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Abstract: Breast cancer is the most prevalent cancer in women around the world, having a sudden spread nowadays because of the poor sedentary lifestyle of people. Comprising several subtypes, one of the most dangerous and aggressive ones is triple-negative breast cancer or TNBC. Even though conventional surgical approaches like single and double mastectomy and preventive chemotherapeutic approaches are available, they are not selective to cancer cells and are only for symptomatic treatment. A new branch called nanotechnology has emerged in the last few decades that offers various novel characteristics, such as size in nanometric scale, enhanced adherence to multiple targeting moieties, active and passive targeting, controlled release, and site-specific targeting. Among various nanotherapeutic approaches like dendrimers, lipid-structured nanocarriers, carbon nanotubes, etc., nanoparticle targeted therapeutics can be termed the best among all for their specific cytotoxicity to cancer cells and increased bioavailability to a target site. This review focuses on the types and molecular pathways involving TNBC, existing treatment strategies, various nanotechnological approaches like exosomes, carbon nanotubes, dendrimers, lipid, and carbon-based nanocarriers, and especially various nanoparticles (NPs) like polymeric, photodynamic, peptide conjugated, antibody-conjugated, metallic, inorganic, natural product capped, and CRISPR based nanoparticles already approved for treatment or are under clinical and pre-clinical trials for TNBC.

Reem A Al Dossary,1 Awatif N Alnafie,2 Salma Ali Aljaroodi,1 Jawad Ur Rahman,1 Basavaraj C Hunasemarada,1 Khaled R Alkharsah1 1Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia; 2Department of Pathology, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Khaled R AlkharsahDepartment of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi ArabiaTel +966-13 3331053Email kalkharsah@iau.edu.saPurpose: Hepatitis E virus (HEV) causes acute hepatitis in humans and constitutes a major problem for immunocompromised patients, patients with hematological diseases, and pregnant women. It is transmitted mainly through fecal oral route; however, transmission through blood and blood products is reported globally and becoming a health concern. We sought to determine the prevalence of HEV among blood donors in the Eastern Province of Saudi Arabia using molecular as well as serological assays to assess the safety of blood transfusion and the need for HEV screening among blood donors.Patients and Methods: A total of 806 whole blood samples were collected from blood donors between May and November 2020 and tested for anti-HEV IgG and IgM antibodies by ELISA and for HEV RNA by RT-PCR.Results: The overall seroprevalence of HEV IgG antibodies was 3.2% with no statistically significant difference between the non-Saudis (3.28%) and Saudis (3.17%) (p value 0.929) or between males (3.14%) and females (4.88%) (p value 0.527). None of the IgG positive individuals had IgM antibodies. HEV RNA was not detected in any of the blood donors.Conclusion: HEV seroprevalence is low among blood donors in the Eastern Province of Saudi Arabia and may constitute minimal risk for transfusion associated infections.Keywords: HEV, IgG, IgM, seroprevalence, ELISA, RT-PCR

