Extending total parenteral nutrition hang time in the neonatal intensive care unit: is it safe and cost effective?

AIM: To investigate the effects of prolonging hang time of total parenteral nutrition (TPN) fluid on central line-associated blood stream infection (CLABSI), TPN-related cost and nursing workload. METHODS: A before-after observational study comparing the practice of hanging TPN bags for 48 h (6 February 2009-5 February 2010) versus 24 h (6 February 2008-5 February 2009) in a tertiary neonatal intensive care unit was conducted. The main outcome measures were CLABSI, TPN-related expenses and nursing workload. RESULTS: One hundred thirty-six infants received 24-h TPN bags and 124 received 48-h TPN bags. Median (inter-quartile range) gestation (37 weeks (33,39) vs. 36 weeks (33,39)), mean (±standard deviation) admission weight of 2442 g (±101) versus 2476 g (±104) and TPN duration (9.7 days (±12.7) vs. 9.9 days (±13.4)) were similar (P > 0.05) between the 24- and 48-h TPN groups. There was no increase in CLABSI with longer hang time (0.8 vs. 0.4 per 1000 line days in the 24-h vs. 48-h group; P < 0.05). Annual cost saving using 48-h TPN was AUD 97,603.00. By using 48-h TPN, 68.3% of nurses indicated that their workload decreased and 80.5% indicated that time spent changing TPN reduced. CONCLUSION: Extending TPN hang time from 24 to 48 h did not alter CLABSI rate and was associated with a reduced TPN-related cost and perceived nursing workload. Larger randomised controlled trials are needed to more clearly delineate these effects.

Synthesis, Characterization and Biological Activity of Benzimidazoleacrylonitrile Derivatives.

BACKGROUND: Benzimidazoles have a wide range of synthetic applications in medicinal chemistry and biological activities like anti-tumor/anti-proliferative activities etc. Moreover, different heterocyclic moieties attached to the benzimidazole ring improved anticancer activities. METHODS: All the chemicals were purchased from Aldrich Chemical Company, are of AR grade and used as received. Microanalytical data (C, H, and N) were analyzed on a Carlo Erba model 1108 analyzer. Melting points were measured by the Kofler apparatus and were uncorrected. Spectroscopic data were obtained using the following instruments: Fourier transform infrared spectra (KBr discs, 4000-400 cm-1) by Shimadzu IR-408 Perkin Elmer 1800 instrument; 1H NMR and 13C NMR spectra by JEOL Resonance Inc. Tokyo, Japan, JNM-ECZ400S/L1 using DMSO-d6 as a solvent containing TMS as the internal standard. Chemical shifts (δ) are reported in parts per million (ppm), and coupling constants (J) are reported in Hertz (Hz). RESULTS: We chose sulfosalicylic acid as a promoter for forming benzimidazole-acrylonitrile derivatives, which is an eco-friendly reaction, and we applied a series of synthesized compounds 3a-g in nematicidal activity. The results indicate that the concentrations of all treatments significantly kill M. incognita. CONCLUSION: This model reaction procedure provides a better method for preparing benzimidazoleacrylonitrile, which is superior to other methods. This protocol simplifies handling model reactions with mild reaction conditions, a short time period, a simple set-up, a fast reaction rate, and so on.

Bounds on the Partition Dimension of Convex Polytopes.

AIMS AND OBJECTIVE: The idea of partition and resolving sets play an important role in various areas of engineering, chemistry and computer science such as robot navigation, facility location, pharmaceutical chemistry, combinatorial optimization, networking, and mastermind game. METHODS: In a graph, to obtain the exact location of a required vertex, which is unique from all the vertices, several vertices are selected; this is called resolving set, and its generalization is called resolving partition, where selected vertices are in the form of subsets. A minimum number of partitions of the vertices into sets is called partition dimension. RESULTS: It was proved that determining the partition dimension of a graph is a nondeterministic polynomial time (NP) problem. In this article, we find the partition dimension of convex polytopes and provide their bounds. CONCLUSION: The major contribution of this article is that due to the complexity of computing the exact partition dimension, we provide the bounds and show that all the graphs discussed in the results have partition dimensions either less or equals to 4, but not greater than 4.

