Iranian Red Crescent Medical Journal
Volume:21 Issue: 2, Feb 2019

 Hormone replacement therapy (HRT) is widely used to control postmenopausal symptoms. This therapy is also used to prevent diseases such as osteoporosis and dementia. However, clinical trials suggest some negative effects regarding postmenopausal HRT. This study evaluates the effects of HRT on postmenopausal cardiovascular events. We collected data from 32 articles by using valid keywords and searching databases of PubMed, Medlib, ScienceDirect, EmBase, Scopus, Index Copernicus, SID, and Iranmedex. Analysis was performed by comparing three groups of postmenopausal women: combined hormone therapy (estrogen + progesterone), estrogen alone treated group, and placebo-receiving group (control group). Data were analyzed using the random effect model meta-analysis by using R software and Stata software Version 11.2. Of the collected 32 studies between 1998 and 2016, there were 1277686 subjects with an average age of 60.6 years. The prevalence of myocardial infarction were (2.64%), coronary heart disease (1.7%), stroke (254%), cardiovascular death (1.54%), revascularization (3.26 %), and cerebrovascular disease (CVD) (2.78%) in the combined hormone therapy group. Also, in the estrogen-treated group were 2.95%, 3.41%, 2.49%, 2.8%, - , 3.14%, respectively. In the placebo-receiving group these events were 2.09%, 2.73%, 2.9%, 2.25%, 4.96%, and 11.92, respectively. The results showed that estrogen therapy could increase the incidence of stroke. Moreover, HRT could have positive effects on the serum lipid profile in postmenopausal women. Postmenopausal HRT appears to be non-effective on coronary artery disease, revascularization, myocardial infarction, and cardiac-related deaths; however, it could play a role in increasing the stroke rate.

Although Matricaria chamomilla L. oil has been shown to contribute to the differentiation of mesenchymal stem cells (MSCs) into insulin-producing cells, the molecular mechanisms underlying its effect in the treatment of Type 1 Diabetes mellitus (T1DM) is still not available. The purpose of this study was to evaluate the effect of cultured MSCs on the surface of electrospun Poly-L-Lactide acid (PLLA) scaffolds coated with Matricaria chamomilla L. oil in treatment of T1DM and clarify its possible mechanisms. The current experimental study was performed using a total number of 36 male New Zealand white rabbits in the Experimental Animal Unit of Shahid Beheshti University of Medical Sciences Tehran, Iran, in 2018. A rabbit model of T1DM was established through a single intraperitoneal injection of streptozotocin (STZ) (80 mg/kg body weight)-1 dissolved in 0.2 mL of normal saline. For 21 days after implantation of cultured MSCs on the surface of electrospun PLLA scaffolds coated with Matricaria chamomilla L. oil, blood glucose levels, plasma insulin levels, plasma and pancreatic glucagon-like peptide 1 (GLP-1) were evaluated. The STZ-treated rabbits exhibited decreased levels of blood glucose (P < 0.01 vs. other groups except control), increased levels of plasma insulin (P < 0.01 vs. other groups except control), plasma and pancreatic GLP-1 (P < 0.001 vs. control, and P < 0.05 vs. other groups except control) at 21 days after implantation of cultured MSCs on the surface of electrospun PLLA scaffolds coated with Matricaria chamomilla L. oil. Collectively, our finding showed the presence of Matricaria chamomilla L. oil might improve survival and differentiation MSCs in insulin producing cells that can be attributed to antioxidant properties of its bioactive compounds.

Parsley (Petroselinum crispum L) (PAR) is used widely as an antioxidant, antihyperlipidemic, diuretic, and medication to reduce hypertension. At the same time, conventional drugs such as Simvastatin (SV) are also used to manage hyperlipidemia in hypertensive patients. However, no studies have reported any interactions for the concomitant use of PAR and SV. The study aimed to evaluate the enzyme-inducing or inhibiting role of PAR for SV at the level of cytochrome P-450 metabolic enzyme. This is an open-label (unblinded) study conducted with 24 healthy albino rats (4X6 = 24), at Imam Abdulrahman Bin Faisal University, Saudi Arabia, in the year 2018 with protocol approval No. IRB-2018-145-Pharm and approval date 18/04/2018. The animals were administered with a loading single oral dose of SV (80 mg), Clarithromycin (CLAR; 80 mg), Carbamazepine (CBZ; 80 mg), and PAR, i.e., dried herb powder (200 mg), in order to achieve a steady state concentration in the blood. Blood samples were collected at specified time points including pre-dose (0.0) and after-treatment, i.e., 0.5, 1, 1.5, 2, and 3 hours, and centrifuged. The plasma was extracted to analyze for SV by LC-MS using a previously developed method. The analysis of pharmacokinetic parameters revealed enhanced Cmax (mean plasma maximum concentration) and AUC0-∞ (area under the concentration-time curve) as 2 and 2.2 folds, respectively, for SV+PAR (P < 0.01) as compared to SV alone. A decrease in CL/F (total-body clearance of drug from the plasma) for SV (P < 0.01) and an increased t1/2 (mean half-life) from 3.20 to 6.12 hours for SV co-administered with PAR were observed. Parsley combined with Simvastatin increased the Cmax and AUCs for Simvastatin as 2 and 2.5 folds; thereby, the moderating enzyme-inhibiting role of Parsley for CYP 3A enzyme may be proposed. Hence, caution is required when administering Parsley with Simvastatin for any therapeutic purpose.

