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Type 2 diabetes (T2D) is a growing problem in children. Children with NAFLD are at potentially high risk for developing T2D; however, the incidence of T2D in this population is unknown. This study aimed to determine the incidence of T2D in children with NAFLD and identify associated risk factors.Children with NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network were followed longitudinally. Incidence of T2D was determined by using clinical history and fasting laboratory values. Cumulative incidence curves were developed for time to T2D. A Cox regression multivariable model was constructed using best subsets Akaike's Information Criteria selection.This study included 892 children with NAFLD and with a mean age of 12.8 years (2.7) followed for 3.8 years (2.3) with a total 3234 person-years at risk. The incidence rate of T2D was 3000 new cases per 100,000 person-years at risk. At baseline, 63 children had T2D, and during follow-up, an additional 97 children developed incident T2D, resulting in a period prevalence of 16.8%. Incident T2D was significantly higher in females versus males (hazard ratio [HR], 1.8 [1.0-2.8]), associated with BMI z-score (HR, 1.8 [1.0-3.0]), and more severe liver histology including steatosis grade (HR, 1.3 [1.0-1.7]), and fibrosis stage (HR, 1.3 [1.0-1.5]).Children with NAFLD are at high risk for existing and incident T2D. In addition to known risk factors for T2D (female and BMI z-score), severity of liver histology at the time of NAFLD diagnosis was independently associated with T2D development. Targeted strategies to prevent T2D in children with NAFLD are needed.

Regional heart attack services have improved clinical outcomes following ST-segment elevation myocardial infarction (STEMI) by facilitating early reperfusion by primary percutaneous coronary intervention (PCI). Early discharge after primary PCI is welcomed by patients and increases efficiency of health care.This study aimed to assess the safety and feasibility of a novel early hospital discharge pathway for low-risk STEMI patients.Between March 2020 and June 2021, 600 patients who were deemed at low risk for early major adverse cardiovascular events (MACE) were selected for inclusion in the pathway and were successfully discharged in 48 hours. Patients were reviewed by a structured telephone follow-up at 48 hours after discharge by a cardiac rehabilitation nurse and underwent a virtual follow-up at 2, 6, and 8 weeks and at 3 months.The median length of hospital stay was 24.6 hours (interquartile range [IQR]: 22.7-30.0 hours) (prepathway median: 65.9 hours [IQR: 48.1-120.2 hours]). After discharge, all patients were contacted, with none lost to follow-up. During median follow-up of 271 days (IQR: 88-318 days), there were 2 deaths (0.33%), both caused by coronavirus disease 2019 (30 days after discharge), with 0% cardiovascular mortality and MACE rates of 1.2%. This finding compared favorably with a historical group of 700 patients meeting pathway criteria who remained in the hospital for48 hours (48-hour control group) (mortality, 0.7%; MACE, 1.9%) both in unadjusted and propensity-matched analyses.Selected low-risk patients can be discharged safely following successful primary PCI by using a pathway that is supported by a structured, multidisciplinary virtual follow-up schedule.

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease. Little is known about outcomes in recognized youth. METHODS: We compared paired liver biopsies from 122 of 139 children with NAFLD (74% male; 64% white; 71% Hispanic; mean age, 13 ± 3 years; age range, 8–17 years) who received placebo and standard of care lifestyle advice in 2 double-blind, randomized clinical trials within the nonalcoholic steatohepatitis (NASH) clinical research network from 2005 through 2015. We analyzed histologic changes with respect to baseline and longitudinal change in clinical variables using regression analysis. RESULTS: At enrollment, 31% of the children had definite NASH, 34% had borderline zone 1 NASH, 13% had borderline zone 3 NASH, and 21% had fatty liver but not NASH. Over a mean period of 1.6 ± 0.4 years, borderline or definite NASH resolved in 29% of the children, whereas 18% of the children with fatty liver or borderline NASH developed definite NASH. Fibrosis improved in 34% of the children but worsened in 23%. Any progression to definite NASH or in fibrosis occurred in 36% of the children, and both occurred in 11% of the children. Any improvement in NASH or fibrosis occurred in 52%, and both occurred in 20% of children. Type 2 diabetes developed in 5% of the cohort. Any progression to NASH and/or fibrosis was associated with adolescent age, higher waist circumference, levels of alanine or aspartate aminotransferase, total and low-density lipoprotein-cholesterol at baseline, increasing level of alanine aminotransferase, and hemoglobin A1C (P < .05). Progression to NASH and/or fibrosis were also associated with increasing level of gamma-glutamyl transferase and development of type 2 diabetes (P < .01). Increasing level of gamma-glutamyl transferase also associated with reduced odds of any improvement (P = .003). CONCLUSIONS: One-third of children with NAFLD enrolled in placebo groups of clinical trials had histologic features of progression within 2 years, in association with increasing obesity and serum levels of aminotransferases and loss of glucose homeostasis.

