PROteolysis-TArgeting Chimeras (PROTACs) have been developed for targeting specific protein destruction. Two recent studies in Science Advances by Liu et al. JAK inhibitor and Reynders et al. reported a novel technology, PHOtochemically TArgeting Chimeras (PHOTACs) or opto-PROTAC, which is light-induced control of protein degradation. This new approach might lead to precision therapeutics in patients with cancer.Penetrating abdominal trauma is responsible for approximately 35% of patients admitted to urban trauma centers, and up to 12% of those admitted in suburban or rural centers in the United States. Current protocol relies heavily on CT imaging as the diagnostic tool in evaluating for peritoneal violation in hemodynamically stable patients, however it is associated with false negative rates. In addition, visualization of the fascia of the rectus abdominis, the transversalis fascia, and the peritoneum cannot be reliably identified with CT. Studies have probed into the use of injecting IV contrast dyes prior to imaging to establish a CT tractography. We present a case of a 31-year-old male presenting to the emergency department for evaluation of stab wounds following an altercation. On exam, a 1 cm penetrating wound to the LUQ of his abdomen was noted. A CT scan of the abdomen and pelvis was performed with 91 mL of Omnipaque-350 intravenous contrast. Prior to imaging, 30 mL of hydrogen peroxide was injected directly into the opening site of the stab wound to amplify the wound tract. The result was a well-visualized intact peritoneum. We propose hydrogen peroxide as an alternative method to liquid contrast in reestablishing the stab wound tract. This method creates a negative contrast level to augment the ability of CT imaging to determine peritoneal penetration. Key Words Penetrating Abdominal Injury, CT Tractography, Abdominal Trauma, Hydrogen Peroxide, Trauma Management.Tissue nutrition is the continuous process which is established just after the conception and persists throughout the life. Ayurveda scholars have mentioned that the manner of tissue nutrition is not same in all phases of life. In prenatal life embryo gets nutrition by Upasneha (filtration) and Upasweda (percolation/secretion) and fetus by Garbhanabhinadi (umbilical cord) which is attached with the heart of mother via Rasavahanadi (blood vessels). Thus in intrauterine life the nutrition of embryo is histotrophic, whereas just after the formation of placenta nutrition becomes haemotrophic. In post-natal life nutrition is enteral means nutrients are taken in the form of food via mouth called Aahar. Ayurveda scholars have postulated theories to understand the mechanism of tissue nutrition are Ksheera Dadhi Nyaya (transformation of nutrients), Khale Kapota Nyaya (selective uptake of nutrients), KedariKulya Nyaya (transportation of nutrients via channels), Ek Kala Dhatu Poshan Nyaya (simultaneous supply of nutrients to whole body). The theories of tissue nutrition discussed in Ayurveda suggest that although tissues are nourished and replenished continuously at different rate as per the functional state of Agni by circulating nutrients obtained from Ahara, but tissues are also dependent on each other for their proper nourishment and metabolism. This concept has great implication in management of malnourishment and various other disorders. This manuscript is an attempt to explore the Ayurveda’s view on tissue nutrition along with physiological and clinical significance of theories of tissue nutrition in a scientific manner.Retinoblastoma is an uncommon solid tumor diagnosed in infants and toddlers. This cancer has a 95% survival rate when diagnosed early. However, this tumor can cause low vision, blindness or loss of life, if not diagnosed early. Pediatric primary care providers are instrumental in detecting abnormal vision findings because they can perform a thorough history and eye examination needed for early detection.

Chronic neuropathic pain (CNP) after burn injury to the hand/upper extremity is relatively common, but not well described in the literature. This study characterizes patients with CNP after hand/upper extremity burns to help guide risk stratification and treatment strategies. We hypothesize that multiple risk factors contribute to the development of CNP and refractory responses to treatment.

Patients older than 15 years admitted to the burn center after hand/upper extremity burns, from January 1, 2014, through January 1, 2019, were included. Chronic neuropathic pain was defined as self-described pain for longer than 6 months after burn injury, not including pain due to preexisting illness/medications. Two analyses were undertaken (1) determining risk factors for developing CNP among patients with hand/upper extremity burns, and (2) determining risk factors for developing refractory pain (ie, nonresponsive to treatment) among hand/upper extremity burn patients with CNP.

Of the 914 patients who met the inclusion criteria, 55 (6%) developed CNP after hand/upper extremity burns. Twenty-nine of these patients (53%) had refractory CNP. Significant risk factors for developing CNP after hand/upper extremity burns included history of substance abuse and tobacco use. Among CNP patients, significant risk factors for developing refractory pain included symptoms of burning sensations. In all CNP patients, gabapentin and ascorbic acid were associated with significant decreases in pain scores on follow-up.

Substance abuse and tobacco use may contribute to the development of CNP after hand/upper extremity burns. Those who developed refractory CNP were more likely to use the pain descriptor, burning sensations. Pharmacological pain management with gabapentin or pregabalin and ascorbic acid may provide the most relief of CNP symptoms.

Therapeutic IV.

Therapeutic IV.

Stigma works to reinforce dominant social values. The meaning of stigma is therefore not static but dependant on the regime in power. Taking into account the significant socioeconomic changes that took place in Vietnam over the last thirty years, this study explores the meaning of stigma directed at Vietnamese people who inject drugs in different social spheres.

This qualitative study was conducted as part of an evaluation of a peer outreach program that distributes harm-reduction supplies and information, and provides treatment referral assistance to people who inject drugs in Haiphong, Vietnam. We conducted ethnographic field observations with peer outreach workers, home visits, and 54 in-depth interviews with participants in 2017 and 2018. Grounded theory led our theoretical sampling and analysis.

Stigma towards people who inject drugs seems to centre on the ability to be self-reliant rather than on drug-using behaviours. Participants described how their families and neighbours expressed expectations that they should manage their substance use issues by themselves, without considering the barriers they face in the job market.