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Butt SR, Soulat A, Lal PM, Fakhor H, Patel SK, Ali MB, Arwani S, Mohan A, Majumder K, Kumar V, Tejwaney U, Kumar S. Impact of artificial intelligence on the diagnosis, treatment and prognosis of endometrial cancer. Ann Med Surg (Lond) 2024; 86:1531-1539. [PMID: 38463097 PMCID: PMC10923372 DOI: 10.1097/ms9.0000000000001733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Endometrial cancer is one of the most prevalent tumours in females and holds an 83% survival rate within 5 years of diagnosis. Hypoestrogenism is a major risk factor for the development of endometrial carcinoma (EC) therefore two major types are derived, type 1 being oestrogen-dependent and type 2 being oestrogen independent. Surgery, chemotherapeutic drugs, and radiation therapy are only a few of the treatment options for EC. Treatment of gynaecologic malignancies greatly depends on diagnosis or prognostic prediction. Diagnostic imaging data and clinical course prediction are the two core pillars of artificial intelligence (AI) applications. One of the most popular imaging techniques for spotting preoperative endometrial cancer is MRI, although this technique can only produce qualitative data. When used to classify patients, AI improves the effectiveness of visual feature extraction. In general, AI has the potential to enhance the precision and effectiveness of endometrial cancer diagnosis and therapy. This review aims to highlight the current status of applications of AI in endometrial cancer and provide a comprehensive understanding of how recent advancements in AI have assisted clinicians in making better diagnosis and improving prognosis of endometrial cancer. Still, additional study is required to comprehend its strengths and limits fully.
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Affiliation(s)
| | | | | | | | | | | | | | - Anmol Mohan
- Karachi Medical and Dental College, Karachi, Pakistan
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Rashid S, Sado AI, Afzal MS, Ahmed A, Almaalouli B, Waheed T, Abid R, Majumder K, Kumar V, Tejwaney U, Kumar S. Role of gut microbiota in cardiovascular diseases - a comprehensive review. Ann Med Surg (Lond) 2024; 86:1483-1489. [PMID: 38463085 PMCID: PMC10923299 DOI: 10.1097/ms9.0000000000001419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/30/2023] [Indexed: 03/12/2024] Open
Abstract
The connection between cardiovascular illnesses and the gut microbiota has drawn more and more attention in recent years. According to research, there are intricate relationships between dietary elements, gut bacteria, and their metabolites that affect cardiovascular health. In this study, the role of gut microbiota in cardiovascular disorders is examined, with an emphasis on the cardiac consequences brought on by changes in gut microbiota. This essay discusses the gut-heart axis in depth and in detail. It talks about clinical research looking at how soy consumption, probiotic supplements, and dietary changes affected gut microbiota and cardiovascular risk variables. Our goal is to clarify the possible pathways that connect gut microbiota to cardiovascular health and the implications for upcoming treatment approaches. The authors examine the composition, roles, and effects of the gut microbiota on cardiovascular health, including their contributions to hypertension, atherosclerosis, lipid metabolism, and heart failure. Endotoxemia, inflammation, immunological dysfunction, and host lipid metabolism are some of the potential processes investigated for how the gut microbiota affects cardiac outcomes. The research emphasizes the need for larger interventional studies and personalized medicine strategies to completely understand the complexity of the gut-heart axis and its implications for the management of cardiovascular disease. The development of novel treatment strategies and cutting-edge diagnostic technologies in cardiovascular medicine may be facilitated by a better understanding of this axis.
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Affiliation(s)
| | | | | | | | | | | | - Rabia Abid
- Liaquat college of medicine and dentistry, Karachi, Pakistan
| | | | | | | | - Sarwan Kumar
- Wayne State University
- Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
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Ahmed G, Rathi S, Sidhu HK, Muzaffar M, Wajid MH, Kumari K, Fakhor H, Attia NM, Majumder K, Kumar V, Tejwaney U, Ram N. Paroxysmal atrial fibrillation and hemochromatosis: a narrative review. Ann Med Surg (Lond) 2024; 86:909-919. [PMID: 38333328 PMCID: PMC10849313 DOI: 10.1097/ms9.0000000000001605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/29/2023] [Indexed: 02/10/2024] Open
Abstract
Paroxysmal atrial fibrillation (PAF) and hemochromatosis have a complex relationship. This review explores its mechanisms, prevalence, correlations, and clinical manifestations. Hereditary hemochromatosis (HH) involves iron overload due to HFE protein mutations, while atrial fibrillation (AF) is characterized by irregular heart rhythms. Iron overload in hemochromatosis can promote cardiac arrhythmias. AF is prevalent in developed countries and may be linked to cryptogenic strokes. Genetic variations and demographic factors influence the occurrence of both conditions. HH affects multiple organ systems, including the heart, while AF causes palpitations and reduced exercise tolerance. Diagnosis involves iron markers, genotypic testing, and electrocardiogram (ECG) findings. Treatment strategies focus on reducing iron levels in hemochromatosis and managing AF through antithrombotic therapy and rhythm control. Untreated hemochromatosis carries a higher risk of complications, and PAF is associated with increased cardiovascular-related mortality. For better understanding of the mechanisms and to improve management, additional studies are required. Tailored approaches and combined treatments may enhance patient outcomes.
