Evaluation of mean neutrophil volume and immature to total neutrophil ratio as a biomarker for bacterial sepsis in adult patients.

INTRODUCTION: Mean neutrophil volume (MNV) and immature to total neutrophil ratio (IT Ratio) has been found to support the detection of sepsis in elderly and neonates. This study aimed to assess the diagnostic significance of MNV and IT ratio in adult sepsis population. MATERIALS AND METHODS: Sixty-four adult patients presented with suspected bacterial sepsis were included in this study. Relevant cultures and/or pertinent serology tests were performed. Full blood counts were analysed for MNV and IT ratio. RESULTS: Fifty-one patients out of 64 recruited subjects were confirmed sepsis. Twentyfour patients had confirmed bacterial infection by cultivation and two were positive for leptospiral serology. MNV was very good in distinguishing sepsis from non-sepsis group (AUC = 0.80, 95% confidence interval (CI) = 0.69-0.91, Accuracy = 0.72, Kappa = 0.40) with a cut-off value of 153.5 (sensitivity = 67%, specificity = 92%). There was no significant difference in IT ratio between sepsis and non-sepsis group (p-value > 0.05). MNV was superior over IT ratio (AUC = 0.85, 95%CI = 0.76-0.95, and AUC = 0.70, 95% CI = 0.56-0.85, respectively) in diagnosing bacterial infection. The optimum cut-off value for MNV in bacterial infection was 154.5 (sensitivity = 67%, specificity = 89%) and for IT ratio was 0.035 (sensitivity = 45%, specificity = 67%). CONCLUSION: MNV appears to be a very good marker for diagnosing sepsis and bacterial infection. We recommend including MNV into sepsis workup in ED setting, since it can be determined without additional specimen.

Effects of mineral trioxide aggregate, calcium hydroxide, biodentine and Emdogain on osteogenesis, Odontogenesis, angiogenesis and cell viability of dental pulp stem cells.

BACKGROUND: Vital pulp therapy preserves and maintains the integrity and the health of dental pulp tissue that has been injured by trauma, caries or restorative procedures. The enhancement of cells viability and formation of reparative dentine and new blood vessels are vital determinants of the success of direct pulp capping. Therefore, the aims of this study was to evaluate and compare the in vitro osteogenic, odontogenic and angiogenic effects of mineral trioxide aggregate (MTA), calcium hydroxide [Ca(OH)2], Biodentine and Emdogain on dental pulp stem cells (DPSCs) and examine the effects of the tested materials on cell viability. METHODS: DPSCs were treated with MTA, Ca(OH)2, Biodentine or Emdogain. Untreated cells were used as control. The cell viability was measured by MTT assay on day 3. Real-Time PCR with SYBR green was used to quantify the gene expression levels of osteogenic markers (alkaline phosphatase and osteopontin), odontogenic marker (dentin sialophosphoprotein) and angiogenic factor (vascular endothelial growth factor) on day 7 and day 14. RESULTS: All capping materials showed variable cytotoxicity against DPSCs (77% for Emdogain, 53% for MTA, 26% for Biodentine and 16% for Ca(OH)2 compared to control (P value < 0.0001). Osteopontin (OPN) and dentin sialophosphoprotein (DSPP) gene expression was increased by all four materials. However, alkaline phosphatase (ALP) was upregulated by all materials except Emdogain. Vascular endothelial growth factor (VEGF) expression was upregulated by all four tested materials except Ca(OH)2. CONCLUSIONS: Our results suggest MTA, Biodentine and Emdogain exhibit similar attributes and may score better than Ca(OH)2. Emdogain could be a promising alternative to MTA and Biodentine in enhancing pulp repair capacity following dental pulp injury. However, further future research is required to assess the clinical outcomes and compare it with the in vitro findings.

Identification of a recurrent frameshift mutation at the LDLR exon 14 (c.2027delG, p.(G676Afs*33)) causing familial hypercholesterolemia in Saudi Arab homozygous children.

