A Comparative Retrospective Survival Analysis Study of Brain Tumor Patients in Age Less Than or Equal to 50 Years versus More Than 50 Years of Age.

Introduction Approximately 2.5% of fatalities from cancer are caused by brain tumors. Even though there is literature regarding prognostic factor of adult brain tumor, studies often resort to Western demographics. Hence, we conducted this retrospective observational study to compare the demographic characteristics and prognosis in patients of glial tumors in Indian population with histological diagnosis with respect to age. Materials and Methods A single-center retrospective observational study with 76 patients of glioma who had been treated with surgery combined with radiotherapy with or without chemotherapy was conducted. Group I patients were aged less than or equal to 50 years and group II more than 50 years of age. There were 28 patients in group I and 48 in group II. Postoperatively, external beam radiation therapy was delivered in a conventional fraction (1.8 Gy/fraction, five fractions/week) using telecobalt 60. Ill patients who presented with grade III and IV gliomas received oral chemotherapy temozolomide at a dose of 100 mg daily during course of radiotherapy. Results The median age of the patients at the time of diagnosis was 45.0 years. More cases of hematologic toxicity occurred in group I than in group II. Total 55 patients were alive at 1-year follow-up (11 in group I and 44 in group II). Conclusion Grade I and II gliomas were predominant in less than 50 years of age and grade III and IV were predominant in more than 50 years age. Male preponderance was seen in age group of more than 50 years (68%). Overall survival and disease-free survival were better for patients aged less than 50 years.

Knowledge Levels and Educational Experiences among Dental Graduates in Saudi Arabia Regarding Child Abuse and Neglect: A National Study.

BACKGROUND: Child abuse and neglect (CAN) is considered a serious problem worldwide. Dentists have a significant role in recognizing and reporting CAN cases. AIM: The aim of this study was to assess the CAN-related knowledge and educational experiences among Saudi dental graduates. DESIGN: Self-administered questionnaires were distributed to dental graduates from all dental schools in Saudi Arabia (n = 1552). Bivariate and multivariate logistic regression analyses were performed to assess the associations between knowledge level and different predictors. RESULTS: A total of 988 dental graduates completed the questionnaire. The majority of them were dissatisfied with the amount of education they had received in their school (56.4%). Around 60% of the participants had inadequate knowledge regarding CAN. Graduates from government schools who received dental education about CAN and female participants had significantly higher odds of having adequate knowledge scores than others (odds ratio = 2.0, 3.1, and 1.7, respectively). Only 39.5% of the participants felt confident in their ability to identify CAN cases, and only 9.7% knew how to report such cases. CONCLUSIONS: Graduate dental students have insufficient knowledge about CAN. More time should be dedicated to educating students about this important topic in dental curricula.

Evaluation of commercially available meth-deterrent pseudoephedrine hydrochloride products.

Pseudoephedrine (PSE) extracted from its dosage forms can be used as the starting material to prepare methamphetamine by drug abusers. Recently, some pseudoephedrine drug products marketed under the over the counter (OTC) monograph have been promoted as 'meth-deterrent'. The goal of this investigation was to evaluate the extraction and dissolution of these product against controls of non-meth-deterrent products of pseudoephedrine. Immediate release (IR) PSE OTC Product-C, Product-D and Product-E with meth-deterrent claim on their packaging were selected for this study. Accordingly, OTC IR PSE tablet Product-A and OTC extended release (ER) PSE tablet Product-B, with no meth-deterrent claims, were used as controls. The extraction studies were performed on intact tablets or capsules and on manipulated products employing water, ethanol and 0.l N HCl as solvents. The extraction studies were also performed in water at elevated temperatures by heating the water in an oven and in a microwave. The dissolution studies were performed in water and 0.1 N HCl. The amount of PSE extracted from Product-C was found similar to the amount extracted from the non-meth-deterrent control Product-A. The amount of PSE extracted from Product-D and Product-E was found lower than the amount extracted from control Product-A under the conditions studied. Product-A, Product-B, and Product-C met their respective dissolution acceptance criteria. The IR Products D and E released less than 50% drug in 12 h and did not meet either IR or ER PSE tablet USP dissolution acceptance criteria. In summary, the extraction of Product-C was found to be high (approximately 85% in 30 min) and was similar in extraction to the control Product-A. The extraction of Product-D and Product-E was found less than the extraction of control Product-A. Also, Product-D and Product-E did not exhibit complete drug release. This study showed that PSE can be extracted from Product D and Product E.

Quinoline Triradicals: A Reactivity Study.

