40 research outputs found
A rational approach for the design and synthesis of 1-acetyl-3,5-diaryl-4,5-dihydro(1H)pyrazoles as a new class of potential non-purine xanthine oxidase inhibitors
Xanthine oxidase is a complex molybdoflavoprotein that catalyses the hydroxylation of xanthine to uric
acid. Fifty three analogues of 1-acetyl-3,5-diaryl-4,5-dihydro(1H)pyrazoles were rationally designed and
synthesized and evaluated for in vitro xanthine oxidase inhibitory activity for the first time. Some notions
about structure activity relationships are presented. Six compounds 41, 42, 44, 46, 55 and 59 were found to be most active against XO with IC50 ranging from 5.3 lM to 15.2 lM. The compound 59 emerged as the most potent XO inhibitor (IC50 = 5.3 lM). Some of the important interactions of 59 with the amino acid residues of active site of XO have been figured out by molecular modeling
Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.
BACKGROUND: Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. METHODS: The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. RESULTS: Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. CONCLUSIONS: Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction
Recommended from our members
Consensus protocols for management of early and late twin-twin transfusion syndrome: Delphi study.
OBJECTIVES: Fetoscopic laser photocoagulation (FLP) is a well-established treatment for twin-twin transfusion syndrome (TTTS) between 16 to 26âweeks' gestation. Strong scientific evidence and uniform guidelines regarding the best clinical management of early (prior to 16âweeks and between 16 to 18âweeks) and late (after 26âweeks) TTTS are currently lacking. The aim of this study was to construct a structured expert-based clinical consensus for the management of early and late TTTS. METHODS: A Delphi procedure was conducted to reach a consensus on the clinical management by an international panel of experts. Participants were chosen by their clinical expertise, affiliation, and relevant publications. A four-round Delphi survey was initiated. The questionnaires were sent using SurveyMonkey, an online survey platform, and responses were collected anonymously. In the first round, a core group of experts was asked to answer open-ended questions regarding the indications, timing and modes of treatment for early and late TTTS. In the following two rounds, participants were asked to grade each statement on a Likert scale (1-5) and to add any suggestions or modifications. At the end of each round, the median score for each statement was calculated. Statements with a median grade of five without suggestions for change were accepted as the consensus. Statements with a median grade of below four were considered non-consensus and excluded from the Delphi. Statements with a median grade of four were modified according to suggestions and reconsidered in the next round. In the last round, participants were asked to agree or disagree on the statements, and statements with more than 70% agreement without suggestions for change were considered the consensus. RESULTS: A total of 122 scholar clinicians met the inclusion criteria and were invited to participate. Fifty-three agreed to participate in the study. Of those, 75.4% completed all four rounds. Following four rounds, a consensus regarding optimal management of early as well as late TTTS was obtained. FLP can be offered as early as 15âweeks gestation for selected cases. Between 16- and 18-weeks gestation, management should be tailored according to Doppler severity. FLP can be considered up to 28âweeks of gestation. CONCLUSIONS: The Delphi method allowed the construction of a generally agreed upon treatment protocol for early and late TTTS. Nevertheless, this protocol can be modified at the discretion of the operators, and their experience and tailored to the specificity of each case. This should advance the quality of future studies, guide clinical practice, and improve patient care. This article is protected by copyright. All rights reserved