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A straightforward method for producing pyrrolo‐chromenes involved the utilization of a Wittig reaction, where maleimides reacted with ortho‐hydroxy benzaldehyde. This reaction yields ortho‐hydroxy benzylidine succinimides, which subsequently undergo molecular bromine‐induced intramolecular cyclization, resulting in (E)‐3‐(substituted benzylidine)‐1‐(substituted phenyl) pyrrolidine‐2,5‐dione derivatives (6g‐n). The traditional reaction methods demonstrates efficient performance when carried out in a DMF solvent. This approach proves to be user‐friendly and provides numerous benefits, including reduced reaction duration, increased product yields, and milder operating conditions. The compounds synthesized in this study will be integrated into our biological screening program and any discoveries pertaining to their biological properties will be further investigated and subsequently documented. [ABSTRACT FROM AUTHOR]

Objectives: The current study work was aimed to improve the solubility of Apixaban by forming co-crystals. Materials and Methods: Two solvents mainly Dimethyl Sulphoxide (DMSO) and 2,2,2-trifluoroethanol were tried during the formulation of co-crystals. The other chemicals oxalic acid, adipic acid and L-Tartaric acid were used. Results: From the different trials it was concluded that oxalic acid and DMSO combination with the drug gave the better results for improvement in the solubility. Hence the batch F3 was analysed further. The melting point of F3 was found lower than pure drug. Drug content was found optimum as 95.06 ±0.65%. FTIR-spectra demonstrated the combined peaks of drug and oxalic acid. DSC thermogram showed the sharp endothermic peak similar to pure drug. SEM and XRD spectra confirmed the formation of co-crystals. Conclusion: It was found that formation of co-crystals of apixaban and oxalic acid was satisfactory and it was beneficial to improve the solubility of the apixaban. [ABSTRACT FROM AUTHOR]

Background: Large right adrenal tumours may invade the liver and mimic primary hepatic malignancy, presenting diagnostic and management challenges. The 'anterior approach hepatectomy' (AAH) using hanging manoeuvre may be safe for resection of such tumours. Methods: Prospectively maintained database was analysed to identify the large tumours of adreno‐hepatic region subjected to hepatectomy. Clinico‐biochemical, radiological and surgical details were reviewed. AAH and hanging manoeuvre was adopted for the patients requiring right hepatectomy. Results: Out of the eight patients with adreno‐hepatic tumour, four had indeterminate origin of the mass, two had complex cysts, and two were diagnosed as hepatocellular carcinoma on the pre‐operative imaging. The median age was 38 years (23–66); male:female ratio was 5:3. AAH was performed in four patients, while others underwent non‐anatomical resection of involved segment(s). This accounted for 1.01% of 789 hepatectomies performed during the study period. The median intra‐operative blood loss was 525 mL (150–2200 mL) and the median tumour size was 9 cm (6–17 cm). All patients underwent R0 resection. The final histopathological diagnoses were: three phaeochromocytomas (two malignant and one benign), two adrenocortical carcinomas, one malignant paraganglionomas and two adrenal cysts. Major complication (grade IVa) was experienced in one patient. On median follow‐up of 67.5 months (7–84), all were alive and one patient had tumour recurrence. Conclusion: Adrenal tumours mimicking primary hepatic malignancy are rare but pose diagnostic challenges. The AAH is a safe approach with acceptable R0 resection, blood loss, surgical complications and overall outcome for the patients requiring right hepatectomy. [ABSTRACT FROM AUTHOR]

In the present investigation, a series of 3-aryl-4-methoxy N-alkyl maleimide 5a-l have been synthesized and screened for their antimicrobial activity against one Gram positive bacteria (S. aureus), one Gram negative bacteria (E. coli) and fungal strains (C. albicans, C. tropicalis, A. niger and A. clavatus). The structures of the compounds have been substantiated by their IR, NMR, mass and elemental analysis. The minimum inhibitory concentrations (MICs) of synthesized maleimides have been determined by broth microdilution method. Of the newly synthesized maleimides, compounds 5c, 5f, 5h, 5i, 5k and 5l registered significant activity against the tested microorganisms. [ABSTRACT FROM AUTHOR]

