This review deals with the synthetic methods, chemical reactions, and applications of triazolopyrimidine derivatives. The synthetic methods and chemical reactions are subdivided into groups according to the junction between triazole and pyrimidine moieties for instance [1,2,4]triazolo[1,5-a]pyrimidine, [1,2,4]triazolo[1,5-c]pyrimidine, [1,2,3]triazolo[1,5-a]pyrimidine, [1,2,3]triazolo[1,5-c]pyrimidine, [1,2,4]triazolo[4,3-c]pyrimidine, and [1,2,4]triazolo[4,3-a]pyrimidine. Pharmacological activity of triazolopyrimidins is also reported.

Aim: Estimation of blood glycated hemoglobin A (HbA1c) level in newly pregnant women at time of pregnancy diagnosis (T0) and 3-monthly thereafter to detect any relation between these levels and the change in maternal blood glucose (BG) levels during pregnancy. Material and Methods: 304 newly pregnant women gave fasting blood samples for estimation of T0 HbA1c level and then underwent the 75-Oral glucose tolerance test (OGTT) and were asked to re-attend the clinic overnight fasting at the start of the 12 th and at the 24 th -28 th gestational week (GW) for estimation of HbA1c levels and to repeat the 75-OGTT. ΔHbA1c was calculated as the difference between HbA1c levels estimated at 12 th GW minus T0 levels. The results of the 75-OGTT were interpreted for diagnosis of gestational diabetes mellitus (GDM) and HbA1c at range of 4-6% indicates non-diabetic state. Study outcome is the ability of T0 levels of HbA1c to discriminate women vulnerable to develop GDM around the 24 th to the 28 th GW. Results: 38 women developed GDM, while 286 women completed their pregnancy free of GDM. GDM women had significantly higher T0 body mass index (BMI) and HbA1c levels than Non-GDM women. Moreover, the 12 th and 24 th GW HbA1c levels and ΔHbA1c were significantly higher in GDM women. The 24 th GW 2hr-postprandial BG (PPBG) levels showed significant positive correlation with T0 BMI, fasting BG and 2hr-PPBG and with T0 and 12th GW levels of HbA1c and ΔHbA1c. Regression analysis defined T0 level of HbA1c, ΔHbA1c, 12 th GW HbA1c level and T0 BMI as the significant positive predictor for the 24 th GW 2hr-PPBG level. ROC curve analysis defined T0 level of HbA1c and ΔHbA1c as the significant predictors for the 24 th GW 2hr-PPBG level which is diagnostic for GDM. Conclusion: Development and severity of GDM could be predicted at time of pregnancy diagnosis by high HbA1c level and assured by calculation of the extent of change in HbA1c level at the 12 th GW.

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Background: Ketamine is a dissociative anesthetic with a unique pharmacological profile that has garnered increasing interest in recent years due to its potential therapeutic uses. This review provides a comprehensive overview of the recent evidence and current uses of ketamine. The clinical uses of ketamine are summarized, including its approved and off-label uses in various anesthetic and medical conditions. Firstly, ketamine has shown efficacy as an adjunct to general anesthesia, contributing to improved analgesia, hemodynamic stability, and reduced opioid requirements. Additionally, it has demonstrated effectiveness in the management of acute and chronic pain, including postoperative pain, neuropathic pain, and cancer pain. Moreover, ketamine infusion therapy has been explored in the context of enhanced recovery after surgery (ERAS) protocols, where it has shown potential in reducing postoperative opioid consumption and accelerating recovery. The use of ketamine as a sole agent for procedural sedation, particularly in resource-limited settings, has also been investigated, highlighting its safety and efficacy. Furthermore, the emerging role of ketamine in managing opioid-tolerant and opioid-dependent patients in the perioperative period presents an intriguing area of research. The safety and adverse effects of ketamine are reviewed, including its potential cardiovascular, respiratory, and psychological effects. Finally, ongoing research and emerging evidence on ketamine are discussed, including new findings on its mechanisms of action, potential novel clinical applications, and optimization of dosing regimens. In conclusion, the reviewed literature supports the use of ketamine in various clinical settings, while acknowledging the limitations and uncertainties in its use. Continued research, evidence-based practice, and interdisciplinary collaboration are essential to help our understanding of ketamine and its potential clinical applications.