Van Neck-Odelberg Disease: A Rare Cause of Pediatric Hip Pain.

Introduction: Synchondrosis ischiopubic syndrome (SIS), also known as Van Neck-Odelberg disease, is a benign skeletal abnormality in children due to delayed closure in the ischiopubic synchondrosis (IPS). Patients may present with vague groin, hip, or buttock pain that can cause limitation of hip movement or limp. Few descriptions of this disorder exist, and it can easily be mistaken for other pathologies, including stress fracture, osteomyelitis, or tumor. Case Report: We report the case of a 9-year-old female gymnast presenting with right hip pain who was diagnosed with SIS. She was managed conservatively by the pediatric orthopedist. Conclusion: Van Neck-Odelberg disease is a rare cause of pediatric hip pain that can be mistaken for other more serious pathologies. The ability to recognize the disease early allows for effective treatment and the avoidance of unnecessary procedures.

Epidemiology and management of Fusarium wilt of Eucalyptus camaldulensis through systemic acquired resistance.

Eucalyptus camaldulensis is a multifunctional tree and is globally used for the reclamation of problematic lands. Eucalyptus camaldulensis is prone to attack by a number of pathogens, but the most important threat is the Fusarium wilt (Fusarium oxysporum). Keeping in view the importance of E. camaldulensis and to manage this disease, five plant activators, i.e., salicylic acid (C7H6O3), benzoic acid (C7H6O2), citric acid (C6H8O7), dipotassium phosphate (K2HPO4), monopotassium phosphate (KH2PO4) and nutritional mixture namely Compound (NPK) and nutriotop (Fe, Zn, Cu, B, Mn) were evaluated in the Fusarium infested field under RCBD in the Research Area, Department of Forestry and Range Management, University of Agriculture, Faisalabad (UAF). Among plant activators, salicylic acid and a combination of compound + nutriotop exhibited the lowest disease incidence and enhanced fresh and dry weight of leaves compared to other treatments and control. Results of the environmental study indicated maximum disease incidence between 35-40 °C (max. T), 6-25 °C (mini. T), 70-80% relative humidity and 1.5-2.5 km/h wind speed while pan evaporation expressed weak correlation with disease development. It was concluded that Fusarium wilt of Eucalyptus camaldulensis could be managed through activation of the basal defense system of the host plant with provision of salicylic acid and balanced nutrition by considering environmental factors. Recent exploration is expected to be helpful for future research efforts on epidemiology and ecologically sound intervention of Fusarium wilt of Eucalyptus camaldulensis.

A sustainable approach for fluoride treatment using coconut fiber cellulose as an adsorbent.

In developing countries like India, an economically viable and ecologically approachable strategy is required to safeguard the drinking water. Excessive fluoride intake through drinking water can lead to dental fluorosis, skeletal fluorosis, or both. The present study has been under with an objective to investigate the feasibility of using cellulose derived from coconut fiber as an adsorbent under varying pH conditions for fluoride elimination from water. The assessment of equilibrium concentration of metal ions using adsorption isotherms is an integral part of the study. This present finding indicates the considerable effect of variation of adsorbent dosages on the fluoride removal efficiency under constant temperature conditions of 25 ± 2 °C with a contact period of 24 h. It is pertinent to mention that maximum adsorption of 88% has been observed with a pH value of 6 with 6 h time duration with fluoride dosage of 50 mg/L. The equilibrium concentration dwindled to 0.4 mg/L at fluoride concentration of 20 mg/L. The Langmuir model designates the adsorption capacity value of 2.15 mg/L with initial fluoride concentration of 0.21 mg/g with R2 value of 0.660. Similarly, the adsorption capacity using Freundlich isotherms is found to be 0.58 L/g and 0.59 L/g with fluoride concentration of 1.84 mg/L and 2.15 mg/L respectively. The results from the present study confirm that coconut fiber possesses appropriate sorption capabilities of fluoride ion but is a pH dependent phenomenon. The outcomes of the study indicate the possible use of cellulose extracted from waste coconut fiber as a low-cost fluoride adsorbent. The present study can be well implemented on real scale systems as it will be beneficial economically as well as environmentally.