Hydrocarbon pollution due to activities of petroleum industry is a major problem worldwide especially in developing countries like India. Hydrocarbon utilizing bacterial consortium (HUBC) consisting of six (06) bacterial isolates viz. Ochrobactrum sp. (01), Stenotrophomonas maltophilia (02) and P. aeruginosa (03) isolated from crude oil polluted sites of ONGC fields of Gujarat, India. The isolates were identified by using VITEK®2 Compact and 16S rDNA gene sequencing. Scale up study of crude oil degradation (K#X, 3% v/v) by HUBC using Bushnell-Hass medium was performed under optimized growth conditions up to 75 days. Gravimetric and gas chromatographic analysis showed 83.70% and 83.49% (C8–C35) degradation, respectively. Presence of paraffins (C20–C40) in crude oil causes well clogging problem during exploration activities. The HUBC utilized paraffin content of crude oil and hence can be used to solve this problem. The findings of ex-situ bioaugmentation studies by halotolerant HUBC suggests its utility for effective in situ bioremediation of hydrocarbon contaminated sites as well as management of sea surface oil spills.

Two new Schiff base receptors 1 and 2 have been synthesized and characterized by FT-IR, HRMS and 1 H NMR spectroscopic techniques. Both the receptors show large fluorescence enhancement after addition of Al 3+ which is recognized by calorimetry. Furthermore, the stability constant and the detection limit of the receptor–Al 3+ complex were found to be 1.41 × 10 4 M −1 and 1.59 × 10 4 M −1 ; and 4.79 × 10 −8 M and 8.28 × 10 −8 M for receptors 1 and 2 respectively, concluded through the titration method. Not only this, the synthesized receptors work glowing in physiological pH range. Thus these receptors could be employed for the estimation of Al 3+ qualitative as well as quantitative.

A new azo compound, 1-(2-pyridylazo)-2-naphthol, has been prepared and characterized. The synthesized compound shows a very high affinity for aluminium. The complexation reaction of aluminium has been explored by Colorimetry, FT-IR, 1 H NMR, HRMS and fluorescence spectroscopy. The detection limit has been found to be 1.81 × 10 −8 M estimated by the titration method. The turn-on fluorescence behaviour of aluminium interaction with ligand has been found to be so fast (

The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver.

Simultaneous determination of ascorbic acid (AA) and caffeine (CAF) in pharmaceutical preparation is important and it has been achieved by square wave voltammetry (SWV) using a glassy carbon electrode (GCE) modified with multiwall carbon nanotubes (MWCNT). The oxidation of AA and CAF at MWCNT occurred at ∼−10 mV and ∼1103 mV at a much lower potential, than that observed (∼202 mV and ∼1402 mV) for their oxidation at bare GCE. The mechanistic study has shown that the equal number of electrons and protons are involved in the oxidation of drugs. The electrodes could be used for the determination of AA and CAF in a wide concentration range 10–500 μM, respectively, whereas the detection limit has been found to be 1.0 × 10 −2 μM and 3.52 × 10 −3 μM respectively. In view of high sensitivity for the detection of the drugs, the technique has been used for the reliable determination of AA and CAF in tea leaves, coffee, cold drink (mountain dew), pharmaceutical preparations and urine samples.

Four ligands (M 1 –M 4 ) have been synthesized and characterized by IR, 1 H NMR, spectroscopic investigations indicate good affinity of these ligands for fluoride anion. Different polyvinyl chloride (PVC) based membranes of ligands have been synthesized using different cationic excluders; CTAB, TDMAC, HTAB, ToMACI and plasticizers; DBBP, DBP, o -NPOE, CN, DOP, TEHB and investigated as F − selective sensors. The best performance is observed by the sensor with a membrane of composition (%, w/w) M 1 :PVC: o -NPOE:CTAB 3.5:30.0:63.0:3.5. The sensor generates linear potential response over a wide concentration range of 2.5 × 10 −7 to 1.0 × 10 −2 M with Nernstian slope (59.8 mV decade −1 of activity) over a pH range of 2.5–6.5 with a fast response time of ∼11 s. It shows good selectivity for fluoride anion (F − ) in preference to many anions. The sensor exhibits a shelf life of two and half months and could be successfully used for the comparative determination of fluoride in different Indian tea samples. The proposed method is faster, cheaper, and more accurate in comparison to already used methods.

