Definitive chemoradiation in locally advanced inoperable esophageal cancer patients - Retrospective analysis of different chemotherapy regimens in a tertiary cancer centre.

BACKGROUND AND AIM: Definitive chemoradiation (dCRT) is the standard treatment for locally advanced inoperable esophageal cancer. The aim of this study is to analyze the effect of dCRT combined with paclitaxel and carboplatin (TC) against cisplatin (CDDP) with radiation. METHODS: The study population included patients with locally advanced inoperable esophageal cancer seeking treatment at our center from March 2013 to December 2017. Case records from 66 patients were extracted. The toxicity profile of patients who received TC or CDDP was reported and analyzed. A Chi-square test and students t-test were used to analyze the categorical, and the continuous variables, respectively. The KaplanMeier method was used to estimate the survival probability. A log-rank test was applied to compare the survival differences between the two groups. RESULTS: The overall survival (OS) did not differ at 3 years between the TC and CDDP (p = 0.286). The median survival duration was 13 months for CDDP and 18 months for TC. The toxicity profile like emesis (93% CDDP vs. 25% TC), neutropenia (79% CDDP vs. 13% TC), thrombocytopenia (10% CDDP vs. 17% TC) and dyselectrolytemia (71% CDDP vs. 8% TC) were compared between the two treatment groups and found to be more in CDDP group. CONCLUSION: The treatment of patients with locally advanced esophageal carcinoma with dCRT and TC showed an improved toxicity profile, but similar OS compared to CDDP. Applying dCRT with TC could be an alternate regimen for locally advanced inoperable esophageal cancer patients. RELEVANCE FOR PATIENTS: Concurrent chemoradiation with TC regimen can be considered as an alternative for cisplatin as it shows equivalent survival and reduced toxicity profile.

Molecular Mechanisms of Metal Toxicity in the Pathogenesis of Alzheimer's Disease.

Alzheimer's disease (AD) is the most common form of dementia, which is progressively affecting elderly people. The dyshomeostasis of biometals and accumulation of toxic metals are usually observed in numerous neurodegenerative diseases including AD. In the central nervous system, metal imbalance-caused neurotoxic activities are usually linked with decreased enzymatic activities, increased aggregation of proteins, and oxidative stress, where a series of processes can result in neurodegeneration and cell death. Even though the relations between neurodegenerative diseases and biometal imbalance are still elusive, there is a growing interest in a group of major endogenous proteins that are associated with the transports of metals. Aberrant expression of these endogenous proteins is associated with the biometal imbalance and AD pathogenesis. Indeed, heavy metals are extremely toxic to the nervous system. Various studies have demonstrated that the toxic effects of heavy metals can result in amyloid beta (Aß) aggregation, neurofibrillary tangles, and even loss of neurons. In this article, we have focused on the molecular processes through which exposure to biometals and toxic metals can play roles in AD pathogenesis.

COVID-19 Outbreak: Pathogenesis, Current Therapies, and Potentials for Future Management.

At the end of 2019, a novel coronavirus (CoV) was found at the seafood market of Hubei province in Wuhan, China, and this virus was officially named coronavirus diseases 2019 (COVID-19) by World Health Organization (WHO). COVID-19 is mainly characterized by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) and creates public health concerns as well as significant threats to the economy around the world. Unfortunately, the pathogenesis of COVID-19 is unclear and there is no effective treatment of this newly life-threatening and devastating virus. Therefore, it is crucial to search for alternative methods that alleviate or inhibit the spread of COVID-19. In this review, we try to find out the etiology, epidemiology, symptoms as well as transmissions of this novel virus. We also summarize therapeutic interventions and suggest antiviral treatments, immune-enhancing candidates, general supplements, and CoV specific treatments that control replication and reproduction of SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV).

Molecular Insight into the Therapeutic Promise of Targeting APOE4 for Alzheimer's Disease.

Alzheimer's disease (AD) is a progressive neurodegenerative disease that causes chronic cognitive dysfunction. Most of the AD cases are late onset, and the apolipoprotein E (APOE) isoform is a key genetic risk factor. The APOE gene has 3 key alleles in humans including APOE2, APOE3, and APOE4. Among them, APOE4 is the most potent genetic risk factor for late-onset AD (LOAD), while APOE2 has a defensive effect. Research data suggest that APOE4 leads to the pathogenesis of AD through various processes such as accelerated beta-amyloid aggregations that raised neurofibrillary tangle formation, cerebrovascular diseases, aggravated neuroinflammation, and synaptic loss. However, the precise mode of actions regarding in what way APOE4 leads to AD pathology remains unclear. Since APOE contributes to several pathological pathways of AD, targeting APOE4 might serve as a promising strategy for the development of novel drugs to combat AD. In this review, we focus on the recent studies about APOE4-targeted therapeutic strategies that have been advanced in animal models and are being prepared for use in humans for the management of AD.

Ultrasound-assisted extracted dietary fibre from culinary banana bract as matrices for anthocyanin: its preparation, characterization and storage stability.

Dietary fibre (DF) functionalized with polyphenols is a functional ingredients as it provides the health benefits associated with consumption of both DF and polyphenols. The present study endeavoured to prepare DF-anthocyanin formulation with different ratio of pigment-matrix where DF and anthocyanin were extracted from culinary banana bracts. The formulated powders were studied for its antioxidant, structural properties and fluorescent properties. DF-anthocyanin formulation exhibited enhancement in anthocyanin content with increase in antioxidant content and it was highest for DF-A3 with better color values (L*, a*, C*) compared to other formulations. The structure of the formulation was mainly attributed to the structure of DF and anthocyanin as evidenced by FT-IR. Moreover, changes in the degree of crystallinity were found after addition of anthocyanin in fibre matrix. The morphology study by SEM confirmed the entrapment of particles (1.97-3.88 µm) on the network structure and surface of DF. Additionally, Akin fluorescence emission spectra of DF-A3 with anthocyanin extract further confirmed the formation of DF-anthocyanin complex. Storage stability study showed DF-A3 with lowest degradation rate (k = 0.0002 day-1) and half-life period of 87 days.

Chemical profiling and functional properties of dietary fibre rich inner and outer bracts of culinary banana flower.

The present study endeavoured to evaluate the nutritional, phytochemical and functional properties of outer and inner bracts of culinary banana flower which is a by-product of banana production. Both outer and inner bracts were found to be rich in dietary fibre (61.13 and 66.22%, respectively) along with other chemical compositions including proximate, minerals, and antioxidant-rich phenolics both free and bound. In addition, the functional properties including glucose dialysis retardation index (GDRI) of outer and inner bracts were also studied. The outer and inner bracts exhibited total polyphenols 7.56 and 9.44 mg phenols/g dry sample, respectively. The polyphenol profile by HPLC, revealed the presence of significant amount of free and bound phenolics in both outer and inner bracts. Functional properties of these dietary fibres-rich fractions of culinary banana flower exhibited lower bulk density, higher water-holding capacity, oil-holding capacity, and water-swelling capacity in outer and inner bracts than cellulose. The outer and inner bracts showed relatively higher GDRI compared to control and cellulose. The results revealed that both the outer and inner bracts of culinary banana flower are rich source of dietary fibre along with high antioxidant activity and could be one of the promising functional ingredients for low-calorie and high-fibre food product.