Synthesis and Evaluation of Analgesic and Anti-inflammatory Activities of Most Active Antioxidant Derivatives of Embelin.

Objective: To evaluate antioxidant, analgesic and anti-inflammatory properties of embelin and its derivatives. Methods: In the present study embelin was condensed with various aliphatic substituted primary amines, hydrazines and amino acids to yield seven new and five reported derivatives. All these compounds along with embelin were evaluated for in vitro antioxidant activity using ABTS and DPPH methods. Potent compounds were selected for in vivo analgesic and anti-inflammatory activities. Results: Hydrazines, amino acids substituted embelin derivatives and phenazines showed potent antioxidant activity. These compounds along with embelin were studied for analgesic and anti-inflammatory activities at 10 and 20 mg/kg doses by standard methods. Potent analgesic activity higher than the standard pentazocine was observed. Embelin and its derivatives almost completely abolished the acetic acid induced writhing. Phenyl alanine and phenazine derivative showed better anti-inflammatory activity than embelin. Conclusion: Further research would be of interest to explain the exact mechanism of these compounds and chemical modifications, biological screening and toxicity studies can also be explored.

Pre-hospital delay in acute myocardial infarction in an urban Indian hospital: a prospective study.

BACKGROUND: Successful treatment of acute myocardial infarction is dependent on early presentation of the patient to the hospital. The factors that contribute to delay in seeking treatment have not been systematically evaluated in the Indian milieu. METHODS: Patients admitted with acute myocardial infarction to a 125-bed urban community hospital were evaluated prospectively. A record of admission characteristics, prior medical history, pre-hospital symptoms and treatment patterns was completed within 48 hours of each admission. Independent predictors of delayed admission were identified by logistic regression. RESULTS: Of 144 consecutive admissions with myocardial infarction, 133 had completed data as per the protocol [mean (SD) age 59 (12.7) years; 79.6% men]. The distribution of presentation times was skewed, with the mode, median and mean being 1, 3 (interquartile range 1.25-11) and 10.9 (SD 20.5) hours, respectively. Seventy-nine patients (59.4%) consulted a general practitioner prior to hospital referral and 48 patients (36.1%) delayed admission to hospital by more than 6 hours from the onset of symptoms. On multivariate analysis, individuals who were initially seen by a general practitioner (OR 5.57; 95% CI 1.84-16.8) and those over the age of 65 years (OR 3.24; 95% CI 1.06-9.89) were identified as 'delayers', while patients with severe symptoms (OR 0.32; 95% CI 0.12-0.87) or prodromal angina (OR 0.25; 95% CI 0.08-0.82) minimized delay. CONCLUSION: Though 50% of patients with acute myocardial infarction present to hospital within 3 hours, about 36% delay seeking treatment by more than 6 hours. Besides age and the pattern and severity of symptoms, visits to the general practitioner were found to be an independent correlate of delay.

Survival after cardiopulmonary resuscitation in an urban Indian hospital.

BACKGROUND: Survival after cardiopulmonary resuscitation depends upon the quality of pre-hospital support, availability of resuscitation equipment and the competence of the resuscitator. There are few data on the prognosis of patients undergoing such resuscitation in India. METHODS: In a retrospective analysis of 215 resuscitations done in a 125-bed community hospital between January 1995 and November 1997, return of spontaneous circulation and survival to discharge were evaluated. Multivariate methods were used to identify the predictors of successful outcome. RESULTS: Of all the patients, 14.4% were alive at discharge. Survival after a cardiorespiratory arrest in the hospital was 18.4%, which was significantly better than survival after pre-hospital events (5.9%; p = 0.027). Multivariate predictors of survival at discharge were resuscitation duration of less than 20 minutes [odds ratio (95% confidence limit): 32.6 (6.5-164.3)], presentation with ventricular tachycardia or fibrillation [odds ratio: 18.5 (4.4-77.9)], in-hospital cardiorespiratory arrest [odds ratio: 5.2 (1.2-21.6)] and female sex [odds ratio: 3.2 (1.1-9.6)]. Bystander resuscitation, though rarely provided, increased survival at discharge (p = 0.026). CONCLUSIONS: With 5.5 resuscitation attempts needed for one live discharge after in-hospital cardiorespiratory arrest and 17 attempts to save a life after pre-hospital events, our outcomes are comparable to those reported from developed nations. A return of pulse after shorter durations of cardiopulmonary resuscitation, ventricular fibrillation or tachycardia as the abnormal presenting rhythm, in-hospital location of cardiorespiratory (CR) arrest and female sex were independent predictors of live discharge. Age and aetiology of CR arrest did not influence the outcome.