Misuse Of Steroids Research Articles

Nonconforming gender expression and adolescent anabolic-androgenic steroids misuse

BackgroundGender nonconformity (GNC) is an under-researched area of adolescent health that is of increasing interest to researchers and general public. However, little is known about whether it is associated with anabolic-androgenic steroids (AAS) misuse. We aimed to investigate the association among high school students using a cross-sectional design.MethodsWe pooled the 6 school districts data from the Youth Risk Behavior Survey in 2017 and 2019. We compared the prevalence of AAS misuse among gender nonconforming and conforming students. AAS misuse was determined on the reported experience of lifetime non-prescription steroid use. GNC was derived from perceived gender expression and sex. We estimated the sex-stratified adjusted odds ratios (AORs) for the association of GNC with AAS misuse after adjusting for race/ethnicity, grade, and sexual orientation.ResultsThe study population consisted of 17,754 US high school students including 9143 (49.67%) female students. Among female students, GNC was significantly associated with moderate (AOR, 3.69; 95% CI 1.28–10.62; P = 0.016) and severe (AOR, 5.00; 95% CI 1.05–23.76; P = 0.043) AAS misuse, but not with any AAS misuse (AOR, 0.85; 95% CI 0.34–2.14; P = 0.734). Among male students, GNC was significantly associated with any (AOR, 4.75; 95% CI 2.93–7.69; P < 0.001), moderate (AOR, 4.86; 95% CI 2.66–8.89; P < 0.001) and severe (AOR, 4.13; 95% CI 1.43–11.95; P = 0.009) AAS misuse. We did not observe a dose-response relationship between GNC and any AAS misuse in female and male students.ConclusionsThis study suggests that AAS misuse is associated with GNC among female and male adolescents.

Difficult to treat superficial fungal infections: Which factors one should consider in clinical practice – An Indian perspective

Dermatophytosis is a superficial fungal infection caused by filamentous fungi- dermatophytes affecting the skin, hair and/or nails. They have also been termed tinea infections. Dermatophytes, the most common contributing agents, are pretending high importance in developing countries like India. Emerging Pathogen Causing Recalcitrant Dermatophytosis like Trichophyton indotineae, which is terbinafine resistant. Development of Anti-fungal resistance due to irrational usage of antifungals, steroid misuse, availability of topical creams with steroid combination on OTC, improper and inadequate treatment, lack of patient counselling and education are the most important factors which made dermatophyte difficult to treat. Proper diagnosis, correct selection of anti-fungal, with adequate duration of therapy, avoidance of steroid, patient education on lifestyle changes will be probable solutions in resolving current challenges.

Cutaneous manifestations of misuse of androgenic anabolic steroids: A retrospective cohort study

Cutaneous manifestations of misuse of androgenic anabolic steroids: A retrospective cohort study

A user-friendly machine learning approach for cardiac structures assessment.

Machine learning is increasingly being used to diagnose and treat various diseases, including cardiovascular diseases. Automatic image analysis can expedite tissue analysis and save time. However, using machine learning is limited among researchers due to the requirement of technical expertise. By offering extensible features through plugins and scripts, machine-learning platforms make these techniques more accessible to researchers with limited programming knowledge. The misuse of anabolic-androgenic steroids is prevalent, particularly among athletes and bodybuilders, and there is strong evidence of their detrimental effects on ventricular myocardial capillaries and muscle cells. However, most studies rely on qualitative data, which can lead to bias and limited reliability. We present a user-friendly approach using machine learning algorithms to measure the effects of exercise and anabolic-androgenic steroids on cardiac ventricular capillaries and myocytes in an experimental animal model. Male Wistar rats were divided into four groups (n = 28): control, exercise-only, anabolic-androgenic steroid-alone, and exercise with anabolic-androgenic steroid. Histopathological analysis of heart tissue was conducted, with images processed and analyzed using the Trainable Weka Segmentation plugin in Fiji software. Machine learning classifiers were trained to segment capillary and myocyte nuclei structures, enabling quantitative morphological measurements. Exercise significantly increased capillary density compared to other groups. However, in the exercise + anabolic-androgenic steroid group, steroid use counteracted this effect. Anabolic-androgenic steroid alone did not significantly impact capillary density compared to the control group. Additionally, the exercise group had a significantly shorter intercapillary distance than all other groups. Again, using steroids in the exercise + anabolic-androgenic steroid group diminished this positive effect. Despite limited programming skills, researchers can use artificial intelligence techniques to investigate the adverse effects of anabolic steroids on the heart's vascular network and muscle cells. By employing accessible tools like machine learning algorithms and image processing software, histopathological images of capillary and myocyte structures in heart tissues can be analyzed.