OBJECTIVE:To determine the percentage of children with nonalcoholic fatty liver disease (NAFLD) in whom intervention for low-density lipoprotein cholesterol or triglycerides was indicated based on National Heart, Lung, and Blood Institute guidelines. STUDY DESIGN:This multicenter, longitudinal cohort study included children with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. Fasting lipid profiles were obtained at diagnosis. Standardized dietary recommendations were provided. After 1 year, lipid profiles were repeated and interpreted according to National Heart, Lung, and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction. Main outcomes were meeting criteria for clinically actionable dyslipidemia at baseline, and either achieving lipid goal at follow-up or meeting criteria for ongoing intervention. RESULTS:There were 585 participants, with a mean age of 12.8 years. The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention. Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications. CONCLUSIONS:More than one-half of children with NAFLD met intervention thresholds for dyslipidemia. Based on the burden of clinically relevant dyslipidemia, lipid screening in children with NAFLD is warranted. Clinicians caring for children with NAFLD should be familiar with lipid management.

A potentiometric aluminium sensor, based on the use N,N′-bis(salicylidene)-1,2-cyclohexanediamine (NBSC) as a neutral carrier, in poly(vinyl chloride) (PVC) matrix, is reported. Effect of various plasticizers; 2-nitrophenyloctylether (o-NPOE), tri-n-butyl phosphates (TBP), dioctylpththalate (DOP) & chloronapthalen (CN), and anion excluder, sodium tetraphenylborate (NaTPB) was studied. The best performance was obtained with a membrane composition of PVC: o-NPOE: NBSC: NaTPB ratio (w/w; mg) of 150:150:5:5. The sensor exhibits significantly enhanced selectivity toward Al3+ ions over the concentration range 1.0 × 10−8–1.0 × 10−1 M with a lower detection limit of 5.0 × 10−9 M and a Nernstian slope of 20.3 ± 0.1 mV decade−1 of activity. Influence of the membrane composition and possible interfering ions was investigated on the response properties of the electrode. Fast and stable response, good reproducibility and long-term stability are demonstrated. The sensor shows response time of

Two patients, aged 60 and 63 years, presented with a pseudoaneurysm of the ascending aorta arising from the cannulation site or suture line after previous cardiac surgery. Successful exclusion of the aneurysm was performed in both patients percutaneously using Amplatzer muscular ventricular septal defect occluders.

A bridge modified 4-tert-butylthiacalix[4]arene (I) has been employed as electroactive material in the preparation of cobalt selective sensor. Polyvinyl chloride (PVC)-based membranes of (I) using sodium tetraphenylborate (NaTPB) as anion discriminator and bis(2-ethylhexyl) sebacate (DOS), chloronaphthalene (CN), tri-n-butylphosphate (TBP), o-nitrophenyl octyl ether (NPOE), tris(2-ethylhexyl)phosphate (TEHP) as plasticizers were prepared and investigated as cobalt selective sensors. A number of membranes of different compositions were prepared and investigated. The best performance was observed with the membrane having composition of 2:66:1.5:127 (mg) = I:NaTPB:PVC:NPOE. The potential response of this membrane is linear to Co2+ ions in the concentration range 5.3 × 10−6 to 1.0 × 10−1 M with near-Nernstian slope of 30.0 mV/decade of activity and a detection limit of ∼0.3 ppm. This membrane also showed lowest response time of 10 s and works satisfactorily in partially non-aqueous medium. The selectivity studies of this sensor, evaluated with fixed interference method and matched potential method, show that the sensor under consideration possesses excellent selectivity for Co2+ over a large number of mono-, bi- and trivalent cations such as Na+, K+, Ag+, Ca2+, Mg2+, Cu2+, Hg2+, Pb2+, Li+, Ba2+, Zn2+, Sr2+, Cr3+, Ni2+, etc. The sensor could be used as an indicator electrode in the quantification of Co2+ by potentiometric titration against EDTA as well as in determination of cobalt content in wastewater and beer samples.

