Combination Therapy With Asciminib and Ponatinib as a Bridge to Brexucabtagene Autoleucel and Maintenance in a Patient With Relapsed Refractory Philadelphia Positive B-Cell Acute Lymphoblastic Leukemia.

Tyrosine kinase inhibitors (TKIs) have changed the prognosis of Philadelphia-positive B-cell acute lymphoblastic leukemia (ALL); however, relapsed and refractory disease after multiple TKIs continues to be a clinical challenge. Brexucabtagene autoleucel (brexu-cel) is a novel FDA-approved therapy for relapsed and refractory ALL. Given the lengthy manufacturing time, bridging therapy is commonly employed prior to brexu-cel. Here we describe a case of a 75-year-old Hispanic male patient with relapsed/refractory Philadelphia-positive B-cell ALL with extramedullary disease involving abdominal lymph nodes and skin. He was initially treated with chemotherapy in combination with imatinib, and later received dasatinib and subsequently blinatumomab and nilotinib. As the patient progressed, he received ponatinib with low-dose salvage chemotherapy and did not show kinase domain mutation. In a final effort, a novel combination of ponatinib with asciminib was used as a bridge therapy before brexu-cel and later as maintenance therapy after brexu-cel. This novel combination was able to control disease prior to brexu-cel for 2 months and maintained remission for at least 10 months. This report shows that the novel combination of ponatinib and asciminib is tolerable and effective as a bridge and maintenance therapy after brexu-cel.

Meta-Analysis of the Global Mortality Rate Due to Infection in Burn Patients Admitted for Plastic Surgery.

Burn patients are generally prone to infection, which causes the patient's condition to be even worse. However, there is no study regarding the difference between the mortality rate of infected and non-infected patients. Therefore, the aim was to identify and compare the global mortality rate between infected and non-infected patients who were admitted to plastic surgery units. We searched PubMed, ScienceDirect, and Google Scholar and finally included five articles for this meta-analysis. We determined the odds ratio (OR) value by forest plot and assessed the study bias by a funnel plot. We also analyzed the quality and heterogeneity. The OR was determined as 0.43 (95%CI: 0.07-2.60), indicating a higher mortality rate in infected burn patients as compared to non-infected patients. The funnel plot showed no significant study bias. The quality of the studies was assessed high as well, and the heterogeneity was determined significant (I2>75%). The sensitivity analysis with the fixed effect model reconfirmed our main outcome. However, as a study limitation, we could not specifically determine the impact of strain-specific infection on the mortality rate and could not find more relevant research regarding this issue. We conclude that the overall non-infected burn patient mortality rate is lower as compared to the infected burn patients; however, non-infected patients can be prone to death if the burn degree is higher, the respiratory organ is injured, or the treatment is poor or delayed.

Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis.

BACKGROUND: Nephropathy is one of the most common microvascular impediments of diabetes mellitus. In this study, we aimed to estimate the prevalence of nephropathy in diabetic patients across the North American region. METHODS: Eligible studies were screened out from 3 electronic databases, for example, PubMed, Google Scholar, and ScienceDirect using specific search keywords based on the eligibility criteria. Extracting the data from the included studies publication bias, quality assessment, outlier investigation, and meta-analysis was done followed by the subgroup analysis. A total of 11 studies met the study inclusion criteria. Meta-analysis was performed with the extracted data. RESULTS: Pooled prevalence of 28.2% (95% confidence interval [CI]: 19.7-36.7) with a high rate of heterogeneity (I2 = 100%) was identified. The pooled prevalence of nephropathy among diabetic patients in the United States of America, Canada, and Mexico was 24.2% (95% CI: 13.8-34.5), 31.2% (95% CI: 25.8-36.5), and 31.1% (95% CI: 20.8-41.5), respectively. CONCLUSION: The prevalence of nephropathy among diabetic patients was found lower in the United States of America as compared to Canada and Mexico. Besides, the pooled prevalence of the North American region was found to be lower as compared to the African, European, and Asian regions. Minimizing the pathogenic factors, sufficient diagnostic, healthcare facilities, and awareness are recommended to improve the situation.