Comparative Evaluation of Safety and Economic Burden Due to Topical Steroid Misuse in Patients with Self-medication and Prescribed Medication

Introduction Topical corticosteroids are currently the primary drugs to treat several dermatological disorders. But they are misused for various indications such as acne, pigmentation, fungal infection, and pruritus, and many times as a cosmetic or a skin cream for any type of rash. This study is performed to compare the magnitude of adverse events between practitioner-prescribed and self-prescribed groups of patients. In addition, this study also focuses on the demographic and educational status of patients where topical steroids are most widely misused. Materials and Methods It is a cross-sectional, hospital-based observational study conducted in the Department of Dermatology in collaboration with the Department of Pharmacology, KIMS, Bhubaneswar. A total of 134 patients were enrolled after getting the informed consent for the study, and assessed based on their topical steroid misuse and their adverse effects. Results The present study showed that steroid misuse was most common between 20 and 30 years of age group patients with low educational status. The most commonly applied steroid was clobetasol followed by mometasone and steroid abuse was more common in self-prescribed patients than physician-prescribed patients. The economic burden was more in the case of people using steroid cream only or steroid + anti-fungal creams because they have to be applied over a large body surface area. Incidence of adverse effects was observed more in self-prescribed patients and with low educational status. Conclusion This study highlights the fact that self-medication increases the incidence of adverse reactions and economic burden on the patients. Continuous education of patients and strict regulations regarding over-the-counter sales of steroids may help decrease the incidence of steroid misuse.

Clinical and Mycological Characterization of Chronic and Recurrent Dermatophytes using Various Staining and Microscopic Methods

Dermatophytosis is a prevalent infection in tropical and subtropical countries, including India. This study aims to investigate the epidemiology and clinical aspects of chronic and recurrent dermatophytosis, identify the clinical isolates, and assess the effectiveness of different microscopy and staining methods for diagnosis. The objective of the study is to study the epidemiology and clinical aspects of chronic and recurrent dermatophytosis and to identify the clinical isolates. Attempts to improve the diagnostic outcome by implementing different microscopy and staining methods have also been performed. Adult patients with chronic and recurrent cases and positive direct microscopy were included, and clinical details were recorded. The mycological culture was performed. Fifteen isolates were selected randomly and subjected to 0.9% NaCl, Chicago sky blue staining, Calcofluor white staining, and Congo red staining in addition to the standard lactophenol cotton blue (LPCB) preparation. Among the 178 patients in the study, females (56.7%) and patients aged 25-45 (50%) were more frequently affected. Tinea corporis was the most common clinical type (89.32%). Recurrent cases (56.1%) were more prevalent than chronic cases (43.9%). Culture positivity was seen in 60.1%, with Trichophyton mentagrophytes being the most common isolate (86%). Among the staining methods used on 15 selected isolates, Lactophenol Cotton Blue (LPCB) was scored as the most effective, scoring 2.6 out of 3. The study revealed several clinical and epidemiological findings related to dermatophytosis in India, including a high degree of communicability, inadvertent therapies including topical steroid misuse, and a persistent nature requiring an extended duration of therapy. Trichophyton mentagrophytes was the most frequently isolated pathogen. Of the staining methods evaluated, Lactophenol Cotton Blue (LPCB) was found to be the most effective. The findings suggest a need for continued research into effective treatments and diagnostic methods for dermatophytosis in India.

