Synthesis of sulpha drug based hydroxytriazene derivatives: Anti-diabetic, antioxidant, anti-inflammatory activity and their molecular docking studies.

Herein, we report synthesis, characterization, anti-diabetic, anti-inflammatory and anti-oxidant activities of hydroxytriazenes derived from sulpha drugs, namely sulphanilamide, sulphadiazine, sulphapyridine and sulphamethazine. Before biological screening of the compounds, theoretical prediction using PASS was done which indicates probable activities ranging from Pa (probable activity) values 65-98% for anti-inflammatory activity. As per the predication, experimental validation of some of the predicted activities particularly anti-diabetic, anti-inflammatory and anti-oxidant was done. Anti-diabetic activities have been screened using two methods namely α-amylase and α-glucosidase inhibition method and IC50 values were ranging from 66 to 260 and 148 to 401 µg/mL, while for standard drug acarbose the values were 12 µg/mL and 70 µg/mL, respectively. Docking studies have also been done for antidiabetic target pancreatic alpha amylase. The molecular docking studies in α-amylase enzyme reveal that the middle phenyl ring of all the compounds mainly occupies in the small hydrophobic pocket formed by the Ala198, Trp58, Leu162, Leu165 and Ile235 residues and sulphonamide moiety establish H-bond interaction by two water molecules. Further, anti-inflammatory activity has been evaluated using carrageenan induced paw-edema method and results indicate excellent anti-inflammatory activity by hydroxytriazenes (71 to 97%) and standard drug diclofenac 94% after 4 h of treatment. Moreover, antioxidant effect of the compounds was tested using DPPH and ABTS methods. All the compounds displayed good results (24-488 µg/mL) against ABTS radical and many compounds are more active than ascorbic acid (69 µg/mL) while all other compounds showed moderate activity against DPPH radical (292-774 µg/mL) and ascorbic acid (29 µg/mL). Thus, the studies reveal potential of sulfa drug based hydroxytriazenes as candidates for antidiabetic, anti-inflammatory and antioxidant activities which have been experimentally validated.

Synthesis, characterization, theoretical prediction of activities and evaluation of biological activities of some sulfacetamide based hydroxytriazenes.

Six new N [(4-aminophenyl)sulfonyl]acetamide based hydroxytriazenes have been synthesized and characterized using elemental analysis, IR, 1H NMR, 13C NMR and MASS spectral analysis. Further, their theoretical predictions for probable activities have been taken using PASS (Prediction of Activity Spectra for Substance). Although a number of activities have been predicted but specifically anti-inflammatory, antiradical, anti-diabetic activities have been experimentally validated which proves that theoretical predictions agree with the experimental results. The object of the Letter is to establish Computer Aided Drug Design (CADD) using our compounds.

Assessment of home hazards for childhood injuries in an urban population in New Delhi.

BACKGROUND: Childhood injuries, especially the unintentional category of injuries, occur most commonly in the environment inside a child's home. The primary objective of the present study was to assess the presence of home hazards for childhood injuries in households in an urban resettlement colony in New Delhi. METHODS: A community-based cross-sectional study was carried out in an urban resettlement colony in Delhi. A hazards assessment tool was used to check the presence of hazards in the houses. RESULTS: A total of 225 households were included. It was seen that121 (53.7%) had a cooking stove within the reach of the child, and 190 (84.3%) had the gas pipe within reach. Fire hazard was seen in 84% of houses. About 78% of households did not have locked storage for chemicals. CONCLUSION: The study revealed a significant burden of hazards for childhood injuries within their own homes, thus emphasizing the need for injury prevention interventions to reduce the number of hazards.

Does extracorporeal shock wave lithotripsy cause hearing impairment? Evaluation by transient evoked otoacoustic emissions.

OBJECTIVE: To evaluate if multiple sessions of extracorporeal shock wave lithotripsy (ESWL) have any effect on the transient evoked otoacoustic emissions (TEOAEs). STUDY DESIGN: Prospective study. SETTING: Academic tertiary medical centre. METHODS: Thirty patients undergoing multiple sessions of ESWL for urinary stone disease were assessed using TEOAEs before and after ESWL. RESULTS: It was found that ESWL does not cause any significant changes in TEOAEs. CONCLUSIONS: ESWL is a safe procedure and does not cause any changes in TEOAEs.

Serum ferritin in renal cell carcinoma: effect of tumor size, volume grade, and stage.

AIM: To study the levels of serum ferritin in patients of renal cell carcinoma (RCC). PATIENTS AND METHODS: Serum ferritin levels were measured preoperatively in 32 patients with radiological evidence of RCC using an enzyme immunoassay. The largest diameter of the primary tumor was measured in the pathological specimens in patients undergoing radical nephrectomy while in patients with non-operable tumor maximum tumor dimension was taken from CT scan. Pathological staging was done according TNM-1997. RESULTS: Mean serum ferritin value in patients of RCC was 283.23+/-77.38 ng/ml while in controls the mean value was 79.98+/-32.96 ng/ml (P CONCLUSIONS: Serum ferritin levels are elevated in patients with RCC although its actual source is unclear. Further studies are needed to establish the role of ferritin in RCC.

