Abstract Introduction: Vancomycin and Amikacin are drugs with renal excretion primarily and are used widely in critically ill children. Fall in urine output is one of the first events in case of kidney injury in PICU setting. It is not clear how early AKI (eAKI),defined as only fall in urine output by KDIGO 2012 AKI definition before rise in serum creatinine, impacts levels of these drugs.We conducted pilot study to determine drug levels of Vancomycin and Amikacin in critically children with eAKI and 48 hours after modification. Methods: Children on Vancomycin or Amikacin were monitored for hourly urine output . Serum creatinine and Amikacin or Vancomycin levels were measured at 24 hours and again at diagnosis of eAKI.Serum Vancomycin and Amikacin levels were estimated in-house as a research tool by high performance liquid chromatography (HPLC) done on Agilent Infinity II system. Results: Incidence of eAKI was 15.7% in children on Vancomycin and these children also had AKI by serum creatinine criterion. Among children on Amikacin, incidence of eAKI was 12.5% and none developed AKI by serum creatinine criterion. In children on Vancomycin, mean drug levels when eAKI was diagnosed was 22.8 ±4.36 mg/L and creatinine was 1.03 ±0.31 mg/dl, both significantly higher than baseline ( P < 0.0001).Post drug-dose modification trough level was 15.48 ±1.64 mg/L still significantly high ( P < 0.0001) but mean serum creatinine reduced to 0.66 ±0.10 mg/dl. Drug levels and creatinine at D7 were comparable.Mean Amikacin levels in children with eAKI were 59.9 ±13.79mg/L, significantly higher than baseline ( P < 0.0001). 48 h after dose reduction, trough Amikacin levels remained significantly elevated but there was no significant difference in serum creatinine from baseline levels in these children with eAKI.Amikacin level at day 7 also significantly higher despite dose modification. Conclusion: Children on Vancomycin with eAKI had simultaneous rise in serum creatinine. Drug levels remained 48h after drug dose modification and became comparable only at day 7. In children on Amikacin,with eAKI, serum creatinine showed no significant rise but drug levels in these children remained significantly high compared to baseline at 48h after dose modification as well at day 7.
Abstract Growing environmental concerns have intensified the demand for green and sustainable approaches in chemical synthesis. In response to this need, we have developed an efficient Ru(II)/PEG-400 system as a homogeneous recyclable catalytic medium for the domino synthesis of 3,4-disubstituted isoquinolines and isocoumarins through C–H activation. The use of a biodegradable solvent, simple starting materials, excellent atom economy, and a broad substrate scope enhances the overall efficiency and sustainability of this protocol. Furthermore, the Ru(II)/PEG-400 catalytic medium can be reused over five successive cycles while maintaining its catalytic activity. In the application part, the practicality of this methodology is demonstrated through gram-scale synthesis and photophysical studies of the isoquinoline derivatives.
Abstract Background: Healthcare emergencies present with high-intensity, rapidly changing environments that challenge the coping mechanisms of healthcare professionals. Coping mechanisms play a crucial role in maintaining performance and psychological balance during crises. Methods: A qualitative study was conducted using in-depth interviews with medical and paramedical staff working in the emergency department of a tertiary care hospital in Western Maharashtra. Data were collected using semi-structured questionnaires, responses were audio-recorded, transcribed verbatim, and coded using NVivo software followed by thematic analysis. Results: A total of 12 participants were interviewed, including doctors, nurses, and paramedical staff with thematic saturation achieved by the twelfth interview. The major themes that emerged were Maintaining Balance, Crisis Control, Human Factors, and Teamwork, each comprising sub-themes related to emotional regulation, leadership and resource management, training and communication, co-operation, and reciprocal trust. Participants described emotional regulation, protocol-driven prioritization, leadership-led crisis control, structured communication, training adequacy, equipment readiness, and mutual trust as central coping mechanisms during emergencies. Conclusion: Emergency response coping skills are multidimensional and system-dependent rather than purely individual attributes. Strengthening these skills among emergency healthcare professionals requires systematic support through training, structured communication frameworks, and psychological reinforcement. Organizational preparedness and peer support play a vital role in maintaining resilience during emergencies, safeguarding the workforce’s well-being, and ensuring patient safety during emergencies.
t is widely recognized in nucleic acid chemistry that activated heterocyclic nucleobases of nucleosides, including purine-, pyrimidine-, and triazole-based systems, can be functionalized through cross-coupling strategies. To obtain synthetically and biologically valuable scaffolds, various nucleoside architectures have undergone chemical modifications, which have subse-quently attracted considerable attention in pharmaceutical research. A broad range of transition-metal-catalyzed methodolo-gies has been developed for nucleoside functionalization. In this context, we present a concise overview of the different approaches employed for nucleoside modification via transition-metal-catalyzed C-H activation.
Chemical safety is an essential component of laboratory work, particularly where users handle substances that may be toxic, corrosive, flammable, or reactive. This study examined the relationship between chemical safety awareness and laboratory practices among laboratory users. A quantitative research design was adopted, and data were collected from 270 respondents using a structured questionnaire based on a five-point Likert scale. Descriptive statistics were used to examine the responses, while Pearson correlation and ANOVA were applied to test the hypotheses. The findings revealed a very strong positive relationship between chemical safety awareness and laboratory practices, with a Pearson correlation coefficient of 0.974 and a significance value of 0.000. The ANOVA results also showed a statistically significant association with the adoption of safe laboratory practices (F = 231.953, p = 0.000). The findings highlight the importance of strengthening chemical safety awareness through regular training, appropriate safety procedures, proper chemical handling, and effective laboratory safety practices.