Topical Steroids: Awareness and Misuse Among General Medical Practitioners

Introduction: Topical steroids (TS) contributed in the management of several inflammatory, tumoral or allergic dermatoses. However, their misuse may lead to serious or even irreversible adverse effects. This study aimed to evaluate the knowledge and attitudes of general medical practitioners in Morocco regarding topical steroids use and misuse. Materials and Methods: Cross-sectional national survey over a 4-month period from 01/09/2022 to 30/12/2022. The data was collected by a Google Forms questionnaire which was shared on different professional groups on the social networks. The target population was Moroccan general practitioners. Data analysis was performed by Excel software. Results: A total of 200 general medical practitioners answered the questionnaire, of which 133(66.5%) practiced in the public sector and 67(33.5%) in the private sector. 11% had rated their frequency of prescription as high, 56% as medium and 33% as minimal or rare; the indications were dominated by eczema, atopic dermatitis and psoriasis. The prescription of topical corticosteroids started from the age of 1 year in 32.5% of general practitioners while the majority prescribed them at any age. Sixty (30%) were aware of the pharmacological effects of topical corticosteroids. The most frequently prescribed galenic form was cream in 95% of cases followed by gels, lotions and finally preparations. One hundred and thirty-three (66%) had answered correctly to the indications of topical corticosteroids and 106(53%) prescribed them in short cures. Few doctors (1%) had been able to identify all side effects. One hundred and fifty (75%) of the general medical practitioners had already seen patients presenting adverse effects dominated by skin atrophy, delayed healing, depigmentation, fungal or bacterial infection; their response consisted of degression in 75% of cases or switching to a lower class, while 11.5% had wrongly suggested an abrupt discontinuation. Conclusion: The high frequency of topical steroids side effects is an increasing problem encountered by dermatologists. Lack of some general practitioners and patient awareness are also important underlying factors. To our knowledge, this is the first Moroccan study that aimed to evaluate the knowledge, attitudes, and behavior regarding topical corticosteroids by general medical practitioners.

Steroid misuse and its effect on sexually transmitted diseases among female sex workers: A cross sectional study

Background: Globally, female sex workers (FSWs) are considered as a high-risk population for sexually transmitted diseases (STDs). Although several studies investigated STDs among FSWs in Bangladesh, but study on misuse of steroid among FSWs was poorly documented

Treatment recalcitrant cases of tinea corporis/cruris causedby T. mentagrophytes - interdigitale complex with mutations in ERG11 ERG 3, ERG4, MDR1 MFS genes & SQLE and their potential implications.

Recalcitrant dermatophyte infections are being reported from various parts of the world due to varied causes including strain variation, steroid misuse, SQLE mutations, and variable quality of itraconazole pellet formulations. The oral drug preferred in endemic areas is itraconazole, to which MIC levels remain low, and clinical failures to itraconazole reported defy a sound scientific explanation. The objective of the study was to conduct a proteomic and genomic analysis on isolates from therapeutically recalcitrant case with isolation of gene mutations and enzymatic abnormalities to explain azole failures. Trichophyton mentagrophyte interdigitale complex strains were isolated from seven clinically non-responding tinea corporis/cruris patients, who had failed a sequential course of 6 weeks of terbinafine 250 mg QD and itraconazole 100 mg BID. After AFST 1 strain, KA01 with high MIC to most drugs was characterized using whole genome sequencing, comparative proteomic profiling, and total sterol quantification. Sterol quantification showed that the standard strain of Trichophyton mentagrophytes (MTCC-7687) had half the ergosterol content than the resistant KA01 strain. Genomic analysis revealed mutations in SQLE, ERG4, ERG11, MDR1, MFS genes, and a novel ERG3 mutation. Proteomic analysis established the aberrant expression of acetyl Co-A transferase in the resistant strain and upregulation of thioredoxin reductase and peroxiredoxin. Our findings demonstrate possible reasons for multidrug resistance in the prevalent strain with mutations in genes that predict terbinafine (SQLE) and azole actions (ERG4, ERG11, ERG3) apart from efflux pumps (MDR1, MFS) that can explain multidrug clinical failures.

Knowledge attitude and practice regarding “over the counter” prescription of topical eye steroid among the pharmacists/medical shopkeepers

Purpose: Aim of this study is to assess knowledge, attitude, and practice among the pharmacists/medical shopkeepers regarding “over the counter” prescription of topical eye steroid. Method: It is a prospective cross-sectional questionnaire-based observational study, carried out among 60 pharmacists/pharmacy shopkeepers. Result: Out of 60 participants, 40% had been sensitized regarding topical steroid misuse. 16% had seen complications following OTC dispensing, and 83% had never seen complications following OTC dispensing of medications. 50% were of the opinion of banning the OTC dispensing of ocular medications, 41.6% were against it, and 8.33% were of no opinion. Conclusion: Doctors and pharmacists play a crucial role regarding spreading awareness of self-medication. Government should take proper initiative in educating patients to discourage the unethical and irrational dispensing of medicine by pharmacists.

