Surgical Resection of a Giant Hepatic Hemangioma in a Hepatitis B-positive Patient: A Case Report.

This case report describes the successful surgical removal of a giant hemangioma in a 41-year-old female with hepatitis B. The patient came with stomach distension, right upper quadrant, and right lumbar region pain. Imaging studies showed a mass measuring 12x7.6x11 cm emerging from the left lobe of the liver, causing compression of surrounding structures. The patient has undergone a laparotomy with successful anatomical resection of the hemangioma. Postoperative recovery was uneventful, and the patient was discharged on the fifth postoperative day. This case highlights the significance of considering surgery for symptomatic giant hemangiomas and normal follow-up to screen for recurrence and aims to present the successful surgical management of a giant hemangioma.

A Giant Cell Tumor of the Tendon Sheath of the Foot: A Rare Presentation.

A giant cell tumor of the tendon sheath (GCTTS) is a benign tumor that can occur in the joint synovium, bursae, or tendon sheath. It generally emerges in the tendons/synovium of the bones of the hand. It has unique characteristics, as noted in histopathological, clinical, and published literature. GCTTS has been reported across different age groups, with higher incidence observed in middle-aged adults. We present an unusual occurrence of GCTTS arising from the foot in a 54-year-old female who visited our medical facility with a history of swelling in her right foot for one year. Ultrasonography suggested a well-defined 5 x 4 cm lesion deep to the flexor tendon with possible intertarsal extension, which was managed surgically. This article represents a detailed understanding of GCTTS, emphasizing its benign yet locally aggressive nature and the complexities involved in its diagnosis and management.

Uterine Leiomyosarcoma in a Young Woman: A Report of a Rare Case.

Uterine leiomyosarcoma (LMS) is an uncommon disease that arises from the smooth muscles present in the uterus. It usually occurs in post-menopausal women. Due to its aggressive nature, it has a very poor prognosis. We present a case of uterine LMS, which presented at a young age of 35 years for infertility, which is rare at this age. She had a fundal fibroid for which myomectomy was done. On histopathology, she was diagnosed with LMS. It is very difficult and nearly impossible to diagnose LMS preoperatively by available imaging modalities. There is an urgent need for a reliable preoperative risk scoring system that can help in diagnosing malignancy so that a correct surgical pathway and treatment can be offered to patients. A total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) was done and was advised adjuvant chemotherapy. The patient remained disease-free and was put on chemotherapy.

1,6-Conjugate addition of in situ generated aryldiazenes to p-quinone methides.

Herein we report a transition-metal free, base-mediated 1,6-conjugate addition of aryldiazenes to para-quinone methides (p-QMs). Arylhydrazines were used for the in situ generation of aryldiazenes using a base-mediated protocol in the presence of air as the oxidant. The 1,6-conjugate addition of aryldiazenes to para-quinone methides via a radical mechanism is followed by an oxidative rearrangement to furnish the desired product, arylhydrazones. Interestingly, our synthetic protocol results in the formation of an aryldiazene radical, which undergoes 1,6-conjugate addition with p-QMs to furnish the arylhydrazones.

Thermally Stable P-Chiral Supramolecular Phosphines, their Self-Assembly and Implication in Rh-Catalyzed Asymmetric Hydrogenation.

P-chiral supramolecular phosphine ligands are crucial for asymmetric transformations, but their synthesis is tedious. We report a one-step synthesis of thermally stable P-chiral supramolecular phosphines and their performance in the asymmetric hydrogenation of functionalized alkenes. A rational designing and synthesis of (R, R)-QuinoxP* ligated palladium complex (Pd-2) in excellent yield is reported. This Pd-2 catalyzed a direct P-C coupling of 2,3-dihydro-1-H-phosphindole (A1)/1,2,3,4-tetrahydrophosphindoline (A2) with 1-(3-iodophenyl)urea (B1)/2-iodo /6-hydroxy pyridine (B2) and,produced corresponding ligands L1-L3. The P-C coupling between A1 and B2 produced 6-(2,3-dihydro-1H-phosphindol-1-yl)pyridine-2(1H)-one (L2) with an excellent enantiomeric excess of up to 99 %. L2 was found to be remarkably stable even at 150 °C and did not oxidize/hydrolyze for at least 24 hours in open air. Such thermal stability and an impediment to oxidation are unprecedented. L2 self-assembled and produced L2-C1 (Pt), L2-C2(Pd), and L2-C3(Rh) assemblies. The utility of the self-assembled P-chiral ligand was demonstrated in the Rh-catalyzed asymmetric hydrogenation (AH) of functionalized olefins. The L2-C3 catalyzed AH of functionalized alkenes and delivered chiral products with excellent enantioselectivity of >99 %. A small library of 16 substrates was subjected to AH using L2-C3 to produce chiral compounds with excellent conversion and ee.