Cd 2+ -selective sensors have been fabricated from poly(vinyl chloride) (PVC) matrix membranes containing t -butyl thiacalix[4]arene (I) and thiacalix[4]arene (II) as electroactive materials. The addition of sodium tetraphenylborate and the plasticizer 2-nitrophenyl octyl ether has been found to improve the performance of the sensors substantially. The membranes of various compositions of the two thiacalixarenes have been investigated and it was found that the best performance was obtained for the membrane of composition II:PVC:NaTPB:NPOE in the ratio 5:120:3:150. The sensor shows a linear potential response for Cd 2+ over a wide activity range 3.2 × 10 −6 to 1.0 × 10 −1 M with Nernstian compliance (29.5 mV decade −1 of activity) in pH range 4.5–6.5 and a fast response time of ∼8 s. The potentiometric selectivity coefficient values determined by matched potential method indicate excellent selectivity for Cd 2+ ions over mono-, di- and trivalent interfering cations. The sensor exhibits adequate shelf life (∼3 months) with good reproducibility (S.D. ±0.2 mV) and can also be used in partially non-aqueous media having up to 20% (v/v) methanol, ethanol or acetone content with no significant change in the value of slope or working activity range. The sensor has been used in the potentiometric titration of Cd 2+ with EDTA. The sensor could be successfully used for the quantification of cadmium in river water samples.

PVC-based membranes of meso-tetrakis-{4-[tris-(4-allyl dimethylsilyl-phenyl)-silyl]-phenyl}porphyrin (I) and (sal)(2)trien (II) as electroactive material with dioctylphthalate (DOP), tri-n-butylphosphate (TBP), chloronapthalene (CN), dibutylphthalate (DBP) and dibutyl(butyl) phosphonate (DBBP) as plasticising solvent mediators have been found to act as Ni(2+) selective sensor. The best performance was obtained with the sensor having a membrane of composition of I: sodium tetraphenyl borate: PVC in the ratio 5:5:150. The sensor exhibits Nernstian response in the activity range 2.5x10(-6) to 1.0x10(-1)M, performs satisfactorily over wide pH range (2-5.5) with a fast response time ( approximately 8s). The sensor was found to work satisfactorily in partially non-aqueous media up to 20% (v/v) content of methanol or ethanol and acetone and could be used over a period of 4 months. Potentiometric selectivity coefficients determined by matched potential method (MPM) indicate excellent selectivity for Ni(2+) ions. The sensors could be used successfully in the estimation of nickel in different brand of chocolates and also as an indicator electrode in potentiometric titration.

The E-Five is a prospective, nonrandomized, multicenter global registry of patients receiving the Endeavor zotarolimus-eluting stent (ZES; Medtronic Vascular, Santa Rosa, CA) for the treatment of coronary artery stenosis. All consecutive procedures were included in the registry, without any specific anatomic or clinical exclusion criteria. Since October 2005, 8,318 patients have been enrolled in the E-Five Registry at 188 hospitals in Europe, South America, Australia, New Zealand, and Asia, and 10,343 lesions have been treated. The primary end point is the rate of major adverse cardiac events (MACE) at 1 year. Of the lesions treated, 60.3% were American College of Cardiology (ACC) and American Heart Association (AHA) type B2 or C lesions, and 16.5% were bifurcation stenoses. The average lesion length was 18.50 +/- 10.60 mm, and 50.6% of the lesions wereor =16 mm long. Clinical data have been analyzed for 1,989 of the patients (23.9%) receiving the Endeavor ZES in this registry, with 30-day clinical outcomes available for 1,985 of these 1,989 patients (99.8%). The acute procedure success rate in these patients was 98.6%, comparable with procedure success rates observed in previous Endeavor ZES clinical trials. The 30-day rate of MACE in these patients was just 1.7%, comparable with 30-day rates of MACE observed in previous ENDEAVOR clinical trials. In an early analysis of a subgroup of patients enrolled in the E-Five Registry, the Endeavor ZES demonstrated encouraging acute and 30-day outcomes in a real-world population of patients who underwent single-vessel or multivessel percutaneous coronary intervention.

A new poly(vinyl chloride) membrane sensor for Pb(II) ions based on N , N ′-dibenzyl-1,4,10,13-tetraoxa-7,16-diazacyclooctadecane ( I ) as an ionophore was prepared. The sensor exhibits a Nernstian response for lead ions over a wide concentration range of 8.2 × 10 −6 to 1.0 × 10 −1 M with a slope of 30.0 ± 0.1 mV/decade of activity. It has a fast response time of about 10 s and can be used for at least 3 months without any divergence in potential. The electrode can be used in the pH range 2.0–6.8. The proposed sensor shows fairly good discriminating ability towards lead ions in comparison with some alkali, alkaline earth, transition and heavy metal ions. It was successfully applied for the direct determination of Pb(II) ions in solution and as an indicator electrode in potentiometric titration of lead ions with EDTA.

