection respectively. Voriconazole and newer routes of administration such as intrastromal and intracameral injection of conventional anti-fungal agents have demonstrated a positive clinical response. Ganciclovir is a newer anti-viral agent with promising results in herpes simplex keratitis. Thus, introduction of newer diagnostic modalities and collagen cross-linking along with fourth-generation fluoroquinolones and newer azoles have a promising role in the management of infectious keratitis