COVID-19 booster dose acceptance, hesitancy and concerns among the elderly population: A cross-sectional study.

INTRODUCTION: The COVID-19 pandemic that originated in Wuhan, China in December 2019 results in respiratory and gastrointestinal infections. Elderly patients are at high risk. Preventive measures like avoiding contact with COVID-19 patients and wearing N95 masks can contribute to reducing the risk of infection, but vaccination remains crucial. METHODOLOGY: A cross-sectional survey-based study was conducted among the elderly population (≥ 50 years) in Pakistan. A 16-items questionnaire explored the socio-demographic profile of the participants, including questions about their age, gender, etc. The other sections included questions regarding vaccine registration, vaccine acceptance, and hesitation and fears towards vaccines. The items were developed to collect the data on the basis of the Likert scale. RESULTS: There was a total of 3059 respondents. The majority of the participants (n = 2726, 89.1%) were aged below 70 years, while 10.9% (n = 333) were aged above 70 years. Many participants (47.1%) expressed their concerns about the efficacy of COVID-19 vaccine booster dose. Despite their willingness to vaccinate with the cOVID-19 vaccine, 24.7% female participants expressed concerns related to the safety of the vaccine. Among all the respondents, 23.1% participants had no concerns about the cOVID-19 vaccine booster dose. The study identified a reluctance and lack of confidence in the efficiency of the COVID-19 booster dose. CONCLUSIONS: The alarming situation is rigidity towards vaccination among the elderly population. Necessary measures must be taken by the health department of Pakistan to manage this reluctant behavior and increase confidence on the efficiency of the COVID-19 booster dose.

The Short- and Long-Term Safety and Efficacy Profile of Subtotal Cholecystectomy: A Single-Centre, Long-Term, Follow-Up Study.

Background Subtotal cholecystectomy (STC) has been reported as an effective method to remove the gallbladder if the hepatocystic triangle anatomy is unfavourable. However, the evidence regarding its long-term outcomes from the United Kingdom (UK) is lacking. This study aimed to assess its short and long-term outcomes with a minimum of one-year follow-up. Methodology We retrospectively analysed all elective and emergency STCs performed in a single UK NHS Trust between 2014 and 2020. Relevant data were collected using electronic patient records and questionnaire-based, long-term, telephonic follow-up (median follow-up of 3.7 years). Outcomes examined were immediate/short-term complications (biliary injury, bile leak, return-to-theatre) and long-term problems (recurrent symptoms, choledocholithiasis, cholangitis/pancreatitis). Results There were a total of 50 STC cases (58% females) out of 4,341 cholecystectomies performed (1.15%), with the median age, body mass index, and length of stay being 69.5 years, 29 kg/m2 and eight days, respectively. Twenty-eight (56%) were emergency. No patient endured bile duct injury. Seven (14%) patients had postoperative bile leak which was significantly more common when Hartmann's pouch was left open (33% vs. 8%; p = 0.03). No bile duct injury was reported. Most were managed conservatively (endoscopic retrograde cholangiopancreatography + stent: four; radiological drainage: one; no intervention: one). Only one patient required laparoscopic lavage and drainage. The true incidence of developing choledocholithiasis over the long term was 4/50 (8%) in our study. The median interval between STC and the diagnosis of postoperative choledocholithiasis was 15.9 months. All four patients had undergone type 1 STC (where the remnant of Hartmann's pouch was closed with sutures); however, subsequent cross-sectional imaging (magnetic resonance cholangiopancreatography or computed tomography) showed that the gallbladder remnant was visible in only two of these four patients. Conclusions STC is a safe option in difficult situations and prevents bile duct injury. Although the risk of bile leak can be reduced by closing Hartmann's pouch remnant, this may slightly increase the risk of subsequent stone formation. Infrequent occurrence of recurrent gallstone-related symptoms or complications favours its use.

