Utilization of DMSO as a solvent-cum-reactant: synthesis of fused 2-aryl-4-methylquinolines.

Herein, we disclose the synthesis of a variety of disubstituted fused quinoline, such as 4-methyl-2-arylbenzo[h]quinolines (3a-j), 1-methyl-3-arylbenzo[f]quinolines (3k-r), 1-methyl-3-arylnaphtho[2,3-f]quinolines (3s-x), and 2-aryl-5,7-dimethoxy-4-methylquinolines (4a-c), derivatives from the reaction of an aryl aldehyde with 1-naphthylamine (1a), 2-naphthylamine (1b), 2-aminoanthracene (1c) and 3,5-dimethoxyaniline (1d), respectively, at 80 °C in the presence of 30 mol% (±)-10-camphorsulfonic acid ((±)-CSA) using DMSO as the solvent-cum-reactant. DMSO molecules regioselectively incorporate three carbon atoms into the target molecule in this distinct reaction. The other advantages of the present protocol are that it can be performed under mild reaction conditions and does not require metal catalysts, additional additives or oxidants.

Oral health status and behaviour among Kanikkaran tribes of Mundandhurai Hills in Tirunelveli district, Tamil Nadu.

Background: Kanikkaran are semi-nomadic tribes inhabiting Mundandhurai hills in Tamil Nadu. Their traditional method of maintaining oral health, seclusion, ignorance, and limited access to dental resources has led to their poor oral health situation. Thus, the present study is designed to assess the oral health status of the Kanikkaran tribals residing in Mundandhurai Hill of Tirunelveli district. Methods: A cross-sectional epidemiological study was conducted among 907 Kanikkaran tribes in Mundandhurai hills. Mundandhurai Hills in Ambasamudram taluk of Tirunelveli district was selected by convenience method. World Health Organization (WHO) oral health assessment form and its self-oral health assessment form (2013) were used. Descriptive and inferential statistics were performed using SPSS version 23.0. Result: There is a significant negative moderate correlation between age and dental caries (r = -0.752). There is a significantly high risk among tribes with the primary school of education and agriculture as an occupation for periodontal disease (OR = 3.48), premalignant lesion (OR = 2.52), and non-carious dental lesions (OR = 3.14). Males with primary school education and agriculture as occupation had a significantly higher consumption of sugar and use of tobacco (p < 0.05). Conclusion: Primary school of education with agriculture/labor as occupation had a high prevalence of DMFT, periodontitis, premalignant, and non-carious dental lesions. The results of the present study punctuate the necessity of raising awareness of the significance of good oral health through education and implementation of necessary dental services in Kanikkaran tribes.

Chitosan-Reinforced Gelatin Microspheres-Modified Glass Ionomer Cement (GIC): A Novel Bone Alloplast Graft Material Synthesis and an In Vivo Analysis.

Aim and objective The study aimed to assess and evaluate the efficacy of glass ionomer modified with chitosan-reinforced gelatin microspheres on bone formation. Materials and methods  The study involved three groups: Group I comprised plain glass ionomer cement; Group II comprised glass ionomer cement/gelatin (70:30 wt%); in Group III, glass ionomer cement/gelatin/chitosan (70:30%) scaffold were made into discs; the gelatin microspheres were synthesized by oil emulsion method. The synthesized scaffold was subjected to the following in vitro testing, Instron Universal Testing Machine (UTM), U3000, (Instron Corporation, Norwood, Massachusetts, United States) to assess compressive strength, scanning electron microscope (SEM) examination, and biocompatibility testing using hemocompatibility assay. The material was then tested in vivo; male Wistar albino rats, a total of nine animals, were utilized for this purpose. Three animals were used in each group; a femoral defect model was the model of choice for the experiment and the animals were observed for a period of four weeks, following which the animals were sacrificed and sent for histopathological analysis. Results The compression testing was carried out using UTM; test group I was 33 MPa, test group II was 2.3 MPa, and test group III was 25.75 MPa. SEM (JSM-IT800 Schottky Field Emission NANO SEM (JEOL, Tokyo, Japan)) analysis was done to observe the porosity of the fabricated scaffold with the average measurement of 0.12 ± 0.2 µm in test group II and 0.29 ± 0.4 µm in test group III. Hemocompatibility reports noted 0.4-0.8% lysis for the synthesized scaffolds. Histopathology staining of the femur defects showed that group III favoured bone formation. One-way analysis of variance (ANOVA) and post hoc Bonferroni test was done on the data. The optical density values of the alizarin red stained slide showed statistical significance for group III. Conclusion In conclusion, the synthesized scaffolds are biocompatible, distribution of porosity and pore characteristics in the glass ionomer cement/gelatin/chitosan group is better than that of the glass ionomer cement/gelatin group. The glass ionomer cement/gelatin/chitosan group had better compressive strength and induced more bone formation compared to the other test group and the control. Thus, the novel glass ionomer modified with chitosan-reinforced gelatin microspheres has optimal properties to be used as a bone graft material.

