Implicative role of epidermal growth factor receptor and its associated signaling partners in the pathogenesis of Alzheimer's disease.

Epidermal growth factor receptor (EGFR) plays a pivotal role in early brain development, although its expression pattern declines in accordance with the maturation of the active nervous system. However, recurrence of EGFR expression in brain cells takes place during neural functioning decline and brain atrophy in order to maintain the homeostatic neuronal pool. As a consequence, neurotoxic lesions such as amyloid beta fragment (Aß1-42) formed during the alternative splicing of amyloid precursor protein in Alzheimer's disease (AD) elevate the expression of EGFR. This inappropriate peptide deposition on EGFR results in the sustained phosphorylation of the downstream signaling axis, leading to extensive Aß1-42 production and tau phosphorylation as subsequent pathogenesis. Recent reports convey that the pathophysiology of AD is correlated with EGFR and its associated membrane receptor complex molecules. One such family of molecules is the annexin superfamily, which has synergistic relationships with EGFR and is known for membrane-bound signaling that contributes to a variety of inflammatory responses. Besides, Galectin-3, tissue-type activated plasminogen activator, and many more, which lineate the secretion of pro-inflammatory cytokines (TNF-α, IL-1ß, IL-6, and IL-18) result in severe neuronal loss. Altogether, we emphasized the perspectives of cellular senescence up-regulated by EGFR and its associated membrane receptor molecules in the pathogenesis of AD as a target for a therapeutical alternative to intervene in AD.

Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India.

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.

Comprehensive Review of Hepatocellular Carcinoma in India: Current Challenges and Future Directions.

There is not much information on hepatocellular carcinoma (HCC) in India. Here, we review the existing data, available treatment choices, and future directions in HCC management. An extensive search was conducted through PubMed and MEDLINE for studies published between January 2000 and June 2022 on the epidemiology of HCC in India using the following key words: atezolizumab, BCLC staging, hepatocellular carcinoma, immune checkpoint inhibitors, immunotherapy, and programmed cell death ligand-1, with the filters humans and English language. The most frequent risk factors for the development of HCC in India include nonalcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infection, liver cirrhosis, and alcohol intake. On the basis of new findings, the Barcelona Clinic Liver Cancer (BCLC) Staging Criteria need to be revised. As most cases in India are discovered at a later stage, curative treatments such as surgical resection, ablation, or liver transplantation may not be an option. Clinical trials are underway for a number of immune checkpoint drugs that target cytotoxic T-cell lymphocyte-4 and programmed cell death-1/programmed cell death-ligand 1. In India, phase III trials of atezolizumab in combination with other drugs are underway for the treatment of various malignancies. Renin angiotensin system inhibitors, antivirals, primary hepatocyte transplantation, and bioartificial liver devices are among the future options for the management of HCC. In developing countries like India, HCC is often diagnosed at an advanced stage because of a delay in routine testing or screening. Therefore, developing effective treatment regimens for such stages is critical. Immunotherapy is a promising treatment option that has the potential to increase overall response and survival rate.

La adhesión al tratamiento antihipertensivo es de fundamental importancia / Adhering to antihypertensive treatment is vitally important

Introduction: Hypertension is one of the most common cardiovascular risk factors but the medication\r\nadherence rate among hypertensive patients is low. Objectives: To develop, validate and test the reliability of Medication Adherence Questionnaire (MAQ) in hypertensive patients. Materials and methods: A\r\ncross-sectional study was conducted among hypertensive patients in Department of General Medicine\r\nfor eight months. The MAQ was prepared by referring to the previously validated questionnaires and\r\nother related medication adherence studies. It was validated by the expert committee and tested for\r\ntest-retest reliability. The medication adherence data It was validated collected from patients who have\r\nbeen receiving at least one antihypertensive medication in the past three months. Results: The mean\r\nmedication adherence score for the test and re-test are 66.25 ± 19.49 were 67.50 ± 19.19 respectively,\r\nand the test-retest reliability of MAQ was 0.979. Out of 299 patients, 180 (60.20%) were males, and\r\n118 (39.46%) were females. In our study population, most of the patients were found to have medium\r\nmedication adherence (53.84%) followed by low medication adherence (39.13%) and high medication\r\nadherence (7.02%). Conclusion: The self-reported 8-item MAQ It was validated developed and tested\r\nfor reliability in South Indian hypertensive patients.The mean medication adherence of the study population was 71.77 ± 13.94, which indicates low medication adherence to antihypertensive treatment

Introducción: La hipertensión es uno de los factores de riesgo cardiovascular más frecuentes y el índice\r\nde adhesión al tratamiento entre los pacientes hipertensos es bajo. Objetivos: Elaborar, validad y evaluar\r\nla fiabilidad del Medication Adherence Questionnaire (MAQ) en pacientes hipertensos. Materiales y métodos: Se llevó a cabo un estudio transversal durante ocho meses en pacientes hipertensos atendidos en\r\nel Departamento de Medicina General. El MAQ fue elaborado con referencia a cuestionarios validados\r\ncon anterioridad y de acuerdo con lo hallado en otros estudios relacionados con la adhesión al tratamiento farmacológico. La validación del MAQ fue realizada por el comité de expertos y analizada en\r\ntérminos de fiabilidad prueba-repetición de la prueba. La información sobre la adhesión al tratamiento\r\nfarmacológico fue recabada mediante la evaluación de los pacientes que habían recibido al menos una\r\ndroga antihipertensiva durante los últimos tres meses. Resultados: El puntaje medio correspondiente a la\r\nadhesión al tratamiento ante la prueba y la reiteración de la prueba fue 66.25 ± 19.49 y 67.5 ± 19.19,\r\nrespectivamente, y la fiabilidad del MAQ fue 0.979. De los 299 pacientes, 180 (60.2%) fueron de sexo\r\nmasculino y 118 (39.46%) fueron de sexo femenino. En nuestra población en estudio, la mayoría de los\r\npacientes presentaron un nivel intermedio de adhesión al tratamiento farmacológico (53.84%), seguido\r\npor el nivel bajo (39.13%) y elevado de adhesión al tratamiento farmacológico (7.02%). Conclusión: El\r\ncuestionario autoadministrado MAQ de ocho ítems fue creado y evaluado en términos de fiabilidad en\r\npacientes hipertensos residentes en el sur de la India. El puntaje medio correspondiente a la adhesión al\r\ntratamiento farmacológico en la población en estudio fue 71.77 ± 13.94, lo cual indica un nivel bajo de\r\nadhesión al tratamiento con drogas antihipertensivas