Reactions of Ketonic Mannich Bases with Malononitrile and Malononitrile dimer

The reaction of malononitrile with the tertiary Mannich base hydrochloride derived from acetophenone and some related compounds 1, 3, 5 and 7, in piperidine at 50°C afforded the pyrido[1,2-a]pyrimidine derivatives 2, tetrahydronaphthalene derivative 4 substituted quinolines 6 and benzopyran derivatives 8. While the condensation of malononitrile dimer with acetophenone, cyclohexanone and/ or α-tetralone Mannich bases hydrochloride 1, 3 and 9 gave the pyridine, isoquinoline and benzo[f]isoquinoline derivatives 10–12 in moderate to good yield.

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

BACKGROUND

The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications.

METHODS

ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery.

RESULTS

The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784.

CONCLUSIONS

This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.

CLINICAL TRIAL REGISTRATION

NCT03044899.

Practical teaching of behavioral sciences to medical students

Introduction

The teaching of behavioral sciences was in form of lectures to the medical students in the 2nd year of the college, because the lecture is the least beneficial method of teaching. As I have noticed also that students were more interested to practice behavioral skills. So I suggested to the authority of the faculty to teach part of the behavioral sciences in a practical way and proposal of that was introduced and accepted to teach in that way and to give 20% of marks to this practical part, this in addition to the same theoretical lectures.

Method

The students were divided into groups of 30, every group present one day only through their 2nd year. This day divided into two parts each is 2 hours and in between have an hour break. The 1st part includes group discussion about communication, group dynamics, group leading and scientific way of problem solving. The 2nd part is dividing students into small groups of 10 students, to practice the previous skills in group interaction to solve one problem in a scientific way. All groups collected again to see what they have done.

Results

The results revealed more interest and more enthusiasm to learn in that way and make it easy to practice in their daily life.

Conclusion

We have to change into more practice in our teaching of medical students especially skills of human communication, group leading group dynamics as well as problem solving.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Synthesis of 2-Acetoacetyl- and 2-OxaIoacetyl-1,3-indandiones and Related Compounds

Claisen condensation of 2-acetyl-1,3-indandione (1) with ethyl acetate afforded the 2-acetoacetyl-1,3-indandione (2) which upon treatment with benzylamine and paraformaldehyde in a molar ratio of (1:1:2) and (1:2:4) afforded the piperidinone and the diazabicyclic derivative (4) and (5) respectively. On the other hand, Claisen condensation of 1 with diethyl oxalate yielded two products (6) and (9). The behaviour of 6 towards phenyl hydrazine, and of 9 towards selenium dioxide and double Mannich reaction were also investigated.

Mannich Reaction with 1 ,3 - Indandione Phenylhydrazones

Mannich reaction of 1,3-indandione-1-phenylhydrazone (1) or 1,3-diphenylhydrazone (5) with

morpholine or piperazine gave the Mannich base-phenylhydrazone 2 and 3 or the diphenylhydrazone

6 and 7, respectively. Whereas, such reaction with 1 or 5 using primary amines afforded

the indeno[2,1-ƒ]-1,2,4-triazepin-6(2H)-one (4) or its 6-phenylhydrazone (8), respectively.

Treatment of 5 with ammonium acetate and formalin afforded 9. The indeno[1,2-ƒ]-1,2,4,5-

tetrazepin-10(2H)-one (11) was obtained from the 1,2-diphenylhydrazone 10 and formaldehyde.

A Study on the Mannich Reaction with 1,3-Indandione

Attempted Mannich reaction with the title compound 1 using morpholine and formalin led to 2 or 4 according to the reaction conditions. Whereas, on using primary amines the diindeno [1,2-b:2′,1′-e]pyridine (9-11) were obtained, in addition to 2-methylene-1,3-indandione (6), in case of 10 and 11.

However, the Mannich bases 13-15 were formed on treating 2-benzylidene-1,3-indandione with the appropriate secondary amine. The structures 2, 9-11 were confirmed via unambiguous syntheses.

Photosynthesis of furocoumarin- and furochromone-types potential intercalative alkylating and oxidizing agents of DNA through photooxidations using gamma-ray

The photooxygenation of imperatorin (1a) under gamma-ray irradiation afforded the hydroperoxides 2a and 3a. Similarly, the photooxygenation of alloimperatorin (1b) gave the hydroperoxide (2b). Visnagin (1c) was also photooxygenated to give the hydroperoxide (2c) as sole product. On the other hand, the photooxygenation of khellin (1d) gave the endoperoxide (2d) as a sole product. The epoxidation of imperatorin (1a) using hydrogen peroxide under gamma-ray irradiation afforded the epoxide 5a. Similarly visnagin (1c) and khellin (1d) were epoxidized to give the epoxides 5c and 5d.

Epoxidation of some natural furocoumarins and furochromones using gamma-ray

Epoxidation of imperatorin (1a) with m-chloroperbenzoic acid (mcpba) under the irradiation of gamma-ray gave a mixture of epoxide 3a and dioxofuran 4a. Whereas, alloimperatorin (1b) under the same condition obtained the epoxide 3b as a sole product. On the other hand, it was successfully epoxidized xanthotoxin (1c) with mcpba under the same condition as above. In addition, visnagin (2a) was epoxidized to give a mixture of epoxides 5a, 6a. While, khellin (2b) gave the epoxide 5b, no other products were observed.

Aminoazoles in heterocyclic synthesis. Synthesis of some new pyrimidobenzimidazoles and pyrazolonopyridines as well as triazolo-, tetrazolo- and pyrazolo-pyrimidines of pharmaceutical interest

The reactivity of 3-cinnamoylindole, 3-cinnamoylantipyrine and 1-(3-methyl-1-phenyl-5-pyrazolon-4 yl)-4-antipyrin-4-yl)-prop-2-ene-1- one(la-c) towards 2-aminobenzimidazole, 3-amino-1,2,4-triazole, 5-aminotetrazole monohydrate, 5-amino-3-phenylpyrazole and 3-amino-1-phenyl-2-pyrazolin-5-one to give the fused heterocycles 2a-c, 4a,b, 5a,b, 8a,b, and 10a-c has been investigated. Structures of the synthesized compounds were confirmed by both the analytical and the spectral data (IR, UV and 1H NMR).