Epileptiform activity predicts epileptogenesis in cerebral hemorrhage.

This retrospective case-controlled study was performed to evaluate whether Epileptiform Activity, suspected clinical seizures, and/or 2HELPS2B/S after nontraumatic Intraparenchymal Hemorrhage or Subarachnoid Hemorrhage can predict Epilepsy. Hundred and thirty-two patients were included-29 (Epilepsy), 103 (Control Group). After matching, the average effect for all three risk factors was significant as follows: (1) Epileptiform Activity (p = 0.012, odds ratio 3.14), (2) suspected seizures (p = 0.021, odds ratio 3.78), and (3) 2HELPS2B/S score (p < 0.001, odds ratio 4.94). This study shows that Epileptiform Activity, suspected seizures, and particularly, the 2HELPS2B/S score in the acute phase are risk factors for the development of epilepsy after nontraumatic intraparenchymal and subarachnoid hemorrhage.

Influence of Elbow Angle on Erosion-Corrosion of 1018 Steel for Gas-Liquid-Solid Three Phase Flow.

Erosive wear due to the fact of sand severely affects hydrocarbon production industries and, consequently, various sectors of the mineral processing industry. In this study, the effect of the elbow geometrical configuration on the erosive wear of carbon steel for silt-water-air flow conditions were investigated using material loss analysis, surface roughness analysis, and microscopic imaging technique. Experiments were performed under the plug flow conditions in a closed flow loop at standard atmospheric pressure. Water and air plug flow and the disperse phase was silt (silica sand) with a 2.5 wt % concentration, and a silt grain size of 70 µm was used for performing the tests. The experimental analysis showed that silt impact increases material disintegration up to 1.8 times with a change in the elbow configuration from 60° to 90° in plug flow conditions. The primary erosive wear mechanisms of the internal elbow surface were sliding, cutting, and pit propagation. The maximum silt particle impaction was located at the outer curvature in the 50° position in 60° elbows and the 80° position in 90° elbows in plug flow. The erosion rate decreased from 10.23 to 5.67 mm/year with a change in the elbow angle from 90° to 60°. Moreover, the microhardness on the Vickers scale increased from 168 to 199 in the 90° elbow and from 168 to 184 in the 60° elbow.

Green Synthesis of Fused Chromeno-pyrazolo-phthalazine Derivatives with Silicasupported Bismuth Nitrate under Solvent-free Conditions.

AIM: The study aimed to synthesize chromeno-pyrazolo[1,2-b]phthalazine-6,9,14(7H)-trione analogs with the help of silica-supported bismuth nitrate catalyst. BACKGROUND: Nitrogen-containing heterocyclic compounds are widespread, and their applications to pharmaceuticals, agrochemicals, and functional materials are becoming more and more important. Pyrazoles are an important class of compounds for new drug development, as they are the core structure of numerous biologically active compounds, including blockbuster drugs such as celecoxib, viagra, pyrazofurine, and many others. Similarly, heterocycles containing a phthalazine moiety are of current interest due to their pharmacological and biological activities; for example, pyrazolo[1,2-b]phthalazinedione is described as an anti-inflammatory, analgesic, antihypoxic, and antipyretic agent. OBJECTIVE: In continuation of our ongoing investigation for the synthesis of efficient and simple approaches for the preparation of heterogeneous catalysts, herein we wish to disclose a highly efficient, simple, and one-pot synthesis of chromeno-pyrazolo-phthalazine derivatives via a one-pot multi-component reaction between 4- hydroxycoumarin, aromatic/heterocyclic aldehydes and 2,3-dihydro-1,4-phthalazinedione using silica-supported bismuth nitrate as an inexpensive, environmentally friendly and reusable catalyst under solvent-free conditions. MATERIALS AND METHODS: Microanalytical data (C, H, and N) were collected on Carlo Erba analyzer model 1108. The microwave synthesis was performed in Anton Paar, Monowave 300 microwave synthesizer. Melting points were measured in open glass capillaries in the Kofler apparatus and are uncorrected. Spectroscopic data were obtained using the following instruments: Fourier transform infrared spectra (KBr discs, 4000-400 cm-1) by Shimadzu IR-408 Perkin-Elmer 1800 instrument; 1H NMR and 13C NMR spectra by Bruker Avance-II 400 MHz using DMSO-d6 as a solvent containing TMS as the internal standard. Mass spectra were set down on a JEOL D-300 mass spectrometer. RESULTS: In continuation of our ongoing studies to synthesize heterocyclic and pharmaceutical compounds by mild, facile, and efficient protocols, herein we wish to report our experimental results of the synthesis of chromeno- pyrazolo-phthalazine derivatives under solvent-free condition derivatives, using various aromatic/heterocyclic aldehydes in the presence of silica-supported bismuth nitrate catalyst. The prepared catalyst was characterized by various physical and chemical techniques. CONCLUSION: We have demonstrated an efficient reaction path for the synthesis of new aryl and heteroaryl chromeno-pyrazolo[1,2-b]phthalazine-6,9,14(7H)-trione by one-pot three-component condensation of aryl/ heteroaryl aldehydes, 2,3-dihydro-1,4-phthalazinedione and 4-hydroxy coumarin using silica-supported bismuth nitrate (SSBN) under microwave irradiation. The scheme not only offers the use of microwave at low temperatures and significant yield of products but also affords mild reaction conditions, without harmful solvent, shorter reaction times, high purity, operational simplicity, and easy workup.