Anabolic-Induced Hypogonadism in Men: Unveiling the Hidden Dangers of Steroid Misuse

Anabolic-Induced Hypogonadism in Men: Unveiling the Hidden Dangers of Steroid Misuse

Mucormycosis in Post Novel Corona Virus Patients: An Institutional Experience.

Mucormycosis is an emerging angioinvasive fungal infection caused by ubiquitous saprophytic filamentous fungus that belongs to the class Zygomycosis. Mucormycosis or black fungus infections in patients with recent COVID-19 infections has given rise to a new epidemic during the second wave of this current COVID-19 pandemic in India. Steroid misuse, poor glycemic control, use of industrial grade oxygen, improper humidification and specific variants strains have resulted in profound immunosuppression and are attributed for the high incidence of COVID associated Mucormycosis (CAM) in India. The aims of the present study were to assess the age and gender specific incidence of CAM, the utility of special stains (PAS and GMS) for diagnosing mucormycosis (false negatives and sensitivity). In the present study emphasis was laid on identifying if there exists a correlation between host response, angioinvasion and bone invasion with mortality. The Present study is a retrospective, cross sectional analytical study taken up in the Department of Pathology, Guntur Medical College for a period of 2months between 1st of May 2021 to 30th of June 2021. Results were tabulated in Microsoft excel 2016 and SPSS software version 14 was used for calculation of odds ratio and for performing multivariate analysis. All samples were routinely fixed using 10% buffered formalin, processed and sectioned. All the sections were stained with Haematoxylin and Eosin and also special stains for fungus like periodic acid Schiff (PAS) and Gomori Methenamine silver (GMS) were used wherever required. CAM is a serious complication after recovery from COVID-19 infection due to its high morbidity and mortality (13.7% in this series). CAM epidemiology and presentation is mostly similar to non-COVID mucormycosis seen in pre-COVID era.

Cytokine Storm, Immunomodulators and Mucormycosis in COVID-19: Bench To Bed Side

The world is undergoing its biggest health crisis named coronavirus disease, which is associated with increased proinflammatory cytokine storm, which ultimately leads to various medical complications including acute respiratory distress syndrome. The treatment protocol was always controversial due to the excessive use of corticosteroids in aggressive pneumonia and associated hyperinflammatory conditions.The excessive use, misuse, and rampant use of steroids may lead to various coinfection like mucormycosis which is referred to as black fungus that manifests within the skin and also affects the lungs and brain which may be more fatal. It is necessary to have early diagnosis and management to tackle the severity of post covid coinfection.

Steroids misuse and abuse

Steroids misuse and abuse

A clinicoepidemiological study on topical steroid misuse in a tertiary-care hospital in North India and the role of dermoscopy as a non-invasive diagnostic modality

Background: Topical corticosteroids (TCs) are one of the most frequently prescribed medications by dermatologists, yet may lead to an array of side effects due to prolonged and improper use. Because of the easy availability of topical corticosteroids as over-the-counter medications in India, these drugs are misused and abused. Objective: The objective was to determine the extent and the side effect profile of topical corticosteroid misuse/abuse in patients attending the OPD, to determine the demographic data and the reason and source of procuring TCs, and to characterize the dermoscopic findings of TSDF. Materials and Methods: This was a prospective, cross-sectional, clinical study conducted over a period of two years in which a predesigned, questionnaire-based proforma was employed. Patients above the age of fifteen reporting to the OPD giving a history of the application of a steroid cream continuously or intermittently for the minimum duration of four weeks were included in the study. A total of two hundred patients who met the clinical criteria were subjected to dermoscopic examination with a handheld dermoscope (DermLite DL4; 3Gen, U.S.; 10×). Results: A total of 2400 patients (fifteen-year-old or older) were enrolled in the study, in which 65% of the patients were females while 35% were males. Mostly, the patients procured these medicines from the pharmacist or paramedic, followed by general practitioners. The most common indications for which topical preparations were used included acne, followed by photodermatoses and ephelides. Most of the patients used combination creams, followed by potent steroids such as clobetasol propionate and betamethasone valerate. The most common side effects were erythema (74%), followed by photosensitivity (49%), hypertrichosis (47%), telangiectasia (42%), acneiform eruption (33%), contact dermatitis (21%), wrinkles (23.50%), etc. The main findings noticed on dermoscopy were irregularly dilated, branching, tortuous vessels almost interconnecting with each other in 79.78%, followed by hypertrichosis in 56.34%, white structureless areas representing atrophy in 42.33%, red dots in 7.22%, and a reddish background in 92.20%. Conclusion: The rampant use of TCs by patients for a prolonged period of time leads to a variety of side effects. Due to the topographical location, the climate of the valley, and the lighter skin type of the local population, the indications for which TCs were employed in our study group and the side effect profile were unique from the rest of the country. Dermoscopy may play a vital role in improving the diagnostic accuracy of TSDF and help us to differentiate it from close mimics.

