Fabrication of calcium phosphate-calcium sulfate injectable bone substitute using chitosan and citric acid.

In this study, an injectable bone substitute (IBS) consisting of citric acid, chitosan solution as the liquid phase and tetra calcium phosphate (TTCP), dicalcium phosphate anhydrous (DCPA) and calcium sulfate hemihydrate (CSH) powders as the solid phase was prepared. Four groups containing different percentages (0-30%) of calcium sulfate hemihydrate (CSH, CaSO(4) . 0.5H(2)O) were investigated. Initial setting times for IBS with CSH were longer than those without CSH. The setting times for all compositions were in the range of 25-45 min. The injectability was improved by the addition of CSH in the present system. Scanning electron microscopy images showed that fiber-like crystallization appeared in the cements. The enhancement of crystallinity was confirmed by XRD profiles where the peak intensity of HAp increased with incubation time and the addition of CSH. Also, the compressive strength increased with the addition of CSH. The maximum compressive strength obtained for IBS was with 20% CSH after 28-day incubation in 100% humidity at 37 degrees C.

An ethno-pharmacological study of plants used for traditional medication in Tangail district, Bangladesh.

BACKGROUND: In Bangladesh, folk medicinal practitioners are called "Kaviraj" and are consulted for treatment of various ailments by a large part of the rural and urban population. There are some previous studies conducted in the Tangail district of Bangladesh about medicinal plants, but there is no relevant information about this aspect in some parts of this district. AIM: To conduct an ethno-pharmacological survey among the "Kaviraj" of two upazilas (regions) in Tangail district, namely Tangail Sadar Upazila and Nagarpur Upazila, to identify the trouble-free formulations of medicinal plants for various diseases used by the folk medicine practitioners on or after other forms of medical practices. METHODS: A guided field-walk survey was carried out employing a local guide and asking local people about practicing "Kaviraj"; four of the "Kaviraj" convened and after receiving permission from the "Kaviraj", interviews were conducted through focused group discussion. RESULTS: It was observed that the "Kaviraj" of the two upazilas used a total of 25 plants distributed into 20 families for healing of various diseases. In most of the cases, leaves were the key part of most of the plants used for treatment. Plants were mainly used for treating gastrointestinal tract disorders, fever, constipation, and diarrhea, and indigestion, loss of appetite, pain and skin disorders. "Kaviraj" also treat complicated diseases such as tuberculosis, hypertension, sexual disorders, infections, urinary problems, hepatic disorders, pneumonia, stomach stones, diabetes, swellings, debility, kidney problems, tumor, vitamin C deficiency and poisoning by using medicinal plants. CONCLUSION: For a country such as Bangladesh, and particularly the district studied, medicinal plants are essential assets and have a major role in people's health care structure. Also, appropriate research should be conducted for using these medicinal plants in possible new drug designs as well as many other pharmaceutical benefits.

Macrocyclic diarylheptanoids from Garuga pinnata.

Three macrocyclic diarylheptanoids, 6'-hydroxygaruganin V (1), 9'-desmethylgarugamblin I (2) and 1,9'-didesmethylgaruganin III (3) were isolated from the petroleum ether and dichloromethane extracts of the stem bark of Garuga pinnata. The structures of these compounds were established by extensive spectroscopic studies, including high field NMR and MS measurements.

Blood glucose and cholesterol levels in adult population of Bangladesh: Results from STEPS 2006 survey.

BACKGROUND: A nationally representative survey was carried out to determine the distribution of blood glucose and cholesterol in adult population of Bangladesh in the absence of existing data. METHODS: The study adopted a multistage and geographically clustered sampling technique of households. A total of 2610 individuals (1444 men and 1166 women) aged 25-64 years were selected from rural and urban areas. Capillary blood glucose and total cholesterol levels were measured using an overnight fasting state. RESULTS: The mean age of the participants was 41 years [standard deviation (SD), 11 years]. Half of them (49%) were from urban areas. Half of them (51%) had primary or higher education. Mean glucose was 74mg/dL (SD 23mg/dL). Men had higher mean glucose levels (79mg/dL) than women (67mg/dL). Age-standardized prevalence of diabetes (blood glucose level ≥126mg/dL and/or use of anti-diabetic medication) was 5.5%. In men, it was almost two-and-half times (7.6%) compared with women (2.8%). It was also double in urban areas (7.8%) compared with rural areas (3.4%). Mean cholesterol level among all participants was 167mg/dL (SD 26mg/dL). Men and women had almost similar levels (169mg/dL versus 166mg/dL, respectively). Prevalence of high cholesterol level (≥240mg/dL) was very low (1.3%) in both men (2.2%) and women (0.5%). However, the prevalence of borderline high cholesterol was substantial (5.8%) in this sample. CONCLUSION: The prevalence of high hypercholesterolemia is low, whereas there is a high prevalence of borderline high cholesterol and diabetes in the adult population of Bangladesh. This warrants population-based interventions to tackle this problem.

