Fabrication of thiosemicarbazone-based Pd(II) complexes: structural elucidations, catalytic activity towards Suzuki-Miyaura coupling reaction and antitumor activity against TNBC cells.

Currently, there are many uses of metal complexes, especially in the fields of medicinal chemistry and catalysis. Thus, fabrication of new complexes which perform as a catalyst and chemotherapeutic drug is always a beneficial addition to the literature. Herein, we report three heterocyclic thiosemicarbazone-based Pd(II) complexes [Pd(HL1)Cl] (C1), [Pd(L2)(PPh3)] (C2) and [Pd(L3)(PPh3)]Cl (C3) having coligands Cl and PPh3. Thiosemicarbazone ligands (H2L1, H2L2 and HL3) and the complexes (C1-C3) were characterized methodically using several spectroscopic techniques. Single-crystal X-ray diffraction methods reveal that the structural environment around the metal center of C2 is square planar, while for C1 and C3 it is a slighty distorted square plane. The supramolecular network of compounds was built via hydrogen bonds, C-H⋯π and π⋯π interactions. Density functional theory (DFT) study of the structure of the complexes supports experimental findings. The application of these complexes as catalysts toward Suzuki-Miyaura coupling reactions has been examined with various aryl halides and phenyl boronic acid in PEG 400 solvent. The complexes displayed good biomolecular interactions with DNA/protein, with a binding constant value of the order of 105 M-1. C3 showed greater binding efficacy toward these biomolecules than the other complexes, which might be due to the cationic nature of C3. Furthermore, antitumor activity of the complexes was studied against the human triple-negative breast cancer (TNBC) cell line MDA-MB-231. It was found that C3 was more toxic (IC50 = 10 ± 2.90 µM) toward MDA-MB-231 cells than the other complexes. A known chemotherapeutic drug, 5-fluorouracil, was included as positive control. The programmed cell death mechanism of C3 was confirmed. Additionally, complex-induced apoptosis was confirmed and occurred via a mitochondria-dependent (intrinsic) pathway.

Composite of graphitic carbon nitride and TiO2 as photo-electro-catalyst in microbial fuel cell.

The widespread application of surfactants and their subsequent discharge in the receiving water bodies is a very common issue in developing countries. In the present investigation, a composite of graphitic carbon nitride (GCN) and TiO2 was used as a photo-electro-catalyst in a microbial fuel cell (MFC)-based hybrid system for bio-electricity production and simultaneous pollutant removal (organic matter and sodium dodecyl sulphate, SDS). The GCN: TiO2 composite with a ratio of 70:30 (by wt. %) revealed a better electrochemical response; thus, it was used as a photo-electro-catalyst in MFC. Additionally, the photochemical characterization indicated a decrease in the band gap and charge recombination of GCN-TiO2 composite compared to standalone TiO2, which indicated a conducive effect of GCN addition. Further, on the actual use as a photo-electro-catalyst, the GCN-TiO2 catalysed MFC attained 58.2 ± 9.6% and 86.5 ± 7.1% of COD and SDS removal; while simultaneously harvesting a maximum power density of 1.07 W m-3, which was higher than standalone TiO2-catalysed MFC. The follow-up treatment in the charcoal bio-filter and photo-cathodic chamber of the hybrid system further improved the overall COD and SDS removal efficiency to 92.1 ± 2.7 and 95.6 ± 1.5%, respectively. The electro-catalytic performance of the GCN-TiO2 can be attributed to the presence of nitrogen-active species in the composite. The results of this investigation demonstrated a potential MFC-based hybrid system for the simultaneous secondary and tertiary treatment of municipal wastewater. Consequently, the outcome of this investigation indicates an innovative research direction in the field of photo-electro-catalyst, which can fit into the role of a photo-catalyst as well as an electro-catalyst.

Facile synthesis of novel NNO-tethered copper(II) complexes: characterization details, theoretical studies, promising enzyme-like activities, and biomolecular interactions.

