A review of the potential of medicinal plants in the management and treatment of male sexual dysfunction.

Male sexual dysfunction is a common disorder that appears to be a consequence of a wide range of physical and psychological conditions. Due to mental stress, insufficient physical exercise and various aetiological factors, human being's life is becoming less pleasant, which leads to incapability to have sexual pleasure. The allopathic drugs used for sexual dysfunction are believed to produce a variety of side effects and affect other physiological processes and, ultimately, general health. Therefore, the search for natural supplement from medicinal plants is being intensified probably because of less side effects availability and affordability. Ethnobotanical surveys have indicated a large number of plants traditionally used as aphrodisiacs but only few of them are scientifically validated for the management and treatment of male sexual dysfunction. This article has summarised the medicinal plants traditionally recommended and scientifically validated for the management and treatment of male sexual dysfunction.

Capsaicin delivery into the skin with lipidic nanoparticles for the treatment of psoriasis.

The study aims to explore the potential of solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) in improving the topical delivery of capsaicin (CAP) by in vitro and in vivo studies. The lipidic nanoparticles were prepared by solvent diffusion method and were characterized for average particle size, zeta potential and entrapment efficiency. TEM photomicrographs revealed that the particles were nanometric in size. Higher amount of CAP can be encapsulated in the NLCs (87.4 ± 3.28) as compared with SLNs (79.7 ± 2.93%). The cumulative amounts of CAP permeated through the skin and retained in the SC were higher in the case of NLCs as compared with plain drug solution and SLNs. SLNs and NLCs exhibited minimum to no irritation. All the results concluded that NLCs and SLNs have shown a good ability to increase drug accumulation in the various skin layers but NLCs may be a more potential carrier for topical delivery of CAP for an effective therapy of psoriasis.

Efficacy of Trikatrayadi Lauha in Panduroga with reference to Iron Deficiency Anemia.

The common nutritional deficiency, iron deficiency, causes Iron Deficiency Anemia (IDA) throughout the world especially in the developing countries. In Ayurveda, different herbal, mineral or herbomineral drugs have been emphasized to combat anemia (Panduroga). Trikatrayadi Lauha and Fersolate-CM (a modern medicine taken as standard control) were administered to the patients to evaluate their role in Panduroga. A simple random sampling method was followed for the clinical study. The 56 iron deficiency anemic patients of both sexes and age group between 16 to 70 years divided into two groups - Group-A (n=34) and Group-C (n=22) were treated with Trikatrayadi lauha and Fersolate-CM, respectively. Both drugs provided significant effect on the signs and symptoms of Shrama (fatigue), Shwasa (dyspnea on exertion), Daurbalya (weakness), Pandu Varna (pallor/yellowish-whitish), Hridspandana (palpitation), Hatanala (diminished digestive capacity), Bhrama (giddiness), Aruchi (anorexia), Arohana Ayasa (exhaustion during climbing), Shiroruja (headache) and Shotha (edema). Trikatrayadi Lauha provided significant results on Hb gm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and TIBC where as insignificant changes were found in MCH and MCHC. Fersolate-CM provided significant results on Hb gm%, RBC, PCV, MCV, MCH, serum iron, percent transferrin saturation and TIBC whereas insignificant change was found in MCHC. Trikatrayadi Lauha showed significant results on Panduroga and Iron Deficiency Anaemia (IDA).

Clinical efficacy of Shilajatu (Asphaltum) processed with Agnimantha (Clerodendrum phlomidis Linn.) in Sthaulya (obesity).

Obesity is defined as the condition in which excessive amount of fat is accumulated in the body. Classical Ayurvedic texts describe eight types of despicable designated as 'Nindita purusha' including atisthaulya. Corpulent people are characterized by short in longevity, slow movement, difficult to indulge in sex, weak, emission of bad body odor, profuse perspiration, excessive hunger and excessive thirst. Sixty to seventy percent of cardiac patients die of obesity and contribute to develop coronary artery disease, diabetes mellitus, hypertension, hyperlipidaemia. In the present study, 66 patients of obesity were treated with Shilajatu processed with Agnimantha. After complition of therapy, 5.09 ± 0.24 kg and 2.06 ± 0.10 kg/m(2) reduction of body weight and body mass index, respectively were noted. The result was found to be statistically highly significant (P<0.001). No adverse effects were observed in any of the treated patients.

