Current and emerging therapeutic strategies in pancreatic cancer: Challenges and opportunities

Pancreatic carcinoma(PC)is one of the leading causes of cancer-related deaths worldwide.Despite early detection and advances in therapeutics,the prognosis remains dismal.The outcome and therapeutic approach are dependent on the stage of PC at the time of diagnosis.The standard of care is surgery,followed by adjuvant chemotherapy.The advent of newer drugs has changed the landscape of adjuvant therapy.Moreover,recent trials have highlighted the role of neoadjuvant therapy and chemoradiotherapy for resectable and borderline resectable PC.As we progress towards a better understanding of tumor biology,genetics,and microenvironment,novel therapeutic strategies and targeted agents are now on the horizon.We have described the current and emerging therapeutic strategies in PC.

Evaluation of quantitative variation of secondary metabolites in Bergenia ciliata(Haw.)using high performance thin layer chromatography

Dear Editor： Therapeutically active metabolite contents in a med- icinal plant vary in nature, which may impact on its therapeutic efficacy. Bergenia （Saxifragaceae） is an evergreen perennial herb widely distributed in Central and East Asia with about 30 species reported worldwide. It grows at a range of altitudes from the Khasia hills at 400 feet to the temperate Himalayas from Kashmir to Bhutan at 7,000-10,000 feet. Its distribution over a wide range of altitudinal zones makes it a good candidate for studying variations in its metabolic profiles under different climatic conditions. Bergenin （C-glycoside of 4-O-methyl gallic acid） has been identified as a potent active secondary metabolite in Bergenia and other therapeutically active constituents including, among others, gallic acid （3,4,5 trihydroxybenzoic acid）, （＋） catechin, and gallicin （Fig. 1）.

Anemia in cirrhosis:An underestimated entity

Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity.Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas:Whether anemia is a disease complication or a part of the disease spectrum?Should iron,folic acid,and vitamin B complex supplementation and nutritional advice,suffice in those who can perform tasks of daily living but have persistently low hemoglobin.How does one investigate and manage anemia due to multifactorial etiologies in the same patient:Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia?To add to the clinician’s woes the prevalence of anemia increases with increasing disease severity.We thus aim to critically analyze the various pathophysiological mechanisms complicating anemia in a patient with cirrhosis with an emphasis on the diagnostic flowchart in such patients and proposed management protocols thereafter.

Pharmacognostic Evaluation and Antioxidant Activity of <i>Urtica dioica</i>L.

Background: Urtica dioica L. is a common Himalayan species which produces allergenic substances causing oedema and inflammation in humans. It has become a source of folk medicine for the treatment of many diseases. The leaves and roots both are used internally as a blood purifier and diuretic and an infusion of the plant is used for nasal and menstrual haemorrhage, diabetes, rheumatism, eczema, anaemia, hair loss, as an expectorant and antidiarrhoeal. Present study includes pharmacognostic evaluation, antioxidant activity and HPTLC analysis of Urtica dioica L. Methods: Pharmacognostic evaluation of aerial part of U. dioica has been performed as per Indian pharmacopoeia. In-vitro antioxidant evaluation of U. dioica has been performed using DPPH free radical scavenging activity. Ferulic acid, a potential phenolic antioxidant present in this species, has been studied through HPTLC. Results: U. dioica hydro-alcoholic extract shows positive results for antioxidant activity with IC50 value of 88.33 ± 2.88 μg/ml. Standard ascorbic acid showed IC50 value of 2.8 ± 0.62 μg/ml. Ferulic acid was identified at Rf 0.61 ± 0.01 and quantified to 0.73% in this species through CAMAG HPTLC analysis. Conclusion: The pharmacognostical parameters reported can be considered as quality standards of U. dioica in herbal industry. Hydro-alcoholic extract of U. dioica showed positive in vitro antioxidant activity. Presence of phenolic compound suggests that antioxidant activity may be due to ferulic acid content.

Determination of Ursolic Acid a Biomarker in Different Swertia Species through High Performance Thin Layer Chromatography

A simple highly precise method has been established for the determination of ursolic acid in three species of Swertia viz. S. angustifolia, S. paniculata, and S. alata. The assay combines identification and quantification of the analyte on silica gel 60GF254 HPTLC plates with visualization under UV light and scanning at 510 nm.