Philadelphia-like B-cell acute lymphoblastic Leukaemia: Disease features and outcomes in the era of immunotherapy.

Philadelphia chromosome (Ph)-like acute lymphoblastic leukaemia (ALL) is a high-risk subtype with a gene expression profile similar to Ph-positive ALL, due to activation of tyrosine kinase signalling. To understand the clinical implications of Ph-like ALL, this single-centre retrospective study evaluates outcomes in 268 adults, largely Hispanic ALL patients treated between 2013 and 2024, with a subgroup analysis of 139 haematopoietic stem cell transplantation (HSCT) patients. ALL subtypes included 68 (25.4%) Ph-like, 89 (33.2%) Ph-positive, and 111 (41.4%) Ph-negative. Ph-like patients were the youngest age at diagnosis (p = 0.007), most likely to have refractory disease (p < 0.001), and least likely to achieve minimal residual disease (MRD) negativity after induction (p = 0.031). Relative to Ph-negative ALL, Ph-like achieved worse event-free survival (EFS) (HR = 1.66; 95% CI 1.12-2.46; p = 0.012), whereas Ph-positive had improved EFS (HR = 0.60; 95% CI 0.38-0.93; p = 0.024) and cumulative incidence of relapse (CIR) (HR = 0.59; 95% CI 0.35-0.99; p = 0.046). Within the transplant subgroup, Ph status did not impact disease-free survival (DFS), CIR, or overall survival (OS). However, patients who received blinatumomab within 1-year pre-HSCT had improved DFS (HR = 0.43; 95% CI 0.20-0.94; p = 0.034) and CIR (HR = 0.26; 95% CI 0.09-0.75; p = 0.13). In conclusion, our data suggest that Ph-like is less likely to respond to standard induction therapy and HSCT may result in similar survival outcomes to Ph-negative ALL.

Graft Versus Host Disease Prophylaxis in Matched Donor Stem Cell Transplantation: Post-transplantation Cyclophosphamide Combinations Versus Methotrexate/Tacrolimus.

BACKGROUND: The use of post-transplant cyclophosphamide (PTCy) is highly effective in preventing graft versus host disease (GVHD) for haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT). There is limited data on the role of PTCy as GVHD prophylaxis in matched-sibling and fully matched-unrelated donor (MSD/MUD) allo-HSCT. METHODS: Our single-center retrospective study aims to compare outcomes of PTCy alone or in combination with mycophenolate mofetil and tacrolimus (PTCy/MMF/TAC) relative to methotrexate and tacrolimus (MTX/TAC). The primary endpoint of our study was GVHD-free, relapse free survival (GRFS). Secondary endpoints were overall survival (OS), disease free survival (DFS), and incidence of severe acute and chronic GVHD. We identified 74 adult patients who underwent MSD/MUD allo-HSCT at our institution from 2015 to 2023. RESULTS: Within our cohort, 33.8% (n = 25) received MTX/TAC, while 54.0% (n = 40) received PTCy/MMF/TAC, and 12.2% (n = 9) received PTCy alone. Patients receiving PTCY had the longest time to neutrophil engraftment relative to MTX/TAC (15 days vs. 12 days, P = .010). PTCy/MMF/TAC was associated with improved GRFS relative to MTX/TAC (hazard ratio [HR] = HR 0.42, 95% CI 0.19-0.93, P = .031), which persisted when controlling for age. Incidence of chronic GVHD was lower in the PTCy/MMF/TAC group compared to MTX/TAC (1-year 9.0% vs. 30.1%, HR 0.19, 95% CI 0.06-0.59, P = .005). However, OS and DFS were comparable across all groups. CONCLUSIONS: Our results demonstrate decreased rates of severe chronic GVHD resulting in improved GRFS when using PTCy/TAC/MTX as GVHD prophylaxis compared to MTX/TAC in MSD/MUD.

Folklore use of medicinal plants for the treatment of gynecological diseases in Pakistan-a review.