P033 Genomic epidemiology of the antifungal-resistant dermatophytosis epidemic, India, 2017-2019

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjectiveThe epidemic of antifungal-resistant dermatophytosis in India has been reported. These infections are associated with severe morbidity, resistance to oral itraconazole and terbinafine, and the widespread misuse of topical steroids. Trichophyton indotineae has emerged as the predominant causative agent. In this study, we investigated 162 dermatophytosis infections from eight Indian states using genomic sequencing. The primary objective was to determine whether a clonal outbreak strain is responsible for the current epidemic.MethodsA total of 161 T. indotineae and one T. rubrum isolates from skin scrapings collected from India in 2017-2019 and previously reported were sent to the U.S. Centers for Disease Control and Prevention (CDC) for genomic analysis. After species identification, genomic DNA was extracted and sequenced using Illumina NovaSeq. Single-nucleotide (SNP) analysis was performed using the portable workflow MycoSNP (v0.21). Briefly, MycoSNP prepared the reference genome, performed pre-processing, aligned sample reads to the reference using the BWA (v 0.7.17) alignment algorithm, and called variants using GATK (v4.1.4.1). High-quality SNPs were used for constructing phylogenetic trees using neighbor-joining (NJ) and maximum likelihood (ML) methods. Further, to understand if infections are genetically clustered by state or region, multi-dimensional scaling (MDS) was applied using the ML tree in R.ResultSNP analysis identified 1259 450 variant sites which were used to construct an NJ and ML tree. The tree topology from both NJ and ML methods showed consensus. All 161 T. indotineae isolates from India clustered together forming a large, well-supported clade. SNP differences between the samples varied from 0-160 SNPs. Historical isolates available at CDC were included as controls and clustered over 40 000 SNPs from the clade comprising isolates from India. The MDS plot revealed that isolates did not cluster by state or region.ConclusionAntifungal-resistant dermatophytosis is an emerging threat with cases of chronic, recurrent infection reported from several countries including India. Additionally, the rapid spread of infections involves person-to-person spread. Our results suggest that a clonal outbreak of a T. indotineae strain is circulating in multiple states in India. Current plans are to expand the geographic scope of the study by including over 10 countries from Europe, Middle East, and the Americas. This work will allow the public health community to better understand the emergence and transmission of antifungal-resistant dermatophytosis worldwide.

Characterization of Recalcitrant Dermatophytosis in a Multicenter Study in Sri Lanka.

A changing clinical scenario of dermatophytosis has been observed in Sri Lanka during the past few years. In keeping with the trend described in India, an increase in the number of chronic, relapsing, and recalcitrant infections has been noted. The objective of our study was to assess the therapeutic response of dermatophytosis to standard antifungal treatment in Sri Lanka and to identify possible contributory factors in cases showing inadequate therapeutic response. A descriptive, observational, cross-sectional study was carried out in nine hospitals, representing each province. Over 6 months, patients with dermatophytosis on glabrous skin were included. All subjects underwent skin scrapings for mycological studies and were treated with a standard course of antifungals for a specific period. In those patients who achieved complete clearance, recurrences were noted. The study included 796 patients, of whom 191 (24%) had symptoms for more than 3 months at presentation. A total of 519 patients (65.2%) had multiple-site involvement, and 503 (63.2%) had evidence of prior use of topical steroids. Skin scrapings were positive for fungal elements in the direct smears of 659 patients (82.8%), and the predominant dermatophyte isolated was Trichophyton mentagrophytes (65.6%). Partial responders after 10 weeks of treatment and recurrences after complete clearance were significantly greater in the group that used topical steroids before presentation (P < 0.001). This study highlights the magnitude of the threat of an inadequate therapeutic response in dermatophytosis in Sri Lanka, and identifies steroid misuse, and the shift of the predominant fungal species to T. mentagrophytes as possible causative factors.

