Virtual keratoconus monitoring clinic in a tertiary university hospital in the United Kingdom.

Purpose: To describe a new pathway for virtual keratoconus (KC) monitoring in the corneal department of a tertiary referral center in the UK during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A virtual outpatient clinic to monitor KC patients (KC PHOTO clinic) was created. All patients from the KC database in our department were included. At each hospital visit, patients' visual acuity and tomography (Pentacam; Oculus, Wetzlar, Germany) were collected by a health-care assistant and an ophthalmic technician, respectively. The results were virtually reviewed by a corneal optometrist to identify stability or progression of KC and discussed with a consultant if needed. Those with progression were contacted by telephone and listed for corneal crosslinking (CXL). Results: From July 2020 until May 2021, 802 patients were invited to attend the virtual KC outpatient clinic. Of them, 536 patients (66.8%) attended and 266 (33.2%) did not attend. After corneal tomography analysis, 351 (65.5%) were stable, 121 (22.6%) showed no definite evidence of progression, and 64 (11.9%) showed progression. Forty-one (64%) patients with progressive KC were listed for CXL and the remaining 23 patients deferred treatment after the pandemic. By converting a face-to-face clinic to a virtual clinic, we were able to increase our capacity by nearly 500 appointments per year. Conclusion: In pandemic times, hospitals have developed novel methods of delivering safe patient care. KC PHOTO is a safe, effective, and innovative method of monitoring KC patients and diagnosing progression. In addition, virtual clinics can increase the clinic capacity tremendously and reduce the need of face-to-face appointments, which is beneficial in pandemic conditions.

Chromone-fused cytosine analogues: synthesis, biological activity, and structure-activity relationship.

The preparation of a series of novel chromone-fused cytosine analogues, i.e., chromeno[2,3-d]pyrimidines has been carried out from substituted 2-amino-4-oxo-4H-chromene-3-carbonitriles with urea, thiourea, and guanidine under different reaction conditions. These chromone-fused cytosine analogues were evaluated for their in vitro activity against Mycobacterium tuberculosis H37Rv strain and different microbial pathogenic strains in cell culture for their structure-activity relationships, respectively. Among the synthesized compounds, 2d, 3a, and 4e showed better results against Mycobacterium tuberculosis H37Rv. The compounds 2a, 2b, and 3a showed potential antibacterial activity against E. coli and P. aeruginosa, while the majority of compounds were found to be active against S. aureus as compared to ampicillin. The synthesized cytosine analogues having an imine (-C&dbnd;NH) have been less sensitive to the bacterial and fungal strains but have a more beneficial effect on Mycobacterium tuberculosis H37Rv.

Design, synthesis and in vitro evaluation of antitubercular and antimicrobial activity of some novel pyranopyrimidines.

The clinical significance of pyran and pyrimidine condensed systems and the raise in problem of multidrug resistant bacterial pathogens has directed us to synthesize pyranopyrimidine derivatives via the reactions of the versatile, 2-amino-4-(4-methoxyphenyl)-4H-substituted chromene-3-carbonitrile with the appropriate reagents. The newly synthesized compounds were characterized by IR, (1)H NMR, (13)C NMR, Mass spectra and Elemental analysis. The compounds were evaluated for their in vitro antitubercular activity against Mycobacterium tuberculosis H(37)Rv [ATCC-27294] and antibacterial activity against Staphylococcus aureus [ATCC-25923] and Streptococcus pyogenes [MTCC-443] as gram-positive, Escherichia coli [ATCC-25922] and Pseudomonas aeruginosa [MTCC-441] as gram-negative bacterial strains and antifungal activity against Aspergillus niger [MTCC-282]. Several derivatives exhibited pronounced antitubercular and antimicrobial activities.