Monometallic and Bimetallic Platinum Complexes with Fluorinated ß-Diketiminate Ligands.

Presented here are complexes of two different fluorinated ß-diketiminate (NacNac) ligands with cyclometalated platinum. Reaction of the cyclometalated platinum dimers [Pt(C^N)(µ-X)]2 [C^N = 2-phenylpyridine (ppy), 2-(2,4-difluorophenyl)pyridine (F2ppy); X = Cl, Br] with lithium salts of backbone-fluorinated ß-diketiminate ligands produces two structure types, depending on the temperature of the reaction. At milder temperatures (<80 °C), the major product is an unusual halide-bridged diplatinum complex, demonstrating a unique NacNac binding mode bridging the two platinum centers. At higher temperatures (>100 °C), the major species is a monoplatinum complex of the type Pt(C^N)(NacNac). The complexes display reduction waves in their cyclic voltammograms at mild potentials, as well as intense visible absorption bands (λ > 500 nm), that depend minimally on the identity of the C^N ligand or, in the case of the bimetallic complexes, the identity of the bridging halide. In addition, the monoplatinum complexes exhibit structured luminescence in the red and near-infrared regions deriving a NacNac-centered triplet state. All of these observations suggest that the NacNac π system contributes substantially to the frontier orbitals and motivates continued exploration of fluorinated ß-diketiminate ligands in the design of complexes with desirable ligand-based redox and optical properties.

Lost in care pathway: a qualitative investigation on the health system delay of extra pulmonary tuberculosis patients in Bangladesh.

BACKGROUND: Although extra pulmonary tuberculosis (EPTB) has long been known as a major public health concern globally, the complex healthcare-seeking pathways of EPTB patients are not widely studied. This study aims to explore the pattern of healthcare-seeking pathways of rural and urban EPTB patients registered with the BRAC TB control programme. BRAC is a Bangladesh-based non-governmental organization dedicated to alleviating poverty through empowering the poor. METHOD: Data were collected through 60 in-depth interviews with rural and urban EPTB patients in Bangladesh. RESULTS: The findings reveal that the rural EPTB patients encountered a substantial diagnostic delay as compared to the urban patients. However, the difference between the average number of healthcare providers consulted by the rural verses the urban EPTB patients was not significant. This study also shows that the healthcare-seeking journey of rural and urban EPTB patients usually starts either at pharmacies or private facilities. Through exploring the detailed nature of the pathway, this study reveals the ways in which non-medical informants, mainly relatives and friends, can benefit patients. CONCLUSIONS: The private and informal healthcare providers should receive appropriate training on the diagnosis of EPTB. Such training could effectively shorten the long and complex healthcare-seeking pathways of EPTB patients.

Outcome of omentopexy as primary repair in perforated duodenal ulcer.

OBJECTIVE: This study was conducted to determine the short-term complications and duration of hospital stay in patients treated with omentopexy as primary repair in perforated duodenal ulcer that were more than 12 hours old and more than 0.5 cm in size. STUDY DESIGN: Case-series study. PLACE AND DURATION OF STUDY: Department of General Surgery, Bolan Medical College, Quetta from January 2006 to January 2007. PATIENTS AND METHODS: Thirty consecutive patients of perforated duodenal ulcer in whom the duration of perforation was greater than 12 hours and size of perforation was greater than 0.5 cm were included in this study. After adequate resuscitation, emergency laparotomy was performed and primary repair with pedicled omental patch performed without primary suturing of the perforation. A thorough peritoneal lavage was done with normal saline. Postoperatively, all the patients were given intravenous fluids, antibiotics and H2-receptor blockers. All the patients were closely monitored for the development of any postoperative complication. All the findings were recorded on a pre-designed proforma. Duration of hospital stay was noted at the time of discharge. All the patients were discharged on proton pump inhibitors, prescribed for 6 weeks. RESULTS: Perforation was present on the anterior surface of the first part of duodenum in all cases. Size of perforation varied from 0.6 cm to 1.5 cm. Median size was 0.8 cm. Wound infection was seen in 10 (33.3%) patients and pneumonia in 7 (23.3%) patients. Two (6.7%) patients developed burst abdomen and residual pelvic collection that required re-operation. Overall, 15 (50%) patients did not develop any complication. Mortality was 1 (3.3%). Median hospital stay was 9 days. CONCLUSION: Omentopexy with thorough peritoneal lavage is simple and safe procedure with low mortality and fewer post-operative complications. It does not require great expertise and can be performed in a very short time in seriously ill patient. It should be chosen instead of an acid reducing operation in an emergency setting.