Primary transitional cell carcinoma of the prostate presenting as a rectal ulcer.

Primary transitional cell carcinoma of the prostate is a rare clinicopathological entity. It is an aggressive tumor with a poor prognosis. Presentation is usually late, with obstructive voiding complaints. Radical surgery offers locoregional control of the disease. We report a case with an atypical presentation of bleeding per rectum and associated obstructive voiding symptoms. Examination revealed a rectal ulcer overlying an enlarged prostate and fixed to it. Histopathology showed a picture of transitional cell carcinoma of the prostate infiltrating the rectum. Imaging studies revealed an enlarged prostate with altered echo pattern with locoregional spread, infiltrating the rectum. Bladder involvement and distant metastases were not evident. External beam radiotherapy achieved good local control. At 3 months of follow-up, the patient was free of urinary symptoms and his rectal ulcer had healed. The patient declined subsequent treatment.

Reninoma treated with nephron-sparing surgery.

A 14-year-old hypertensive boy was evaluated in our clinic. The physical examination was essentially normal except for his high blood pressure. Laboratory findings showed increased plasma renin activity. Abdominal ultrasonography detected a hypoechoic, 2-cm mass in right kidney. Contrast-enhanced computed tomography of the abdomen revealed a well-circumscribed, solid, hypoenhancing cortical lesion in the middle of the right kidney. Magnetic resonance angiography documented bilateral normal renal arteries. With a preoperative diagnosis of reninoma, the patient underwent nephron-sparing surgery. Intraoperative frozen section analysis revealed a benign lesion. Subsequently, histopathologic examination and electron microscopy confirmed the diagnosis of juxtaglomerular cell tumor. The patient remained normotensive in the postoperative period. Follow-up intravenous urography showed bilateral normally functioning kidneys.

Monitoring of irrigation fluid absorption during percutaneous nephrolithotripsy: the use of 1% ethanol as a marker.

This study was performed in 32 ASA I patients undergoing percutaneous nephrolithotripsy under general anaesthesia, using absorption of 1% ethanol as a marker to monitor irrigation fluid absorption. Various parameters of fluid absorption were studied and compared, including irrigation fluid volume, irrigation time, total volume of irrigation fluid absorbed and the rate of irrigation. The amount of irrigant used vs. the volume absorbed and the volume absorbed vs. total irrigation time were observed. Fluid absorption occurred in 78% of patients, and 28% absorbed volumes in excess of 1 l. The mean volume of fluid absorbed was 696.7 ml. The maximum fluid absorption was observed when the irrigation fluid volume, total irrigation time and irrigation rate exceeded 10 l, 30 min and 200 ml.min(-1), respectively. In conclusion, this study has shown 1% ethanol to be a safe, simple and cost-effective marker of fluid absorption during percutaneous nephrolithotripsy associated with minimal adverse effects.

Management of colonic perforation during percutaneous nephrolithotomy in horseshoe kidney.

Few cases of colonic injury during percutaneous nephrolithotomy (PCNL) have been reported in orthotopic kidneys and none in horseshoe kidney, and the management protocol has not been standardized. A plain film on postoperative day 1 following PCNL showed contrast medium in the descending colon, leading to the diagnosis of colonic injury in a 53-year-old male patient with horseshoe kidney and multiple bilateral stones. He was asymptomatic and was treated successfully by minimally invasive techniques. An asymptomatic patient with a colonic injury following PCNL can be treated by minimal manipulations. Computed tomography imaging is necessary prior to percutaneous surgery on a horseshoe kidney.

Prevalence of enuresis and other bladder symptoms in patients with active Graves' disease.

OBJECTIVE: To determine the prevalence of bladder symptoms in patients with Graves' disease and assess their abnormalities on urodynamic studies. PATIENTS AND METHODS: The study comprised 30 consecutive patients (13 female, 17 male, mean age 31 years, SD 10) with active Graves' disease. Before and after attaining euthyroidism with carbimazole, their bladder symptoms were assessed using a questionnaire adapted from the American Urologic Association voiding symptom score, the serum levels of total triiodo-L-thyronine (T3), serum thyroxine (T4) and thyroid-stimulating hormone (TSH) were measured by radioimmunoassay, and uroflowmetry, cystometry and perineal muscle electromyography were performed. RESULTS: Twelve of the 30 patients (40%) had the onset of bladder symptoms 1-6 months after the onset of symptoms of Graves' disease; four of the 12 patients had enuresis. Urodynamic studies were possible in five patients and showed reduced flow rates in all, a significant post-void residual volume in four, and enlarged bladder capacity and increased perineal muscle electromyographic activity during the voiding phase in three. Voiding disturbances and urodynamic abnormalities resolved after attaining euthyroidism. CONCLUSION: Significant bladder symptoms can occur in about 40% of patients with active Graves' disease but resolve on euthyroidism; in some patients, urodynamic studies show significant abnormalities which are also reversible.