Significance of Serum Lactate Dehydrogenase as a Prognostic Marker and Outcome Predictor in Patients With Breast Cancer.

Background Breast carcinoma has been the most prevalent cancer in women, with research-based evidence showing a significant rise in the incidence of cancer and related morbidity and mortality in the Indian subcontinent. The predictive value of plasmatic lactate dehydrogenase (LDH) levels has been studied in breast cancer. Numerous studies have connected high LDH values to a poor prognosis, increased risk of incidence, recurrence, and associated mortality in patients with breast carcinoma. This study aimed to assess the clinical profile of breast carcinoma and determine the correlation of serum lactate dehydrogenase levels with the stage of the disease and assessment of high-risk features using histopathology and immunohistochemistry. Methods A total of 75 patients with carcinoma breast were enrolled for this study and classified into two groups: upfront surgery and post-adjuvant therapy. Serum LDH levels were estimated a day before the surgery (baseline) and on postoperative days 1, 7, 14, and 30. The clinical tumor, node, metastasis (cTNM) staging was correlated with pathological tumor, node, metastasis TNM (pTNM) staging and immunohistochemistry findings. Results The clinical characteristics of breast cancer, serum LDH levels, and stage of the disease were collected and analyzed. A significant decreasing trend was noted in LDH values post-op days, and statistically significant higher LDH values were noted in the triple-negative group, positive lymph nodes, and positive lymphovascular invasion patients. Conclusion Regularly elevated levels or an unanticipated rise in serum LDH might indicate poor outcomes. Hence, this non-specific enzyme marker can be suggested to be used routinely to assess disease outcomes.

Electrochemical Determination of Fentanyl Using Carbon Nanofiber-Modified Electrodes.

In this work, we report the direct electrochemical oxidation of fentanyl using commercial screen-printed carbon electrodes (SPCEs) modified with carboxyl-functionalized carbon nanofibers (fCNFs). CNFs have surface chemistry and reactivity similar to carbon nanotubes (CNTs), yet they are easier to produce and are of a lower cost than CNTs. By monitoring the current produced during the electrochemical oxidation of fentanyl, variables such as fCNF loading, fentanyl accumulation time, electrolyte pH, and differential pulse voltammetry parameters were optimized. Under an optimized set of conditions, the fCNF/SPCEs responded linearly to fentanyl in the concentration range of 0.125-10 µM, with a limit of detection of 75 nM. The fCNF/SPCEs also demonstrated excellent selectivity against common cutting agents found in illicit drugs (e.g., glucose, sucrose, caffeine, acetaminophen, and theophylline) and interferents found in biological samples (e.g., ascorbic acid, NaCl, urea, creatinine, and uric acid). The performance of the sensor was also successfully tested using fentanyl spiked into an artificial urine sample. The straightforward electrode assembly process, low cost, ease of use, and rapid response make the fCNF/SPCEs prime candidates for the detection of fentanyl in both physiological samples and street drugs.

Surgical Perspectives of Open vs. Laparoscopic Approaches to Lateral Pancreaticojejunostomy: A Comprehensive Review.

Pancreaticojejunostomy, a critical step in pancreatic surgery, has significantly evolved surgical approaches, including open, laparoscopic, and robotic techniques. This comprehensive review explores open surgery's historical success, advantages, and disadvantages, emphasizing surgeons' accrued experience and familiarity with this approach. However, heightened morbidity and prolonged recovery associated with open pancreaticojejunostomy underscore the need for a nuanced evaluation of alternatives. The advent of robotic-assisted surgery introduces a paradigm shift in pancreatic procedures. Enhanced dexterity, facilitated by wristed instruments, allows intricate suturing and precise tissue manipulation crucial in pancreatic surgery. Three-dimensional visualization augments surgeon perception, improving spatial orientation and anastomotic alignment. Moreover, the potential for a reduced learning curve may enhance accessibility, especially for surgeons transitioning from open techniques. Emerging technologies, including advanced imaging modalities and artificial intelligence, present promising avenues for refining both open and minimally invasive approaches. The ongoing pursuit of optimal outcomes mandates a judicious consideration of surgical techniques, incorporating technological advancements to navigate challenges and enhance patient care in pancreaticojejunostomy.