Membranes of dicyclohexano-24-crown-8 ( I ) as an ion-selective compound in poly(vinyl chloride) (PVC) based matrix have been tried for cadmium(II)-selective sensors. The effect of anion excluder, sodiumtetraphenylborate (NaTPB) and plasticizers dibutylphthalate (DBP), dioctylphthalate (DOP), di(butyl)butylphosphonate (DBBP), 1-chloronaphthalene (CN), tri-butylphosphate (TBP) and tris-(2-ethyl hexyl)phosphate (TEHP) on the performance of the membrane sensor has also been studied. It was observed that the membrane having the composition I : NaTPB:DBBP:PVC in the ratio 10:1:100:100 exhibited the best performance with a wide working concentration range of 3.0 × 10 −5 to 1.0 × 10 −1 M, a Nernstian slope of 30.0 ± 1.0 mV/decade of activity, and with a response time of 23 s. It was found selective to cadmium ions over a number of mono-, bi- and trivalent cations. The sensor works satisfactorily in the pH range of 2.0–5.4 and can successfully determine cadmium ions in partially non-aqueous medium having up to 40% (v/v) non-aqueous content. The sensor could be used as an indicator electrode in the titration of Cd 2+ ions with EDTA.

Cu2+ selective sensors have been fabricated from polyvinyl chloride (PVC) matrix membranes containing neutral carrier porphyrin (A and B) ionophores. The addition of sodium tetraphenylborate and the plasticizer DOP has been found to substantially improve the performance of the sensors. The membranes of various compositions of the two porphyrins were investigated and it was found that the best performance was obtained for the membrane of composition B:PVC:NaTPB:DOP in the ratio 5:150:2:150. The sensor shows a linear potential response for Cu2+ over a wide concentration range 4.4 × 10−6 to 1.0 × 10−1 M with Nernstian compliance (29.3 mV decade−1 of activity) between pH 2.8 and 7.9 and a fast response time of ∼8 s. The potentiometric selectivity coefficient values as determined by fixed interference method indicate excellent selectivity for Cu2+ ions over interfering cations. The sensor exhibits adequate shelf life (∼4 months) with good reproducibility (standard deviation ± 0.2 mV). The sensor can also be used in partially non-aqueous media having up to 20% (v/v) methanol, ethanol or acetone content with no significant change in the value of slope or working concentration range. The sensor has been used in the potentiometric titration of Cu2+ with EDTA. The utility of the sensor has been tested by determining copper in vegetable foliar and swimming pool water sample successfully.

Two neutral ionophores, 2,12-dimethyl-7,17-diphenyltetrapyrazole ( I ) and 5,11-dibromo-25,27-dipropoxycalix[4]arene ( II ) have been explored for preparing PVC based membrane sensors selective to Pb 2+ . The addition of sodium tetraphenylborate and various plasticizers viz. DOS, TEHP, DBP, DOP and TBP has been found to substantially improve the performance (working concentration range, slope and response time) of the sensors. The best performance was obtained with the sensor having a membrane of composition (w/w) of ( I ) (1%):PVC (33%):TBP (65%):NaTPB (1%). The sensor exhibits Nernstian response in the concentration range 2.5 × 10 −6 to 5.0 × 10 −2 M Pb 2+ , performs satisfactorily over wide pH range (1.6–6.0) with a fast response time (∼10 s). The sensor was found to work satisfactorily in partially non-aqueous media up to 25% (v/v) content of acetone, methanol or ethanol and could be used over a period of 5 months. Potentiometric selectivity coefficients as determined by match potential method (MPM) indicate excellent selectivity for Pb 2+ ions. The sensors could be used successfully in the estimation of lead in Eveready battery waste and also as an indicator electrode in potentiometric titration.

Tri-o-thymotide (I) has been used as an electroactive material in PVC (poly(vinyl chloride)) matrix for fabrication of chromium(III)-selective sensor. The membrane containing tri-o-thymotide, sodium tetraphenyl borate (NaTPB), dibutyl phthalate (DBP) and PVC in the optimum ratio 5:1:75:100 (w/w) exhibits a working concentration range of 4.0 × 10−6 to 1.0 × 10−1 M with a Nernstian slope of 20.0 ± 0.1 mV/decade of activity in the pH range of 2.8–5.1. The detection limit of this sensor is 2.0 × 10−7 M. The electrode exhibits a fast response time of 15 s, shows good selectivity towards Cr3+ over a number of mono-, bi- and trivalent cations and can also be used in partially non-aqueous medium (up to 15%, v/v) also. The assembly has been successfully used as an indicator electrode in the potentiometric titration of chromium(III) against EDTA and also to determine Cr(III) quantitatively in electroplating industry waste samples.