الملخص: أهداف البحث: يحمل وجود المبيضات في الدم معدل وفيات مرتفعا، وقد ازدادت حالاته في السنوات القليلة الماضية. اقترحت الدراسات السابقة توزيع متغير من المبيضات بين المناطق المختلفة. وقد أجريت هذه الدراسة لتحديد الأنواع الموجودة في التهابات مجرى الدم بالمبيضات، وتحديد استجابتها لمضادات الفطريات الروتينية، مع نتائج الوفيات في مركز طبي أكاديمي. طرق البحث: بين يناير ٢٠١٢ وديسمبر ٢٠١٨، تمت دراسة نتائج مزارع الدم الإيجابية لعدوى مجرى الدم المبيضية، وتحليلها إحصائيا لانتشار الأنواع ونمط القابلية للحساسية، ومعدل الوفيات بعد ١٤ و٣٠ و٦٠ و٩٠ يوما. النتائج: من بين ١٥٦ حالة من حالات وجود المبيضات في الدم، كان سبب أغلبية الحالات (٦٩.٢٪) غير مجموعة المبيضات البيضاء. بعد مجموعة المبيضات البيضاء (٣٠.٨٪) كانت مجموعتا المبيضات الاستوائية والمبيضات المرطية، ثاني أكثر معزولة في كثير من الأحيان (٢٣.٧٪). واكتشفت المقاومة المكتسبة من الفلوكونازول في ١٤.٨٪ من سلالات المبيضات. ولم يتم الكشف عن أي مقاومة أخرى لمضادات الفطريات. وكانت المعدلات الإجمالية للوفيات لجميع الأنواع ٢٩.٣٪ و٤٧.٩٪ و٥٦.٤٪ و٥٨ في ١٤ و٣٠ و٦٠ و٩٠ يوما على التوالي. ولوحظ ارتفاع معدل الوفيات في حالات العدوى بالمبيضة الكروزية (الوفيات الخام ٧١.٤-١٠٠٪). الاستنتاجات: لوحظ تحول كبير من المبيضات غير البيضاء للتسبب بعدوى مجرى الدم. ولكونها تهديدا خطيرا للمرضى في المستشفيات، يجب حث مختبرات علم الأحياء المجهرية على اعتماد التشخيص السريع واستعمال الحد الأدنى من الاختبارات على أساس التراكيز المثبطة للكشف عن الأنماط الظاهرية المعتمدة على الجرعة. الدراسات المستقبلية ضرورية للنظر في تشخيص عدوى مجرى الدم من قبل أنواع المبيضات المختلفة في نموذج متعدد المتغيرات. Abstract: Objectives: Candidemia incidence has increased in the past few years, with high mortality. Previous studies have reported a variable distribution of Candida spp. among different regions. This study aimed to identify the species found in Candida bloodstream infections, routine antifungal susceptibility testing, and mortality outcomes in an academic medical centre. Methods: Between January 2012 and December 2018, the positive blood cultures for candidemia infection were retrieved and statistically analysed for species prevalence, susceptibility pattern, and crude mortality at 14, 30, 60 and 90 days. Results: Of 156 candidemia cases, a majority (69.2%) was caused by non-albicans Candida spp. After Candida albicans (30.8%), Candida tropicalis and Candida parapsilosis were the second and third most frequeunt isolates spp, each counting for 23.7%. Acquired resistance was detected in 14.8% of candidemia strains. No other antifungal resistance was detected. The overall crude mortality rates of all species were 29.3%, 47.9%, 56.4%, and 58.0% at 14, 30, 60, and 90 days, respectively. A higher mortality rate was noted in cases of Candida krusei infection (crude mortality 71.4–100%, p = 0.002). Conclusion: In this study, a considerable shift to non-albicans Candida causing most bloodstream infections was observed. As such infections pose a serious threat to hospitalised patients, microbiology laboratories are urged to adopt rapid diagnostic and minimal inhibitory concentration-based testing for the detection of susceptible dose-dependent phenotypes. Prospective studies are essential to consider the prognosis of bloodstream infections by various Candida species in a multivariate model.

Simple Summary Cancer is the deadliest disease affecting humans, with more than 14 million cases and 8 million deaths. A successful therapeutic interception of cancer is urgently required. We have reviewed the immunologic involvement of various types of cancers that are well substantiated in the existing literature. Interestingly, multiple signalling pathways of the immune system could be modulated with miRNAs (noncoding RNAs of 22 nucleotides), such as miR-19a-3p, which induces macrophage polarization and the amelioration of cancer progression and metastasis. Developing a specific profile of miRNA within immune cells could also help in diagnosis and treatment. miRNA-based immune therapeutics that help to reduce cancer immune escape hold possibilities for developing cancer chemotherapy. Abstract In the last few decades, carcinogenesis has been extensively explored and substantial research has identified immunogenic involvement in various types of cancers. As a result, immune checkpoint blockers and other immune-based therapies were developed as novel immunotherapeutic strategies. However, despite being a promising therapeutic option, immunotherapy has significant constraints such as a high cost of treatment, unpredictable toxicity, and clinical outcomes. miRNAs are non-coding, small RNAs actively involved in modulating the immune system’s multiple signalling pathways by binding to the 3′-UTR of target genes. miRNAs possess a unique advantage in modulating multiple targets of either the same or different signalling pathways. Therefore, miRNA follows a ‘one drug multiple target’ hypothesis. Attempts are made to explore the therapeutic promise of miRNAs in cancer so that it can be transported from bench to bedside for successful immunotherapeutic results. Therefore, in the current manuscript, we discussed, in detail, the mechanism and role of miRNAs in different types of cancers relating to the immune system, its diagnostic and therapeutic aspect, the effect on immune escape, immune-checkpoint molecules, and the tumour microenvironment. We have also discussed the existing limitations, clinical success and the prospective use of miRNAs in cancer.