A new approach in the treatment of epilepsy is to use new drugs with neuroprotective, antioxidant, and anti-inflammatory effects. The study aimed to investigate the protective effects of Artemisia persica essential oil (EO) against pentylenetetrazol (PTZ)-induced seizure in mice. This experimental study was conducted at the Izeh Islamic Azad University, Iran. 70 male BALB/c mice were divided into seven groups of 10 using simple random allocation, including control (normal saline), PTZ (35 mg/kg i.p. with 48 hours intervals and then 60 mg/kg on the 10th day), interventions (PTZ plus daily i.p. injection of EO at doses of 50, 75, and 100 mg/kg), diazepam (PTZ plus EO at a dose of 100 mg/kg + diazepam), and flumazenil (PTZ plus EO at a dose of 100 mg/kg + flumazenil) groups. The treatment of PTZ-kindled mice with 50 mg/kg of EO significantly reduced the seizure onset latency (P < 0.05). EO at a dose of 100 mg/kg significantly decreased tonic seizures, head tics, and repeated spinning and jumping (P < 0.05). Diazepam improved, and flumazenil weakened the anticonvulsant effects of the EO. The treatment of PTZ-kindled mice with EO (100 mg/kg) significantly decreased nitric oxide and malondialdehyde, and increased the total antioxidant capacity in both serum and brain (P < 0.05). EO at a dose of 100 mg/kg could significantly decrease IL-1β and TNF-α expression in the brain of epileptic mice (P < 0.05). A. persica EO shows anticonvulsant effects through benzodiazepine receptor binding activity and modulation of oxidative stress and the inflammatory process.

Some data suggest the protective effect of Portulaca oleracea against renal failure and its association with the preservation of the renal antioxidant status and the regulation of apoptosis. The current study aimed to examine the renoprotective effects of treatment with Portulaca oleracea (PO), a prominent hydrogen sulfide donor, in a 5/6 nephrectomy animal model. In this experimental study, 32 adult male Wistar rats, initially weighting 200 - 250 g, were housed under standard conditions since the beginning of April 2017 until the end of January 2018. The effect of PO extract on renal dysfunction induced by gentamicin was studied. The male rats were treated with two selected doses of PO (i.e., 200 and 600 mg/kg p.o.) and normal saline (5 mL/kg p.o.) for 28 consecutive days. Gentamicin (80 mg/kg/day intraperitoneally [i.p.]) was administered to two groups for seven days, and they were considered as the PO200 and PO600 gentamicin groups, respectively, while the group administered normal saline (5 mL/kg p.o.) for 35 consecutive days was considered as the control group. The rats were anesthetized on day 36. Then, they were sacrificed under deep anesthesia, and plasma and tissue samples were obtained. Treatment with PO decreased the renal histological damages and apoptosis induced by gentamicin and enhanced renal function parameters compared to the gentamicin group. The present findings provide strong evidence to support the traditional medicinal use of this herb by the tribal people in the treatment of renal impairment. Finally, these results support the therapeutic effect of PO in preventing the development of renal dysfunction.

