Identification of potential edible spices as EGFR and EGFR mutant T790M/L858R inhibitors by structure-based virtual screening and molecular dynamics.

Epidermal growth factor receptor (EGFR) tyrosine kinases are overexpressed in several human cancers and could serve as a promising anti-cancer drug target. With this in view, the main aim of the present study was to identify spices having the potential to inhibit EGFR tyrosine kinase. The structure-based virtual screening of spice database consisting of 1439 compounds with EGFR tyrosine kinase (PDB ID: 3W32) was carried out using Glide. Top scored 18 hits (XP Glide Score ≥ -10.0 kcal/mol) was further docked with three EGFR tyrosine kinases and three EGFR T790M/L858R mutants using AutodockVina, followed by ADME filtration. The best three hits were further refined by Molecular Dynamics (MD) simulation and MM-GBSA-based binding energy calculation. The overall docking results of the selected hits with both EGFR and EGFR T790M/L858R were quite satisfactory and showed strong binding compared to the three coligands. Detailed MD analysis of CL_07, AC_11 and AS_49 also showed the stability of the protein-ligand complexes. Moreover, the hits were drug-like, and MM-GBSA binding free energy of CL_07 and AS_49 was established to be far better. AC_11 was found to be similar to the known inhibitor Gefitinib. Most of the potential hits are available in Allium cepa, CL_07 and AS_49 available in Curcuma longa and Allium sativum, respectively. Therefore, these three spices could be used as a potential therapeutic candidate against cancer caused by overexpression of EGFR after validation of the observations of this study in in-vitro experiments. Further extensive work is needed to improve the scaffolds CL_07, AC_11, AC_17, and AS_49 as potential anti-cancer drugs.Communicated by Ramaswamy H. Sarma.

A Comparison Between Histology and Rapid Urease Test in the Diagnosis of Helicobacter Pylori in Gastric Biopsies: A Systematic Review.

Helicobacter pylori (H. pylori) is a gram-negative aerobic pathogen that primarily colonizes the gastric mucosa. Peptic ulcer disease, atrophic gastritis, gastric cancer, and mucosal-associated lymphoid tissue lymphoma have all been linked to chronic H. pylori infection. Hence, it is critical to diagnose and treat it as early as possible. There are both invasive and noninvasive tests available to detect it. In this review, the diagnostic abilities of two invasive tests - histology and the rapid urease test (RUT) - are compared in a variety of clinical situations. This systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist. We performed a literature search using the PubMed and Google Scholar databases in accordance with the eligibility criteria and ultimately selected eight articles for final analysis. The Newcastle-Ottawa scale adapted for cross-sectional studies, the Scale for the Assessment of Narrative Review Articles (SANRA), and the PRISMA 2020 checklist were used to assess the quality of selected articles for cross-sectional studies, traditional literature reviews, and systematic reviews, respectively. According to the findings of the review, both histology and the RUT have high sensitivity and specificity in diagnosing H. pylori though this varies depending on the clinical situation, making one test superior to the other. Neither of these tests can be considered the gold standard method on its own. Hence, using at least two diagnostic tests at the same time is critical for ensuring high sensitivity and specificity while accurately diagnosing the pathogen.

Detection and Diagnostic Accuracy of Cardiac Arrhythmias Using Wearable Health Devices: A Systematic Review.

Photoplethysmography (PPG) is the wearable devices' most widely used technology for monitoring heart rate. The systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and guidelines. This systematic review seeks to establish the effects of wearable health devices on cardiac arrhythmias concerning their impact on the personalization of cardiac management, their refining effect on stroke prevention strategies, and their influence on research and preventive care of cardiac arrhythmias and their re-evaluation of the patient-physician relationship. The population, exposure, control, outcomes, and studies (PECOS) criteria were used in the systematic review. This review considered studies that covered the tests conducted on individuals who presented with cardiovascular diseases (CVD) and also healthy people. The intervention for studies included wearable health devices that could detect and diagnose cardiac arrhythmias.  The study considered articles that reported on the personalization of cardiac management, stroke prevention strategies, influence in research and preventive care of cardiac arrhythmias, and the re-evaluation of the patient-physician relationship. Two independent researchers were used in the extraction of the data. In case of dispute, the issue was resolved using a third party. The study's quality analysis was conducted using AXIS. The management of atrial fibrillation (AF) lies heavily in the prevention of stroke. The accuracy being reported in the prediction of arrhythmias and the monitoring of heart rates makes wearable devices an efficient means to personalize health care. Personalization of health and treatment in preventing and managing arrhythmias becomes possible due to the portability of smart wearable devices. However, limitations may be observed due to the high costs incurred in their purchase and use. Using smart wearable devices for the detection of cardiac arrhythmias was very significant.

The Correlation Between Otitis Media With Effusion and Adenoid Hypertrophy Among Pediatric Patients: A Systematic Review .