Given the ubiquitous and multifaceted role of copper ions in various biological processes, we report herein the one-pot facile synthesis, X-ray structure, Hirshfeld surface analysis, enzyme-like activities, and biomolecular interactions of three mononuclear copper(II) complexes, [Cu(L)(X)] (1-3) with a tridentate quinoline-based salicylaldimine Schiff base (LH) having an N2O donor set where X denotes NCS, N3, and NO3 for complexes 1, 2, and 3, respectively. Single-crystal X-ray study, spectroscopic techniques, DFT, and TD-DFT calculations were all used to fully characterize the complexes. The bio-inspired catalytic activities of the synthesized complexes were spectrophotometrically evaluated for the aerial oxidation of 3,5-di-tert-butylcatechol (3,5-DTBC) and 2-aminophenol (OAPH) in acetonitrile. The results of ESI mass spectrometry, EPR analysis of the reaction mixture, and DFT computations established that the aforementioned oxidation is metal-mediated and radical-driven, leading us to propose a viable mechanistic scheme. In complex 3, coordinated nitrate probably confers greater lability, allowing it to be the most effective enzyme for catecholase and phenoxazane-synthase activities. The biological activity of complexes 1-3 and the ligand LH towards calf thymus DNA and proteins (bovine serum albumin (BSA)) was explored using absorption and fluorescence spectral titrations, which affirmed that the compounds underwent avid binding with DNA, with high binding affinities (Kb) of approximately 104-105 M-1. The observed DNA binding constants and viscosity measurement data suggested an intercalative mode of DNA binding with the copper(II) complexes. Spectral evidence also supports the high binding propensity (on the order of approximately 105 M-1) of the complexes with the protein. They actively suppressed the protein's intrinsic fluorescence in a static quenching mode, as further determined by fluorescence lifetime titration of protein with the complexes. Circular dichroism and synchronous spectroscopic experiments supported the protein's conformational alterations mediated by copper(II) complexes (1-3) in the microenvironment of the tryptophan residue of the protein. The typical binding distance between BSA and complexes was also computed using fluorescence resonance energy transfer. Of the three complexes (1-3), complex 3 stands out as the most efficacious.

Red Light Absorption of [ReI(CO)3(α-diimine)Cl] Complexes through Extension of the 4,4'-Bipyrimidine Ligand's π-System.

Rhenium(I) complexes of type [Re(CO)3(NN)Cl] (NN = α-diimine) with MLCT absorption in the orange-red region of the visible spectrum have been synthesized and fully characterized, including single crystal X-ray diffraction on two complexes. The strong bathochromic shift of MLCT absorption was achieved through extension of the π-system of the electron-poor bidiazine ligand 4,4'-bipyrimidine by the addition of fused phenyl rings, resulting in 4,4'-biquinazoline. Furthermore, upon anionic cyclization of the twisted bidiazine, a new 4N-doped perylene ligand, namely, 1,3,10,12-tetraazaperylene, was obtained. Electrochemical characterization revealed a significant stabilization of the LUMO in this series, with the first reduction of the azaperylene found at E1/2(0/-) = -1.131 V vs. Fc+/Fc, which is the most anodic half-wave potential observed for N-doped perylene derivatives so far. The low LUMO energies were directly correlated to the photophysical properties of the respective complexes, resulting in a strongly red-shifted MLCT absorption band in chloroform with a λmax = 586 nm and high extinction coefficients (ε586nm > 5000 M-1 cm-1) ranging above 700 nm in the case of the tetraazaperylene complex. Such low-energy MLCT absorption is highly unusual for Re(I) α-diimine complexes, for which these bands are typically found in the near UV. The reported 1,3,10,12-tetraazaperylene complex displayed the [Re(CO)3(α-diimine)Cl] complex with the strongest MLCT red shift ever reported. UV-Vis NIR spectroelectrochemical investigations gave further insights into the nature and stability of the reduced states. The electron-poor ligands explored herein open up a new path for designing metal complexes with strongly red-shifted absorption, thus enabling photocatalysis and photomedical applications with low-energy, tissue-penetrating red light in future.

Double Effects of Interfacial Ag Nanoparticles in a ZnO Multipod@Ag@Bi2S3 Z-Scheme Photocatalytic Redox System: Concurrent Tuning and Improving Charge-Transfer Efficiency.

