Screening factors affecting proper levothyroxine therapy among patients with primary hypothyroidism: a cross-sectional study.

Primary hypothyroidism, the most common form of hypothyroidism, requires effective patient understanding and management for successful long-term treatment. This study aimed to investigate the influence of patient knowledge, attitude, practice (KAP), depression, and medication adherence on treatment response in primary hypothyroidism. A cross-sectional observational study was conducted at Al Hassan Metabolism, Endocrine, and Diabetes Center (HMEDC) in Iraq between September 2022 and March 2023. We enrolled 111 patients with signs and symptoms of primary hypothyroidism over 6 months. A validated questionnaire assessed patient knowledge, attitude, practice (KAP), depression, and medication adherence. Thyroid-stimulating hormone (TSH) levels were measured to assess treatment response. Data were analyzed using SPSS v26, with categorical variables presented as percentages. The student's t-test was used to assess statistical significance, with P - valuess below 0.05 considered significant and P - values below 0.01 considered highly significant. The mean age of patients was 45 ± 11.9 years. Approximately 34% of patients had insufficient knowledge, and 30% indicated a positive attitude towards their treatment. A total of 35% of patients had excellent practice. There was no statistically significant association between KAP and age or gender. There was a significant positive correlation between higher levels of education and improved KAP scores. A total of 44.1% of participants reported moderate depression, and 58% demonstrated adherence to levothyroxine (LT4) treatment. Despite good adherence, the combination of fair knowledge and moderate-to-severe depression resulted in suboptimal outcomes for replacement treatment.

Assessing pyridoxine adjuvant therapy effects on blood glucose levels in type 2 diabetes: A randomized clinical trial.

Pyridoxal-5-phosphate (PLP) is the bioactive derivative of vitamin B6, functioning as a coenzyme in over 150 metabolic pathways. Insufficient PLP levels could be associated with the onset and progression of diabetes. This study aimed to assess the effects of pyridoxine adjuvant treatment on blood glucose levels in patients with type 2 diabetes mellitus (T2DM). This interventional, randomized, open-label study was conducted in the Mesan Governorate, with participants from the Mesan Center for Diabetes and Endocrinology as the study population. This study included patients newly diagnosed with T2DM. Patients were randomized into three groups: Group 1, the control group, treated with non-pharmacological therapy (lifestyle modification) (n=20); Group 2, treated with Metformin 500 mg/day in addition to non-pharmacological therapy (lifestyle modification) (n=20). Group 3 was treated with Metformin 500 mg/day plus vitamin B6 300 mg/day in addition to non-pharmacological therapy (lifestyle modification) (n=68). The findings revealed a considerably favorable impact of pyridoxine adjuvant treatment with Metformin on blood glucose levels and other study variables. Compared to the patients in the control group G1, the reductions in fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were statistically significant in groups G2 and G3 after a 4-week treatment period. Similar results were observed for fasting serum insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels, with a significant decrease in groups G2 and G3 (p<0.05). Furthermore, the reductions in indoleamine 2,3-dioxygenase levels were also significantly higher in groups G2 and G3 at the end of the 4-week treatment period (-14.48% vs -21.16%) (p<0.05). Adding pyridoxine adjuvant therapy to Metformin treatment could effectively improve the blood glucose levels of patients with T2DM.

Anticancer Effects of Herbal Medicine Compounds and Novel Formulations: a Literature Review.

INTRODUCTION: Many agents disrupt the cell cycle and its signaling circuits leading to cancer progress. Cancer therapy is performed by surgery, radiation, and chemical drugs remaining some side effects. OBJECTIVE: To evaluate the anticancer traits of herbal medicines. METHODS: We collected previously published data in searching engines (Web of Science, PubMed, Medline, and SCOPUS) by searching key words "herbal medicine," "anticancer effect," "compounds," and "fractions." RESULTS: Herbal medicines have unraveled anticancer effects mostly through cancer cells apoptosis via blocking NF-κB pathway by curcumin and terpenoides; CD95 signaling and enhancement of CD95L expression by resveratrol; and inhibiting tyrosine kinas, angiogenesis, and cell cycle arrest in G2/M phase by ß-lapachone-genistein and cytochrome-c release into the cytosol and caspase-9 activation by biocalein and quercetin. Additionally, impeding cell cycle in the G1 phase in ovarian cancer cells by 7-hydroxystaurosporine, immune cells enrichment (neutrophils and NK cells activation by Viscum album L., T cells and NK cells activation and cytokines such as tumor necrosis factor release by Ganoderma lucidum and microRNAs regulation (by Sinomeniumacutum, shikonin, Oleaeuropaea, curcumin and ginseng). These effects have implications for proper cancer cells elimination. It has been revealed that cytotoxic effects of herbal compounds (mostly those secondary metabolites) have exerted anticancer properties against several cancer cell lines. In addition, targeting microRNAs, nanoparticle-assisted herbal synergism, and novel drug delivery systems and combination chemotherapies have also emerged exerting higher efficacies for specific cell targeting as novel cancer therapy approaches. CONCLUSION: Considering side effects, toxicity, and higher costs of common cancer therapy approaches, application of novel herbal medicine-based therapies will confer promising insights for health outcomes.

The Anticancer Efficiency of Citrullus colocynthis Toward the Colorectal Cancer Therapy.

BACKGROUND: Colorectal cancer (CRC) remains a major cause of death worldwide. Chemotherapy is associated with some side effects during CRC treatment. Hence, proper employment of lower toxic and approaches exerting lowest side effects are essential. The Citrullus colocynthis (C. colocynthis) seems a potential anticancerous herbal medicine (HM) against CRC mostly via various efficient compounds. METHODS: We performed a literature review regarding the anticancer traits of C. colocynthis against CRC. The possible active compounds, mechanisms, and combination therapies in vitro and in vivo or clinical trials have been also stated where found. RESULTS AND CONCLUSION: The anticancerous effects of C. colocynthis has been via a variety of pathways including apoptotic pathways (increase in caspase-3 and inhibiting STAT3 function), antioxidant and anti-inflammatory (TNF-α, nitric oxide, and pro-inflammatory cytokines such as IL-6, IL-8, and IL-1α) traits, inhibition of Wnt/ß-catenin signaling pathway, and antiangiogenesis and antimetastatic effects. Future studies will be promising regarding proper application of C. colocynthis compounds following their extraction.