Observations on the trypanosomosis problem outside the tsetse belts of Sudan.

Entomological and trypanosomosis surveys were conducted in the Blue Nile area between Admazien and Khartoum. The surveys showed the area to be tsetse free. The only species of trypanosome found to infect cattle in this study was Trypanosoma vivax, which infected some of the local cattle that had no history of entering tsetse belts. The prevalence of disease varied with the season. High disease prevalence coincided with the periods when tabanid and stomoxy flies were abundant. The study showed that the months when biting flies were most numerous coincided with trypanosomosis outbreaks, but even minimal numbers of these flies may cause the cycle of mechanical transmission to continue in stable enzootic conditions.

Transforming growth factor-beta (TGF-beta1) genotype and lung allograft fibrosis.

BACKGROUND: TGF-beta1 is a prosclerotic cytokine implicated in fibrotic processes. Fibrosis of the pulmonary parenchyma and airways is a frequent presentation in lung transplant recipients before and after transplantation. There are two genetic polymorphisms in the DNA sequence encoding the leader sequence of the TGF-beta1 protein, located at codon 10 (either leucine or proline) and at codon 25 (either arginine or proline). The codon 25 arginine allele is associated with higher TGF-beta1 production by cells activated in vitro. We tested the hypothesis that inheritance of alleles of the TGF-beta1 gene conferring higher production of TGF-beta1 may be responsible for over-expression of TGF-beta1 in transplant recipients resulting in lung allograft fibrosis. METHODS: We extracted DNA from leukocytes collected from 91 pulmonary transplants performed at our centre and 96 normal healthy volunteers between May 1990 and September 1995. Part of the first exon was amplified by PCR. Samples were genotyped by using sequence specific oligonucleotide probes. RESULT: The distribution of codon 10 alleles was similar in a normal healthy control group and in lung transplant recipients, regardless of their pretransplant lung pathology. By contrast, there was a significant difference in the frequency of codon 25 alleles between the control and transplant groups. In the normal control group 81% were codon 25 arginine/arginine (A/A) homozygotes, 19% were arginine/proline (A/P) heterozygotes and none were proline/proline (P/P) homozygotes. The distribution of codon 25 alleles was similar in lung transplant recipients who did not have a significant fibrosis in pretransplant pathology, but in transplant recipients who came to transplantation with lung fibrosis 98% (41 of 42 patients) were homozygous for the codon 25 A/A allele (p < .05). After lung transplantation 39 of 91 patients developed lung allograft fibrosis, and of these 92.3% (36 of 39 recipients) were of homozygous codon 25 A/A high TGF-beta1 producer genotype (p < .001). Lung transplant recipients who were homozygous for both codon 10 L/L and codon 25 A/A showed poor survival compared with all other TGF-beta1 genotypes (p < .03). CONCLUSION: Homozygosity for arginine at codon 25 of the leader sequence of TGF-beta1 that correlates with higher TGF-b production in vitro, is associated with fibrotic lung pathology before lung transplantation and with the development of fibrosis in the graft. In combination with the codon 10 leucine allele, homozygosity for the codon 25arginine allele is a marker for poor post-transplant prognosis and recipient survival.

The epidemiology of schistosomiasis in Egypt: Gharbia Governorate.

Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 14,344 individuals from 1,952 households in 34 rural communities in Gharbia Governorate of Egypt to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp. A subset, every fifth household, of 1,973 subjects had physical and ultrasound examinations to investigate prevalence of and risk factors for morbidity. Community prevalence of Schistosoma mansoni ranged from 17.9% to 79.5% and averaged 37.7%. The geometric mean egg count (GMEC) was 78.9 eggs/gram of feces. The prevalence and intensity of infection was 40-50% and 70-100 eggs/gram of feces in those > or =10 years of age. Schistosoma haematobium was detected in 5 of the 34 communities. The maximum infection rate was 2.8% and mean GMEC in the five communities was 2.1/10 ml of urine. The overall prevalence of S. haematobium in the governorate was 0.3%. Risk factors for infection with S. mansoni were male gender, an age >10 years, living in smaller communities, exposures to canal water, prior therapy for schistosomiasis, or blood in the stool (in children only). Morbidity detected by physical examination or ultrasonography did not correlate with S. mansoni infection in individuals with the exception of periportal fibrosis (PPF, odds ratio [OR] = 1.25). Periportal fibrosis was detected in more than half of the subjects by ultrasonography; 5.3% had grade II lesions and 1.0% had the most severe grade III changes. Risk factors for morbidity as manifested by ultrasonographically detected PPF were similar to those for infection. Periportal fibrosis had a negative relationship with abdominal pain (OR = 0.45) and hepatomegaly detected by physical examination and ultrasonography (ORs = 0.72 and 0.68), but it was associated with splenomegaly (ORs = 4.14 and 3.55). The prevalence of PPF, hepatomegaly, and splenomegaly increased with age. There was no relationship between community burden of schistosomiasis mansoni and any measurements of morbidity with the exception of splenomegaly detected by physical examination (r = 0.40). Schistosoma mansoni has almost completely replaced S. haematobium in Gharbia, which has a high prevalence and moderate intensity of S. mansoni infection. Periportal fibrosis was detected by ultrasonography in more than half of the subjects, and 1 in 16 had grade II and III lesions. The only relationship between PPF and other morbidity findings was its positive relationship with splenomegaly and negative association with hepatomegaly. Hepatic morbidity is common in communities in Gharbia but the role of schistosomiasis mansoni in this is uncertain.

Diagnosis and treatment of psychotic symptoms in elderly patients.

The diagnosis and treatment of psychotic symptoms in elderly patients requires more than extrapolation from studies of similar symptoms in the adult population. In comparison with early-onset psychosis, late-onset psychosis is characterised by differences in both its risk factors and typical signs and symptoms. Diagnosis may include psychotic disorders, mood disorders, delusional disorder, dementia or delirium. Several medications have also been associated with the development of psychotic symptoms in the elderly. There is a paucity of literature concerning psychotic symptoms specifically in elderly patients, and this complicates management. Treatment involves the resolution of any causative general medical condition, and/or symptomatic management with antipsychotic medication. The high-potency antipsychotics are typically better tolerated in the elderly than their low-potency counterparts. In addition, the newer atypical antipsychotics such as clozapine have shown early promise. It is important to consider the higher incidence of adverse effects and tardive dyskinesia in the elderly when choosing a drug and its dosage. Consideration of psychosocial factors completes the appropriate management of psychotic symptoms in older patients.

Chemistry of 8-chloroberberine.

8-Chloroberberine (V), obtained by treatment of oxyberberine (I) with phosphorus oxychloride, is a reactive intermediate. Treatment with ammonia, methylamine, n-propylamine, aniline, and p-toluidine furnished the 8-berberinylidene derivatives IV and VII-X. Reaction of V with malononitrile, ethyl acetoacetate, and ethyl malonate anions yielded the 8-berberinylidene derivatives XII-XIV. Acid hydrolysis of XIV gave 8-berberinylacetic acid (XV) whose reduction provided 8-canadinylacetic acid (XVI). Grignard reagents react readily with V. Methylmagnesium iodide, ethylmagnesium iodide, and benzylmagnesium iodide led to 8,8-dimethyldihydroberberine (XVII), 8,8-diethyldihydroberberine (XIX), and the benzyl derivative XX, respectively. Sodium borohydride reduction of XX gave rise to 8-benzylcanadine (XXI).

Synthesis of some benzofuran and furocoumarin derivatives for possible biological activity.