A survey on etiopathological correlation of Krimi (intestinal helminths) and Pandu (anemia).

A survey study was aimed to find etiopathological status of intestinal helminths and also to accomplish its association with clinical condition Pandu. The survey samples included population of five schools and two localities in and around Jamnagar. The study was conducted on 337 subjects, of whom 36.20% cooperated to give stool samples to pathology laboratory; more than half of the samples surveyed were suffering with various parasitic infestations and one-third of the total subjects were found at risk to develop Pandu. Ascariasis patients were found in 71.14%, a potent cause of Pandu. Enterobius vermicularis was found in 19.05%, while Hymenolepisnana in 6.35%. 77.77% were in the age group of 10 to 20 years, 58.73% were male, 93.65% patients were Hindu, 80.95% of the patients had secondary level of education, dominancy of rural habitat was in 77.77%, and 39.68% each were from lower and lower middle class.

Randomized placebo-controlled trial of Mustadi Ghanavati in hyperlipidemia.

Hyperlipidemia is one of the major lifestyle disorders. Its role has been appreciated in the manifestation of serious diseases like ischemic heart disease, diabetes, stroke etc. These lifestyle diseases are a result of lifestyle factors such as overnutrition etc., which have been referred to as the Santarpanjanya Vyadhis in the classical texts. Mustadi Ghanavti is a modified form of the classical formulation Mustadi Kwath that has been advocated by Acharya Charaka for the management of Santarpanjanya Vikaras. This placebo-controlled randomized trial of Mustadi Ghanavati was carried out on 61 patients suffering from hyperlipidemia; of the 61 patients, 50 completed the entire course of treatment. The results of the study revealed that Mustadi Ghanavati decreased serum cholesterol by 22.4%, serum triglycerides by 19.6%, serum LDL by 18.2%, and serum VLDL by 4.2%; serum HDL increased by 5.6%. Thus Mustadi Ghanavati was able to effect a total improvement of 58.8% in the lipid profile. It brought about mild improvement in 42.86% of patients and moderate improvement in 14.28% of patients. Mustadi Ghanavati was also found to have a significant effect on other subjective as well as objective parameters considered for the study.

Clinical study on erectile dysfunction in diabetic and non-diabetic subjects and its management with Ficus relegiosa Linn.

Healthy sexual functioning plays an essential role in maintaining the harmony and happiness in marital life. It provides a media to express love, which is the base for all sorts of creative activities. The absence of this function hampers the marital relationship, leading to frustration and, sometimes, ending in divorce, and causes inadequacy in performing the routine duties. In this study, 53 patients having diabetes mellitus were surveyed to find out the incidence of erectile dysfunction (ED). Considering the high prevalence of the disease and the need to look for alternative medicine, a clinical trial on 44 patients of ED was carried out. These patients were divided into two main groups: diabetic and non-diabetic, and were further divided into two subgroups as trial group and placebo group. In the trial group, Ashvattha Kshirpaka prepared with 10 g powder of its root bark, stem bark, fruit and tender leaf buds was given twice a day. In both the diabetic and the non-diabetic subjects, Ashvattha provided encouraging results on ED as well as on seminal parameters in comparison to the placebo.

A clinical study on the role of ama in relation to Grahani Roga and its management by Kalingadi Ghanavati and Tryushnadi Ghrita.

Grahani and Agni are having Adhara-Adheya-Sambandha. Grahani is described as an Agni Adhishthana by most of the acharyas. Mandagni is a root cause of Ama Dosha and it is the crucial factor for manifestation of most of the diseases. Among them, Grahani is the prime disease of gastro-intestinal tract and seen often in day-to-day practice. A total of 66 patients were randomly divided in three groups and treated with: A) Kalingadi Ghanavati, three vatis of 500 mg twice daily with takra, B) Tryushnadi Ghrita, 10 g twice daily before meal with lukewarm water and C) Combination of both the drugs for 14 days. An assessment was done on the basis of Rogabala, Dehabala, Agnibala, and Chetasabala. The study revealed that combination proved better results than those of individuals.