Background: Gynecological issues and sexually transmitted infections (STIs) pose significant challenges to women's health, particularly in developing nations. These challenges are exacerbated by limited access to modern reproductive healthcare facilities, economic constraints, and entrenched cultural norms. Consequently, most of the Pakistani population relies on traditional ethno-medicinal healthcare systems. This preference stems from the ease of access, affordability, widespread availability, and inherent trust placed in these alternative healthcare methods. Aim/objective: The inquiry aimed to report details on the application of conventional uses of plants in the health field in rural areas that could contribute to advancing the natural discovery of drugs. The objective of this analysis is to provide researchers with information on conventional and empirical knowledge of plant species concerning women's diseases. Methodology: Information on the common use of medicinal plants in treating women's diseases was gathered from electronic databases. As a keyword for the quest, ethnobotany, and ethnopharmacology were used together with gynecological complications. Result: The work of the current analysis has revealed that 217 plant species belonging to 89 families have been used in Pakistan's rural communities. The majority of plant species belong to the Apiaceae family, followed by the Asteraceae, Fabaceae, Solanaceae, Rosaceae, Lamiaceae, and other families. The biological interpretation of plants used in rural communities of Pakistan revealed that herbs and trees are the dominant forms with 58 % and 23 % respectively while shrubs and sub-shrubs with a low percentage of 17 % and 2 %. In natural preparation, leaves 29 %, flowers 22 %, seeds 14 %, fruits 14 %, roots 13 %, bark 7 %, and stems 5 % were the most used parts respectively and aerial parts, dried pericarp, bulb, bud, berry, latex, wood, rhizome, husk, fruit coat, oil, resins, twigs, and shoot were also used in minimum percentage. A multitude of plant species have found extensive application in the management of diverse women's health issues. These encompass concerns such as fatigue, mood fluctuations attributed to menstrual problems, gonorrhea, complications related to pregnancy, cravings for specific foods, throbbing breast pain, abdominal and pelvic cramps, excessive vaginal discharge, mastitis, irritability, abortion-related matters, headaches, uterine hemorrhage, Menorrhagia, Amenorrhea, Menopause, Vomiting Abortion, infertility and lactation challenges, as well as the regulation of lochia flow. Conclusion: This review provides remarkable information about the use of medicinal plants against women's diseases in the rural communities of Pakistan. It opens the gateway for the discovery of natural drug development.

Development of Acceptable Quality Dose (AQD) and image quality-related diagnostic reference levels for common computed tomography investigations in a tertiary care public sector hospital of Khyber Pakhtunkhwa, Pakistan.

PURPOSE: To describe the first experience of patient dose optimization in developing AQD, SSDE and image quality-related DRLs for common CT examinations in the adult age group using the concept of AQD. MATERIALS AND METHODS: The recent published IQSC from 0 to 4 were used by radiologists for the assessment of image quality. The entire data were collected for five types (brain CT, chest CT, chest HRCT, abdomen KUB CT and abdomen + pelvic CT) CT investigations based on anatomic region (head, chest and abdomen + pelvic). The entire datasets of 264 patients were categorized into three groups based on their weights: group-1 (41-60 kg), group-2 (61-80 kg) and group-3 (81-100 kg). Only score-3 images were considered to assess median and 75th percentile values of CTDIvol and DLP to obtain AQDs and DRLs, respectively. RESULTS: Following the practical training of four radiologists on image quality scoring criteria for CT images, 264 (92%) out of 288 patient images were clinically acceptable as per IQSC for the study. The AQD (median) values in terms of CTDIvol for the mentioned weight groups were 25.8, 2.7, and 30.6 mGy, while the median DLP values for these groups were 496, 510 and 557 mGycm, respectively, for brain CT. The 75th percentile values in terms of CTDIvol were 30.2, 35.3 and 36.2 mGy, while in terms of DLP, they were 583, 619 and 781 mGycm for brain CT, respectively. Similar results are presented for the above-mentioned procedures, as well as in terms of SSDE. CONCLUSION: The first ever experience in obtaining AQD, SSDE and DRLs values for specific CT procedures couples image quality with dose indices, showing comparable values with other relevant studies. Hence, it will provide a baseline for comparison within the facility for future studies and facilitate dose optimization for other facilities aiming for improvement.