Distinct functional materials in their combined form in a well-designed hybrid architecture offer great possibilities for creating a highly active photocatalytic system. Herein, a uniform multipod-shaped ZnO is synthesized through a natural template assisted route and progressively integrated with Ag nanoparticles (NPs) and Bi2S3 to form a three-component (3C) ternary photocatalytic system by a facile, two -step wet chemical approach. Encapsulation of polycrystalline Bi2S3 and assimilation of Ag NPs in between the interface of ZnO and Bi2S3 in the ternary hybrid are confirmed from electron microscopy and X-ray photoelectron spectroscopy, which resulted in improved UV-vis absorption, charge separation efficiency, and photocurrent response evaluated from optical absorption spectroscopy, photoluminescence, and photoelectrochemical cell measurements. This ternary hybrid shows high photoredox activity toward the hydrogen evaluation reaction (HER) (218.7 µmol h-1 g-1) and methyl orange (MO) oxidation (k = 3.21 × 10-2 min-1) compared to their binary and single counterparts. Moreover, on the basis of the estimation of the predominant active species (O2•-, •OH) in the photoredox catalysis and band edge positions from the Mott-Schottky plot, it was determined that both binary ZnO multipod@Bi2S3 and ternary ZnO multipod Ag@Bi2S3 hybrids undergo a Z-scheme electron transfer mechanism under irradiation of light. Here, the Ag ingredient in the ternary hybrids acts as an interfacial charge-transfer mediator to accelerate the Z-scheme electron transfer between Bi2S3 and ZnO along with plasmonic photosensitization to trigger the generation of plasmon-induced hot electrons. Such a cooperative concurrent dual role of Ag NPs in the Z-scheme ternary hybrid system considerably boosts the photoredox performance compared to direct Z-scheme binary hybrids. This work will enlighten and uncover the essential roles of metal NPs along with their cooperative synergy in Z-scheme photocatalytic systems as a prototypical example for substantial solar energy conversion.

Comparative evaluation of analgesic sparing efficacy between dexmedetomidine and clonidine used as adjuvant to ropivacaine in thoracic paravertebral block for patients undergoing breast cancer surgery: A prospective, randomized, double-blind study.

INTRODUCTION: Thoracic paravertebral block (TPVB) is an effective method for intra- and post-operative pain management in thoracic surgeries. For a long time, various adjuvants have been tried for prolonging the duration of TPVB. OBJECTIVE: In this prospective study, we have compared the analgesic sparing efficacy of dexmedetomidine and clonidine, two α2 adrenergic agonists, administered along with ropivacaine for TPVB for breast cancer surgery patients. MATERIALS AND METHODS: Forty-four breast cancer surgery patients undergoing general anesthesia (GA) were randomly divided into Group C and Group D (n = 44 each) receiving preoperative TPVB at T3-5 level with 0.5% ropivacaine solution admixture with clonidine and dexmedetomidine, respectively. Cancer surgery was performed under GA. Intraoperative fentanyl and propofol requirement was compared. Visual analogue scale was used for pain assessment. Total dose and mean time to administration of first rescue analgesic diclofenac sodium was noted. Side effects and hemodynamic parameters were also noted. RESULTS: Intraoperative fentanyl and propofol requirement was significantly less in dexmedetomidine group than clonidine. The requirement of diclofenac sodium was also significantly less and later in Group D than Group C. Hemodynamics, and side effects were comparable among two groups. CONCLUSION: Dexmedetomidine provided better intraoperative as well as postoperative analgesia than clonidine when administered with ropivacaine in TPVB before breast cancer surgery patients without producing remarkable side effects.

Strategic Synthesis of SiO2-Modified Porous Co3O4 Nano-Octahedra Through the Nanocoordination Polymer Route for Enhanced and Selective Sensing of H2 Gas over NO x.

In this work, a strategic synthesis of Co3O4 nano-octahedra was developed through the facile nanoscale coordination polymer (NCP) route, which was further modified by SiO2 to be used as a sensor for enhanced sensing of hydrogen. The Co(II)-NCP-derived Co3O4 octahedra and SiO2-modified Co3O4 octahedra were characterized using Fourier transform infrared, powder X-ray diffraction, Brunauer-Emmett-Teller, thermogravimetric analysis, field emission scanning electron microscopy, high-resolution transmission electron microscopy, X-ray photoelectron spectroscopy, and hydrogen temperature-programmed reduction (H2TPR) techniques. The SiO2-modified Co3O4 sensor exhibited a stronger and selective electrical response to H2 gas over NO x at 225 °C than Co(II)-NCP-derived Co3O4 octahedra and the conventional Co3O4 powder. The composite sensor shows faster recovery and significant repeatability than the other two. The enhancement in the sensing performance of the SiO2-modified Co3O4 octahedron was explained by the effectiveness of surface modification, controlled morphology, and combination of synergistic effect of Co3O4 and SiO2. Surface engineering of the as-prepared Co3O4 nano-octahedra with an exposed (111) surface plane and later SiO2 modification facilitates effective gas adsorption, resulting in enhancement in sensing and selectivity over NO x . The details of the synergistic effect and the plausible reasons for the improvement in gas-sensing parameters are discussed here. This study would offer new directions for development on the controlled synthesis of porous materials, in general, and in gas sorption or sensing, in particular.

