Current Issue : January-March Volume : 2025 Issue Number : 1 Articles : 2 Articles
Fatty liver disease (FLD), particularly non-alcoholic fatty liver disease (NAFLD), is a growing global health concern, affecting approximately 25% of the adult population. It can progress to non-alcoholic steatohepatitis (NASH), leading to severe liver complications. This study evaluates the effectiveness of targeting Diacylglycerol O-acyltransferase 2 (DGAT2) and enhancing urea cycle function as dual therapeutic strategies to reverse fatty liver progression. A prospective, multi-center clinical trial was conducted involving 100 adults aged 18-65 years diagnosed with moderate to severe NAFLD. Participants were randomized into three groups: DGAT2 inhibitor therapy, urea cycle enhancers and combination therapy. Outcome measures included changes in hepatic triglyceride levels, liver enzyme levels (ALT, AST), ammonia levels and quality of life assessed via SF-36. Significant reductions in hepatic triglycerides (30%) and liver enzyme levels were observed in the DGAT2 inhibitor group. Urea cycle enhancers led to a 43% decrease in ammonia levels, while combination therapy achieved a 45% reduction in hepatic fat. Histological improvement was noted in 75% of cases. Targeting both DGAT2 and urea cycle dysregulation presents a promising therapeutic strategy for managing fatty liver disease, offering a comprehensive approach to treatment....
Proton-pump inhibitors (PPIs) are commonly prescribed for managing gastrointestinal conditions such as peptic ulcers, gastroesophageal reflux disease (GERD) and Zollinger–Ellison syndrome. While they are generally considered safe, long-term PPI use has been associated with adverse effects, including osteoporosis, pneumonia and nutrient deficiencies. A rare but significant adverse effect is drug-induced thrombocytopenia (DITP), which can have severe clinical implications. A 34-year-old female presented with worsening epigastric pain, nausea, vomiting and haematochezia. She had a prior history of gastrointestinal disturbances and was being treated with intravenous pantoprazole, followed by oral esomeprazole. Within 20 days, she developed severe gastrointestinal hemorrhage, a petechial rash and emesis. Laboratory findings revealed severe thrombocytopenia (platelet count: 62,000/μL), suggesting a potential immune-mediated drug reaction to esomeprazole. Immediate discontinuation of the suspected drug and supportive management, including hydration, corticosteroids and platelet monitoring, led to clinical improvement, with platelet recovery observed within four days. This case highlights the critical need for ongoing surveillance for uncommon side effects, such as thrombocytopenia, in patients taking proton-pump inhibitors (PPIs). Healthcare providers, including pharmacists, should be particularly attentive to any signs of blood-related issues, especially in individuals with a history of PPI use. Prompt recognition and management of these potential complications can significantly enhance patient safety. Given the widespread use of PPIs, it is vital to comprehend their risk factors to ensure effective treatment of gastrointestinal conditions while minimizing adverse outcomes....
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