Water Quality Index Assessment of River Ganga at Haridwar Stretch Using Multivariate Statistical Technique.

The Ganges (Ganga) river contributes significant water resources for the ecology and economy, but it frequently encounters severe deterioration due to cumulative impact from upstream natural and anthropogenic variables. Knowledge and understanding of the dynamic behavior of such networks remain a significant challenge, particularly in the context of rising environmental pressures, such as climate change and industrialization, as well as constraints in both process and data understanding across geographies. An interdisciplinary approach is required to be developed to investigate the hydrogeochemical dynamics and anthropogenic sources influencing water quality in major river systems. The present study has been carried out to evaluate the characterization of river water quality in terms of the physico-chemical & bacteriological parameters. Also, the development of a water quality index (WQI) for Domestic (drinking) and Spiritual (bathing) usage is a part of the study. The water quality index has been developed using the Canadian Council of Ministers of the Environmental Water Quality Index (CCME WQI). The river's water quality index score in the present study lies in the range of 38.32 to 79.82, indicating the quality of water from fair to poor for drinking purposes. The highest water quality index value of 79.82 has been observed at Guru Kashnik Ghat, while the lowest WQI value of 38.32 has been observed at Har ki Pauri for drinking purposes. However, the water quality score for bathing purposes ranged from 71.04 to 91.22 thus signifying the quality of the water from fair to good for bathing purposes. The highest water quality index value of 91.22 has been assessed at Guru Kashnik Ghat, while the lowest WQI value of 71.04 has been assessed at Bhimgoda Barrage. The developed water indices assessment in the present study will be beneficial for society to provide a benchmark for the control of water pollution in River Ganga. These findings will support policymakers and stakeholders in addressing water quality issues in a more efficient and effective manner. The study also emphasizes the requirement for ongoing water quality monitoring and evaluation in order to guarantee the long-term well-being of the river and its ecosystems.

Remote Health Monitoring Systems for Elderly People: A Survey.

This paper addresses the growing demand for healthcare systems, particularly among the elderly population. The need for these systems arises from the desire to enable patients and seniors to live independently in their homes without relying heavily on their families or caretakers. To achieve substantial improvements in healthcare, it is essential to ensure the continuous development and availability of information technologies tailored explicitly for patients and elderly individuals. The primary objective of this study is to comprehensively review the latest remote health monitoring systems, with a specific focus on those designed for older adults. To facilitate a comprehensive understanding, we categorize these remote monitoring systems and provide an overview of their general architectures. Additionally, we emphasize the standards utilized in their development and highlight the challenges encountered throughout the developmental processes. Moreover, this paper identifies several potential areas for future research, which promise further advancements in remote health monitoring systems. Addressing these research gaps can drive progress and innovation, ultimately enhancing the quality of healthcare services available to elderly individuals. This, in turn, empowers them to lead more independent and fulfilling lives while enjoying the comforts and familiarity of their own homes. By acknowledging the importance of healthcare systems for the elderly and recognizing the role of information technologies, we can address the evolving needs of this population. Through ongoing research and development, we can continue to enhance remote health monitoring systems, ensuring they remain effective, efficient, and responsive to the unique requirements of elderly individuals.

Marine Cyanobacterial Peptides in Neuroblastoma: Search for Better Therapeutic Options.

Neuroblastoma is the most prevalent extracranial solid tumor in pediatric patients, originating from sympathetic nervous system cells. Metastasis can be observed in approximately 70% of individuals after diagnosis, and the prognosis is poor. The current care methods used, which include surgical removal as well as radio and chemotherapy, are largely unsuccessful, with high mortality and relapse rates. Therefore, attempts have been made to incorporate natural compounds as new alternative treatments. Marine cyanobacteria are a key source of physiologically active metabolites, which have recently received attention owing to their anticancer potential. This review addresses cyanobacterial peptides' anticancer efficacy against neuroblastoma. Numerous prospective studies have been carried out with marine peptides for pharmaceutical development including in research for anticancer potential. Marine peptides possess several advantages over proteins or antibodies, including small size, simple manufacturing, cell membrane crossing capabilities, minimal drug-drug interactions, minimal changes in blood-brain barrier (BBB) integrity, selective targeting, chemical and biological diversities, and effects on liver and kidney functions. We discussed the significance of cyanobacterial peptides in generating cytotoxic effects and their potential to prevent cancer cell proliferation via apoptosis, the activation of caspases, cell cycle arrest, sodium channel blocking, autophagy, and anti-metastasis behavior.

