Small molecular inhibitors: Therapeutic strategies for pancreatic cancer.

Pancreatic cancer (PC), a disease with high heterogeneity and a dense stromal microenvironment, presents significant challenges and a bleak prognosis. Recent breakthroughs have illuminated the crucial interplay among RAS, epidermal growth factor receptor (EGFR), and hedgehog pathways in PC progression. Small molecular inhibitors have emerged as a potential solution with their advantages of oral administration and the ability to target intracellular and extracellular sites effectively. However, despite the US FDA approving over 100 small-molecule targeted antitumor drugs, challenges such as low response rates and drug resistance persist. This review delves into the possibility of using small molecules to treat persistent or spreading PC, highlighting the challenges and the urgent need for a diverse selection of inhibitors to develop more effective treatment strategies.

Efficacy and safety of diode laser for facial hair reduction in hirsutism-a clinico-trichoscopic evaluation.

Background: Hirsutism is the presence of excessive terminal hair on androgen-dependent sites of the body. Lasers like Alexandrite, diode, and Nd:Yag lasers have been used for hair reduction with varying efficacy. Trichoscopy of hair is a simple noninvasive method of hair assessment. However, it has not been used in the assessment of diode laser hair reduction. Objectives: This study aimed to assess the efficacy and safety of diode laser hair reduction in skin color with the help of clinical and trichoscopic assessment. Materials and Methods: This prospective observational study included 73 patients of hirsutism recruited in 18-month period. All participants received sessions of 805 nm diode laser at monthly intervals up to six sessions. Clinical and trichoscopic evaluation along with photographs were obtained at each visit. Side effects, if any, were noted in every sitting. Results: All patients were females of Fitzpatrick skin types III-V. All clinical parameters showed statistically significant hair reduction when compared with baseline. Trichoscopic parameters of hair reduction like total hair count, terminal hair count, and terminal/vellus hair ratio showed reduction compared to baseline which was statistically significant (P < 0.05). The most common side effect noted in our study was pain followed by erythema and perifollicular edema. Conclusions: Diode laser is an effective and safe procedure for the reduction of unwanted facial hair, even in darker skin types. We also wish to emphasize that trichoscopy for the assessment of laser hair reduction is a recent, noninvasive, simple, and underutilized tool. No serious adverse events were noted in our study.

Quantifying the advantages and acceptability of linking dialysis machines to an electronic medical record.

AIM: To establish and quantify the time saved by redirecting nursing workload from recording and entering haemodynamic data during chronic dialysis sessions by linking dialysis machines directly to the electronic medical record. METHODS: We developed a bespoke interface from the HL7 feed from the dialysis machines (largely Fresenius 5008) to our EMR system (Cerner). We quantified the time nurses spent with the patient, computer, dialysis machine and sorting our patient related issues by observation using independent observers in a time and motion study. We performed these observations before and after implementation of the computer interface. We established patient and nursing acceptance by survey. We established adequacy of observations by counting the number of patients who received the minimum number of observations recorded in the system before and after implementation. RESULTS: Implementation of a dialysis machine direct EMR interface reduced the time the nurses spent with the computer significantly by ∼9 % (around 28 min, p < 0.05) per dialysis shift, and this was accompanied by a similar increase in time spent sorting out patient-related issues. The interface was well accepted by staff and patients. An immediate benefit was a ∼60 % improvement in the adequacy of recording vital signs in our dialysis patients. Then simply by showing these results to the nursing staff there was further improvement. CONCLUSIONS: In these days of machine interconnectivity there is really no good reason why dialysis nurses should be used to transfer data between machines. It is far better to utilise their skills in helping patients with their medical issues. We have shown that such a link improves efficiency, patient and staff satisfaction and dialysis governance.

Linear morphea with overlying lichen sclerosus and calcinosis cutis associated with juvenile dermatomyositis.

Juvenile dermatomyositis (JDM) is associated with many distinguishing features including cutaneous calcinosis, vasculitis, and ulcerated lesions. In this case, we describe an unusual presentation in a 12-year-old girl who had muscle weakness along with linear morphea over the right upper and lower extremities with overlying lichen sclerosus and calcinosis cutis. Of interest, these initial cutaneous manifestations occurred years before onset of myositis.

Gas chromatography-mass spectrometry (GC-MS) profiling of aqueous methanol fraction of Plagiochasma appendiculatum Lehm. & Lindenb. and Sphagnum fimbriatum Wilson for probable antiviral potential.