STI management in Tanzanian private drugstores: practices and roles of drug sellers.

OBJECTIVES: To describe the role and possible contribution of private drugstores in sexually transmitted infection (STI) management in rural Tanzania. METHODS: A cross-sectional study that included drug sellers in private drugstores in eight districts of Tanzania. Data collected through interviews with drug sellers and the simulated client method presenting a male and female STI case. "QATI" scores (Questions, Advice, Treatment and drug Information) were developed to describe overall STI management. RESULTS: Although 74% of drug sellers stated that there were no STI-related drugs in the store, medications were dispensed in 78% of male and 63% of female simulated client visits. The clients were dispensed drugs recommended in the Tanzanian guidelines for syndromic management of urethral or vaginal discharge in 80% of male and 90% of female cases. Drug sellers dispensed antibiotics during 76% of male and 35% of female simulated client visits. Dosage regimens were often incorrect and complete syndromic management rarely provided. Most drug sellers agreed that it is within their professional role to give information on STI treatment (89%) and prevention (95%). Drug-use information was almost always provided. Advice was however seldom given and questions occasionally asked. Overall STI management was better for men than for women. CONCLUSIONS: The drug sellers, although aware of the prescription-only status of antibiotics, saw themselves as having a role in STI management and were ready to provide drugs. In this resource-limited setting, drug sellers could provide effective and safe STI management especially to male patients if given appropriate tools to improve practice. The consequences of this for official policy need to be discussed.

Biodisposition of PEG-coated lipid microspheres of indomethacin in arthritic rats.

Conventional lipid microspheres (LM) were prepared using soybean oil and lipid at a 5.5:1 weight ratio with lipid phase consisting of PC (phosphatidyl choline):CH (cholesterol) (1:0.5) by molar ratio. The average diameter of the particles was 150 nm. Long-circulating microspheres (S-LM) were also prepared similarly but the lipid phase consisted of PC:CH:DSPE-PEG (phosphatidyl choline:cholesterol:distearoyl phosphatidyl ethanolamine-polyethylene glycol) 1:0.5:0.16 by molar ratio. A comparative biodistribution study was conducted between free indomethacin and lipo-indomethacin (LM and S-LM) in the arthritic rats by administering the formulations at a dose equivalent to 12 mg of indomethacin/kg. It was observed that the free drug as well as the encapsulated drug followed biphasic clearance from the blood. Pharmacokinetic parameters, such as AUC(0-t), terminal half-life, MRT increased significantly when the drug was used in encapsulated form (p < 0.05). Clearance of the drug was reduced 1.4 times with the conventional lipid microspheres and was reduced three-fold when encapsulated in polyethylene glycol-coated lipid microspheres. The overall drug targeting efficiency (T(e)) with the PEG-coated lipid microspheres was 7.5-fold higher than the conventional lipid microspheres. The high accumulation of the drug in arthritic paw with S-LM system may be accounted for by the reduced uptake by RES cells, and thereby, availability for extravascularization in the inflammatory tissues.

The use of hyaluronidase in nasal infiltration: prospective randomized controlled pilot study.

A double-blind randomized prospective case-control pilot study was performed to assess tissue distortion caused by the infiltration of local anaesthetic to the dorsum of the nose and to see if this was altered by the addition of hyaluronidase. Forty patients undergoing nasal manipulation for fractured nasal bones were randomized to receive either 4 ml of two per cent lignocaine and adrenaline 1:200000 or 4 ml of two per cent lignocaine and adrenaline 1:200000 with 1500 IU hyaluronidase, which was infiltrated subcutaneously over the nasal dorsum. One surgeon using a standardized technique performed the nasal infiltration. Other outcome measures were ease of manipulation, adequacy of the reduction, patient satisfaction with cosmesis and patient analgesia requirements. There were trends for decreased tissue distortion and improved ease of manipulation in the hyaluronidase group. Larger trials are required to confirm these results.

Preparation and pharmacodynamic evaluation of liposomes of indomethacin.