Temozolomide-induced vitiligo-like reaction: An extremely rare phenomenon.

ABSTRACT: Temozolomide (TMZ) is an alkylating chemotherapeutic drug, often used in high-grade glioma and metastatic melanoma. Common side effects of this include myelosuppression and gastrointestinal side effects. Vitiligo-like reaction is extremely rare after TMZ. Here, we report a case of a 55-year-old patient of glioblastoma who developed vitiligo-like reaction after starting adjuvant TMZ.

The Efficacy of Ultrasound-guided Transversus Abdominis Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia in Lower-Segment Cesarean Section with Low-Dose Bupivacaine: A Randomized Controlled Trial.

Background and Objectives: The study sought to compare the postoperative analgesia after ultrasonography (USG)-guided bilateral transversus abdominis plane (TAP) block versus quadratus lumborum (QL) 1 block with lower concentration of bupivacaine in patients undergoing lower-segment cesarean section (LSCS). Materials and Methods: A randomized controlled trial was conducted at a tertiary hospital, Bengaluru, from 2019 to 2021. Fifty-six patients belonging to the American Society of Anesthesiologists physical status Class I and II aged 20-40 years posted for LSCS under subarachnoid block were divided into two groups. Patients in Group I were given bilateral TAP block and patients in Group II were given bilateral QL1 block under USG guidance at the end of surgery using 0.125% bupivacaine (20 ml) and 4 mg dexamethasone. Patients were monitored for postoperative pain with Numerical Pain Intensity Scale (NPIS) at 0, 1, 4, 8, 12, and 24 h. Rescue analgesic was given if NPIS score was 6 or more. Time to first dose of rescue analgesic was noted. NPIS scores and time to rescue analgesic were compared using independent t test. P < 5% was considered statistically significant. Results: Average NPIS scores were less at 0, 1, and 4 h (<6) and higher at 8, 12, and 24 h in both the groups postoperatively. NPIS scores at 8 h were significantly higher in Group I compared to Group II (P = 0.02). Time to first dose of rescue analgesic was 7.32 h in Group I and 9.07 h in Group II (P < 0.001). Conclusions: Postoperative analgesia was better with USG-guided QL1 block versus USG-guided TAP block with 0.125% bupivacaine and 4 mg dexamethasone in patients undergoing LSCS.

Comparison between an Operating Surgical Microscope and High Magnification Surgical Loupes in Microvascular Reconstruction of Head and Neck Defects in a Tertiary Healthcare Centre.