Familial hypercholesterolemia (FH) is an autosomal dominant disease, predominantly caused by variants in the low-density lipoprotein (LDL) receptor gene (LDLR). Herein, we describe genetic analysis of severely affected homozygous FH patients who were mostly resistant to statin therapy and were managed on an apheresis program. We identified a recurrent frameshift mutation p.(G676Afs*33) in exon 14 of the LDLR gene in 9 probands and their relatives in an apparently unrelated Saudi families. We also describe a three dimensional homology model of the LDL receptor protein (LDLR) structure and examine the consequence of the frameshift mutation p.(G676Afs*33), as this could affect the LDLR structure in a region involved in dimer formation, and protein stability. This finding of a recurrent mutation causing FH in the Saudi population could serve to develop a rapid genetic screening procedure for FH, and the 3D-structure analysis of the mutant LDLR, may provide tools to develop a mechanistic model of the LDLR function.

Prevalence of Psychiatric Disorders among Female Juvenile Offenders.

Inmates of Juvenile Developmental Centers are the special group of youth population who are in conflict with law. They are vulnerable to psychiatric illness. The objective of this study was to see the prevalence and type of psychiatric disorders in institutionalized female juvenile offenders and non-offenders of same age, sex and socioeconomic group in the community. The association of mental disorders was examined in 43 female inmates of Juvenile Development Centers and 43 randomly selected comparison subjects in community. One stage-structured assessment of psychopathology was carried out by using a structured and valid Bangla version of the Development and Well-Being Assessment (DAWBA). Development and Well-Being Assessment generated psychiatric diagnosis was assigned based on ICD-10 diagnostic criteria for research. The result revealed that, of those who were in conflict with law, 93% had mental disorder, whereas 14% of non-offenders had psychiatric disorder. Among the offenders with psychiatric disorders, most of them (32.6%) suffered from Major Depressive Disorder (MDD), followed by combined MDD & Post Traumatic Stress Disorder (PTSD). On the other hand, among the non-offenders with psychiatric disorder 9.3% suffered from MDD. It can be concluded that considerable psychiatric disorders are prevalent among the female juvenile offenders with comparison to non-offenders. Broad-based replication study could confirm these findings.

The association of GSTM1 and GSTT1 polymorphisms with squamous cell carcinoma of cervix in Pakistan.

Gene deletions in GSTM1 and GSTT1 may result in tempering the activation and detoxification of several carcinogens and thereby may increase the risk of cancer pre-disposition. This study aims to investigate the clinical impact of glutathione-S-transferase GSTM1 and GSTT1 polymorphisms on squamous cell carcinoma of cervix (SCCA).The GSTM1 and GSTT1 polymorphisms were analyzed in cervical cancer patients and healthy controls. Touch down multiplex polymerase chain reaction (PCR) strategy was adopted for genotyping of GSTM1 and GSTT1 polymorphisms. The null genotype of GSTM1 exhibited a significantly higher percentage in patients with SCCA (74 %) than in the control group (34.0 %). However, no significant difference was observed in the null genotype of GSTT1 among SCC patients and healthy subjects, respectively. GSTM1 exhibited a significant association with increased risk of squamous cell carcinoma (p < 0.001). The odds ratio for the GSTM1 null genotype was also calculated (odds ratio 3.7484; 95 % confidence interval 1.6562-84834). This suggests that GSTM1 null genotype in cervical cell samples may be associated with more severe precancerous lesions of the cervix.

Modeling of wastewater quality in an urban area during festival and rainy days.

Water pollution during festival periods is a major problem in all festival cities across the world. Reliable prediction of water pollution is essential in festival cities for sewer and wastewater management in order to ensure public health and a clean environment. This article aims to model the biological oxygen demand (BOD(5)), and total suspended solids (TSS) parameters in wastewater in the sewer networks of Karbala city center during festival and rainy days using structural equation modeling and multiple linear regression analysis methods. For this purpose, 34 years (1980-2014) of rainfall, temperature and sewer flow data during festival periods in the study area were collected, processed, and employed. The results show that the TSS concentration increases by 26-46 mg/l while BOD(5) concentration rises by 9-19 mg/l for an increase of rainfall by 1 mm during festival periods. It was also found that BOD(5) concentration rises by 4-17 mg/l for each increase of 10,000 population.