Curve Fitting for Damage Evolution through Regression Analysis for the Kachanov-Rabotnov Model to the Norton-Bailey Creep Law of SS-316 Material.

In a number of circumstances, the Kachanov-Rabotnov isotropic creep damage constitutive model has been utilized to assess the creep deformation of high-temperature components. Secondary creep behavior is usually studied using analytical methods, whereas tertiary creep damage constants are determined by the combination of experiments and numerical optimization. To obtain the tertiary creep damage constants, these methods necessitate extensive computational effort and time to determine the tertiary creep damage constants. In this study, a curve-fitting technique was proposed for applying the Kachanov-Rabotnov model into the built-in Norton-Bailey model in Abaqus. It extrapolates the creep behaviour by fitting the Kachanov-Rabotnov model to the limited creep data obtained from the Omega-Norton-Bailey regression model and then simulates beyond the available data points. Through the Omega creep model, several creep strain rates for SS-316 were calculated using API-579/ASME FFS-1 standards. These are dependent on the type of the material, the flow stress, and the temperature. In the present work, FEA creep assessment was carried out on the SS-316 dog bone specimen, which was used as a material coupon to forecast time-dependent permanent plastic deformation as well as creep behavior at elevated temperatures and under uniform stress. The model was validated with the help of published experimental creep test data, and data optimization for sensitivity study was conducted by applying response surface methodology (RSM) and ANOVA techniques. The results showed that the specimen underwent secondary creep deformation for most of the analysis period. Hence, the method is useful in predicting the complete creep behavior of the material and in generating a creep curve.

Meningococcal and pneumococcal carriage in Hajj pilgrims: findings of a randomized controlled trial.

BACKGROUND: Intense congestion during the Hajj pilgrimage amplifies the risk of meningococcal carriage and disease, and there have been many meningococcal outbreaks reported amongst pilgrims. Thus, a strict vaccination policy is enforced by the host country and either polysaccharide or conjugate quadrivalent meningococcal vaccines are mandatory. However, unlike conjugate vaccines, the polysaccharide vaccine is not thought to reduce pharyngeal carriage of meningococci. METHODS: A single-blinded, randomized, controlled trial amongst pilgrims from Saudi Arabia and Australia during the Hajj seasons of 2016-2017 was conducted to compare MenACWY-Conjugate vaccine with MenACWY-Polysaccharide vaccine, to determine if the conjugate vaccine is more effective in reducing asymptomatic carriage of meningococci, and whether the effect may be long-standing. Oropharyngeal swabs were obtained pre-, immediately post- and 6-11 months following completion of Hajj and tested for the presence of meningococci. RESULTS: Amongst 2000 individuals approached, only 1146 participants aged 18-91 (mean 37.6) years agreed to participate and were randomized to receive either the polysaccharide (n = 561) or the conjugate (n = 561) vaccine, 60.8% were male, and 93.5% were from Saudi Arabia. Amongst oropharyngeal swabs obtained before Hajj, only two (0.2%) tested positive for Neisseria meningitidis. Similarly, meningococci were identified in only one sample at each of the post-Hajj and late follow-up visits. None of the carriage isolates were amongst the serogroups covered by the vaccines. A post hoc analysis of the third swabs revealed that 22.4% of all participants (50/223) were positive for Streptococcus pneumoniae nucleic acid. CONCLUSION: The low overall carriage rate of meningococci found amongst Hajj pilgrims in 2016 and 2017 demonstrates a successful vaccination policy, but neither supports nor refutes the superiority of meningococcal conjugate ACWY vaccine over the polysaccharide vaccine against carriage. Although an association could not be established in this study, molecular epidemiology would help to establish the role of Hajj in facilitating transmission of pneumococci and inform vaccination policy.

