The safety, efficacy and pharmaceutical quality of male enhancement nutraceuticals bought online: Truth versus claim / 中西医结合学报

OBJECTIVE@#Nutraceutical products are widely used for their claimed therapeutic benefits. However, falsified or adulterated nutraceuticals present a major health threat to consumers. This study investigates the pharmaceutical quality, safety and anti-inflammatory effects of six male enhancement nutraceuticals that claim to be 100% natural.@*METHODS@#Three batches of six male enhancement products were tested to detect the presence and levels of adulterants via high-performance liquid chromatography (HPLC). The pharmaceutical quality of the selected nutraceuticals was tested with near infrared spectroscopy (NIR) and SeDeM. The cytotoxic effects of these products on HepG2 cells were determined through cell proliferation (XTT) and lactate dehydrogenase (LDH) cytotoxicity assays. Lastly, the in vitro inflammatory effects of these products were investigated using murine J774 macrophages through cytokine release analysis.@*RESULTS@#HPLC analysis detected the presence of sildenafil citrate, a vasodilator, and the active ingredient in Viagra and Revatio, in all batches of the products we analyzed. Amount of sildenafil citrate ranged from 0.45 mg to 51.85 mg among different batches. NIR assessment showed inter- and intra-batch heterogeneity in product composition. Results of the XTT and LDH assays showed significant cytotoxic effects of the analyzed products. XTT analysis revealed that the viability of HepG2 treated with tested products varied from 27.57% to 41.43%. Interestingly, the male enhancement products also showed anti-inflammatory effects.@*CONCLUSION@#Despite their labeling as 100% natural, all products tested in this study contained levels of sildenafil citrate, which was not reported on the packaging. There was a lack of pharmaceutical uniformity among products of the same batch and across different batches. Additionally, the products we tested had cytotoxic effects. These study findings highlight the adulteration, poor quality and hazard of these nutraceuticals. Therefore, strict regulation of these products and standardization of the definition of nutraceuticals are urgently needed. Further, these falsely advertised products should be withdrawn from the market due to potential adverse effects on the health of their consumers.

Synthesis with spectral investigation of new ligand derived from pyrimidine with some metal complexes / 国际药学研究杂志

New ligand were synthesized by two steps in first steps were prepared chalcones compound from reacting of various carbonyl compounds (3-amino acetophenone with salicyldehyde,the second steps were closure of the ring by reacting(chalcones compound(AS) with thiouria, then reaction mixture was reflux for (8h) to produce Pyrimidine derivatives(AST) also prepared some complexes with Fe(II),Co(II), Ni(II),Cu(II),the ligand (AST)with its complexes were characterized by ((FT.IR, Uv-Vis, HNMR, Mass)–spectra,elemental analysis, melting point, molar conductivity).

Neuroprotective effect of melatonin against ethanol-induced damage in rat brain stem

Chronic ethanol administration has been found to have neuronal damaging effect through free radical generation. The aim of this study is to determine the possible neuroprotective effect of melatonin [MLT] against ethanol induced neuronal damage in the brain stem of male albino rats. Rats were randomly divided into 3 groups: control group, 35% ethanol-treated group and melatonin [l0mg/kg I. P. for 7 consecutive days] pre-treated ethanol group. Administration of ethanol [35%] orally in drinking water for 30 consecutive days decreased glutathione [GSH], dopamine [DA], norepinephrine [NE] and serotonin [5-HT] contents and superoxide dismutase [SOD] activity. The maximal percentage of decrease was 44%, 34%, 41%, 29% and 40%, respectively. On the other hand; there was a progressive increase in malondialdehyde [MDA] level and DNA fragmentation by 128% and 53%, respectively. Melatonin administration prior to ethanol significantly increased. GSH, DA, 5-HT, and NE contents in brain stem by 53%, 30%, 33%, 33% respectively and SOD activity by 35%. MDA level and DNA fragmentation were markedly reduced by 36% and 30%, respectively. Our data suggest that melatonin is capable of at least partially preventing ethanol -induced neurodegeneration in the brain stem of rats. This effect might be attributed to direct free radical scavenging properties and regulation of antioxidative enzyme activity of melatonin

