A simple technical innovation to prevent needle stick injuries among dental professionals

OBJECTIVE

Dental healthcare personnel face the potential danger of being exposed to infectious patients while administering local anesthesia injections during dental operations. This could lead to unintentional transfer of infectious diseases from patients to physicians. Although safety measures such as the One-hand-scoop technique and the use of safety syringes, plastic needle cap holders, and needles with safety caps are in place, there have been instances of needle stick injuries reported in clinics. This might be due to the lack of adherence to conventional safety measures or the impracticality of safety techniques and safety syringes. This article aims to demonstrate the utilization of dental tweezers, specifically London College tweezers or dental forceps, for the secure recapping of needles, eliminating the requirement for extra equipment or devices.

SUBJECTS AND METHODS

After obtaining ethical approval (Approval No.: 024-01-2024) from the College of Dentistry, Dar Al Uloom University, 67 dental professionals, with consent for participation in the study, were included. They were requested to use dental tweezers/London College tweezers and dental extraction forceps such as maxillary anterior, mandibular anterior, and maxillary bayonet root forceps individually to recap the local anesthetic needles. The efficacy of these techniques was evaluated against the one-hand scoop technique for its ease, convenience, and reliability in preventing needle stick injuries.

RESULTS

The evaluation of dental professionals regarding the ease of using dental tweezers to recap needles, compared to the one-hand scoop technique (p=0.592), maxillary bayonet root forceps (p=0.746), mandibular anterior forceps (p=0.380), and maxillary anterior forceps (p=0.808), did not yield statistically significant results. The assessment of the procedural simplicity of the one-hand scoop technique showed a satisfaction rate of over 40%, whereas the application of dental tweezers resulted in a satisfaction rate of 30%. However, the use of dental tweezers for needle recapping resulted in a satisfaction rate of over 50%, compared to a satisfaction rate of 30% for the one-handed scoop technique.

CONCLUSIONS

There is no statistically significant difference in the assessment of the efficacy of dental tweezers and the one-hand scoop technique, bayonet root forceps, mandibular anterior forceps, maxillary anterior forceps, and dental tweezers for the needle capping technique. Therefore, dental forceps can be used instead of the one-handed scoop approach. The needle recapping procedure outlined in our study, aimed at preventing needle stick injuries, is simple to implement, and all dental specialties have convenient access to the required instruments.

Perspectives and challenges in lip rejuvenation: a systematic review

OBJECTIVE

There is an abundance of information on facelifts, blepharoplasties, rhinoplasty, and other cosmetic surgical procedures for the upper third of the face, but little is known about perioral lip rejuvenation. The aim of this article is to examine the existing literature on lip rejuvenation and perioral procedures related to lip rejuvenation. Additionally, this article aims to highlight the importance of addressing perioral areas alongside lip rejuvenation procedures, rather than solely focusing on lip rejuvenation. We also discussed the extensive procedures and materials used for lip rejuvenation, such as hyaluronic acid, botulinum toxin A, abobotulinum, onabotulinum, incobotulinum, prabobotulinum, fat grafts, silicone fillers, human collagen, collagen stimulating procedures such as derma pens and derma rolls, radiation frequency, stem cells, and plasma therapy, as well as the underlying factors that contribute to varying success rates.

MATERIALS AND METHODS

A thorough literature search was done using PubMed, Cochrane, Ebsco search, Google Scholar, Scopus, and Web of Science for the articles pertaining to facial and lip cosmetic surgeries 1995-2020. Keywords for the search included anatomy of the face, facial aging, perioral areas, lip rejuvenation, botox, grafts, facelift, plastic surgery, stem cell therapy, plasma treatment, and cosmetic surgery.

