Inflammatory mediators as surrogates of malignancy.

Inflammation related to cancer occurs in the cellular vicinity of the tumour and is involved with predictions related to the course of disease and survival prognosis in varioua malignancies. These inflammatory markers affect different phases of tumourigenesis, i.e. carcinogenesis, tumour expansion, lymphovascular invasion, and distant metastasis, and, as a result, tumour cells can activate immune mediators and cells directly and/or chemokines as well as prostaglandins. Numbers of circulating different blood cells, i.e. lymphocytes, platelets, neutrophils and levels of plasma proteins, like C-reactive protein and interleukins that are components of inflammatory responses, are hallmarks of pathways leading to tumourigenesis. Thus, they can provide vital information in stratifying patients according to the risk and precisely targeted clinical care and outcome in malignancies. The current narrartive review was planned to discuss the role of platelet-to-lymphocyte ratio alongside the use of systemic immune inflammation index as the inflammatory mediators of malignancies along with overview of their role in different studies. It was also planned to recommend what the future studies should should aim at, including multiple risk factors, exposures and inflammatory profiles and as well as their combined interactions, for a better understanding of the role of the inflammatory mediators in malignancy.

Past, present, and future of surgical simulation and perspective of a developing country: A narrative review.

Healthcare systems around the globe have been revolutionised in the last few decades, resulting in a greater need and demand for surgical education outside the operation theatres. Surgical education through simulations started around 2,500 years ago when they were first used in the planning of unique and innovative surgeries while ensuring the safety of the subjects. Currently, simulations include animal models, cadaveric models, benchtop models and complex robotic models. In a programme involving surgical simulators, four requirements are followed to optimise their effectiveness, including mandatory involvement, skill-based instruction, standardised training plan, and overtraining. We can make a reasonable estimation that the future is technology-based. The speed with which we anticipate the fusion of these virtual reality and robotics-based simulation technology with medical educations and practices largely depends on the affordability and economics of these tools. The current narrative review was planned to highlight the historical aspects of simulations, their role in surgical education, and their importance in the future as an essential adjunct to surgical education.