Ru(II)-Catalyzed Asymmetric Transfer Hydrogenation of α-Alkyl-ß-Ketoaldehydes via Dynamic Kinetic Resolution.

The (R,R)-Teth-TsDPEN-Ru(II) complex promoted the one-pot double C=O reduction of α-alkyl-ß-ketoaldehydes through asymmetric transfer hydrogenation/dynamic kinetic resolution (ATH-DKR) under mild conditions. In this process, ten anti-2-benzyl-1-phenylpropane-1,3-diols (85:15 to 92:8 dr) were obtained in good yields (41-87%) and excellent enantioselectivities (>99% ee for all compounds). Notably, the preferential reduction of the aldehyde moiety led to the in situ formation of 2-benzyl-3-hydroxy-1-phenylpropan-1-one intermediates. These intermediates played a crucial role in enhancing both reactivity and stereoselectivity through hydrogen bonding.

Hydrogen induced optically-active defects in silicon photonic nanocavities.

We demonstrate intense room temperature photoluminescence (PL) from optically active hydrogen- related defects incorporated into crystalline silicon. Hydrogen was incorporated into the device layer of a silicon on insulator (SOI) wafer by two methods: hydrogen plasma treatment and ion implantation. The room temperature PL spectra show two broad PL bands centered at 1300 and 1500 nm wavelengths: the first one relates to implanted defects while the other band mainly relates to the plasma treatment. Structural characterization reveals the presence of nanometric platelets and bubbles and we attribute different features of the emission spectrum to the presence of these different kind of defects. The emission is further enhanced by introducing defects into photonic crystal (PhC) nanocavities. Transmission electron microscopy analyses revealed that the isotropicity of plasma treatment causes the formation of a higher defects density around the whole cavity compared to the ion implantation technique, while ion implantation creates a lower density of defects embedded in the Si layer, resulting in a higher PL enhancement. These results further increase the understanding of the nature of optically active hydrogen defects and their relation with the observed photoluminescence, which will ultimately lead to the development of intense and tunable crystalline silicon light sources at room temperature.

Enhanced 1.54 µm emission in Y-Er disilicate thin films on silicon photonic crystal cavities.

We introduce an Y-Er disilicate thin film deposited on top of a silicon photonic crystal cavity as a gain medium for active silicon photonic devices. Using photoluminescence analysis, we demonstrate that Er luminescence at 1.54 µm is enhanced by coupling with the cavity modes, and that the directionality of the Er optical emission can be controlled through far-field optimization of the cavity. We determine the maximum excitation power that can be coupled into the cavity to be 12 mW, which is limited by free carrier absorption and thermal heating. At maximum excitation, we observe that nearly 30% of the Er population is in the excited state, as estimated from the direct measurement of the emitted power. Finally, using time-resolved photoluminescence measurements, we determine a value of 2.3 for the Purcell factor of the system at room temperature. These results indicate that overcoating a silicon photonic nanostructure with an Er-rich dielectric layer is a promising method for achieving light emission at 1.54 µm wavelength on a silicon platform.

Lymphadenectomy for papillary thyroid cancer: changes in practice over four decades.

AIMS: Lymphadenectomy in the management of papillary thyroid cancer (PTC) has evolved. The aim of this study was to examine the changing role of neck dissection as reflected in the practice of a large thyroid unit over four decades. METHODS: A retrospective cohort study of patients that underwent primary thyroid surgery for papillary cancer in a single unit in the period 1958-2002. Nine 5-year periods were considered and the data relevant to the treatment of the regional lymph nodes reviewed. RESULTS: Nine hundred patients with PTC underwent surgery between 1958 and 2002 of whom 32.7% underwent lymph node dissection (LND). The use of lymphadenectomy increased from 21.4% in 1958-1962 to 48.1% in 1998-2002 of which 84% underwent a selective lymph node dissection (SLND)-a dissection where the LND is determined by the extent of the disease encountered. The mean number of nodes removed during SLND was 12.6 (range 1-56) of which a mean of 3.1 (24.8%) (0-19) were involved by the disease. Cervical levels 6 and level 4 were those most frequently dissected. There was no statistically significant difference in the complication rates in patients undergoing neck dissection and those not. CONCLUSION: The four decade experience reflects a move away from modified radical neck dissection and cherry picking towards SLND. Growing evidence suggests that lymphadenopathy in adult PTC is an adverse prognostic factor. SLND, a lymphadenectomy tailored to the extent of the disease process, is the coherent treatment for PTC since it serves the dual purpose of staging as well as control of local disease. This can be achieved with little morbidity when performed in a specialist centre.

Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial.

