Diagnosis and Treatment of Liver Disease: Current Trends and Future Directions.

This narrative review delves into the intricate landscape of liver diseases, providing a comprehensive background of the diverse conditions that afflict this vital organ. Liver diseases, ranging from viral hepatitis and non-alcoholic fatty liver disease (NAFLD) to cirrhosis and hepatocellular carcinoma (HCC), pose significant global health challenges. Understanding these diseases' multifaceted origins and progression is pivotal for developing effective diagnostic and therapeutic strategies. The epidemiology and etiology of liver diseases emphasize the global impact of viral hepatitis, with hepatitis B and C as significant contributors. Concurrently, the rising prevalence of NAFLD, linked to lifestyle factors and metabolic syndrome, underscores the intricate relationship between modern living and liver health. Chronic liver diseases often evolve insidiously, progressing from inflammation to fibrosis and, ultimately, to cirrhosis - a stage characterized by irreversible scarring and compromised function. The heightened risk of HCC in advanced liver disease stages further underscores the urgency of effective diagnostic and therapeutic interventions. The evolving landscape of non-invasive diagnostic tools is explored for their role in enabling early detection and accurate staging of liver diseases. In the realm of treatment, there is a continuous transition toward personalized medicine, customized to suit the unique profiles of individual patients. This shift encompasses a broad spectrum, ranging from personalized pharmacological interventions to lifestyle modifications and surgical options. Delving into innovative therapies, such as gene editing and immunomodulation, offers a glimpse into the promising future directions that have the potential to redefine the landscape of liver disease diagnosis and treatment.

Cardio-Oncology: Managing Cardiovascular Complications of Cancer Therapies.

This narrative review explores the complex relationship between cancer medicines and cardiovascular health in the junction of oncology and cardiology, known as cardio-oncology. The study examines the historical development of cancer treatments and highlights the growing importance of cardiovascular problems in patient care. This text delves into the topic of cardiotoxicity, examining both conventional chemotherapeutic drugs like anthracyclines and more recent tyrosine kinase and immune checkpoint inhibitors. The complex molecular and cellular mechanisms that control cardiovascular problems are explained, including an understanding of how genetic predisposition influences an individual's sensitivity. The narrative expands into the crucial realm of risk stratification and evaluation, revealing advanced instruments for identifying cardiovascular risk in cancer patients. The importance of non-invasive imaging methods and biomarkers in early detection and continuous monitoring is emphasized. The prioritization of preventive tactics emphasizes the need to take proactive measures incorporating therapies to protect the heart throughout cancer treatment. It also highlights the significance of making lifestyle improvements to reduce risk factors. The narrative emphasizes the changing collaborative treatment environment, advocating for merging oncologists and cardiologists in a coordinated endeavor to maximize patient outcomes. In addition to clinical factors, the review explores the critical domain of patient education and support, acknowledging its crucial role in promoting informed decision-making and improving overall patient well-being. The latter portions of the text anticipate and consider upcoming treatments and existing research efforts that offer the potential for the future of cardio-oncology. This review seeks to provide a detailed viewpoint on the intricate connection between cancer treatments and cardiovascular well-being. Its objective is to encourage a more profound comprehension of the subject and prompt careful contemplation regarding the comprehensive care of cancer patients who confront the intricate difficulties presented by their treatment plans.

Effect of vitamin D supplementation on various parameters in non-alcoholic fatty liver disease patients.

There are still no FDA approved drugs for NAFLD so far. Vitamin D may be a good therapeutic option for NAFLD patients due to its insulin sensitizing and anti-inflammatory properties. The purpose is to investigate the effect of oral vitamin D supplementation on various parameters in NAFLD patients. In this double blind randomized placebo controlled trial, 109 patients of NAFLD diagnosed by abdominal ultrasound and liver enzymes were divided into two groups for treatment with oral capsule of vitamin D3 50,000 IU and capsule placebo weekly for a period of 12 weeks. Anthropometric, chemical, metabolic and inflammatory parameters were assessed pre and post treatment by using SPSS 16. After 12 weeks oral treatment with vitamin D , its level increased significantly in vitamin D group from 12.5±4.2 to 24.5±3.8 ng/ml p =0.003 vs placebo group. This rise was further accompanied by decrease in HOMA-IR (4.56±1.6 to 3.26± 1.8 p=0.003) liver enzymes (i.e. ALT: 72.±17.6 to 54.5±14.5 IU/L p=0.04; AST: 68±14.5 to 46.± 10.5 p =0.002) serum CRP 3.25±0.68 to 2.28±0.44 mg/L p =0.06 and increase in serum adiponectin 8.56 ±1.12 to 10.44±2.35 mg/L p =0.03 as compared to placebo group. However non significant changes were observed in both groups in terms of body weight, BMI, and serum lipid profiles. Vitamin D supplementation not only improved its own status but also caused a significant amelioration in metabolic, chemical and inflammatory parameters in NAFLD patients. So it should be consider as an adjunctive therapy in NAFLD patients.

Advance workflow in lipoproteomics via polymeric ion exchanger.

A workflow is designed for the analysis of lipoproteins, high density lipoproteins (HDL), apoproteins, and lipid fraction, employing an organic polymeric anion exchanger through the enrichment of lipoproteins/peptides from serum. Polymeric separation media are chemically stable over the wide pH range. Poly(GMA/DVB), poly(GMA/EGDMA), and poly(GPE/DVB) are synthesized by radical polymerization, derivatized as strong anion exchangers, and used for lipoproteins enrichment. Lipoprotein's surface is covered by phospholipids, having phosphate groups, therefore lipoproteins are enriched by the interaction of anion exchanger with the phosphate groups and eluted at the pH of 7.5. HDL are further isolated by precipitating the very low-density lipoproteins (VLDL) and low-density lipoproteins (LDL) with phosphotungstic acid as precipitating reagent, followed by delipidation via liquid/liquid extraction. Apolipoproteins profiling is done by MALDI-MS, and lipids are analyzed using gold nanoparticles in the LDI-MS process. This study introduces a lipoproteomics work flow in separation science which analyses the intact lipoproteins. Furthermore, solid phase extraction (SPE)-based methodology is reported for the first time in lipoproteomics. Use of organic polymers, high reproducibility, detailed analysis of lipoproteins, apoproteins/peptides, and lipids from the single serum sample are the distinctive features of this workflow. Being biomarkers of numerous diseases, lipoproteins have clinical significance, and this workflow can be used at diagnostic and therapeutic levels.