Antioxidant and Hypoglycemic Potential of Phytogenic Selenium Nanoparticle- and Light Regime-Mediated In Vitro Caralluma tuberculata Callus Culture Extract.

In vitro plant cultures have emerged as a viable source, holding auspicious reservoirs for medicinal applications. This study aims to delineate the antioxidant and hypoglycemic potential of phytosynthesized selenium nanoparticle (SeNP)- and light stress-mediated in vitro callus cultures of Caralluma tuberculata extract. The morphophysicochemical characteristics of biogenic SeNPs were assessed through a combination of analytical techniques, including UV-visible spectrophotometry, scanning electron microscopy, energy-dispersive X-rays, Fourier transform infrared spectrometry, and zeta potential spectroscopy. The antioxidative potential of the callus extract 200 and 800 µg/mL concentrations was assessed through various tests and exhibited pronounced scavenging potential in reducing power (26.29%), ABTS + scavenging (42.51%), hydrogen peroxide inhibition (37.26%), hydroxyl radical scavenging (40.23%), and phosphomolybdate (71.66%), respectively. To inspect the hypoglycemic capacity of the callus extract, various assays consistently demonstrated a dosage-dependent relationship, with higher concentrations of the callus extract exerting a potent inhibitory impact on the catalytic sites of the alpha-amylase (78.24%), alpha-glucosidase (71.55%), antisucrase (59.24%), and antilipase (74.26%) enzyme activities, glucose uptake by yeast cells at 5, 10, and 25 mmol/L glucose solution (72.18, 60.58 and 69.33%), and glucose adsorption capacity at 5, 10, and 25 mmol/L glucose solution (74.37, 83.55, and 86.49%), respectively. The findings of this study propose selenium NPs and light-stress-mediated in vitro callus cultures of C. tuberculata potentially operating as competitive inhibitors. The outcomes of the study were exceptional and hold promising implications for future medicinal applications.

Exposure of Caralluma tuberculata to biogenic selenium nanoparticles as in vitro rooting agent: Stimulates morpho-physiological and antioxidant defense system.

The commercial-scale production of Caralluma tuberculata faces significant challenges due to lower seed viability and sluggish rate of root growth in natural conditions. To overcome these obstacles, using phyto-mediated selenium nanomaterials as an in vitro rooting agent in plant in vitro cultures is a promising approach to facilitate rapid propagation and enhance the production of valuable therapeutic compounds. This study aimed to investigate the impact of phytosynthesized selenium nanoparticles (SeNPs) on the morphological growth attributes, physiological status, and secondary metabolite fabrication in in vitro propagated Caralluma tuberculata. The results demonstrated that a lower dose of SeNPs (100 µg/L) along with plant growth regulators (IBA 1 mg/L) had an affirmative effect on growth parameters and promoted earliest root initiation (4.6±0.98 days), highest rooting frequency (68.21±5.12%), number of roots (6.3±1.8), maximum fresh weight (710±6.01 mg) and dry weight (549.89±6.77 mg). However, higher levels of SeNPs (200 and 400 µg/L) in the growth media proved detrimental to growth and development. Further, stress caused by SeNPs at 100 µg/L along with PGRs (IBA 1 mg/L) produced a higher level of total chlorophyll contents (32.66± 4.36 µg/ml), while cultures exposed to 200 µg/L SeNPs alone exhibited the maximum amount of proline contents (10.5± 1.32 µg/ml). Interestingly, exposure to 400 µg/L SeNPs induced a stress response in the cultures, leading to increased levels of total phenolic content (3.4 ± 0.052), total flavonoid content (1.8 ± 0.034), and antioxidant activity 82 ± 4.8%). Furthermore, the combination of 100 µg/L SeNPs and plant growth regulators (1 mg/L IBA) led to accelerated enzymatic antioxidant activities, including superoxide dismutase (SOD = 4.4 ± 0.067 U/mg), peroxidase dismutase (POD = 3.3 ± 0.043 U/mg), catalase (CAT = 2.8 ± 0.048 U/mg), and ascorbate peroxidase (APx = 1.6 ± 0.082 U/mg). This is the first report that highlights the efficacy of SeNPs in culture media and presents a promising approach for the commercial propagation of C. tuberculata with a strong antioxidant defense system in vitro.