ID:16534 Prescription Opioids and Steroid Misuse Masking Underlying Infection of Spinal Hardware

The use of opioids for benign rheumatological disorders has been limited by concerns about adverse events and potential misuse. There has been an increase in use of opioids seen over the years for nonmalignant rheumatologic diseases. Opioids are currently approved as complementary therapy in inflammatory joint and rheumatological conditions. Severe adverse events, including abnormal drug-seeking behavior, although relatively rare, have been documented in a number of cases. This specific case report highlights opioid misuse and is an example of a patient becoming obtunded from a constellation of adverse events because of opioid misuse and overdose.

COVID-19 associated mucormycosis in Assiut University Hospitals: a multidisciplinary dilemma

Mucormycosis is a life-threatening opportunistic angioinvasive fungal infection. We aimed to describe the frequency, presentations, predictors, and in-hospital outcome of mucormycosis patients in the scope of CoronaVirusDisease-19 (COVID-19) during the third viral pandemic wave. This cross-sectional retrospective study included all patients who fulfilled the criteria of mucormycosis with concurrent confirmed covid19 infection admitted to Assuit University Hospital between March 2021 and July 2021. Overall, 433 patients with definite covid-19 infection, of which 33 (7.63%) participants were infected with mucormycosis. Mucormycosis was predominantly seen in males (21 vs. 12; p = 0.01). Diabetes mellitus (35% vs. 63.6%; p < 0.001), hypertension (2% vs.45.5%; p 0.04), and Smoking (26.5% vs. 54.5%; p < 0.001) were all significantly higher in mucormycosis patients. Inflammatory markers, especially E.S.R., were significantly higher in those with mucormycosis (p < 0.001). The dose of steroid intake was significantly higher among patients with mucormycosis (160 mg vs. 40 mg; p < 0.001). Except for only three patients alive by residual infection, 30 patients died. The majority (62%) of patients without mucormycosis were alive. Male sex; Steroid misuse; D.M.; Sustained inflammation; Severe infection were significant risk factors for mucormycosis by univariate analysis; however, D.M.; smoking and raised E.S.R. were predictors for attaining mucormycosis by multivariate analysis.

Renoprotective and hepatoprotective activity of Lepidium draba L. extracts on oxymetholone-induced oxidative stress in rat.

Misuse and abuse of anabolic androgenic steroids (AAS) such as oxymetholone (OM) cause side effects such as male infertility, cardiovascular disorders, musculoskeletal, and hepato-renal dysfunctions in athletes. The aim of this study was to evaluate the protective effects of Lepidium draba L. (L. draba) extract on OM-induced hepato-renal toxicity. Thirty adult male Wistar rats into six groups (n=5) were randomly divided as follows: control (normal saline), OM (5 mg/kg/day), L. draba-treated (100, 200, and 400 mg/kg/d) plus 5mg/kg/day OM, and L. draba (400 mg/kg/d) groups. Normal saline, OM and L. draba extract were orally administered for 30 days. On day 31 of the study, hepatic and renal biochemical parameters were measured. Serum cytokines (IL-1β, IL-10, IL-6) tumor necrosis factor- α (TNF-α) and nitric oxide, levels alongside catalase, glutathione peroxidase, and superoxide dismutase activity were evaluated. Also, changes in liver and kidney histopathology were evaluated. Finally, the anti-oxidant properties of the extract were determined. The results of this study showed that in the groups treated with the L. draba extract, hepatic-renal biochemical parameters improved and also the level of nitric oxide and inflammatory cytokines decreased and the activity of anti-oxidant enzymes increased compared with the OM group. These findings revealed that L. draba, due to its high anti-oxidant properties and high content of polyphenols (especially flavonoids), can improve OM-induced hepato-renal oxidative damages. PRACTICAL APPLICATIONS: L. draba due to its remarkable anti-oxidant and anti-inflammatory properties can protects the kidney and liver injuries against oxymetholone. These features are attributed to the presence of phenolic and flavonoid components. This fidings would be helpful to desgin new therapeutic agents for treating and preventing liver/kidney injuries.