Sulfad in Controlling Fatty Liver, NASH in Obese Patients

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Transcript of Sulfad in Controlling Fatty Liver, NASH in Obese Patients

  • 1. Sulfad Morbid Obesity Dr. Islam Sobhy

2. Mr. Mohammed Age: 36 Years Old Profession: AccountantControlled Diabetes Fatty Liver High Liver Enzymes BMI = 35 Feel Dizziness and tiredness 3. Morbid Obesity Four studies evaluating > 600 morbidly obese patients undergoing gastric bypass All patients underwent intraoperative liver biopsies Prevalence of NAFLD ranged from 30-90% NASH was documented in 33-42%. > 2/3 of morbidly obese patients undergoing gastric bypass surgery have NAFLD/NASHAbrams GA, et al. Hepatology 2004;40:475-483; Frantzides CT, et al. J Gastrointest Surg 2004;8:849-855; Dallal RM, et al. Obes Surg 2004;14:47-53; Beymer C, et al. Arch Surg 2003;138:12401244. 4. Dyslipidemia Canadian study used U/S to screen 95 adults with dyslipidemia Detected fatty liver in 50% Steatosis was particularly common in individuals with moderate to severe hypertriglyceridemia or mixed dyslipidemia Hypertriglyceridemia and mixed dyslipidemia increased the risk for hepatic steatosis by ~5foldAssy N, et al. Dig Dis Sci 2000;45:1929-1934. 5. FATTY LIVER Also known as Hepatic Steatosis or fatty liver refers to a reversible condition in which there are acummulation of trygliceride fat into intracitoplasmic vacuoles. 6. Prevalence of fatty liver Estimated prevalence is 2.8 - 25 % of population Hepatology 2003 20 to 30 % adults in western countries have NAFLD Imaging & autopsy study Steatosis seen in 80 % obese patients Hepatology 2003 NASH seen in 9 - 30 % obese Hepatology 2003 7. PathophysiologySalgado W, et al. Acta Cir. Bras. 2006; 21. 8. Two-hit Hypothesis Diet FFA Oxidative Stress Toxins Inflammatory MoleculesFatty Liver1st Hit Susceptibility2nd HitDamaged Liver Donnelly et al. J. Clin. Invest. 113: 1343, 2005 Day and James. Gastroenterol. 114: 842, 1998Burned VLDL-TG 9. Fatty Liver2nd Hit Liver Damage2nd Hit Sat FA Liver DamageApoptosis Hepatocyte Mass 10. Controlling Obesity & Fatty LiverDietMedicationEmotional Well-beingExercise 11. TreatmentInflammationOxidative StressCholesterol& TGCellular Insulin Resistant 12. Treatment Increase Bile Flow 1 Lipid Lowering Effect 2,3,4,5,6 Free Radical Scavenger8CAF6CAF8Tumeric Antiinflammatory7 Insulin Sensitizer7Glyc-6Mariana 90 Stem Cell Stabilizer 9,10,11 13. What is Sulfad Sulfad is combination of four potent compounds acting in synergy and delivering rapid control for hepatitis and Fatty liver patients. Main active Ingredients CAF6-CAF8 Bioactive compound of Cynara Glyc-6 Bioactive of Liquorice Tumeric Bioactive compound of curcuma Mariana 90 Bioactive compound of Milkthistle Manufacturer and Package Sulfad produces by ABC PHARMACEUTICAL S.P.A Marketed by Land Pharma s.r.l- Italy 14. Dose 1 Tablet BID or TID Best given half an hour before meals 15. References 1. 2.3. 4. 5.6.Antichoke Increase Bile Output, Herbal Gram. 1996; 37:16 American Botanical Council Beneficial effects of Artichoke leaf extract supplementation on increasing HDL cholesterol in subjects with primary mild hypercholesterolemia: a double-blind, randomized, Placebo-controlled Trial, Feb 2013 HerbClip April 30, 2010. Potential Cholesterol-Lowering Effect of Artichoke Leaf Extract HerbClip September 30, 2008. Efficacy of Artichoke Leaf Extract in Reducing Plasma Cholesterol concentrations HerbalGram. 1998; 44:21 American Botanical Council. Benefits of Artichoke Leaf Extract in Hypercholesterolemia, Dyspepsia, and Liver Function. HerbClip April 15, 2011. Natural Cholesterol-lowering Agents as Alternatives to Prescription statins 16. References 7.HerbClip June 15, 2009. Picroliv, Ellagic Acid, and Curcumin: Effectiveness in Treating Liver Diseases 8. International Journal of Molecular Sciences 2011. Hepatoprotective and Antioxidant Effects of Licorice Extract against CCI4-Induced Oxidative Damage 9. HerbClip September 24, 2002. Liver Detoxification and Herbs 10. National Institute for Health Research. http://www.ahrq.gov/clinic/epcsums/milktsum.htm. Milk thistle: effects on liver disease and cirrhosis and clinical adverse effects 11. HerbClip May 31, 2005. Silymarin in the Treatment of Liver DiseaseA Conservative Meta-analysis 17. Thank You