Donor matters: Donor selection impact on hematopoietic stem cell transplantation outcomes in Hispanic patients with B-cell acute lymphocytic leukemia: Insights from a myeloablative HSCT study.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a pivotal treatment for high-risk acute lymphocytic leukemia (ALL), although limited by suitable human leukocyte antigen (HLA)-matched sibling donors (MSD). This study evaluates the impact of donor selection on outcomes in post-HSCT Hispanic B-cell ALL patients. METHODOLOGY: This single-center retrospective study evaluates outcomes in 88 adult Hispanic B-cell ALL patients who underwent haploidentical, MSD, or MUD myeloablative HSCT between 2013 and 2023. RESULTS: Compared to Haploidentical transplants, MSD exhibited worse cumulative incidence of relapse (CIR) (HR = 3.39; P = 0.014) and disease-free survival (DFS) (HR = 2.44; P = 0.048) whereas MUD outcomes did not differ. This effect persisted even when controlling for pre-HSCT stage and Minimal residual disease (MRD) status. In addition, Ph-like was a significant predictor of worse DFS (HR = 3.60; P=0.014) and CIR (HR = 2.97; P=0.035) on multivariate analysis. Older donor age correlated with worse GVHD-free, relapse-free survival (GRFS) in haploidentical transplants (HR = 1.05; P=0.036). CONCLUSION: Our data highlights improved outcomes with younger, haploidentical donors among Hispanic B-cell ALL patients undergoing myeloablative HSCT. This underscores the importance of donor selection in optimizing outcomes for ALL patients.

Diabetes and the fabkin complex: A dual-edged sword.

The Fabkin complex, composed of FABP4, ADK, and NDPKs, emerges as a novel regulator of insulin-producing beta cells, offering promising prospects for diabetes treatment. Our approach, which combines literature review and database analysis, sets the stage for future research. These findings hold significant implications for both diabetes treatment and research, as they present potential therapeutic targets for personalized treatment, leading to enhanced patient outcomes and a deeper comprehension of the disease. The multifaceted role of the Fabkin complex in glucose metabolism, insulin resistance, anti-inflammation, beta cell proliferation, and vascular function underscores its therapeutic potential, reshaping diabetes management and propelling advancements in the field.

Liver-boosting potential: chicory compound-mediated silver nanoparticles for hepatoprotection-biochemical and histopathological insights.

Background: Liver disease is a serious health concern in today's world, posing a challenge to both healthcare providers and pharmaceutical companies. Most synthetic drugs and chemicals cause liver damage accounting for approximately 10% of acute hepatitis and 50% of acute liver failure. Purpose: The present study aimed to evaluate the hepato-protective activity of an extract of chicory formulation assisted by silver nanoparticles against carbon tetra chloride (CCl4)-induced hepatic damage in rat's liver. Methods: Rats of the Wistar strain (Rattus norvegicus) were used to test the in vivo hepato-protective efficacy at various doses. Rats were randomly divided into nine groups, each containing six rats. The groups were as follows: first group (control), second group (CCl4), third group, silymarin (20 mg/kg of body weight), fourth group (CCl4+chicory) (1.75 mg/kg of b. wt), fifth group (CCl4 + chicory at the dose of 2.35 mg/kg), sixth group (CCl4 + chicory of 3.25 mg/kg), seventh group (CCl4 +AgNPs 1.75 mg/kg of b. wt.), eighth group (CCl4 + AgNPs 2.35 mg/kg of body weight), and ninth group (CCl4 + AgNPs 3.25 mg/kg of b. wt.). Blood samples were taken 24 h after the last administration (i.e., 30th day). The blood samples were analyzed for different serum enzymes such as ALP (alkaline phosphatase), ALT (alanine transaminase), bilirubin (Blr), triglyceride, and cholesterol. Histology liver sections were performed. Results: Treatment with AgNPs and chicory extract showed significant hepato-protective activity in a dose-dependent manner. In three doses, the chicory extract at a rate of 3.25 mg/kg of body weight significantly reduced elevated levels of biochemical markers in comparison to CCl4-intoxicated rats. Histology of the liver sections from CCl4-treated rats revealed inflammation of hepatocytes, necrosis, cytoplasmic degeneration, vacuolization, and a deformed central vein. The chicory formulation extract exhibited a remarkable recovery percentage in the liver architecture that was higher than the drug (i.e., silymarin). While treatment with AgNPs also repaired the degenerative changes and restored the normal form of the liver, chicory formulation extract possessed more hepato-protective potential as compared to AgNPs by regulating biochemical and histo-pathological parameters. Conclusion: This study can be used as confirmation of the hepato-protective potential of chicory compounds for possible use in the development programs of drugs to treat liver diseases.