RESULTS

37 articles met the study criteria. 14 out of 37 studies included procedures for lip and perioral region rejuvenation. The remaining 23 studies either involved lip procedures alone or lip procedures in conjunction with facial cosmetic procedures. Lip rejuvenation with perioral enhancement with hyaluronic acid gel demonstrated a 94.3% improvement on the lip fullness scale (LFS) one month after re-treatment. The amalgamation of lip and perioral region rejuvenation produces a synergistic effect. Whereas, sole lip rejuvenation procedures showed short-term results with less patient satisfaction, calling for secondary lip rejuvenation procedures. It was also observed that hyaluronic acid was the most commonly used agent for lip rejuvenation procedures with minimal or no side effects.

CONCLUSIONS

In conjunction with perioral rejuvenation, lip rejuvenation procedures produce more aesthetically appealing results. However, any cosmetic surgical or non-surgical procedure is limited by the nature and composition of the products used. The use of FDA-approved products for rejuvenation is strongly advised to avoid undesirable side effects. Further extensive research is required on the long-term outcomes and adverse effects of stem cell transplants, such as tumor development.

Synthesis, in silico analysis and antidepressant activity of 1,3,4-oxadiazole derivatives

The compounds 1,3,4-oxadiazole derivatives (1-8) were synthesized by the cyclization of 4-hydroxy benzhydrazide (1) with various substituted aroma-tic aldehydes (2) using FeCl3 as catalyst and methanol as a solvent medium. The structures of the newly synthesized compounds were assigned based on FT-IR, 1H-NMR, and mass spectral data. In vivo antidepressant activity was performed by tail suspension test and forced swimming test models. Using the Schrodinger Maestro, the in silico analysis was performed and docked to the glycogen synthase kinase 3β binding site (PDB: 3GB2). Compounds 8 [4,4'-(1,3,4-oxadiazole-2,5-diyl)diphenol] and 3 [3-(5-(4-hydroxyphenyl)-1,3,4-oxadiazol-2-yl) phenol] showed both potent inhibitory activity against GSK-3β with a docking score of -7.800 kcal/mol as well as good antidepressant activity in both tail suspension and forced swimming tests models. The synthesized derivatives showed good antidepressive potential.

3D energy frameworks of dimethylbenzophenone tetramorphs

The tetramorph^th crystals of 4,4-dimethylbenzophenone (D) were obtained using slow-evaporation crystallization method and the structure is elucidated using single crystal X-ray diffraction technique. D crystallizes in the orthorhombic crystal system (space group Pbca) with cell parameters a = 14.6986 (11) Å, b = 6.1323 (4) Å, c = 26.2730 (18) Å, V = 2368.2 (3) ų and Z = 8. In the crystal structure, intermolecular interaction of the type C---H^...π stabilizes the crystal packing. This polymorph is the fourth candidate of its kind and second candidate in the orthorhombic crystal system. The structural comparisons and crystal packing of tetramorphs (A, B, C and D) are analyzed using molecular structures, Hirshfeld surfaces, enrichment ratios (E) and energy frameworks. The conformational differences are observed in all the tetramorphs and the intercontacts H ⋯ H and C ⋯ H contributes around 85 % to the Hirshfeld surfaces. The E ratio provides evidence of H ⋯ H, C ⋯ H and O ⋯ H intercontacts having high propensity to form contacts in the crystal packing. The average energy (dimer formation) for each polymorph is calculated from energy framework analysis. The systematic comparison of crystal packing in tetramorphs through 3D-topology is visualized. In the energy-frameworks of the crystal packing, dispersion energy dominates over the electrostatic energy. Overall, the molecular packings of the four polymorphic structures are different.

Microalgae biomass from swine wastewater and its conversion to bioenergy

Ever-increasing swine wastewater (SW) has become a serious environmental concern. High levels of nutrients and toxic contaminants in SW significantly impact on the ecosystem and public health. On the other hand, swine wastewater is considered as valuable water and nutrient source for microalgae cultivation. The potential for converting the nutrients from SW into valuable biomass and then generating bioenergy from it has drawn increasing attention. For this reason, this review comprehensively discussed the biomass production, SW treatment efficiencies, and bioenergy generation potentials through cultivating microalgae in SW. Microalgae species grow well in SW with large amounts of biomass being produced, despite the impact of various parameters (e.g., nutrients and toxicants levels, cultivation conditions, and bacteria in SW). Pollutants in SW can effectively be removed by harvesting microalgae from SW, and the harvested microalgae biomass elicits high potential for conversion to valuable bioenergy.