Therapeutic potential of marine peptides in malignant melanoma.

Malignant melanoma is the most dangerous type of skin cancer. It is becoming more common globally and is increasingly resistant to treatment options. Despite extensive research into its pathophysiology, there are still no proven cures for metastatic melanoma. Unfortunately, current treatments are frequently ineffective and costly, and have several adverse effects. Natural substances have been extensively researched for their anti-MM capabilities. Chemoprevention and adjuvant therapy with natural products is an emerging strategy to prevent, cure or treat melanoma. Numerous prospective drugs are found in aquatic species, providing a plentiful supply of lead cytotoxic chemicals for cancer treatment. Anticancer peptides are less harmful to healthy cells and cure cancer through several different methods, such as altered cell viability, apoptosis, angiogenesis/metastasis suppression, microtubule balance disturbances and targeting lipid composition of the cancer cell membrane. This review addresses marine peptides as effective and safe treatments for MM and details their molecular mechanisms of action.

Diffuse St Depression With St Elevation Avr In Acute Coronary Syndrome And Its Association With Significant Left Main Or Three Vessel Coronary Artery Disease And Its Confounders.

BACKGROUND: : Global ST depression in 8 or more leads along with ST elevation in aVR has been considered as hallmark of widespread sub-endocardial ischemia. It has been associated with left main (LM) stem or three vessel disease (3VD). But different studies have shown different results. We collected data from patients to see association of these ECG changes with significant LM stem disease and/or significant (3VD). METHODS: TIt was a prospective observational study performed at tertiary care cardiac center. All patients with acute coronary syndrome (ACS) having global ST depression and ST Elevation in aVR (that is ST depression of at least 0.5 mv in ≥8 leads along with ST elevation in aVR of at least 0.5 mv) and have undergone coronary angiogram were included. RESULTS: Our study included 404 patients with above mentioned ECG findings. We observed significant LM stem or significant 3VD in 67% (n=274), 3VD in 55% (n=222) and significant LM stem in only 29% (n=118). Risk factors like diabetes, hypertension and smoking increase probability of these ECG changes up to 40.4%, 32.1% and 33.3% for significant LM stem disease and 62.7%, 57.1% and 57.5% for significant 3VD. Magnitude of ST elevation in aVR leads ≥1 mm increase sensitivity for LM stem disease 35% and for 3VD up to 60.4% and TIMI score ≥4 up to 36.7% for significant LM stem disease and 62.5% for significant 3VD. CONCLUSIONS: : Global ST depression along with ST elevation in aVR in patients with ACS has low probability for significant LM stem intermediate probability for significant 3VD. Factors like presence of diabetes, hypertension, smoking, magnitude of ST elevation in aVR, and TIMI score improves its diagnostic yield.

Associations Between Built Environment Factors and SARS-CoV-2 Infections at the Neighbourhood Level in a Metropolitan Area in Germany.