Introduction and Objective: Microvascular free tissue transfers have become an important method of reconstruction following head & neck oncological resection. The objective of this study was to evaluate the efficacy of surgical loupes against surgical operating microscope, which is the gold standard for microvascular anastomosis and also to explore the possibility of surgical loupes as an essential cost-effective armamentarium in head and neck reconstruction. Materials and Methods: This prospective randomized study included 40 patients diagnosed with head and neck malignancies, requiring microvascular free flap reconstruction. A total of 20 patients who underwent free flap reconstruction following oncologic/maxillofacial defects using high magnification surgical loupes & the other 20 patients were subjected to reconstruction under an operating surgical microscope. The efficacy was assessed based on the following parameters. 1. Total operating time taken for completing anastomosis. 2. Overall fatigue. 3. Free flap failure rate. Results: The microscope group took an overall mean time of 34.26 min considering its limited degree of freedom in adjusting intraoperatively whereas the loupes group had a shorter mean anastomosis time 33.29 min considering its ease of operator adjustability. Overall, fatigue was compared using Mann-Whitney Test and found to be statistically significant with P value of 0.17, the loupe group was found to be better with mean score of 6.90 in 21 patients than microscope with mean score of 6.21in 19 patients. Flap survival rate in the loupe group had two cases of venous obstruction at 24 h follow-up and microscope group had 1 case of venous.obstruction. Conclusion: The success with loupe only free tissue transfer can be attributable considering expertise with the microscope and the loupes can be a cost-effective alternative to microscope.

Clinical studies in Ayurveda: A bibliometric analysis of articles indexed in AYUSH research portal.

Bibliometric analysis is a standard method for evaluating the quality and quantity of published articles. AYUSH research portal (ARP) is meant for the dissemination of research findings in the domains of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-rigpa, and Homoeopathy and allied faculties. The study attempts to understand the trend of published Ayurveda clinical trial-based articles in terms of quality and quantity. Three perspectives of research output assessed in this study are productivity in the field of Ayurveda, evidence from articles, and its involvement with the body system where disease or malfunctions are induced. Based on the study, it is observed that the highest number of articles have been published under the musculoskeletal, endocrine/metabolic/nutritional categories, and skin. Further, it is observed that only 4.50% of articles are categorized under the evidence of Grade "A" (randomized controlled trials [RCTs]) as per the World Health Organization's traditional medicine research guidelines. Out of the top 20 journals which publish Ayurveda-based research works, only five journals are indexed in reputed indexing platforms viz., PubMed and Scopus. The findings indicate that, Ayurveda clinical trials have to be planned meticulously and carried out as per the RCT guidelines for producing quality evidence so that the abysmal percentage of grade-A category articles will increase in ARP. Further, the journals, which are not yet indexed in standard indexing platforms, must strive to secure a place in them to ensure access to appropriate peers and effective dissemination of findings.

Adherence to safety precautions in the operation theatre among anaesthesiologists in the COVID era.

Background and Aims: The COVID-19 pandemic led to significant infections among healthcare workers and deaths warranting the need for personal protective equipment. This study aimed to estimate the proportion of anaesthesiologists adhering to safety precautions and to evaluate their adherence patterns, difficulties faced and coping mechanisms in the operation theatre during the pandemic. Methods: This was a multicentric mixed methods study conducted among anaesthesiologists from two tertiary care hospitals. A paper-based questionnaire was given to all participants. The first part consisted of 21 questions regarding safety measures and extent of adherence. The second part was a response sheet regarding the various difficulties faced and coping mechanisms adopted. Following this, an in-depth interview was conducted to understand the same. The proportion of anaesthesiologists in different categories of adherence, patterns of adherence, difficulties faced, and coping mechanisms were computed and compared. Thematic framework analysis was done for in-depth interview. Results: Sixty participants were included. The adherence levels for N95 masks and face shields were higher. Most participants practised frequent handwashing and took showers after work. Fogging, difficulty in communication, marks on the face were the commonly faced difficulties. Self reassurance, adjusting the fit of masks/face shields, or taking breaks were the coping mechanisms mostly followed. Themes generated from in-depth interview include waning of caution, adaptation through innovative methods and stress due to uncertainty. Conclusion: The N95 mask was the most preferred safety precaution. Ease of use and safety were important considerations for adherence. Physical and mental acclimatisation and improved knowledge of disease played a vital role.