OBJECTIVES: The aim was to investigate whether 2 weeks of inspiratory muscle training (IMT) could preserve respiratory muscle strength in high-risk patients referred for pulmonary resection on the suspicion of or confirmed lung cancer. Secondarily, we investigated the effect of the intervention on the incidence of postoperative pulmonary complications. METHODS: The study was a single-centre, parallel-group, randomized trial with assessor blinding and intention-to-treat analysis. The intervention group (IG, n = 34) underwent 2 weeks of postoperative IMT twice daily with 2 × 30 breaths on a target intensity of 30% of maximal inspiratory pressure, in addition to standard postoperative physiotherapy. Standard physiotherapy in the control group (CG, n = 34) consisted of breathing exercises, coughing techniques and early mobilization. We measured respiratory muscle strength (maximal inspiratory/expiratory pressure, MIP/MEP), functional performance (6-min walk test), spirometry and peripheral oxygen saturation (SpO2), assessed the day before surgery and again 3-5 days and 2 weeks postoperatively. Postoperative pulmonary complications were evaluated 2 weeks after surgery. RESULTS: The mean age was 70 ± 8 years and 57.5% were males. Thoracotomy was performed in 48.5% (n = 33) of cases. No effect of the intervention was found regarding MIP, MEP, lung volumes or functional performance at any time point. The overall incidence of pneumonia was 13% (n = 9), with no significant difference between groups [IG 6% (n = 2), CG 21% (n = 7), P = 0.14]. An improved SpO2 was found in the IG on the third and fourth postoperative days (Day 3: IG 93.8 ± 3.4 vs CG 91.9 ± 4.1%, P = 0.058; Day 4: IG 93.5 ± 3.5 vs CG 91 ± 3.9%, P = 0.02). We found no association between surgical procedure (thoracotomy versus thoracoscopy) and respiratory muscle strength, which was recovered in both groups 2 weeks after surgery. CONCLUSIONS: Two weeks of additional postoperative IMT, compared with standard physiotherapy alone, did not preserve respiratory muscle strength but improved oxygenation in high-risk patients after lung cancer surgery. Respiratory muscle strength recovered in both groups 2 weeks after surgery. CLINICAL TRIALSGOV ID: NCT01793155.

Cholera epidemic in Goa.

Two hundred and fifty stool samples were studied during an outbreak of cholera in Goa during the months of July to September, 1988. 80 strains of Vibrio were isolated with an isolation rate of 32%. 72.5% of those affected were adults. All strains of Vibrio cholerae isolated belonged to Eltor biotype, Fifty three (66.25%) of them being Ogawa serotype while 21 (26.25%) were Inaba. NAG Vibrios accounted for 6 (7.5%) strains. Antimicrobial sensitivity pattern showed high degree of sensitivity to chloramphenicol, gentamicin and naladixic acid.

Evaluation of HBsAg carrier rate in acute viral hepatitis and high risk individuals using RPHA and ELISA.

A total of 600 individuals including 500 cases of hepatitis and 100 individuals at high risk for developing hepatitis were screened for hepatitis B surface antigen (HBsAg) using reverse passive haemagglutination (RPHA) and enzyme linked immunosorbent assay (ELISA). HBsAg carrier rate in clinically diagnosed cases of hepatitis was 38% and 32.4% by RPHA and ELISA respectively. In high risk individuals, the carrier rate was 14% by RPHA and 11% by ELISA. Taking ELISA as gold standard, RPHA showed 5.33% false positivity and 0.33% false negativity. The over all correlation between RPHA and ELISA was to the tune of 82.66%.

Antimicrobial resistance among nosocomial isolates in a teaching hospital in goa.

BACKGROUND: Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital. MATERIALS AND METHODS: A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI). Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. RESULTS: The overall infection rate was 33.93 +/- 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%), followed by surgical site infection (23.67%), wound infection (23%) and nosocomial pneumonia (18.34%). Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii. Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting. CONCLUSION: Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

Bacterial pneumonias--evaluation of various sputum culture methods.

With an objective of improving diagnostic value of sputum in bacterial pneumonias, 50 uncomplicated 'community' acquired cases were studied using Gram staining of sputum along with bedside inoculation with/without dilution of the specimen. Gram staining of sputum samples collected before treatment revealed pneumococcal infection in 46% cases. The results were however inconclusive on samples sent by routine procedure involving logistic delay. Cultural analysis of sputum processed by three different techniques showed that bedside inoculation of sputum after dilution to be the most efficient technique yielding Streptococcus pneumoniae in 34% cases, Gram positive cocci in lesser number (20%), Gram negative rods (GNR) in 18% cases. Sputum samples processed bedside without dilution yielded a lower number of pneumococci and other Gram positive cocci (24% & 16% cases respectively). Routine processing of sputum, involving logistic delay yielded a high number of Gram negative rods (62%), indicating their overgrowth. Thus bedside inoculation of sputum after dilution coupled with direct Gram staining serves as a simple and yet valuable laboratory aid in the diagnosis of uncomplicated 'community' acquired bacterial pneumonias.