Facemask against viral respiratory infections among Hajj pilgrims: A challenging cluster-randomized trial.

BACKGROUND: In this large-scale cluster-randomized controlled trial (cRCT) we sought to assess the effectiveness of facemasks against viral respiratory infections. METHODS AND RESULTS: Over three consecutive Hajj seasons (2013, 2014, 2015) pilgrims' tents in Makkah were allocated to 'facemask' or 'no facemask' group. Fifty facemasks were offered to participants in intervention tents, to be worn over four days, and none were offered to participants in control tents. All participants recorded facemask use and respiratory symptoms in health diaries. Nasal swabs were collected from the symptomatic for virus detection by reverse transcription polymerase chain reaction. Clinical symptoms and laboratory results were analyzed by 'intention- to-treat' and 'per-protocol'. A total of 7687 adult participants from 318 tents were randomized: 3864 from 149 tents to the intervention group, and 3823 from 169 tents to the control group. Participants were aged 18 to 95 (median 34, mean 37) years, with a male to female ratio of 1:1.2. Overall, respiratory viruses were detected in 277 of 650 (43%) nasal/pharyngeal swabs collected from symptomatic pilgrims. Common viruses were rhinovirus (35.1%), influenza (4.5%) and parainfluenza (1.7%). In the intervention arm, respectively 954 (24.7%) and 1842 (47.7%) participants used facemasks daily and intermittently, while in the control arm, respectively 546 (14.3%) and 1334 (34.9%) used facemasks daily and intermittently. By intention-to-treat analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.9 to 2.1, p = 0.18) nor against clinical respiratory infection (OR, 1.1; 95% CI, 0.9 to 1.4, p = 0.40). Similarly, in a per-protocol analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (OR 1.2, 95% CI 0.9-1.7, p = 0.26) nor against clinical respiratory infection (OR 1.3, 95% CI 1.0-1.8, p = 0.06). CONCLUSION: This trial was unable to provide conclusive evidence on facemask efficacy against viral respiratory infections most likely due to poor adherence to protocol.

Surveillance of Australian Hajj pilgrims for carriage of potentially pathogenic bacteria: Data from two pilot studies.

AIM: To estimate the pharyngeal carriage rate of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) among Australian Hajj pilgrims. METHODS: In 2014, surveillance was conducted in two phases among Australian Hajj pilgrims: The first phase during Hajj in Mina, and the second phase soon after returning home to Australia. Nasopharyngeal or oropharyngeal swabs were taken from participants then tested, firstly by nucleic acid testing, and also by standard culture. RESULTS: Of 183 participants recruited in the first phase, 26 (14.2%) tested positive for S. pneumoniae; 4 had received pneumococcal conjugate vaccine (PCV13). Only one tested positive for N. meningitidis (W). Of 93 2nd phase samples cultured, 17 (18.3%) grew S. aureus, all methicillin sensitive, 2 (2.2%) grew N. meningitidis (on subculture; one serotype B, one negative), and 1 (1%), from an unvaccinated pilgrim, grew S. pneumoniae. CONCLUSION: Relatively high carriage of S. pneumoniae and little meningococcal carriage was found. This indicates the importance of a larger study for improved infection surveillance and possible vaccine evaluation.

Barriers of vaccinations against serious bacterial infections among Australian Hajj pilgrims.