Tridentate NacNac Tames T-Shaped Nickel(I) Radical.

The reaction of a nickel(II) chloride complex containing a tridentate ß-diketiminato ligand with a picolyl group [2,6-iPr2 -C6 H3 NC(Me)CHC(Me)NH(CH2 py)]Ni(II)Cl (1)] with KSi(SiMe3 )3 conveniently afforded a nickel(I) radical with a T-shaped geometry (2). The compound's metalloradical nature was confirmed through electron paramagnetic resonance (EPR) studies and its reaction with TEMPO, resulting in the formation of a highly unusual three-membered nickeloxaziridine complex (3). When reacted with disulfide and diselenide, the S-S and Se-Se bonds were cleaved, and a coupled product was formed through carbon atom of the pyridine-imine group. The nickel(I) radical activates dihydrogen at room temperature and atmospheric pressure to give the monomeric nickel hydride.

Carney Complex and Its Association With Thyroid Cancer, Molecular Pathway, and Treatment.

Thyroid cancer, being the prevailing form of endocrine malignancy, exhibits a notable surge in its incidence rates. Follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) represent the predominant well-differentiated subtypes and are recognized as the most prevalent forms of thyroid carcinomas. Over the course of several years, numerous molecular, genetic, and epigenetic modifications have been discerned in diverse forms of thyroid neoplasms. Common occurrences comprise point mutations in the BRAF and RAS genes, along with chromosomal rearrangements involving the RET/PTC and PAX8/PPARγ genes. Thyroid carcinoma, encompassing both FTC and PTC, has been documented in individuals diagnosed with Carney complex (CNC), a hereditary syndrome passed down in an autosomal dominant manner causing increased susceptibility to diverse neoplasms. CNC manifests as a result of inactivating mutations occurring within the tumor-suppressor gene known as PRKAR1A, which is responsible for encoding the regulatory subunit of protein kinase A (PKA) type 1α. Studies have shown that this mutation leads to activation of PKA, which, in turn, can induce FTC. In this comprehensive review, we aim to elucidate the intricate molecular mechanisms underlying thyroid tumorigenesis, specifically focusing on the deleterious consequences resulting from the deactivation of the PRKAR1A gene.

Intramolecular donor-stabilized tetra-coordinated germanium(iv) di-cations and their Lewis acidic properties.

We report the first examples of intramolecular phosphine-stabilized tetra-coordinated germanium(iv) di-cationic compounds: [LiPr2Ge][CF3SO3]23iPr and [LPh2Ge][CF3SO3]23Ph (LiPr = 6-(diisopropylphosphanyl)-1,2-dihydroacenaphthylene-5-ide; LPh = 6-(diphenylphosphanyl)-1,2-dihydroacenaphthylene-5-ide). The step wise synthetic strategy involves the isolation of neutral and mono-cationic Ge(iv) precursors: [LiPr2GeCl][X] (X = GeCl31iPr, OTf 2iPr), [LPh2GeCl2] 1Ph and [LPh2GeCl][OTf] 2Ph. Both 3iPr and 3Ph exhibit constrained spiro-geometry. DFT studies reveal the dispersion of di-cationic charges over P-Ge-P sites. Anion or Lewis base binding occurs at the Ge site resulting in relaxed distorted trigonal bipyramidal/tetrahedral geometry. 3iPr and 3Ph activate the Si-H bond initially at the P-site. The hydride ultimately migrates to the Ge-site rapidly giving [LPh2GeH][CF3SO3] 3PhH, while sluggishly forming [LiPr2GeH][CF3SO3] 3iPrH. Compounds 3iPr and 3Ph were tested as catalysts for the hydrosilylation of aromatic aldehydes. While catalytic hydrosilylation proceeded via the initial Et3Si-H bond activation in the case of 3iPr, compound 3Ph as a catalyst showed a masked Frustrated Lewis Pair (FLP) type reactivity in the catalytic cycle.

NHC-Catalyzed Enantioselective Synthesis of Tetracyclic δ-Lactones by (4 + 2) Annulation of ortho-Quinodimethanes with Activated Ketones.

The N-heterocyclic carbene (NHC)-catalyzed generation of ortho-quinodimethanes (o-QDMs) from 9H-fluorene-1-carbaldehydes followed by the interception with activated ketones resulting in the enantioselective synthesis of tetracyclic δ-lactones is presented. High diastereoselectivity of products, remote C(sp3)-H functionalization, broad substrate scope, and mild reaction conditions are the notable features of the present (4 + 2) annulation.

