Synthesis, characterization and biological evaluation of some 5-methylpyrazine carbohydrazide based hydrazones

Pyrazine carbohydrazide based hydrazones were synthesized starting from 5-methylpyrazine-2-carboxylic acid. The acid was first converted to its methyl ester, which on further treatment with hydrazine hydrate transformed to carbohydrazide. The carbohydrazide was treated with differently substituted aromatic carbonyl compounds giving hydrazones. Characterization of the synthesized compounds was carried out using modern spectroscopic techniques and unambiguously confirmed through X-ray crystallographic studies of compound 3d. The purity of the compounds was verified using elemental analysis. The target molecules were evaluated for urease inhibition, antioxidant and antimicrobial activity

Changes in doppler ultrasound indices of hepatic circulation after treatment with beta blockers: a pilot study

Background: Portal hypertension is a serious complication of liver cirrhosis. Doppler ultrasound assessment may be a non-invasive and cost-effective means of evaluating portal hemodynamics in patients with portal hypertension

Aims and objectives: To assess efficacy of Doppler ultrasound in detecting changes in hemodynamics of hepatic circulation after beta-blocker administration

Methodology: 11 patients with liver cirrhosis and portal hypertension were included. All underwent Doppler assessment of portal vein velocity [PVV], spleno-portal index [SPI], congestive index [CI], liver vascular index [LVI], dampening index [DI], hepatic artery velocity [HAV], splenic artery velocity [SAV], hepatic artery resistive index [HARI] and splenic artery resistive index [SARI]. They were started on beta-blocker carvedilol 6.25 mg once daily and recalled after two weeks for repeat assessment

Results: Out of 13 enrolled, 4 were lost to follow up and one stopped carvedilol. 8 remained. The changes in parameters were: PVV: reduction in 3 [37.5%], no change in 1 and increase in 4[50%] patients; SPI: reduction in 3 [37.5%] and increase in 5 [62.5%]; CI: reduction in 3 [37.5%], no change in 1 and increase in 4 [50%]; LVI: decrease in 3 [50%], no change in 1 and increase in 2; DI: decrease in 5 [62.5%] and increase in 3 [37.5%]; HAV: increase in 4 [50%], no change in 1 [12.5%] and decrease in 3 [37.5%]; SAV: decrease in 4 [50%] and increase in 4 [50%]; HARI: increase in 7 [87.5%] and decrease in 1 [12.5%]; SARI: reduction in 3 [37.5%] and increase in 3 [37.5%]. 3 patients achieved reduction in 5 [PVV, LVI, DI, SARI and SAV] parameters. DI had the largest number of patients with observable reduction and HARI with the largest number showing observable increase in measured parameters

Conclusion: Doppler ultrasound represents a cost effective means of assessing the hemodynamics of hepatic circulation and any associated changes due to diseases and drugs

Awareness and compliance about forensic dentistry among dental professionals of twin cities of Rawalpindi-Islamabad: a questionnaire based study

The objective of the present study was to evaluate the awareness and compliance among dental surgeons working within twin cities about "forensic dentistry". Secondary objective was to evaluate the need of this specialty to be added in BDS curriculum as an independent subject or part of any major subject. This cross sectional Study was done in five teaching dental hospitals of Rawalpindi and Islamabad which are affiliated with Dental colleges. 318 questionnaires consisting of fourteen basic questions were distributed in the dental colleges/ hospitals selected for the study. Data were then compiled, categorized and analyzed using SPSS. The response rate was 93%. Participants who had never studied forensic dentistry at any level were 99.32% and who never got any formal training in forensic dentistry were 100%. Individuals who opted to study forensic as a subject if opportunity of training was given within Pakistan were 60%. Forensic Dentist may play a major role in identification of those individuals who cannot be identified otherwise. Recent tragedies and situations have increased awareness concerning the importance of forensic dentistry in identification of victims especially in current era in Pakistan. Forensic dentistry must be introduced into the BDS curriculum effectively as a subject. Moreover, the likelihood of future disasters due to terrorism, earthquakes and other causes require the dental profession in Pakistan to be prepared for an ex-pended role

Impacted third molar extractions-are we following any recommended guidelines?