Effect of Clonidine as Adjuvant in Thoracic Paravertebral Block for Patients Undergoing Breast Cancer Surgery: A Prospective, Randomized, Placebo-controlled, Double-blind Study.

BACKGROUND AND AIMS: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution. MATERIALS AND METHODS: Fifty-two patients (25-55 years) scheduled for breast cancer surgery under general anesthesia were randomly divided into Group A (n = 26) receiving preoperative TPVB at T3 with clonidine added to local anesthesia solution and Group B (n = 26) receiving identical TPVB with local anesthesia but without any adjuvant. This was followed by balanced general anesthesia. A visual analog scale was used to assess pain postoperatively up to 48 h. Meantime to administration of the first dose of rescue analgesic was noted. Total dose of fentanyl consumption, hemodynamic parameters, and side effects were all recorded for each patient. RESULTS: The dosage of fentanyl required in the intraoperative period was significantly lower in Group A. Mean time to administration of rescue analgesic was found to be significantly longer in clonidine group. Hemodynamics and side effects were quite comparable among two groups. CONCLUSION: Clonidine as adjuvant in TPVB provided profound analgesia for up to 48 h postoperatively for patients undergoing breast cancer surgery without any appreciable side effects.

Evaluation of Preoperative Flupirtine in Ambulatory Functional Endoscopic Sinus Surgery: A Prospective, Double-Blind, Randomized Controlled Trial.

BACKGROUND: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting. MATERIALS AND METHODS: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia. Perioperative Nasal bleeding and surgeon's satisfaction score during operation; amount and number of patients receiving fentanyl, propofol, and esmolol infusion for analgesia; maintenance of desired bispectral index (BIS) and deliberate hypotension, respectively. Postanesthesia Care Unit (PACU) and hospital stay, hemodynamic parameters, and side effects were all recorded for each patient. RESULTS: Significantly, less number of patients and less dosage of esmolol were required (P = 0.0040 and 0.0001, respectively) in Group F as compared to that in Group C. Again, number of patients requiring fentanyl and dosage of the same drug was significantly lower in Group F. Dose of propofol for the maintenance of BIS was significantly lower in Group F. However, the duration of controlled hypotension was almost similar in both groups. Group F patients suffered significantly less nasal bleeding and surgeon's satisfaction score was also high in this group. Discharge time from PACU and hospital was similar between two groups without any appreciable side effects. CONCLUSION: Flupirtine as a premedication found to be providing more favorable perioperative hemodynamic conditions, analgesia and thus allowing less nasal bleeding as well as more surgeons' satisfaction score.

Perineural Nalbuphine in Ambulatory Upper Limb Surgery: A Comparison of Effects of Levobupivacaine with and without Nalbuphine as Adjuvant in Supraclavicular Brachial Plexus Block - A Prospective, Double-blinded, Randomized Controlled Study.

BACKGROUND AND AIMS: Various opioid additives have been trialed to prolong brachial plexus block. We evaluated the effect of adding nalbuphine hydrochloride to levobupivacaine for supraclavicular brachial plexus blockade. The primary end-points were the onset and duration of sensory and motor blocks and duration of analgesia. MATERIALS AND METHODS: Seventy-eight patients (aged 25-45 years) posted for ambulatory forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Groups LN and LC) in a randomized, double-blind fashion. In Group LN (n = 39), 30 ml 0.5% levobupivacaine + 10 mg (diluted in 2 ml 0.9% saline) nalbuphine hydrochloride, and in Group LC (n = 39), 30 ml 0.5% levobupivacaine + 2 ml normal saline (0.9%) were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS), hemodynamics, and side effects were recorded for each patient. RESULTS: Although with similar demographic profile and block (sensory and motor) onset time, sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in Group LN (P < 0.05) than Group LC. Postoperative VAS value at 24 h was significantly lower in Group LN (P < 0.05). Intraoperative hemodynamics was comparable between two groups, and no any appreciable side effect was noted throughout the study period. CONCLUSION: It can be concluded that adding nalbuphine hydrochloride to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side effects.

