A series of fenamate pyridyl or quinolinyl analogues of 1,3,4-oxadiazol-2-ones 5a-d and 6a-r, and 1,3,4-oxadiazole-2-thiones 5e-g and 6s-v, respectively, have been synthesized and evaluated for their analgesic (hot-plate) , antiinflammatory (carrageenin induced rat's paw edema) and ulcerogenic effects as well as plasma prostaglandin E2 (PGE2) level. The highest analgesic activity was achieved with compound 5a (0.5 ,0.6 ,0.7 mrnolkg b.wt.) in respect with mefenamic acid (0.4 mmollkg b.wt.). Compounds 6h, 6l and 5g showed 93, 88 and 84% inhibition, respectively on the carrageenan-induced rat's paw edema at dose level of 0.1rnrnol/kg b.wt, compared with 58% inhibition of mefenamic acid (0.2mmoll kg b.wt.). Moreover, the highest inhibitory activity on plasma PGE2 level was displayed also with 6h, 6l and 5g (71, 70,68.5% respectively, 0.lmmolkg b.wt.) compared with indomethacin (60%, 0.01 mmolkg b.wt.) as a reference drug. In addition 6i, 6k, 6p, 6r, 6t and 6v were devoid of any ulcerogenicity.
It is likely that brain electrical function monitoring will play an increasingly important role in evaluating prognosis of coma in children.Aim: To compare the predictive values of clinical examinations combined with the recordings of Electroencephalography (EEG) and Brainstem Auditory-Evoked Potentials (BAEP) and computed tomography (CT) of the brain in the evaluation of coma outcome in children.Methods: Twenty children with coma aged 3-14 years were included in the study and subjected to: full history, clinical, neurological and otological examination. Medical investigations for coma, EEG, CT brain and auditory brainstem evoked potential (BAEP) measurements were performed for all patients. They were subdivided into 2 groups: group 1 included 8 patients with surgical causes of coma, group 2 include 12 patients with medical causes of coma.Results: There was younger age, lower Glasgow Coma Scale (GCS) and more significant incidence of unfavourable outcome (death, disability) in patients of surgical coma (group 1). A significant difference between both groups was observed regarding the presence of brain edema and intracranial hemorrhage (100% in group 1) while normally visualized basal cisterns were significantly more in group (2) (p=0.02). Favourable outcome was strongly related to normally visualize basal cisterns in CT brain (p=0.002), normal/ borderline EEG activity (p=0.03) and normal BAEP waves (p=0.009). Disability was significantly related to slow activity waves (p=0.015) and diffuse high voltage EEG discharges (0.009). While mortality was significantly related to the presence of intracranial bleeding in CT brain (p=0.02), silence EEG waves (p=0.005) and absent BAEP waves (0.012). Conclusion:EEG and Auditory brainstem response are valuable as prognostic predictors of pediatric coma either due to medical or surgical causes. The Glasgow Coma Scale (GCS) has several important limitations as a predictor of survival in the general critically ill population while CT brain is mostly important for diagnostic rather than prognostic factor in comatosed children.
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