Di-aqua-bis-(nicotinamide-κN (1))bis-(thiocyanato-κS)cobalt(II).

In the title compound, [Co(NCS)2(C6H6N2O)2(H2O)2], the Co(II) cation is located on an inversion centre and is coordinated by two thio-cyanate anions, two nicotinamide mol-ecules and two water mol-ecules in a distorted N2O2S2 octa-hedral geometry. The amide group is twisted by 31.30 (16)° with respect to the pyridine ring. In the crystal, mol-ecules are linked by O-H⋯O, O-H⋯S and N-H⋯S hydrogen bonds into a three-dimensional supra-molecular network. Weak π-π stacking is observed between parallel pyridine rings of adjacent mol-ecules, the centroid-centroid distance being 3.8270 (19) Å.

Di-aqua-bis-(nicotinamide-κN (1))bis-(thio-cyanato-κN)nickel(II).

In the title complex, [Ni(NCS)2(C6H6N2O)2(H2O)2], the Ni(II) ion is located on an inversion center and is coordinated in a distorted octa-hedral environment by two N atoms from two nicotinamide ligands and two water mol-ecules in the equatorial plane, and two N atoms from two thio-cyanate anions in the axial positions, all acting as monodentate ligands. In the crystal, weak N-H⋯S hydrogen bonds between the amino groups and the thio-cyanate anions form an R 4 (2)(8) motif. The complex mol-ecules are linked by O-H⋯O, O-H⋯S, and N-H⋯S hydrogen bonds into a three-dimensional supra-molecular structure. Weak π-π inter-actions between the pyridine rings is also found [centroid-centroid distance = 3.8578 (14) Å].

Chemical kinetics of silver diammine fluoride in demineralization and remineralization solutions-an in vitro study.

Introduction: Silver Diammine Fluoride (SDF) is a clinical minimal intervention to manage dentin caries. Its chemistry in demineralization conditions has been investigated widely, but far less in remineralization conditions. The aim was to investigate and compare the chemical reactions when SDF is added to remineralization and demineralization solutions. Methods: 0.01 ml SDF (Riva Star) was added to deionized water (DW); demineralization (DS = pH4) and remineralization (RS = pH7.0) solutions. The time sequence of concentrations of NH4+, F-, and Ag+ were measured using ion selective electrodes (ISEs) every 2 min. The pH was also measured. Precipitates were characterized using x-ray Diffraction (XRD) and, 31P and 19F nuclear magnetic resonance spectroscopy (NMR). Results: The concentrations of NH4+ and Ag+ showed decreasing trends in DW (-0.12 and -0.08 mM/h respectively), and in DS (-1.06 and -0.5 mM/h respectively); with corresponding increase in F- concentration (0.04 and 0.7 mM/h respectively). However, in RS, NH4+ concentration showed little change (0.001 mM/h), and Ag+ and F- concentrations were negligible. XRD results showed that precipitates (in RS only) contained AgCl, and metallic Ag. NMR showed that fluorapatite/carbonated fluorapatite (FAP/CFAP) were formed. The pH increased after SDF addition in all three solutions. Discussion: SDF dissolved to release NH4+, F- and Ag + . In DW and DS, NH4+ combined with Ag+ to form diamminesilver, causing an increase of F- and pH. In RS, F- reacted with Ca2+ and (PO)43- to form FAP/CFAP, and Ag+ reacted with Cl- to form AgCl/Ag. These suggests why SDF is effective in managing dentin caries.

Characterization of chemical reactions of silver diammine fluoride and hydroxyapatite under remineralization conditions.