The bryophytes consist of liverworts, mosses, and hornworts, among which the liverworts are quite different in having cellular oil bodies and contain numerous terpenoids, acetogenins, quinones, phenylpropanoids, flavonoids, etc. These metabolites exhibit interesting biological activity such as allergenic response, insecticide, cytotoxic, neurotrophic, antimicrobial, and anti-HIV actions, etc. Though several bioactive compounds have been isolated in many liverworts, yet most of the liverworts have been unexplored till date regarding their phytochemistry. The ability of liverworts to generate a wide range of important phytochemicals makes them a hoard of bioactive compounds. In the past, a few species of bryophytes have been evaluated against a few viruses and interesting results were obtained that showed their role as an immunity enhancer against viral infection. The phytoconstituents found in liverworts and mosses can be useful to increase human immunity against a variety of viruses, including SARS-CoV-2. Keeping this in view, one of the most developed and robust metabolomics technologies, Gas chromatography-mass spectroscopy (GC-MS) was used to estimate the various phytoconstituents found in a commonly growing thalloid liverwort, Plagiochasma appendiculatum, and moss Sphagnum fimbriatum. The obtained profiles were appraised for their bioactive potential and probable role as antiviral agents.

Teledermatology Services during COVID-19 Pandemic: Experience of a Tertiary Care center in Western India.

Background: Telemedicine has emerged as an important tool in providing patient care during the COVID-19 pandemic. Hence, we aimed to study the clinico-epidemiological profile of patients seen in the teledermatology outpatient department (OPD) during the COVID-19 pandemic. Material and Methods: Retrospective data analysis of records of patients, who consulted in telemedicine OPD from 20 April 2020 to 5 Feb 2021 was done. Results: Out of 2524 patients registered for teledermatology consultation, 2117 completed the process of teleconsultation. The mean age of patients was 35.59 ± 15.60 years. There was a male preponderance with 1372 (64.81%) patients while females were 745 (35.19%). 1773 (83.75%) patients were managed on telemedicine alone and 344 (17.42%) patients required face to face physical consultation. The most common disorder was dermatophytosis seen in 316 (17.82%) followed by hair disorders like androgenetic alopecia and telogen effluvium in 239 (13.48%), acne in 238 (13.42%) and dermatitis in 196 (11.05%). Blood investigations were advised in 365 (17.24%) patients and skin biopsy was advised in 23 (1.09%) patients. The major causes for incomplete teleconsultation procedure were no response to telephone calls in 207 (8.2%), 76 (3.01%) patients had taken a prior consultation and 60 (2.37%) patients didn't give consent for teleconsultation. Conclusion: Common dermatological diseases like tinea, acne, hair disorders and dermatitis can be managed on telemedicine alone. In India, there are fewer dermatologists per population, therefore telemedicine can be continued even after the pandemic is over in cases where diagnoses and treatment are straight forward.

A comprehensive analysis of Trehalose-6-phosphate synthase (TPS) gene for salinity tolerance in chickpea (Cicer arietinum L.).

Soil salinity affects various crop cultivation but legumes are the most sensitive to salinity. Osmotic stress is the first stage of salinity stress caused by excess salts in the soil on plants which adversely affects the growth instantly. The Trehalose-6-phosphate synthase (TPS) genes play a key role in the regulation of abiotic stresses resistance from the high expression of different isoform. Selected genotypes were evaluated to estimate for salt tolerance as well as genetic variability at morphological and molecular level. Allelic variations were identified in some of the selected genotypes for the TPS gene. A comprehensive analysis of the TPS gene from selected genotypes was conducted. Presence of significant genetic variability among the genotypes was found for salinity tolerance. This is the first report of allelic variation of TPS gene from chickpea and results indicates that the SNPs present in these conserved regions may contribute largely to functional distinction. The nucleotide sequence analysis suggests that the TPS gene sequences were found to be conserved among the genotypes. Some selected genotypes were evaluated to estimate for salt tolerance as well as for comparative analysis of physiological, molecular and allelic variability for salt responsive gene Trehalose-6-Phosphate Synthase through sequence similarity. Allelic variations were identified in some selected genotypes for the TPS gene. It is found that Pusa362, Pusa1103, and IG5856 are the most salt-tolerant lines and the results indicates that the identified genotypes can be used as a reliable donor for the chickpea improvement programs for salinity tolerance.

Pharmacological, Cytotoxic, Immunostimulant, and Auto-Immune Activity of Thalloid Liverworts: An Overview.

Bryophytes have historically been employed as verdant medicine in China, Native America and India. Phenolics, glycosides, fatty acids, other rare aromatic compounds and Terpenoids found in bryophytes may help prevent cancer and other chronic disorders. Liverworts have historically been utilized in traditional medicine and also as immu-nomodulators or immunostimulants. Diterpenoids, Lipophilic mono-, sesqui- and aromatic compounds assisting to the biological activities of liverworts. For their biological functions more than 220 aromatic compounds and 700 terpenoids and other chemicals discovered in liverworts scrutinized for their pharmacological, cytotoxic, immunostimulant and auto-immune efficacies.