Among the minor oral surgeries done by an oral surgeon and surgeries carried out in the department of oral and maxillofacial surgery all over the world third molar removal is one of the most frequent procedures done. The procedure is accompanied by significant risks, with possible damage to the inferior alveolar and/or lingual nerve being of special concern. Considering these risks of mor-bidity, it is essential to establish the need of removal. National Institute of Clinical Excellence [NICE] in the United Kingdom introduced guidelines for removal of third molars in 2000, advocating that only pathological third molars should be removed. The following article makes reference to a study carried out in Ireland where third molars are extracted in accordance with NICE guidelines. This study was carried out to assess the compliance of general dental practitioners and oral surgeons to the NICE guidelines. It was noted that 90% of the patients referred for third molars extraction fulfilled the criteria set forth by NICE.A few modification were carried out in the guidelines provided which were done under scientific evidence based knowledge i.e. Prophylactic extraction of impacted third molars. These guidelines cut down lot of unnecessary referrals and allowed for organization of the patient load by the secondary referral center, as well as limiting unnecessary surgeries and postoperative complications. It is suggestive that the governing authorities in Pakistan should also implement such guidelines for extractions of impacted third molars

comparison of scalp closure with staples, silk, prolene and vicryl following a gillie's temporal approach for malar / zygomatic complex fracture; a prospective study

This study compared the healing, the type of micro-organisms around the suture material, pain score during removal of suture I staple and cost of the closure material per patient. Sixty patients were allocated in 4 groups. Each group had 15 patients, aged 16 to 70 years of age with isolated fractured zygoma. They were prospectively randomly selected to have staple, silk, prolene or uicryl rapide for closure of their scalp incision. Patients returned at a week for staple or suture removal, a culture swab, pain score and evaluation of healing. Patients were then reviewed at 6 to 8 weeks time to re-evaluate the healing of the temple I scalp wound. The wounds in the first group were closed with staples, in the second group with silk, the third group with prolene and the fourth group with vicryl rapide. There were no differences in age, wound length, number of staples I sutures [3], or surgeon experience. There was no difference in wound healing or type of micro-organism around the staples I sutures. Staples resulted in shorter wound closure time but had a higher pain score on the removal [average 2.4 on a visual analogue scale]. Staple had a less growth of micro-organisms compared to other groups. The follow up rate was 100%. There was no cosmetic or significant complications problem in any group apart from wound breakdown, one in silk and one in the prolene group that both healed with minor scar formation. There was no difference in healing in all four groups but staples were easier and faster and had less micro-organisms growth around them. Staples are more expensive and more painful on removal when compared to other groups. The main advantage of vicryl rapide was that there was no need for removal and had comparable results. Silk had the same results as the other groups but is considerably cheaper when compared to the other materials

Prevalence of HCV genotypes in patients reporting in tertiary health care hospital of Karachi

The present study was designed to see the variables which may affect the conventional treatment outcome by injection interferon in chronic hepatitis "C" patients. Among these variables hepatitis "C" genotype is most important, as it influences the duration and dosage of anti-viral therapy. To determine the frequency distribution of HCV genotypes, a study was conducted in a tertiary care centre of Karachi, the largest metropolitan city of Pakistan, where people of all ethnic origins are found. All the HCV positive patients, including impatient admitted in hospital and outpatients, more than 18 years of age, reported for genotyping of HCV in the clinical laboratory of Dr. Ziauddin Hospital from May 2009 to April 2010 were studied. HCV genotyping was performed on a total of 457 patients who tested positive for presence of Hepatitis "C" viral RNA. The most prevalent genotype was type 3 with 392 [85.8%] cases, followed by type 1 with 51 [11.2%] cases. There were only two cases with a co-infection of type 1 and 3, while genotype 2,4 and 5 were also seen in a few cases. Among the cases studied, there were higher proportion of females 276 [60.4%], dominating the HCV infected population. The present study revealed that genotype 3 was the most common genotype in patients with HCV infection in Karachi. Other genotypes were also present in the patients infected with HCV, but were of lesser frequency. To prevent the treatment failure it is advisable that before commencement of therapy, the genotype of the patient should be established so that appropriate treatment in correct dosage for optimal duration of time of time could be instituted

Comparative predictive value of three prognostic markers, s-phase fraction, PCNA and mitotic count on axillary lymph node metastasis in carcinoma breast

Axillary lymph node metastasis is the single most important prognostic factor in carcinoma of the breast. Therefore, prognostic markers that may reliably predict probability of lymph node [LN] metastases are of great value. This study was conducted to compare the predictive value of two novel prognostic/ proliferative markers i.e. S-phase fraction [SPF] and proliferating cell nuclear antigen [PCNA] in parallel with mitotic index. Data of consecutive cases of infiltrating ductal carcinoma [IDC] breast diagnosed from July 2003 to July 2004 at the section of the Histopathology, The Aga Khan University Hospital, Karachi, were reviewed. A total of 112 cases of infiltrating ductal carcinoma [IDC] of the breast with axillary LN sampling were selected. SPF was calculated by flow cytometry while PCNA staining was done by immunohistochemistry. Mitotic count was calculated according to modified Bloom and Richardson's grading guidelines. It was observed that the number of axillary LN was found between the results of various categories of PCNA on axillary LN metastases [p value: 0.182] and mitotic count with axillary lymph node metastases [p value: 0.324]. It was concluded that mitotic count and /PCNA alone cannot be used in predicting axillary LN metastases. SPF was found to be a more reliable marker compared to PCNA reactivity and conventional mitotic count in predicting axillary LN metastases

