Bioassay-guided isolation of novel and selective urease inhibitors from Diospyros lotus / 中国天然药物

Two new dimeric naphthoquinones, 5',8'-dihydroxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (1; Di-naphthodiospyrol D) and 5',8'-dihydroxy-5,8-dimethoxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (2; Di-naphthodiospyrol E), along with known naphthoquinones diospyrin (3) and 8-hydroxy diospyrin (4) were isolated from the chloroform fraction of extract of Diospyros lotus roots. Their structures were elucidated by advanced spectroscopic analyses, including HSQC, HMBC, NOESY, and J-resolved NMR experiments. The fractions and compounds 1-4 were evaluated for urease activity and phosphodiesterase-I, carbonic anhydrase-II and α-chymotrypsin enzyme inhibitory activities. Compounds 1 and 2 and their corresponding fractions showed significant and selective inhibitory effects on urease activities. The IC values of 1 and 2 were 260.4 ± 6.37 and 381.4 ± 4.80 µmol·L, respectively, using thiourea (IC = 21 ± 0.11 µmol·L) as the standard inhibitor. This was the first report demonstrating that the naphthoquinones class showed urease inhibition.

Spectrum of rhabdomyosarcoma-A study of 53 cases at Armed Forces Institute of Pathology, Rawalpindi [Pakistan]

Objective: To study the spectrum of rhabdomyosarcoma, diagnosed at Armed Forces Institute of Pathology [AFIP], Rawalpindi [Pakistan]

Study Design: Descriptive study

Place and Duration of Study: AFIP, Rawalpindi from 1st Jan 2009 to 31st Dec 2013

Material and Methods: The study included all the cases diagnosed as rhabdomyosarcoma from 1st January 2009 to 31st Dec 2013. Records of the malignant tumors of soft tissue that presented during this period were analyzed and out of these spectrums rhabdomyosarcoma was studied. The data analysis included the age, gender, site of tumor and histopathological pattern of Rhabdomyosarcoma

Results: A total of 19140 malignant tumors were diagnosed at AFIP Rawalpindi from 1st Jan 2009 to 31st Dec 2013. Out of these, 512 [2.67%] were malignant soft tissue tumors. Out of these 53 cases were rhabdomyosarcoma with an overall frequency of 0.27% of the malignant neoplasm and 10.3% of soft tissue sarcomas. The age ranged from 1-70 years. Out of these 53 cases 36 were males and 17 were females with a male to female ratio of 2.1:1. The most common subtype of tumor seen was embryonal rhabdomyosarcoma n=22 [41.5%]. The age for embryonal rhabdomyosarcoma ranged from 3 to 71 years with median age of 16 years while most of the patients are effected during 1st decade of life [55%]. Out of 20 cases of rhabdomyosarcoma during the first two decades of life 18 [90%] were embryonal rhabdomyosacoma. Thirty cases of rhabdomyosarcoma encountered during the adult life contained only 4 cases [11%] of embryonal rhabdomyosarcoma. The majority of the tumors originated from lower extremities [41%] and in lower extremities most common site was thigh [27%]. A total of 18% of the tumors originated in head and neck region. Second most common type of the tumor was pleomorphic rhabdomyosarcoma n=21 [39.6%] with age range 40 to 78 years and median age of 60 years. Ten cases were reported during 6th and 7th decade of life. Majority of the cases occurred in lower extremities [47.6%] and thigh was the most common site [42%]. Alveolar rhabdomyosarcoma n=6 [11.32%] was the 3rd most common tumor with age range of 15 to 46 years and median age of 29 years. Four cases [67%] occurred in 3rd and 4th decades of life. The most commonly involved region was lower extremities [50%] followed by upper extremities [17%]. Among lower extremities again thigh was the most common site [33%]. Anaplastic rhabdomyosarcoma n=4 [7.54%] was the least common type of rhabdomyosarcoma with age range of 12 to 45 years and median age of 31 years. Three cases [75%] occurred in the 3rd and 4th decade of life. Two cases [50%] occurred in lower extremities and one case [25%] in the upper extremity

Conclusion: Embryonal rhabdomyosarcoma is the most common rhabdomyosarcoma during the first two decades of life. While pleomorphic rhabdomyosarcoma is the most common rhabdomyosarcoma encountered in adults. Extremities are most common site of involvement by rhabdomyosarcoma followed by the head and neck and abdomen in our setup. This finding needs to be evaluated by a larger scale study

Charcoal Hemoperfusion for Phenytoin Intoxication.