The side effects of indomethacin, such as ulceration of the kidney and central nervous system (CNS) toxicity, limit its use as a drug for rheumatoid arthritis. Encapsulation of this drug in liposomes may reduce the toxic effects. The aim of this study was to determine the factors influencing encapsulation of indomethacin in liposomes and to determine anti-inflammatory potential of liposomal indomethacin. A series of liposomal formulations of indomethacin were prepared using various phospholipids. The effects of method of preparation, lipid composition, charge, and cholesterol (CH) on encapsulation of indomethacin in liposomes were investigated. A significant variation in encapsulation of the drug in liposomes was observed when prepared by different methods. With all the methods of preparation tried, the favorable lipid composition for high encapsulation of this drug was egg phosphatidyl choline:CH: stearlyamine (PC:CH:SA) at a 1:0.5:0.1 molar ratio. Inclusion of cholesterol did not affect the encapsulation efficiency of the drug in liposomes. The drug release profile from the liposomes was biphasic, and the highest percentage drug release was observed with large unilamellar vesicles (LUVs) (100 nm). Inclusion of stearylamine (PC:CH:SA 1:0.5:0.1) and phosphatidyl glycerol (PG) (PC:CH:PG 1:0.5:0.2) in the liposomes reduced the release of the drug in comparison to the neutral liposomes (PC:CH 1:1). The slow release of the drug from stearylamine-containing liposomes may be explained by the electrostatic interaction between the acid moiety of the drug and the amine moiety of the lipid. It is assumed that the possible hydrogen bonding between--OH groups of phosphatidyl glycerol and the--COOH group of the drug might be the reason for the slow release of the drug from PC:CH:PG (1:0.5:0.2) containing liposomes. Pharmacodynamic evaluation of the liposomes was performed by carrageenan-induced rat paw edema (acute) and adjuvant arthritis (chronic) models. The anti-inflammatory activity was increased from the first to fifth hour PC:CH:PG (1:0.5:0.2) and PC:CH:SA (1:0.5:0.1) liposomes showed the highest percentage inhibition of edema. In both these models, anti-inflammatory activity of liposomal indomethacin was significantly higher than that of free indomethacin (p < .01). The ulcer index of the free drug was about three times more than the encapsulated drug when administered at the same dose intraperitoneally to arthritic rats consecutively for 21 days.

Mind-body therapy in the management and prevention of coronary disease.

Conventional mind-body therapy has been proven a valuable noninvasive way to manage coronary disease. Yoga practice, especially, has been found to be valuable in preventing adverse outcomes of coronary disease by improving resistance to stress.

Multiple emulsion-based systems carrying insulin: development and characterization.

An insulin delivery system based on liquid surfactant membranes has been developed. The formulation was based on a w/o/w emulsion where an organic membrane separated two aqueous phases and the internal aqueous phase contained insulin. Sesame and cotton seed oils were used as organic membranes. In order to facilitate the transportation of glucose across the organic membrane various additives such as calcium stearate, lecithin, cholesterol, hexamine, stearic acid and glyceryl tristearate were used. The additives were found to be successful carriers for the transportation of glucose to the internal aqueous phase. Similarly, viscosity enhancers, e.g. cetostearyl alcohol, in the organic phase enhanced the immobilization of insulin. Various parameters affecting the stability of the emulsions were established. The developed system was characterized for insulin activity and insulin efflux profile.

A lymphotropic colloidal carrier system for diethylcarbamazine: preparation and performance evaluation.

Targeting to organs other than the RES-bearing organs is difficult to achieve. A nanoparticle-based emulsion delivery system was prepared and its efficacy in enhancing the lymphatic uptake of the anti-filarial drug diethylcarbamazine was evaluated. It was compared with a simple w/o emulsion and a control aqueous solution. The effect of route of administration on the lymphatic uptake was studied and it was found that the i.p. route gave better results as compared to the i.v. route, in which total lack of lymphatic uptake was observed. The nanoparticle-in-oil emulsion system holds excellent potential as a lymphotropic carrier system.

Induction of calbindin-D 28K gene and protein expression by physiological stimuli but not in calcium-mediated degeneration in rat PC12 pheochromocytoma cells.