Introduction: Silver Diammine Fluoride (SDF) is a clinically used topical agent to arrest dental caries. However, the kinetics of its chemical interactions with hydroxyapatite (HA), the principal inorganic component of dental enamel, are not known. The aim was to characterize the step-wise chemical interactions between SDF and HA powder during the clinically important process of remineralization. Methods: Two grams of HA powder were immersed in 10 ml acetic acid pH = 4.0 for 2 h to mimic carious demineralization. The powder was then washed and dried for 24 h and mixed with 1.5 ml SDF (Riva Star) for 1 min. The treated powder was then air-dried for 3 min, and 0.2 g was removed and stored in individual tubes each containing 10 ml remineralizing solution. Powder was taken from each tube at various times of exposure to remineralization solution (0 min, 10 min, 2 h, 4 h, 8 h, 24 h, and 10 days), and characterized using Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR) spectroscopy. Results and discussion: 19F MAS-NMR spectra showed that calcium fluoride (CaF2) started to form almost immediately after HA was in contact with SDF. After 24 h, the peak shifted to -104.5 ppm suggesting that fluoride substituted hydroxyapatite (FSHA) was formed with time at the expense of CaF2. The 31P MAS-NMR spectra showed a single peak at 2.7 ppm at all time points showing that the only phosphate species present was crystalline apatite. The 35Cl MAS-NMR spectra showed formation of silver chloride (AgCl) at 24 h. It was observed that after the scan, the whitish HA powder changed to black color. In conclusion, this time sequence study showed that under remineralization conditions, SDF initially reacted with HA to form CaF2 which is then transformed to FSHA over time. In the presence of chloride, AgCl is formed which is subsequently photo-reduced to black metallic silver.

Comparative analysis of virulence factors secreted by Bacillus anthracis Sterne at host body temperature.

AIMS: For the analysis of virulence factors produced and secreted by Bacillus anthracis vegetative cells during mammalian host infection, we evaluated the secretome of B. anthracis Sterne exposed to host-specific factors specifically to host body temperature. METHODS AND RESULTS: We employed a comparative proteomics-based approach to analyse the proteins secreted by B. anthracis Sterne under host-specific body temperature conditions. A total of 17 proteins encoded on a single chromosome and the pXO1 plasmid were identified by peptide mass fingerprinting. Multiple algorithms were used to predict the secretion mechanisms of the detected proteins in B. anthracis. CONCLUSIONS: Several putative virulence factors and known factors responsible for sporulation were differentially regulated, including CodY, pXO1-130 and BA1952, revealing insights into temperature cues in the B. anthracis secretome. SIGNIFICANCE AND IMPACT OF THE STUDY: This study identified temperature-regulated proteins. Further studies aimed at understanding the physical and functional roles of these proteins in infection and control by elevated temperatures will contribute to detection, diagnostics and prophylaxis.

Effect of topically applied silver compounds on the demineralisation of hydroxyapatite.

OBJECTIVES: This study investigates the demineralization inhibitory mechanisms of AgNO3, AgF and silver diamine fluoride (SDF) using a previously used hydroxyapatite (HAP) caries demineralization model system. METHODS: HAP discs were allocated into three groups (n = 3) and immersed in demineralization solution (buffered pH 4.0, 0.1 mol/L acetic acid) for 4 h. Each disc was treated topically with either 3.16 M AgNO3, 3.16 M AgF or 3.16 M SDF using a micro-brush. The discs were then demineralized for a further 4 h. Calcium, silver, and fluoride ion selective electrodes (ISEs) were used to monitor the changes in each ion concentration at 1 min intervals throughout. Demineralization inhibition was calculated as the percentage reduction in the rate of calcium ion loss from HAP (PRCLHAP). Characterization of similarly treated HAP powder was carried out with Magic Angle Spinning-Nuclear Magnetic Resonance RESULTS: The mean PRCLHAP for each treatment group was; AgF (72.3 + 4.8%), SDF (69.7 + 5.3%) and AgNO3 (14.9 + 2.7%). Ag3PO4 was detected in all HAP powders. CaF2 and fluorohydroxyapatite (FHA) were detected only in powders treated with either AgF or SDF. The demineralization inhibitory efficacy of topically applied AgNO3 results from the formation of a Ag3PO4 barrier. Whereas, the demineralization inhibitory efficacy of topically applied AgF, and SDF, results from the formation of a barrier composed of Ag3PO4, CaF2, and FHA. SIGNIFICANCE: In addition to their anti-microbial properties, clinical topical application of silver compounds for caries preventative treatment is due to their ability to form acid-resistant barriers composed of silver phosphate. When fluoride is present, this barrier also contains CaF2 and FHA, additionally protecting the mineral.

