琥珀酸索利那新片治疗膀胱过度活动症的效果分析

目的:观察琥珀酸索利那新片治疗膀胱过度活动症的临床效果。方法:回顾性分析我科收治的膀胱过度活动症患者共90例,所有患者均符合由中华医学会泌尿外科分会尿控学组制定的《膀胱过度活动症临床指导原则》。其中43例患者采用酒石酸托特罗定片治疗并设为对照组,47例患者采用琥珀酸索利那新片治疗并设为观察组,对比两组患者用药前后排尿症状和尿动力学参数变化、膀胱过度活动症症状评分表(OABSS评分)和前列腺症状评分(IPSS评分)变化以及不良反应发生率对比情况。结果:观察组患者用药后平均24 h尿急次数、平均24 h排尿次数均明显低于对照组,最大尿流率(Qmax)、初始尿意容量(FDV)、最大膀胱压容量(MCBC)均明显高于对照组,两组患者以上指标相比较,差异均有显著性(P0.05);两组患者用药后OABSS评分和IPSS评分均有所下降,但是两组相比,差异不具有显著性(P0.05);3两组患者用药后均有不同程度的不良反应,其中口干症状患者比例具有差异性(P0.05)。结论:琥珀酸索利那新片治疗膀胱过度活动症疗效确切,安全性高。     

The Content of Mercury in Herbal Dietary Supplements

Biological Trace Element Research - The dietary supplement market in Poland has been growing rapidly, and the number of registered products and their consumption increases steadily. Among the most...     

Defining Efficacy in the Treatment of Overactive Bladder Syndrome

Patients seek treatment for overactive bladder syndrome (OAB) due to poor quality of life, and perceived improvement in quality of life (QOL) from medical therapy is multifactorial. Many feel that efficacy/success of medical therapy for OAB should not be linked to improvements in 1 or 2 endpoints, but instead should be linked to patient expectation and QOL improvement. Ideally, once patient-centered goals are defined, outcomes should be correlated with relief of symptom(s), patient satisfaction, and goal attainment expectations as a result of treatment.Key words: Overactive bladder syndrome, Patient-centered treatment, Medical therapy for OABOveractive bladder syndrome (OAB) as defined by the International Continence Society (ICS) consists of the presence of urinary urgency, with or without urge incontinence, usually with frequency and nocturia.¹ The prevalence rates in both men and women in the United States is estimated at approximately 17%.¹ The total cost of OAB for the year 2000 has been estimated at $12.6 billion.² This cost is made up of diagnostic, treatment, routine care, consequence, and indirect costs from loss of productivity. Due to prevalence and cost of this condition, there are significant resources being utilized to develop treatments that improve patient quality of life (QOL) and reduce the financial burden to society.OAB is a medical problem largely due to its negative impact on daily QOL. The subjective impact of urinary frequency and urgency (with/without urge incontinence) on psychosocial and physical well-being is an important aspect of caring for this group of patients. The severity and degree of bother associated with the symptoms of OAB can directly influence a person’s mobility, degree of social isolation, impairment in work-related activities, disruption of sleep, impairment of domestic and sexual life, and result in depression.³ Patients may also develop extreme coping strategies including self-imposed fluid restrictions, avoidance of social events and travel, and dependence on protective undergarments. OAB not only affects the lives of patients, but also the lives of their caretakers and their QOL. Thus, many patients and their caretakers seek out treatments that will help provide improvement in these aspects of their lives. Unfortunately, relatively few data are available on the effect of current treatments on patient QOL.Most clinical trials evaluating the efficacy of medications and other treatments related to OAB define success as efficacy based on improvements in primary and secondary clinical endpoints. Generally, these clinical endpoints include reduction in incontinence episodes, micturition frequency, urgency measures, and nocturia. The potential problem with this is that clinically significant changes in these parameters compared with placebo may not result in meaningful change in QOL for the patient or the caretaker and may result in discontinuation of medication. Failure to achieve meaningful changes in quality may be related to the fact that a particular symptom is not adequately changed or an adverse event impacts negatively on QOL. A strong argument for this is the poor rate of medication persistence seen in managed care patients with OAB that are significantly lower than reported discontinuation rates from clinical trials.^4–7 Persistence rates for OAB drugs range from 8% to 29% in studies with at least 1 year of follow-up.^4,5,7–9 When comparing extended-release (ER) formulations with immediate-release (IR) formulations, no significant difference was seen in persistence rates after multivariate analysis.⁶ In a study evaluating patient reasoning for OAB medication discontinuation, only one-third of patients cited a single reason for discontinuation, with most citing multiple reasons with a mean of 2.3 reasons.¹⁰ The more common reasons included: 46.2%, “didn’t work as expected”; 21.1%, “side effects”; 17.2%, cost; and 11.2%, “another medication/medical condition required me to stop.” Patient adherence with prescribed therapy is affected by perceived benefit, pill burden, complexity of dosing schedule, memory lapses, and adverse events.¹¹With patients seeking treatment for OAB due to poor QOL and perceived improvement in QOL from medical therapy being multifactorial, it is clear why many believe that efficacy/success of OAB medication probably should not be linked to improvements in 1 or 2 endpoints, but instead should be linked to patient expectation and QOL improvement. Ideally, once patient-centered goals such as the ability to perform certain tasks are defined, outcomes should be correlated with relief of symptom(s), patient satisfaction, and goal attainment expectations as a result of treatment. We need to establish more clear-cut evidence of how a myriad of factors affect treatment response.     

