Gastrointestinal (GI) cancers arise in the GI tract and accessory organs, including the mouth, esophagus, stomach, liver, biliary tract, pancreas, small intestine, large intestine, and rectum. GI cancers are a major cause of cancer-related morbidity and mortality worldwide. Exosomes act as mediators of cell-to-cell communication, with pleiotropic activity in the regulation of homeostasis, and can be markers for diseases. Non-coding RNAs (ncRNAs), such as long non-coding RNAs (lncRNAs), can be transported by exosomes derived from tumor cells or non-tumor cells. They can be taken by recipient cells to alter their function or remodel the tumor microenvironment. Moreover, due to their uniquely low immunogenicity and excellent stability, exosomes can be used as natural carriers for therapeutic ncRNAs in vivo. Exosomal lncRNAs have a crucial role in regulating several cancer processes, including angiogenesis, proliferation, drug resistance, metastasis, and immunomodulation. Exosomal lncRNA levels frequently alter according to the onset and progression of cancer. Exosomal lncRNAs can therefore be employed as biomarkers for the diagnosis and prognosis of cancer. Exosomal lncRNAs can also monitor the patient’s response to chemotherapy while also serving as potential targets for cancer treatment. Here, we discuss the role of exosomal lncRNAs in the biology and possible future treatment of GI cancer.

Background: Otomycosis is defined as a superficial fungal infection, accounting for about 10% of infectious otitis externa cases. Objectives: This study investigated patients with suspicious symptoms through the examination of their demographic information, isolate etiological agents, and in vitro antifungal susceptibility patterns. Methods: The samples of 170 patients with otitis externa symptoms were collected and confirmed for otomycosis by mycological examination (e.g., potassium hydroxide, methylene blue staining, and fungal culture) and molecular sequencing. In vitro antifungal susceptibility tests against miconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute (M27-A3/S4 and M38-A2). Results: Out of 170 patients, 145 subjects (85.29%) showed positive mycological findings. In this study, 55.8% of the patients were male, and the most common age group affected was 50 - 59 years (26.2%). Hearing loss and pruritus were the most common clinical manifestations. The most common occupation was being a housewife (47.5%), and most cases occurred during the winter (40%). Aspergillus niger was the most common species, followed by Aspergillus fumigatus, Candida albicans, and Candida glabrata. Caspofungin showed the highest activity against Aspergillus and Candida isolates; nevertheless, itraconazole demonstrated the lowest activity against Aspergillus isolates. Fluconazole showed the weakest power against Candida species. Conclusions: Due to climatic conditions, humidity, and dust, otomycosis has a high occurrence in Iran. Although otomycosis needs long-term antifungal therapy and recurrence is high in some cases, it is rarely life-threatening, and eardrop antifungals are usually enough to eradicate the infection. Local information about the antifungal pattern is useful for the control, prevention, and treatment of otomycosis.

BackgroundAlanine aminotransferase (ALT) is an enzyme whose activity became the principal biomarker for liver disease. In the current study, we aimed to determine the prevalence of abnormal ALT, as a surrogate of nonalcoholic fatty liver disease (NAFLD) and its associated determinants using different criteria among Tehranian subjects between 2018 and 2022.MethodsThis is a cross‐sectional study on 5676 Tehranian individuals aged 20–70 years. The weighted prevalence of abnormal ALT was calculated using both the National Health and Nutrition Examination Survey in the United States (US‐NHANCE; ALT ≥30 U/L for females and ≥40 U/L for males) and the American College of Gastroenterology (ACG) guideline (ALT >25 U/L for females, and >33 U/L for males) thresholds. Moreover, uni/multivariable logistic regression analysis was performed to find the determinants of abnormal ALT.ResultsThe weighted prevalence of abnormal ALT was 12.8% (7.6% females and 18% males) and 22.5% (17.7% females and 27.3% males) based on US‐NHANCE and ACG criteria, respectively. Our results showed every decade increase in age decreased the risk of abnormal ALT by 32%. We also found that generally male gender, being overweight/obese, central adiposity, TG ≥6.9 mmol/L, non‐HDL‐C ≥3.37 mmol/L, lipid‐lowering medications, pre‐diabetes/T2DM were associated with abnormal ALT using different cutoff points. Moreover, among men resting tachycardia (≥90 beats per min), hypertension, and females past‐smoker were also found as other determinants of abnormal ALT.ConclusionHigh prevalence of abnormal ALT among non‐elderly Iranian adults, especially among men, necessitates immediate multifaceted strategies by policymakers to prevent potential complications caused by NAFLD.