Complementary and alternative medicine use among people living with HIV in Shiraz, Southern Iran

Survival rate and its predictors in HIV patients: A 15-year follow-up of 3030 patients

BACKGROUND

The high prevalence of HIV infection and the deaths caused by it is one of the challenges for the healthcare systems throughout the world. In this study, we analyzed the survival of people living with HIV and co-infections, and related factors.

METHODS

This retrospective cohort study was performed on 3030 people living with HIV admitted to Imam Khomeini Behavioral Disease Counseling Center, Tehran, Iran, during 2004-2018. Required data were obtained from the individuals' files. Kaplan Meier diagrams and Log-rank tests were used to assess the relationship between different factors and survival. In addition, Cox regression analysis was performed to determine the effective factors in HIV mortality. Data were analyzed using STATA software, version 14.

RESULTS

The mean age of studied population was 43.2 ± 9.5 [years] and 77.3 % were male. Among the subjects, 3.2 % were infected with hepatitis B, 31.5 % with hepatitis C, and 13.9 % with Tuberculosis (TB). One, five, ten, and fifteen-year survival rates were 97.0 %, 93.0 %, 86.0 %, and 54.0 %, respectively. The mean survival time was 154.2 ± 0.9 months. Age more than 35, history of imprisonment, Unsafe sexual behavior, TB, and hepatitis C are independently associated with death in people living with HIV (p < 0.05).

CONCLUSION

The survival of people living with HIV in the present study was in the favorable range compared to previous studies. However, co-infection with hepatitis C was associated with reduced survival of the subjects in this study. Therefore, it is suggested to detect and then prevent and control HCV co-infection to increase the survival of subjects.

A review of inflammatory bowel disease from the perspective of Persian medicine

The initial descriptions of inflammatory bowel disease (IBD) have been a topic of discussion. Cases of persistent diarrhea have been documented as far back as ancient Greece, with even Hippocrates (∼ 460-370 BCE) exploring various potential causes of diarrhea. Persian medicine was the predominant medical practice in the Eurasia region until the 18th century and had roots in Hippocrates and the ancient civilization of the region. Scholars, such as Avicenna (980-1025 CE), extensively described a disease characterized by intestinal ulcers, bloody diarrhea, and abdominal pain in the early medieval period. While some of the definitions and etiologies of IBD in Persian medicine are based on humoral theories that differ from current medical concepts, recent studies have suggested a potential relationship between the traditional Persian medicine understanding of the disease and IBD. Persian medicine classifies patients with specific diseases into different types of disorders known as dystemperament, with the application of these differences referred to as "syndrome differentiation." These traditional classifications require distinct therapeutic approaches. Research has delved into the molecular bases of the humoral theory and the impact of syndrome differentiation on drug selection for patients, including those with IBD. However, further research is needed to explore the potential effectiveness of Persian medicine in treating IBD and to understand how this ancient classification system can contribute to improved disease management.

Prevalence, patterns, and disclosure of complementary and alternative medicine (CAM) use among patients with thyroid diseases: A cross-sectional study in Iran

Introduction

Complementary and alternative medicine (CAM) has gained popularity as a therapeutic approach outside conventional medicine for various medical conditions. This study aimed to assess the prevalence, patterns, and disclosure of CAM use among patients with thyroid diseases in Iran.

Methods

This descriptive-analytic cross-sectional study involved patients with thyroid diseases who were visiting Internal Medicine Clinics in Shiraz. The use of CAM was assessed by employing the Persian edition of the I-CAM-Q (I-CAM-IR) questionnaire.

Results

A total of 343 individuals took part in the study, and 85.4 % of them reported using CAM within the previous 12 months. Medicinal herbs were the most commonly used CAM modality (63 %). CAM use was primarily for enhancing overall well-being. Among self-care CAM practices, praying was the most frequently employed (70 %). Women exhibited a significantly higher CAM utilization rate (four times greater) compared to men (p < 0.001), with herbs being more commonly used by women (p < 0.001). A significant proportion of participants did not inform their physicians about their CAM use, and 46 % experienced significant benefits from using CAM.

Conclusion

This study highlights a high prevalence of CAM use, particularly herbal remedies, among Iranian patients with thyroid diseases.