膀胱过度活动症的抗胆碱治疗及其不良反应

膀胱过度活动症(overactive bladder,OAB)是一种令人烦恼的疾病,它影响着人们生活的质量。病人常常表现为尿急,伴有或不伴有急迫性尿失禁,通常有尿频和夜尿的症状。虽然膀胱过度活动症的病因不是很明确,但是抗胆碱药物作为其治疗的基石,在减少膀胱储尿期的收缩,增加膀胱的容量,起着重要的作用。这类药物具有一定的安全性,副作用小,并且有着相似的疗效。尽管如此,当治疗膀胱过度活动时,抗胆碱药物种类的选择,其治疗的预期利弊平衡也应在考虑之中,尤其是合并有中枢神经系统或者心脑血管系统疾病的老年患者。本文通过查阅国内外新近相关的文献,从受体的选择,临床应用和不良反应等方面对7种抗胆碱药物进行综述。     

Factors Associated with Therapeutic Efficacy of Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Syndrome

Objectives

To analyze the predictors of therapeutic efficacy after intravesical botulinum toxin A injection for overactive bladder syndrome (OAB) refractory to antimuscarinic therapy.

Methods

All consecutively OAB patients, who visited the urologic outpatient clinics of a medical center and refractory to antimuscarinic treatment, were prospectively enrolled. All enrolled patients received intravesical injection of 100 U onabotulinumtoxinA (Botox). The Global Response Assessment (GRA) score ≥ 2 at 3 months after Botox injection was defined as a successful treatment, otherwise failed.

Results

Overall, 89 patients received intravesical injection. Eighty patients, including 42 men and 38 women, had received follow-up at 3 months. The overall success rate was 63.8%. The global response assessment, urgency severity score, urgency, urgency urinary incontinence and frequency episodes, and functional bladder capacity improved after treatment. However, post-void residual volume (PVR) increased, and voiding efficiency (VE) decreased after treatment. Female gender (odds ratio = 3.75) was the only independent factor associated with the success. Female gender (coefficient = 0.74), low baseline overactive bladder symptoms score (coefficient = -0.12) and the presence of OAB-wet (coefficient = 0.79) were independent factors associated with therapeutic efficacy (i.e., GRA score). VE (odds ratio = 0.062) was the only predictor for a large PVR at 3 months. The optimum cutoff value of VE was <87% with the area under the ROC curve being 0.64 (sensitivity = 63.8%, specificity = 57.1%).

Conclusions

The therapeutic effects of Botox can persist till 6 months after treatment. Female gender, low overactive bladder symptoms score and OAB-wet are associated better therapeutic efficacy, and low baseline VE is associated with large PVR. These findings can serve as an initial guide or assist in consultation regarding the treatment of OAB patients with Botox injection.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01657409","term_id":"NCT01657409"}}NCT01657409     

Estimation of Potential Availability of Essential Oil in Some Brands of Herbal Teas and Herbal Dietary Supplements

Introduction

The aim of the study was to estimate potential availability of essential oil in some brands of herbal products.

Methods

A comparison was performed on the basis of the essential oil yield in the unprocessed raw materials such as leaves of peppermint and lemon balm and inflorescence of chamomile as well as herbal tea bags and in dietary supplements. The yield of essential oil was determined by distillation. Essential oil was analyzed by GC-FID and GC-MS.