Prognostic value of proliferating cell nuclear antigen [PCNA] in infiltrating ductal carcinoma breast

To assess the independent and interdependent prognostic value of proliferating cell nuclear antigen [PCNA] in carcinoma of breast in our female population and its association with pathologic variables and disease outcome. A descriptive study. Section of Histopathology, Department of Pathology and Microbiology. The Aga Khan University, Karachi from January 1992 to December 1997. All cases diagnosed with invasive ductal carcinomas [IDC] of breast with lymph nodes sampling were included. The expression of PCNA was analyzed on tumor specimens of IDC breast. These patients also had axillary lymph node sampling. The expression of PCNA protein was analyzed immunohistochemically by PAP technique. Patients were followed for a median duration of 48 months. The percentage of PCNA positive tumor cells was estimated semi-quantitatively. Positivity was seen in every case, mean PCNA positivity was 27% [range 10-80] with a median of 28%. The <25% positivity was seen in 149 [47%] cases, and >25% positivity seen in 166 [53%] cases. According to the pathological grading lowest mean PCNA was seen in grade-I i.e., 26% tumor cells showed nuclear reactivity to PCNA followed by grade-II 30% and grade-III 33%. PCNA categorical expression was significantly correlated with histological differentiation, [p<0.05] and tumor size [p<0.01]. Distant metastases were seen in>25% positive cases [p<0.05]. PCNA expression when correlated with overall survival, showed significant correlation between categorical PCNA [p<0.05]. At a median follow-up of 48 months, 66% of <25 PCNA positive patients died with an overall survival of 3.16 years and diseasefree survival of 2.5 years, among >25% PCNA positive patients 77% died with an overall survival of 2.7 years and a disease-free survival of 2.2 years. In this study PCNA proved to be an independent prognostic indicator in predicting disease-free and overall survival in breast carcinoma patients

Characterization of angioimmunoblastic T-cell lymphomas [AILT] and its association with Epstein-Barr Virus [EBV] in Pakistani patients

To characterize angioimmunoblastic T-cell lymphoma [AILT] on morphological, immunohistochemical and molecular grounds and its association with Epstein-Barr virus [EBV] in Pakistani patients. Case series. Histopathology section of the Department of Pathology and Microbiology, The Aga Khan University Hospital, Karachi from January 01, 1992 to December 31, 2002. Over a period of 11 years archival biopsy material of 13 AILT cases [lymph nodes], identified on the basis of histological and immunohistochemical criteria, using REAL and WHO classifications, were retrieved from the files of Department of Pathology. Immunophenotyping was carried out by using CD45 [LCA], two T-cell markers CD45RO [UCHL1; monoclonal] and CD3 [polyclonal]. Polymerase chain reaction [PCR] was used to assess T-cell clonality for T-cell receptor [TCR]-b, g and immunoglobulin heavy chain [IgH] for FR2 and FR3 regions using primers recognizing conserved sequences of the variable [V], diversity [D] and joining [J] region segments. Association of EBV in AILT cases was studied by PCR and in situ hybridization [ISH]. This study showed AILT to constitute 0.71% of all NHLs [non-Hodgkin's lymphoma] [both T and B]. Immunohistochemical study revealed that the tumor cells were positive for CD45 [LCA], CD45RO [UCHL1] and CD3. All the 13 cases were largely negative for CD20 [L26], a B-cell marker, except few large scattered cells labelling. DNA extracted from all 13 lymph nodes was amplified using polymerase chain reaction [PCR]. PCR technique demonstrated clonal gene rearrangement of the TCR-b, g and IgH regions in 3 [23.1%], 7 [53.8%] and 3 [23.1%] AILT cases, respectively out of 13 cases. Association of EBV was seen in 11 out of 13 cases [84.6%] of AILT by PCR. By ISH the prevalence of EBV was detected in 8 [88.8%] out of 9 cases. The prevalence of AILT in the Pakistani population is slightly lower compared to other studies and that EBV is an etiological agent in pathogenesis of this disease