Biomedical Research and Therapy

The most useful medicinal herbs to treat diabetes

2018-09-18T16:42:07+00:00

Diabetes mellitus is a syndrome that is characterized by hyperglycemia, change in the metabolism of lipids, carbohydrates, and proteins, and in the long term, with eye, kidney, cardiovascular, and neurological complications. Plenty of plants from different regions of the world have been investigated for anti-diabetic effects. This review article was designed to report some of the most important medicinal plants with hypoglycemic properties according to reliable clinical and laboratory evidence, and also touched on the medicinal plants that are prescribed in Iranian traditional medicine, for the treatment of diabetes. The information in this review was obtained from the eligible articles retrieved using the search terms diabetes mellitus, medicinal plants, type 1 diabetes and medicinal plants, type 2 diabetes and medicinal plants, and the effect of extract and essential oil of medicinal plants affecting diabetized tissues in the human body indexed in databases such as Iran medex, Irandoc, ISI, PubMed, Scopus, SID, Magiran, Google Scholar, etc. Based on the results drawn in this review the plants, Urtica, Trigonella foenum-graecum, Allium sativum, Carthamus tinctorius, Ferula assa-foetida, Bauhinia, Gymnema sylvestre, Swertia, Combretum, Sarcopoterium, Liriope, Caesalpinia bonduc, Coccinia grandis, Syzygium cumini, Mangifera indica, Momordica charantia, Ocimum tenuiflorum, Pterocarpus, Tinospora cordifoli, Salvia officinalis, Panax, Cinnamomum verum, Abelmoschus moschatus, Vachellia nilotica, Achyranthes, Fabaceae, Mentha, Asphodelaceae, Andrographis paniculata L, Artemisia herba-alba, Artemisia dracunculus, Azadirachta indica, Caesalpinioideae, Pachira aquatic, Gongronema latifolium, Nigella Sativa, Tinospora cordifolia (guduchi), Chrysanthemum morifolium, Zingiber zerumbet, Symphytum, Cactaceae, Symplocos, Perilla frutescens, Terminalia chebula and Aloe vera are effective to controland treat diabetes.

Inflammation in Alzheimer’s disease: A friend or foe?

2018-09-18T16:42:05+00:00

Background: There is a dearth of precise information for molecular and cellular mechanisms responsible for the development of Alzheimer’s disease (AD). However, convincing data from clinical research and basic molecular biology have shown that inflammation of the brain is an integral part of AD. In this review, the role of inflammation in AD will be highlighted.

Methods: Articles from credible scientific databases, such as ScienceDirect, Scopus, PubMed, Google Scholar and Mendeley, were searched and retrieved using keywords ‘inflammation’, ‘Alzheimer’s disease’, ‘tau’, and ‘beta amyloid’.

Results: At present, there is no local inflammatory-inciting factor that is closely associated with AD, although it has been proposed that inflammation could be induced by pathologic hallmarks of AD, such as beta amyloid (Aβ) peptide plagues and neurofibrillary tangles (NFTs), or fragments of degenerated neurons. However, it is still unclear whether inflammation leads to the development of AD or if the pathological hallmarks of AD induce inflammation.

Conclusion: Inflammation is, indeed, an integral part of AD. Further studies on inflammatory-targeted therapies for AD are highly recommended.

The relationship between lipid profiles in pregnancy and preterm delivery: a systematic review

2018-09-18T16:41:57+00:00

Background: High-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and total cholesterol (TC) are associated with maternal hormonal changes which can lead to pregnancy complications. High lipid levels during pregnancy may be accompanied by an increased risk of spontaneous preterm labor. The purpose of this review was to determine the relationship between lipid profiles in pregnancy and preterm delivery.

Methods: A systematic search was performed in PubMed, EMBASE, Web of Science, Scopus, and Science Direct databases to find cross-sectional, case-control, and cohort studies on the associations between lipid profiles in pregnancy and preterm delivery. The search results were limited to papers published during 2000-2018. The quality of the selected studies was assessed based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Finally, a total of 25 eligible high-quality papers were reviewed.

Results: A high maternal TG level in the first trimester of pregnancy was identified as a significant risk factor for preterm delivery. Low TG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels were uniquely associated with an increased risk of preterm delivery. High TC, TG, and LDL-C levels increased the risk of spontaneous preterm labor. A further association was found between high TG and TC levels and an elevated risk of preterm labor before 34 weeks of gestation. The risk of preterm labor before 34 weeks and during the 34th-37th weeks of gestation increased with increasing TG and TC levels. Moreover, overweight women who had a delivery before 34 weeks exhibited significant increases in TC and LDL concentrations during early pregnancy.