Accidental ingestion of phenytoin can lead to severe neurological sequelae. Charcoal hemoperfusion decreases phenytoin levels but has never been reported before in children. We present a child with accidental ingestion of phenytoin who responded to charcoal hemoperfusion.

Rescue High Frequency Oscillation in Neonates with Acute Respiratory Failure.

The aim was to study the efficacy of rescue High Frequency Oscillatory Ventilation (HFOV) in improving the oxygenation and ventilation in neonates with acute respiratory failure after failing Conventional Mechanical Ventilation (CMV). Primary outcome was short term oxygenation, lung recruitment, and ventilation and secondary outcome studied was survival. 675 babies were ventilated and 97 of them received HFOV. HFOV significantly improved oxygenation index, alveolararterial oxygen gradient, pH, PCO2, PO2 and caused better lung recruitment within 2 hours. Fifty seven babies (58.77%) survived and the mortality was more in <28 weeks, babies with pulmonary hemorrhage, sepsis and CDH.

Prolonged neonatal interhospital transport on road: Relevance for developing countries.

Objective. To compare prolonged inter hospital long distance transports on road undertaken by a qualified transport team vs those done by the same team from shorter distances and time. Methods. Retrospective descriptive comparative study of the neonatal transports done during a period of 48 mo. All neonates transferred on road to a tertiary level pediatric hospital from various maternity and pediatric centers. The biochemical characteristics, adverse effects during transport and 24 hr survival after the transport in both the groups were compared. Results. The babies were comparable in their gestational age and ventilatory requirements (46% vs 39%). The biochemical and metabolic characteristics and 24 hr mortality rates for babies who were transported for longer times and distances were comparable (p value =0.75) to those transported for shorter times. Conclusion. Long distance neonatal transport on road is feasible and with a qualified team results can be comparable to those transported from shorter distances.

Extraskeletal osteogenic sarcoma: a rare entity.

A 25-year-old female presented with a rapidly increasing painful swelling around right lower thigh and knee for the last 5 months with distant metastasis in the form of lung involvement. X-ray of the part showed only soft tissue swelling without any bony involvement. A diagnosis of extraskeletal osteosarcoma was made which was confirmed by immunohistochemistry.

Glomus tumor of lesser omentum--a case report.

A case of glomus tumor of lesser omentum occurring in a 24 years old male is being reported for its rarity.

Role of video assisted thoracoscopy in management of empyema thoracis

The hospital based Cohort study was carried out over a period of 21 months to analyze and evaluate the out come of patients who had presented with acute stage of empyema thoracis and were treated by video assisted thoracoscopy. 30 patients with acute empyema thoracis received treatment by video assisted thoracoscopy in Combined Military Hospital Rawalpindi from March 2000 to December 2001. Both civilians as well as military personnel were included in the study out of which 22 were males and 8 were females. Majority of the patients were of 30 years and above age group. The most common etiology was respiratory tract infection with pneumonia and tuberculosis making the largest proportion. The leading presenting symptoms included low grade pyrexia, breathlessness, loss of weight and chest pain. One third of patients had some other associated systemic illness. Video assisted thoracoscopy was used in all 30 patients with only 2 patients requiring open thoracotomy. Post operative wound infection was the most commonly encountered complication. In most of the cases the procedure was over within an hour and in majority of patients hospital stay was upto 2 weeks. There was one death, which was not due to procedure but due to septicemia. These results are similar to those found elsewhere in the world