Studies on the Effect of Picolines on the Stereochemistry of Lanthanide(III) Nitrate Coordination Compounds of 4[N-Furfural)amino]antipyrine Semicarbazone and Antibacterial Activities

Agarwal, Ram K.,Agarwal, Himanshu,Prasad, Surendra,Kumar, Anil Korean Chemical Society 2011 대한화학회지 Vol.55 No.4

4[N-(furfural)amino]antipyrine semicarbazone(FFAAPS)와 질산 란탄(III)이 형성하는 배위화합물의 입체화학에 미치는 ${\alpha}$-, ${\beta}$- 및 ${\gamma}$-picolines의 영향을 연구하였다. 이들 배위화합물의 일반적 조성은 [Ln(FFAAPS)$(NO_3)_3$Pic] (Ln=La, Pr, Nd, Sm, Gd, Tb, Dy 또는 Ho 및 Pic=${\alpha}$-, ${\beta}$- or ${\gamma}$-picolines)이다. 모든 배위화합물은 원소분석, 분자량, 몰전기전도도, 자기수자율, 적외선 및 자외선 스펙트럼으로 특성을 조사하였다. 적외선 연구결과 FFAAPS는 N, N, O 주개를 갖는 중성 삼배위 리간드로 행동하는 반면, ${\alpha}$-, ${\beta}$- 또는 ${\gamma}$-picoline는 헤테로 N-원자를 통하여 란탄(III) 이온에 배위된다. 질산 음이온은 이들 화합물에서 이배위로 결합한다. 자외선 스펙트럼 결과로부터 전자구름 퍼짐 효과(${\beta}$), covalence factor($b^{1/2}$), Sinha parameter (${\delta}%$) 및 covalence angular overlap parameter(${\eta}$)를 계산하였다. 이들 착물의 열적성질을 열무게 분석법에 의해 연구하였다. 본 화합물에 있어서 란탄(III)의 배위수는 10으로 조사되었다. 기본 리간드인 FFAAPS와 착물의 항박테리아 선별조사 결과, 이들 착물은 중간 정도의 항박테리아 활성을 보였다. The effect of ${\alpha}$-, ${\beta}$- and ${\gamma}$-picolines on the stereochemistry of the coordination compounds of lanthanide(III) nitrates derived from 4[N-(furfural)amino]antipyrine semicarbazone (FFAAPS) has been studied. The general composition of the present coordination compounds is [Ln(FFAAPS)$(NO_3)_3$Pic] (Ln=La, Pr, Nd, Sm, Gd, Tb, Dy or Ho and Pic=${\alpha}$-, ${\beta}$- or ${\gamma}$-picolines). All these coordination compounds have been characterized by elemental analyses, molecular weight, molar conductance, magnetic susceptibility, infrared and electronic spectra. The infrared studies suggest that the FFAAPS behaves as a neutral tridentate ligand with N, N, O donor while ${\alpha}$-, ${\beta}$- or ${\gamma}$-picoline is coordinated to the lanthanide(III) ions via heterocyclic N-atom. Nitrates are bicovalently bonded in these compounds. From the electronic spectral data, nephelauxetic effect (${\beta}$), covalence factor ($b^{1/2}$), Sinha parameter (${\delta}%$) and the covalence angular overlap parameter (${\eta}$) have been calculated. Thermal stabilities of these complexes have been studied by thermogravimetric analysis. The coordination number of lanthanide(III) ions in the present compound is found to be ten. The antibacterial studies screening of the primary ligand FFAAPS and the complexes showed that the present complexes have moderate antibacterial activities.

Endovascular interventions for central vein stenosis

( Anil K. Agarwal ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.4

Central vein stenosis is common because of the placement of venous access and cardiac intravascular devices and compromises vascular access for dialysis. Endovascular intervention with angioplasty and/or stent placement is the preferred approach, but the results are suboptimal and limited. Primary patency after angioplasty alone is poor, but secondary patency can be maintained with repeated angioplasty. Stent placement is recommended for quick recurrence or elastic recoil of stenosis. Primary patency of stents is also poor, though covered stents have recently shown better patency than bare metal stents. Secondary patency requires repeated intervention. Recanalization of occluded central veins is tedious and not always successful. Placement of hybrid graft-catheter with a combined endovascular surgical approach can maintain patency in many cases. In the presence of debilitating symptoms, palliative approach with endovascular banding or occlusion of the access may be necessary. Prevention of central vein stenosis is the most desirable strategy.

Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis

Avinash Agarwal,Ambuj Yadav,Manish Gutch,Shuchi Consul,Sukriti Kumar,Ved Prakash,Anil Kumar Gupta,Annesh Bhattacharjee 대한내분비학회 2016 Endocrinology and metabolism Vol.31 No.3

Background: Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical andbiochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity andmortality. Methods: Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically andby laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted aseither discharged to home or death. Results: The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus,systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II(APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamicoxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected tomultivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorableoutcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in meanAPACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively,compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04). Conclusion: Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of theDKA-associated mortality.

Evaluation of the Efficacy of Methylprednisolone, Etoricoxib and a Combination of the Two Substances to Attenuate Postoperative Pain and PONV in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Placebo-controlled Trial

Gautam, Sujeet,Agarwal, Amita,Das, Pravin Kumar,Agarwal, Anil,Kumar, Sanjay,Khuba, Sandeep The Korean Pain Society 2014 The Korean Journal of Pain Vol.27 No.3

Background: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. Methods: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. Results: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P<0.05). The methylprednisolone + etoricoxib combination caused a significant reduction in postoperative pain and fentanyl consumption as compared to methylprednisolone or etoricoxib alone (P<0.05); however, there was no significant difference between the methylprednisolone and etoricoxib groups (P>0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P<0.05). Conclusions: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo.

KJP : Original Article; Bertolotti Syndrome : A Diagnostic and Management Dilemma for Pain Physicians

( Anuj Jain ),( Anil Agarwal ),( Suruchi Jain ),( Chetna Shamshery ) 대한통증학회 2013 The Korean Journal of Pain Vol.26 No.4

Background: Bertolotti`s syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief. (Korean J Pain 2013; 26: 368-373)

Intractable anal pain in B-cell acute lymphocytic leukemia patients: treatment options

Vijayakumar, Vissnukumar,Agarwal, Anil,Shamshery, Chetna,Gautam, Sujeet The Korean Pain Society 2019 The Korean Journal of Pain Vol.32 No.1

Prevention of epidural catheter migration: a comparative evaluation of two tunneling techniques

Gautam Sujeet,Agarwal Anil,Das Pravin Kumar,Khuba Sandeep,Kumar Sanjay 대한마취통증의학회 2021 Korean Journal of Anesthesiology Vol.74 No.1

BackgroundEpidural analgesia failure episodes can be reduced by catheter fixation techniques with a lower incidence of catheter migration. In this clinical study, we compared the roles of two epidural catheter tunneling techniques for the prevention of epidural catheter migration.MethodsPatients undergoing major abdominal surgery were randomized into three groups of 50 patients each based on the method used to secure the epidural catheter. In the control group (CG), the epidural catheter was secured without tunneling. Tunneling groups 1 and 2 (TG1 and TG2) were defined as tunneling with and without a catheter loop, respectively. The primary outcome measure was the migration of the epidural catheter, while the secondary outcome measures were the adequacy of analgesia and signs of inflammation. All patients were followed up by the acute pain service team twice daily in the postoperative period until the epidural catheter was removed. The results were analyzed by the one-way analysis of variance (ANOVA), chi-square test, and Fisher’s exact test. P values <0.050 were considered significant.ResultsThe three groups were similar with respect to patient characteristics. Catheter migration was significantly reduced in TG2 (two patients) compared to those in the other two groups, i.e., TG1 (eight patients) (P = 0.045) and CG (17 patients) (P = 0.001). No differences were found amongst the three groups in analgesia adequacy and catheter site inflammation (P > 0.050).ConclusionsCatheter migration was significantly reduced by tunneling without a catheter loop in TG2 as compared to the other two groups. Therefore, we suggest routine use of tunneling without a catheter loop technique in anesthesia practice and look forward to future studies with larger sample sizes.

Depression masquerading as chest pain in a patient with Wolff Parkinson White syndrome

Madabushi, Rajashree,Agarwal, Anil,Tewari, Saipriya,Gautam, Sujeet KS,Khuba, Sandeep The Korean Pain Society 2016 The Korean Journal of Pain Vol.29 No.4

Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology.

Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians

Jain, Anuj,Agarwal, Anil,Jain, Suruchi,Shamshery, Chetna The Korean Pain Society 2013 The Korean Journal of Pain Vol.26 No.4

Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

Intractable anal pain in B-cell acute lymphocytic leukemia patients: treatment options

Vissnukumar Vijayakumar,Anil Agarwal,Chetna Shamshery,Sujeet Gautam 대한통증학회 2019 The Korean Journal of Pain Vol.32 No.1

.