Conclusion: Lipid metabolism undergoes complicated changes in pregnancy. Lipid levels (LDL, HDL, TC, and TG) above or below the normal range during pregnancy increase the risk of preterm delivery. Considering the significance of maternal lipid metabolism in the incidence of preterm delivery, lipid profile screening in early pregnancy can largely contribute to the prevention of preterm delivery. Further studies are warranted to meticulously examine the effects of lipid profile on preterm delivery.

Comparing the effects of three different doses of caudal ketamine plus bupivacaine on pain control after paediatric surgery

2018-09-18T16:42:01+00:00

Introduction: Adding ketamine to bupivacaine in caudal anaesthesia is likely to increase its analgesic effect. However, it is not clear which dose of ketamine will have the greatest impact and the lowest level of complications. Thus, the purpose of this study was to compare the effects of three different doses of caudal ketamine plus bupivacaine on pain control after pediatric surgery.

Methodology: The present double-blinded clinical trial was conducted on 69 pediatric patients, of age ranging from 6 months to 10 years. Patients were assessed via the American Society of Anaesthesiologists (ASA) physical status classification system (ASA I-II), and had been also hospitalized for herniorrhaphy and orchidopexy. The patients were randomly divided into three groups. The first group received 0.75 mg/kg of 0.25% bupivacaine plus 0.25 mg/kg of ketamine, the second group received 0.75 mg/kg of 0.25% bupivacaine and 0.5 mg/kg of ketamine, and the third group received 0.75 mg/kg of 0.25% bupivacaine with 0.75 mg/kg of ketamine (as caudal anaesthesia). The duration of motor block and analgesia, as well as sedation levels, were measured for each study group. Each patient’s level of pain was also measured (at 1, 2, 3, 4, 6 and 24 hours after the surgery) via the All India Institute of Medical Sciences (AIIMS) pain discomfort scale. The data were then compared using SPSS Statistics (Version 22), with descriptive statistics, analysis of variance (ANOVA), and Chi-square test.

Results: The findings revealed that gender distribution did not differ significantly in the three study groups (p=0.896). The mean age of the first, second, and third group were reported to be 2.82±1.86, 3.1±2.4, and 2.48±1.06, respectively; thus, there was no significant difference in terms of age between the three groups (p=0.569). Upon examining the AIIMS pain discomfort scale scores during the first 24 hours following surgery, it was observed that the pain intensity was higher in the first group than in the second and third groups. Moreover, evaluation of the pain intensity in the first and the second groups revealed comparable results, while those of the second and the third groups did not show a significant difference in this respect.

Conclusion: The results demonstrated that the most effective and safest dose of ketamine, in this study, for pain control after pediatric surgery in the inguinal region was the 0.5 mg/kg dose.

Molecular detection of virulence genes in Klebsiella Pneumoniae clinical isolates from Kurdistan Province, Iran

2018-09-18T16:41:59+00:00

Introduction: The purpose of this study was to detect ybtS, entB, mrkD, magA, kfu, iutA, rmpA and K2 genes in extended-spectrum beta-lactamase (ESBL) - and non-ESBL producing Klebsiella pneumoniae.

Methods: To this end, 70 K. pneumoniae isolates were selected from hospitals of Kurdistan Province, Iran. The ESBL phenotype was conducted utilizing the disc diffusion technique in accordance with CLSI procedures. Detection of virulence factor genes was performed by the PCR in the ESBL and non-ESBL isolates.

Results: Sixty-two (88.6%) isolates of K. pneumoniae were ESBL producers. Further, entB had the most frequency in all the isolates. There were no significant differences between ESBL production and the presence of ybt S, entB, mrkD, magA, kfu, iutA, rmpA and K2 genes and the presence of these genes and variables such as presence of sex, clinical specimen type, and hvKP phenotype among the ESBL and non-ESBL K. pneumoniae isolates.

Conclusion: In conclusion, in other studies, K. pneumoniae strains were separated from liver abscesses and the magA gene was frequently present; however, in our study, the K. pneumoniae strains were separated from various clinical specimens and the magA gene had low frequency.

The therapeutic effectiveness of sitagliptin with niacin and chromium picolinate on glycosylated hemoglobin in type 2 diabetes mellitus patients

2018-09-18T16:41:48+00:00

Purpose: The purpose of this study was to evaluate the effectiveness of niacin (B3) on glycosylated hemoglobin (HbA1c), alone and as adjunct therapy, with chromium picolinate (CrPlt) and sitagliptin. In the present study, we have evaluated the effects of niacin and chromium picolinate supplementation with sitagliptin in Type 2 diabetes mellitus (T2DM) patients.