Results

It was found that the average potential availability of essential oils in the products such as dietary supplements for the doses recommended by the producers is lower than in the corresponding tea infusions: for peppermint formulations approximately 6-fold lower, for the formulations with lemon balm about 4-fold lower, and for the chamomile preparations about 3-fold lower. It was found that essential oils extracted from herbal teas have a similar chemical profile with characteristic deviations in the amount of individual components, which arise from the origin of the raw material.

Discussion

In contrast to homogenous pharmaceutical herbal mixtures consistent with, the Pharmacopoeia requirements, herbal teas (available in grocery stores) and dietary supplements are often out of control in terms of the yield and composition of the essential oil, which is primarily responsible for the health benefits and aromatic qualities of these products. Analysis of the composition of the dietary supplements showed that they contain on average significantly lower amounts of plant material compared to the herbal teas.     

A 型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果观察

目的：探讨A 型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果。方法：选择2010 年10 月至2012 年10 月,哈尔滨 医科大学附属第四医院泌尿外科收治的女性膀胱过度活动症患者24 例,随机分为治疗组和对照组,治疗组(A 组)选用国产A 型 肉毒素(衡力)100 IU 治疗,用10 mL 生理盐水稀释后,通过膀胱镜进行壁内注射;对照组(B 组)患者给予口服经典的抗胆碱制剂, 酒石酸托特罗定片,每天口服2 次,每次2 mg,疗程不少于6 周。于治疗前,治疗后1 周和4 周观察和比较两组患者的IPSS评分、 初尿意膀胱容量、最大膀胱容量。结果：与治疗前比较,A 组治疗后1 周,IPSS评分显著下降(P<0.05),初尿意膀胱容量及最大膀胱 容量显著上升(P<0.05),治疗后第2 周和第4 周均维持在相当水平,残余尿量第1 周未见明显下降(P>0.05),第4 周时与基线比较 下降明显(P<0.05);B组于治疗后第4 周时,以上三项指标与治疗前比较才有统计学差异(P<0.05),残余尿量在第1 周即有明显下 降(P<0.05),并且第4 周时仍维持第1 周水平(P>0.05)。此外,治疗后第1 周两组比较以上指标比较有统计学差异(P<0.05),而治疗 后第4 周无明显差异(P>0.05)。结论：经尿道膀胱壁内肉毒素A 注射和口服酒石酸托特罗定均是治疗女性膀胱过度活动症的有效 方法,但A 型肉毒素膀胱内注射起效更快,同时由于其接触性和直观性,疗效更确切。     

A型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果观察

目的：探讨A型肉毒素膀胱内阻滞治疗女性膀胱过度活动症的临床效果。方法：选择2010年10月至2012年10月,哈尔滨医科大学附属第四医院泌尿外科收治的女性膀胱过度活动症患者24例,随机分为治疗组和对照组,治疗组（A组）选用国产A型肉毒素（衡力）100IU治疗,用10mL生理盐水稀释后,通过膀胱镜进行壁内注射;对照组（B组）患者给予口服经典的抗胆碱制剂,酒石酸托特罗定片,每天口服2次,每次2mg,疗程不少于6周。于治疗前,治疗后1周和4周观察和比较两组患者的1PSS评分、初尿意膀胱容量、最大膀胱容量。结果：与治疗前比较,A组治疗后1周,IPSS评分显著下降（P〈0．05）,初尿意膀胱容量及最大膀胱容量显著上升（P〈0．05）,治疗后第2周和第4周均维持在相当水平,残余尿量第1周未见明显下降（P〉0．05）,第4周时与基线比较下降明显（P〈0．05）;B组于治疗后第4周时,以上三项指标与治疗前比较才有统计学差异（P〈0．05）,残余尿量在第1周即有明显下降（P〈0．05）,并且第4周时仍维持第1周水平（P〉0．05）。此外,治疗后第1周两组比较以上指标比较有统计学差异（P〈0．05）,而治疗后第4周无明显差异（P〉0．05）。结论：经尿道膀胱壁内肉毒素A注射和口服酒石酸托特罗定均是治疗女性膀胱过度活动症的有效方法,但A型肉毒素膀胱内注射起效更快,同时由于其接触性和直观性,疗效更确切。     