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Sado AI, Batool W, Ahmed A, Zafar S, Patel SK, Mohan A, Zia U, Aminpoor H, Kumar V, Tejwaney U. Role of microRNA in colorectal carcinoma (CRC): a narrative review. Ann Med Surg (Lond) 2024; 86:308-318. [PMID: 38222721 PMCID: PMC10783342 DOI: 10.1097/ms9.0000000000001494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/01/2023] [Indexed: 01/16/2024] Open
Abstract
MicroRNAs (miRNAs) are short non-coding RNAs that play a critical role in regulating gene expression by binding to target messenger RNAs (mRNAs). They were first discovered around 8 years after the identification of the first miRNA in 1993, and since then, there has been a significant increase in miRNA-related research and discoveries. MiRNAs have been implicated in various biological processes, including cancer, particularly in colorectal cancer (CRC). In CRC, miRNAs act as either oncogenes or tumor suppressors, influencing essential cellular functions such as cell proliferation, apoptosis, angiogenesis, and metastasis. The dysregulation of miRNAs in CRC can arise from different factors, leading to abnormal expression levels of their target mRNAs and subsequently affecting protein production. Consequently, miRNAs may directly target oncogenes or tumor suppressor genes, thereby contributing to cancer initiation and progression. Notably, tumors often exhibit reduced expression of mature miRNAs. In CRC research, miRNAs offer potential as diagnostic biomarkers and therapeutic targets. Specific miRNA profiles could serve as non-invasive tools for early CRC detection and risk assessment. Additionally, miRNA-based therapies present a promising approach for targeted cancer treatment by modulating miRNA expression. However, challenges related to delivery systems and long-term safety must be addressed to fully harness their therapeutic potential.
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Affiliation(s)
| | | | | | | | | | | | - Umar Zia
- Khyber Medical University, Peshawar, Pakistan
| | | | - Vikash Kumar
- The Brooklyn Hospital Center, Brooklyn, New York
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Mohan A, Asghar Z, Abid R, Subedi R, Kumari K, Kumar S, Majumder K, Bhurgri AI, Tejwaney U, Kumar S. Revolutionizing healthcare by use of artificial intelligence in esophageal carcinoma - a narrative review. Ann Med Surg (Lond) 2023; 85:4920-4927. [PMID: 37811030 PMCID: PMC10553069 DOI: 10.1097/ms9.0000000000001175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/05/2023] [Indexed: 10/10/2023] Open
Abstract
Esophageal cancer is a major cause of cancer-related mortality worldwide, with significant regional disparities. Early detection of precursor lesions is essential to improve patient outcomes. Artificial intelligence (AI) techniques, including deep learning and machine learning, have proved to be of assistance to both gastroenterologists and pathologists in the diagnosis and characterization of upper gastrointestinal malignancies by correlating with the histopathology. The primary diagnostic method in gastroenterology is white light endoscopic evaluation, but conventional endoscopy is partially inefficient in detecting esophageal cancer. However, other endoscopic modalities, such as narrow-band imaging, endocytoscopy, and endomicroscopy, have shown improved visualization of mucosal structures and vasculature, which provides a set of baseline data to develop efficient AI-assisted predictive models for quick interpretation. The main challenges in managing esophageal cancer are identifying high-risk patients and the disease's poor prognosis. Thus, AI techniques can play a vital role in improving the early detection and diagnosis of precursor lesions, assisting gastroenterologists in performing targeted biopsies and real-time decisions of endoscopic mucosal resection or endoscopic submucosal dissection. Combining AI techniques and endoscopic modalities can enhance the diagnosis and management of esophageal cancer, improving patient outcomes and reducing cancer-related mortality rates. The aim of this review is to grasp a better understanding of the application of AI in the diagnosis, treatment, and prognosis of esophageal cancer and how computer-aided diagnosis and computer-aided detection can act as vital tools for clinicians in the long run.
