Sulfur ion-exchange strategy to obtain Bi2S3 nanostructures from Bi2O3 for better water splitting performance.

A two-step simple and efficient ion-exchange chemical strategy is proposed to obtain nanostructured Bi2S3 electrodes of different surface morphologies from the Bi2O3. In the first step, nanoplates of the Bi2O3 are obtained on nickel-foam using successive ionic layer adsorption and reaction method at room-temperature (25 °C). In the second phase, as-obtained nanoplates of the Bi2O3 are transferred to the Bi2S3 using four autoclaves containing different sulfur precursor solutions at 120 °C for 8 h for phase change, structural conversion and surface morphological modification (i.e., walnuts, network-type, nanowires, and nanoflowers). Due to higher surface area and conductivity, lower charge transfer resistance, and reduced band gap caused by ionic and phase conversion, the Bi2S3 surpasses the Bi2O3 in hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) activities. The overpotential of 112-370 mV for the Bi2S3 network is much lower than that of the nanoplates of the Bi2O3 (275-543 mV), and walnuts (134-464 mV), nanowires (125-500 mV), and nanoflowers (194-520 mV) of the Bi2S3. The Bi2S3 network-type Bi2S3 electrode shows considerable chemical stability through cycling measurement, suggesting the importance of the present study in obtaining metal sulfides from metal oxide with better water splitting activities.

Emerging autophagic endo-lysosomal targets in the management of Parkinson's disease.

Synucleopathies, specifically Parkinson's disease, are still incurable and available therapeutic options are scarce and symptomatic. The autophagy-lysosomal-endosomal system is an indigenous mechanism to manage the proteome. Excess/misfolded protein accumulation activates this system, which degrades the undesired proteins via lysosomes. Cells also eliminate these proteins by releasing them into the extracellular space via exosomes. However, the sutophagy-lysosomal-endosomal system becomes unfunctional in Parkinson's disease and there is accumulation and spread of pathogenic alpha-synuclein. Neuronal degeneration results Owing to pathogenic alpha-synuclein. Thus, the autophagy-lysosomal-endosomal system could be a promising target for neuroprotection. In the present review, we discuss the autophagy-lysosomal-endosomal system as an emerging target for the management of Parkinson's disease. Modulation of these targets associated with the autophagy-lysosomal-endosomal system can aid in clearing pathogenic alpha-synuclein and prevent the degeneration of neurons.

Tungsten oxides: green and sustainable heterogeneous nanocatalysts for the synthesis of bioactive heterocyclic compounds.

Tungsten oxide (WO3) as an efficient heterogeneous catalyst was prepared via a simple hydrothermal route for the synthesis of a wide range of bioactive heterocyclic compounds. The present investigation deals with the rapid and low-cost synthesis of C-3-alkylated 4-hydroxycoumarin, chromene, and xanthene derivatives. WO3 nanorods (NRs) are successfully envisaged to catalyze desired transformations, demonstrating the wide range of their potential applications in catalysis. Synthetic transformation details, smallest catalytic amounts, excellent product yields, and plausible reaction mechanisms for the formation of these heterocyclic scaffolds are elicidated. As-prepared WO3 NRs are characterized to confirm their structural, chemical, and morphological parameters by X-ray diffraction, X-ray photoelectron spectroscopy, and field emission scanning electron microscopy measurements, respectively. We discuss the factors that govern the formation of products, and the active role of WO3 NRs, which are essential for the activation of substrates in the present study of thermal conditions. Herein, detailed synthesis and spectroscopic information of the prepared compounds are reported.

Phase controlled synthesis of bifunctional TiO2 nanocrystallites viad-mannitol for dye-sensitized solar cells and heterogeneous catalysis.

The crystal architecture of TiO2 was successfully tailored via a low-temperature (≤200 °C) hydrothermal process in the presence of d-mannitol for feasible applications in dye-sensitized solar cells (DSSCs) and heterogeneous catalysis. In the development of anatase-TiO2 (A-TiO2), d-mannitol does not merely acts as a complexing agent to manage the zigzag chains of octahedral TiO6 2- with dominant edge sharing but also performs as a capping agent by influencing the hydrolysis process during nucleation, as confirmed by Fourier-transform infrared spectroscopy and dynamic light scattering studies. After physical measurements, the as-synthesized nanocrystallites (NCs) of A-TiO2 were used in DSSCs, where a fascinating power conversion efficiency (PCE) of 6.0% was obtained, which showed excellent performance compared with commercial anatase-TiO2 (CA-TiO2: 5.7%) and rutile-TiO2 (R-TiO2) obtained without d-mannitol (3.7%). Moreover, a smart approach was developed via the A-TiO2 catalyst to synthesize pharmaceutically important C-3 alkylated 4-hydroxycoumarins through different activated secondary alcohols under solvent-free, and heat/visible light conditions. In addition, the catalytic activity of the so-produced A-TiO2 catalyst under solvent-free conditions exhibited remarkable recyclability with up to five consecutive runs with negligible reduction, which is superior to existing reports, and clearly reveals the novelty, and green, sustainable nature of the as-synthesized A-TiO2 catalyst. A plausible reaction mechanism of both coupling partners was activated through the interaction with the A-TiO2 catalyst to produce valuable C-3 alkylated 4-hydroxycoumarins with 95% yield and high selectivity.

