Identification of key biomarkers and associated pathways of pancreatic cancer using integrated transcriptomic and gene network analysis.

Pancreatic cancer shows malignancy around the world standing in 4th position for causing death globally. This cancer is majorly divided into exocrine and neuroendocrine where exocrine pancreatic ductal adenocarcinoma is observed to be nearly 85% of cases. The lack of diagnosis of pancreatic cancer is considered to be one of the major drawbacks to the prognosis and treatment of pancreatic cancer patients. The survival rate after diagnosis is very low, due to the higher incidence of drug resistance to cancer which leads to an increase in the mortality rate. The transcriptome analysis for pancreatic cancer involves dataset collection from the ENA database, incorporating them into quality control analysis to the quantification process to get the summarized read counts present in collected samples and used for further differential gene expression analysis using the DESeq2 package. Additionally, explore the enriched pathways using GSEA software and represented them by utilizing the enrichment map finally, the gene network has been constructed by Cytoscape software. Furthermore, explored the hub genes that are present in the particular pathways and how they are interconnected from one pathway to another has been analyzed. Finally, we identified the CDKN1A, IL6, and MYC genes and their associated pathways can be better biomarker for the clinical processes to increase the survival rate of of pancreatic cancer.

An Isolated Displaced Coracoid Fracture Treated with Open Reduction Internal Fixation with 4 mm Cannulated Cancellous Screw.

Introduction: Isolated coracoid process fracture of scapula is a rare. Usually, it happens along with the rotator cuff tear, dislocation of acromioclavicular joint, or glenohumeral joint. Displaced fracture will cause impairment of upper limb movement. Since there are very low numbers of cases reported so far, the treatment is still controversial. Case Report: We report a case of a 42-year-old male laborer with motor vehicle accident, following which he had pain and restricted movements on his left shoulder. On examination, Glasgow Coma Scale 15/15 and left shoulder had swelling and tenderness at mid-third clavicle. Range of motion (ROM) is painful and restricted. Plain radiograph shows suspected fracture at coracoid process and computerized tomography scan confirms displaced isolated coracoid process fracture. He underwent open reduction with internal fixation with a 4 mm cannulated cancellous screw with washer. Following surgery, initial 2 weeks shoulder immobilized in arm sling and gradual pendulum exercise was started as pain tolerable. At the end of 6 weeks, radiological investigation showed fracture united and he was advised to do ROM exercise and restricted activity of daily living. At the end of 3 months, he was able to do his normal activity of daily living as before injury. The patient followed up to 6 months and had full range of movements in all directions and there was no pain and he was able to do daily activities. Conclusion: In this case of isolated coracoid fracture was found displaced more than 1 cm, hence we preferred open reduction and internal fixation with 4 mm cannulated cancellous screw with washer to avoid non-union.