Teucrium polium hexane extract downregulated androgen receptor in testis and decreased fertility index in rats.

Teucrium polium L. (Lamiaceae) is a commonly used medicinal plant in folk medicine. Among several uses, T. polium is used to treat male fertility problems. This research was conducted to study the effect of T. polium on spermatogenesis, testosterone level, androgen receptor expression, and fertility in male rats. Administration of hexane extract for 6 days to aging rats increased testosterone level. When administered for 60 days, T. polium hexane extract downregulated androgen receptors, decreased sperm count without producing histological changes in different stages of spermatogenesis. Also, fertility index decreased without making teratogenic effects when treated males were mated with untreated females on the 55th day of extract administration. Therefore, the downregulation of androgen receptor could be due to the continued elevation in testosterone level over time. In conclusion, this study suggests that the prolonged use of T. polium in folk medicine may negatively affect male fertility.

Is the use of plants in Jordanian folk medicine for the treatment of male sexual dysfunction scientifically based? Review of in vitro and in vivo human and animal studies.

Male sexual dysfunction is a serious problem which has an impact on the quality of life. In Jordanian folk medicine, 56 plant species were reported to be used by males to improve sexual potency and as aphrodisiacs. The aim of this study was to search for scientific evidence justifying their folk use. Of the 15 studied plants, only five were found to enhance spermatogenesis. The other 10 were reported to decrease spermatogenesis at least by one study. The majority of the studied plants possessed a protective effect on testis in different in vivo models as well as antioxidant activities. The effect of these plants on steroidogenesis and the hypothalamic-gonadal axis was also reviewed. The effect of only five plants was studied on sexual behaviour enhancement and three of them were active. Three of the four studied plants enhanced erection. The mechanism of action of active constituents isolated from the studied plants was also investigated. In conclusion, many plants used in Jordanian folk medicine decreased or had no effect on spermatogenesis in animal models. These plants have antioxidant and/or adaptogenic effects, and this may result in a beneficial action on male reproductive system.

Greater occipital nerve block using local anaesthetics alone or with triamcinolone for transformed migraine: a randomised comparative study.

OBJECTIVE: To determine whether adding triamcinolone to local anaesthetics increased the efficacy of greater occipital nerve block (GONB) and trigger-point injections (TPIs) for transformed migraine (TM). METHODS: Patients with TM were randomised to receive GONB and TPIs using lidocaine 2% and bupivacaine 0.5% + either saline or triamcinolone 40 mg. We assessed the severity of headache and associated symptoms before and 20 minutes after injection. Patients documented headache and severity of associated symptoms for 4 weeks after injections. Changes in symptom severity were compared between the two groups. RESULTS: Thirty-seven patients were included. Twenty minutes after injection, mean headache severity decreased by 3.2 points in group A (p<0.01) and by 3.1 points in group B (p<0.01). Mean neck pain severity decreased by 1.5 points in group A (p<0.01) and by 1.7 points in group B (p<0.01). Mean duration of being headache-free was 2.7+/-3.8 days in group A and 1.0+/-1.1 days in group B (p = 0.67). None of the outcome measures differed significantly between the two groups. Both treatments were well tolerated. CONCLUSIONS: Adding triamcinolone to local anaesthetics when performing GONB and TPIs was not associated with improved outcome in this sample of patients with TM.

Laparoscopic-assisted resection of bleeding jejunal leiomyoma.

Laparoscopic-assisted resection has shown remarkable improvements in the treatment of small bowel diseases, notably the leiomyomas. This case report documents the successful removal of a bleeding jejunal leiomyoma with the aid of laparoscopy. A 51-year-old man was admitted to the hospital twice within 3 months with melena. On the first admission, upper and lower gastrointestinal endoscopy were negative, and small bowel enema was inconclusive. On the second admission, Technetium-99 Red Blood Cells (Tm-99 RBC) scan showed dye extravasation (interpreted as from the left colon). Subsequent colonoscopy was normal, as was a barium enema. An elective superior mesenteric angiography revealed a benign-looking jejunal leiomyoma. Subsequent CT (intravenous contrast scan) revealed a 4.6 x 3.5 cm mass with neither extraluminal infiltration nor enlarged lymph nodes. The patient underwent successful laparoscopic-assisted resection of the leiomyoma and enjoyed an uneventful postoperative recovery. Subsequent histopathology confirmed the diagnosis. The diagnosis of small bowel leiomyoma is generally difficult because the conventional radiographic methods are unhelpful. These tumors are therefore best detected preoperatively with superior mesenteric angiography. Repeat of the noninvasive tests is strongly indicated if they are initially negative. Once discovered, small bowel leiomyoma should be resected to avoid catastrophic complications. Thereafter, it has an excellent prognosis. In this context, minimal-access surgery is a safe and approachable method to deal with such a problem.