Discordance Therapeutic Protocol of Cystic Echinococcosis With WHO Guideline: A Descriptive Study Based on Liver Ultra-Sonographic Data in North Khorasan Province, Northeastern of Iran.

BACKGROUND: Cystic echinococcosis (CE), a helminth-associated zoonosis caused by Echinococcus granulosus, poses a significant public health problem, particularly in pastoral-rearing regions. The lack of uniform guidelines led to variations in CE management. Based on ultrasound data, the World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification system categorizes cysts into active, transitional, and inactive groups. This study assesses whether the therapeutic approach from liver human operation cases in North Khorasan province aligns with the WHO-IWGE reference based on ultrasound data. METHODS: The research is based on ultrasound data from liver CE human operation cases collected between 2018 and 2022. This retrospective study investigates the therapeutic protocol for (CE) in North Khorasan Province, Iran, comparing it with the WHO-IWGE guidelines. We collect data from previously registered patients' medical information from our studied area's main CE surgical hospital. Moreover, as the first hospitalized survey in Iran, this study reveals insights into patient demographics, cyst stage prevalence, and treatment modalities. RESULTS: Notably, more than half of the patients were treated for CE1 stage cysts, and CE4 cases, which generally do not require surgery, underwent open surgery. The results suggest a need for adherence to the "watch-and-wait" approach in specific cases. All patients underwent successful surgeries, but we do not have access to follow-up data from patients after discharge. CONCLUSIONS: This descriptive study contributes to understanding the implementation of WHO guidelines in a regional context, shedding light on the challenges and variations in CE management. It seems, retraining courses for surgeons are required to update their knowledge of standard CE diagnostic and treatment methods.

Integrating natural compounds and nanoparticle-based drug delivery systems: A novel strategy for enhanced efficacy and selectivity in cancer therapy.

Cancer remains a leading cause of death worldwide, necessitating the development of innovative and more effective treatment strategies. Conventional cancer treatments often suffer from limitations such as systemic toxicity, poor pharmacokinetics, and drug resistance. Recently, there has been growing attention to utilizing natural compounds derived from various sources as possible cancer therapeutics. Natural compounds have demonstrated diverse bioactive properties, including antioxidant, anti-inflammatory, and antitumor effects, making them attractive candidates for cancer treatment. However, their limited solubility and bioavailability present challenges for effective delivery to cancer cells. To overcome these limitations, researchers have turned to nanotechnology-based drug delivery systems. Nanoparticles, with their small size and unique properties, can encapsulate therapeutic agents and offer benefits such as improved solubility, prolonged drug release, enhanced cellular uptake, and targeted delivery. Functionalizing nanoparticles with specific ligands further enhances their precision in recognizing and binding to cancer cells. Combining natural compounds with nanotechnology holds great promise in achieving efficient and safe cancer treatments by enhancing bioavailability, pharmacokinetics, and selectivity toward cancer cells. This review article provides an overview of the advancements in utilizing natural substances and nanotechnology-based drug delivery systems for cancer treatment. It discusses the benefits and drawbacks of various types of nanoparticles, as well as the characteristics of natural compounds that make them appealing for cancer therapy. Additionally, current research on natural substances and nanoparticles in preclinical and clinical settings is highlighted. Finally, the challenges and future perspectives in developing natural compound-nanoparticle-based cancer therapies are discussed.