Use of Al-Sidr honey for treatment of suppurative otitis media, in vivo study

Suppurative otitis media is a common disease affecting all ages and both sexes. Development of bacterial resistance is very common making difficulties in management of both acute suppurative otitis media [Ac s o m] and chronic suppurative otitis media [Ch s o m] cases. More recently, interest in honey as a therapeutic agent has undergone a renaissance. Honey is used for management of infected wounds, burns and exhibited excellent results against Gram +ve and Gram-ve organisms in vitro and in some in vivo studies on infected wounds. To compare results of using Al-sidr honey and antibiotics for treatment of acute and chronic suppurative otitis media. Culture and sensitivity of honey, using agar incorporation technique to prepare plates containing serial dilutions of honey to detect MIC for the selected organisms. Preparing honey as ear drops 10% more than MIC. One hundred twenty patients, 60 with [Ac s o m] and 60 with [Ch s o m] divided into 2 groups, Group 1 honey group divided into Group 1A: 30 patients with ac s o m [10 with Streptococcus pneumonia, 10 with Haemophilus influenza and 10 with Moraxtila catarrhalis] and Group IB 30 patients with ch s o m [10 with Pseudomonas aeroginosa, 10 iuith KLebsiella and 10 with Proteus] treated by Al-sidr honey local ear drops. Group 2 antibiotic group same distribution as group 1 and treated by antibiotics. There is significant differences between using honey and traditional approach for antibiotic use even after CIS without side effects or complications. We recommend start thinking to use Al-sidr honey as local ear drops for management policies of suppurative otitis media

Peritonsillar infections: management and importance of bacterial culture

Peritonstilar infection describes a spectrum of diseases that range from peritonsillar cellulitis to peritonsillar abscess. To assess the disease pattern and its management and to examine the role of routine bacterial cultures. We carried out a prospective study with 30 patients diagnosed with peritonsillar infection. Twenty two patients with peritonsillar abscess [PTA] and eight cases with peritonsillar cellulitis [PTC] of these eight cases 4 cases resolved with medicine and the other 4 cases progressed to [PTA] so finally we have 26 cases with [PTA], for these needle aspiration is done from the most prominent point and if pus came we progressed to incision and drainage wider local or general anesthesia according to patients condition. Around 3ml of pus is taken and sent to lab. Immediately and processed for culture for aerobic and anaerobic organisms. Then these 26 cases of PTA divided into 2 groups each one contains 13 cases group I received ampicillin plus metronidazole and group 2 received 3rd generation cephalosporins plus metronidazole. We assessed number of bacteria per aspirate as well as type of bacteria present aerobic or anaerobic. After results of c/s came we assessed the need to change antibiotics. Lastly we assessed length of stay in the hospital for both groups according to antibiotics used. We found 2.1 bacteria per aspirate. Bacteria grown from all aspirates with culture positivness 100%. We found 55 bacteria grown from 26 cases of PTA, with 28 aerobes and 27 anaerobic organisms. There were need to change antibiotics in 3 cases of group I and in 5 cases of group 2 with significant difference. Mean length of stay in group 1 was 4 +/- 3 while in group 2 was 5 +/- 2 with non significant differences between both groups. 1-Culture and sensitivity of pus drained from PTA should be done. 2-We should use drugs for anaerobic organisms on treatment of peritonsillar infections

Enoxaparin versus unfractionated heparin in acute ischemic stroke [in-evolution type]. Differential effects of enoxaparin on von willebrand factor release and a possible relation to improved clinical outcomes

The significance of low-molecular-weight heparins [LMWHs] in the management of acute stroke remains controversial. Investigating the effect of early administration of Enoxaparin [ENOX] on risk reduction of early recurrent ischemic strokes compared with Unfractionated Heparin [UFH]. Besides, exploring whether these benefits of ENOX might lead to reduction in death and disability. One hundred patients with acute ischemic stroke in evolution were enrolled [with symptoms of stroke within eight hours randomization]. Patients were randomized to receive UFH or ENOX for ten days. National Institutes of Health Stroke Scale [NIHSS] and Computed Tomography [ct] scan were performed at the time of admission, and after 48 hours of randomization. The mean baseline of [NIHSS] were 9.14 +/- 0.62 and 7.86 +/- 0.54 among patients randomized to UFH and ENOX respectively [P-value 0.2]. At discharge, the mean NIHSS showed a statistically significant difference in favor of the ENOX group [7.9 +/- 0.82 vs 4.96 +/- 0.54 for ENOX and UFH respectively [P-value = 0.002]] The mean NIHSS after therapy in patients who demonstrated neurological improvement was 5.6 +/- 0.46 in the UFH arm compared to 3.65 +/- 0.39 in the ENOX arm [P-valne=0.001]. A deterioration in the clinical neurological condition [progressive stroke symptoms] inspite of treatment with anticoagulant therapy was seen in 20% [n=10] of the patients in the UFH treatment arm compared to none [n=0] in the ENOX treatment arm [P-value=0.005]. ENOX + aspirin was superior to UFH + aspirin in reducing adverse neurological disability after acute ischemic stroke in evolution

