Synthesis and biological evaluation of novel substituted pyrrolo[2,3-d]pyrimidines as anticancer agents

Pyrrolopyrimidines are well known scaffold, which play a critical role as anticancer agents, so it thought of interest tosynthesize a series of novel substituted pyrrolo[2,3-d]pyrimidines having diverse groups at position C4 and N7 of thepyrrolo[2,3-d]pyrimidine core and performed in vitro screening against MDA-MB-468 (breast cancer cell line) cellline. The details of the synthetic methods and characterization data of the synthesized compounds have been presentedin this study. Compounds 8a, 8h, 8j, 9h, 9i, 9j, 9m, 9n, and 9o showed the excellent anticancer activity compared tostandard doxorubicin with an IC50 value of 6.17 µM/ml against MDA-MB-468 (breast cancer cell line), which wasnon-toxic to normal vero cell line.

Epidemiological factors affecting acute respiratory infection at Government Medical College and Hospital, Miraj

Background: Acute respiratory infections (ARI) comprising of a group of respiratory diseases of varying etiology and severity is being increasingly recognized as a major public health problem particularly amongst children below five years of age. In all countries ARI is a leading cause of hospitalization and death. Therefore ARIs represent a large challenge in field of communicable diseases. The study was conducted with the objective to assess the socio-demographic, epidemiological and clinical profile of ARI cases.Methods: A descriptive cross sectional, hospital based study was conducted at Government Medical College and Hospital. All children admitted with ARI in the paediatric ward during the study period of one calendar year.Results: Maximum (53.13%) cases of ARI were from the age group <1 year. Males (60.80%) outnumbered the females (M:F ratio was 1.5:1). Month wise and season wise distribution of ARI cases showed that, most of the cases were admitted in the month of December (13.35%), followed by January (12.78%) and November (10.80%).Conclusions: Prevalence of ARI cases as well as severity of the disease was more in participants less than 1 year of age.

Observational study to assess demographic, clinical profile and outcome of acute kidney injury due to acute gastroenteritis during monsoon season

Background: Worldwide incidence and causes of acute kidney injury (AKI) are variable and even more in developed and developing countries. At least 80% of AKI in tropics is community acquired. Acute gastroenteritis (AGE) is a common problem in developing countries. Present study concentrates on AGE as cause of AKI during monsoon period. It presents in epidemic proportion during monsoon and is preventable with timely intervention.Methods: The study was carried out prospectively in tertiary care hospital in Mumbai during monsoon season of 2012 and 2013. AKI was staged as per AKIN criteria. Patients were treated for primary disease and AKI, initially conservatively and dialysis if indicated. Patients were followed during the hospital stay.Results: Two hundred and thirty patients had AKI due to infectious disease during monsoon. Incidence of AKI due to diarrhea was 23%, and affecting males predominantly in 4th decade. Diarrhea and vomiting were the most common presenting complaints. 32% patients required dialysis. Mortality rate was 3.8%.Conclusions: AKI secondary to AGE is common in tropics. Treatment of primary disease and hemodynamic optimization at the earliest helps to prevent AKI. Presents with less severe AKI and has better outcome. Multiorgan involvement and need for supportive lifesaving therapies were risk factors for AKI.

Nonmaleficence in medical training: Balancing patient care and efficient education

The principle of nonmaleficence requires that every medical action be weighed against all benefits, risks, and consequences, occasionally deeming no treatment to be the best treatment. In medical education, it also applies to performing tasks appropriate to an individual’s level of competence and training. Students, residents, and attending physicians alike maintain a beneficence-based responsibility to patients, and attending physicians have a fiduciary responsibility to educate younger generations of doctors. For medical education to progress, medical students and resident physicians must develop new skills throughout their time in training. Yet involving inexperienced students in delivering patient care can place the value of education and training in opposition to the bioethics values of patient-centred care and nonmaleficence by increasing the risk of harm to patients. Having all medical procedures, examinations, and histories performed by seasoned medical professionals would mitigate the risk but would also destroy the institution of medical education and lead to a shortage of trained professionals. For medical education to be successful, students and their supervisors must balance the principles of nonmaleficence with those of education in order to ensure excellence in both patient care and medical training. We present a broad discussion of the ethical dilemmas raised by the interaction of medical education and current patient care and suggest guideposts for training practices that satisfy the dual requirements of medical learning and patient-centred care.

Design, characterization and biological activity of a new series of s-Triazines derived with morpholine.

4,6-dimethoxypyrimidin-2-amine condensed with trichloro s-triazine. The product of the above reaction was allowed to react with Morpholine. Finally various aromatic amines derivatives were allowed to react and the product were characterized by conventional and instrumental methods. Their structures were determined and important biological properties were studied.

Spironolactone; the ultimate blocker of RAAS cascade in hypertensive patients with special reference to its cardiovascular benefits: Revisiting the forgotten ways.

Acknowledgement: All the authors would like to express their heartfelt thanks to Dr Jagadeesh Tangudu, Mtech, MS, PhD and Sowmya Jammula, M Tech for their immense and selfless contribution towards manuscript preparation, language editing and final approval of text. Abstract: Hypertension is a major risk factor for various macro and microvascular complications in a patient with diabetes. Control of hypertension is of paramount importance in the care of a diabetes subject. The goals for blood pressure in diabetes subjects are below 130/ 80 mmHg and below 125/75 mmHg if accompanying renal impairment is there. Spironolactone is a medication that has been used to treat high blood pressure since the 1960s. While there is some belief spironolactone reduces blood pressure, there are concerns due to the potential for this drug to cause adverse effects. Previous Meta analysis has shown that spironolactone reduces systolic/diastolic blood pressure by approximately 20/7 mmHg compared to placebo. Spironolactone has also been shown to decrease morbidity and mortality in patients with heart failure. We have tried to emphasize upon the usage of this old but important drug in management of resistant hypertension with reference to its mode of action, benefits and recent studies pertinent to cardiovascular benefits of spironolactone. Data Source:We searched PUBMED and MEDLINE database for relevant articles including key words. References of each article were further reviewed for final synthesis of the manuscript.

How to prevent complications in vaginal surgery

Vaginal surgery complications can at times be difficult to manage. Clearly the best management scheme entails steps to prevent complications. This requires judicious planning preoperatively with detailed knowledge of this patient's case, operative anatomy, surgical indications and expectations, as well as prudent use of preoperative diagnostic testing. Thus, being prepared facilitates better recognition of intraoperative complications and subsequent treatment in an expeditious fashion. The most frequent and important complications of vaginal surgery are listed in the following sentences and are extensively discussed: 1)- Bleeding: most cases of bleeding that one experiences during transvaginal surgery are self corrected; 2)- Infection: since bacteria potentially contaminate the vagina, it is a frequent site of infections in the postoperative period; osteomyelitis of the public bone is an infrequent occurrence, however, with the increasing use of bone anchors in vaginal sling surgery, one must be aware of this complication; 3)- Bladder Injuries/Perforation: injuries to the bladder may occur during dissection of the vaginal epithelium off of the underlying perivesical fascia and bladder or during suture passage in cystocele repairs or incontinence procedures; 4)- Urethral Injury: intraoperative injuries to the urethra should be an infrequent occurrence due to its easy identification with a foley catheter in place; 5)- Ureteric Injuries: occur in 0.3 to 3 percent of patients undergoing gynecologic surgery; 6)-Bowel/Rectal Injury: should be an uncommon complication, yet when injury does occur, one must approach it seriously; 7)- Neurologic Injury/Postoperative Pain: sacropinous fixation can be complicated by nerve injury as the pudendal nerve lies in proximity to the sacrospinous ligament...