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Objective: The objective of conducting prescribing pattern study is to monitor, evaluate, and if necessary, recommend modifications in the prescribing behavior of medical practitioners. Hence, this study was conducted to analyze the drug utilization and prescribing pattern of drugs in orthopedic outpatient department (OPD). Methods: This prospective observational study was conducted in the orthopedic OPD of tertiary care hospital for a period of 3 months. Data were obtained from the prescriptions through one-to-one interviews and recorded in a separately designed case report form. Results: Out of the 260 patients enrolled in the study, 181 were female and 79 were male. The patients between the ages of 50 and 60 years constituted the higher number with a mean age of 52.2 years. The total number of drugs prescribed in the analyzed prescriptions was 1012 which includes orthopedic drugs as well as drugs prescribed to treat various comorbidities. The World Health organization drug prescribing indicators were used to assess the appropriate use of drugs. Conclusion: Our study concludes that drug utilization and prescribing quality should be improved by promoting medical education on current updates. The periodic audit should be conducted by a clinical pharmacist to reduce an error in the prescription as well as to check the compliance of prescription with standard treatment guidelines for rationalizing the therapy.

Higher cocrystal synthesis depends acutely on a knowledge of supramolecular synthons. We report three synthetic approaches towards ternary halogen bonded cocrystals that illustrate specificity and generality. Electrophilicity/nucleophilicity differences are needed among alternative sites of halogen bond formation. The two halogen bonds Aâ� â� â� B and Bâ� â� â� C in a halogen bonded ternary cocrystal ABC need to be of different strength. Interaction mimicry of hydrogen bonds by halogen bonds is a viable approach towards ternaries as illustrated with the pyrene structure. Finally, the crystal engineer should well be able to anticipate halogen bonds that are stronger than hydrogen bonds. © 2021 Wiley-VCH GmbH

The current ST-elevation myocardial infarction (STEMI) vs. non-STEMI (NSTEMI) paradigm prevents some NSTEMI patients with acute coronary occlusion from receiving emergent reperfusion, in spite of their known increased mortality compared with NSTEMI without occlusion. We have proposed a new paradigm known as occlusion MI vs. nonocclusion MI (OMI vs. NOMI).We aimed to compare the two paradigms within a single population. We hypothesized that STEMI(-) OMI would have characteristics similar to STEMI(+) OMI but longer time to catheterization.We performed a retrospective review of a prospectively collected acute coronary syndrome population. OMI was defined as an acute culprit and either TIMI 0-2 flow or TIMI 3 flow plus peak troponin T 1.0 ng/mL. We collected electrocardiograms, demographic characteristics, laboratory results, angiographic data, and outcomes.Among 467 patients, there were 108 OMIs, with only 60% (67 of 108) meeting STEMI criteria. Median peak troponin T for the STEMI(+) OMI, STEMI(-) OMI, and no occlusion groups were 3.78 (interquartile range [IQR] 2.18-7.63), 1.87 (IQR 1.12-5.48), and 0.00 (IQR 0.00-0.08). Median time from arrival to catheterization was 41 min (IQR 23-86 min) for STEMI(+) OMI compared with 437 min (IQR 85-1590 min) for STEMI(-) OMI (p 0.001). STEMI(+) OMI was more likely than STEMI(-) OMI to undergo catheterization within 90 min (76% vs. 28%; p 0.001).STEMI(-) OMI patients had significant delays to catheterization but adverse outcomes more similar to STEMI(+) OMI than those with no occlusion. These data support the OMI/NOMI paradigm and the importance of further research into emergent reperfusion for STEMI(-) OMI.

There may be non-traditional pathways of chronic kidney disease (CKD) progression that are complementary to classical pathways. Therefore, we aimed to examine non-traditional risk factors for incident CKD and its progression.Generally healthy population (n=4,382) starting at age 27-41 years in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort which is an observational longitudinal study. Non-traditional risk factors included forced vital capacity (FVC), inflammation, serum urate, and serum carotenoids. CKD risk category was classified using the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) measured in 1995-96 and repeated 5-yearly for 20 years: No CKD, Low Risk, Moderate Risk, High Risk, and Very High Risk.At baseline, 84.8% had no CKD (eGFR ≥60 ml/min/1.73 mSeveral non-traditional markers were significantly associated with an increased risk of progression to higher CKD categories in generally healthy young to middle-aged adults.

Stoichiometric ternary and quaternary, and nonstoichiometric quinary molecular solids were engineered based on structural inequivalence and combinatorial approaches from 2-nitroresorcinol. A total of 32 binary, ternary, quaternary and quinary solids were characterized. The great difficulty in obtaining such solids is that crystallization must occur in a single step from precursors in solution, with multistep sequences, as are typical in solution syntheses, not being possible in most situations., A synthetic strategy for the formation of stoichiometric quaternary and non­stoichiometric quinary solids is outlined. A series of 2-nitro­resorcinol-based quaternary cocrystals were developed from binary precursors in two conceptual stages. In the first stage, ternary solids are synthesized based on the structural inequivalence at two recognition sites in the binary. In the second stage, the ternary is homologated into a stoichiometric quaternary based on the same concept. Any cocrystal without an inequivalence becomes a synthetic dead end. The combinatorial approach involves lower cocrystal systems with different structural environments and preferred synthon selection from a synthon library in solution. Such are the stepping stones for the isolation of higher cocrystals. In addition, a quaternary cocrystal of 4,6-di­chloro­resorcinol is described wherein an unusual synthon is observed with two resorcinol molecules in a closed loop with two different ditopic bases. The concept of the virtual synthon in binaries with respect to isolated ternaries is validated for the 4,6-di­chloro­resorcinol system. It is possible that only some binary systems are amenable to homologation into higher cocrystals. The reasons for this could have to do with the existence of preferred synthon modules, in other words, the critical components of the putative higher assembly that cannot be altered. Addition of the third and fourth component might be more flexible, and the choices of these com­ponents, possible from a larger pool of chemically related molecules.