Metal-free heterogeneous and mesoporous biogenic graphene-oxide nanoparticle-catalyzed synthesis of bioactive benzylpyrazolyl coumarin derivatives.

We report the preparation of graphene oxide nanoparticles (GONPs), a metal-free, heterogeneous, non-toxic, reusable and mesoporous green-(acid)-catalyst obtained by sugar carbonization through a micro-wave chemical synthesis method for the synthesis of bio-active benzylpyrazolyl coumarin derivatives (BCDs) under thermal conditions (50 °C) in ethanol solvent. The obtained products were purified by re-crystallization from ethanol, assuring usability of GONPs in multicomponent reactions (MCRs) that could find wide application in the synthesis of a variety of biologically potent molecules of therapeutic significance.

Understanding administrative abdominal aortic aneurysm mortality data.

OBJECTIVE: Administrative data in the form of Hospital Episode Statistics (HES) and the Scottish Morbidity Record (SMR) have been used to describe surgical activity. These data have also been used to compare outcomes from different hospitals and regions, and to corroborate data submitted to national audits and registries. The aim of this observational study was to examine the completeness and accuracy of administrative data relating to abdominal aortic aneurysm (AAA) repair. METHODS: Administrative data (SMR-01 returns) from a single health board relating to AAA repair were requested (September 2007 to August 2012). A complete list of validated procedures; termed the reference data set was compiled from all available sources (clinical and administrative). For each patient episode electronic health records were scrutinised to confirm urgency of admission, diagnosis, and operative repair. The 30-day mortality was recorded. The reference data set was used to systematically validate the SMR-01 returns. RESULTS: The reference data set contained 608 verified procedures. SMR-01 returns identified 2433 episodes of care (1724 patients) in which a discharge diagnosis included AAA. This included 574 operative repairs. There were 34 missing cases (5.6%) from SMR-01 returns; nine of these patients died within 30 days of the index procedure. Omission of these cases made a statistically significant improvement to perceived 30-day mortality (p < .05, chi-square test). If inconsistent SMR-01 data (in terms of ICD-10 and OPCS-4 codes) were excluded only 81.9% of operative repairs were correctly identified and only 30.9% of deaths were captured. DISCUSSION: The SMR-01 returns contain multiple errors. There also appears to be a systematic bias that reduces apparent 30-day mortality. Using these data alone to describe or compare activity or outcomes must be done with caution.

Antibiotic prophylaxis is unnecessary in clean surgery.

A significant number of paediatric surgical patients undergone clean surgical procedures. Most of the paediatric surgeon use perioperative prophylactic antibiotic in this clean procedure because of undue fear of infection in their mind. The objective of this study is to evaluate whether the use of perioperative prophylactic antibiotics have an effect to prevent post operative wound infection in clean operation in paediatric surgical patients. This study was conducted in the paediatric surgery department of Bangabandhu Sheikh Mujib Medical University and some private clinics of Dhaka city from January 2009 to December 2009. Two hundred patients who were undergone clean elective surgical procedure on day case basis were included in this study. They were divided into two equal groups (Group A and Group B). The patients of Group A were given intransverse Cephradine 30 minutes before incision and then oral Cephradine was advised postoperatively for 7 days. The patients of Group B were not given any perioperative antibiotic. All the patients of both groups were advised to come on 3rd, 6th and 10th postoperative day for examination of wound. In Group A (With chemo prophylaxis), five patients (5%) developed postoperative wound infection and in Group B (without chemo prophylaxis), three patients (3%) developed postoperative wound infection. Thus the rate of postoperative wound infection is slightly more in patients with chemo prophylaxis but it was not statistically significant by chi-square test. Based on the result of this study, it may be concluded that the antibiotic prophylaxis is not necessary in clean surgery in paediatric age group.