To understand the role of calbindin-D 28K in neuronal degeneration, we examined its expression in differentiated PC12 cells in response to calcium intoxication, using the ionophore A23187 treatment, that results in cell degeneration and death. We first established that calbindin-D 28K is expressed in PC12 cells. The amounts of calbindin-D 28K mRNA and protein were increased by the differentiation factors, NGF and retinoic acid, but not by vitamin D3. Calbindin-D 28K expression was also significantly up-regulated by stimuli (depolarization, low concentrations of Ca2+ ionophore A23187) which increase intracellular calcium levels within the physiological range. In contrast, the calbindin-D 28K mRNA and protein concentrations were not modulated by high concentrations of A23187, which resulted in cell degeneration and death. Experiments with the antisense oligonucleotides showed that, although the calbindin-D 28K protein levels were decreased significantly, the progression of degenerative changes induced by calcium via A23187, was not altered.

Decreased choline acetyltransferase mRNA expression in the nucleus basalis of Meynert in Alzheimer disease: an in situ hybridization study.

The subnormal choline acetyltransferase (ChoAcTase) activity in the cerebral cortex of patients with Alzheimer disease (AD) is thought to originate from the loss of cholinergic neurons in the nucleus basalis of Meynert (nbM). To examine possible changes in the functional activity of the remaining cholinergic neurons in the nbM of patients with AD, the level of expression of ChoAcTase mRNA was evaluated. A procedure for double-labeling cholinergic neurons to detect ChoAcTase mRNA and the corresponding protein in the same cell was developed, taking advantage of an anti-ChoAcTase antibody and the recently isolated cDNA complementary to a sequence of the human ChoAcTase mRNA. In the study of three controls and four patients with AD, the presence of both ChoAcTase mRNA and protein was observed in the same large neurons in both nbM and putamen. Specificity of in situ hybridization was further supported by the absence of neuronal staining with a sense probe. In AD patients a subnormal level of expression of ChoAcTase mRNA per cholinergic cell was detected in the nbM but not in the putamen. Our data support the hypothesis that expression of ChoAcTase mRNA might be down-regulated in the surviving cholinergic neurons in the nbM of patients with AD, raising the possibility of functional restoration by stimulating ChoAcTase synthesis.

Toxic effects of iron for cultured mesencephalic dopaminergic neurons derived from rat embryonic brains.

Iron, a transition metal possibly involved in the pathogenesis of Parkinson's disease, was tested for its toxic effects toward cultures of dissociated rat mesencephalic cells. When cultures were switched for 24 h to serum-free conditions, the effective concentrations of ferrous iron (Fe2+) producing a loss of 50% of dopaminergic neurons, as quantified by tyrosine hydroxylase (TH) immunocytochemistry, TH mRNA in situ hybridization, and measurement of TH activity, were on the order of 200 microM. High-affinity dopamine (DA) uptake, which reflects integrity and function of dopaminergic nerve terminals, was impaired at significantly lower concentrations (EC50 = 67 microM). Toxic effects were not restricted to dopaminergic neurons inasmuch as trypan blue dye exclusion index and gamma-aminobutyric acid uptake, two parameters used to assess survival of other types of cells present in these cultures, were also affected. Protection against iron cytotoxicity was afforded by desferrioxamine and apotransferrin, two ferric iron-chelating agents. Normal supplementation of the culture medium by serum proteins during treatment was also effective, presumably via nonspecific sequestration. Potential interactions with DA were also investigated. Fe2+ at subtoxic concentrations and desferrioxamine in the absence of exogenous iron added to the cultures failed to potentiate or reduce DA cytotoxicity for mesencephalic cells, respectively. Transferrin, the glycoprotein responsible for intracellular delivery of iron, was ineffective in initiating selective cytotoxic effects toward dopaminergic neurons preloaded with DA. Altogether, these results suggest (a) that ferrous iron is a potent neurotoxin for dopaminergic neurons as well as for other cell types in dissociated mesencephalic cultures, acting likely via autoxidation into its ferric form, and (b) that the presence of intra- and extracellular DA is not required for the observed toxic effects.