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Objective: To evaluate the antidiabetic and anti-obesity potentials and the safety of a polyherbal remedy. Method: A mixture of polyherbal remedy containing Gymnema sylvestre, Garcinia cambogia, Cleome droserifolia, and Nigella sativa (100 or 200 mg/Kg, p.o.) was subjected to qualitative chemical identification for marker compounds on individual plant extracts using Q-TOF-LC-MS. In addition, the antidiabetic and antiobesity potential were evaluated in streptozotocin-induced diabetic rats using metformin (100 mg/Kg, p.o.) and insulin (10 U/Kg, IP) as standards. The evaluation based on fasting blood glucose level (FBG), insulin level, and change in body weight gain of different treatment groups. Furthermore, the safety profile was assessed by the measurement of certain biochemical, hematological, and histopathological parameters. Results: A total of thirteen marker compounds, (Gymnemoside ND1, Myricetin, Hydroxycitric acid lactone, Garcinol, Garcimangosone D, 5,3`-Dihydroxy-3,6,7,4`,5`pentamethoxyflavone, 5-Hydroxy-3,6,7,3`,4`,5`-hexamethoxyflavone, Magnoflorine, Kaempferol glycoside, Sapindoside B, Alpha-hedrin, Tauroside H2, and Thymoquinone) were identified in the four plant extracts individually. The administration of polyherbal remedy extract (100 or 200 mg/Kg, p.o.)-, metformin-, and insulin-treated diabetic rats resulted in a significant decrease in the FBG by 62, 67, 44 and 73 % respectively, and significant increase in insulin level by 2161, 3433, 2400 and 5658 %, respectively, as compared to vehicle-treated control. Regarding the body weight change, polyherbal remedy extract (100 or 200 mg/Kg, p.o.)-, metformin-, and insulin-treated animals demonstrated a significant decrease by 45, 54, 72 and 65%, respectively, as compared to their initial weight. The results of polyherbal remedy (100 or 200 mg/Kg, p.o.)-treated groups showed a dose-independent potency between that obtained from insulin-and metformin-treated groups. Concerning the safety profile; treatment with remedy extracts markedly improved the streptozotocin-induced alteration in the hepatic biochemical, and hematological indices (liver enzymes, total protein, albumin, TC, TG, HDL, LDL, RBCs count, WBCs count, Hb concentration and platelet count) besides preservation of the normal histopathological features of liver, kidney, and pancreas. Conclusion: The polyherbal remedy can be used as an effective and safe treatment of obesity, diabetes, and its complications.

Background: Hearing loss is considered to be one of the most common factors of moderate to severe disability specially in the developing countries. Ototoxicity is inner ear damage due to usage of chemical substances, which can lead to either reversable or permanent hearing loss and/or vestibular loss. Ototoxic hearing impairment can impact the quality of life by many ways; therefore, we should be very careful when it comes to choose drug therapy to minimize the risk. Aim of the work:To identify the commonly implicated ototoxic medications among the adult Egyptian population and to study its presenting features.Patients and Methods: This is a retrospective study, that involved review for the medical notes of all adult patients, who attended the Audio-Vestibular Unit with otological problems between January 2014 and December 2018. A total of 1110 medical folders were reviewed, and data were manually extracted. Results:The prevalence of ototoxic medication among the adult attendees was 26.6%. The most common manifestation was hearing impairment, as it was reported in 83.2% of the cases. Tinnitus came second by 70% followed by vertigo in 31%. Aspirin was the most common drug used [44.7%] of the patients, followed by aminoglycoside in 15% of our study sample, then the non-steroidal anti-inflammatory drugs [NSAIDS] in 14.3%. Conclusion:Audiometric screening is critical to capture the true prevalence of hearing loss. Baseline audiometric and vestibular function test should be performed before prescribing any ototoxic medication especially in patients with other associated risk factors.

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