Study of muscle biopsy in children with muscular dystrophy

Muscular Dystrophy [MD] is a genetically heterogeneous group of disorders characterized by progressive weakness and degeneration of skeletal muscles. The present study was designed to help in proper diagnosis of different types of muscular dystrophy through analysis of muscle biopsy and not by clinical picture alone. In addition to Hematoxylin and eosin stain we used antidystrophin antibody to stain the muscle specimens. The study included 18 children diagnosed as having muscular dystrophy on clinical basis. They were selected from out-patient and Genetics specialized clinics, Pediatric Hospital, Ain Shams University. Their ages ranged from 9 to 180 months [mean value 90.3 +/- 54.5 months]. They were 13 males [72.3%] and 5 females [27.7%]. The primary diagnosis was based on clinical data and neurological examination then on creatine phosphokinase [CPK] values, electromyography [EMG] and nerve conduction [NCV] studies. The muscle biopsy was the final procedure to establish the diagnosis of muscular dystrophy and to know the type. All muscle biopsy specimens showed dystrophic pattern but with different degrees. We have also seen three different patterns of dystrophin expression using the anti-dystrophin antibody. Dystrophin stain was negative in [44.4%], positive in [38.8%] and mosaic in [16.8%]. There was significant statistical relation between the duration of illness, presence of pseudohypertrophy and Gower's sign on one side and the result of dystrophin stain [being negative] [P= 0.033, 0.05 and 0.05 respectively]. Also the presence of endomesial and perimesial fibrous tissues, which are important dystrophic changes, was significantly related to the result of dystrophin stain [being negative] [P= 0.028]. This study proved that immunohistochemical analysis using antidystrophin antibody is important to differentiate between X-linked dystrophinopathy or its carrier state and severe childhood autosomal recessive muscular dystrophy [SCARMD]

Hypobaric bupivacaine spinal anesthesia for cystoscopic intervention: the impact of adding fentanyl

Addition of fentanyl to hyperbaric bupivacaine spinal anesthesia prolonged the duration of sensory block. This study seeks to test the hypothesis that adding fentanyl to small dose hypobaric spinal anesthesia will improve intraoperative patients and surgeon satisfaction without delay in recovery. Patients [n = 80] subjected to minor cystoscopic surgery were randomly assigned to have spinal anesthesia with either 5mg bupivacaine 0.1% or 5mg bupivacaine 0.1% mixed with 20microg fentanyl. The main outcome measures included intraoperative patient and endoscopist satisfaction, sedative/analgesic supplementation, postoperative side effects and time to ambulation. Patients in the bupivacaine group needed more analgesic supplementation. Analgesia was more adequate in the bupivacaine-fentaynl group. Pruritus was the main side effect in the bupivacaine fentanyl group. Ambulation and discharge of patients were nearly the same in both groups. Conclusions: Spinal anesthesia with small dose [5mg] hypobaric [0.1%] bupivacaine mixed with fentanyl [20micro g] produced adequate anesthesia for short cystoscopic procedures with minimal side effects and without delay in ambulation

Nitric oxide in gall bladder diseases

Nitric oxide is implicated in the physiological modulation of gastric and gall bladder motility during the inter and postprandial phases.In this study, we have investigated nitric oxide in the sera of 50 individuals, 10 healthy controls [Group I] and 40 randomly selected patients with chronic cholecystitis [Group II]. Patients were subdivided into 3 subgroups, 15 patients with calculous cholecystitis [Group IIa], 15 parients within non-calculous cholecystitis [Group IIb] and 10 cases with biliary sludge [Group llc]. Results of this study have demonstrated high concentrations of serum nitric oxide in patients with chronic cholecystitis particularly those with calculous cholecystitis and those with biliary sludge. These observations may suggest that, the increase in nitric oxide production impair gall bladder emptying leading to gall stasis and hence, together with other factors, may lead to gall stone formation. This study, has also shown that, obesity, smoking and gender don't affect nitric oxide serum level. Further studies are recommended especially on large number of patients to varify the effect of nitric oxide on gall bladder motility. It is recommended also to evaluate the benefits of using nitric oxide synthase inhibitors in high risk groups as obese females and patients using nitric oxide donar medications

Kikuchi histiocytic necrotizing lymphadenitis: clinicopathological and immunohistochemical study