Synthesis of novel rhodamine type Anthrone Spiro-lactam (ASL) analogues and evaluation of antiviral activity against dengue and chikungunya viruses.

A series of Rhodamine type Anthrone-Spirolactam (ASL) derivatives Benzylimin-Anthrone-Spirolactam (ASL-1 to ASL-10) and Benzamide-Anthrone-Spirolactam (ASL-11 and ASL-12) were synthesized via a simple condensation reaction between Anthrone Spiro-lactamine (2) and various aromatic aldehyde and acyl chlorides respectively. Since rhodamine-based compounds were reported to have antiviral activity, the ASL derivatives were examined for in vitro antiviral activity against dengue and chikungunya viruses. Among all the analogues, ASL-3, ASL-6, ASL-7, ASL-8, ASL-9 and ASL-10 were the most potent against dengue virus (DENV) and exerted around one log reduction in virus titre under post-treatment conditions. At the same time ASL-3 was effective under co-treatment conditions. Two analogues ASL-6 and ASL-12 exerted anti-chikungunya virus (CHIKV) activity under post-treatment conditions. In silico docking studies revealed that the ASL derivatives interacted with the proteins of DENV and CHIKV. Together, the results suggest the anti-DENV and CHIKV activity of ASL derivatives which may be exploited further for therapeutic purposes.

Crystal structure of 1-(4-bromo-phen-yl)but-3-yn-1-one.

The title compound, 1-(4-bromo-phen-yl)but-3-yn-1-one, C10H7BrO, crystallizes in the monoclinic space group P21/n with one mol-ecule in the asymmetric unit. The structure displays a planar geometry. The crystal structure is consolidated by C-H⋯O hydrogen bonding and a short C=O⋯C≡C (acetyl-ene) contacts. Hirshfeld surface analysis indicates that H⋯H, C⋯H/H⋯C and H⋯Br/Br⋯H inter-actions play a more important role in consolidating the crystal structure compared to H⋯O/O⋯H and C⋯C contacts.

Emerging aspects of metal ions-doped zinc oxide photocatalysts in degradation of organic dyes and pharmaceutical pollutants - A review.

In recent periods, a broad assortment of continual organic contaminants has been released into our natural water resources. Indeed, it is exceedingly poisonous and perilous to living things; thus, the elimination of these organic pollutants before release into the water bodies is vital. A variety of techniques have been utilized to remove these organic pollutants with advanced oxidation photocatalytic methods with zinc oxide (ZnO) nanoparticles being commonly used as a capable catalyst for contaminated water treatment. Nevertheless, its broad energy gap, which can be only stimulated under an ultraviolet (UV) light source, and high recombination pairs of electrons and holes limit their photocatalytic behaviors. However, numerous methods have been suggested to decrease its energy gap for visible regions. Including, the doping ZnO with metal ions (dopant) can be considered as an effectual route not only the reason for a movement of the absorption edges toward the higher (visible light) region but also to lower the electron-hole pair (e--h+) recombination. This review concentrated on the impact of dissimilar types of metal ions (dopants) on the advancement in the degradation performance of ZnO. So, this work demonstrates a vital review of contemporary attainments in the alteration of ZnO nanoparticles for organic pollutants eliminations. Besides, the effect of doping ions including transition metals, rare earth metals, and metal ions (substitutional and interstitial) concerning numerous types of altered ZnO are summarized. The photodegradation mechanisms for pristine and metal-modified ZnO nanoparticles are also conferred.

On the competition between six-membered and five-membered NHC towards alane centered ring expansion.

The combination of 6-SIDipp·AlH3 (1) and 5-IDipp resulted in the ring expansion of 6-NHC, while the five-membered NHC remained unchanged, which was subsequently explained by DFT studies. Besides, the substitution chemistry of 1 was also studied with TMSOTf and I2, which gave rise to the substitution of a hydride by triflate or iodide ligands.

Iron-Catalyzed Alkoxylation, Dehydrogenative-Polymerization and Tandem Hydrosilylative-Alkoxylation.

