Impact of Treatment with Metformin in Comparison with Insulin in Gestational Diabetes in Libyan Population a Randomized Controlled Study.

Background: The aim of this study was the comparison of the glycemic control and maternal outcomes in women affected with gestational diabetes mellitus (GDM) managed with metformin versus insulin. Materials and Methods: The participants included in this study were 140 women diagnosed with GDM. They were randomized into two groups, women included in the first group were treated with metformin and the women of the second group were managed with insulin. Results: The glycemic control was similar in both the treatment arms and the only noteworthy difference was found in the mean fasting blood glucose, which was significantly higher in the women receiving insulin as compared to the women receiving metformin. There were no substantial differences in the maternal outcome with the use of metformin compared to insulin in women with GDM. Conclusion: The incidence of operative delivery was higher in metformin-treated group, whereas the hospital admission rate was considerably elevated in insulin-treated group.

The Mechanisms of Dietary Phytoestrogen as a Potential Treatment and Prevention Agent against Alzheimer's Disease.

Alzheimer's disease (AD) is a major dementia disease worldwide with an increasing incidence rate among the elderly. It is a neurodegenerative disease with symptoms starting slowly and then progressing over time. There has been extensive research on AD prevention and treatment; however, there is no cure as of yet. Several drugs are being researched for the treatment and prevention of AD, with a rising interest in specific dietary compounds as potential interventions with lower side effects. One such dietary compound being tested is phytoestrogen. Phytoestrogens are chemically, structurally, and functionally similar to estrogen, which has numerous functions as a cognition-promoting agent; although, as a supplement it can be damaging. Phytoestrogens have the unique ability to substitute for estrogen in elderly individuals with Alzheimer's disease and depleted estrogen levels. This paper aims to contribute to the collective understanding of phytoestrogen's role in the treatment and prevention of Alzheimer's disease by describing its various mechanisms, including its ability to decrease amyloid beta peptide production, promote calcium outflow and acetylcholine release, and reduce Tau protein phosphorylation. The paper also addresses phytoestrogen's role as an anti-inflammatory and antioxidant agent for the cholinergic neurons associated with Alzheimer's disease.

Caffeine: A Potential Protective Agent Against Cognitive Decline in Alzheimer's Disease.

Over the past few decades, caffeine has been well recognized as a stimulant whose effects can be detected particularly in the central nervous system. A stimulating effect of caffeine has been found useful in treating patients with many neurological disorders, including Alzheimer's disease (AD). AD is reported to be a rapidly increasing public health problem with lack of a remedial treatment. However, the assumed protective effects of caffeine against AD are of huge interest. This study substantiates caffeine's role as a potential prevention agent against AD through several epidemiological studies. More than 75% of available study reports support the opinion that caffeine has a favorable effect against cognitive decline and AD. Moreover, other studies have discussed the effect of caffeine drinking and concluded several positive effects on cognitive functioning. The present study, however, focuses more on the potential mechanisms by which caffeine diminishes effects as well as delays the onset of AD.

Gastroesophageal Reflux Disease: A Review of Symptomatic Management.

Considered as a chronic illness, gastroesophageal reflux disease (GERD) has manifested itself as a widespread condition throughout the adult population. As a growing epidemic, GERD has reached a staggering prevalence of 10% to 20% in the Western world, by affecting up to 30 million people in the United States alone. Sixty percent of individuals in an adult population will experience symptoms and the impact of GERD over a period of 12 months, whereas a remarkable 20% to 30% of individuals will have weekly symptoms. This rapid increase in the prevalence of the disease requires equally rapid management techniques. Although the disease itself has no cure, management of symptoms and certain pharmacological and surgical advancements have allowed for individuals affected by GERD to receive specific treatment options sufficient for them to live a healthy life. In this paper, such management options will be examined and discussed in reference to their effectiveness in treating the symptoms presented in GERD patients.

A review on prescribing patterns of antihypertensive drugs.

Hypertension continues to be an important public health concern because of its associated morbidity, mortality and economic impact on the society. It is a significant risk factor for cardiovascular, cerebrovascular and renal complications. It has been estimated that by 2025, 1.56 billion individuals will have hypertension. The increasing prevalence of hypertension and the continually increasing expense of its treatment influence the prescribing patterns among physicians and compliance to the treatment by the patients. A number of national and international guidelines for the management of hypertension have been published. Since many years ago, diuretics were considered as the first-line drugs for treatment of hypertension therapy; however, the recent guidelines by the Joint National Commission (JNC8 guidelines) recommend both calcium channel blockers as well as angiotensin-converting enzyme inhibitors as first-line drugs, in addition to diuretics. Antihypertensive drug combinations are generally used for effective long-term management and to treat comorbid conditions. This review focuses on the antihypertensive medication utilization, their cost factors, adherence to treatment by patients, and physicians' adherence to guidelines in prescribing medications in different settings including Indian scenario. The antihypertensive medication prescribing pattern studies help in monitoring, evaluation and necessary modifications to the prescribing habits to achieve rational and cost-effective treatment. Additionally, periodic updating of recommended guidelines and innovative drug formulations, and prescription monitoring studies help in rational use of antihypertensive drugs, which can be tailored to suit the patients' requirements, including those in the developing countries.