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Affiliation(s)
| | | | - Rabia Abid
- Liaquat College of Medicine and Dentistry
| | - Rasish Subedi
- Universal College of Medical Sciences, Siddharthanagar, Nepal
| | | | | | | | - Aqsa I. Bhurgri
- Shaheed Muhtarma Benazir Bhutto Medical University, Larkana, Pakistan
| | | | - Sarwan Kumar
- Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
- Wayne State University, Michigan, USA
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Kan Changez MI, Mubeen M, Zehra M, Samnani I, Abdul Rasool A, Mohan A, Wara UU, Tejwaney U, Kumar V. Role of microRNA in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): a comprehensive review. J Int Med Res 2023; 51:3000605231197058. [PMID: 37676968 PMCID: PMC10492500 DOI: 10.1177/03000605231197058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver condition that affects people who do not overconsume alcohol. Uncertainties exist over how microRNAs (miRNAs) in the blood and liver relate to NAFLD. The aim of this narrative review was to investigate the role of miRNAs in the onset and progression of non-alcoholic steatohepatitis (NASH) from NAFLD, and explore their potential as diagnostic tools and treatment targets for NAFLD patients. Liver miRNA-34a levels were found to accurately represent the degree of liver damage, with lower levels suggesting more damage. In patients with NAFLD and severe liver fibrosis, higher levels of miRNA-193a-5p and miRNA-378d were found. Moreover, miRNA-34a, miRNA-122, and miRNA-192 levels might aid in differentiating NASH from NAFLD. Similar to this, miRNA-21 and miRNA-27 levels in rats were able to distinguish between steatosis and steatohepatitis. High-fat diets enhanced the expression of 15 distinct miRNAs in rats, and there were substantial differences in the miRNA expression patterns between obese and lean people. The results from the present review imply that miRNA microarrays and sequencing may be helpful diagnostic tools, and miRNAs may be a possible treatment target for patients with NAFLD.
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Affiliation(s)
- Mah I Kan Changez
- Department of Medicine, Quetta Institute of Medical Sciences, Quetta, Pakistan
| | - Maryam Mubeen
- Department of Medicine, Punjab Medical College, Faisalabad, Pakistan
| | - Monezahe Zehra
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Inara Samnani
- Department of Medicine, Karachi Medical & Dental College, Karachi, Pakistan
| | | | - Anmol Mohan
- Department of Medicine, Karachi Medical & Dental College, Karachi, Pakistan
| | - Um Ul Wara
- Department of Medicine, Karachi Medical & Dental College, Karachi, Pakistan
| | - Usha Tejwaney
- Department of Pharmacy, Valley Health System, New Jersey, USA
| | - Vikash Kumar
- Department of Internal Medicine, The Brooklyn Hospital Center, New York City, NY, USA
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Mohan A, Haider R, Fakhor H, Hina F, Kumar V, Jawed A, Majumder K, Ayaz A, Lal PM, Tejwaney U, Ram N, Kazeem S. Vitamin D and polycystic ovary syndrome (PCOS): a review. Ann Med Surg (Lond) 2023; 85:3506-3511. [PMID: 37427232 PMCID: PMC10328709 DOI: 10.1097/ms9.0000000000000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/13/2023] [Indexed: 07/11/2023] Open
Abstract
A common health problem known as polycystic ovarian syndrome (PCOS), is characterized by irregular periods, an excess of androgen production, and polycystic ovaries. It is one of the most prevalent endocrine disorders in women of reproductive age, affecting 4-20% of women worldwide. Numerous studies have found a connection between the onset and symptoms of PCOS and Vitamin D insufficiency. Vitamin D insufficiency causes calcium dysregulation and follicular arrest in women with PCOS, which is connected to menstrual irregularities and fertility issues. Studies have connected PCOS metabolic alterations to VDR polymorphisms such as iApa-I, Taq-I, Cdx2, and Fok-I. Insulin resistance is directly related to Vitamin D, is one of the most distinctive characteristics of the PCOS phenotype. Thus, it is suggested that Vitamin D therapy may help PCOS patients with their insulin sensitivity. In addition to insulin resistance, cardiovascular issues are a second metabolic disturbance that PCOS patients with low Vitamin D levels experience. Dyslipidemia is not linked to an increased risk of cardiovascular disease in PCOS-affected women. Vitamin D dramatically improves glucose metabolism by increasing insulin production, insulin receptor expression and reducing pro-inflammatory cytokines. The effect of Vitamin D on the metabolic and reproductive dysfunctions associated with PCOS may be mediated by an overall impact on insulin resistance. Vitamin D supplementation improved menstrual periods, increased folliculogenesis, and decreased blood testosterone levels in PCOS patients, all of which had a significant impact on the ability to procreate. As a result, it might be a cutting-edge therapeutic strategy for treating PCOS concurrently.
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Affiliation(s)
| | | | | | - Fnu Hina
- Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | | | | | | | | | | | | - Nanik Ram
- Aga Khan University Hospital, Karachi
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