Lung cancer has the highest mortality rate among all the highly prevalent neoplasia globally. The major concern with its frontline treatment-cisplatin, is the rapid progression of chemoresistance and multi-organ-based toxicities including hearing loss and tinnitus, nephrotoxicity, hepatotoxicity and myelosuppression including anemia and neutropenia. In this review, studies concluding the association of single nucleotide polymorphisms (SNP) in disparate genes with aforementioned toxicity points are summarized to observe the pharmacogenomic pattern. Especially, SNPs in ATP7B, ERCC-1, ERCC-2, MATE-1, OCT-2, ABCB-1, ABCC-1, ABCG-2, ABCC-2, SLC22A, ERCC-5, BRCA-1, GSTM-3, GSTM-4 and GSTM-5 genes appear to be associated with the therapeutic response and/or adverse effects of cisplatin. We recommend utilizing this information to minimize the risk of treatment failure due to chemoresistance and adverse effects on other organs.

Background: Cyclophosphamide is a widely prescribed chemotherapeutic agent. Its toxic metabolites induce oxidative stress which burdens the cardiac tissue. With recent advancements in gaining deeper insight in natural antioxidants, Sekikaic acid (SA) is gaining popularity as a novel depside compound with significant organ protective potential. This study seeks to explore and assess the cardio-protective and antioxidant effects of sekikaic acid against anti-cancer drug toxicity. Methods: Experimental animals were divided into three groups: normal untreated control, cyclophosphamide toxic control, and cyclophosphamide with sekikaic acid group where sekikaic acid was administered for 14 continuous days followed by a single dose of cyclophosphamide. For assessing myocardial injury serum cardiac biomarkers (creatine kinase, lactate dehydrogenase, troponin I, C-reactive proteins) and tissue oxidative stress markers (glutathione, super-oxide dismutases and malondialdehyde) were evaluated. Results: The control group demonstrated normal physiologic values of serum and tissue biomarkers. The toxic control demonstrated signs of cardiac injury with a single dose of cyclophosphamide, with raised levels of serum and tissue oxidative stress markers alongside receding natural antioxidant pools of glutathione and super-oxide dismutases. On the contrary the oxidative burden on myocardium was significantly reduced (p?0.05), and cellular antioxidants were preserved with co-administration of sekikaic acid validating its potential as a cardioprotective agent. Conclusion: The antioxidant potential of sekikaic acid can effectively ameliorate cyclophosphamide induced cardiotoxicity and can be incorporated in cyclophosphamide containing chemotherapeutic and immunosuppressive regimens. Pak J Physiol 2025;21(2):38-41, DOI: https://doi.org/10.69656/pjp.v21i2.1776

Osteogenesis imperfecta (OI), is a rare genetic disorder, primarily characterized by skeletal fragility, recurrent fractures, and bone deformities due to mutational defects in collagen synthesis and subsequent bone matrix. In routine, prenatal mid trimester anomaly scan can facilitate an early diagnosis of such skeletal dysplasias. We present a rare case of prenatal OI identified at 23 weeks of gestation in a 28-year-old female during a mid-trimester screening which demonstrated multiple atypical sonographic findings. There were multiple fractures, bowing of long bones and rhizomelic proximal segments suggesting OI, mostly consistent with type II/III OI. Of particular significance, striking unusual findings such as Rocker-bottom foot, beaded ribs, disproportionate limbs, and ossification with firm calvarium were noticed. The thoracic cavity however had no relevant inordinate ratios. These overlapping findings with other osteochondral disorders posed a diagnostic challenge and hampered distinction in OI subtypes. This case highlights the significance of early recognition of both classic and atypical ultrasound evaluation of OI in accurate antepartum analysis and subsequent post birth management alongside relevant counseling. The aim is to offer clinical awareness and refined diagnostic criteria for OI by suggesting an expanded phenotypic spectrum beyond conventional patterns for facilitation in terms of early recognition and directed clinical approach.

Postoperative ileus remains one of the most frequent barriers to timely recovery after colorectal resection, even in the modern era of minimally invasive s

Background: Acute ischemic stroke (AIS) is a major cause of death and disability worldwide. Early antiplatelet therapy reduces recurrence and improves outcomes. Although aspirin is standard treatment, its use is limited by bleeding risk. Indobufen, a reversible cyclooxygenase inhibitor with shorter platelet inhibition, may offer a safer alternative. Objective: To compare the efficacy and safety of indobufen versus aspirin in patients with AIS. Methods: A systematic review and meta-analysis was performed according to PRISMA guidelines. PubMed, Embase, Cochrane Library, and ScienceDirect were searched through February 2026 for randomized controlled trials comparing indobufen with aspirin in adults with AIS. Primary outcomes were functional outcomes (modified Rankin Scale), neurological improvement (NIHSS) at 90 days, recurrent ischemic stroke at 90 days, and composite vascular events. Secondary outcomes included bleeding and other adverse events. Pooled estimates were calculated using fixed- or random-effects models based on heterogeneity. The risk of bias was assessed using Cochrane RoB 2.0. Results: Four randomized controlled trials (278 records screened) were included. Indobufen showed no significant difference versus aspirin in NIHSS improvement at 90 days (MD: 0.01, 95% CI: −0.07 to 0.09) or recurrent ischemic stroke (OR: 0.54, 95% CI: 0.05-5.61). However, indobufen significantly improved modified Rankin Scale outcomes (MD: −1.11, 95% CI: −1.32 to −0.90) and reduced moderate-to-severe bleeding at 3 months (OR: 0.57, 95% CI: 0.35-0.92). Conclusions: Indobufen provides efficacy comparable to aspirin, with better functional outcomes and lower short-term bleeding risk, supporting its potential as an alternative antiplatelet therapy in AIS. Larger, international, multicenter trials are warranted. Larger, high-quality, multicenter international trials are warranted to confirm these findings.