Platelets and atherothrombosis: causes, targets and treatments for thrombosis.

Arterial thrombosis is the acute complication that develops on the chronic lesions of atherosclerosis and reasons heart attack and stroke, today the most common causes of mortality in developed countries. According to the WHO, 17.1 million people died world wide of cardiovascular diseases (CVD), per year, accounting for one-third of all deaths globally. On the basis of current estimates from the American Heart Association, more than 60 million people in the United States alone have one or more forms of cardiovascular disease, and a high proportion of these individuals are at increased risk of arterial thrombosis. The involvement of platelets in atherogenesis and the subsequent formation of occlusive thrombi depend on platelets' adhesive properties and the ability to respond to stimuli with rapid activation. By understanding the multifaceted mechanisms involved in platelet interactions with vascular surfaces and aggregation, new approaches can be tailored to selectively inhibit the pathways most relevant to the pathological aspects of atherothrombosis. The present review aims to describe the haemostasis phenomenon along with the centrality of the platelet in atherothrombosis, and briefly looks at the efficacy of reported antiplatelet agents.

Congenital bladder diverticulum causing acute urinary retention in an infant.

Congenital bladder diverticula (CBD) are unusual but not rare in childhood. Report of acute urinary retention due to congenital bladder diverticula are rarely found in the literature. Here we report a case of congenital bladder diverticulum with acute urinary retention in a ten months old male infant. Urinary tract infection and urinary retention are the most frequent presentation forms. In this case CBD produce urinary obstruction as a result of compression of the urethra which causes urinary retention. Voiding cystourethrogram revealed a large bladder diverticulum. Bladder diverticulum should be a differential diagnosis in male children, presenting with urinary retention, fever and an abdominal mass. Ultrasonography, voiding cystourethrogram & cystoscopy confirm the diagnosis and diverticulectomy was successfully done for the child.

Melanotic neuroectodermal tumour of infancy.

Melanotic neuroectodermal tumour in infancy is rare, mainly benign with little tendency to recur after excision or effective curettage. This pigmented neoplasm of neural crest origin occurring in infants before 1 year of age. The most common site of occurrence is the anterior maxillary alveolar ridge (70%), following by the skull, brain and mandible. The genital organ is the most frequent extra cranial site. We report a 6 months old male baby with a similar tumour arising from right half of cheek involving the maxilla. We diagnosed the case after histological report. We remove the tumour through a sub-labial incision. The mass was blackish in colour, and was mobilized from all side including from the maxillary sinuses. The author thought that this should be reported for improving the clinical awareness and treatment of pigmented soft tissue mass in children. Almost one year follow up of the patients showed no recurrence.

Outcome of adult acute lymphoblastic leukemia: a single center experience.

OBJECTIVE: To study the outcomes of adult patients with acute lymphoblastic leukemia. SETTING: Tertiary care hospital. STUDY DESIGN: Retrospective analysis. METHODS: Fifty eight adult patients (age >14 years) diagnosed as cases of acute lymphoblastic leukemia were studied with respect to their clinical, morphological and immunopathological features at presentation and their relationship with treatment outcomes. RESULTS: Forty five (77.5%) of the patients belonged to younger age group with male preponderance. The median age was 20 years and mean age was 25.1 years. Male to female ratio was 3:1. Common presenting signs were lymphadenopathy (17.2%), hepatomegaly (32.7%) and splenomegaly (62%). Laboratory features at presentation revealed: hemoglobin > or = 10 gm/dl in 18 (31%), WBC >50 x 10E9 / L in 18 (31%), LDH more than 1000 IU/L in 44 (75.8%) of patients. Morphology revealed that FAB L1 was seen in 21(37.2%) and L2 in 62 (32.7%). Immunophenotyping showed that 26 (61.9%) were early pre-B ALL, 6 (14.2%) were pre-B ALL and T-ALL were 10 (23.8%). Univariate analysis showed age more than 30 years, male gender, total leucocyte count >50 x 10(9)/L and hemoglobin more than 10 gm/dl to be risk factors for poor outcome. Multivariate analysis revealed age more than 30 years, male sex and total leucocyte count > 50 x 10(9)/L are independent risk factors for poor survival. Patients were treated according to the MRCUKX and XII adult protocols. Thirteen (22.4%) patients died during induction therapy secondary to sepsis and progressive disease whereas 42 (72.4%) patients achieved complete remission. Median survival was 18.6 months and 42% patients were alive at 5-years. CONCLUSION: Overall survival and disease free survival were comparable to those reported in literature. However, age more than 30 years, male gender and total leucocyte count >50 x 10(9)/L had an adverse impact on overall survival.

