The aim of this study was to prepare a liposomal formulation of a model drug (budesonide) for colonic delivery by incorporating a bile salt (sodium glycocholate, SGC) into liposomes followed by coating with a pH-responsive polymer (Eudragit S100, ES100). The role of the SGC is to protect the liposome from the emulsifying effect of physiological bile salts, while that of ES100 is to protect the liposomes from regions of high acidity and enzymatic activity in the stomach and small intestine. Vesicles containing SGC were prepared by two preparation methods (sonication and extrusion), and then coated by ES100 (ES100-SGC-Lip). ES100-SGC-Lip showed a high entrapment efficiency (>90%) and a narrow size distribution (particle size = 275 nm, polydispersity index < 0.130). The characteristics of liposomes were highly influenced by the concentration of incorporated SGC. The lipid/polymer weight ratio, liposome charge, liposome addition, and mixing rate were critical factors for efficient and uniform coating. In vitro drug release studies in various simulated fluids indicate a pH-dependent dissolution of the coating layer, and the disintegration process of ES100-SGC-Lip was evaluated. In conclusion, the bile salt-containing ES100-coated liposomal formulation has potential for effective oral colonic drug delivery.

Type 2 diabetes mellitus (T2DM) is a major global health issue associated with chronic inflammation, which contributes to both disease progression and its complications, including cardiovascular and microvascular disorders. Key inflammatory markers such as tumor necrosis factor-alpha, interleukin-6 (IL-6), E-selectin, and P-selectin are elevated in T2DM patients and are implicated in the development of these complications. Understanding how treatments such as insulin and metformin affect these markers is crucial for improving therapeutic strategies in T2DM. This study investigated the effects of insulin and metformin on these inflammatory markers in T2DM patients. This was a cross-sectional study involving patients with diabetes on insulin (group A), metformin only (group B), and healthy controls (group C). Participants were enrolled from the Diabetic Center in Karbala, Iraq and underwent clinical assessments including ophthalmologic examinations. Fasting blood glucose, HbA1c and lipids levels were assessed. The levels of inflammatory markers (IL-6 and TNF-α), and adhesion molecules (sE-selectin and sP-selectin) were measured using Enzyme-Linked Immunosorbent Assay (ELISA). The study included 522 patients with diabetes: 356 receiving insulin (group A), 70 receiving metformin (group B) and 96 healthy controls (group C). T2DM patients treated with insulin exhibited significantly more microvascular complications than those treated with metformin. Higher rates of retinopathy (64.3% vs 11.4%) and neuropathy (69.9% vs 11.4%) were observed in the insulin group, whereas the incidence of nephropathy did not differ significantly (14.6% vs 11.4%). Inflammatory markers were lower in the insulin group: TNF-α levels were 3-fold lower and IL-6 levels were 8-fold lower. Conversely, sE-selectin levels were 1.5-fold higher in the insulin group, and sP-selectin levels were 1.4-fold higher in the metformin group. This study highlights distinct differences in inflammatory markers and systemic complications between T2DM patients treated with insulin and those treated with metformin alone. Further research is needed to explore the mechanisms underlying these observations and optimize treatment strategies for T2DM patients.

Type 2 diabetes (T2D) is a chronic metabolic disorder requiring insulin therapy as β-cell function declines. Despite insulin's proven efficacy, adherence remains a significant challenge. This study aims to identify factors influencing insulin adherence among patients with T2D to inform targeted clinical interventions. A cross-sectional study was conducted at a tertiary diabetes clinic, recruiting adult patients with T2D on insulin therapy for at least six months. A structured, validated questionnaire was administered in person to collect demographic, clinical, and treatment-related data, along with patient beliefs about insulin. Insulin adherence was defined as taking ≥80% of prescribed doses over the past month. Statistical analysis included univariate and multivariate logistic regression to identify independent predictors of adherence. Among 111 patients, 49 (44.1%) were adherent, while 62 (55.9%) were non-adherent. Adherence was associated with male gender, higher education levels, smoking abstinence, and adherence to recommended diet and exercise regimens. Non-adherent patients had a higher prevalence of family history of diabetes, more diabetic complications, increased comorbidities, and more frequent hospitalizations. Self-injection of insulin and regular self-monitoring of blood glucose were linked to better adherence, whereas fear of injections and the use of herbal medicine were associated with lower adherence. Negative beliefs about insulin were not significantly different between groups. Insulin adherence in T2D is influenced by lifestyle, clinical, and practical treatment factors rather than negative beliefs alone. Addressing practical barriers, such as fear of injection and alternative treatment use, through patient education and supportive interventions may improve adherence rates.

Transfusion-dependent β-thalassaemia (TDT) requires lifelong blood transfusions, resulting in progressive iron overload and liver injury. Serum ferritin is a practical surrogate for iron burden, while liver function tests (LFTs) may reflect hepatic damage. However, the influence of gender and the chelation regimen on the ferritin-LFT relationship remains underexplored. This study evaluated these associations in a large Iraqi TDT cohort. A retrospective cross-sectional study was conducted on 323 patients with TDT at the Center of Hereditary Blood Diseases, Karbala, Iraq. Data on demographics, ferritin, LFTs, transfusion history and chelation regimen were collected. Mann-Whitney U test, Fisher's exact test, Spearman's correlation and multiple linear regression were used to explore predictors of ferritin, including interaction terms. Receiver operating characteristic (ROC) analysis assessed aspartate aminotransferase (AST) and alanine aminotransferase (ALT) cut-offs for predicting ferritin >2500 ng/mL. Median ferritin was 2214 ng/mL. AST (ρ=0.581) and ALT (ρ=0.516) showed strong positive correlations with ferritin (p<0.001). Gender-stratified analyses revealed consistent AST-ferritin associations, with females demonstrating additional links involving bilirubin and alkaline phosphatase (ALP). Patients on deferasirox (DFX) + deferoxamine (DFO) had higher ferritin, AST and ALT than DFX alone (p0.79 in all subgroups). Gender and the chelation regimen modify the ferritin-LFT relationship in TDT. AST is a consistent predictor of ferritin across all groups, while bilirubin and interaction terms contribute in specific subgroups. These findings highlight the need for gender- and regimen-specific interpretation of biochemical markers, especially where advanced iron assessment is unavailable.