Condensation of 5-formyl-6-methoxy-2,3-diphenylbenzofuran (I) and 6-formyl-5-methoxy-2,3-diphenylbenzofuran (II) with aliphatic or aromatic primary amines led to the formation of the corresponding anils (IIIa-k and IVa-c). The anils (IIIa,f,k or IVa-c) reacted with ethyl cyanoacetate, ethyl acetoacetate, or diethyl malonate to form the respective esters (Va-c or VIa-c). When Va-c or VIa-c were treated with pyridine hydrochloride, demethylation occurred followed by cyclization to form the corresponding furocoumarins (VIIa-c or VIIIa-c). Reduction of the anils using sodium borohydride furnished the corresponding Mannich bases (Xa-d and XI). The antimicrobial activity of compounds IIIi, IVc, Va, VIa, and VIIIa was investigated.

Brief report on Ziprasidone.

Ziprasidone is a new antipsychotic with combined dopamine and serotonin receptor antagonist activity. The initial evidence suggests an effective dosage range of 80-160 mg/day. Clinical trials suggest that the drug is an effective antipsychotic in schizophrenia and schizo-affective disorder with a beneficial effect on negative symptoms and symptoms of depression. The main adverse effects appear to be somnolence (14%) and nausea (10%). Ziprasidone has relatively fewer side effects and yet has at least equivalent efficacy for florid 'positive' symptoms compared to conventional anti psychotics. The additional serotonergic actions deliver further efficacy against 'negative' and affective symptoms of schizophrenia. Reduced effects on cognitive abilities compared to conventional anti psychotics make Ziprasidone more attractive.

Synthesis of indole-N-propionitrile, N-propionic acid and N-propionamide derivatives of potential biological activity.

Cyanoethylation of a selected group from indole derivatives 1a-i using acrylonitrile in pyridine and potassium hydroxide afforded the corresponding indole-1-propionitrile 2a-h derivatives which readily hydrolysed in basic medium to the corresponding indole-1-propionic acid derivatives 4a-c. A several attempts to cyclize the above products-to the corresponding dihydropyrroloquinolin-4-one derivatives. The indole-1-propionamide derivatives reacted with diethyl carbonate and ethyl acetate under Claisen condensation also, with diazonium salts and nitric acid.

Synthesis and evaluation of some new substituted benzofuran derivatives as potentially active antimicrobial agents.

6-(omega-Bromoacetyl)-2,3-diphenyl-5-methoxybenzofuran derivative (2) was synthesized and allowed to react with different reagents to get new benzofuran derivatives that are substituted with isolated or fused heterocyclic ring systems. The antimicrobial activity of the hitherto synthesized products was tested and evaluated.

Synthesis and reactions of some new substituted 6-imidazolyl-4-oxo-4H-1-benzopyran-3-carboxaldehyde and use of DNA in evaluation of their biological activity.

Vilsmeier-Haack reaction of imidazolyl acetophenone I gave 6-imidazolyl-4-oxo-4H-1-benzopyran-3-carboxaldehyde II. The compound II was reacted with primary amines (1:1 molar ratio) to form the corresponding n-aril (meteroaryl) imino derivatives IIIa-f. Treatment of aldehyde II with excess amines (1:2 molar ratio) gave the corresponding 2-arylamino-3-arylaminomethylenebenzopyran derivatives IVa-c. The n-aril (meteroaryl) imino derivatives IIIb,d,e,f were reacted with thioglycollic acid to give benzopyranothiazepinone derivatives VIa-d. When the aldehyde II was treated with secondary amines gave the corresponding trans-enaminoketones VIIIa-c. Trans-enaminoketones VIIIa-c were reacted with hydrazines and/or hydroxylamine hydrochloride to give pyrazolyl and/or isoxazolyl benzene IXa-c and X, respectively. The reaction of aldehyde II with hydrazines on cold gave the corresponding hydrazones XIIIa-d. However, the reaction of aldehyde II with hydrazines on refluxing gave the corresponding pyrazole derivatives 5 XIVa,b and XVa,b.. The structural formula of the new compounds were established by using different instrumental analyses. Some compounds in this study were biologically evaluated for their ability to bind to DNA.

Preparation of new polycyclic compounds derived from benzofurans and furochromones. An approach to novel 1,2,3-thia-, and selena-diazolofurochromones of anticipated antitumor activities.