COVID-19 and Diabetes Mellitus: From Pathophysiology to Clinical Management.

An increase in the severity of the coronavirus disease 2019 (COVID-19) was observed in patients infected with the acute severe metabolism syndrome coronavirus type 2 (SARS-CoV-2). Patients who have COVID-19 infection may also be more susceptible to hyperglycemia. When paired with other risk factors, hyperglycemia might alter immune and inflammatory responses, predisposing people to significant COVID-19 and perhaps deadly outcomes. Angiotensin-converting accelerator 2 (ACE2), a component of the renin-angiotensin-aldosterone system (RAAS), is the principal entry receptor for SARS-CoV-2; nevertheless, dipeptidyl enzyme 4 (DPP4) may potentially serve as a binding target. However, preliminary data did not indicate a substantial effect on the susceptibility to SARS-CoV-2 using glucose-lowering DPP4 inhibitors. Because of their pharmacologic characteristics, salt-glucose cotransporter 2 (SGLT2) inhibitors should not be advised for COVID-19 patients because they may have adverse effects. Currently, taking a hypoglycemic drug should be the most efficient way to manage acute glycemia. The majority of market proof is said to categorize two diabetes mellitus (DM) and fails to distinguish between the two primary categories of DM due to its widespread use. For grouping one DM and COVID-19, there is now some constrained proof available. Most of those findings are just preliminary, so further research will undoubtedly be required to determine the best course of action for DM patients.

Role of protein kinase C ß and vascular endothelial growth factor receptor in malignant pleural mesothelioma: Therapeutic implications and the usefulness of Caenorhabditis elegans model organism.

PURPOSE: To examine the role of both protein kinase C (PKC)-ß and vascular endothelial growth factor receptor (VEGFR)-2 in malignant pleural mesothelioma (MPM) using respective inhibitors, enzastaurin and KRN633. MATERIALS AND METHODS: MPM cell lines, control cells, and a variety of archived MPM tumor samples were used to determine the protein expression levels of PKC-ß, VEGFR-2, VEGF, and p-AKT. Effects of enzastaurin and KRN633 on phosphorylation status of key signaling molecules and viability of the mesothelioma cells were determined. The common soil nematode, Caenorhabditis elegans, was treated with enzastaurin to determine its suitability to screen for highly potent kinase inhibitors. RESULTS: PKC-ß1, PKC-ß2 and VEGFR-2/KDR were overexpressed in MPM cell lines and MPM tumor tissues. Enzastaurin treatment resulted in significant loss in viability of VEGF induced cell proliferation; however, the effect of KRN633 was much less. Enzastaurin also dramatically decreased the phosphorylation of PKC-ß, its downstream target p-AKT, and surprisingly, the upstream VEGFR-2. The combination of the two drugs at best was additive and similar results were obtained with respect to cell viability. Treatment of C. elegans with enzastaurin resulted in clear phenotypic changes and the worms were hypermotile with abnormal pattern and shape of eggs, suggesting altered fecundity. CONCLUSIONS: PKC-ß1 and VEGFR-2 are both excellent therapeutic targets in MPM. Enzastaurin was better at killing MPM cells than KRN633 and the combination lacked synergy. In addition, we show here that C. elegans can be used to screen for the next generation inhibitors as treatment with enzastaurin resulted in clear phenotypic changes that could be assayed.

The effect of ultrasound on the uptake of fluoride by glass ionomer cements.