A new polyvinylchloride-based membrane of rubeanic acid as an ion carrier was fabricated using oleic acid as lipophilic additive. The best performance was exhibited by the membrane having composition rubeanic acid:PVC:OA:o-NPOE as 5:180:18:208 (w/w). The sensor exhibited a Nernstian response for La3+ over a wide concentration range of 3.2 × 10−8 to 1.0 × 10−2 M with a detection limit of 2.5 × 10−8 M. It showed response time of less than 15 s and could be used for 5 months without any significant divergence. The proposed membrane sensor revealed good selectivity for La3+ over a wide variety of other metal ions and can be used in a pH range of 3.5–9.5 and in mixtures containing up to 30% (v/v) non-aqueous content. It was successfully used as an indicator electrode in the potentiometric titration of La(III) against EDTA.

Novel ionophore, C-thiophenecalix[4]resorcinarene ( I ) has been synthesized and characterized by IR, NMR and C, H, N analysis. Poly(vinyl chloride) (PVC) based membranes of ionophore ( I ) using dibutylphthalate (DBP), dioctylphthalate (DOP), 1-chloronapthalene (CN), tris(2-ethylhexyl) phosphate (TEHP) and bis(2-ethylhexyl)sebacate (DOS) as plasticizing solvent mediators were prepared and used as Cr O 4 2 − selective sensors. Of the various sensors prepared, the one with membrane composition 2:66:120 mg (I: PVC: DBP) exhibited the best performance. This sensor works well over a wide concentration range 5.6 × 10 −6 –1.0 × 10 −1 M (detection limit ∼ 0.30 ppm) with Nernstian compliance (29.0 mV per decade) between pH 6.5–10.0 with a fast response time of ∼13 s. The selectivity coefficient values as determined by fixed interference method (FIM) indicate excellent selectivity for Cr O 4 2 − ions over a large number of anions. The sensor exhibits adequate shelf-life ( ∼5 months) with good reproducibility (S.D. ± 0.2 mV). The sensor has been used in the potentiometric titration of chromate with Pb(II). Determination of chromium in electroplating waste using the sensor was successfully achieved.

Brush cytology, routinely performed at ERCP to assess malignant-appearing biliary strictures, is limited by relatively low sensitivity and negative predictive value. This study assessed whether the combination of stricture dilation, endoscopic needle aspiration, and biliary brushing improves diagnostic yield.In a prospective nonrandomized study, 46 consecutive patients were evaluated with malignant-appearing biliary strictures at ERCP. Twenty-four patients (Group A) underwent standard brush cytology alone and 22 patients (Group B) underwent stricture dilatation to 10F, endoscopic needle aspiration, and subsequent biliary brushing by using the Howell biliary system. The diagnostic yields for both techniques were compared.Of the 46 patients, 34 had proven malignant strictures (14 Group A, 20 Group B). Compared with brushing alone, the combination of stricture dilatation, endoscopic needle aspiration, and subsequent biliary brushing significantly increased both the sensitivity (57% vs. 85%, p0.02) and specificity (80% vs. 100%, p0.02) of cytology with positive brushings in all patients with pancreatic or gallbladder carcinoma.The combination of stricture dilation, endoscopic needle aspiration, and biliary brushing significantly improves diagnostic yield for malignant bile duct strictures and may particularly be of benefit for extrinsic strictures caused by pancreatic or gallbladder carcinoma.

Thalassaemic children being multi-transfused are at increased risk of parenterally transmissible hepatitis viruses and majority of them prone to develop chronic liver disease. The study is designed to find out the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) seromarkers and correlation of age, sex, number of transfusions and the viral aetiology in thalassaemics of central India. One hundred and four thalassaemic children were subjected to clinical, biochemical and serological analysis for the HBV, HCV and HDV viruses. The chi(2) test was applied to check the statistical significance of different variables. In the present study HBV markers were detected in 57 (56%) of the subjects while anti-HCV antibodies were observed in 21% of the patients. However, only four subjects were detected hepatitis B surface antigen (HBsAg) reactive but none of them were reactive for anti-HDV antibodies. Forty patients had raised alanine transaminase (ALT) levels and among them two were HBsAg reactive, 16 were anti-HBc antibody positive and 14 were anti-HCV reactive. The prevalence of hepatitis viruses and raised ALT levels are found to be significantly associated with the increasing age and number of blood units transfused to them. The present findings also document the excellent contribution of stringent screening of blood units and HBV vaccination programme for containing the HBV infection among thalassaemics.