Synthesis, structural, biological andin silicostudies of new 5-arylidene-4-thiazolidinone derivatives as possible anticancer, antimicrobial and antitubercular agents

Thiazolidinone–sulfonamide hybrids emerged as promising anticancer and antitubercular agents, and their anticancer activity was confirmed by docking studies.

Crystal structure and Hirshfeld surface analysis of N,N'-bis-(2-nitro-phen-yl)glutaramide

The asymmetric unit of the title compound, C17H16N4O6, contains two independent mol-ecules (A and B). The two benzene rings are twisted by an angle of 79.14 (7)° in mol-ecule A, whereas, in mol-ecule B, they are inclined by 19.02 (14)°. The conformations of the mol-ecules are stabilized by intra-molecular N-H⋯O hydrogen bonds between the amide nitro-gen atom and the O atom of the ortho-nitro substituent on the phenyl ring, enclosing an S(6) ring motif. In the amide and aliphatic segments, all the N-H, C=O and C-H bonds are anti to each other. In the crystal, the A and B mol-ecules are linked by inter-molecular amide-to-amide N-H⋯O hydrogen bonds, resulting in chains running along the b-axis direction. The inter-molecular inter-actions were analysed using Hirshfeld surface analysis. The two-dimensional fingerprint plots of the inter-molecular contacts indicate that the major contributions are from H⋯H and O⋯H inter-actions.

Crystal structure of SAM-dependent methyltransferase from Pyrococcus horikoshii

Methyltransferases (MTs) are enzymes involved in methylation that are needed to perform cellular processes such as biosynthesis, metabolism, gene expression, protein trafficking and signal transduction. The cofactor S-adenosyl-L-methionine (SAM) is used for catalysis by SAM-dependent methyltransferases (SAM-MTs). The crystal structure of Pyrococcus horikoshii SAM-MT was determined to a resolution of 2.1 Å using X-ray diffraction. The monomeric structure consists of a Rossmann-like fold (domain I) and a substrate-binding domain (domain II). The cofactor (SAM) molecule binds at the interface between adjacent subunits, presumably near to the active site(s) of the enzyme. The observed dimeric state might be important for the catalytic function of the enzyme.

Synthesis, anticancer, structural, and computational docking studies of 3-benzylchroman-4-one derivatives

A series of 3-Benzylchroman-4-ones were synthesized and screened for anticancer activity by MTT assay. The compounds were evaluated against two cancerous cell lines BT549 (human breast carcinoma), HeLa (human cervical carcinoma), and one noncancerous cell line vero (normal kidney epithelial cells). 3b was found to be the most active molecule against BT549 cells (IC₅₀ = 20.1 µM) and 3h against HeLa cells (IC₅₀ = 20.45 µM). 3b also exhibited moderate activity against HeLa cells (IC₅₀ = 42.8 µM). The molecular structures of 3h and 3i were solved by single crystal X-ray crystallographic technique. Additionally, the molecular docking studies between the tumour suppressor protein p53 with the lead compound 3h, which exhibited better anticancer activity against HeLa cells was examined.