Postoperative Sore Throat Prevention in Ambulatory Surgery: A Comparison between Preoperative Aspirin and Magnesium Sulfate Gargle - A Prospective, Randomized, Double-blind Study.

BACKGROUND: Postoperative sore throat (POST) frequently hampers the positive feedback of ambulatory surgery in spite of so many measures. This study was carried out to compare the efficacy of preoperative magnesium sulfate and aspirin gargle in preventing POST after ambulatory surgery. MATERIALS AND METHODS: It was a prospective, randomized, and double-blinded study. Fifty-six adult patients of either sex, aged 25-50, of American Society of Anesthesiologists physical status I-II, scheduled for day care surgery, were randomly allocated to Group A ([n = 28] receiving aspirin gargle [325 mg tablet]) and Group M ([n = 28] receiving magnesium sulfate [20 mg/kg] gargle). In both groups, the medications were made into 20 mL of (5% dextrose) solution. Patients were asked to gargle with this mixture for 30 s, 15 min before induction of anesthesia. Episodes of POST were measured at 0, 2, 4, 6, 9, 12, and 16 h postoperatively with a four-point scale. RESULTS: Both groups had a similar demographic profile with comparable oxygen saturation, hemodynamics, and consciousness status at immediate postoperative period. Number of patients with sore throat was significantly lower in magnesium group compared to aspirin group at 0 h (P = 0.0376), 2 h (P = 0.0429), 4 h (P = 0.0394) after the operation. POST pain score (visual analog scale) was significantly (P < 0.05) lower in magnesium group compared to aspirin group after the operation at 0, 2, 4 h after operation. CONCLUSION: It is evident that preoperative magnesium sulfate gargle significantly attenuated the incidence and severity of POST, especially in the early postoperative period, with no adverse effects in patients undergoing day care surgery under general anesthesia.

The effect of dexmedetomidine added to preemptive (2% lignocaine with adrenaline) infiltration on intraoperative hemodynamics and postoperative pain after ambulatory maxillofacial surgeries under general anesthesia.

BACKGROUND: Lignocaine + adrenaline; a local anesthetic agent; frequently used for perilesional infiltration, maintains the stable hemodynamics and decreases the postoperative pain after maxillofacial surgery. α2 agonists have peripheral analgesic effects. This prospective study was to evaluate the effectiveness of perilesional dexmedetomidine administered preincisionally in addition to conventional lignocaine adrenaline combinations for reconstructive maxillofacial surgery in an ambulatory care setting. MATERIALS AND METHODS: 76, American Society of Anesthesiologists I-II patients scheduled for unilateral traumatic maxillofacial surgeries were randomly allocated into group DL (n = 38) receiving 15 cc of 2% lignocaine + adrenaline (1:200,000) mixed with 1 µg/kg dexmedetomidine and group PL receiving 15 cc of 2% lignocaine + adrenaline with normal saline (placebo) via local wound infiltration 5 min prior to skin incision. Perioperative hemodynamics, time to first analgesic use, total analgesic need, bleeding, and side effects were recorded for each patient. RESULTS: Dosage of supplemental propofol; total perioperative, postoperative, and postanesthesia care unit (PACU) fentanyl consumption was significantly lower (P = 0.0001, P= 0.0001, P= 0.0001, P= 0.004, respectively) in dexmedetomine treated group than placebo. Rescue analgesic requirement was significantly earlier in group PL than group DL. Group DL patients suffered from significantly less (P = 0.02) bleeding and surgeon's satisfaction score was also high in this group. Discharge from PACU was significantly earlier in group DL. Intraoperative hemodynamic parameters were significantly lower in group DL (P < 0.05) without any appreciable side effects. CONCLUSION: Thus, prior dexmedetomidine local infiltration at the site of maxillofacial trauma has significantly reduced bleeding from wound site; perioperative fentanyl, propofol consumption, and subsequently ensured earlier discharge from PACU, better surgeon's satisfaction score with better hemodynamic control and lesser side effects.

