Antioxidant and zinc supplementation can improve MHE in patients with liver cirrhosis.

Hepatocellular carcinoma is the second leading cause of cancer deaths worldwide. It is characterized by unique features that can be utilized for selective and targeted therapy, which aids in preserving healthy tissues from deteriorating effects of traditional chemotherapeutics. In this minireview, a brief overview of recent drug delivery attempts for the management of hepatocellular carcinoma with the aid of nanomedical structures is presented. The beneficial impact of nanomaterials in terms of prolonged retention in blood and target sites, controlled biodistribution and improved stability of the encapsulated payloads, will be described, together with the possibility of incorporating more than one cargo into the same nanostructure. Incorporation of stimuli-responsive components, decoration with targeting moieties and the use of molecularly targeted drugs for treatment of hepatocellular carcinoma are also highlighted.

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Background: Loop duodenal switch with sleeve gastrectomy is reported to be associated with accepted rates of diabetes remission in obese patients suffering from type II diabetes. We conducted this study to assess the metabolic outcomes of this operation on obese diabetic patients. Study type: Prospective longitudinal cohort study. Patients and methods: Twenty-five cases were included in the study with mean BMI of 61.15 kg/m 2 . All cases underwent open loop duodenal switch with sleeve gastrectomy. Patients were followed for up after operation for diabetic and metabolic changes. Results: The mean age of the included cases was 34.16 years. Patient weight and BMI were significantly decreased at follow up (p < 0.001). Lipid profile showed a marvelous improvement compared to baseline levels preoperatively. Blood glucose and HbA1c levels were significantly improved (p < 0.001). No significant changes were detected regarding bilirubin or calcium levels. Diabetes full remission was detected in 12 cases (48%) and 8 cases (32%) at 1 and 2 years respectively whereas diabetic control was found 4 cases (16%) at the previously mentioned follow up visits. Regarding complications, GERD was detected in 2 cases (8%) while leakage and intestinal obstruction were detected in one case (4%) for each complication. Conclusion: Based on the results of our study, it is evident that loop duodenal switch with sleeve gastrectomy is effective surgical method in the management of diabetes in obese individuals with accepted morbidity and mortality rates.

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