Crystal structures of N,N-dimethyl-(2-(2,2-diphen-yl)-2-prop-2-yn-yloxy)acet-oxy)ethyl-amine and N,N-dimethyl-(2-(2,2-diphen-yl)-2-prop-2-yn-yl--oxy)acet-oxy)ethyl-ammonium 2,4,6-tri-nitro-phenolate

The N,N-di-methyl-ethylamminium unit in N,N-dimethyl-[2-(2,2-diphen-yl)-2-prop-2-ynyloxyacet-oxy]ethyl-amine, C21H23NO3 (I), is disordered over two sets of atomic sites having occupancies of 0.880 (3) and 0. 120 (3), but there are no direction-specific inter-actions between the mol-ecules of (I). The cation in N,N-dimethyl-[2-(2,2-diphen-yl)-2-prop-2-ynyloxyacet-oxy]ethyl-ammonium 2,4,6-tri-nitro-phenolate (picrate), C21H24NO3+·C6H2N3O7- (II), shows a similar type of disorder, with occupancies of 0.654 (11) and 0.346 (11), although the overall conformation of the cation in (II) is different from that in the neutral (I). The component ions are are linked by an almost planar three-centre N-H⋯(O)2 hydrogen bond, and the ion pairs are further linked by a combination of three C-H⋯O hydrogen bonds to form sheets. Comparisons are made with some related structures.

Crystal structure of ebastinium 3,5-di-nitro-benzoate

Ebastine, 4-(benzhydr-yloxy)-1-[4-(4-tert-butyl-phen-yl)-4-oxobut-yl]piperidine, reacts with 3,5-di-nitro-benzoic acid in methanol solution to give the title 1:1 salt, ebastinium 3,5-di-nitro-benzoate, C32H40NO2+·C7H3N2O6-. In the cation, the disubstituted aryl ring exhibits orientational disorder over two sets of atomic sites having occupancies 0.706 (4) and 0.294 (6), with a dihedral angle of 41.2 (5)° between the two orientations: the bulky Ph2CH-O- substituent occupies an axial site on the piperidine ring. The two ions in the selected asymmetric unit are linked by a nearly linear N-H⋯O hydrogen bond and this, in combination with two C-H⋯O hydrogen bonds, links the ions into complex sheets.

Effect of nucleants in photothermally assisted crystallization

Laser-induced crystallization is emerging as a promising technique to crystallize biomolecules like amino acids and proteins. The use of external materials as nucleants and novel seeding methods open new paths for protein crystallization. We report here the results of experiments that explore the effect of nucleants on laser-based crystallization of microlitre droplets of small molecules, amino acids, and proteins. The role of parameters like solute concentration, droplet volume, type and size of the nucleant, and laser power, are systematically investigated. In addition to crystallization of standard molecules like NaCl, KCl, and glycine, we demonstrate the crystallization of negatively (l-histidine), and positively (l-aspartic acid) charged amino acids and lysozyme protein. Single crystal X-ray diffraction and Raman spectroscopy studies unequivocally indicate that the nucleants do not alter the molecular structure of glycine, hydrogen bonding patterns, and packing. Localized vaporization of the solvent near the nucleant due to photothermal heating has enabled us to achieve rapid crystallization - within 3 s - at laser intensities of 0.1 MW cm^-2, significantly lower than those reported earlier, with both saturated and unsaturated solutions. The outcome of the current experiments may be of utility in tackling various crystallization problems during the formation of crystals large enough to perform X-ray crystallography.

4-Chloro-2-nitro-1-(2-phenylethyl)benzene

In the title compound, C14H12ClNO2, the dihedral angle between the aromatic rings is 6.09 (17)° and the Car—C—C—Cartorsion angle is −179.4 (3)°. The nitro group is close to coplanar with its attached ring [dihedral angle = 7.9 (2)°] and the Cl atom is disordered over two adjacent sites in a 0.54 (4):0.46 (4) ratio. In the crystal, C—H...O hydrogen bonds link the molecules intoC(6) [001] chains.

Design, synthesis and pharmacological studies of some new quinoline Schiff bases and 2,5-(disubstituted-[1,3,4])-oxadiazoles

G6P-Ligand (4f) and (5b) interactions as visualized using Chimera (Version 1.8).