Alkoxylation, hydrosilylative-alkoxylation, and dehydrogenative-polymerization are some of the most widely used transformations in synthetic chemistry. However, these transformations are traditionally catalyzed by precious, and rare late-transition metals. Presented here is a molecularly defined iron complex that catalyzes alkoxylation, tandem hydrosilylative-alkoxylation, and dehydrogenative polymerization of silanes under mild conditions. The iron complex [Fe(CO)4 (H)(SiPh3 )] 1 catalyzes a direct Si-O coupling reaction between an array of silanes and alcohols to produce desired alkoxysilanes in excellent yield, with H2 as the only byproduct. The iron catalyst tolerates various functional groups and provides access to 20 alkoxysilanes, including essential molecules such as ß-citronellol and cholesterol. Further, complex 1 catalyzes the polymerization of renewable diol and silane monomer to produce a renewable and degradable poly(isosorbide-silyl ether). Remarkably, complex 1 catalyzes a tandem hydrosilylative-alkoxylation of alkynes under mild conditions to yield unsaturated silyl ethers. The synthetic utility has been demonstrated by gram-scale alkoxylation and hydrosilylative-alkoxylation reactions.

Organocatalysed one-pot three component synthesis of 3,3'-disubstituted oxindoles featuring an all-carbon quaternary center and spiro[2H-pyran-3,4'-indoline].

A simple and efficient methodology for the one-pot synthesis of 3,3'-disubstituted oxindoles featuring an all-carbon quaternary center has been demonstrated through l-proline catalysed three-component reaction based on sequential Knoevenagel condensation/Michael addition and also one-pot synthesis of spiro[2H-pyran-3,4'-indoline] through consecutive Knoevenagel condensation/Michael addition/reduction/cyclization reactions from readily available isatin derivatives, malononitrile, and ketones. The present methodology presents several advantages, including simple reaction set-up, short reaction times, and easy to work-up. Also, this strategy offers broad substrate scope with excellent yields and high atom economy, under mild reaction conditions.

Manganese(I)-Catalyzed Chemoselective Transfer Hydrogenation of the C=C Bond in Conjugated Ketones at Room Temperature.

Chemoselective transfer hydrogenation of C=C bond in α,ß-unsaturated ketones is demonstrated at room temperature employing a manganese(I) catalyst and half an equivalent of ammonia-borane (H3 N-BH3 ). A series of mixed-donor pincer-ligated Mn(II) complexes, (tBu2 PN3 NPyz )MnX2 [κP ,κN ,κN -(N-(di-tert-butylphosphaneyl)-6-(1H-pyrazol-1-yl)pyridin-2-amine)MnX2 ] {X=Cl (Mn2), X=Br (Mn3), X=I (Mn4)} were synthesized and characterized. Amongst the Mn(II) complexes, (Mn2, Mn3, Mn4) and Mn(I) complex, (tBu2 PN3 NPyz )Mn(CO)2 Br (Mn1) screened; the Mn1 acts as an efficient catalyst for the chemoselective C=C bond reduction in α,ß-unsaturated ketones. Various synthetically important functionalities like halides, methoxy, trifluoromethyl, benzyloxy, nitro, amine, and unconjugated alkene and alkyne groups, including heteroarenes, were compatible and provided saturated ketones in excellent yields (up to 97 %). A preliminary mechanistic study highlighted the crucial role of metal-ligand (M-L) cooperation through the dearomatization-aromatization process in catalyst Mn1 for the chemoselective C=C bond transfer hydrogenation.

Prevalence of impaired upper extremity neural mobility among smart device users during the COVID-19 pandemic.

BACKGROUND: Both the development of various countries and people's health were impacted by the unforeseen global COVID-19 outbreak. Many countries prefer to do their daily business online. Although it was incredibly useful at the time, it still had a problem that was not properly addressed, especially among the student population. OBJECTIVE: The objective of this study was to examine the prevalence of upper extremity neural mobility among students who were using smart devices during the COVID-19 pandemic. METHODS: 458 students who had previously taken home-based online classes during the COVID-19 pandemic and used a smart device for more than six hours were included in this study. The study was conducted in three phases. After being examined in the first two stages of the study, a total of 72 people were chosen for the final phase. Peripheral nerve mobility tests were performed on these 72 subjects. RESULTS: This study observed that 15.72% of smart device users have been affected by forward neck posture and impaired peripheral nerve mobility in the cervical spine. CONCLUSION: The study concludes that forward neck posture is associated with impaired peripheral nerve mobility among smart device users who were in home-based online classes during the COVID-19 pandemic lockdown. Hence, we suggest an appropriate treatment strategy focusing on preventing the forward neck posture through timely analysis and self-care therapies.