The recently published universal definition of myocardial infarction (MI) reiterates the importance of troponins as a pivotal measure in the diagnosis of MI. This importance is based on the sensitivity and specificity of the troponins and their known correlation with the outcome of acute coronary syndromes. Raised levels of troponin are known to be related to a worse prognosis, including death and recurrent cardiac events. The universal definition introduces sub-types of MI, based on the differing pathological processes that may lead to myocardial necrosis. The new definition of MI will result in greater numbers of patients being diagnosed with MI, with important implications for work, insurance, and lifestyle. However, it is likely that this ‘new’ group of patients will receive therapy with treatments known to improve prognosis. In this paper, we describe the implications of the universal definition of MI in the context of diagnosis, investigation, treatment and prognosis.

Poly(vinyl chloride) (PVC) based membranes of 5,10,15,20-tetraphenylporphyrinatocobalt, ( I ), incorporating dibutyl phthalate (DBP) in the composition 9:55:36 ( I :PVC:DBP) responds to molybdate (MoO 2− 4 ) over the concentration range 7.6×10 −6 –1.0×10 −1 mol l −1 , pH between 4.9 and 11.3, with a Nernstian slope and a fast response time of 15 s. The membrane shows excellent selectivity towards MoO 2− 4 ions over a number of other anions and exhibits stable response for more than four months. The sensor can be used in non-aqueous medium with no significant change in the value of slope or working concentration range for the estimation of MoO 2− 4 in solutions having upto 25% (v/v) non-aqueous fraction. It was applied for the estimation of molybdenum as molybdate in a sample of molybdenite, a low grade ore.

5,10,15,20-tetraphenylporphyrin (TPP) and 5,10,15,20-tetra(4-methylphenyl) porphyrin (TMPP) have been explored as electroactive materials for preparing poly(vinyl chloride) (PVC) based membrane sensors selective to Ni 2+ . The membrane incorporating TMPP, sodium tetraphenylborate and a solvent mediator (dibutylphthalate) in PVC in the ratio (7 : 35 : 4 : 54) gave the best results, exhibiting Nernstian response in the concentration range 5.6× 10 −6 –1.0×10 −1 mol/l between pH 2.5–7.4 and a fast response time of 20 s. The electrode shows moderate selectivity and has been used for the quantitative determination of Ni 2+ in chocolates and also as an indicator electrode for the end point detection in the potentiometric titration of Ni 2+ against EDTA.

Endoscopic variceal ligation and endoscopic sclerotherapy are both recommended for the prevention of variceal rebleeding. To compare their efficacy, their influence on gastric varices and the development of portal gastropathy, 95 patients with variceal bleeding were studied.The patients were randomized to receive weekly endoscopic sclerotherapy using alcohol (n=48) or endoscopic variceal ligation (n=47). The endoscopic sclerotherapy and endoscopic variceal ligation groups were comparable in etiology, severity of liver disease and grade of varices.In the arrest of acute bleed, endoscopic sclerotherapy and endoscopic variceal ligation were comparable (86% vs. 80%, p=ns). Endoscopic variceal ligation as compared to endoscopic sclerotherapy, obliterated esophageal varices in fewer sessions (4.1+/-1.2 vs. 5.2+/-1.8, p0.01) and a shorter time (4.4+/-1.3 vs. 6.9+/-3.4 wk, p0.01). Three (6.4%) patients bled after endoscopic variceal ligation and 10 (20.8%) after endoscopic sclerotherapy (p0.05). The actuarial percentage of variceal recurrence during a follow-up of 8.5+/-4.4 months, was higher after endoscopic variceal ligation than endoscopic sclerotherapy (28.7% vs 7.5%, p0.05). Esophageal stricture formation after endoscopic sclerotherapy occurred in five (10.4%) patients, but in none after endoscopic variceal ligation. Significantly more patients developed gastropathy after endoscopic sclerotherapy than ligation (20.5% vs. 2.3%; p=0.02). Endoscopic sclerotherapy (52%) and endoscopic variceal ligation (59%) were equally effective in obliterating the lesser curve gastric varices. Six patients died: three in each group.(i) Endoscopic sclerotherapy and endoscopic variceal ligation were equally effective in controlling acute bleed; (ii) endoscopic ligation achieved variceal obliteration faster and in fewer treatment sessions; (iii) endoscopic variceal ligation had a significantly lower rate of development of portal gastropathy and rebleeding, (iv) while both techniques influenced gastric varices equally, there was significantly higher esophageal variceal recurrence after endoscopic variceal ligation than sclerotherapy.