The gas-phase reactivities of several protonated quinoline-based σ-type (carbon-centered) mono-, bi-, and triradicals toward dimethyl disulfide (DMDS) were studied by using a linear quadrupole ion trap mass spectrometer. The mono- and biradicals produce abundant thiomethyl abstraction products and small amounts of DMDS radical cation, as expected. Surprisingly, all triradicals produce very abundant DMDS radical cations. A single-step mechanism involving electron transfer from DMDS to the triradicals is highly unlikely because the (experimental) adiabatic ionization energy of DMDS is almost 3 eV greater than the (calculated) adiabatic electron affinities of the triradicals. The unexpected reactivity can be explained based on an unprecedented two-step mechanism wherein the protonated triradical first transfers a proton to DMDS, which is then followed by hydrogen atom abstraction from the protonated sulfur atom in DMDS by the radical site in the benzene ring of the deprotonated triradical to generate the conventional DMDS radical cation and a neutral biradical. Quantum chemical calculations as well as examination of deuterated and methylated triradicals provide support for this mechanism. The proton affinities of the neutral triradicals (and DMDS) influence the first step of the reaction while the vertical electron affinities and spin-spin coupling of the neutral triradicals influence the second step. The calculated total reaction exothermicities for the triradicals studied range from 27.6 up to 29.9 kcal mol-1.

Application of in vitro lipolysis for the development of oral self-emulsified delivery system of nimodipine.

The objective of the current study was to optimize for the first time the formulation variables of self-emulsified drug delivery system (SEDDS) based on drug solubilization during lipolysis under a biorelevant condition of digestion such as lipase activity, temperature, pH, fed-fasting state, etc. Nimodipine (ND), a BCS class II, was used as a model drug to prepare the SEDDS. Various oils, surfactants, and cosurfactants were screened for their solubilization potential of ND. Area of self-emulsification was identified using various ternary phase diagrams. Box-Behnken design was employed to investigate effects of formulation variables on various dispersion, emulsification, and lipolysis characteristics of SEDDS. Among 26 candidate formulations, highest ND solubility of 12.72%, 11.09% and 11.2% w/w were obtained in peppermint oil as the oily phase, Cremphor EL as the surfactant and PEG400 as the cosurfactant, respectively. Cremphor EL was the most significant factor to decrease SEDDS droplet size to 30.16 nm. On the other hand, increasing the oil concentration was found to significantly increase the polydispersity index up to 0.31. A faster emulsification rate of 3.37%/min was obtained at higher Cremphor El/PEG 400 ratio. Increasing the percentage of lipid components of SEDDS resulted in lower rate of lipolysis with less recovery of ND in aqueous phase. Under fed state, percentage of lipolysis of optimized formulation was less than that observed under fasted state. However, lowest rate and percentage of lipolysis were observed in lipolysis media without phospholipids and bile salts. Hence, this study demonstrated that in vitro lipolysis could be used as a surrogate approach to distinguish effects of formulation variables on fate of SEDDS upon digestion. Further studies are in progress to identify the lipolytic products of the employed excipients by LC-MS/MS.

Reactivity of the 4,5-didehydroisoquinolinium cation.

The chemical properties of a 1,8-didehydronaphthalene derivative, the 4,5-didehydroisoquinolinium cation, were examined in the gas phase in a dual-cell Fourier-transform ion cyclotron resonance (FT-ICR) mass spectrometer. This is an interesting biradical because it has two radical sites in close proximity, yet their coupling is very weak. In fact, the biradical is calculated to have approximately degenerate singlet and triplet states. This biradical was found to exclusively undergo radical reactions, as opposed to other related biradicals with nearby radical sites. The first bond formation occurs at the radical site in the 4-position, followed by that in the 5-position. The proximity of the radical sites leads to reactions that have not been observed for related mono- or biradicals. Interestingly, some ortho-benzynes have been found to yield similar products. Since ortho-benzynes do not react via radical mechanisms, these products must be especially favorable thermodynamically.

Concise assembly of linear alpha(1-->6)-linked octamannan fluorescent probe.

Synthesis of a fluorescently labelled (dansylated) linear alpha(1-->6)-linked octamannan, using glycosyl fluoride donors and thioglycosyl acceptors is described. A selective and convergent two-stage activation progression was executed to construct di-, tetra and octa-mannosyl thioglycosides in three glycosylation steps with excellent yield. Further a 5-N,N-Dimethylaminonaphthalene-1-sulfonamidoethyl (dansyl) group was coupled to 1-azidoethyl octamannosyl thioglycoside. Global deprotection of the coupled product afforded the desired dansylated homo-linear alpha(1-->6)-linked octamannan.