Hesperetin is potential natural compound for its attributes in various anticancer activities. Hesperetin can modulate diverse signaling pathways in cancer cells related to growth, metastasis, and apoptosis. Hesperetin also increases chemosensitivity in chemotherapy in a synergistic approach. Hesperetin processes less toxicity in human body but more bioavailability, conferring its application in clinical settings.
The use of dietary phytochemical rather than conventional therapies to treat numerous cancers is now a well-known approach in medical science. Easily available and less toxic dietary phytochemicals present in plants should be introduced in the list of phytochemical-based treatment areas. Sesamin, a natural phytochemical, may be a promising chemopreventive agent aiming to manage breast cancer. In this study, we discussed the pharmacological properties of sesamin that determine its therapeutics opportunity to be used in breast cancer treatment and other diseases. Sesamin is available in medicinal plants, especially in Sesamum indicum, and is easily metabolized by the liver. To better understand the antibreast cancer consequence of sesamin, we postulate some putative pathways related to the antibreast cancer mechanism: (1) regulation of estrogen receptor (ER-α and ER-β) activities, (2) suppressing programmed death-ligand 1 (PD-L1) overexpression, (3) growth factor receptor inhibition, and (4) some tyrosine kinase pathways. Targeting these pathways, sesamin can modulate cell proliferation, cell cycle arrest, cell growth and viability, metastasis, angiogenesis, apoptosis, and oncogene inactivation in various in vitro and animal models. Although the actual tumor intrinsic signaling mechanism targeted by sesamin in cancer treatment is still unknown, this review summarized that this phytoestrogen suppressed NF-κB, STAT, MAPK, and PIK/AKT signaling pathways and activated some tumor suppressor protein in numerous breast cancer models. Cotreatment with γ-tocotrienol, conventional drugs, and several drug carriers systems increased the anticancer potentiality of sesamin. Furthermore, sesamin exhibited promising pharmacokinetics properties with less toxicity in the bodies. Overall, the shreds of evidence highlight that sesamin can be a potent candidate to design drugs against breast cancer. So, like other phytochemicals, sesamin can be consumed for better therapeutic advantages due to having the ability to target a plethora of molecular pathways until clinically trialed standard drugs are not available in pharma markets.
Prostate cancer remains one of the most frequent and deadliest malignancies in males, where the rate of disease progression is closely associated with the type of dietary intake, specifically Western-style diet. Indeed intake of the Asian diet, which contains abundant phytoestrogens, is inversely correlated with a higher risk of prostate cancer, suggesting a chemoprotective effect of phytoestrogen against cancer progression. Although the role of phytoestrogens in cancer treatment was well documented, their impact on prostate cancer is not well understood. Therefore, the present review discusses the possible chemopreventive effect of phytoestrogens, emphasizing their efficacy at the different stages of carcinogenesis. Furthermore, phytoestrogens provide a cytoprotective effect in conventional chemotherapy and enhance chemosensitivity to tumor cells, which have also been discussed. This compilation provides a solid basis for future research on phytoestrogens as a promising avenue for anticancer drug development and also recommends these beneficiary compounds in the daily diet to manage and prevent prostate cancer.
Background: End-stage renal disease (ESRD) patients undergoing maintenance hemodialysis often suffer from malnutrition. The primary objective of the study was to measure the level of serum prealbumin, assess the correlation of serum prealbumin with modified subjective global assessment score and determine a cut-off value for prealbumin that can estimate the nutritional status of the study population with highest accuracy, among ESRD patients under maintenance hemodialysis. Methods: A one year long cross-sectional study from July 2016 to June 2017 was conducted at hemodialysis unit of SSMC & MH, BSMMU, BIRDEM hospital and NIKDU, Dhaka, among 80 maintenance hemodialysis patients. Adult patients over the age of 18 years and on regular (≥2 sessions per week) hemodialysis for more than 3 months without any acute infection were enrolled. Nutritional status of the patients was evaluated using modified subjective global assessment score. Serum prealbumin level was compared with both anthropometric and biochemical parameters, as well as with modified SGA score. Using modified SGA score as gold standard, receiver operating characteristic curve was used to estimate best fitting cut-off value for serum prealbumin for nutritional assessment among ESRD patients under maintenance hemodialysis. Results: Mean age of study population was 52.3 years and 66.3% respondents were male. Most prominent primary renal diseases were diabetic nephropathy (48.8%). According to modified SGA score, 10% of the study population had normal nutritional status and 90% had mild to moderate malnutrition. Mean serum prealbumin was 27.8 mg/dl. Serum prealbumin showed significant negative correlation with age, modified SGA score and triglyceride; significant positive correlation was shown with BMI, serum creatinine and serum albumin. Using receiver operating characteristic curve, 32.6 mg/dl was found to be the best fitting cut-off value for nutritional assessment with 73.6% sensitivity, 62.5% specificity and 72.5% accuracy. Conclusion: Data obtained from this study strongly indicates that serum prealbumin can be used as a marker for nutritional assessment among ESRD patients undergoing maintenance hemodialysis. JOPSOM 2021; 40(2):9-15
Background: Patients under maintenance hemodialysis are at increased risk of malnutrition, causing from multitude of factors. Present study aims to assess the prevalence of malnutrition among maintenance hemodialysis patients using both modified subjective global assessment score and body mass index, compare them and assess the sensitivity and specificity of body mass index for detecting malnutrition, along with determining a new cutoff value for BMI that better represent the maintenance hemodialysis patient’s nutritional status. Methods: This was a cross-sectional study conducted in the hemodialysis unit of Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College Mitford Hospital, BIRDEM General Hospital and National Institute of Kidney Diseases & Urology; among 80 adult CKD patients who were on regular (≥2 sessions per week) maintenance hemodialysis for more than 3 months without any acute infection, during the period of July 2016 to June 2017. Nutritional assessment was done for each patient using modified SGA score along with BMI. Sensitivity analysis of WHO recommended cutoff value for BMI was done among the study population using modified SGA score as gold standard test for detection of malnutrition among the respondents. ROC curve was used to estimate the best fitting cutoff value of BMI that showed highest sensitivity, specificity and accuracy for detracting malnutrition among maintenance hemodialysis patients. Results: The study participants were predominantly male (66.3%) and from age group 45 to 59 years (36.3%). Modified SGA score detected 90.0% of the study population as malnourished. WHO recommended 18.5 kg/m2 cutoff value was also used to detect malnutrition among study population and 13.8% were found to be malnourished, with a sensitivity and specificity of 12.5% and 75.0% respectively. Accuracy was found to be 18.8%. Using ROC curve, 23.1 kg/m2 was found to be the best fitting cutoff value of BMI for the study population to detect malnutrition. With a sensitivity of 47.2%, specificity of 37.5% and accuracy of 46.3%. Conclusion: BMI showed low sensitivity for detecting malnutrition among patients under maintenance hemodialysis, compared to modified SGA score and should be avoided as a screening tool, but 23.1 kg/m2 cutoff value for BMI showed potential to be used as an easy to use and quick tool for detecting malnutrition among such patients. Further study with larger sample size could shed more light on this. JOPSOM 2021; 40(1): 14-21
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