Unlocking the therapeutic potential of Nigella sativa extract: phytochemical analysis and revealing antimicrobial and antioxidant marvels

The growing global threat of antimicrobial resistance endangers both human and animal life, necessitating the urgent discovery of novel antimicrobial solutions. Medicinal plants hold promise as sources of potential antimicrobial compounds. In this study, we investigated the phytochemical constituents and microbicidal capabilities of the ethanolic extract from Nigella sativa (black seed). Gas chromatography analysis (GC) identified 11 compounds, among them thymoquinone, and thymol, contributing to antimicrobial and antioxidant properties. Antimicrobial assays demonstrated notable inhibition zones against broad spectra of bacteria, including Pseudomonas aeruginosa, Escherichia coli, Salmonella typhi, Staphylococcus aureus, Enterobacter, and Bacillus subtilis, along with potent antifungal activity against Aspergillus niger, Penicillium, and Candida albicans. Notably, when combined with antibiotics, the extract displayed exceptional synergistic antimicrobial efficacy. The black seed extract demonstrated membrane-damaging activity and disrupted virulence factors that protect microbes from antimicrobial agents, including the formation of bacterial biofilm and protease secretion. Thymoquinone, the primary active constituent of the extract, exhibited similar antimicrobial and ant virulence properties. In silico analysis targeting key regulators of quorum sensing and biofilm formation in P. aeruginosa, such as RhlG, LasR, and PqsR, showed a remarkable affinity of thymol and thymoquinone for these targets. Moreover, the N. sativa extract exhibited dose-dependent cytotoxicity against both the promastigote and amastigote forms of Leishmania tropica parasites, hinting at potential antiparasitic activity. In addition to its antimicrobial properties, the extract displayed potential antioxidant activity at a concentration of 400 μg/mL.

An update on drug-drug interactions in older adults living with human immunodeficiency virus (HIV)

INTRODUCTION

People with HIV are living longer due to advances in antiretroviral therapy. With improved life expectancy comes an increased lifetime risk of comorbid conditions - such as cardiovascular disease and cancer - and polypharmacy. Older adults, particularly those living with HIV, are more vulnerable to drug interactions and adverse effects, resulting in negative health outcomes.

AREA COVERED

Antiretrovirals are involved in many potential drug interactions with medications used to treat common comorbidities and geriatric conditions in an aging population of people with HIV. We review the mechanisms and management of significant drug-drug interactions involving antiretroviral medications and non-antiretroviral medications commonly used among older people living with HIV. The management of these interactions may require dose adjustments, medication switches to alternatives, enhanced monitoring, and considerations of patient- and disease-specific factors.

EXPERT OPINION

Clinicians managing comorbid conditions among older people with HIV must be particularly vigilant to side effect profiles, drug-drug interactions, pill burden, and cost when optimizing treatment. To support healthier aging among people living with HIV, there is a growing need for antiretroviral stewardship, multidisciplinary care models, and advances that promote insight into the correlations between an individual, their conditions, and their medications.

Efficacy and safety of Plantago major seeds in patients with diabetic nephropathy: A randomized open-labeled controlled clinical trial

BACKGROUND

Diabetic Nephropathy (DN) is characterized by albuminuria and a declining glomerular filtration rate (GFR) in diabetic patients. Plantago major (plantain) seed powder is traditionally used in these patients. Despite emerging and promising pre-clinical evidence, no clinical study investigated the potential efficacy of this intervention in patients with DN, which is the aim of this study.

METHODS

In a randomized clinical trial 60 DN patients were recruited from November 2022 to March 2023 and randomly assigned to the plantain group that received standard treatment (Losartan 25 mg twice a day) and plantain seeds' powder (10 gm sachet twice a day) plus sweet almond and the control group was received only standard treatment for 60 days. Proteinuria, as per 24-hour urinary protein, as well as fasting blood sugar (FBS), blood urea nitrogen (BUN), serum creatinine, serum potassium, and quality of life score were measured at baseline and after 60 days as study outcome measures.

RESULTS

Proteinuria was significantly decreased from 165.04 mg to 135.84 mg (p = 0.026) in the plantain group. The mean level of proteinuria was significantly lower in the plantain group (135.84 vs. 192.04, p = 0.039) compared to the control group after treatment. The plantain group showed more increase in quality of life score after treatment (33.89±9.67 vs 38.28±10.72, p = 0.041). Other outcomes showed no significant difference between the two study groups.

CONCLUSION

Adjuvant supplementation with plantain seeds powder may decrease proteinuria in patients with diabetic nephropathy. Further studies with larger sample sizes and longer duration are needed to confirm these results.

Prevalence of Complementary and Alternative Medicine Use and Its Associated Factors among Iranian Diabetic Patients: A Cross-Sectional Study

Objective

This cross-sectional study aimed to assess the prevalence of complementary and alternative medicine (CAM) use and its associated factors among diabetic patients in Fasa, a city in southern Iran.