5-Bromo-1,2,4-triazolo[1,5-a]pyrimidine

In the title compound, C5H3BrN4, the almost planar triazolopyrimidine ring system (r.m.s. deviation = 0.014 Å) carries a bromo substituent at the 5-position. In the crystal, C—H...N hydrogen bonds form inversion dimers enclosingR22(8) rings and also link molecules intoC(5) chains along thec-axis direction. Br...N halogen bonds [3.185 (4) Å], π–π stacking interactions, centroid-to-centroid separation [3.663 (3) Å] and C—Br...π contacts [Br...Cg= 3.7881 (17) Å] are also found and combine with the C—H...N hydrogen bonds to stack the molecules along thea-axis direction.

5-(2-Ethoxy-4-fluorophenyl)-1,2,4-triazolo[1,5-a]pyrimidine

In the title compound, C13H11FN4O, the dihedral angle between the triazolopyrimidine ring system and fluorophenyl ring is 39.16 (12)°. In the crystal, C—H...N hydrogen bonds link the molecules resulting inR22(8) ring motifs andC(8) chain motifs.

Ethyl (naphthalen-2-yloxy)acetate

In the title compound, C14H14O3, the dihedral angle between the naphthyl ring system and the side chain is 9.00 (14)°, and the ethoxy chain adopts an extended conformation [C—O—C—C = 176.0 (3)°]. There are no directional interactions in the crystal beyond normal van der Waals contacts.

4-Chloro-1-[2-(2-chlorophenyl)ethyl]-2-nitrobenzene

In the title compound, C14H11Cl2NO2, the dihedral angle between the phenyl rings is 8.60 (17)° and the nitro group makes a dihedral anle of 29.4 (4)° with its attached ring. The crystal structure features C—H...O hydrogen bonds and π–π interactions.

2-[(5-Amino-1,3,4-thiadiazol-2-yl)sulfanyl]-N-(2,4,5-trichlorophenyl)acetamide

In the title compound, C10H7Cl3N4OS2, the dihedral angle between the trichlorobenzene and thiadiazole rings is 29.26 (17)°. In the crystal, molecules are connected by N—H...O and C—H...O hydrogen bonds, forming chains propagating along [001]. The chains are linkedviaN—H...N hydrogen bonds to form slabs parallel to (100).

Ethyl 1-benzyl-2-(3-chlorophenyl)-1H-benzimidazole-5-carboxylate

In the title compound, C23H19ClN2O2, the dihedral angles between the imidazole ring system and the chlorobenzene and phenyl rings are 48.05 (14) and 82.53 (15)°, respectively. In the crystal, inversion dimers linked by pairs of C—H...O hydrogen bonds generateR22(22) loops. Weak C—H...π and π–π stacking interactions are also observed.

5-(2,4-Dichlorophenoxy)-3-methyl-1-phenyl-1H-pyrazole-4-carbaldehyde

In the crystal structure of the title compound, C17H12Cl2N2O2, the pyrazole ring makes dihedral angles of 65.0 (2) and 43.9 (2)° with the dichlorophenyl and phenyl rings, respectively. The dihedral angle between the chlorophenyl and phenyl rings is 59.1 (2)°. In the crystal, the molecules are linked by C—H...O hydrogen bonds and weak C—Cl...π and C—H...π interactions, generating a three-dimensional network.

2-[(5-Amino-1,3,4-thiadiazol-2-yl)sulfanyl]-N-(4-chlorophenyl)acetamide

In the title compound, C10H9ClN4OS2, the dihedral angle between the planes of the chlorophenyl and thiadiazole groups is 32.93 (16)°. The molecules are connected through intermolecular N—H...N and N—H...O hydrogen bonds. An N—H...N hydrogen bond formsR22(8) ring motifs.