Methods: A randomized controlled trial was conducted on 600 patients suffering from T2DM from four different hospitals in Lahore, Punjab, Pakistan; patients were divided into three groups (n=200 per group). Group A was given sitagliptin (100 mg), Group B received niacin (14 mg/d) along with sitagliptin, and Group C received chromium picolinate (200 mcg/d) and niacin (14 mg/d) along with sitagliptin, for a duration of 6 months. Analysis of variance (ANOVA) was used to compare the efficacy of all treatment groups, and statistical significance was set at p≤0.05.

Results: The data indicated that all defined therapies have a significant influence with respect to fasting blood sugar (FBS) (p<0.0001), random blood sugar (RBS) (p<0.0001) and glycosylated hemoglobin (p<0.0001).

Conclusion: Our study demonstrated that low doses of niacin and chromium picolinate supplementation with sitagliptin helps in maintaining glycemic control in patients with T2DM, and provides the best treatment option among those considered.

Evaluation of the role of whey with dodder oxymel on mild to moderate psoriasis: A double-blind, randomized controlled trial

2018-09-18T16:41:52+00:00

Introduction: Psoriasis is a common chronic inflammatory disease that affects the physical, mental and sexual well-being of patients. Numerous side effects of different treatments and inadequate response to medications have resulted in pursuit of ideal treatment with low toxicity in low burden psoriasis hence complementary medicine. This study aims to evaluate the effects of whey with dodder oxymel on mild to moderate psoriatic skin lesions.

Methods: A 12-week double-blind, randomized, controlled, clinical trial was designed. Ninety psoriatic patients participated in the intervention. Drug and placebo were randomly assigned to two groups identically (whey with dodder oxymel and lactose). Patients were visited twice by a dermatologist. Their clinical responses were evaluated using the Psoriasis Area Severity Index (PASI), the Dermatology Life Quality Index (DLQI), the Visual Analogue Scale (VAS) and the Body Surface Area (BSA).

Results: After 12 weeks, in the intragroup analysis, the mean PASI score (P-value < 0.001) and BSA (P-value = 0.004) decreased in the intervention group. The mean VAS score (P-value < 0.001) and DLQI (Pvalue < 0.001) in both groups decreased. However, this decrease was much higher in the intervention group. In the intergroup analysis, 70% of patients reported improvement in PASI score (P-value < 0.001), the 88% improvement in quality of life (P-value < 0.001) and pruritus intensity (VAS) (P-value < 0.001), and the 54% reduction was detected in the area of lesions (BSA) (P-value = 0.001) as compared to the placebo group.

Conclusion: It appears that whey with dodder oxymel would improve psoriasis conditions and it can increase patients’ quality of life.

Galectin-3 as a potential marker of myocardial hypertrophy in essential hypertension in individuals with polymorphic AT1R genotypes

2018-09-18T16:41:41+00:00

Background: The potential use of plasma galectin-3 level as a of myocardial changes in the development of hypertrophy in males with essential hypertension (EH), carriers of polymorphic variants of II type 1 receptor gene, was studied. The level of brain peptide (BNP), as well as the parameters of central and systemic, and structural and functional parameters of the heart in carriers of polymorphic variants of II type 1 receptor gene, were studied as reference.

Methods: The study included 79 individuals with no signs of cardiovascular disease, and 62 males with stage II EH, aged 40-60, who were residents of Ukraine. All patients were treated at the Military Medical Clinical Center of Central Region of Air Forces of Ukraine and Vinnytsia Regional Specialized Clinical Hospital of Radiation Protection of the Ministry of Health of Ukraine, from December 2013 to June 2015. The patients were studied during their treatment at the in-patient department. Anesthetic, clinical and laboratory findings, and measures were entered into a special chart. Biochemical analyses were done upon admission of the patients to the hospital. Immunologic, and instrumental methods of examination were used as well. Statistical analyses of the results obtained were done on a personal computer using standard statistical package STATISTICA 10. Microsoft Excel was used for primary preparations of tables and intermediate calculations.

Results: In patients with EH and myocardial hypertrophy, the C allele of angiotensin II type 1 receptor gene was found to be dominating. They had higher levels of both galectin-3 and BNP. The threshold levels of galectin-3 and BNP for screening diagnosis of EH with myocardial hypertrophy in males (who were residents of the Podillya region of Ukraine) were evaluated.

Romiplostim: Successful treatment of a pregnant woman with refractory immune thrombocytopenia

2018-09-18T16:42:03+00:00

Immune thrombocytopenia is characterized by reduced platelet count. This condition occurs in both adults and children. The most common form of thrombocytopenia is primary ITP and autoantibodies are involved in its development. In this study, our patient was a pregnant woman with ITP who showed refractory to prednisolone and splenectomy as first and second line treatment, respectively, but the response to treatment with Romiplostim and platelet count was favorable, and delivery was reported without fetal complications.