Availability of Essential Elements in Nutrient Supplements Used as Antidiabetic Herbal Formulations

Five brands of antidiabetic herbal formulations as tablets, Diabetex, Divya Madhu Nashini, Jambrushila, Diabeticin, and Madhumeh Nashini, from different pharmacies were analyzed for six minor (Na, K, Ca, Cl, Mg, and P) and 20 trace (As, Ba, Br, Ce, Co, Cr, Cs, Cu, Fe, Hg, La, Mn, Rb, Sb, Sc, Se, Sm, Th, V, and Zn) elements by thermal neutron irradiation followed by high-resolution gamma ray spectrometry. Further Ni, Cd, and Pb were determined by atomic absorption spectrophotometry. Most elements vary in a narrow range by a factor of 2–4 while a few others vary in a wide range, e.g., Na (0.05–0.67 mg/g), Mn (26.7–250 μg/g), and V (0.26–2.50 μg/g). All the five brands contain K, Cl, Mg, P, and Ca as minor constituents along with mean trace amounts of Cr (2.11 ± 0.67 μg/g), Cu (15.7 ± 7.11 μg/g), Fe (459 ± 171 μg/g), Mn (143 ± 23 μg/g), Se (238 ± 112 ng/g), and V (0.99 ± 0.93 μg/g). Jambrushila is enriched in Na, Ca, Mg, Cl, Fe, Cu, Se, and Zn, essential nutrients responsible for curing diabetes. Dietary intake of Mn, Fe, and Cu are greater than 10% of the recommended dietary allowance, whereas that for Zn and Se is less than 2%. Mean contents of toxic elements (As, Cd, Hg, and Pb) were found below permissible limits except in Jambrushila. Cr and Zn were inversely correlated with r = −0.81, whereas Rb and Cs exhibit linear correlation (r = 0.93) in five brands. C, H, N analysis showed C ∼ 55%, H ∼ 12%, and N ∼ 2% with a total of ∼70% organic matter. However, thermal decomposition studies at 700°C suggest less than 5% nonvolatile metal oxides. Herbal formulations contain minor and trace elements in bioavailable forms that favorably influence glucose tolerance and possibly increase the body’s ability to ameliorate development of diabetes.     

臭氧水膀胱腔内灌注治疗女性膀胱过度活动症疗效评价*

目的:评价臭氧水膀胱腔内灌注疗法对膀胱过度活动症的有效性和安全性。方法:2016年1月至2016年12月间共60例患者入组,所有患者均行尿流动力学检查证实膀胱逼尿肌不稳定。患者被随机分入治疗组(n=30)和对照组(n=30),对照组采用行为训练疗法并口服索利那新治疗。治疗组在行为训练疗法于口服索利那新的基础上,同时行臭氧水膀胱腔内灌注治疗。在治疗结束时通过患者病情改善情况评价疗效,主要评价指标包括:治疗前、后的患者24h排尿次数、平均夜尿次数、24h尿失禁次数、OABSS评分、I-QOL评分、治疗前和治疗结束末4周复查尿流动力学检查评估,并评估患者的不良反应。获得的数据采用t检验进行统计学分析。结果:结果证实,在24h排尿次数、平均夜尿次数、OABSS评分和I-QOL评分方面,各组治疗后有改善,而臭氧治疗组改善情况优于对照组(P0.05)。尿流动力学检查证实所有治疗后患者逼尿肌不稳定情况均有改善;初始尿意时膀胱容量、最大膀胱容量、储尿期膀胱逼尿肌最大压力变化情况治疗组改善优于对照组。不良反应由患者自主报告,治疗组主要表现为灌注后尿道内及下腹部不适感,多自主恢复,两组间差异不明显(P0.05)。结论:臭氧水膀胱腔内灌注治疗女性膀胱过度活动症安全、有效,能改善膀胱过度活动症患者排尿次数、夜尿次数和24小时尿失禁次数,能改善OABSS评分,能改善尿流动力学结果,提高患者的生活质量。     