OBJECTIVES: Vaccination against serious bacterial infections is recommended for Hajj pilgrims. Although the uptake of mandatory vaccines among Hajj pilgrims is acceptable, the uptake of other recommended vaccines remains suboptimal. In this study, we have explored the barriers to vaccination against serious bacterial infections among Australian Hajj pilgrims. METHODS: Travellers aged 18 years and older planning to attend Hajj in the years 2014 and 2015 were surveyed at the immunization clinic of the Children's Hospital at Westmead, Sydney, Australia. A questionnaire-based survey was conducted to explore pilgrims' vaccination histories for their previous visits to Mecca, the reasons for non-receipt of vaccination, and to assess knowledge about the transmission of infections. RESULTS: A total of 300 participants aged 18-76 (median 41) years completed the survey. Most (233 [77.7%]) were born outside Australia. Overall, 113 (37.7%) had performed pilgrimage in the past; 19 (16.8%) of them reported receiving pneumococcal vaccine and 16 (14.1%) diphtheria, tetanus and pertussis (DTP) vaccine. Lack of awareness about the availability of the vaccines was the main reason for non-receipt of pneumococcal and DTP vaccines (respectively 41.1% and 44.7%). Most pilgrims (266 [88.7%]) believed that travel vaccines are necessary before embarking on a journey; however, some expressed concerns about adverse reactions (156 [52.0%]), cost (114 [38.0%]), and permissibility of the vaccine according to their religion (6 [2.0%]). Respectively, 187 (62.3%), 145 (48.3%) and 86 (28.7%) respondents did not correctly know how meningococcal and pneumococcal diseases and pertussis transmit. Nevertheless, most (256 [85.3%]) indicated that they trust their family doctor for medical information and most (203 [67.7%]) preferred to receive the medical information in English. CONCLUSION: The uptake of recommended vaccines against serious bacterial infections among Australian Hajj pilgrims is low. Lack of awareness about the availability of vaccines, misperceptions surrounding the safety of vaccines and high cost are key barriers of uptake.

Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data.

BACKGROUND: Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade. METHOD: Data for this analysis is a synthesis of raw and published data from eleven Hajj seasons between 2005 and 214. For seven Hajj seasons the data were obtained from studies involving pilgrims of UK, Saudi Arabia and Australia; and for the remaining four Hajj seasons data were abstracted from published studies involving pilgrims from multiple countries. The data from both sources were synthesised to estimate the relative risk (RR) of acquisition of ILI in vaccinated versus unvaccinated pilgrims. RESULTS: The pooled sample size of the included studies was 33,213 with most pilgrims being in the age band of 40-60 years (range: 0.5 to 95 years) and a male to female ratio of 1.6. The pilgrims originated, in order of frequency, from Iran, Australia, France, UK, Saudi Arabia, Indonesia, India, Algeria, Ivory Coast, Nigeria, Somalia, Turkey, Syria, Sierra Leone and USA. Except for one year (2008), data from individual years did not demonstrate a noticeable change in the rate of ILI against influenza vaccine coverage, however the combined data from all studies suggest that the prevalence of ILI decreased among Hajj pilgrims as the vaccine coverage increased over the last decade (RR 0.2, P<0.01). CONCLUSION: This analysis suggests that influenza vaccine might be beneficial for Hajj pilgrims. However, controlled trials aided by molecular diagnostic tools could confirm whether such an effect is real or ostensible.

Knowledge, Attitude and Practice (KAP) Survey Concerning Antimicrobial Use among Australian Hajj Pilgrims.

Resistance to antimicrobial agents has increased for reasons relating to the use and misuse of antimicrobials in human, agriculture and aquaculture. Antimicrobial use is quite high during mass gatherings such as the Hajj pilgrimage. To reduce non-prescription use and inappropriate prescribing of antimicrobials, a more thorough understanding of their use and the motives behind why patients request, even demand, antimicrobials, fail to adhere to the prescription is important. Therefore, we conducted a knowledge, attitude and practice (KAP) survey among Australian Hajj pilgrims in Mecca during Hajj 2013 using an anonymous, self-administered questionnaire concerning antimicrobial use. Our sample consisted of 229 adult Australian subjects. Mean age was 42.4 (SD±12.7) years, 178 (77.9%) were male and 80 (34.9%) used antimicrobials during their stay in Saudi Arabia. Twenty one (26.3%) obtained these in Saudi Arabia without prescription, and about half (38, 47.5%) brought them from Australia. Of the respondents, 55.8% believed that antibiotics are effective against viruses, 53.6% thought that antibiotics are effective against common cold and flu, 78.6 % that humans themselves can become resistant to antibiotics and 75.9% knew that overuse or unnecessary use of antibiotics can cause them to lose effectiveness. This study has revealed that Hajj pilgrims have inappropriate access to antimicrobials in Saudi Arabia as well as in Australia. A large scale education campaign and tighter control on prescribing and dispensing of antimicrobials could improve the appropriate antimicrobial use among Hajj pilgrims.

