Prospective study to evaluate the clinical outcome of intralesional interferon-α2b in the management of Peyronie's disease.

CONTEXT: Interferon (IFN)-α2b in Peyronie's disease (PD). AIMS: This study aims to evaluate clinical efficacy of the IFN-α2b in both subjective and objective manner for the treatment of PD and compared with previously used intralesional verapamil in terms of cost-benefit analysis. SETTINGS AND DESIGN: Prospective study. MATERIALS AND METHODS: A prospective study conducted from January 2013 to July 2016 in the Department of Urology, Government Medical College, Kota, Rajasthan, India. We included patients with identifiable Peyronie's plaque with or without pain, curvature ranging between 30 and 90 degrees. We excluded patients with a calcified plaque and the ventral location of the plaque, any infective foci over the penis, erectile dysfunction due to other etiologies and patients who had received previous intralesional therapy. Patients were evaluated by clinical history, physical examination including plaque location, size, consistency, and penile curvature. Patients received intralesional IFN-α2b in a dose of 3 × 106 IU. Patients completed the visual analogue pain (VAS) score for pain, and International Index of Erectile Function-5 (IIEF-5) questionnaire at first visit as well as at follow-up of 1 month and 3 months. STATISTICAL ANALYSIS USED: Comparisons were performed using the paired Student's t-test and Chi-square tests as appropriate. Patient's objective and subjective clinical characteristics were described as a means (standard deviation). RESULTS: We included 86 patients in this study. Patients had a mean age of 48.6 years, mean plaque volume 256 mm3, and disease duration of 15.2 years. After 1 month of treatment, there was a significant change in plaque volume 256-60.8 mm3; P < 0.01) and penile curvature 34.8-24.6°; P < 0.01). The patients reported significant improvement in pain score VAS and IIEF-5. CONCLUSIONS: IFN-α2b, as minimal invasive (intralesional) options for the treatment of PD, demonstrated significant improvement in plaque volume, penile curvature with minimal complications. Patients subjectively reported significant improvement in pain on erection and sexual activities. IFN-α2b and verapamil had an almost similar clinical outcome, but verapamil at much lower cost.

Protective effects of Phyllanthus acidus (L.) Skeels leaf extracts on acetaminophen and thioacetamide induced hepatic injuries in Wistar rats.

OBJECTIVE: To investigate and compare the hepatoprotective effects of crude ethanolic and aqueous extracts of Phyllanthus acidus (L.) Skeels (P. acidus) leaves on acetaminophen (APAP) and thioacetamide (TAA) induced liver toxicity in wistar rats. Silymarin was the reference hepatoprotective agent. METHODS: In two different sets of experiments, the P. acidus extracts (200 and 400 mg/kg, body weight) and silymarin (100 mg/kg, body weight) were given orally for 7 days and a single dose of APAP (2 g/kg, per oral) or TAA (100 mg/kg, subcutaneous) were given to rats. The level of serum aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin and total protein were monitored to assess hepatotoxicity and hepatoprotection. RESULTS: APAP or TAA administration caused severe hepatic damage in rats as evident from significant rise in serum AST, ALT, ALP, total bilirubin and concurrent depletion in total serum protein. The P. acidus extracts and silymarin prevented the toxic effects of APAP or TAA on the above serum parameters indicating the hepatoprotective action. The aqueous extract was found to be more potent than the corresponding ethanolic extract against both toxicants. The phenolic and flavonoid content (175.02±4.35 and 74.68±1.28, respectively) and 2,2-diphenyl-1-picrylhydrazil (DPPH) [IC(50) = (33.2±0.31)µg/mL] scavenging potential was found maximum with aqueous extract as compared to ethanolic extract. CONCLUSIONS: The results of present study suggests that the aqueous extract of P. acidus leaves has significant hepatoprotective activity on APAP and TAA induced hepatotoxicity, which might be associate with its high phenolic and flavonoid content and antioxidant properties.

Effects of Phyllanthus acidus (L.) Skeels fruit on carbon tetrachloride-induced acute oxidative damage in livers of rats and mice.

OBJECTIVE: The present study was undertaken with a view to validate the traditional use of Phyllanthus acidus (L.) Skeels fruit as a hepatoprotective agent. METHODS: The 70% ethanolic extract of P. acidus fruit (100, 200 and 400 mg/kg, p.o.), and reference drug silymarin (100 mg/kg, p.o.) were given to rats of different groups respectively once a day for 5 d and the carbon tetrachloride (CCl4) (2 mL/kg, subcutaneously) was given on days 2 and 3. Serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin (TB) and total protein (TP) were assessed along with liver histopathological examination. The effects on oxidative stress markers such as lipid peroxidation (LPO), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were also assessed in liver tissue homogenate to evaluate in vivo antioxidant activity. In addition, the effects on hexobarbitone-induced sleeping time were observed and the free radical-scavenging potential was determined by using 2, 2-diphenyl-1-picrylhydrazil (DPPH) in mice. RESULTS: P. acidus extracts and silymarin exhibited a significant hepatoprotective effect as evident from the decreases of serum AST, ALT and ALP levels and LPO and increases in the levels of TP, GSH, SOD, CAT, and GPx compared with control group (P<0.01 or P<0.05). The biochemical results were supplemented with results of histopathological sections of the liver tissues. P. acidus extracts considerably shortened the duration of hexobarbitone-induced sleeping time in mice compared with control group (P<0.01) and showed remarkable DPPH-scavenging activity. CONCLUSION: The present findings suggest that the hepatoprotective effect of P. acidus against CCl4-induced oxidative damage may be related to its antioxidant and free radical-scavenging potentials.