Platelet-derived sTLT-1 is associated with platelet-mediated inflammation in coronary artery disease patients.

The development of coronary artery disease (CAD) depends heavily on platelet activation, and inflammation plays a major role in all stages of atherosclerosis. Platelet-specific soluble triggering receptor expressed on myeloid cells like transcript 1 (sTLT-1) facilitate clot formation and have been linked to chronic inflammation. In this study, we explored the role of platelet-derived sTLT-1 in platelet-mediated inflammation in CAD patients. Plasma levels of sTLT-1 were measured using enzyme-linked immunosorbent assay in CAD patients (n = 163) and healthy controls (n = 99). Correlation analysis was performed to determine the circulatory sTLT-1 levels with platelet activation markers, immune cells, and inflammatory cytokines/chemokines. Increased plasma sTLT-1 levels were observed in CAD patients compared with those in healthy controls (p < 0.0001). A positive correlation was observed between sTLT-1 and platelet activation markers (P-selectin, PAC-1), CD14++ CD16- cells (classical monocytes), Natural killer T (NKT) cells, and platelet-immune cell aggregates with monocytes, neutrophils, dendritic cells, CD11c+ cells, and NKT cells. In contrast, a significant negative correlation was observed with CD8 cells. Furthermore, a significant positive correlation was observed between sTLT-1 and inflammatory markers (TNF-α, IL-1ß, IL-2, IL-6, IL-12p70, IL-18, CXCL-12, and CCL-11). Logistic regression analysis identified sTLT-1 and triglycerides as predictors of CAD. Receiver operating characteristic curve (ROC) analysis showed that sTLT-1 had a higher sensitivity and specificity for predicting CAD. Our findings suggest that platelet activation induces the release of sTLT-1 into the circulation in CAD patients, which aggregates with immune cells and enhances inflammatory responses.

Aging Enjoyment: A Grounded Theory Study.

Objective: The aim of this study was to investigate the factors contributing to enjoyment in old age. Method : To this end, this research used a qualitative exploratory research design known as grounded-theory research. Seventeen elderly participants (aged 65-85 years), comprising 11 men and 6 women, were selected using purposive sampling. A semi-structured interview was used as the data collection instrument. The method proposed by Corbin and Strauss was employed to design the interview questions. In this study, data analysis was interpretive using phenomenological analysis, which was done through open, axial, and selective coding. Results: The results indicated that the new emergent construct - ageing enjoyment - consisted of five categories and 19 subcategories. These categories include present moment awareness, liberating past, psychosocial safety, ultimate purpose for being, and self-peace. Subcategories include: Vitality, Family solidarity and intimacy, Occupational Adequacy, Economic wisdom, Social Acceptability, Healthy society, Talent flourish, productive experiences, Physical well-being, Willingness to develop, Mindfulness, satisfaction, Moralization, Adaptability, Benevolence, Acceptance, Desire to live, Meaningfulness, Religiosity. Conclusion: These categories suggest that present moment awareness, liberating past, as well as having psychosocial safety help the elderly experience ageing enjoyment. Hence, they are likely to reach self-peace through an ultimate purpose for being as they deal with challenging life issues. Practical implications of the findings are further discussed.

