Evaluation of Plant-Based Silver Nanoparticles for Antioxidant Activity and Promising Wound-Healing Applications.

The current research focuses on the green synthesis of silver nanoparticles (AgNPs) using a polar extract of taro corms and the evaluation of its antioxidant properties and wound-healing applications. Taro corm extract (100 mL) was treated with a 5 mM AgNO3 solution (100 mL) at room temperature for the formation of AgNPs, and a color change was observed. The surface plasmon resonance (SPR) peaks in their UV-visible spectra appeared at a range of 438-445 nm. Fourier transform infrared, scanning electron microscopy, energy-dispersive X-ray, dynamic light scattering, and X-ray diffraction were used for the characterization of the taro corms extract-mediated AgNPs (TCE-AgNPs). The synthesized AgNPs were crystalline and spherical, with an average size of 244.9-272.2 nm with a polydispersity index of 0.530 and zeta potential of -18.8 mV, respectively. The antibacterial potential of TCE-AgNPs was tested, and the inhibition zones detected against Cronobacter sakazakii, Pseudomonas aeruginosa, Listeria monocytogenes, and Enterococcus faecalis were 28, 26, 18, and 13 mm, respectively. Furthermore, the antioxidant activity of TCE-AgNPs showed significant radical-scavenging activity compared to the standard used. Collagen content data collected from regenerated tissue and higher collagen content indicated rapid wound healing compared to others, which was seen in a group treated with TCE-AgNP film bandages.

Impact of Cancerous Pulmonary Involvement on Outcomes in COVID-19 Patients.

BACKGROUND: SARS-CoV2 is a highly contagious virus causing COVID-19 (Corona virus disease 2019), which has resulted in more than 6 million deaths worldwide as of June 2022. Mortality in COVID-19 has mainly been attributed to respiratory failure. Previous studies showed that the presence of cancer did not adversely affect the outcome of COVID-19. However, in our clinical practice, it was noted that in cancer patients with pulmonary involvement, COVID-19-related morbidity, and morbidity were high. Therefore, this study was designed to assess the impact of cancerous pulmonary involvement on COVID-19 outcomes and to compare clinical outcomes of COVID-19 in cancer and non-cancer population, with further discretion between cancers with and without pulmonary involvement. METHODS: We performed a retrospective study from April 2020 until June 2020 with a sample size of 117 patients with a confirmed diagnosis of SARS-CoV2 on nasal swab PCR. Data was extracted from HIS (Hospital Information System). Hospitalization, supplemental oxygen, ventilatory support, and death were compared between non-cancer and cancer patients with a particular focus on pulmonary involvement. RESULTS: Admissions, supplemental oxygen requirement, and mortality were significantly higher in cancer patients with pulmonary involvement (63.3%, 36.4%, and 45%, respectively) compared to cancer patients without pulmonary involvement (22.1%, 14.7%, and 8.8% respectively) (p-values: 0.00003, 0.003, and 0.00003 respectively). In the non-cancer group, there was no mortality, only 2% required admission, and none needed supplemental oxygen. CONCLUSION: We conclude that the cancer patient with pulmonary involvement was significantly at higher risk of complications and death from COVID when compared with the non-pulmonary cancer group and the general population.

An Insight into the lynch Syndrome: Retrospective Study of the Pattern of Presentation and Management of Lynch Syndrome in Pakistan.

Introduction: The primary objective of this study was to evaluate the baseline characteristics of Lynch syndrome (LS). Furthermore, the study aimed to evaluate overall survival (OS) among patients with LS. Materials and Methods: This was a retrospective study of colorectal cancer patients registered from January 2010 to August 2020 with an immunohistochemical diagnosis of LS. Results: A total of 42 patients were assessed. The mean age at presentation was 44 years, with male predominance (78%). Demographic preponderance was from the North of Pakistan (52.4%). The family history was positive in 32 (76.2%) patients. The colonic cancer distribution was 32 (76.2%) on the right side. Most of the patients presented with Stage II disease (52.4%), and the common mutations were MLH1 + PMS2 16 (38.1%) followed by MSH2 + MSH6 9 (21.4%). The 10-year OS was found to be 88.1%. However, the OS was 100% post pancolectomy. Conclusion: LS is prevalent in the Pakistan population, especially in the North of Pakistan. Clinical presentation and survivals are similar to the Western population.