Viral respiratory infections among Hajj pilgrims in 2013.

Middle East respiratory syndrome coronavirus (MERS-CoV) has emerged in the Arabian Gulf region, with its epicentre in Saudi Arabia, the host of the 'Hajj' which is the world's the largest mass gathering. Transmission of MERS-CoV at such an event could lead to its rapid worldwide dissemination. Therefore, we studied the frequency of viruses causing influenza-like illnesses (ILI) among participants in a randomised controlled trial at the Hajj 2013. We recruited 1038 pilgrims from Saudi Arabia, Australia and Qatar during the first day of Hajj and followed them closely for four days. A nasal swab was collected from each pilgrim who developed ILI. Respiratory viruses were detected using multiplex RT-PCR. ILI occurred in 112/1038 (11%) pilgrims. Their mean age was 35 years, 49 (44%) were male and 35 (31%) had received the influenza vaccine pre-Hajj. Forty two (38%) pilgrims had laboratory-confirmed viral infections; 28 (25%) rhinovirus, 5 (4%) influenza A, 2 (2%) adenovirus, 2 (2%) human coronavirus OC43/229E, 2 (2%) parainfluenza virus 3, 1 (1%) parainfluenza virus 1, and 2 (2%) dual infections. No MERS-CoV was detected in any sample. Rhinovirus was the commonest cause of ILI among Hajj pilgrims in 2013. Infection control and appropriate vaccination are necessary to prevent transmission of respiratory viruses at Hajj and other mass gatherings.

Pneumococcal Vaccine Uptake Among Australian Hajj Pilgrims in 2011-13.

The uptake of the pneumococcal vaccine is suboptimal in Australia and remains unknown among Australian Hajj pilgrims, many of whom are eligible because of age or underlying disease and at particular risk because of travel and activities at Hajj. Pneumococcal vaccination uptake was examined over three consecutive years (2011 to 2013) through anonymous self-administered cross sectional surveys among Australian pilgrims who assembled in Mina valley, Mecca, Saudi Arabia. Respectively, 158, 513 and 219 pilgrims were recruited in 2011, 2012 and 2013; their mean ages were 43.8 (SD±13), 43 (SD±13.5) and 42.6 (SD±12.3) years; males accounted for 67 (42.4%), 325 (63.4%) and 172 (78.5%). Pneumococcal vaccine uptake rates were 28.5% (45/158), 28.7% (147/513) and 14.2% (31/219); among the pilgrims with 'at risk' conditions the pneumococcal vaccine uptake rates were 15 (30.6%), 43 (45.3%) and 9 (29%) respectively. According to our surveys, the pneumococcal vaccine uptake among Australian pilgrims is low. Further research is needed to explore the reasons through a validated study.

Hypotensive activity and toxicology of constituents from root bark of Polyalthia longifolia var. pendula.

A defatted extract of Polyalthia longifolia var. pendula root bark (PRB) in 50% methanol showed a significant ability to reduce blood pressure. It caused a 22% and 47% fall in mean arterial blood pressure (MABP) in rats at doses of 3 mg/kg and 30 mg/kg, respectively. Compounds purified from this extract include kolavenic acid (3), clerodane (1) and its isomer (2), liriodenine (4), lysicamine (5) and bisclerodane imide (6) and its isomer (7). Of these, only kolavenic acid produced a 22% fall in MABP, at a dose of 30 mg/kg. PRB showed a decrease in blood pressure of normotensive and egg yolk induced hypertensive rats. The LD50 of PRB was determined as 100 mg/kg in mice.