A retrospective study on genito urinary Rhabdomyosarcoma.

A retrospective study was carried out on Genitourinary Rhabdomyosarcoma in the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period January 1990 to December 1999. Total thirteen patients were treated during this period, age ranging from 1 month to 12 years. Eight patients were male and five were female (M: F = 1.6: 1). Diagnosis was made by history, thorough physical examination, digital rectal examination, ultrasonography, intravenous urography, CT scan and biopsy. All the patients were treated with chemoradiation theraphy as a first line of management and surgical excision was done for local residual tumours. Eight children (61.5%) were asymptomatic after completion of chemo-radiation therapy. Three (23.07%) patients discontinued the chemo-radiation schedule. Residual mass was present in one (7.7%) case for which partial cystectomy was done and the patient died in the 5th post operative day. Another patient (7.7%) who had pulmonary metastasis at the time of diagnosis, died during chemo-radiation therapy.

Male breast cancer.

OBJECTIVE: To review cases of male breast cancer. SETTINGS: Histopathology Section, Department of Pathology, The Aga Khan University, Karachi. METHOD: Fifty one cases of male breast cancer specimens, received during a period of 10 years, routinely processed and stained with Haematoxylin and Eosin were analyzed. Special stains and Immunohistochemistry were used in difficult cases. RESULTS: Male breast cancer affected individuals in the sixth and seventh decades of life with a mean age of 56.2 years. Infiltrating ductal carcinoma (IDC) was the predominant type. Skin involvement was seen in 27.45% of the cases. Breast lump was the most common presenting symptom followed by skin ulceration. At the time of presentation 43.13% patients had a tumour size of more than 3 cm. CONCLUSION: Male breast cancer is a rare disease. Most of our findings correspond to the published local and international data.

Anticataract activity of Kohl-Chikni Dawa--a compound ophthalmic formulation of Unani medicine in alloxan-diabetic rats.

Kohl-Chikni Dawa (KCD), a compound ophthalmic formulation of Unani medicine was studied for anticataract activity in alloxan-diabetic rats. When one drop of 3% KCD solution was applied (once and twice daily) in both eyes for 90 days in alloxan-diabetic rats, a significant reduction of lens opacification was noticed. On the other hand, local application of 3% KCD solution (once and twice daily) did not reduce the blood sugar concentration in normal and alloxan-diabetic rats. Blood sugar in all the rats was estimated by glucometer and the morphological changes of the lenses were examined by slit-lamp biomicroscope before and after therapy at various time intervals for 90 days. These results suggest that the local application of 3% KCD solution possesses anticataract effect in alloxan-induced hyperglycaemic rats.

Comparative double-blind randomized placebo-controlled clinical trial of a herbal eye drop formulation (Qatoor Ramad) of Unani medicine in conjunctivitis.

Qatoor Ramad (QR) is an ophthalmic formulation of Unani medicine. It is reputed for its beneficial effects in the treatment of the inflammatory conditions of the eyes. The effect of QR eye drops was studied by a double-blind, randomized, prospective, placebo-controlled clinical trial, conducted in 70 patients (20-60 yrs) suffering from different types of conjunctivitis, namely mucopurulent, phlyctenular and allergic conjunctivitis. Local application of two drops (3-4 times/day) of QR was applied to the affected eyes for up to 14 days. Patients were examined at the time of diagnosis and after 2, 7 and 14 days. Clinical efficacy was measured as the cumulative sum score of several signs and symptoms of different types of conjunctivitis. Side effects, if any, were also noted during the study. In mucopurulent conjunctivitis QR showed excellent results. In the few cases of phlyctenular and allergic conjunctivitis it controlled the deterioration and seems to help in improvement. There were no side effects observed during the course of the study and the eye drop was well tolerated by the patients. It is considered to be a useful drug in all conditions studied.

Clinical, pathological and molecular factors predicting axillary node involvement in primary breast cancer in Pakistani women.

BACKGROUND: Axillary lymph node involvement in primary breast cancer is one of its most important prognostic features. Thus any factors that may predict axillary lymph node involvement in this setting could be potentially helpful in treatment planning and other interventions. OBJECTIVE: The objective of this study was to evaluate clinical, pathological and immuno-histochemical markers in univariate and multivariate analysis, which may be helpful predictors of axillary lymph node involvement in breast cancer. METHOD: A retrospective analysis of 555 cases. Of these 58% had axillary nodal positivity and 42% were negative. CONCLUSION: Factors of no significance included patient's age, height, weight, age of first pregnancy, parity, marital status, menopausal status, family history of breast cancer, side of tumor. In univariate analysis the age of menarche, duration of symptoms, tumor size, site in outer quadrant, S phase and skin and nipple involvement all predicted axillary nodal involvement. The length of breast-feeding, increased intraductal component and increased PCNA were inversely proportional to nodal involvement. In multiple regression analysis however only size of the tumor, involvement of the skin and nipple and disease in the outer quadrant of breast were the factors, which assumed significance.