Case report: Pulse cyclophosphamide for treatment of multi-agent-refractory hepatic graft-versus-host disease.

Graft-versus-host disease (GVHD) is a common complication in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). GVHD is characterized as either acute or chronic based on symptomatology and histopathological findings. Despite advancements in disease-targeting therapeutics, steroid-refractory GVHD remains a significant contributor to mortality in HSCT recipients, highlighting the gaps in our understanding of its pathophysiology and treatment strategies. We present the case of a 46-year-old woman diagnosed with acute undifferentiated leukemia, who exhibited persistently elevated levels of serum total bilirubin (T.Bili), alkaline phosphatase (ALP), and liver function tests (LFTs) beginning on [day +201] post-haploidentical peripheral blood stem cell (PBSC) transplantation. The patient received fludarabine/total body irradiation (Flu/TBI) as a myeloablative conditioning regimen and post-transplant cyclophosphamide/tacrolimus/mycophenolate mofetil (PTCy/Tac/MMF) as GVHD prophylaxis. A liver biopsy confirmed the diagnosis of GVHD, while other possible etiologies were excluded by corresponding tests. Initial treatment with prednisone and tacrolimus, and the later addition of ruxolitinib, all showed poor response indicated by worsening T.Bili, ALP, and LFTs at the same time. Based on a multidisciplinary comprehensive assessment, we decided to administer 1,000 mg/m2 (1,600 mg) of cyclophosphamide ("pulse Cy"), which resulted in a dramatic improvement in T.Bili and transaminases starting from the very next day. A durable response to pulse cyclophosphamide was observed, as all indicators normalized ("complete response") within 55 days without relapses. The patient remains in good health with no recurrence of hepatic GVHD. To our knowledge, this is the first case in which Grade IV hepatic GVHD, refractory to multiple agents including steroids, tacrolimus, and ruxolitinib, demonstrated a complete response to pulse cyclophosphamide. The success highlights the potential therapeutic role of cyclophosphamide, a potent and cost-effective chemotherapy agent, in treating multi-agent-refractory GVHD. Large-scale clinical trials are warranted to validate its efficacy in this setting.

Exposure to zinc oxide nanoparticles induced reproductive toxicities in male Sprague Dawley rats.

BACKGROUND: This research delves into the reproductive toxicology of zinc oxide nanoparticles (ZnO-NPs) in male Sprague Dawley rats. It specifically examines the repercussions of Zn accumulation in the testes, alterations in testosterone levels, and histopathological changes in the gonadal tissues. AIMS: The primary objective of this study is to elucidate the extent of reproductive toxicity induced by ZnO-NPs in male Sprague Dawley rats. The investigation aims to contribute to a deeper understanding of the potential endocrine and reproductive disruptions caused by ZnO-NPs exposure. METHODS: Characterization techniques including SEM-EDX and XRD affirmed the characteristic nature of ZnO-NPs. Twenty-five healthy post weaning rats (200-250 g) were intraperitoneally exposed to different concentrations of ZnO-NPs @ 10 or 20 or 30 mg/kg BW for 28 days on alternate days. RESULTS: Results showed significant dose dependent decline in the body weight and testicular somatic index of rats. It also showed significant dose dependent accumulation of Zn in testis with increasing dose of ZnO-NPs. Conversely, serum testosterone level and sperm count were reduced with increasing dose of ZnO-NPs. Histological results showed dose dependent abnormalities i.e., vacuolization, edema, hemorrhage, destruction of seminiferous tubules, loss of germ cells and necrosis in rat testis. CONCLUSION: The findings of this study clearly indicate that high doses of zinc oxide nanoparticles (ZnO-NPs) can adversely affect the structural integrity and functional efficacy of the male reproductive system. Given these results, it becomes crucial to implement stringent precautionary measures in the utilization of ZnO-NPs, particularly in cosmetics and other relevant sectors. Such measures are imperative to mitigate the toxicological impact of ZnO-NPs on the male reproductive system and potentially on other related physiological functions. This study underscores the need for regulatory vigilance and safety assessments in the application of nanotechnology to safeguard human health.

