Batterjee Medical College

Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related deaths globally, with limited treatment options and a poor prognosis. The identification of reliable prognostic biomarkers and novel therapeutic candidates is essential for improving patient outcomes. This study employed an integrative bioinformatics and molecular simulation approach to uncover key gene signatures and explore potential plant-based therapeutics for HCC. Gene expression profiles from the GEO dataset GSE121248 were analyzed using R-based statistical tools to identify differentially expressed genes (DEGs). Key hub genes were selected through protein-protein interaction network analysis and functional enrichment. Three hub genesCOL1A1, NQO1, and FOS-were identified, and their expression was validated using the TCGA, GEPIA, and HPA databases. Notably, COL1A1 and NQO1 were upregulated in tumor tissues and associated with poor survival outcomes, while FOS was downregulated. To identify therapeutic candidates, bioactive compounds from Astragalus membranaceus were screened using ADMET profiling. Selected compounds were docked with the hub proteins, and molecular dynamics simulations, MM/GBSA binding energy calculations, and quantum chemical descriptors were employed to evaluate stability and reactivity. Among the candidates, isorhamnetin demonstrated strong and stable binding to all three hub targets, suggesting its potential as a multi-target inhibitor for HCC therapy. These findings provide new insights into HCC pathogenesis and propose isorhamnetin as a promising natural compound for further experimental validation.

Radicicol (RAD) is a 14-membered resorcylic acid lactone biosynthesized mainly by fungi, originally known as an antifungal antibiotic and later as a potent Hsp90 (heat shock protein 90) inhibitor with diverse bioactivities. The current work aimed to provide a comprehensive review of RAD, including its pharmacological activities and mechanisms of action, as well as its sources, biosynthesis, isolation, and characterization. RAD possessed potent anticancer activity mediated by high-affinity inhibition of Hsp90. By disrupting the stability of oncogenic client proteins such as Raf-1, HER2, and Akt, RAD modulated key signaling pathways, induced apoptosis, and suppressed tumor progression. It also augmented the efficacy of chemotherapeutics and radiotherapy and targeted additional enzymes like ATP citrate lyase and topoisomerase II. Additionally, it demonstrated notable anti-inflammatory, anti-obesity, antiparasitic, antifungal, and antiviral capacities. These findings highlight RAD's significance as a multifunctional therapeutic scaffold for treating cancer and other disorders.

Cognitive impairment is a common comorbidity, yet overlooked, in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the current practice and perceptions of physicians on recognising and managing cognitive impairment in patients with COPD in Saudi Arabia. This study aimed to investigate current practices and perceptions of physicians in Saudi Arabia regarding the recognition and management of cognitive impairment in COPD patients.

An online cross-sectional questionnaire was distributed between March and October 2023 to physicians in Saudi Arabia. The collected responses were analysed using descriptive statistics.

A total of 808 physicians completed the online survey. Of whom, only 19% indicated receiving adequate training for managing cognitive impairment. Although the vast majority of physicians reported that cognitive impairment leads to underestimation of COPD severity (85%) and interferes with self-management (85%), only 11% agreed on the important role of screening. In addition, only half of the study participants aimed to identify possible cognitive impairment, with only 4% screening for cognitive impairment during patients' assessment. The overall confidence level in recognising and managing cognitive impairment was relatively low. The most common barriers contributing to the suboptimal management of cognitive impairment in COPD were poor training (62%), the absence of standardised procedures (63%) and limited knowledge (58%) about cognitive impairment in COPD.

The current practice of recognising and managing cognitive impairment in Saudi Arabia is suboptimal. This is likely to be attributed to inadequate training, the absence of standardised procedures, and limited knowledge about cognitive impairment in COPD. Healthcare systems should provide more training and implement a holistic approach to detect and manage cognitive impairment during patients' visits.