Background: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD) as the chief modifiable contributor to residual cardiovascular risk, especially in conditions associated with insulin-resistant,and call to improve awareness and clinical management.The probable benefit of residual CVD risk reductionsuggests a role for treatment of persistently high TGconcentration even in statin – treated patients, with TG lowering agents including fibrates, niacin, omega polyunsaturatedfatty acids, and other non statin treatment.Therapeutic lifestyle changes including; medically assistedweight loss, physical activity, and dietary changes, as well as improvement of glycemic control should be an adjunct to lipid-lowering pharmacological therapies. Therapy should be concomitantly assessed for treatment tolerance and adequacy with focused laboratory evaluations and patient follow-up. Therapy should be boosted to attain goals according to risk level, and that even more intensive therapy might be warranted in patients with CVD history.
Residual cardiovascular risk in diabetes and obesity: Targeting lipid abnormalities other than LDL cholesterol
: Cardiovascular Risk
Type2 diabetes
Obesity
Atherogenic dyslipidemia
Lipid lowering treatment
Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Anal Fissure: Is it becoming a medical disorder?
Non-surgical treatment of anal fissure
fissure in ano
sphicterotomy
botulinum toxin in anal fissures
glyceryl trinitrate.
Chemical sphincteratomy
pharmacological sphincteratomy.
An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological s
... Show MorePublication Date
Sat Dec 01 2012
Journal Name
Advances In Bioresearch
Cytotoxicity of Miltefosine against Leishmania majorPromastigotes
Leishmaniasis has poor vaccination trials and the available drugs have side effects on patients. Therefore
development ofnew chemicals is important for public health. Miltefosine is the first drug used for oral treatment of visceral leishmaniasis.Previous studies approved that miltefosine is an effective treatment against visceral leishmaniasis
the visceral form ofLeishmania
and also on L. major
the cutaneous form of Leishmania. Here
we investigated the in vitro cytotoxicity ofmiltefosine on the procyclic promastigotes forms of L. major. Different concentrations of miltefosine were investigatedagainst the flagellated form of L. major
and results showed that miltefosine has inhibited the in vitro proliferation of theparasite
approving the cytotoxic effect of the compound on Leishmania
EC50 was determined after 24 hours exposure forthe drug and it was 1.54 μM. Our findings indicate that miltefosine has a cytotoxic effect on the insect stage of the old worldL. major and can be a new anti-Leishmanial drug