Circulating tumor DNA (ctDNA) application in investigation of cancer: Bench to bedside.

Now, genomics forms the core of the precision medicine concept. Comprehensive investigations of tumor genomes have made it possible to characterize tumors at the molecular level and, specifically, to identify the fundamental processes that cause condition. A variety of kinds of tumors have seen better outcomes for patients as a result of the development of novel medicines to tackle these genetic-driving processes. Since therapy may exert selective pressure on cancers, non-invasive methods such as liquid biopsies can provide the opportunity for rich reservoirs of crucial and real-time genetic data. Liquid biopsies depend on the identification of circulating cells from tumors, circulating tumor DNA (ctDNA), RNA, proteins, lipids, and metabolites found in patient biofluids, as well as cell-free DNA (cfDNA), which exists in those with cancer. Although it is theoretically possible to examine biological fluids other than plasma, such as pleural fluid, urine, saliva, stool, cerebrospinal fluid, and ascites, we will limit our discussion to blood and solely cfDNA here for the sake of conciseness. Yet, the pace of wider clinical acceptance has been gradual, partly due to the increased difficulty of choosing the best analysis for the given clinical issue, interpreting the findings, and delaying proof of value from clinical trials. Our goal in this review is to discuss the current clinical value of ctDNA in cancers and how clinical oncology systems might incorporate procedures for ctDNA testing.

Hospital Pharmacy Professionals and Cardiovascular Care: A Cross-Sectional Study Assessing Knowledge, Attitudes, and Practices in Saudi Arabia.

BACKGROUND: In Saudi Arabia, cardiovascular diseases (CVDs) establish a significant health challenge, with a high prevalence and substantial impact on mortality and disability burden. Evaluating the knowledge, attitude, and practices (KAPs) of hospital pharmacy professionals towards CVDs prevention and management is crucial for effective healthcare strategies. METHODS: A cross-sectional, multicenter study was conducted using a self-administered survey targeting hospital pharmacists and pharmacy technicians in the Madinah region of Saudi Arabia. The survey assessed their KAPs towards CVDs prevention and management, incorporating demographic variables and perceived barriers. RESULTS: Out of 177 contacted pharmacy professionals, 159 (89.8%) completed the survey. The study results revealed inadequate knowledge levels with an average score of 3.87 out of 7, indicating significant gaps in comprehending drug interactions, managing lipid levels, and addressing resistant hypertension. Attitudes were generally positive towards CVDs prevention. Practices in CVDs prevention were satisfactory but varied, with notable gaps in providing educational materials and collaboration with other healthcare professionals. Major barriers included time constraints, lack of private counseling areas, and low patient expectations regarding pharmacy professionals' roles. CONCLUSION: The study has uncovered notable deficiencies in cardiovascular care, especially within the realm of hospital pharmacy professionals in Saudi Arabia's Madinah region. This finding underscores the importance of implementing specialized educational initiatives and ongoing professional development programs for these healthcare workers. By focusing on these areas and overcoming the challenges identified, we can significantly improve the contribution of hospital pharmacy professionals in Saudi Arabia toward the prevention and management of cardiovascular diseases.

Effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates: a randomised controlled trial.

INTRODUCTION: Raised serum bilirubin levels can cause kernicterus, and premature infants are at increased risk owing to metabolic immaturity. The standard treatment for neonatal jaundice is phototherapy, but probiotics alone can reduce the duration of phototherapy and hospitalisation. OBJECTIVES: To determine the effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates. PATIENTS AND METHODS: The open-labelled randomised controlled trial was conducted from January 2022 to January 2023 in the neonatal unit of the University of Lahore Teaching Hospital, Pakistan. A total of 76 preterm neonates who fulfilled the selection criteria were included and divided into two groups. Both groups received standard phototherapy. In Group B, a probiotic (Saccharomyces boulardii) 125 mg, twice daily, orally (in 5 cc of whichever milk the infant was receiving) was given until discharge from hospital. The primary outcome measurements were the duration of phototherapy and the length of hospitalisation. RESULTS: The mean (SD) duration of phototherapy was 36.55 (14.25) hours in Group A and 24.61 (9.25) hours in Group B (p <0.05). The mean (SD) duration of hospital stay was 47.36 (16.51) hours in Group A and 33.13 (8.93) hours in Group B (p <0.05). CONCLUSION: Oral probiotics (Saccharomyces boulardii) have a significant effect on the duration of phototherapy for neonatal hyperbilirubinaemia, and they decrease the chances of nosocomial infection. Exploration of clinical outcomes by investigating faecal flora and undertaking large randomised controlled trials of various probiotics are needed. ABBREVIATIONS: ABE: acute bilirubin encephalopathy; CNS: central nervous system; GA: gestational age; IVIG: intravenous immunoglobulin; KSD: kernicterus; NNU: neonatal unit; RCT: randomised controlled trial; S. boulardii: Saccharomyces boulardii.