Over-the-Counter Herbal Weight Loss Supplements in Egypt: Label Claim, Microbiological and Pharmaceutical Quality, and Safety Assessments

Pharmaceutical Polygon Fingerprinting Matrix System (PharmP-FM): A Potential Tool for Pharmaceutical Quality Control

Background & Purpose A new discriminatory system for evaluating the quality of pharmaceuticals is described in this paper as the Pharmaceutical Polygon Fingerprint Matrix system (PharmP-FM). To assess the quality of various pharmaceutical formulations and dosage forms, PharmP-FM uses both qualitative and quantitative fingerprinting techniques. The system expands on the SeDeM expert system, which was initially created to evaluate the suitability of powder for direct compression. PharmP-FM creates a graphical representation of the product's pharmaceutical quality using a set of input parameters. The Performance Index (PI), Normalized Parameter Index (NPI), and Formulation Index (FI) are among the system's output parameters. Methods To evaluate PharmP-FM's performance, the paper examines its application in assessing batch-to-batch variability of weight loss supplement capsules and the quality of multisource brand products of levothyroxine tablets. The findings demonstrate PharmP-FM's capability to identify variations in pharmaceutical quality across these products. Results & Conclusion This paper concludes that PharmP-FM exhibits potential promise as a pharmaceutical quality assessment tool. Its user-friendly nature and adaptability to different formulations and dosage forms make it a versatile discriminatory system. Additionally, PharmP-FM is an open-ended and scalable system that can incorporate additional parameters and accommodate products of varying complexities. The study's results strongly suggest its potential as a potential tool for pharmaceutical quality assessment.

Effects of blended microbial feed additives on performance, meat quality, gut microbiota and metabolism of broilers

The present study investigated the effects of blend microbial feed additive (BMFA) in diet on performance, meat quality, gut microbiota and metabolism of broilers. In this study 240 seventy-day-old female Wenchang broilers were randomly allocated into four groups with five replicates of 12 broilers each. Broilers in the control group was fed only basal diet (S0), and the other three groups were fed the same basal diet supplemented with 0.2% (S1), 0.4% (S2), or 0.6% (S3) of BMFA, respectively. The trial continued for 54 days. The results showed that broilers in S2 and S3 had lower average daily feed intake (ADFI) compared with S0 and S1 (P < 0.05). However, diet supplementation with BMFA had no significantly influence on the average daily gain (ADG) and the ratio of ADFI to ADG (F/G) (P > 0.05). The highest thigh muscle percentage was observed in S2 (P < 0.05) among all groups. Diet supplementation with BMFA reduced the shear force in both breast and thigh muscles (P < 0.05) of broilers. An increase (P < 0.05) in the total unsaturated fatty acid (USFA), monounsaturated fatty acids (MUFA), and ratio of unsaturated fatty acids to saturated fatty acid (USFA/SFA) in breast muscles was observed in S3 compared with S0. It was found that the S3 had a relatively higher abundance of Lactobacillus (P < 0.001), as well as a lower abundance of the Bacteroides, Rikenellaceae RC9 gut group, Olsenella, Prevotellaceae UCG-001 and Prevotella (P < 0.05) than the S0. Correlation analysis indicated that a total of 17 differential metabolites between the S3 and S0 were significantly correlated with the 7 differential genera microflora. Overall, diet supplementation with 0.6% of BMFA can significantly improve the meat quality of broilers by decreasing the concentration of SFA and enhancing the levels of the total USFA, MUFA and USFA/SFA in breast muscles. Those findings were tightly bound to the higher proportion of Lactobacillus genus in the intestinal tract of broilers influenced by BMFA.

Adulteration of Weight Loss Supplements by the Illegal Addition of Synthetic Pharmaceuticals

Weight loss supplements that have illegal additives of pharmaceutical drugs or analogues have additional health risks, and customers may not be aware of what they are taking. This research is an essential investigation and quantification of illegally added pharmaceuticals or prescription medications, specifically fluoxetine, phenolphthalein, and sibutramine, in herbal weight loss supplements offered for sale in the United Arab Emirates (UAE). In this case, 137 weight loss supplements were collected and analyzed in this study. Reversed-phase high-performance liquid chromatography with UV absorption detection coupled to tandem mass spectrometry (RP-HPLC-MS/MS) analyses were used to determine the presence of the pharmaceutical chemicals. Among the weight loss supplements, 15.3% (95% CI: 9.2-21.4) contained undeclared sibutramine, 13.9% (95% CI: 8.01-19.7) contained undeclared phenolphthalein, and 5.1% (95% CI: 1.4-8.8) contained undeclared fluoxetine. Amongst all weight loss supplements, 17.5% (95% CI: 11.07-24) contained significant concentrations of either sibutramine, phenolphthalein, or fluoxetine. Whilst weight loss herbal supplements offered for sale in the UAE have relatively low percentages of undeclared pharmaceuticals, many people take several different supplements daily and may encounter quite high levels of combined exposure to toxic compounds.

Recent Analytical Method for Detection of Chemical Adulterants in Herbal Medicine

Herbal medicine has become popular in recent years as an alternative medicine. The problem arises when herbal medicines contain an undeclared synthetic drug that is illegally added, since it is a natural product that does not contain any chemical drugs due to the potential cause of harmful effects. Supervision of herbal medicines is important to ensure that these herbal medicines are still safe to use. Thus, developing a reliable analytical technique for the determination of adulterated drugs in herbal medicine is gaining interest. This review aims to provide a recent analytical method that has been used within the past 5 years (2016-2021) for the determination of chemical adulterants in herbal medicine.