坦索罗辛联合索利那新对老年男性膀胱过度活动症患者的临床疗效及其作用机制

目的:探究坦索罗辛联合索利那新对老年男性膀胱过度活动症患者的临床疗效及其可能的作用机制。方法:收集我院泌尿科收治的老年男性膀胱过度活动症患者100例,根据随机对照表分为对照组和试验组,各50例,2组均实施常规治疗以及对症治疗,对照组给予盐酸莫西沙星片及盐酸坦索罗辛缓释胶囊,试验组在对照组的基础上联合给予琥珀酸索利那新片。两组7天为一个治疗周期,共治疗12个周期。治疗后,对比分析两组的临床疗效、治疗前后储尿期症状评分(USPSS)、排尿期症状评分(VSS)、OABSS评分、尿液神经生长因子水平、P2X3受体表达情况以及不良反应的发生情况。结果:治疗后,与对照组相比,试验组临床总有效率较高(P0.05),USPSS、VSS、OABSS评分较低(P0.05),尿液神经生长因子水平及P2X3表达较低(P0.05),两组不良反应比较,差异无统计学意义(P0.05)。结论:坦索罗辛联合索利那新对老年男性膀胱过度活动症患者的临床疗效显著,安全性高,这可能与其显著降低尿液神经生长因子以及P2X3受体表达水平有关。     

Presence of Cleaved Synaptosomal-Associated Protein-25 and Decrease of Purinergic Receptors P2X3 in the Bladder Urothelium Influence Efficacy of Botulinum Toxin Treatment for Overactive Bladder Syndrome

Objectives

To evaluate whether botulinum toxin A (BoNT-A) injection and Lipotoxin (liposomes with 200 U of BoNT-A) instillation target different proteins, including P2X3, synaptic vesicle glycoprotein 2A, and SNAP-25, in the bladder mucosa, leading to different treatment outcomes.

Materials and Methods

This was a retrospective study performed in a tertiary teaching hospital. We evaluated the clinical results of 27 OAB patients treated with intravesical BoNT-A injection (n = 16) or Lipotoxin instillation (n = 11). Seven controls were treated with saline. Patients were injected with 100 U of BoNT-A or Lipotoxinin a single intravesical instillation. The patients enrolled in this study all had bladder biopsies performed at baseline and one month after BoNT-A therapy. Treatment outcome was measured by the decreases in urgency and frequency episodes at 1 month. The functional protein expressions in the urothelium were measured at baseline and after 1 month. The Wilcoxon signed-rank test and ordinal logistic regression were used to compare the treatment outcomes.

Results

Both BoNT-A injection and Lipotoxin instillation treatments effectively decreased the frequency of urgency episodes in OAB patients. Lipotoxin instillation did not increase post-void residual volume. BoNT-A injection effectively cleaved SNAP-25 (p < 0.01). Liposome encapsulated BoNT-A decreased urothelial P2X3 expression in the five responders (p = 0.04), while SNAP-25 was not significantly cleaved.

Conclusions

The results of this study provide a possible mechanism for the therapeutic effects of BoNT-A for the treatment of OAB via different treatment forms. BoNT-A and Lipotoxin treatments effectively decreased the frequency of urgency episodes in patients with OAB.     

Increased Serum Adipokines Implicate Chronic Inflammation in the Pathogenesis of Overactive Bladder Syndrome Refractory to Antimuscarinic Therapy

Objectives

Recent studies have shown that chronic inflammation is involved in overactive bladder (OAB) syndrome. OAB could be a subtype of neurogenic inflammation. This pilot study investigated serum adipokine levels in patients with OAB refractory to antimuscarinic therapy.

Methods

Thirty consecutive patients with OAB-dry (n = 16) or OAB-wet (n = 14) refractory to previous antimuscarinic treatment were prospectively enrolled in this study, a group of 26 normal subjects without lower urinary tract symptoms served as controls. Concentrations of serum C-reactive protein (CRP), nerve growth factor (NGF), and adipokines including interleukins ([IL], IL-1β, IL-6, IL-8), tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1, insulin, and leptin were quantified using a bead-based human serum adipokine panel B kit. Data were analyzed using the LX 200 platform. Patients were further classified as having dry or wet OAB and having medical diseases or not. The serum CRP, NGF, and adipokine levels were compared between OAB patients and the controls, and between OAB subgroups.

Results

The serum concentrations of CRP, NGF, IL-1β, IL-6, IL-8, and TNF-α in OAB-dry and OAB-wet patients were significantly higher than among the controls. There was no significant difference in adipokine levels between OAB-dry and OAB-wet, or between OAB patients with and without medical diseases. Serum CRP and NGF levels were significantly higher only in OAB-wet or OAB patients with medical diseases than among controls. The MCP-1 levels, on the other hand, were significantly higher in OAB-dry or OAB patients with disease, than the controls.