Methods

Data were collected from diabetic patients who visited the endocrinology clinics at Fasa University of Medical Sciences. A structured questionnaire was administered to gather information on CAM use, including the types of CAM modalities used, and reasons for use. The patient's demographic and clinical characteristics, such as age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c) levels, and quality of life (QoL) were also recorded. Descriptive statistics were used to determine the prevalence of CAM use, while logistic regression analysis was employed to identify factors associated with CAM use.

Results

A total of 376 diabetic patients participated in the study, with more than 89% reporting CAM use within the past year. Herbal preparations were the most commonly used type of CAM, with a prevalence rate of 99.4%. Factors associated with CAM use included patients' psychological health, attitude towards the safety of CAM, belief in the synergistic effects of combining routine medications with CAM, and previous positive experiences with CAM.

Conclusion

The high prevalence of CAM use highlights the importance of considering it in diabetes management and the need for healthcare professionals' engagement in open discussions with patients about their CAM practices. Understanding the factors influencing CAM use can inform healthcare providers and policymakers in developing appropriate strategies for integrating CAM approaches into conventional diabetes care.

Molecular mechanism of resveratrol promoting differentiation of preosteoblastic MC3T3-E1 cells based on network pharmacology and experimental validation

The purpose of this study was to investigate the mechanism by which resveratrol (Res) inhibits apoptosis and promotes proliferation and differentiation of pre-osteoblastic MC3T3-E1 cells, laying the groundwork for the treatment of osteoporosis (OP). The TCMSP database was used to find the gene targets for Res. The GeneCards database acquire the gene targets for OP. After discovering the potential target genes, GO, KEGG, and Reactome enrichment analysis were conducted. Verifying the major proteins involved in apoptosis can bind to Res using molecular docking. CCK8 measured the proliferative activity of mouse pre-osteoblasts in every group following Res intervention. Alkaline phosphatase staining (ALP) and alizarin red staining to measure the ability of osteogenic differentiation. RT-qPCR to determine the expression levels of Runx2 and OPG genes for osteogenic differentiation ability of cells. Western blot to measure the degree of apoptosis-related protein activity in each group following Res intervention. The biological processes investigated for GO of Res therapeutic OP involved in cytokine-mediated signaling pathway, negative regulation of apoptotic process, Aging, extrinsic apoptotic signaling pathway in absence of ligand, according to potential therapeutic target enrichment study. Apoptosis, FoxO signaling pathway, and TNF signaling pathway are the primary KEGG signaling pathways. Recactome pathways are primarily engaged in Programmed Cell Death, Apoptosis, Intrinsic Apoptotic Pathway, and Caspase activation via extrinsic apoptotic signaling pathways. This research established a new approach for Res treatment of OP by demonstrating how Res controls the apoptosis-related proteins TNF, IL6, and CASP3 to suppress osteoblast death and increase osteoclastogenesis.

Alleviating effect of lavender (Lavandula angustifolia) and its major components on postherpetic pain: a randomized blinded controlled trial

BACKGROUND

Postherpetic neuralgia (PHN) causes severe pain which can lead to decreased quality-of-life. This study aimed to evaluate the effects of inhalation of lavender (Lavandula angustifolia) oil and its major components (linalool and linalyl acetate) on the pain in patients with PHN.

METHODS

This study was performed at an outpatient clinic. Sixty-four patients with postherpetic neuralgia were randomly allocated to a control group (almond oil) or one of three experimental groups (lavender oil, linalool, or linalyl acetate diluted in almond oil at concentration of 1% v/v), and the participants inhaled the aroma by natural breathing. Quality, severity, and intensity of pain were measured before and after the intervention.

RESULTS

Six patients discontinued the intervention for personal reasons; hence, data from 58 patients were analyzed (control group, n = 14; 1% lavender oil group, n = 15; 1% linalool, n = 15; 1% linalyl acetate, n = 14). Reduction in sensory pain was greater in the 1% lavender oil group, 1% linalool group, and 1% linalyl acetate group than in the control group (all P < 0.001). Reduction in affective pain was greater in the 1% lavender group (P < 0.001) and the 1% linalool group (P = 0.007) than in the control group. Decreases in pain severity and intensity were significantly greater in all three intervention groups than in the control group.

CONCLUSIONS

Inhalation of lavender oil and its major volatile components effectively reduced the quality, severity, and intensity of postherpetic pain, suggesting that lavender oil, linalool, and linalyl acetate may each be an effective intervention for reducing pain in patients with postherpetic neuralgia.

TRIAL REGISTRATION

This study was retrospectively registered on the Clinical Research Information Service.

REGISTRATION NUMBER

KCT0007772, first registration 06/10/2022.