Base catalyzed condensation of enaminoketones (3a,b) with malononitrile yields the respective 7-imino-5[2(substituted)prop-1-enyl]furochromene-6-carbonitriles (4a-d) according to the nature of base used. Compounds (3a, b) condense also with indan-1,3-diketone (5) to give α, ß-unsaturated carbonyl compounds (6a) and (6b), respectively. Pyrrolidine-catalyzed condensation of visnaginone (2a) and khellinone (2b) with active methylenes yields the corresponding 1-[7,7-(substituted) furobenzodihydropyrone derivatives (7a-e) which condense with semicarbazide to give the respective semicarbazones (8a-e). Compounds (8b,e) react with thionyl chloride to give the respective 1,2,3-thiadiazoles (9a,b) meanwhile compounds (8a-e) react also with selenium dioxide to give 1,2,3-selenadiazoles (9c-g), respectively. Chalcones (11a,b) were obtained upon condensing (2a,b) with ferrocene-2-carboxaldehyde (10). Compatible elementary and spectroscopic measurements were in good accord with the structures postulated for the new compounds. The antitumor activities of certain selected new compounds were screened, in vitro, against a panel of four (breast: MCF-7, cervix: HELA, colon: HCT116 and liver: HEPG2) human solid tumor cell lines and the structure activity relationship (SAR) was discussed.

Susceptibility of Sudanese Nubian goats, Nilotic dwarf goats and Garag ewes to experimental infection with a mechanically transmitted Trypanosoma vivax stock.

The present study was conducted to study the susceptibility of two different types of Sudanese goats namely: Black Nubian, the Nilotic dwarf goats and ewes of Garag type to experimental infection with Trypanosoma vivax stock isolated from cattle outside tsetse area. The infection caused parasitaemia, anaemia and pyrexia in the infected goats. However, the Nilotic dwarf goats were more tolerant to the infection than the Nubian goats, showing significantly higher values of packed cell volume, haemoglobin concentration, total red and white blood cells counts and significantly low parasitaemia and low body temperature. Garag ewes which were found to be susceptible to T. vivax infection showed different signs of anaemia and pyrexia; it is recommended that comparative studies on sensitivity of this type and other different Sudanese types of sheep to Trypanosomosis should be conducted.

Psychosocial responses to disaster: An Asian perspective.

The psychological and psychiatric impact of great natural disasters are beginning to be understood leading to new methods of prevention, intervention and mitigation. There is limited data from the Asian continent, however, which has been the location of some of the greatest disasters of recent times. In this paper, we outline the psychosocial intervention efforts from nine Asian nations when confronted with large-scale natural catastrophic events. These include reports from situations where local services have some capacity to respond as well as those where services are destroyed or overwhelmed. From this it is possible to draw some general principles of psychosocial disaster intervention: (1) Assessment of disaster, extant service systems and incoming resources. (2) Assessment of help-seeking pathways and cultural models of illness. (3) Facilitation and support for family reunion, identification of the dead and cultural and religious practices to address death and grief. (4) Foster and bolster community group activities where possible. (5) Psychosocial training of community, aid and health workers using a train the trainer model to promote case identification, psychoeducation and intervention, with specific emphasis on vulnerable groups, especially children. (6) Promote general community psychoeducation. (7) Train medical and health staff in basic psychiatric and psychological assessment and intervention for post-traumatic stress, mood and anxiety disorders. (8) Minimise risk factors for psychiatric morbidity such as displacement and loss of gainful activity. (9) Reshape mental health systems recognising the long-term psychiatric sequelae of disaster. The collective learnt experience from Asian natural disasters may be constructively used to plan strategies to respond appropriately to the psychosocial consequences of disaster both within Asia and in the rest of the world.

Leg bone pain syndrome in a patient with ulcerative colitis treated with cyclosporin.

BACKGROUND: Leg bone pain syndrome is an unusual condition associated with the use of calcineurin antagonists, initially described in patients receiving allograft transplantation. AIM: To describe the first known reported case of leg bone pain syndrome in a patient with ulcerative colitis receiving cyclosporin. RESULTS: Investigations revealed no diagnostic features. Calcium channel blocker was used successfully in the treatment of this condition. CONCLUSION: In the absence of diagnostic investigations, a high index of clinical suspicion is needed to diagnose and successfully manage leg bone pain syndrome. This may prevent further complications such as osteonecrosis that may arise.