Repeat spinal anesthesia in cesarean section: A comparison between 10 mg and 12 mg doses of intrathecal hyperbaric (0.05%) bupivacaine repeated after failed spinal anesthesia: A prospective, parallel group study.

BACKGROUND: Spinal anesthesia for cesarean section is not a 100% successful technique. At times, despite straightforward insertion and drug administration, intrathecal anesthesia for cesarean section fails to obtain any sensory or motor block. Very few studies and literature are available regarding repeat administration of spinal anesthesia and its drug dosage, especially after first spinal failure in cesarean section lower segment cesarean section (LSCS) due to fear of the excessive spread of drug. The aim of our study is to compare the outcome between two different doses of 0.5% hyperbaric bupivacaine repeated intrathecally after failed spinal. MATERIALS AND METHODS: After taking informed consent and Ethical Committee approval this prospective, randomized single-blinded study was conducted in 100 parturients of American Society of Anesthesiologists I-II who were posted for elective LSCS and had Bromage score 0 and no sensory block even at L4 dermatome after 10 min of first spinal anesthesia; were included in the study. Group A (n = 50) patients received 2.4 ml and Group B (n = 50) patients received 2 ml of 0.5% hyperbaric bupivacaine respectively for administering repeat spinal anesthesia. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation, respiratory rate and electrocardiogram were monitored both intra- and post-operatively and complications were recorded. RESULTS: Incidence of high spinal, bradycardia, hypotension, respiratory complications, and nausea vomiting are significantly higher in Group A compared to Group B (P < 0.05). SBP, DBP, and HR were significantly low in Group A patients compared to Group B in the first 10 min (P < 0.05). CONCLUSION: Spinal anesthesia can be safely repeated in the cesarean section with 10 mg of 0.5% hyperbaric bupivacaine provided after first spinal anesthesia, the level of sensory block is below L4 and motor power in Bromage scale is 0.

Does the preoperative administration of tranexamic acid reduce perioperative blood loss and transfusion requirements after head neck cancer surgery? A randomized, controlled trial.

BACKGROUND: Head and neck cancer (HNC) surgery is associated with high intraoperative blood loss which may require urgent blood transfusion. Many strategies have been recommended to decrease the need for allogenic transfusion. Use of perioperative tranexamic acid (TA) has a promising role. AIMS: This study was to evaluate the effectiveness of single preoperative bolus dose of TA on blood loss prevention and red blood cell transfusion in patients undergoing HNC surgery. STUDY DESIGN: A prospective, double-blind, and randomized controlled study. MATERIALS AND METHODS: From 2007 July to 2010 January; 80 patients, aged (35-55), of American Society of Anesthesiologists II-III scheduled for unilateral HNC surgeries were randomly received either TA (Group T) in a dose of 20 mg/kg diluted to 25 cc with normal saline or an equivalent volume of normal saline (Group C) in a tertiary care hospital. Hemoglobin (Hb) concentration, platelet count, packed cell volume, fibrinogen level, D-dimer level were measured pre- and post-operatively. RESULTS: Saline (C) Group required more blood, colloid, crystalloid for blood loss. In Group T, 32 patients did not require transfusion of any blood products compared to five patients in Group C (P < 0.0001) and only eight units of blood was transfused in Group T, whereas a total of 42 units of blood was transfused in Group C. Even after numerous transfusions, Hb% after 6 h and 24 h in Group C were significantly low in comparison with Group T (P < 0.05). CONCLUSION: Thus, TA significantly reduces blood loss and chances of colloid, blood, and crystalloid transfusion caused by HNC surgery.

Effect of dexmedetomidine as adjuvant in ropivacaine-induced supraclavicular brachial plexus block: A prospective, double-blinded and randomized controlled study.