Lack of benefit of granulocyte macrophage or granulocyte colony stimulating factor in patients with febrile neutropenia.

OBJECTIVES: To compare the clinical benefits of granulocyte-colony stimulating factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF) plus standard supportive care to supportive care alone among cancer patients with febrile neutropenia. METHODS: Clinical data were collected retrospectively from 148 consecutive cancer patients with neutropenia and fever. Patients had hematologic (i.e., acute leukemias or lymphoproliferative disorders) or non-hematologic malignancies (i.e., solid tumors including carcinoma of breast, lung, or colon). Clinical variables analyzed included: age and sex; underlying malignancies; chemotherapy regimens; symptoms at time of presentation; duration of fever prior to study enrollment; days from chemotherapy until administration of GM-CSF or G-CSF; number of previous neutropenic episodes; duration of fever and day of defervescence; absolute neutrophil count on day of defervescence; duration of neutropenia; number and types of antibiotics used; day amphotericin B begun; number of culture-documented infective episodes involving bloodstream, lung, pleura, urinary tract, gastrointestinal tract, intravenous cannulae, or skin; types of antimicrobial isolates; cost of cytokine therapy; length of hospital stay and clinical outcome. RESULTS: The use of myeloid growth factors increased the number of circulating peripheral white blood cells, but no significant effect was noted in terms of duration of neutropenia or fever, number of culture-proven infections (except pneumonia; p < 0.04), length of hospital stay, or survival. CONCLUSION: In areas with limited health care resources, expensive treatment with GM-CSF or G-CSF should be reserved for patients with complicated febrile neutropenia where the expected risk of infection is high and the duration of neutropenia is prolonged, or those with documented infections that are refractory to antibiotic treatment.

Nitric oxide inhibitors ameliorate indomethacin-induced enteropathy in rats.

The role of nitric oxide (NO) synthase inhibitors in indomethacin (INDO) -induced enteropathy was investigated in male Sprague-Dawley rats. Rats were subcutaneously administered 5% sodium bicarbonate (controls), two doses of INDO 7.5 mg/kg, and three different inducible NO synthase (iNOS) inhibitors at various concentrations 24 hr, apart; aminoguanidine (AG), guanidinoethyldisulfide (GED), and n-(3-aminomethyl)benzylacetamidine (1400W). Rats were killed four days after the initial injection and small intestinal mucosa was assayed for myeloperoxidase (MPO) activity and iNOS expression by western blot analysis. Serum nitrite/nitrate (NOx) concentration was measured colorimetrically. INDO produced acute ulcers along the mesenteric border from the ileum to proximal jejunum. Rats treated with AG (25 and 50 mg/kg), GED (2.5 mg/kg), and 1400W (0.1 mg/kg) showed decreased total ulcer length and MPO activity by 51, 72, 53, and 61% and by 58, 88, 68, and 70%, respectively, compared to INDO alone. All inhibitors similarly reduced INDO-enhanced serum NOx concentrations to its basal levels. Significant iNOS expression was detected in INDO-treated rats, but the inhibitors did not alter iNOS expression. Our data suggest that NO derived from iNOS may be a key factor in the pathogenesis of acute INDO-induced enteropathy in rats.

Radiological features of hepatocellular carcinoma in Southern Pakistan.

We describe the radiological features of 201 patients diagnosed as having hepatocellular carcinoma (HCC) in Southern Pakistan. The cases of biopsy-proven HCC were analysed retrospectively for years 1994-1998. Age, sex, underlying cirrhosis, hepatitis markers, and radiological description were recorded. The mean age was 56 years. There were 149 males and 52 females. 82% patients had underlying cirrhosis. The tumour size was measured in at least two dimensions, and the maximum mean tumour size at the time of diagnosis was 8.3 +/- 4.0 cm. Of the tumours 79.5% were more than 5 cm; 56% of primary HCC were multifocal; 51% involved the right lobe only; 15% involved the left lobe; 34% involved both lobes of liver. Portal vein thrombosis was detectable in 17%. There were no significant differences in the radiological patterns amongst patients who had hepatitis B virus related and hepatitis C virus-related HCC except for age.