Response to different medical treatment options for mastalgia in fibrocystic breast disease

Background: Fibrocystic breast disease is the most common type of benign breast disease and mastalgia is the most common symptom of fibrocystic breast disease. Various types of medical management are given as a gold standard treatment for that. The aim of this study was to compare the effects of different commonly used medical management options of mastalgia of fibrocystic breast disease on the quality of life of patients and their side effects as well. Methods: This quasi-experimental study was carried out in Out-patients Department of General Surgery, BIRDEM General Hospital, Dhaka, from July 2018 to June 2019. Total 45 patients with fibrocystic breast disease were selected according to the eligibility criteria and were allocated to two groups by alternative random selection. In non-pharmacological treatments receiving group, lifestyle modification advices along with evening primrose oil were given. On the other hand, in pharmacological treatment receiving group, bromocriptine and danazole were given according to some selection criteria of the patients. Response of treatments to each group and side effects were determined at one month, three months and six months follow-up respectively. Mastalgia was measured by visual analogue scale (VAS) score and quality of life was calculated by modified WHO-QOL scoring in each follow-up. Results: Patients had an average age of 30.24±6.93 years with a majority in the age group 31-35 years (33.3%). Most patients were married (64.4%), housewives (62.20%), from middle-class groups (62.20%), multiparous (57.78%) and the majority had absence of the family history of breast diseases (84.45%). Majority of them presented with cyclical mastalgia (57.78%), bilateral mastalgia (60%) and mastalgia with lumpiness (44.4%). Among the patients who received non-pharmacological treatment, mastalgia improved in 34.78% cases and patients received pharmacological treatment, mastalgia improved in 72.73% cases. Different domains of quality of life were improved significantly in patients who received pharmacological treatment. Though majority of the patients had side effects due to pharmacological treatment, they were well tolerated. Conclusion: Despite having various side effects, pharmacological management by danazol or bromocriptine was well tolerated to our patients and a dramatic improvement was observed on quality of life than the nonpharmacologically treated patients. BIRDEM Med J 2022; 12(1): 22-29

Synergistic Effects of Korean Red Ginseng Extract and the Conventional Systemic Therapeutics of Atopic Dermatitis in a Murine Model

The synergistic effects of Korean Red ginseng (KRG, Panax ginseng C.A. Mey.) on conventional systemic therapeutics of atopic dermatitis (AD) have not been studied yet. To analyze the synergistic effects of KRG extract and the conventional systemic therapeutics of AD in TNCB-induced AD mouse model, we determined the change in modified scoring of index, the transepidermal water loss, the skin pathology, serum IgE, and the expression of various cytokines after combination treatment to the five-week-old NC/Nga female mice. The severity of AD was significantly decreased in the KRG + hydroxyzine (AH) group than AH group, and in the KRG + evening primrose oil (EPO) group than EPO group. A significant decrease in dermal inflammation was observed in the KRG + AH group than that in the AH group, and in the KRG + EPO group than that in the EPO group (p = 0.008), respectively. A decrease in CD1a expression was observed in the KRG + AH group when compared to the AH group (p = 0.008), and KRG + EPO group when compared to the EPO group. Compared to the CS group, the KRG + CS group showed a significant decrease in IL-17 expression. A combination of KRG and conventional systemic therapeutics can safely and effectively manage the AD.

Herbal Products Used in Menopause and for Gynecological Disorders

Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms and gynecological disorders (such as premenstrual syndrome and dysmenorrhea) are the indications where pharmacological therapy may have serious adverse events, hence many women prefer to use herbal products to help with these symptoms. Here, we reviewed plants and derived products, which are commonly used for the abovementioned indications, focusing on clinical data, safely profile and whether or not their use is justified. We noted that limited data are available on the use of some plants for alleviating the symptoms of menopause and gynecological disorders. While black cohosh (Cimicifuga racemose) and red clover (Trifolium pretense) were consistently shown to help reduce menopausal symptoms in clinical studies, currently available data do not fully support the use of fenugreek (Trigonella foenum-graecum), hops (Humulus lupulus), valerian (Valeriana officinalis), and soybean (Glycine max and Glycine soja) for this indication. For premenstrual syndrome and premenstrual dysphoric disorder, chaste tree (Vitex agnus-castus) shows effectiveness, but more clinical studies are needed to confirm such effect upon the use of evening primrose (Oenothera biennis).