Ethyl 2-(4-cyanophenyl)-1-(4-fluorobenzyl)-1H-benzo[d]imidazole-5-carboxylate

The title benzimidazole derivative, C24H18FN3O2, is T-shaped, with the 4-cyanobenzene and 4-fluorobenzyl rings inclined to the imidazole ring system by 32.89 (10) and 83.63 (10)°, respectively, and by 89.00 (12)° to one another. The terminal methyl group of the ethylcarboxylate group is disordered over three sites and was refined with a fixed occupancy ratio of 1/3:1/3:1/3. In the crystal, molecules are essentially linked by offset π–π interactions, involving inversion-related imidazole rings [inter-centroid distance = 3.763 (1) Å], and stack along theb-axis direction.

Comparative evaluation of intrathecal morphine and intrathecal dexmedetomidine in patients undergoing gynaecological surgeries under spinal anaesthesia: A prospective randomised double blind study

BACKGROUND AND AIMS

Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing gynaecological surgeries.

METHODS

This was a prospective, randomised, double blind study involving 25 patients in each group. Group M received 15 mg of 0.5% hyperbaric bupivacaine with 250 μg of morphine while Group D received 15 mg of 0.5% hyperbaric bupivacaine with 2.5 μg of dexmedetomidine. Characteristics of spinal block, time for first rescue analgesic and total dose of rescue analgesics were noted. Vital parameters and adverse effects were noted perioperatively. Data analysis was done with independent two sample t-test and Mann-Whitney U test.

RESULTS

Time for first rescue analgesic (P = 0.056) and total analgesic demand were similar in both groups. Duration of sensory (P = 0.001) and motor (P = 000) block was significantly higher in dexmedetomidine group. Itching was noticed in 36% and nausea in 52% of patients in the morphine group, either of which was not seen in dexmedetomidine group.

CONCLUSION

Intrathecal dexmedetomidine produces prolonged motor and sensory blockade without undesirable side effects but intraoperative hypotension was more frequent in dexmedetomidine group.

Ethyl 2-(3,5-difluorophenyl)quinoline-4-carboxylate: a second triclinic polymorph

The title compound, C18H13F2NO2, is a polymorph of the structure reported by Sunithaet al.[Acta Cryst.(2015), E71, o341–o342]. Both compounds crystallize in the triclinic space groupP-1. The principal difference between the two polymorphs lies in the orientation of the carboxylate substituents with respect to the planes of the quinoline ring systems. In the crystal, the packing features C—H...O hydrogen bonds together with short C—F...π and π–π interactions [inter-centroid distances of 3.8199 (11), 3.6825 (12) and 3.8722 (13) Å].

Tramadolium 2-chlorobenzoate

In the title molecular salt, C16H26NO2+·C7H4ClO2−, {systematic name: [2-hydroxy-2-(3-methoxyphenyl)cyclohexylmethyl]dimethylammonium 2-chlorobenzoate}, the cyclohexane ring of the cation exhibits a chair conformation with the aromatic and amine substituents in equatorial orientations and the hydroxyl group in an axial orientation. In the anion, the dihedral angle between the aromatic ring and the carboxylate group is 39.16 (13)°. In the crystal, the cations are linked to the anions by O—H...O, N—H...O and C—H...O hydrogen bonds, generating [010] chains. Further C—H...O and C—H...π interactions are also observed, which link the chains into a three-dimensional framework.

Crystal structure of 4-[(E)-(4-fluoro-benzyl-idene)amino]-3-methyl-1H-1,2,4-triazole-5(4H)-thione

The title compound, C10H9FN4S, crystallizes with two mol-ecules (A and B) in the asymmetric unit. The dihedral angle between the planes of the trizole and fluoro-benzene rings is 7.3 (3)° in mol-ecule A and 41.1 (3)° in mol-ecule B. Mol-ecule A features an intra-molecular C-H⋯S hydrogen bond, which closes an S(6) ring. In the crystal, A+B dimers linked by pairs of N-H⋯S hydrogen bonds occur, generating R 2 (2)(8) loops. Weak π-π stacking contacts [centroid-centroid separation = 3.739 (6) Å] are also observed.