COVID-19-related health outcomes displayed distinct geographical patterns within countries. The transmission of SARS-CoV-2 requires close spatial proximity of people, which can be influenced by the built environment. Only few studies have analysed SARS-CoV-2 infections related to the built environment within urban areas at a high spatial resolution. This study examined the association between built environment factors and SARS-CoV-2 infections in a metropolitan area in Germany. Polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infections of 7866 citizens of Essen between March 2020 and May 2021 were analysed, aggregated at the neighbourhood level. We performed spatial regression analyses to investigate associations between the cumulative number of SARS-CoV-2 infections per 1000 inhabitants (cum. SARS-CoV-2 infections) up to 31.05.2021 and built environment factors. The cum. SARS-CoV-2 infections in neighbourhoods (median: 11.5, IQR: 8.1-16.9) followed a marked socially determined north-south gradient. The effect estimates of the adjusted spatial regression models showed negative associations with urban greenness, i.e. normalized difference vegetation index (NDVI) (adjusted ß = - 35.36, 95% CI: - 57.68; - 13.04), rooms per person (- 10.40, - 13.79; - 7.01), living space per person (- 0.51, - 0.66; - 0.36), and residential (- 0.07, 0.16; 0.01) and commercial areas (- 0.15, - 0.25; - 0.05). Residential areas with multi-storey buildings (- 0.03, - 0.12; 0.06) and green space (0.03, - 0.05; 0.11) did not show a substantial association. Our results suggest that the built environment matters for the spread of SARS-CoV-2 infections, such as more spacious apartments or higher levels of urban greenness are associated with lower infection rates at the neighbourhood level. The unequal intra-urban distribution of these factors emphasizes prevailing environmental health inequalities regarding the COVID-19 pandemic.

A Self-Decoupling Technique to Realize Dense Packing of Antenna Elements in MIMO Arrays for Wideband Sub-6 GHz Communication Systems.

A self-decoupled technique is described that enables the radiating elements in the antenna array to be densely packed for multiple-input multiple-output (MIMO) wireless communications systems. High isolation between the adjacent antenna elements is obtained by fixing the radiating elements in an orthogonal configuration with respects to each other. Current from the adjacent ports cancels their impact which results in low mutual coupling. The additional benefit of this configuration is realizing a densely packed array. The ground plane of each radiating element on the array board itself are isolated to mitigate surface wave propagations to suppress mutual coupling between the antenna elements. The radiating elements are based on a modified edge-fed circular patch antenna that includes a curved slot line and open-circuited stub to widen the array's impedance bandwidth with no impact on the antenna's footprint size. The proposed technique was verified with the design of an antenna array of matrix size 4 × 4 centered at 3.5 GHz. The array had a measured impedance bandwidth of 4 GHz from 1.5 GHz to 5.5 GHz, which corresponds to a fractional bandwidth of 114%, peak gain of 3 dBi and radiation efficiency of 84%. Its average diversity gain and envelope correlation coefficient (ECC) over its operating band are 9.6 dB and <0.016, respectively. The minimum isolation achieved between the radiating elements is better than 15 dB. The dimensions of the array are 0.4 × 0.4 × 0.039λ_g^3. The proposed array has characteristics suitable for sub-6 GHz wireless communication systems

Outwelling of nutrients into the Pasur River estuary from the Sundarbans mangrove creeks.

The Pasur River estuary (PRE), the largest estuary in the Sundarbans mangrove area, provides vital fishery resources and supports millions of livelihoods in the southwestern coastal region of Bangladesh. This study focused on the tidal and run-off effects on the outwelling of nutrients from the Sundarbans mangrove creeks to the PRE. Spatial and temporal variations of nutrient and chlorophyll-a concentrations were assessed by water sampling at 11 stations in the study area from January to December 2019. Dissolved inorganic nutrients and chlorophyll-a were analyzed by standard methods using a spectrophotometer. In the tidal mangrove creeks, dissolved inorganic nitrogen, phosphate, and silica concentrations were significantly higher (p < 0.05) during the spring tide than those during the neap tide, suggesting that these nutrients were flushed from the mangrove area by the inundation and tidal mixing of the spring tide. In general, chlorophyll-a (mean ± SD) concentrations in the PRE and the tidal mangrove creeks were 5.62 ± 1.30 µg/L and 9.03 ± 0.59 µg/L in the wet season, respectively. During the dry season, the chlorophyll-a decreased to 4.37 µg/L ± 0.68 and 4.94 ± 1.52 µg/L in the PRE and the tidal mangrove creek, respectively. The amount of nutrients outwelled from the mangrove creeks to the estuary was 1.53 ± 0.67 mg/L DIP, 0.001 ± 0.0004 mg/L DIN, and 1.38 ± 0.48 mg/L dissolved silica. DIP, silica, and chlorophyll-a concentrations were significantly higher (p < 0.05) during the spring tide compared to the neap tide, but salinity was not significantly (p > 0.05) different between the two tidal levels. This study showed that the mangrove creeks formed an important link in transporting nutrients from the mangrove forest to the estuary.