Polyarteritis nodosa presenting as perirenal hemorrhage.

Though renal involvement with microaneurysm formation is common in polyarteritis nodosa (PAN), spontaneous perirenal hematoma (SPH) is rare. We report a patient in whom SPH was the presenting manifestation of PAN. SPH is a potential life-threatening complication of PAN and its early recognition is emphasized.

How safe is 1% alum irrigation in controlling intractable vesical hemorrhage?

A prospective study was done to evaluate the efficacy and safety of intravesical instillation of 1% alum solution in 12 cases of hematuria of vesical origin, uncontrolled by saline irrigation for 24 hours via a 3-way Foley catheter. There were 10 cases of transitional cell carcinoma and 2 of radiation cystitis. Complete response was noted in 6 patients and a partial response in 4. Local side effects included suprapubic pain and vesical tenesmus, which were controlled by antispasmodic and/or analgesic drugs. Transient low grade pyrexia (maximum up to 38.2C) was noted in 4 patients. Among the other various clinical and biochemical parameters, serum aluminum level and prothrombin time showed statistically highly significant changes. Serum aluminum increased from an average baseline value of 1.68 to 3.36 mumol./l. without clinical evidence of aluminum toxicity and with levels well below the recommended safe limit. Prothrombin time increased parallel with the increase in serum aluminum level to a maximum of 1 1/2 times the control. Prothrombin values, therefore, can be used clinically, since they are readily obtainable whereas serum aluminum levels are not. Vesical irrigation with 1% alum solution is a safe method to control hematuria of vesical origin in properly selected cases.

Massive prolapsing orthotopic ureterocele.

A ureterocele may prolapse through the external urethral meatus and present as an interlabial mass. We report a case of a prolapsing ureterocele measuring 10 cm in diameter.

Case report: traumatic loss of the entire urethra and bladder neck in a girl--reconstruction by modified Flocks bladder tube.

Complete loss of the urethra and bladder neck secondary to pelvic fracture in a female patient is rare. We report a case of pelvic fracture resulting from a traffic collision leading to complete loss of the urethra including the bladder neck in an adolescent girl. A new urethra was reconstructed from a modified Flocks bladder tube and wrapped with omentum. At 2 years follow-up, the patient is fully continent and voiding satisfactorily. The problems of female urethral reconstruction are discussed.

Coexisting renal cell carcinoma and xanthogranulomatous pyelonephritis in a chronic calculous disease.

Association of renal cell carcinoma (RCC) with renal calculi is very rare. Herein we report a case of RCC developing in a non-functioning kidney containing multiple renal and ureteric calculi. Histologically, the kidney, in addition, revealed changes of xanthogranulomatous pyelonephritis (XGP). XGP can be confused clinically, grossly and microscopically with RCC. In the present case both were coexistent and thus make it interesting.

Urethrorectal fistulas complicated by posterior urethral stricture: an appraisal of management by transpubic approach.

Seven cases of difficult urethrorectal fistulas complicated by posterior urethral stricture following accidental trauma were repaired successfully by a transpubic approach. This method makes urethroplasty of complex posterior urethral stricture, closure of urethrorectal fistulas and an omental interposition possible. This approach was considered after a review of all techniques described to treat the urethrorectal fistulas.

Fine-needle aspiration cytology in azoospermic males.

Bilateral testicular fine-needle aspiration cytology (FNAC) was performed in 100 males, including 10 controls with normal fertility and 90 infertile azoospermic males. The various seminiferous tubular cells were easily identified in smears. It was possible to give a cytological diagnosis in histologic terms by analysis of the combinations of various cell types. The cytohistologic correlation in 25 cases was nearly 100%. FNAC is particularly useful in cases of obstructive azoospermia, where mature spermatozoa are seen in smears.

Ureterovaginal fistula: summary of 18 years' experience.

Ureterovaginal fistula is an uncommon complication of pelvic operations. We report 31 such cases seen over an 18-year period, all of which followed surgery for benign gynaecological conditions. Most patients had no urinary symptoms until the sudden onset of incontinence 1 to 4 weeks post-operatively. Diagnosis was established by a combination of intravenous urography, cystography, cystoscopy, retrograde ureteropyelography and dye studies. Twenty-nine patients underwent ureteroneocystostomy, 10 with a Boari flap and 19 by a direct method; fistulas healed in 2 patients following conservative treatment. Renal salvage was achieved in all cases.

The use of percutaneous diversion during pregnancy.

Two patients with infected hydronephrosis and one patient with calculus anuria during pregnancy were managed initially by percutaneous nephrostomy. Maintenance of percutaneous diversion allowed continuation of pregnancy to term and effectively preserved renal function. Definite surgical treatment for the obstructive pathology was done electively in the postpartum period.