The efficacy and safety of intracavernosal alprostadil was evaluated for the treatment of erectile dysfunction in men with type I or type II diabetes mellitus. This was an open-label, flexible doseescalating study involving 336 men (77% of whom were Asian=Oriental) enrolled by 15 centres in Australia, Canada and seven countries in Asia. The effective alprostadil dose, ie the dose producing penile rigidity adequate for intercourse and lasting up to 60 min, was established by titration at the clinic prior to entry into the 6 month self-treatment home phase. All men were fully trained in the self-injection technique before entry into the home phase. Efficacy and safety were assessed using patient and partner diaries and by interview at clinic visits during the titration phase and after 1, 3 and 6 months of treatment. An effective home dose was established by titration for 94% of the 336 men (median dose 20 mg, range 2.5 -60 mg). Of 278 (83%) men who entered the home phase, 277 men (247 with type II diabetes and 30 with type I diabetes) had evaluable data for alprostadil dosage and clinical response. During the home phase, a satisfactory erectile response was achieved after 99% of injections, and the median alprostadil dose remained unchanged. The initial home dose and clinical response were similar in type I and type II diabetic men. Treatment was generally well tolerated with a low incidence of penile pain (24%) In conclusion, intracavernosal alprostadil was effective and well tolerated in type I and type II diabetic men with erectile dysfunction of mixed aetiology.

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Tujuan Membandingkan kadar IL-10 pada pasien sindrom koroner akut (SKA) dan pasien dengan penyakit jantung koroner (PJK).

Background:The standard treatment for multiple myeloma (MM) which ineligible transplant is melphalan prednisone (MP). Curcumin has anti‐inflamatory, anti angiogenesis, decrease proliferation and delay progression of monoclonal gammopathy undetermined significant or smoldering myeloma. There is no study of curcumin in MM patientsAims:To evaluate the effect of curcumin addition to remission status at MM patient with regiment MPMethodsThis experimental study was involved 35 patients which randomly into treatment (n = 17) and control (n = 16). The treatment group was given melphalan 4 mg/m2, prednisone 40 mg/m2 (MP) for 7 days and curcumin 8 gram daily for 28 days. The control group was given MP and placebo. Remision status was evaluated after 4 cycles treatment. The difference between two groups was analysed by Mann‐Whitney U‐Test. Trend analysis was evealuated by Friedman. Remission status was evaluated by Chi‐square. Multivariate analysis was evaluated by multiple logistic regression.Results:There was a significant decrease of NF‐KB, VEGF, TNF‐α, LDH levels in the treatment group compared with control. There was a decreasing trend of IL‐6 levels in the treatment group significantly. There was significant difference of remission status beetween the treatment and control group [(75 vs 33.3), X2 = 6.89,df = 1, p = 0.009]. There was significant correlation between TNF‐α levles and remission status [OR = 1.35; (95% CI = 1.03‐1.7.6), p = 0.03].Summary/Conclusion:The curcumin addition on MM patient with MP regiment improved the remision status through decreased of TNF‐α levels.