Malignant peritoneal mesothelioma-a diagnostic challenge.

Malignant peritoneal mesothelioma is a rare cancer originating primarily from the peritoneum with a poor prognosis and non-specific clinical presentation. We present a case of a 60-year-old male, retired metallurgy engineer who initially presented with shortness of breath, lethargy, weight loss, vague abdominal pain and night sweats. Extensive workup for almost 2 months finally leads to the diagnosis of primary malignant peritoneal mesothelioma based on immunohistochemical analysis of loss of BAP1 gene. The patient was deemed non-suitable for surgical management and started on palliative carboplatin and pemetrexed. In conclusion, histological diagnosis is essential for peritoneal diseases before considering it as a metastasis from other primary tumours. Furthermore, immunohistochemical analysis and genetic profiling may also guide towards the diagnosis and possible treatment.

Diuretic and anti-diarrheal potential of four fruit extracts of Capsicum annum L.

Capsicum has been an important part of diet since centuries and has been widely used traditionally for ailments. The objective of the present analysis was to determine the diuretic and antidiarrheal potentials of four variations of Capsicum annum L. fruits available in local market of Karachi, Pakistan. It belongs to family Solanaceae and extracts were prepared in 95% ethanol and was given in doses of 200 and 400mg/kg and the activity was correlated with commonly used diuretics and anti-diarrheal further reinforcing its conventional use. Fruits extracts were evaluated for anti-diarrheal properties in castor-oil induced diarrhea to confirm its activity. The diuretic activity of the 95% ethanolic extracts of Capsicum annum L. was assessed based on diuresis of 24 hr. collected through metabolic cage. Urinary excretion of water and electrolytes (Na+ and K+) is significantly increased by the standard diuretic drug furosemide, which is comparable with the extract. The anti-diarrheal effects of 95% ethanolic extracts of Capsicum annum L. were examined by castor oil induced diarrhea and all varieties of Capsicum annum L. significantly inhibited the number of defecations.

Analysing Interlinked Frequency Dynamics of the Urban Acoustic Environment.

As sustainable metropolitan regions require more densely built-up areas, a comprehensive understanding of the urban acoustic environment (AE) is needed. However, comprehensive datasets of the urban AE and well-established research methods for the AE are scarce. Datasets of audio recordings tend to be large and require a lot of storage space as well as computationally expensive analyses. Thus, knowledge about the long-term urban AE is limited. In recent years, however, these limitations have been steadily overcome, allowing a more comprehensive analysis of the urban AE. In this respect, the objective of this work is to contribute to a better understanding of the time-frequency domain of the urban AE, analysing automatic audio recordings from nine urban settings over ten months. We compute median power spectra as well as normalised spectrograms for all settings. Additionally, we demonstrate the use of frequency correlation matrices (FCMs) as a novel approach to access large audio datasets. Our results show site-dependent patterns in frequency dynamics. Normalised spectrograms reveal that frequency bins with low power hold relevant information and that the AE changes considerably over a year. We demonstrate that this information can be captured by using FCMs, which also unravel communities of interlinked frequency dynamics for all settings.

Assessment of COVID-19 vaccine booster dose acceptance, reluctance and concerns among elderly diabetes patients in Pakistan.