Crystal structure of (E)-3-(4-hy-droxy-benz-yl)-4-{[4-(methyl-sulfan-yl)benzyl-idene]amino}-1H-1,2,4-triazole-5(4H)-thione

In the title compound, C17H16N4OS2, the triazole and methyl-thio-benzyl-idene rings are nearly coplanar, making a dihedral angle of 6.52 (12)°. An intra-molecular C-H⋯S hydrogen bond forms an S(6) ring motif. The hy-droxy-benzyl ring is almost normal to the triazole and methyl-thio-benzyl-idene rings, making dihedral angles of 78.56 (12) and 84.79 (11)°, respectively. In the crystal, mol-ecules are linked through O-H⋯N and N-H⋯O hydrogen bonds, forming layers parallel to the ac plane. The layers are linked via C-H⋯N hydrogen bonds, forming a three-dimensional structure. In addition, a short π-π inter-action is observed [inter-centroid distance = 3.764 (3) Å], involving inversion-related methyl-thio-benzyl-idene rings.

Crystal structure of {[2-hy-droxy-2-(3-meth-oxy-phen-yl)cyclo-hex-yl]meth-yl}di-methyl-ammonium benzoate

The title compound, C16H26NO2 (+)·C7H5O2 (-), is a benzoate salt of the painkiller Tramadol. The six-membered cyclo-hexane ring of the cation adopts a slightly distorted chair conformation and carries OH and 3-meth-oxy-phenyl substituents at the 2-position and a protonated methyl-aza-niumylmethyl group at the 3-position. In addition, a weak intra-molecular C-H⋯O hydrogen bond is observed in the cation. In the crystal, weak O-H⋯O, N-H⋯O and C-H⋯O hydrogen bonds link the components into chains along [010]. A C-H⋯π contact is also observed.

High prevalence of undiagnosed diabetes among tuberculosis patients in peripheral health facilities in Kerala

SETTING

Two tertiary care hospitals and 12 peripheral health institutions (PHIs) in Trivandrum, Kerala, India.

OBJECTIVE

To determine factors associated with the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients and examine differences in the proportion of new DM cases among TB patients diagnosed at tertiary care centres and PHIs.

DESIGN

A descriptive study: TB patients diagnosed during March-September 2012 were screened for known DM. Those with unknown DM status were tested for random blood glucose and fasting blood glucose (FBG); FBG ≥ 126 mg/dl was diagnosed as new DM.

RESULTS

Of 920 TB patients, 689 (72%) were male and the mean (standard deviation) age was 47.6 (16.4) years. Of these, 298 (32.4%) were diabetic: 235 (26%) had previously known DM and 63 (7%) were newly diagnosed. During the screening at PHIs and tertiary care hospitals, respectively 30/183 (16.4%) and 33/737 (4.5%) were newly diagnosed with DM (OR 3.71; 95%CI 2.17-6.32). Overall, age >50 years and pulmonary tuberculosis were independently associated with a higher prevalence of diabetes.

CONCLUSION

As nearly one in three TB patients had DM, we recommend that TB patients should be routinely screened for DM in Kerala. As the proportion of new DM was higher among TB patients diagnosed at PHIs, we would recommend that specific attention and investment be directed to PHIs.

Crystal structure of ATP-binding subunit of an ABC transporter from Geobacillus kaustophilus

The ATP binding cassette (ABC) transporters, represent one of the largest superfamilies of primary transporters, which are very essential for various biological functions. The crystal structure of ATP-binding subunit of an ABC transporter from Geobacillus kaustophilus has been determined at 1.77 Å resolution. The crystal structure revealed that the protomer has two thick arms, (arm I and II), which resemble 'L' shape. The ATP-binding pocket is located close to the end of arm I. ATP molecule is docked into the active site of the protein. The dimeric crystal structure of ATP-binding subunit of ABC transporter from G. kaustophilus has been compared with the previously reported crystal structure of ATP-binding subunit of ABC transporter from Salmonella typhimurium.