Prevalence and Predictors of Self-Medication with Antifungal Drugs and Herbal Products Among University Students: A Cross-Sectional Study from Egypt

Background and Purpose

Irrational use of drugs for self-medication (SM) is a worldwide public health problem which results in treatment failure, economic loss, and increased burden of morbidity and mortality. Thus, the purpose of this study was to explore SM with antifungal drugs and herbal products among university students in Egypt.

Methods

A cross-sectional sectional study was conducted over 7 months among 403 university students in Egypt. The students were invited to complete a self-administered questionnaire through an online Google form. Questionnaire items included socio-demographic characteristics of the students, practice of and attitude towards SM with antifungal drugs, and SM with herbal products.

Results

Prevalence of SM with antifungal drugs among students stood at 38.2%. The main reasons for SM with antifungal drugs were perceiving their health problem as being minimal, followed by having fears of a doctor’s visit. About 73% of the students thought that SM was not a safe practice. Older age (AOR = 1.5, 95% CI= 1.3–1.8), affiliation to a private university (AOR = 3.7, 95% CI= 2.2–6.4), and being a medical student (AOR =2.4, 95% CI= 1.3–4.5) were the significant predictors of SM with antifungal drugs. A high prevalence of SM with herbal products (70.7%) was reported, with most students having used some form of herbal weight loss preparation (64%). Being a Cairo resident (AOR= 2.4, 95% CI =1.5–3.8, P<0.05) and being a medical student (AOR= 2.1, 95% CI =1.3–3.4, P<0.05) were the significant predictors of SM with herbal products.

Conclusion

In the current study, SM was common among Egyptian university students. Providing counseling and public health education to university students with regards to SM is crucial. Implementing strict regulations and the full enforcement of excitant laws pertaining to the use of medication supplies is also needed. Herbal products should face the scrutiny of evidence-based medicine. Further studies are needed to evaluate the impact of SM among university students.

The safety, efficacy and pharmaceutical quality of male enhancement nutraceuticals bought online: Truth versus claim

OBJECTIVE

Nutraceutical products are widely used for their claimed therapeutic benefits. However, falsified or adulterated nutraceuticals present a major health threat to consumers. This study investigates the pharmaceutical quality, safety and anti-inflammatory effects of six male enhancement nutraceuticals that claim to be 100% natural.

METHODS

Three batches of six male enhancement products were tested to detect the presence and levels of adulterants via high-performance liquid chromatography (HPLC). The pharmaceutical quality of the selected nutraceuticals was tested with near infrared spectroscopy (NIR) and SeDeM. The cytotoxic effects of these products on HepG2 cells were determined through cell proliferation (XTT) and lactate dehydrogenase (LDH) cytotoxicity assays. Lastly, the in vitro inflammatory effects of these products were investigated using murine J774 macrophages through cytokine release analysis.

RESULTS

HPLC analysis detected the presence of sildenafil citrate, a vasodilator, and the active ingredient in Viagra and Revatio, in all batches of the products we analyzed. Amount of sildenafil citrate ranged from 0.45 mg to 51.85 mg among different batches. NIR assessment showed inter- and intra-batch heterogeneity in product composition. Results of the XTT and LDH assays showed significant cytotoxic effects of the analyzed products. XTT analysis revealed that the viability of HepG2 treated with tested products varied from 27.57% to 41.43%. Interestingly, the male enhancement products also showed anti-inflammatory effects.

CONCLUSION

Despite their labeling as 100% natural, all products tested in this study contained levels of sildenafil citrate, which was not reported on the packaging. There was a lack of pharmaceutical uniformity among products of the same batch and across different batches. Additionally, the products we tested had cytotoxic effects. These study findings highlight the adulteration, poor quality and hazard of these nutraceuticals. Therefore, strict regulation of these products and standardization of the definition of nutraceuticals are urgently needed. Further, these falsely advertised products should be withdrawn from the market due to potential adverse effects on the health of their consumers.

Counterfeit formulations: analytical perspective on anorectics

Purpose

This paper examines the scope of anorectics in counterfeit weight-reducing formulations and provides insight into the present state of research in determining such adulterants. Analytical techniques utilised in profiling adulterants found in slimming products, including limitations and mitigation steps of these conventional methods are also discussed. The current legal status of the anorectics and analogues routinely encountered in non-prescription slimming formulations is also explored.

Methods

All reviewed literature was extracted from Scopus, Web of Science, PubMed, and Google Scholar databases using relevant search terms, such as, ‘counterfeit drugs’, ‘weight loss drugs’, ‘weight-reducing drugs’, ‘slimming drugs’, ‘anorectic agents’, and ‘counterfeit anorexics’. Legislation related to anorectics was obtained from the portals of various government and international agencies.

Results

Anorectics frequently profiled in counterfeit slimming formulations are mostly amphetamine derivatives or its analogues. Five routinely reported pharmacological classes of adulterants, namely anxiolytics, diuretics, antidepressants, laxatives, and stimulants, are mainly utilised as coadjuvants in fake weigh-reducing formulations to increase bioavailability or to minimise anticipated side effects. Liquid and gas chromatography coupled with mass spectrometric detectors are predominantly used techniques for anorectic analysis due to the possibility of obtaining detailed information of adulterants. However, interference from the complex sample matrices of these fake products limits the accuracy of these methods and requires robust sample preparation methods for enhanced sensitivity and selectivity. The most common anorectics found in counterfeit slimming medicines are either completely banned or available by prescription only, in many countries.

Conclusions

Slimming formulations doped with anorectic cocktails to boost their weight-reducing efficacy are not uncommon. Liquid chromatography combined with mass spectrometry remains the gold standard for counterfeit drug analysis, and requires improved preconcentration methods for rapid and quantitative identification of specific chemical constituents. Extensive method development and validation, targeted at refining existing techniques while developing new ones, is expected to improve the analytical profiling of counterfeit anorectics significantly.

Interpol review of controlled substances 2016-2019

This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.