[Figure][1] A patient with acute ST-segment elevation myocardial infarction (STEMI), caused by complete thrombotic occlusion of the right coronary artery (A) , underwent aspiration thrombectomy (B) , but optical coherence tomography revealed persistent thrombus protruding into the lumen (C

An 82-year-old woman with stage 3 non-small cell lung cancer presented with a large pericardial effusion demonstrated by transthoracic echocardiography (TTE) (Figure 1, white arrow) (Supplemental Digital Content 1, http://links.lww.com/JTO/A157). She had a history of previous pericardial effusion treated with pericardiocentesis. She was evaluated and deemed high risk for definitive surgical treatment. Therefore, she underwent percutaneous balloon pericardiotomy, performed from a subxiphisternal approach under aseptic technique with fluoroscopic and echocardiographic guidance (Figures 2A–D) (Supplemental Digital Content 2– 4, http://links.lww.com/JTO/A158, http://links.lww.com/JTO/A160, and http://links.lww.com/ JTO/A161). Six hundred milliliters of serous fluid was aspirated, resulting in immediate symptomatic improvement. Three months later, TTE revealed a small stable effusion with no diastolic right atrium/right ventricle/collapse. Malignant disease is a common cause of pericardial effusion with incidences ranging from 1 to 20% in all cancer patients.1,2 Management is challenging with recurrence rates of 13 to 50%3 after pericardiocentesis and patients often unsuitable for surgical intervention. Percutaneous balloon pericardiotomy is a simple and safe minimally invasive alternative to drain pericardial effusions.

Rate constants for the aminolysis of a few O-aryl oximes with several primary alkl amines, CH3NH2—C6H13NH2, in 1:1 water-acetonitrile are reported. Reactions of methylamine with substrates possessing poor nucleofugues are very weakly sensitive to base catalysis while reactions of higher amines are not. Slightly higher rate of long chain amine may be considered as a consequence of hydrophobic interaction. Cationic micelles of cetyltnmethyl ammonium bromide enhance the rate. Magnitude of micellar catalysis increases towards higher amines.

The study of counterion association is of importance as it throws light on the parameters affecting micellar behavior. A number of methods have been used to determine the extent of counterion association and they often tend to give widely different values. Ion-selective membrane electrodes of adequate mechanical and chemical stability which are not poisoned by surfactants are expected to give a direct measure of counterion activity. A number of membrane electrodes have been investigated to determine counterion association. In this study a report is given on the use of a new membrane electrode system of adequate mechanical and chemical stability which is not poisoned by surfactants and alcohols. The effect of alcohols on counterion association of sodium dodecyl sulfate is investigated systematically. 13 references.

Cu(II), Ni(II), Co(II), Fe(II) and Mn(II) chelates of 5,5 dimethylcyclohexane-2-(2-hydroxyphenyl) hydrazono 1,3 dione (DCPHD) have been prepared and characterised on the basis of analytical, magnetic moment, conductance and electronic and IR spectral data. Two type of complexes, 1:1 and 1:2 (M:L) are formed. Electronic spectral data suggest high spin octahedral geometry for all the chelates except that of Cu(II) which shows square planar geometry. The ligand shows unusual behaviour with Cu(II) which is explained by IR studies.

The solubility of cadmium laurate in water, many nonaqueous solvents, and aqueous solutions of Manoxol OT has been determined by using 115mCd as a tracer and in methanol-benzene mixtures by an evaporation method. The cadmium soap has been found to be spare both in water and in many nonaqueous solvents. However, its solubility in alcohols is relatively much higher, owing to solute-solvent interaction. The c.m.c. values of cadmium laurate in benzene, toluene, and m-xylene have been calculated from the solubility data at different temperatures and found to be 3.8 × 10−5 M, 9.0 × 10−5 M, and 9.8 × 10−5 M, respectively. Solubility data have also been used to calculate the c.m.c. of Manoxol OT in aqueous solution. Small amounts of methanol in benzene enhance the solubility of cadmium soap in the latter solvent tremendously.