A Diagnostic Challenge: Erdheim Chester Disorder

Erdheim-Chester disease (ECD) is a rare, multisystemic, idiopathic disease often associated with BRAF V600E mutation. Its diagnosis is typically delayed and challenging due to its variable manifestations. Although it has an indolent course, advanced stages can manifest fulminant behavior with multiple vital organ involvement. It is a class 2a, non-Langerhans cell histiocytosis with characteristic radiological appearance. Whole body imaging might be helpful, particularly, to assess skeletal lesions. Although widespread disease with typical skeletal involvement on imaging can prompt diagnosis, histopathology with immunohistochemistry is required for confirmation. The disease can also manifest itself with a large variety of central nervous system related or orbital symptoms. Cardiac involvement is quite common. We present an interesting image of a patient with ECD who underwent PET/CT. Informed consent of the subject described in this image is waived by the Institutional Review Board.

Efficacy And Toxicity Of Carboplatin/Paclitaxel Based Chemoradiation For Localized Oesophageal Cancer.

BACKGROUND: The management of Oesophageal and Gastroesophageal junction cancers is challenging. Multimodality therapy with carboplatin/paclitaxel based chemoradiation (CRT) and surgery shows improved efficacy. In this study, we wanted to establish the efficacy and safety of CRT for neoadjuvant and radical treatment of localized oesophageal cancer. METHODS: Patients with oesophageal cancer, registered between September 2013 and October 2014 were reviewed retrospectively. Toxicity and efficacy analysis in the form of radiological response rate, R0 resection rate, Progression free survival (PFS) and overall survival (OS) was performed on 102 patients who received radical carbo/pacli induction chemotherapy followed by CRT. Impact of Surgery was seen on PFS and OS. RESULTS: Males and females were 71 (51.1%) and 68 (48.9%) respectively, with squamous cell carcinoma being the predominant histology (92%). Majority of patient belonged to T3/4 and N1 stage. Grade III/IV thrombocytopenia, neutropenia, anaemia, febrile neutropenia requiring hospitalisation, non-hematologic toxicities were noted in 13 (12.8%), 18 (17.7%), 18 (17.7%), 1 (1%), 1 (1%), patients respectively. Complete Radiological response, partial response, Stable disease, progressive disease was seen in 6 (5.9%), 51 (50%), 23 (22.5%) 8 (8.7%), respectively. Resection was done in 29 (28.4%). Complete and partial pathological response were seen 19 (65.5%), 10 (34.4%), respectively. PFS at 40 and 80 weeks was 90%, 73%, respectively and OS at 80 weeks was 86%. PFS at 40 and 80 weeks was 100% and 90.5%, respectively with resection, while it was 86% and 65%, without resection (P value 0.015). OS at 40 and 80 weeks was 100% (both) with resection, while it was 96% and 79.5% weeks without resection. (p-value 0.034). CONCLUSIONS: Carbo/pacli based CRT is effective with acceptable toxicity profile in treating localised oesophageal cancer as both as Radical CRT and as a part of multimodality therapy. For definitive results, long term follow up and prospective analysis are required.

Characteristics And Outcome Of Patients With Diffuse Large B Cell Lymphoma-Treated With Chemotherapy Or Chemo-Immunotherapy.

BACKROUND: Diffuse large-B-cell lymphoma, is the most common subtype of Non-Hodgkin lymphoma. Aim of this study was to look at the characteristics and outcome of DLBCL patients who were treated with chemotherapy or chemotherapy plus rituximab at our institution. METHODS: Data of 750 patients, who got registered at our institute between 2007 and 2014, was reviewed retrospectively. After appropriate exclusions, 337 were included. Disease free survival (DFS) and overall survival (OS) were compared between patients who received rituximab plus CHOP (Cyclophosphamide, Doxorubicine, Vincristine, Prednisolon) (R-Ch) and standard chemotherapy- CHOP (S-Ch). RESULTS: Males and females were 216 (64%) and 121 (36%) respectively, with median age 38 years (Range 18-80 yrs.). R-Ch and S.Ch was received by 129(38.3%) and 197(58.4%) patients, respectively. Complete remission (CR) was achieved by 81 (62.8%) vs. 105 (53.3%) patients in R-Ch vs. S-Ch cohorts, respectively. In subset analysis CR was seen in 34 (63.0%) and 45 (58.4%) (p=0.01) in R-Ch/XRT and S-Ch/XRT, respectively. At three years, DFS was 85.3% vs. 74% (p=0.04) and OS was 82.2% vs. 72.6% (p=0.02) in R-Ch and S-Ch cohorts respectively. Deaths observed were 9 Vs.13 in R-Ch/XRT and S-Ch/XRT, respectively. CONCLUSIONS: Based on our study, onset of DLBCL is at younger age in our population with male predominance. Addition of rituximab to CHOP resulted in better DFS and OS in patients with DLBCL. In developing countries, due to cost, large number of patients do not have access to rituximab. Efforts should be made to reduce the price of targeted therapies so that more and more patients are benefitted from these newer agents.