Ultrasound has been shown to improve the set of glass ionomer cements (GICs) and also other cement properties. In particular, the release of fluoride is enhanced. These cements also can take up fluoride ion from liquids. The aim of this study is to investigate the effect of ultrasound on this cement property. Two commercial dental restorative GICs were used together with a modified commercial material and an experimental material based on a F-free glass. All three commercial materials came in capsules which were mixed as makers directed, the experimental material was mixed as in previous papers. Mixed cement was placed polyethylene moulds to create 3 × 2 mm thick discs. These were either allowed to standard set for 6 min or set with ultrasound for 55 s. 18 samples were made for each material/set. Three samples were placed in 4 ml of 0.2% NaF solution for 24 h at 37°C. The cylinders were removed and the F concentration of the solutions measured by ISE using TISAB decomplexant. F uptake was determined by difference from the original NaF concentration. The two conventional GICs showed reductions of 17.4 and 8.5% for ultrasound compared to standard set whereas the modified material increased by 32.3% and the experimental one by 20.6%. It is suggested that the effect of ultrasound may increase the surface area of the residual glass particles in the GIC which would increase F uptake. In GICs where considerable F ion is released into the cement matrix by the enhanced reaction caused by ultrasound this may be sufficient to reverse the former effect producing the reduced uptake observed.

Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River.

Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.

Scleral-fixated intraocular lens implants-evolution of surgical techniques and future developments.

Varied options are available for the implantation of secondary intraocular lens implants in the absence of zonular or capsular support. Loss of the capsule can occur in the context of complicated cataract surgery, trauma or inherited conditions such as Marfan syndrome or pseudoexfoliation. Approaches to overcome this include optical measures such as the use of spectacles or contact lenses, and surgical therapy incorporating the use of anterior chamber, iris-fixated or scleral-fixated lenses. Surgical techniques to implant scleral-fixated lenses have undergone various modifications, since the first publication of sutured intrascleral fixation described in the 1980s. However, despite the advances in surgical techniques, studies are limited either by their retrospective nature, small sample size and most importantly small duration of follow-up. This comprehensive review aims to amalgamate the evolution of various surgical techniques with regards to intrascleral lens fixation and suggests areas for future development.

Remineralising fluorine containing bioactive glass composites.

OBJECTIVES: The objective was to investigate the mechanical properties, fluoride release and apatite formation of resin based dental composites based on a fluoride containing Bioactive Glass (BG) with and without a silylating agent. METHODS: A SiO2-P2O5-CaO-SrO-Na2O-CaF2 BG was synthesized by the melt quench route. This glass and a commercially available inert glass (IG) were incorporated into a light cured BisGMA-TEGMA resin. The composite resins were then evaluated in terms of their ability to form apatite by Fourier Transform Infrared spectroscopy (FTIR) and by scanning electron microscopy (SEM) following immersion in artificial saliva at pH 4 (AS4) and pH 7 (AS7). The experiments were performed with and without silylation of the BG. The compressive strength and flexural strength were determined after 1, 28 and 84 days of immersion in the AS4 and AS7 immersion media. RESULTS: The FTIR spectra of the BG composites exhibited split bands at approximately 560 and 600 cm-1 corresponding to a apatite formation in the surface or on the surface under all immersion conditions. SEM showed the presence of a reacted layer of glass particles in the composite surface and the presence of a surface layer of apatite in AS7. The compressive strength and flexural strength were significantly higher for the silylated BG composites. The strengths of both silylated and non silylated BG composites and IG composites decreased upon immersion. SIGNIFICANCE: BG composites exhibit reduced strengths upon immersion but still exhibit strengths comparable to existing composites after 84 days of immersion.

Tyrosine Kinase Inhibitors (TKIs) in Lung Cancer Treatment: A Comprehensive Analysis.

Lung cancer is the leading type of cancer worldwide today. Kinases play a crucial role in mediating the signaling pathways, and it directs to control several necessary cellular processes. Conversely, the deregulation of tyrosine kinases leads to oncogenic conversion, uncontrolled cell proliferation and tumorigenesis. Tyrosine kinases are largely deregulated in lung cancer and specifically in non-small cell lung cancer (NSCLC). Therefore, the inhibition of pathogenic kinases is a breakthrough development in cancer research, treatment and care, which clinically improve the quality of life. In the last decades, various single or combination inhibitors are approved by U.S Food and Drug Administration (FDA) and commercially available in clinics, and currently, several preclinical studies are ongoing and examining the kinase inhibitors. However, many gaps remain in understanding the mechanisms of kinase inhibitors and their selectivity. In this analysis, we focus on a class of receptor and non-receptor tyrosine kinase inhibitors and their novel role in lung cancer.