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Abstract :

Esomeprazole is a proton pump inhibitor (PPIs) successfully used to inhibit gastric acid secretion and treat peptic ulcers and other acid-related disorders. However, the studies of the effect of esomeprazole on liver enzymes are limited. This study aims to investigate the effect of esomeprazole on liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphates (ALP) in peptic ulcer patients. Twenty-nine omeprazole users and twenty-four health control were recruited from outpatient clinics. Serum levels of liver enzymes Alanine transferase (ALT), aspartate transferase (AST), and alkaline phosphates (ALP) were evaluated at least 2 months after the medication use. Serum levels of ALP (74.31± 19.63 U/L, P<0.0001) were significantly higher in esomeprazole users compared to non-users. While serum levels of ALT (16.07± 6.3 U/L, P=0.008) were significantly lower in esomeprazole users. Serum AST levels (18.86±6.4 U/L, p= 0.192) were not changed between the 2 groups. Whilst this study did not confirm the hepatotoxicity of esomeprazole on the liver, it could indicate that esomeprazole might affect the liver. Further research is required to determine whether esomeprazole is hepatotoxic or not.

Abstract : Adverse drug reactions are increasingly challenging in medical settings; either due to their high doses or prolonged use or due to the pharmacodynamics nature of the medications. Methotrexate found applications for different ailments making their adverse effects common. It's worth trying to prevent or mitigate these adverse effects of methotrexate using available remedies if any. We aimed to reduce the hepatotoxic effects of methotrexate using L-carnitine compared to N-acetylcysteine as a positive control. To do so, a group of rats were exposed to methotrexate alone or in combination with L-carnitine or N-acetyl cysteine. Liver biochemical parameters and histological architecture were identified and compared with negative and positive groups. The results confirmed that L-carnitine and N-acetyl cysteine mitigated hepatic tissue injury confirmed by biochemical analysis of liver enzymes and histological study. The present study confirms the hepatoprotective effect of L-carnitine as a protective substance to reduce the adverse side effects of chemotherapeutic agents that cause oxidative tissue injury concomitant with inflammation.

Abstract : Nephropathy is one of the serious diabetic comorbid complications. Propolis has been used for the treatment of various illnesses due to its complex composition of various therapeutic constituents including antioxidant compounds which might help regenerate the pancreas or facilitate tissue glucose utilization or improve insulin action. The present study aimed to demonstrate a comparative renoprotective effect provided by vitamin E or propolis in the same diabetic patient sample on standard therapy of sitagliptin plus metformin therapy. To do so serum sample has been collected before (baseline) and after the addition of vitamin E (8 weeks) or propolis (8 weeks) to the patient therapy; the serum was frozen until analysis. The consecutive application of either vitamin E or propolis was carried out with a one-week washout period in-between both courses of therapy. The results demonstrate that propolis provides intensified renoprotection rate indicated by significantly (p<0.05) reducing the level of creatinine, uric acid, and urea alongside improved microalbuminuria. The study concluded that compared to vitamin E; propolis induced a positive effect on one of the major diabetic devastating complications, nephropathy. We do advise diabetic patients to add regular propolis doses to their standard therapy.

Abstract : Type 2 diabetes mellitus (T2DM) is the major type of diabetes around the world with a diabetic nephropathy (DN) is the most common complication of this illness. Several pathways involving pro-inflammatory and polyol are activated through the course of T2DM. The current study aims to evaluate the role of sorbitol dehydrogenase (SDH), zinc, fructose and glycosyl phosphatidyl inositol high density lipoprotein binding protein 1 (GPIHBP1) in development of DN in T2DM Iraqi patients. This is a nested case control study, involved 122 patients with DN (72 patients with microalbuminuria (MA) and 50 patients with normoalbuminuria (NA)) and other age- and gender-matched 58 apparently healthy subjects. The SDH activity, fructose and Zn+2 concentration were determined using spectrophotometric assays, while enzyme linked immunosorbent assay (ELISA) was used to measure serum level of GPIHBP1. Other parameters including lipid profile, fasting blood sugar (FBS), glycated hemoglobin (HbA1c) and renal function tests were measured with standard biochemical methods. The mean serum level of SDH activity in MA and NA was 22.26±9.91U/L and 26.39±10.58 U/L, respectively with no significant difference. However, both groups differed significantly from controls (48.39±24.43 U/L). Similarly, fructose level was comparable between MA and NA groups (6.1±1.5 mg/dl and 6.75±1.54 mg/dl, respectively) and significantly lower than that of controls (10.0±2.0 mg/dl). The median level of GPIHBP1 in MA patients was (878.2 pg/ml) which was higher than that of NA group (1014.05pg/ml) and controls (1189.5 pg/ml) with significant differences. In the context of discrimination between MA and healthy control, the area under the curve (AUC) for SDH and fructose was 0.904, 95%CI= 0.853-0.954, p <0.00 and 0.931, 95%CI= 0.886-0.976, p <0.001, respectively, while in the context of discrimination between NA and healthy controls, it was 0.841, 95%CI= 0.767-0.915, p <0.001, and 0.903, 95%CI= 0.848-0.958, p <0.001, respectively. For GPIHBP1, the AUC in the context of discrimination between MA and healthy controls 0.846, 95%CI= 0.776-0.916, p <0.001; between MA and NA controls 0.773, 95%CI= 0.688-0.857, p <0.001, and between NA and healthy controls 0.762, 95%CI= 0.616-0.837, p <0.001. Diabetic nephropathy (whether normo- or microalbuminuria) is associated with elevated serum levels of TG and vLDL compared with healthy subjects. Serum level of GPIHBP1 is not only decreased in patients with DN, but also inversely associated with the severity of the disease, and can differentiate between normo- and microalbuminuria with a good sensitivity and specificity.

Abstract : Breast cancer (CA breast) is most common cancer in women globally. It accounts for 23 percent of cancer cases worldwide. To evaluate demographics and incidence of breast cancer in Iraqi women undergoing obstetric care at Al-Elwiya Maternity Teaching Hospital. A prospective observational research done in Breast clinic at Al-Elwiya Maternity Teaching Hospital between January 1, 2021 and January 1, 2022. Patients were women who came with a breast mass for whom a core needle biopsy revealed breast cancer. Exclusion criteria were benign breast tumors. Study extended over one-year period with total cases presented to breast clinic 3433 case, 67 cases had malignant breast cancer rate 1.95% in 2021. Mean age was 47.7±10.34 years ranged (24-75) years. Twelve cases (17.9%) were asymptomatic and diagnosed in screening visit, while 38.8% of cases had history of more than 1 year of breast complain before diagnosis. In regard to imaging, 83.3% presented with BIRAD 4 according to ultrasound, while depending on mammography 65.1% were BIRAD 4. With an expected 2.3 million new cases in 2020, accounting for 11.7% of all cancer cases, female breast cancer has now overtaken lung cancer worldwide. With 685,000 fatalities, it is sixth largest cause of cancer mortality globally. Incidence of breast cancer is increasing. Predominant breast cancer presentation in baghdad was mass. Our screening program should be made more exhaustive. Medical education regarding value of early breast cancer screening for women aged 45 to 55 (most prevalent age of presentation).