No abstract

Sodium valproate (SV) is an antiepileptic drug that is widely used in the treatment of ‎different seizure disorders. The topical SV has a hair regenerative potential through activating the Wnt/β-catenin pathway and anagen phase induction‎. The aim of the current investigation was to fabricate nanospanlastics of SV for improving its dermal delivery by providing ‎prolonged drug effect and increasing its permeability ‎for treatment of androgenic alopecia (AGA). SV-loaded nanospanlastics were formulated according to 23 factorial design by ethanol injection method using a non-ionic surfactant (Span 60) and edge activators (EAs), such as Tween 80 and Cremophor RH 40, to explore the influence of different independent variables on entrapment efficiency (EE%) and percentage drug released after 12 h (Q12h) in order to choose the optimized formula using Design-Expert software. The optimized formula (F8) appeared as spherical deformable vesicles with EE% of 90.32 ± 2.18% and Q12h of 90.27 ± 1.98%. F8 exhibited significant improvement of ex vivo permeation than free SV. The clinical study exhibited no comparable difference between F8 and marketed minoxidil lotion. However, F8 demonstrates less adverse effects than minoxidil lotion. Nanospanlastics could be a safe and effective method for improving the topical delivery of SV in the management of AGA.

Gut microbiota is mainly composed of four phyla; however, the human gut microbiota is dominated by only 2 of them and most of them are uncultivable. Psoriasis is an inflammatory skin disorder with associated inflammation of internal organs and musculoskeletal system. This study aimed to, identify numerically abundant bacteria phyla in fecal samples of patients with psoriasis, evaluate whether differences in fecal microbiota correlate with the occurrence of psoriasis and understand the possible pathogenesis behind psoriasis-related bacterial targets. From April, 2015 to 2016, 90 adults were selected prospectively to allocate 2 equal groups: Gr1 (45 cases) patients with psoriasis, and Gr2 (45 cases) healthy controls. Psoriasis Area and Severity Index (PASI) for each psoriasis patient was detected. All subjects were subjected to history taking, clinical examination, and fecal real time polymerase chain reaction (PCR) testing for the Firmicutes, Bacteroidetes, and Actinobacterial phyla. In both groups, Firmicutes were the most common detected phylum followed by Bacteroidetes and finally Actinobacterial phyla. High statistically significant difference was reported for the Firmicutes/ Bacteroidetes ratio between the psoriasis patients and the control group and showed statistically significant positive correlations with PASI. Actinobacterial count was significantly higher in the control group than in psoriasis patients and showed statistically significant negative correlations with PASI. It is believed that, there are fractions of the gut microbiota with the ability to counteract inflammation (Bacteroidetes and Actinobacterial), and others that are more prone to induce inflammation (Firmicutes) and the disturbed microbiome ratio may be the cause for inducing psoriasis.

Graphical abstract

This trial aimed to assess the efficacy of on‐demand oral dapoxetine versus topical lidocaine treatments for lifelong PE. Cases with lifelong PE were randomised to start treatment by oral dapoxetine 60 mg or topical lidocaine 10% spray. The intravaginal ejaculatory latency time (ILET), validated Arabic Index for PE (AIPE), Sexual Health Inventory for Men (SHIM) and frequency of intercourse/week were recorded at the baseline and after 12 weeks treatment period of the first medication before two weeks washout period and then crossing over to the other one for another 12 weeks. Results showed that both medications significantly increased both IELT and AIPE scores compared with the baseline being significantly better with topical lidocaine (63.44 s, 179.4 s versus 21.87 s, p < .05). Significant decrease of SHIM score was recorded with lidocaine but not with dapoxetine. Global Efficacy Question for the patient's assessment of the effectiveness of drugs showed that lidocaine was described as being effective by 43 cases and ineffective by 12 cases, oral dapoxetine was described as being effective by 16 cases and ineffective by 39 cases. From these accumulated data, it is concluded that topical lidocaine is more effective on‐demand therapy for lifelong PE compared with oral dapoxetine.