RESUMEN
The review discusses the etiology, epidemiology, classification, risk factors, assessment, the role of biomarkers in the development of hemorrhoids, operative and non-operative treatment options, post-operative complications of hemorrhoids, preclinical evaluation methods of anti-hemorrhoidal drugs, and different medicinal plants that exhibit anti-hemorrhoidal activity. The dilation and dislocation of normal anal cushions characterizes hemorrhoids. One of the most significant discoveries regarding hemorrhoids is the atypical enlargement and distortion of blood vessels, along with damage and modifications to the anal cavity’s supporting connective tissue. Hemorrhoids are categorized into different classifications based on various factors, Golingher’s classification commonly used, which divides the hemorrhoidal condition into four grades according to prolapse and the development of hemorrhoids. Hemorrhoids are recognized as one of the leading causes of morbidity, affecting millions of populations worldwide and also increasing the economic burden on the healthcare system. Current treatment options for hemorrhoids often involve conservative approaches, including fiber supplements, anti-inflammatory medications, lifestyle changes, and venotonic medicines. Additionally, operative treatments like rubber band ligation, hemorrhoidectomy, and injection sclerotherapy are utilized. Various biomarkers are responsible for the occurrence of hemorrhoids, such as matrix metalloproteinase (MMP), vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), and C-reactive protein (CRP). These biomarkers hold potential as targets for developing new anti-hemorrhoidal agents.
RESUMEN
L-carnitine (LC), which is a type of quaternary amine, is an essential element for energy metabolism in mammals, plants, and specific bacteria. Originating from the amino acid methionine and lysine, it is primarily synthesized in the kidneys and liver. L-carnitine is a pharmacologically active form of carnitine that plays a vital role in energy generation and the breakdown of fatty acids via ?-oxidation in metabolism. Deficiencies in organic cation transporter-2 (OCTN2) can arise due to gene mutations or in conjunction with other conditions like renal or hepatic disorders. Deficiency in carnitine regulation results in several diseases, including cardiomyopathy, cirrhosis, diabetes, endocrine disorders, malnutrition, aging, sepsis, and malnutrition. LC is known for its anti-inflammatory and antioxidant properties. Research indicates that incorporating LC into the diet can ameliorate inflammatory ailments by decreasing the presence of inflammatory agents. Supplementation with LC is particularly useful for individuals with predominant carnitine deficiencies, which can be life-threatening, as well as certain subsidiary deficiencies like organic acid disorders, muscle wasting, and weakness. Moreover, emerging evidence suggests that LC may have therapeutic benefits for various diseases, including renal diseases, liver diseases, neurodegenerative disorders, cardiovascular diseases (CVDs), cancer, diabetes, cachexia, obesity, depression, and epilepsy.