BackgroundMelasma is an acquired increased pigmentation of the skin characterized by symmetrical and confluent grey-brown patches usually on the areas of the face exposed to the sun. Silymarin strongly prevents photocarcinogenesis, and significantly prevented melanin production. The objectives of this study were the assessment of safety and efficacy of topical Silymain (SM) cream in a double-blind placebo controlled study for treatment of melasma patients.MethodsExperimentally on 24 Albino rabbits were randomly divided into 4 equal groups. [A] No treatment, [B] received placebo, [C] treated with SM cream (0.1), & [D] treated by SM (0.2), were applied topically before UV sun light exposure for 30 days, assessed clinically & tissue pathology. Clinically on 96 adults diagnosed with melasma randomized to three equal groups to receive one of the tested drugs applied twice daily for 4 weeks, evaluated by the response; lesion size, melasma area and severity index score, Physician global assessment, and subjective assessment.ResultsThe Clinical and histopathology observations were reduced significantly in SM groups. Clinically; all patients showed significant excellent pigment improvement & lesion size reduction with SM treatments from the 1st week. All patients were fully satisfied 100%. No side effects were observed.ConclusionsSilymarin showed tremendous improvement of melasma in a dose-dependent manner, and was effective in prevention of skin damage caused by U.V. sunlight. It is a safe new candidate effective treatment for melasma.Trial registrationAustralian New Zealand Clinical Trials Registry - ACTRN12612000602820

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One of the most common and deadly diseases is tuberculosis, which has been known to be originated in ancient times. The assessment of the effectiveness of treatment regimens involves the monitoring of adverse events and the estimation of biomarkers. Serum biomarkers: Chemokine, Hematology, Liver function tests, and Kidney function tests were studied in forty tuberculosis patients of pulmonary and extra-pulmonary with its correlation. The monitoring and follow-up were assessed for the presence of any adverse effects, and compliance to treatment by Isoniazid 300 mg/kg, and Rifampicin 600 mg/kg during the study period. A significant difference was recorded between pulmonary and extra-pulmonary patients of the serum chemokine CXCL8 after one and two months of the treatment. The serum CXCL8 was increased in pulmonary and decreased in extra-pulmonary TB patients. The conclusion of this study described that chemokines play a role in mediating an effective immune-modulatory role during the treatment of TB infection and the therapeutic drug monitoring for compliance with TB treatment. A significant difference was noticed in the levels of liver enzymes (AST and ALT) between pulmonary and extra-pulmonary tuberculosis. Kidney function parameters showed a difference in creatinine levels between the two studied groups.

Purpose: Therapeutic drug monitoring is used to prevent or decrease the risk associated with the toxic effects of medication. This study aims to evaluate the potential advantages of Therapeutic Drug Monitoring (TDM) of subcutaneous Deferoxamine injection and prevention of clinical problems in β-thalassaemia major patients. Patients & Methods: Fifty-four thalassemia patients were allocated into two groups; missing, and not missing deferoxamine dose. TDM of Deferoxamine injection and its clinical outcomes were critically studied under the following subheadings: assessment of the adequacy of Deferoxamine usage, serum peak and trough concentrations of Deferoxamine and ferroxamine with needed pharmacokinetics, cardiac parameters and biomarkers, biochemical and hematological indices, adverse effects/ toxicity, urinary assessment of Fe, Zn, selenium, and copper levels, compliance to treatment, dose adjustment in correlation to therapeutic index and life style. Results: Demographic data showed no significant difference. Peak plasma concentrations were 144.83 ± 69 and 43.54 ± 39.16 µg/L, while trough concentrations were 33 ± 26.32 and 31.13 ± 21.58 µg/L of Deferoxamine and ferroxamine, respectively. The elimination rate constant was 0.0237 ± 0.00029 min −1 , half-life was 34 min, and distribution volume was 0.93 ± 0.078. Although cardiac parameters showed no significant differences, there were significant differences in CK-MB, and hsCRP levels; troponin I value could not be detected. Biochemical and hematological studies showed significant differences in Ferritin B, urea, SGPT, SGOT, alkaline phosphatase, serum albumin and serum calcium. Assessment of adverse effects/toxicity showed significant differences. The correlation of serum ferritin to therapeutic index, and the life style including Vitamin C and/or E administration were assessed for the compliance to treatment. Conclusion: Therapeutic monitoring of chelation therapy by Deferoxamine in β-thalassemia patients is necessary to ensure effective treatment, compliance, and to avoid adverse side effects and toxicity.