Evaluation of Brown and red seaweeds-extracts as a novel larvicidal agent against the deadly human diseases-vectors, Anopheles stephensi, Aedes aegypti and Culex quinquefasciatus.

Infectious diseases such as malaria, dengue, and yellow fever are predominantly transmitted by insect vectors like Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus in tropical regions like India and Africa. In this study, we assessed the larvicidal activity of commonly found seaweeds, including Padina gymnospora, P. pavonica, Gracilaria crassa, Amphiroa fragilissima, and Spatoglossum marginatum, against these mosquito vectors. Our findings indicate that extracts from P. gymnospora Ethyl Acetate (PgEA), P. pavonica Hexane (PpH), and A. fragilissima Ethyl Acetate (AfEA) displayed the highest larval mortality rates for A. stephensi, with LC50 values of 10.51, 12.43, and 6.43 µg/mL, respectively. Additionally, the PgEA extract from P. gymnospora exhibited the highest mortality rate for A. aegypti, with an LC50 of 27.0 µg/mL, while the PgH extract from the same seaweed showed the highest mortality rate for C. quinquefasciatus, with an LC50 of 9.26 µg/mL. Phytochemical analysis of the seaweed extracts revealed the presence of 71 compounds in the solvent extracts. Fourier-transform infrared spectra of the selected seaweeds indicated the presence of functional groups such as alkanes, alcohols, and phenols. Gas chromatography-mass spectrometry analysis of the seaweeds identified major compounds, including hexadecanoic acid in PgEA, tetradecene (e)- in PpEA, octadecanoic acid in GcEA, and 7-hexadecene, (z)-, and trans-7-pentadecene in SmEA.

Concordance of Next-Generation Sequencing and Multiparametric Flow Cytometry Methods for Detecting Measurable Residual Disease in Adult Acute Lymphoblastic Leukemia: Optimizing Prediction of Clinical Outcomes From a Single-Center Study.

INTRODUCTION: Detection of measurable residual disease (MRD) in adults with acute lymphoblastic leukemia (ALL) is a vital biomarker in risk prediction and treatment selection. Next-generation sequencing (NGS) offers greater sensitivity relative to multiparametric flow cytometry (MFC) and may be a better predictive tool for identifying ALL patients at risk of relapse. PATIENTS AND METHODS: This single-center retrospective study compares MRD detection by NGS versus MFC in 52 adult B- and T-ALL patients treated at our institution between 2018 and 2023. Pretreatment bone marrow samples were used for assay calibration, while post-treatment MRD assessment was completed up to 4.5 months after the first complete remission (CR1) using an MRD cutoff of 10-6 for distinguishing relapse risk. RESULTS: The 2-year cumulative incidence of relapse (CIR) among patients who were MRD positive using MFC and NGS was 39.5% and 46.2%, respectively. Unlike MFC, post-CR1 MRD positivity with NGS significantly predicted CIR (HR = 9.47, P = .028). In patients who were MRD negative by MFC, low levels of MRD detected by NGS distinguished patients at high risk of relapse (HR 10.3, P = .026, 2-year CIR 51.6%). CONCLUSION: Our data suggests that assessment of post-CR1 MRD using a highly sensitive NGS assay can identify ALL patients undergoing frontline therapy at increased risk of relapse and guide the use of adjuvant therapy.

Thermal and Nonlinear Optical Properties of Sudan III.

We report the experimental and theoretical study of the diffraction patterns (DPs) and thermal properties of Sudan III. DPs are used in the calculation of the Sudan III nonlinear refractive index (NLRI), n 2 . As high as n 2 = 7.69 ×10-6 cm2/W is obtained. The study of the Sudan III thermal conductivity, TC, shows the reduction of the TC against the increase of the Sudan III temperature. The property, all-optical switching (AOS), is studied in details, both static and dynamic ones, using two, cw, visible, single mode laser beams of wavelengths 473 and 635 nm.