Open Classic Latarjet Procedure Performed Using Freehand Technique-Surgical Technique and Outcome.

INTRODUCTION: Latarjet procedure is commonly performed for recurrent anterior shoulder instability with glenoid side bone loss. Classic Latarjet procedure can be performed using specially designed drill guides, jigs, or by freehand technique. Here we have described a technical note on classic Latarjet procedure performed with freehand technique utilizing simple rulers and caliper. The functional and radiological outcomes of our patients have also been analysed. MATERIAL AND METHODS: 149 open classic Latarjet procedures were performed using our technique between March 2015 and July 2018. The mean age of the patients was 32.95 years (Range 22-59 years). The functional outcome of the patients was measured using Western Ontario Shoulder Instability (WOSI) and Oxford Shoulder Instability Score (OSIS) at 2 years of follow-up. Screw and graft positioning were studied in 24 consecutive patients with a postoperative computed tomography (CT) scan. RESULTS: There was no incidence of recurrent subluxation or dislocation post-surgery. Mean OSIS score increased from 15.63 ± 3.20 preoperatively to 42.44 ± 3.88 postoperatively (p value < 0.05). WOSI score decreased significantly from 62.54% ± 8.24 to 10.26 ± 6.33 postoperatively at 2-year follow-up (p value < 0.05). Postoperative CT scan also showed satisfactory screw placement in all patients. CONCLUSION: Open Latarjet procedure performed using freehand technique provides good functional and radiological outcomes in patients with recurrent anterior shoulder instability with glenoid side bone loss. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43465-021-00385-7.

Hyperhomocysteinemia and Evan's syndrome with uncal herniation for emergency splenectomy.

Hyperhomocysteinemia is a genetic disorder of metabolism and transport of amino acid, commonly present as a pro-coagulant state. Evan's syndrome is an autoimmune disorder with pancytopenia, a diagnosis of exclusion. The present report highlights the anesthetic management of a rare case, where both these clinical entities coexist. A 26-year-old male, a known case of hyperhomocyteinemia on medication for 4 years, came with a history of severe headache, blurring of vision and bleeding gums. Computerized tomography brain report showed subdural hematoma (SDH) of 16 mm with 9 mm right midline shift and on investigation had thrombocytopenia (5000 cells/cumm). Patient was diagnosed to have Evan's syndrome. Because he was refractory to the medical management, taken up for emergency splenectomy, followed by burr hole evacuation of SDH. Successful anesthetic management of the case is presented in this report.

A novel transcriptional regulator, Sll1130, negatively regulates heat-responsive genes in Synechocystis sp. PCC6803.

A conserved hypothetical protein, Sll1130, is a novel transcription factor that regulates the expression of major heat-responsive genes in Synechocystis sp. PCC6803. Synechocystis exhibited an increased thermotolerance due to disruption of sll1130. Δsll1130 cells recovered much faster than wild-type cells after they were subjected to heat shock (50°C) for 30 min followed by recovery at 34°C for 48 h. In Δsll1130 cultures, 70% of the cells were viable compared with the wild-type culture in which only 30% of the cells were viable. DNA microarray analysis revealed that in Δsll1130, expression of the heat-responsive genes such as htpG, hspA, isiA, isiB and several hypothetical genes were up-regulated. Sll1130 binds to a conserved inverted-repeat (GGCGATCGCC) located in the upstream region of the above genes. In addition, both the transcript and protein levels of sll1130 were immediately down-regulated upon shift of wild-type cells from 34 to 42°C. Collectively the results of the present study suggest that Sll1130 is a heat-responsive transcriptional regulator that represses the expression of certain heat-inducible genes at optimum growth temperatures. Upon heat shock, a quick drop in the Sll1130 levels leads to de-repression of the heat-shock genes and subsequent thermal acclimation. On the basis of the findings of the present study, we present a model which describes the heat-shock response involving Sll1130.