Clinical, morphological and immunohistochemical features of 10 cases having the lymphnodal histological pattern of Kikuchi disease were examined. Two of these were diagnosed as systemic lupus erythematosus [SLE]. Morphologically, Kikuchi disease and SLE were nearly indistinguishable. Plasma cells, neutrophilic infiltration, haematoxyphilic bodies and vasculitis were not useful in differentiating the conditions. Kikuchi lymphadenitis and malignant lymphoma however could be differentiated histologically. Morphological features that exclude malignancy included: polymorphous nature of cellular infiltrate, absence of abnormal mitosis, preservation of sinusoidal pattern on intervening areas and presence of extracellular and intracellular karyorrhectic debris

Primary prevention of non insulin dependent diabetes mellitus

This work was conducted aiming at early prediction of individual at high risk of development of type 2 diabetes mellitus and evaluation of the efficacy of primary prevention of type 2 DM in such individual by diet control and /or metformin therapy. It was conducted on 100 individuals at high risk of development of type 2DM. Subjects were classified into 3 groups: Group I [Individuals with positive family history of DM], 30 cases, subdivided into two equal subgroups, Group la used as control and left without diet control and Group Ib were on diet control. Group II [individuals with upper body segment obesity], 40 cases, subdivided into 3 subgroups: Group II a, 10 cases, left without neither diet control nor metformin therapy, Group II b, 15 cases, were on diet control only while Group IIC, 15 cases, were on both diet control and metformin treatment. The third group [Group III] were females with history of gestational diabetes, 30 cases, subdivided into two equal subgroups, Group IIIa used as control and left without diet control, while Group IIIb were on diet control. All cases were subjected to through history taking, complete physical examination, liver function tests, renal function tests, fasting and two hours post-pr and ial plasma glucose estimation, glycosylated haemoglobin [Hb A[1]c] and complete lipid profile. Results showed that individuals with family history of DM had a significant decrease of both FPG and 2HPG together with highly significant decrease in Hb A[1]C after one year of diet control together with significant decrease in total cholesterol, TG and LDL-cholesterol with increase in HDL-cholesterol levels compared to those individuals on free diet reigmen. As regard those with upper body segment obesity, there were significant decreases in both FPG, 2HPG and highly significant decrease in Hb A[1]c in those on diet control and those on both diet control and metformin therapy together with decrease in BMI after one year of follow up compared to those obese with free diet reigmen. This study also showed that females with history of gestational diabetes are more prone to develop type 2DM if left without any diet control since there were significant decrease of both FPG, 2HPG and HbA[1]c levels after one year of follow up. The results of this study showed that diet control has a significant role in preventing or at least delaying the occurrence of type 2DM in those studied high risk groups. Similar effect was obtained by metformin therapy on subjects with upper body segment obesity in preventing the development of type 2DM. Nevertheless, this role need large scale research for long term follow up period to be cleared. The results of this study showed also that, diet control and /or metformin therapy have a significant effect on modification of the different parameters of lipid profile in those individuals which may subsequently have a beneficial effect on reducing or delaying the appearance of the diabetic vascular complications

Cephalometric evaluation of artificial occlusal plane of complete dentures

An investigation was conducted to study the relationship and the angulation of the artificial occlusal plane as related to the maxillary plane, Cook's plane, Frankfort horizontal plane and the cephalometric occlusal plane. Twenty completely edentulous patients were selected for this study. Lateral cephalometric radiograph was taken for each patient and the cephalometric films were traced. The result obtained indicated that the cephalometric occlusal plane determined by the quadrilateral analysis was the only plane which tends to be parallel with the artificial occlusal plane. The statistical analysis showed that there was no significant correlation between the artificial occlusal Cook's plane angle and the artificial occlusal-Frankfort horizontal plane angle

Kupffer cell count and plasma fibronectin level in hepatic schistosomiasis with and without virus hepatitis

The aim of this work was to study some kupffer cell receptors which influence their immunophagocytic capacity in relation to the levels of circulating immune complexes [CICs] and plasma fibronectin [PFN] in four groups of patients: early or late schistosomiasis and schistosomiasis associated with virus B or C infection as compared to a control group. Patients were diagnosed on clinical basis together with ultrasonography and various laboratory tests. Liver biopsies were obtained to confirm the diagnosis and provide Kupffer cells. After dispersion, total nucleated cells and liver macrophage counts were found to be elevated in early schistosomiasis compared to the other groups. The number and percent of Kupffer cells carrying Fc or complement receptors were significantly higher in early schistosomiasis as compared to all other groups, yet by referring to normal values as reported in the literature the percent carrying, receptors could be considered lower than normal. The CICs were higher in all groups than control. The levels were lower in early Schistosomiasis and highest in patients with mixed infection particularly in those with HBV. There was a negative correlation between CICs levels and the number and proportion of Kupffer cells carrying receptors. Plasma fibronectin [PFN] showed a significant increase in early schistosomiasis patients and a significant decrease in patients with schistosomiasis combined with virus hepatitis particularly HCV; compared to controls. Positive correlation was detected between PFN level and the number and percent of Kupffer cells carrying Fc and complement receptors. No correlation was found between PFN and CICs in all groups. It could be concluded that during early schistosomiasis, there is an increase in the immunophagocytic function of Kupffer cells. In chronic schistosomiasis a decreased activity was noted probably due to immunomodulation and fibrosis. In schistosomiasis associated with HBV or HCV, the function of Kupffer cells was markedly decreased. This is probably due to affection of the hepatocytes leading to lower FN level and increased CICs which may block the receptors. The marked lowering of PFN in schistosomiasis associated with HCV could be explained by the direct cytopathic effect of the virus

