Ebtihal E Eltyeb, Ali A Al-Makramani, Mai M Mustafa, Sahar M Shubayli, Khalid A Madkhali, Shaden A Zaalah, Ali T Ghalibi, Suhaila A Ali, Angum M Ibrahim, Randa A Basheer
Caffeine Consumption and Its Potential Health Effects on Saudi Adolescents in Jazan
Cureus
changing vision understanding interpretation analysis certain data scientific dilemmas able change status quo revitalize mission impulse important thoughts thus creating conditions increase immensely chances bringing success following albert einsteins postulate cannot solve problems thinking used created think road success start solve neutralize problem answer taking consistent systematic approach analyzing component eliminate every possibility negative influence thoughts apply full force cancer rates general also melanoma rates particular murderous tempo globalization modernization medicine yet led desired decrease rates contrary rising headlong remain largely unpredictable difficult regulate conclusion solution sought refracting light another prism nitrosogenesis pharmacooncogenesis stepbystep systematic approach solving problem requires patience determination perseverance perseverance needed mainly overcome general ignorance neglect disinterest uneducation uncertainty others rather doubt ones thesis analysis need active approach careful analysis concepts drug mediated nitrosogenesis oncopharmacogenesispharmacooncogenesis skin cancer would certainly contribute elucidation skin carcinogenesis context polymedication contamination polymorbidity worldwide fda already 2019 taken much needed first step universal awareness arm taken seriously responsibly solely dermatologists dermatosurgeons guild guild launched independent neverending observations logically grounded hypotheses remaining date confirmatory unshakable enigmatic regarding unit intake potentially contaminated medication subsequent development melanomas branch medical guild also become guarantor safety objectivity science thus safety fight survival huge number skin cancer patients contaminated oral antidiabetic drugs face metformin sitagliptin make exception respect similarly cutaneous melanomas occurring published scientific literature combined intake monomedication ranitidine valsartan olmesartan candesartan telmisartan irbesartan losartan enalapril lisinopril perindopril hydrochlorothiazide nifedipine amlodipine propafenone bisoprolol nebivolol melitracen number others inform another rare unexpected clinical observation occurrence cutaneous melanomas taking another class drugs oral antidiabetic ones intake nitrosaminecontaminated antidiabetic drugs whether contamination real potential left regulators manufacturers decide accept realpotential potentiallyreal fact neither regulators manufacturers know whether arose data shared patients one two presented scientific work confirmatory relation potential pathogenetic action nitrosamine contaminated drugs 1 bisoprolol nebivolol candesartan hydrochlorothiazide amlodipine well 2 furosemide direction cutaneous melanoma patient 3 fact also represents first formally described patient subsequent melanoma development worldwide developed following intake potentiallyactually nitrosaminecontaminated metformin metforminsitagliptin drugs themed fdas potentially contaminated drug bulletin 1 metformin multiple times 202021 due contamination ndma 2 sitagliptin september 2022 due contamination nttp seen surprising anyone intake relatively similar carcinogensnitrosamines ndsris unofficial component heterogeneous drugs produces relatively monomorphic clinical picture cutaneous melanoma put metaphorically wolf changes hair mood carcinogen remains carcinogen regardless whether ingested lemonade tablet sandwich bonbon similarly intake nitrosamines food future studies address important tasksdilemmas elucidate 1 phototoxicphotocarcinogenic effect unmetabolized nitrosamines identified drug formulations 2 phototoxicphotocarcinogenic effect dna adducts generated metabolization 3 availability specific dna adducts lesionaltumor tissue blood patients ingestion nitrosocontaining drug formulations level evidence likely lead reconsideration arguments introduction permanent elimination regimes nitrosamines medicines metabolic reprogramming relationship uvb radiation due availability nitrosamines cigarette smoke also currently proven reality based available clinicopathological correlations believe nitrosamines drugs similar effect part key pathway activating skin carcinogenesis influence solar radiation intake contaminated medication associated skin cancer generation progression regulators manufacturers justify merits benefits selfimposed presence carcinogens drugs benefits drugs apart cancergenerating benefit course already widely known let us forget lie stops lie becomes truth moment officially refuted