A series of 3-methoxy-4-phenyl-1-p-tolyl-1H-pyrrole-2,5-dione 5a-l were synthesized with almost 80 to 90% yield. All the maleimides were well characterised and screened against panel of four fungal strains and two bacterial strains. The structures of compounds were characterized by their IR, NMR, mass and elemental analysis. The minimum inhibitory concentrations (MICs) of synthesized maleimides were carried out by broth microdilution method. Out of tested maleimides, compounds 5f and 5j registered significant activity antibacterial activity. While rest of compounds showed moderate to marginal antimicrobial activity. [ABSTRACT FROM AUTHOR]

Background To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split. Methods We performed in situ splitting of the whole liver using LDLT techniques from a hemodynamically stable young deceased donor and transplanted into two adult recipients, both with model for end-stage liver disease score of 17. The transection was carried out through the midplane of liver, generating a right lobe and a left lobe graft. Results Both the recipients had uneventful postoperative recovery. At ten months of follow up, both the recipients are doing well with good liver function. Conclusion Based on the concept of living related liver transplantation, our case explores the technical feasibility of full-right and full-left in situ liver split. [ABSTRACT FROM AUTHOR]

Since 1984 the diagnosis of ankylosing spondylitis (AS) has been based upon the modified New York (mNY) criteria with mandatory presence of radiographic sacroiliitis, without which the diagnosis is not tenable. However, it may take years or decades for radiographic sacroiliitis to develop delaying the diagnosis for long periods. It did not matter in the past because no effective treatment was available. However, with the availability of a highly effective treatment, namely, tumour necrosis factor-α inhibitors (TNFi), the issue of early diagnosis of AS acquired an urgency. The Assessment of SpondyloArthritis International Society (ASAS) classification criteria published in 2009 was a significant step towards this goal. These criteria described an early stage of the disease where sacroiliitis was demonstrable only on MRI but not on standard radiograph. Therefore, this stage of the disease was labelled “nonradiographic axial SpA” (nr-axSpA). But questions have been raised if, in search of early diagnosis, specificity was compromised. The Federal Drug Administration (FDA, USA) withheld approval for the use of TNFi in patients with nr-axSpA because of issues related to the specificity of these criteria. This review attempts to clarify some of these aspects of the nr-axSpA-AS relationship and also tries to answer the question whether ASAS classifiable radiographic axial spondyloarthritis (r-axSpA) term can be interchangeably used with the term AS. [ABSTRACT FROM AUTHOR]

An ideal definition of early allograft dysfunction (EAD) after live donor liver transplantation (LDLT) remains elusive. The aim of the present study was to compare the diagnostic accuracies of existing EAD definitions, identify the predictors of early graft loss due to EAD, and formulate a new definition, estimating EAD-related mortality in LDLT recipients. Consecutive adult patients undergoing elective LDLT were analyzed. Patients with technical (vascular, biliary) complications and biopsy-proven rejections were excluded. There were 19 deaths due to EAD of a total of 304 patients. On applying the existing definitions of EAD, we revealed their limitations of being either too broad with low specificity or too restrictive with low sensitivity in patients with LDLT. A new definition of EAD-LDLT (total bilirubin >10 mg/dL, international normalized ratio [INR] > 1.6 and serum urea >100 mg/dL, for five consecutive days after day 7) was derived after doing a multivariate analysis. In receiver operator characteristics analysis, an AUC for EAD-LDLT was 0.86. The calibration and internal cross-validation of the new model confirmed its predictability. The new model of EAD-LDLT, based on total bilirubin >10 mg/dL, INR >1.6 and serum urea >100 mg/dL, for five consecutive days after day 7, has a better predictive value for mortality due to EAD in LDLT recipients. [ABSTRACT FROM AUTHOR]