Otitis media with effusion (OME) affects approximately 80% of children due to the middle ear being flooded with fluids, though with no microbial infection manifestations. Multiple issues can drive recurring pediatric OME, such as environment-based issues, previous medical issues, inherited vulnerability from family, contact time at childcare institutes, passive smoking, and more than three siblings together with atopy or allergic rhinitis. If OME is not promptly addressed, this could eventually result in hearing impairment or loss, with consequent negative repercussions on the child's communicative and behavioral patterns. OME diagnosis within the clinic is possible, with hearing capacity being assessed pre- and post-therapy. Adenoid hypertrophy (AH) represents a typical causative factor for middle-ear conditions, stemming from mechanical or anatomical issues. Consequently, adenoid size is paramount when determining tympanometry types and ear fluids. This systematic review investigated PubMed, Medline, Cochrane Library, and Science Direct databases in order to retrieve knowledge related to this issue, adopting inclusion and exclusion criteria and maintaining review quality through the employment of the Assessment of Multiple Systematic Reviews (AMSTAR), the Newcastle-Ottawa tool, and the Axis scale. This systematic review analyzed a previous review article, six observation-based investigations, and three cross-sectional investigations. Previous randomized controlled trials (RCTs) were not found within previous literature, suggesting such scarcity in this research niche and thus warranting future RCT investigations based on this compelling research niche.

The Efficacy of Sitz Baths as Compared to Lateral Internal Sphincterotomy in Patients with Anal Fissures: A Systematic Review.

An anal fissure is a common condition that affects patients of all ages. Its clinical presentation is a sharp pain on defecation with or without blood. It is treated by conservative or surgical means. This study aims to assess the efficacy of a sitz bath as compared to lateral internal sphincterotomy in the treatment of anal fissures. The search strategy used keywords related to the topic of study. Three databases were used: PubMed, Google Scholar, and Science Direct. A total of 551 articles were screened. A quality assessment check was done on the articles leaving 11 articles. Four aspects of sitz bath outcomes were evaluated in the articles. In terms of analgesia, articles showed conflicting evidence. However, the overall evidence supports the use of sitz baths for their analgesic properties. In terms of healing, most articles had similar recovery rates of around 80%. Much of the research supported the use of sitz baths as the primary treatment to heal acute fissures. When compared to lateral internal sphincterotomy, the recovery rates of lateral internal sphincterotomy are superior to those of conservative treatment, including sitz baths. However, studies showed incontinence as a side effect of lateral internal sphincterotomy, and no studies reported side effects from the sitz baths. To conclude, the results of the articles support the use of sitz baths to treat anal fissures. Sitz baths have been found to have analgesic properties, as well as a good healing time. But, compared to lateral internal sphincterotomy, there is a significant difference in the healing rate at the end stage of treatment, lateral internal sphincterotomy is found to be superior. With regards to the side effects, none have been reported from using a sitz bath.

Accuracy of Ultrasonography vs. Elastography in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review.

Ultrasonography and elastography are the most widely used imaging modalities for diagnosing non-alcoholic fatty liver disease. This study aimed to assess and compare the diagnostic accuracy in patients with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was done for the past seven years using Pubmed, Pubmed Central, Cochrane, and Google Scholar databases on Jun 29, 2022. Studies were included based on the following predefined criteria: observational studies, randomized controlled trial (RCT), comparative studies, studies using liver biopsy or MRI proton density fat fraction (MRI PDFF) as a reference standard, ultrasonography, and elastography with measures of their diagnostic accuracy like sensitivity (SN), specificity (SP), area under the receiver operating characteristic (AUROC) curve, and English language. The data were extracted on a predefined template. The final twelve eligible studies were assessed using the quality assessment of diagnostic accuracy tool (QUADS-2). Most studies focused on elastography techniques, and the remaining focused on quantitative ultrasonography methods like the controlled attenuation parameter (CAP) and attenuation coefficient (AC). Only one study was available for the evaluation of qualitative ultrasonography. MRI was generally found superior to other diagnostic tests for determining liver stiffness through magnetic resonance elastography (MRE) and steatosis through MRI PDFF. Data assessing the comparative diagnostic accuracy of the two tests were inconclusive.

OctNET: A Lightweight CNN for Retinal Disease Classification from Optical Coherence Tomography Images.

BACKGROUND AND OBJECTIVE: Retinal diseases are becoming a major health problem in recent years. Their early detection and ensuing treatment are essential to prevent visual damage, as the number of people affected by diabetes is expected to grow exponentially. Retinal diseases progress slowly, without any discernible symptoms. Optical Coherence Tomography (OCT) is a diagnostic tool capable of analyzing and identifying the quantitative discrimination in the disease affected retinal layers with high resolution. This paper proposes a deep neural network-based classifier for the computer-aided classification of Diabetic Macular Edema (DME), drusen, Choroidal NeoVascularization (CNV) from normal OCT images of the retina. METHODS: In the proposed method, we demonstrate the feasibility of classifying and detecting severe retinal pathologies from OCT images using a deep convolutional neural network having six convolutional blocks. The classification results are explained using a gradient-based class activation mapping algorithm. RESULTS: Training and validation of the model are performed on a public dataset of 83,484 images with expert-level disease grading of CNV, DME, and drusen, in addition to normal retinal image. We achieved a precision of 99.69%, recall of 99.69%, and accuracy of 99.69% with only three misclassifications out of 968 test cases. CONCLUSION: In the proposed work, downsampling and weight sharing were introduced to improve the training efficiency and were found to reduce the trainable parameters significantly. The class activation mapping was also performed, and the output image was similar to the retina's actual color OCT images. The proposed network used only 6.9% of learnable parameters compared to the existing ResNet-50 model and yet outperformed it in classification. The proposed work can be potentially employed in real-time applications due to reduced complexity and fewer learnable parameters over other models.