Dietary Phytochemicals in Cancer Signalling Pathways: Role of miRNA Targeting.

Cancer is a multi-factorial health condition involving uncontrolled cell divisions. The disease has its roots in genetic mutation. This disease affects men, women, and even children. Chemotherapy, photodynamic, photothermal, and hormonal therapies have been used to treat this deadliest disease, but a huge percentage of patients have chances of disease recurrence or resistance. Nowadays, dysregulation in miRNAs is considered one of the key factors for the development and progression of different types of cancers as they control the expression of genes responsible for cell proliferation, growth, differentiation, and apoptosis. Dietary phytochemicals with anticancer properties have been gaining focus for cancer treatment since they have been found more effective in targeting cancer via regulating miRNAs expression. These phytochemicals have no side effects and are readily available at a low cost. Several dietary phytochemicals with regulatory effects on the expression of miRNAs have been reported, including curcumin, diallyl disulfide, 3, 30-diindolylmethane, ellagic acid, genistein, indole-3-carbinol, quercetin, resveratrol, and sulforaphane. They exert their regulatory effects against different cancers either by upregulating or downregulating different cancer signalling pathways and inhibiting their progression. Curcumin down-regulates SHH pathways, epigallocatechin-3-gallate regulates the Notch pathway and inhibits TGFß1/SMAD signalling, and resveratrol regulates the Wnt/ß-catenin pathway and carnosic acid-induced apoptosis in colon cancer cell via JAK2/STAT3 signalling pathway. The miRNAs are used for the treatment of cancer as essential modulators in cellular pathways. Therefore, identifying the miRNAs and their targets and countering them with specific phytochemicals provide a safe and effective mechanism for the treatment of cancer.

Thromboprophylaxis after bariatric surgery.

BACKGROUND: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a known cause of morbidity and mortality after bariatric surgery. However, the data concerning appropriate thromboprophylaxis after bariatric surgery is uncertain. The objective of this study was to evaluate the efficacy and safety of extended duration thromboprophylaxis in post-bariatric surgery patients. METHODS: We conducted a retrospective study of consecutive patients who underwent bariatric surgery from November 2014 to October 2018 at King Fahad General Hospital in Jeddah, Saudi Arabia. All included patients were treated with extended duration thromboprophylaxis. RESULTS: We identified 374 patients who underwent bariatric surgery during the study period. Of these, 312 patients (83%) were followed for at least 3 months. The most common type of surgery was a laparoscopic sleeve gastrectomy (N=357) and the median weight was 110 kg. The cumulative incidence of symptomatic postoperative VTE at 3 months was 0.64% (95% confidence interval, 0.20-1.52). All events occurred after hospital discharge. The most commonly used pharmacological prophylaxis (91%) for VTE prevention after bariatric surgery was enoxaparin 40 mg subcutaneously twice daily for 10-14 days after hospital discharge. There were no reported cases of bleeding or VTE related mortality after 3 months. CONCLUSION: Extended thromboprophylaxis after bariatric surgery appears to be an effective and safe strategy for VTE prevention. Large prospective studies are needed to evaluate the optimal thromboprophylaxis regimen after bariatric surgery.