Crystal structures of type IIIH NAD-dependent D-3-phosphoglycerate dehydrogenase from two thermophiles

In the L-Serine biosynthesis, D-3-phosphoglycerate dehydrogenase (PGDH) catalyzes the inter-conversion of D-3-phosphoglycerate to phosphohydroxypyruvate. PGDH belongs to 2-hydroxyacid dehydrogenases family. We have determined the crystal structures of PGDH from Sulfolobus tokodaii (StPGDH) and Pyrococcus horikoshii (PhPGDH) using X-ray diffraction to resolution of 1.77Å and 1.95Å, respectively. The PGDH protomer from both species exhibits identical structures, consisting of substrate binding domain and nucleotide binding domain. The residues and water molecules interacting with the NAD are identified. The catalytic triad residues Glu-His-Arg are highly conserved. The residues involved in the dimer interface and the structural features responsible for thermostability are evaluated. Overall, structures of PGDHs with two domains and histidine at the active site are categorized as type IIIH and such PGDHs structures having this type are reported for the first time.

Bis(2-bromo-benz-yl) ether

In the title compound, C₁₄H₁₂Br₂O, the dihedral angle between the aromatic rings is 2.7 (3)° and the Br atoms lie on the same side of the mol­ecule. No inter­molecular inter­actions occur in the crystal beyond van der Waals contacts.

5-(4-Chloro-phen-oxy)-3-methyl-1-phenyl-1H-pyrazole-4-carbaldehyde

In the title compound, C₁₇H₁₃ClN₂O₂, the phenyl and chloro­benzene rings are inclined to the central pyrazole ring at 40.84 (9) and 65.30 (9)°, respectively. In the crystal, pairs of C—H⋯π inter­actions link the mol­ecules into inversion dimers and C—H⋯O hydrogen bonds link these dimers into columns extended in [010]. The crystal packing exhibits short inter­molecular O⋯Cl contacts of 3.0913 (16) Å.

2-Nitro-benzyl methane-sulfonate

In the title compound, C₈H₉NO₅S, the dihedral angle between the benzene ring and the nitro group is 5.86 (15)° and the C—C—O—S group adopts an anti conformation [torsion angle = −168.44 (15)°]. In the crystal, mol­ecules are linked by C—H⋯O hydrogen bonds, generating a three-dimensional network.

4-(4-Methyl-phen-yl)-2-(prop-2-yn-1-yl)phthalazin-1(2H)-one

In the title compound, C₁₈H₁₄N₂O, the dihedral angle between the methyl­phenyl ring and the phthalazone ring system (r.m.s. deviation = 0.034 Å) is 53.93 (9)°. In the crystal, mol­ecules are connected by C—H⋯O hydrogen bonds, forming chains along [101]. The chains are linked by π–π inter­actions [centroid–centroid distance 3.6990 (12) Å], forming layers parallel to (10-1).

6,7-Dimethoxy-2,4-diphenylquinoline

In the title structure of the title compound, C₂₃H₁₉NO₂, two conformationally similar mol­ecules (A and B) comprise the asymmetric unit. The dihedral angle between phenyl rings bridged by the quinoline moiety are 76.25 (8)° in mol­ecule A and 70.39 (9)° in mol­ecule B. In the crystal, the independent mol­ecules are connected by C—H⋯O hydrogen bonds and the resulting dimeric aggregates are linked by π–π [inter-centroid distance = 3.7370 (8) Å] and C—H⋯π inter­actions, forming a three-dimensional architecture.

(E)-N′-[4-(Dimethylamino)benzylidene]-2-(4-methylphenoxy)acetohydrazide

In the title compound, C₁₈H₂₁N₃O₂, the dihedral angle between the benzene rings is 68.85 (11)°. In the crystal, the mol­ecules are linked by C—H⋯O and N—H⋯O hydrogen bonds, as well as weak C—H⋯π contacts, forming a three-dimensional supra­molecular architecture.