People around the globe rumored so many things about the safety and efficacy of initial two doses and booster dose of Covid-19 vaccine, which eventually affected the acceptance of the only tool available against the fight between humans and virus. The aim of current study is to evaluate the acceptance and reluctance level among the population specifically elderly diabetes patients. The cross-sectional study was conducted during a time period of 3 months i.e. from July 2021 until September 2021. A 16-item questionnaire was used to assess the acceptance, reluctance and concerns of the Covid-19 vaccine booster dose among elderly diabetes patients. A 16-item questionnaire was used to assess the acceptance, reluctance and concerns of the Covid-19 vaccine booster dose among elderly diabetes patients. A total of 497 responses were collected and analyzed. Approximately 32% of respondents believed that they need additional information about the Covid-19 vaccine booster dose will be ineffective due to not enough information about the potential side effects of the vaccine dose, while around 80% of respondents showed concerns about safety, efficacy, newness and not enough information about vaccine contents. Around 47.1% of respondents expressed robust concerns about possible side effects of the Covid-19 vaccine booster dose.

Natural products targeting the ATR-CHK1 signaling pathway in cancer therapy.

Cancer is one of the most severe medical conditions in the world, causing millions of deaths each year. Chemotherapy and radiotherapy are critical for treatment approaches, but both have numerous adverse health effects. Furthermore, the resistance of cancerous cells to anticancer medication leads to treatment failure. The rising burden of cancer requires novel efficacious treatment modalities. Natural remedies offer feasible alternative options against malignancy in contrast to available synthetic medication. Selective killing of cancer cells is privileged mainstream in cancer treatment, and targeted therapy represents the new tool with the potential to pursue this aim. The discovery of innovative therapies targeting essential components of DNA damage signaling and repair pathways such as ataxia telangiectasia mutated and Rad3 related Checkpoint kinase 1 (ATR-CHK1)has offered a possibility of significant therapeutic improvement in oncology. The activation and inhibition of this pathway account for chemopreventive and chemotherapeutic activity, respectively. Targeting this pathway can also aid to overcome the resistance of conventional chemo- or radiotherapy. This review enlightens the anticancer role of natural products by ATR-CHK1 activation and inhibition. Additionally, these compounds have been shown to have chemotherapeutic synergistic potential when used in combination with other anticancer drugs. Ideally, this review will trigger interest in natural products targeting ATR-CHK1 and their potential efficacy and safety as cancer lessening agents.

New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review.

BACKGROUND: Liver diseases post-COVID-19 vaccination is extremely rare but can occur. A growing body of evidence has indicated that portal vein thrombosis, autoimmune hepatitis, raised liver enzymes and liver injuries, etc., may be potential consequence of COVID-19 vaccines. OBJECTIVES: To describe the results of a systematic review for new-onset and relapsed liver disease following COVID-19 vaccination. METHODS: For this systematic review, we searched Proquest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA guideline for studies on the incidence of new onset or relapsed liver diseases post-COVID-19 vaccination, published from December 1, 2020 to July 31, 2022, with English language restriction. RESULTS: Two hundred seventy-five cases from one hundred and eighteen articles were included in the qualitative synthesis of this systematic review. Autoimmune hepatitis (138 cases) was the most frequent pathology observed post-COVID-19 vaccination, followed by portal vein thrombosis (52 cases), raised liver enzymes (26 cases) and liver injury (21 cases). Other cases include splanchnic vein thrombosis, acute cellular rejection of the liver, jaundice, hepatomegaly, acute hepatic failure and hepatic porphyria. Mortality was reported in any of the included cases for acute hepatic failure (n = 4, 50%), portal vein thrombosis (n = 25, 48.1%), splanchnic vein thrombosis (n = 6, 42.8%), jaundice (n = 1, 12.5%), raised liver enzymes (n = 2, 7.7%), and autoimmune hepatitis (n = 3, 2.2%). Most patients were easily treated without any serious complications, recovered and did not require long-term hepatic therapy. CONCLUSION: Reported evidence of liver diseases post-COIVD-19 vaccination should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively very small in relation to the hundreds of millions of vaccinations that have occurred and the protective benefits offered by COVID-19 vaccination far outweigh the risks.