Characterization of three different benzimidazolium ligands and their organo-selenium complexes by using density functional theory and Raman spectroscopy.

In the present study, Raman spectroscopy (RS) along with density functional theory (DFT) calculations have been performed for the successful characterization and confirmation of the formation of three different selenium-based N-heterocyclic carbene (NHC) complexes from their respective salts. For this purpose, mean RS features and DFT calculations of different ligands and their respective selenium NHC complexes are compared. The identified characteristic RS and DFT features, of each of these ligands and their selenium complexes, show that the polarizability of benzimidazolium rings increases after complex formation with selenium. This has been shown by the enhanced intensity of the associated Raman peaks, therefore, confirming the formation of newly formed bonds. The complex formation is also confirmed by the identification of several new peaks in the spectra of complexes and these Raman bands were absent in the spectra of the ligands. Moreover, Raman spectral data sets are analyzed using a multivariate data analysis technique of Principal Component Analysis (PCA) to observe the efficiency of the RS analysis. The results presented in this study have proved the RS technique, along with DFT, an undoubtedly fast approach for the confirmation of synthesis of selenium based NHC-complexes.

Epipericardial Fat Necrosis: A Concise Review of Literature.

Epipericardial fat necrosis (EFN) is an inflammatory process that occurs in the mediastinal fat surrounding the heart. It is a rare cause of acute chest pain and mimics more ominous clinical conditions such as acute coronary syndrome, aortic dissection, and pulmonary embolism. Clinicians are often not familiar with this condition due to its infrequent occurrence, and traditional textbooks of medicine and cardiology have not covered this topic adequately. In the past, EFN had been managed primarily with thoracotomy and surgical excision. This has changed with advances in imaging techniques and their more frequent utilization. Computed tomography (CT) of the chest is essential for the diagnosis of EFN as it allows for the evaluation of the nature and precise location of the lesion. Magnetic resonance imaging helps to differentiate EFN from other mediastinal fatty lesions such as lipomas or liposarcomas. The clinical presentation of acute chest pain along with CT findings of the encapsulated fatty pericardial lesion is adequate for diagnosis. Our review describes the emerging role of imaging in diagnosis and change in management over the last few years.

Salmonella Urinary Tract Infection and Bacteremia Following Non-Typhoidal Salmonella Gastroenteritis: An Unusual Presentation.

Salmonella is primarily known to affect the gastrointestinal tract but can rarely cause infections at uncommon sites, such as the urinary tract. It is known that Salmonella can infect the urinary tract directly by blood, fecal contamination of urethra, urolithiasis, or secondary intraluminal ascending infection. Our patient is a 59-year-old female with a past medical history of nephrolithiasis and multiple urinary tract infections (UTI) who presented with altered mental status and sepsis complicated by Salmonella bacteremia and UTI. Urine and blood cultures revealed Salmonella species > 100,000 colony-forming units per milliliter (CFU/mL) and non-typhoidal Salmonella, respectively. During the course of her hospital admission, the patient was treated with multiple antibiotics. On further review, it was noted that the patient had presented to the emergency room (ER) about four months earlier with abdominal pain and watery diarrhea with a stool culture being positive for non-typhoidal Salmonella. Gastroenteritis, sepsis, and enteric fever are normally known with Salmonella enterica serotype Typhi (S. Typhi). Less common extraintestinal diseases like UTI are due to non-typhoidal Salmonella. The most frequent pathogenesis of Salmonella UTI is probably hematogenous. UTI caused by non-typhoidal Salmonella is usually associated with structural abnormalities of the urinary tract. In our case, the patient had non-typhoidal Salmonella gastroenteritis followed by non-typhoidal Salmonella bacteremia and UTI.

Use of Cyclosporine Therapy in Steroid Resistant Nephrotic Syndrome (SRNS): A Review.

A chronic, progressive disorder Steroid Resistant Nephrotic Syndrome (SRNS) accounts for 10-20% of all children with Nephrotic Syndrome. It is a heterogeneous disorder comprised of persistent edema, proteinuria, hypoalbuminemia and hyperlipidemia. Treatment for steroid-resistant nephrotic syndrome (SRNS) is challenging and children who suffer from SRNS require aggressive treatment to achieve remission. Calcineurin inhibitors have been used more in an empirical manner than on the basis of clear rationale. It was in 1984 when cyclosporine was first considered for the treatment of steroid resistant nephrotic syndrome. Cyclosporin is a calcineurin inhibitor that suppresses immune response by downregulating the transcription of various cytokine genes. Till now many studies have been conducted to determine dosages, duration of therapy, side effects and advantages of cyclosporine. Treatment of SRNS remains a difficult challenge in pediatric nephrology.  Treatment should be individualized according to the underlying histopathology, and clinical and environmental conditions of the children. There is an urgent need to distinguish as soon as possible those patients who may benefit from prolonged immunosuppressive treatment from those who will not benefit from such treatment and who will just suffer from its major side effects. The emerging evidence that the majority of genetic forms of SRNS should receive symptomatic treatment only, should also be clinically tested and studies baring its significance should be evaluated in the future.

End Stage Renal Disease: Seroprevalence of Hepatitises B and C along with Associated Aetiology and Risk Factors in Children.

Background. End Stage Renal Disease (ESRD) normally requires dialysis or transplantation for survival. Since ESRD patients are on long term dialysis, infections such as Hepatitis B (HBV) and Hepatitis C (HCV) are commonly reported. Methods. This was a retrospective study carried out at a government hospital during a 12-month period from January 2013 to December 2013. The data was collected using a predesigned pro forma to note the etiology, gender, age, and HBsAg and anti-HCV test result of each patient. Results. 444 children suffering from ESRD were included in our analysis. The mean age of sample was 12.7 ± 4.1 years. Sixty percent (n = 262) of the children were boys. The most common etiology of ESRD was kidney stones (n = 44, 29.3%). HBV was positive in 11 children (2.5%) while HCV was positive in 13 (2.9%). Conclusion. This study asserts the need for carrying out further work to confirm these findings and expand our recommendations. It is imperative to reliably determine the burden of HBV and HCV disease and to determine the aetiology of their spread especially in children with ESRD.

Sociodemographic Pattern of Depression in Urban Settlement of Karachi, Pakistan.

INTRODUCTION: Depression is a global issue prevalent among developing countries like Pakistan as compared to developed countries. We conducted a study to assess the prevalence and identify the significant predictors of depression in an elite urban settlement in Karachi, Pakistan. MATERIALS AND METHODS: This cross-sectional study was done in the elitist residential area of Karachi; Defence Housing Authority (DHA). Four hundred and twenty three participants were included by going to their residences. Self-administered questionnaires were handed out after taking informed consent. Level of depression was assessed by Patient Health Questionnaire (PHQ-9). Data were entered and analysed in Predictive Analytical Software v. 18.0. RESULTS: The mean and median total score of the scale were 5.9 ± 5.4 and 4 (7) respectively with minimum score 0 and maximum 27. In this sequence, 139 (32.86%) respondents were identified to be depressed. It was found that females were slight more depressed than males (p = 0.063). Regression Model identified only gender and marital status as significant predictors of depression. Having a female gender increased 0.658 times chance of being depressed (p = 0.047). Unmarried person had 0.296 times more likely to be depressed (p = 0.019). Boredom was considered as significant factor of depression by the participants (p< 0.0001). Odds ratio signified depression occurred 0.310 times more if one was bored. DISCUSSION: Depression should be considered as a major public health issue for the city. Public awareness should be done in all parts of the city in an attempt to reduce depression especially among the female gender.