Value of certain parameters in differential diagnosis of ascites

Ascitis is not a disease by itself but it is a manifestation of diseases of various organs of the body. It is often a complication of schistosomal hepatic fibrosis, liver cirrhosis, congestive heart failure nephrotic syndrome, tuberculous peritonitis, disseminated carcinomatosis and/or nutritional diseases. In this study, albumin, cholesterol and lactate dehydrogenase [LDH] were estimated in serum and ascitic fluid in different types of ascitis. In tuberculous and malignant ascitis, ascitis albumin was markedly elevated and serum ascitic albumin gradient was less than 1.1 g/dl. On the other hand, serum cholesterol was significantly elevated in renal ascitis, while ascitic fluid cholesterol was significantly elevated in malignant ascitis. Ascitic LDH was significantly elevated in malignant ascitis, compared with other types. These parameters can be used as tools for diagnosis of different types of ascitis when the etiology is obscure

Levels of anti-streptolysin-O antibody correlated to throat colonization with haemolytic streptococci

Antistreptolysin O titer [ASO] was determined in the sera of rheumatic heart patients and age matched controls, together with the isolation of possible offending organisms in their throats. The average of ASO titer in patients group was 1/276 Todd units/ml [Tu.ml], compared with I/I72 TU/ml in the control group, an average which is higher than other studies made abroad, which may reflect a higher exposure rate to infection by haemolytic streptococci in our environment. Within patient group, ASO titer was markedly diminished in those receiving penicillin as prophylactic measure [1/204 TU/ml] compared with those who did not receive this therapy [1/800 TU/ml]. A greater reduction was observed in ASO titer with increasing the period of receiving penicillin therapy. Also, the average ASO titer was higher in younger age group, [6 to 9 years old] than older age group [10 to 12 years] in both patients and control groups which may reflect higher susceptibility and lower resistance to streptococcal in infection in younger age group. Streptococcus pyogenes was isolated from patients who did not receive penicillin with failure to detect this organism in treated patients and the highest ASO titer coincided with the isolation of this organism in both patient and control groups

Prevalence of campylobacter SPPS in infantile diarrhoea in Cairo

A group of 84 infants below one year of age who attended Rehydration Clinic at Bab El-Shairia Teaching Hospital during the period from April to September, 2987 were included in the present study. It was reported, clinically, that those infants were having acute diarrhoea. 25 apparently healthy infants from a private nursery were included as a control group. Three rectal swabs were collected carefully to avoid contamination with bacteria from the anal skin and inoculated to Campylobacter selective medium and MacCondey's agar plates. The isolated organisms were identified by their culturing, microscopic and biochemical characteristics. Serological identification of some enterotoxigenic strains of Escherichia coli [ETEC] was done. Five isolates of Campylobacter jejuni [5.95%], three isolates of Shigella dysenteriae [3.57%], two of Salmonella spps. [2.38%] and 12 isolate of ETEC strains [14.29%] were isolated during the present study. None of the reported enteropathogens was isolated from the control group of infants

Shoulder pain in hemiplegia: a clinical experience with 102 patients

Shoulder pain is a frequent complication of hemiplegia. In this series, 102 hemiplegic patients were regularly followed up after their cerebrovascular accident for a period up to 12 months. They were 60 males and 42 females with a mean age 54 years. Evaluation of the shoulders of the patients was done before starting the rehabilitation programme. Distinction was made between flaccid and spastic hemiplegia. In this study, 62.7% of the patients had shoulder pain, more commonly encountered in those with spasticity [84.4%]. Soft tissue inflammation was present in 48.4% and reflex sympathetic dystrophy in 17.1% of the cases more in those with spasticity. Subluxation was demonstrated in 17.1% and associated of more than one local problem was encountred in 17.1% of the cases with painful shoulder. There was a significant correlation of shoulder pain and the degree of spasticity and the age of the patients