BACKGROUND AND AIMS: Different additives have been used to prolong brachial plexus block. We evaluated the effect of adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. MATERIALS AND METHODS: A total of 84 patients (20-50 years) posted for elective forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Group R and RD) in a randomized, double-blind fashion. In group RD (n = 42) 30 ml 0.5% ropivacaine +1 ml (100 µg) of dexmedetomidine and group R (n = 42) 30 ml 0.5% ropivacaine +1 ml normal saline were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS), hemodynamics and side-effects were recorded for each patient. RESULTS: Though with similar demographic profile in both groups, sensory and motor block in group RD (P < 0.05) was earlier than group R. Sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in group RD (P < 0.05) than group R. Post-operative VAS value at 12 h were significantly lower in group RD (P < 0.05). Intra-operative hemodynamics were significantly lower in group RD (P < 0.05) without any appreciable side-effects. CONCLUSION: It can be concluded that adding dexmedetomidine to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side-effects.

The effect of the lunar cycle on frequency of births: a retrospective observational study in Indian population.

For ancient period moon has been held responsible for many biological activities. That way, lunar cycle, by activity of moon, has been held responsible for increase in number of child birth. In this retrospective, observational study, we examined a total of 9890 full-term spontaneous deliveries as well as non-elective cesarean sections that occurred throughout 12 lunar months (February 7 th , 2008-January 25 th , 2009) in a rural medical college to evaluate the influence of the lunar position on the distribution of deliveries among Indian population. Student's 't' test and ANOVA were used for statistical analysis where each delivery was considered as a single measure. We found no significant differences in the frequency of births during various phase of lunar cycle regardless of route of delivery. Our observations do not support the hypothesis of a relationship between lunar cycle and the frequency of obstetric deliveries.

High-contrast Cu(I)-selective fluorescent probes based on synergistic electronic and conformational switching.

The design of fluorescent probes for the detection of redox-active transition metals such as Cu(I/II) is challenging due to potentially interfering metal-induced non-radiative deactivation pathways. By using a ligand architecture with a built-in conformational switch that maximizes the change in donor potential upon metal binding and an electronically decoupled tunable pyrazoline fluorophore as acceptor, we systematically optimized the photoinduced electron transfer (PET) switching behavior of a series of Cu(I)-selective probes and achieved an excellent fluorescence enhancement of greater than 200-fold. Crystal structure analysis combined with NMR solution studies revealed significant conformational changes of the ligand framework upon Cu(I) coordination. The photophysical data are consistent with a kinetically controlled PET reaction involving only the ligand moiety, despite the fact that Cu(I)-mediated reductive quenching would be thermodynamically preferred. The study demonstrates that high-contrast ratios can be achieved even for redox-active metal cations, providing that the metal-initiated quenching pathways are kinetically unfavorable.

Anesthetic management of a patient with sickle ß thalassemia.

Sickle cell disease is a congenital condition and its most common clinical manifestation is anemia due to chronic hemolysis. Persistent and accelerated hemolysis associated with multiple transfusions is a recognized risk factor for the development of cholelithiasis. The occurrence of gallstones is one of the most important manifestations of sickle cell disease in the digestive tract. Most gallstones are pigmented and characteristically occur at younger ages and the prevalence of cholelithiasis increases progressively with age, affecting 50% of young adults. Cholecystectomy is the most common surgical procedure performed in sickle cell disease patients. Anesthesia in this population of patients for major surgeries deserves special attention due to various complications particularly silent infarctions of end organs are common. We are reporting a 14-year-old girl diagnosed with sickle cell anemia and ß(+) thalassemia with cholelithiasis went for cholecystectomy under general anesthesia. Although the patient has both ß(+) thalassemia and sickle cell disease component, the latter is of more concern for anesthesia.

Intravitreal bevacizumab (avastin) for circumscribed choroidal hemangioma.

Circumscribed choroidal hemangiomas are rare ophthalmic entities that cause diminution in vision due to accumulation of subretinal and/or intraretinal fluid in the macular area. Various treatment options ranging from conventional laser to photodynamic therapy have been employed to destroy the tumor and reduce the exudation; however, either the inability to penetrate through the exudative fluid or the collateral retinal damage induced by these treatment modalities make them unsuitable for lesions within the macula. We evaluated the role of intravitreal bevacizumab, a pan-vascular endothelial growth factor (VEGF) inhibitor, in reducing the sub- and intraretinal fluid in three patients with circumscribed choroidal hemangiomas. All the patients had complete resolution of the serous retinal detachment that was maintained till at least 12 months after the first injection. Intravitreal bevacizumab may be used in combination with thermal laser or photodynamic therapy in treating circumscribed choroidal hemangiomas with subretinal fluid.