Introduction. Carbapenem resistant Enterobacterales (CRE) are one of the leading causes of systemic and nosocomial infections and are multidrug-resistant organisms producing different carbapenemases. There are many genotypic and phenotypic methods for detecting the carbapenemases; however, there is a limitation for each. Modified carbapenem inactivation method (mCIM) assay is a recent phenotypic method which has been published by the Clinical and Laboratory Standards Institute. Hypothesis / Gap Statement. mCIM assay could provide a reliable method for the detection of carbapenemases in CRE. Aim. Evaluation of the mCIM assay performance for the detection of carbapenemases in Enterobacterales and the identification of the common carbapenemase genes at Eastern Province of Saudi Arabia and Kingdom of Bahrain. Methodology. A collection of 197 non-duplicate carbapenem resistant Enterobacterales clinical isolates, were evaluated with the mCIM test comparing its performance to multiplex PCR. The minimum inhibitory concentration susceptibility testing was done by the Etest method for imipenem, meropenem, and ertapenem. Results. The sensitivity of the mCIM assay was 94 % (95 % CI, (89.3–97.1)). In Saudi Arabia and Bahrain, OXA-48 was the most prevalent carbapenemase gene followed by NDM. Coexistence of multiple carbapenemase genes is reported in eleven cases. Conclusion. These findings indicate that the mCIM test is a reliable and simple assay for detecting the activity of carbapenemase in Enterobacterales , especially in resource-limited laboratories.

Glioblastoma multiforme (GBM) is the most aggressive (WHO grade IV) form of diffuse glioma endowed with tremendous invasive capacity. The availability of narrow therapeutic choices for GBM management adds to the irony, even the post-treatment median survival time is roughly around 14-16 months. Gene mutations seem to be cardinal to GBM formation, owing to involvement of amplified and mutated receptor tyrosine kinase (RTK)-encoding genes, leading to dysregulation of growth factor signaling pathways. Of-late, the role of different microRNAs (miRNAs) in progression and proliferation of GBM was realized, which lead to their burgeon potential applications for diagnostic and therapeutic purposes. miRNA signatures are intricately linked with onset and progression of GBM. Although, progression of GBM causes significant changes in the BBB to form BBTB, but still efficient passage of cancer therapeutics, including antibodies and miRNAs are prevented, leading to low bioavailability. Recent developments in the nanomedicine field provide novel approaches to manage GBM via efficient and brain targeted delivery of miRNAs either alone or as part of cytotoxic pharmaceutical composition, thereby modulating cell signaling in well predicted manner to promise positive therapeutic outcomes.

Introduction: High blood pressure (BP) is one of the most important risk factors for cardiovascular disease (CVD), which is the leading cause of mortality. Aims and objectives: The main objective of the relationship of blood pressure and hypertension in the risk assessment of coronary heart diseases. Methodology of the study: This study was conducted at Jinnah Hospital Lahore During March 2018 till September 2018. The data was collected from 100 patients which was suffering from high blood pressure and any kind of heart issue. We collect the data in two sections, as first of all we collect some demographic information regarding age, sex, socio-economic status and history of blood pressure. Results: The data was collected from 100 patients. The data shows that there is a significant relationship between hypertension and CVD. There is also some positive relationship between socio-economic status and hypertension with respect to CVD. Conclusion: In conclusion, the current hypertension paradigm does not account for the continuous risk associated with elevated BP or the multifactorial nature of CVD, the primary consequence of elevated BP.&nbsp

Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, including emphysema and large and small airway disease. Objectives of the study: The main objective of the study is to analyze the risk of obstructive lung disease in childhood pneumonia among local population of Pakistan. Methodology of the study: This study was conducted at Children Hospital Lahore during 2018. This study was done with the permission of ethical committee. For this purpose, we select 50 patients of pneumonia (age 1 to 15 years) for further analysis. The patients of both genders were selected for this study. Childhood pneumonia was defined by subject self-report. Result: Significant differences were observed between patients who received extra-fine versus fine-particle COPD in the demographics and baseline characteristics, as shown inTable 1. The COPD treatments prescribed to patients before and at step-up are shown inS1 Tablein the supporting information. Conclusion: In conclusion, the COPD exacerbation rate was higher among the patients who had a history of pneumonia or a high rate of COPD exacerbation in the preceding period of 1 year. Key words: Pneumonia, fever, COPD, Lungs