Vomiting is a common act after strabismus surgery. Three points (BL10, BL11, GB34) belong to the eye's energy channels and may be more effective in vomiting after strabismus surgery compared to P6 point. The present study aimed to compare the effects of stimulation of BL10, BL11, and GB34 acupuncture points with point P6 via the use of a low-level laser in the prevention of vomiting after strabismus surgery. The present study used a randomized, double-blind, clinical trial design. The participating samples of this study were 63 strabismus surgery candidates with ASA I physical status, aged from 3 to 35 years who admitted to a university-affiliated hospital in Ahvaz, Iran, and were. The patients were randomly divided into three groups (21 patients in each group): Group I (laser acupuncture P6), group II (laser acupuncture BL10, BL11, GB34), and group III (control). Laser stimulation was performed on acupuncture points (P6 & BL10, BL11, GB34) for 60 seconds and 15 minutes before anesthesia induction and 15 minutes after arrival in the PACU. Group III (control) received placebo (laser off) stimulation on sham point. The number of vomits occurred 2, 6, and 24 hours after the surgery was recorded. Significant statistical differences were not observed in the number of vomiting after 6 hours among the three groups (P = 0.01). On the other hand, significant statistical differences were found between P6 point and placebo groups in terms of the mean value of vomiting 2 and 24 hours after the surgery (P = 0.03). However, no significant statistical differences were observed between P6 and BL10 groups at any time of the study. Based on the findings, laser acupuncture of P6 point reduced the incidence of vomiting after strabismus surgery. Also, laser acupuncture of BL10, BL11, and GB34 points showed no significant differences in terms of the incidence of PONV when compared to P6 point. P6 point was the most effective point in controlling the incidence of PONV.

Neonatal respiratory distress syndrome (RDS) is a problem that often occurs in preterm neonates. The present study was conducted to compare the efficacy and complications of humidified high flow nasal cannula (HFNC) with those of nasal continuous positive airway pressure (NCPAP) after surfactant therapy in neonates with RDS. This clinical trial was conducted on 60 neonates with the gestational age of 28 - 36 weeks suffering from RDS and admitted to Fatemieh Hospital in Hamadan, Iran, during 2017. Initially, all newborns were administered with exogenous surfactant. Subsequently, the participants were randomly assigned into two groups of HFNC (group 1) and NCPAP (group 2) to receive respiratory support. The NCPAP group was managed with a mask or nasal prong. The HFNC group was given warm and humid oxygen through a short binasal cannula proportional to the weight of each neonate until the recovery of respiratory distress. The mean one-minute Apgar scores were obtained as 6.23 ± 1.55 and 6.60 ± 1.07 in the HFNC and NCPAP groups, respectively. Furthermore, the mean five-minute Apgar scores were 8.0 ± 1.11 and 8.17 ± 0.95 in these groups, respectively. The mothers and neonates in both groups were comparable in terms of demographic and clinical data, except for gestational age and neonatal gender (P = 0.05). Furthermore, there was no statistically significant difference between the HFNC and NCPAP groups regarding the respiratory outcomes (P = 0.05). As the findings indicated, humidified high flow nasal cannula was as effective as nasal continuous positive airway pressure in the management of respiratory distress in premature neonates with the gestational age of 28 - 36 weeks. Consequently, these two interventions could be used interchangeably for the provision of respiratory support among these patients.

The purpose of this study is to explore the factors affecting the resiliency of Humanitarian Aid Workers in disasters in Iran. The present qualitative study has been conducted using a content analysis method. A purposeful sampling method was applied until reaching data saturation. A total of 18 Humanitarian Aid Workers participated in this study. Data were collected using face-to-face semi-structured interviews. Six main categories which influence resiliency of Humanitarian Aid Workers in disasters were extracted from the data: challenges of disasters' scene, self-adequacy, self-care, burnout, organizational support, and supportive network. The officials and executive directors of humanitarian service organizations should be aware of the factors affecting resiliency and try to enhance the resiliency of their workers in order to encourage them for keeping on their voluntary efforts.

Chronic vertigo is a disabling disease that influences the quality of life. There are simple and low-cost treatments in Iranian traditional medicine (ITM) with minimal side effects for some subtypes of this disease based on the ancient classification. One of them is gastric-related vertigo (GRV) that is diagnosed by a rational relationship between digestive symptoms and vertigo. Two adult patients with chronic vertigo were visited in the Behesht - Iranian traditional- medicine outpatient clinic of Iran University of Medical Sciences in Tehran, Iran, in the year 2017. They were evaluated and treated according to gastric-related vertigo management. The patients received 5 mL of pomegranate concentrated juice after each meal for four weeks. Their symptoms were checked after four weeks and the validated Persian version of dizziness handicap inventory (DHI) was completed for them as a pre-treatment and post-treatment monitoring tool. Pomegranate concentrated juice as a stomach tonic led to the improvement of the digestive symptoms and vertigo. The six-month follow-ups after treatment were normal.