Surfactant protein D (SP-D) is a C-type collectin and plays an important role in innate immunity and homeostasis in the lung. This study studied SP-D role in the nontypeable Haemophilus influenzae (NTHi)-induced otitis media (OM) mouse model. Wild-type C57BL/6 (WT) and SP-D knockout (KO) mice were used in this study. Mice were injected in the middle ear (ME) with 5 μL of NTHi bacterial solution (3.5 × 105 CFU/ear) or with the same volume of sterile saline (control). Mice were sacrificed at 3 time points, days 1, 3, and 7, after treatment. We found SP-D expression in the Eustachian tube (ET) and ME mucosa of WT mice but not in SP-D KO mice. After infection, SP-D KO mice showed more intense inflammatory changes evidenced by the increased mucosal thickness and inflammatory cell infiltration in the ME and ET compared to WT mice (p < 0.05). Increased bacterial colony-forming units and cytokine (IL-6 and IL-1β) levels in the ear washing fluid of infected SP-D KO mice were compared to infected WT mice. Molecular analysis revealed higher levels of NF-κB and NLRP3 activation in infected SP-D KO compared to WT mice (p < 0.05). In vitro studies demonstrated that SP-D significantly induced NTHi bacterial aggregation and enhanced bacterial phagocytosis by macrophages (p < 0.05). Furthermore, human ME epithelial cells showed a dose-dependent increased expression of NLRP3 and SP-D proteins after LPS treatment. We conclude that SP-D plays a critical role in innate immunity and disease resolution through enhancing host defense and regulating inflammatory NF-κB and NLRP3 activation in experimental OM mice.

The serendipitous formation of Bandrowski's base, an oxidized trimer of p-phenylenediamine, a backbone molecule of the hair dye industry, in the presence of the antifungal/antidandruff agent clotrimazole, and the subsequent formation of a cocrystal has the potential of leading to a new group of commercially important formulations.

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Chromatography is an important biophysical process, allowing the components of a mixture to be isolated, classified and extracted for qualitative and quantitative analysis. Proteins can be purified based on features such as size and shape, total charge, surface hydrophobic groups and stationary phaset binding ability. Four separation strategies based on molecular characteristics and form of interaction Four separation techniques based on molecular characteristics and form of interaction use ion exchange mechanisms, surface adsorption, partition, and exclusion of the size. Column chromatography is one of the most common methods of protein purification Chromatography is based on the theory of separation of fluid stationary phase (stable phase) when traveling with the support of a mobile phase. The variables that are involved in this separation process include adsorption (liquid-solid), partition (liquid-solid), and affinity or variations between their molecular weights. Due of these variations, certain components of the mixture stay in the stationary phase longer, and travel gradually in the chromatography system, while others move rapidly through the mobile phase, leaving the system faster. Based on this method, three components form the basis of the chromatography technique. Stationary phase: is a phase consisting of a "solid" phase or a "solid surface adsorbed layer" Mobile phase: is a phase consisting of a "liquid" or a "gaseous part." Separate molecules which form the interaction between stationary phase, mobile phase and substances contained in the mixture are the basic component that is successful in separating molecules from the partition-based chromatography methods are very effective in separating small molecules and distinguishing them as amino acids, carbohydrates and fatty acids. In the separation of macromolecules as nucleic acids and proteins, however, affinity chromatography’s (i.e. ion-exchange chromatography) are more efficient. Paper chromatography is used in protein separation and protein synthesis studies; gas-liquid chromatography is used to isolate alcohol, ethanol, lipid, and amino groups, and to analyze enzymatic interactions, while molecular-sieve chromatography is used in particular to evaluate molecular protein weights. Agarose gel chromatography is used to purify RNA, DNA particles, and viruses. The chromatography stationary phase is a solid phase or liquid phase that is sprayed on a solid phase surface. A gaseous or liquid phase is a mobile phase which flows through the stationary phase. If the mobile phase is liquid, it is called liquid chromatography, and if it is gas, it is called gas chromatography. of gases and mixtures of volatile liquids, and solid material, gas chromatography is used. Liquid chromatography is used in particular for thermal unstable and non-volatile materials. The purpose of applying chromatography, which is used as a quantitative analysis tool apart from its separation, is to record a sufficient separation within an acceptable time interval. Various chromatography methods have been developed to that end. Some of these have chromatography on columns, thin layer chromatography (TLC), paper chromatography, gas chromatography, ion exchange chromatography, gel permeation chromatography, liquid high pressure chromatography, and affinity chromatography.

How can we maximize what is learned from a replication study? In the creative destruction approach to replication, the original hypothesis is compared not only to the null hypothesis, but also to predictions derived from multiple alternative theoretical accounts of the phenomenon. To this end, new populations and measures are included in the design in addition to the original ones, to help determine which theory best accounts for the results across multiple key outcomes and contexts. The present pre-registered empirical project compared the Implicit Puritanism account of intuitive work and sex morality to theories positing regional, religious, and social class differences; explicit rather than implicit cultural differences in values; self-expression vs. survival values as a key cultural fault line; the general moralization of work; and false positive effects. Contradicting Implicit Puritanism's core theoretical claim of a distinct American work morality, a number of targeted findings replicated across multiple comparison cultures, whereas several failed to replicate in all samples and were identified as likely false positives. No support emerged for theories predicting regional variability and specific individual-differences moderators (religious affiliation, religiosity, and education level). Overall, the results provide evidence that work is intuitively moralized across cultures.