Conclusions

Both OAB-dry and OAB-wet patients showed increased serum CRP, NGF, and adipokine levels compared with the controls, suggesting chronic inflammation of the bladder involving both peripheral and central mechanisms in all OAB patients refractory to antimuscarinic therapy. The increased serum adipokine levels were not relevant to medical diseases.     

Risk Associated with the Use of Selected Ingredients in Food Supplements

This review focuses on four new product categories of food supplements: pre-workout, fat burner/thermogenic, brain/cognitive booster, and hormone/testosterone booster. Many food supplements have been shown to be contaminated with unauthorized substances. In some cases, the ingredients in the new categories of dietary supplements were medicinal products or new synthetic compounds added without performing clinical trials. Some of the new ingredients in dietary supplements are plant materials that are registered in the pharmacopoeia as herbal medicines. In other cases, dietary supplements may contain plant materials that have no history of human use and are often used as materials to ‘camouflage’ stimulants. In the European Union, new ingredients of dietary supplements, according to European Food Safety Authority or unauthorized novel food. Furthermore, selected ingredients in dietary supplements may be prohibited in sports and are recognized as doping agents by World Anti-Doping Agency.     

Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection on Elderly Patients with Chronic Central Nervous System Lesions and Overactive Bladder

Purpose

Intravesical injection of onabotulinumtoxinA is an effective treatment for overactive bladder (OAB). Nonetheless, the treatment outcome is unclear in OAB patients with central nervous system (CNS) lesions. This study evaluated the efficacy and safety of intravesical onabotulinumtoxinA treatment in elderly patients with chronic cerebrovascular accidents (CVAs), Parkinson’s disease (PD) and dementia.

Materials and Methods

Patients with CVA, PD, dementia, and OAB refractory to antimuscarinic therapy were consecutively enrolled in the study group. Age-matched OAB patients without CNS lesions were selected to serve as a control group. OnabotulinumtoxinA (100 U) was injected into the bladder suburothelium at 20 sites. The clinical effects, adverse events, and urodynamic parameters were assessed at baseline and 3 months post-treatment. The Kaplan-Meier method was used to compare long-term success rates between groups.

Results

A total of 40 patients with OAB due to CVA (23), PD (9), dementia (8) and 160 control patients were included in this retrospetive analysis. Improvement of urgency severity scale, increased bladder capacity and increased post-void residual volume were comparable between the groups at 3 months. Patients with CNS lesions did not experience increased risks of acute urinary retention and urinary tract infection; nonetheless, patients with CVA experienced a higher rate of straining to void. Long-term success rates did not differ between the patients with and without CNS lesions.

Conclusion

Intravesical injection of 100 U of onabotulinumtoxinA effectively decreased urgency symptoms in elderly OAB patients with CNS lesions. The adverse events were acceptable, and long-term effects were comparable to OAB patients in general. Nonetheless, the possibility of longstanding urinary retention and chronic catheterization need careful evaluation for this very vulnerable population before choosing intravesical onabotulinumtoxinA treatment.     

Effects of Selenium and Zinc Status in Biological Samples of Hepatitis C Patient After Herbal and Pharmaceutical Supplements

The use of natural remedies and pharmacological mineral supplements for liver disease treatment has a long history. In present study, the levels of selenium (Se) and zinc (Zn) were determined in biological samples (serum and whole blood) of female hepatitis C patients (n?=?132), age ranged 30–45 years, before and after 30 days treatment with herbal/pharmaceutical supplements. For comparative study, 128 age-matched female subjects, residing in the same residential areas and have socioeconomic status, were selected as referents. The Se and Zn in supplements, blood, and sera were determined by atomic absorption spectrometry. It was observed that Zn and Se in blood and serum samples of viral hepatitis C (HCV) patients were reduced in the range of 28.6–39 % and 24–36 %, respectively, as compared to those of referents. After herbal/pharmaceutical supplementations, 20.6–25.0 and 9.15–13.2 % of Zn and 10.6–12.1 and 19.6–21.4 % of Se were enhanced in sera and blood samples of HCV patients, respectively. The resulted data indicated that the levels of Se and Zn in addition to some biochemical parameters were improved in HCV patients after herbal/pharmaceutical supplementation. The effects of both supplements were not significantly different (p?>?0.05).