Comparative Analysis of Complete Chloroplast Genomes of 13 Species in Epilobium, Circaea, and Chamaenerion and Insights Into Phylogenetic Relationships of Onagraceae

The evening primrose family, Onagraceae, is a well defined family of the order Myrtales, comprising 22 genera widely distributed from boreal to tropical areas. In this study, we report and characterize the complete chloroplast genome sequences of 13 species in Circaea, Chamaenerion, and Epilobium using a next-generation sequencing method. We also retrieved chloroplast sequences from two other Onagraceae genera to characterize the chloroplast genome of the family. The complete chloroplast genomes of Onagraceae encoded an identical set of 112 genes (with exclusion of duplication), including 78 protein-coding genes, 30 transfer RNAs, and four ribosomal RNAs. The chloroplast genomes are basically conserved in gene arrangement across the family. However, a large segment of inversion was detected in the large single copy region of all the samples of Oenothera subsect. Oenothera. Two kinds of inverted repeat (IR) region expansion were found in Oenothera, Chamaenerion, and Epilobium samples. We also compared chloroplast genomes across the Onagraceae samples in some features, including nucleotide content, codon usage, RNA editing sites, and simple sequence repeats (SSRs). Phylogeny was inferred by the chloroplast genome data using maximum-likelihood (ML) and Bayesian inference methods. The generic relationship of Onagraceae was well resolved by the complete chloroplast genome sequences, showing potential value in inferring phylogeny within the family. Phylogenetic relationship in Oenothera was better resolved than other densely sampled genera, such as Circaea and Epilobium. Chloroplast genomes of Oenothera subsect. Oenothera, which are biparental inheritated, share a syndrome of characteristics that deviate from primitive pattern of the family, including slightly expanded inverted repeat region, intron loss in clpP, and presence of the inversion.

A PROSPECTIVE STUDY TO COMPARE THE EFFICACY OF THREE TREATMENT MODALITIES ON BENIGN BREAST DISEASE VIZ. EVENING PRIMROSE OIL (EPO), DANAZOLAND CENTCHROMAN

Background: Breast pain among women, with or without lump is common complaint and a cause of signicant anxiety and fear of breast cancer. Breast feeding is additionally one of the reasons for non-cyclic pain, brocystic breast disease is otherwise called broadenosis. Material and Methods:This is prospective study in the Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar. Conclusion: Centchroman is a selective anti estrogen effective in the treatment of brocystic disease. Centchroman is effective in reducing the sizes of breast lumps, providing relief from mastalgia and in curing cyclical and noncyclical breast pain in the premenopausal women.

Effect of Evening Primrose (Oenothera biennis) Oil Cake on the Properties of Polyurethane/Polyisocyanurate Bio-Composites

Rigid polyurethane/polyisocyanurate (RPU/PIR) foam formulations were modified by evening primrose (Oenothera biennis) oil cake as a bio-filler in the amount of 5 to 50 wt.%. The obtained foams were tested in terms of processing parameters, cellular structure (SEM analysis), physico-mechanical properties (apparent density, compressive strength, brittleness, accelerated aging tests), thermal insulation properties (thermal conductivity coefficient, closed cells content, absorbability and water absorption), flammability, smoke emission, and thermal properties. The obtained results showed that the amount of bio-filler had a significant influence on the morphology of the modified foams. Thorough mixing of the polyurethane premix allowed better homogenization of the bio-filler in the polyurethane matrix, resulting in a regular cellular structure. This resulted in an improvement in the physico-mechanical and thermal insulation properties as well as a reduction in the flammability of the obtained materials. This research provided important information on the management of the waste product from the edible oil industry and the production process of fire-safe RPU/PIR foams with improved performance properties. Due to these beneficial effects, it was found that the use of evening primrose oil cake as a bio-filler for RPU/PIR foams opens a new way of waste management to obtain new “green” materials.