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Abdollahy A, Salehi M, Mahami S, Bernkop-Schnürch A, Vahedi H, Gharravi AM, Mehrabi M. Therapeutic effect of 5-ASA and hesperidin-loaded chitosan/Eudragit® S100 nanoparticles as a pH-sensitive carrier for local targeted drug delivery in a rat model of ulcerative colitis. Int J Pharm 2024; 652:123838. [PMID: 38266937 DOI: 10.1016/j.ijpharm.2024.123838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 01/20/2024] [Accepted: 01/20/2024] [Indexed: 01/26/2024]
Abstract
Ulcerative colitis (UC) is an idiopathic disease characterized by colonic mucosal tissue destruction secondary to an excessive immune response. We synthesized pH-sensitive cross-linked chitosan/Eudragit® S100 nanoparticles (EU S100/CS NPs) as carriers for 5-aminosalicylic acid (5-ASA) and hesperidin (HSP), then conducted in-vitro and in-vivo studies and evaluated the therapeutic effects. In-vitro analysis revealed that the 5-ASA-loaded EU S100/CS NPs and the HSP-loaded EU S100/CS NPs had smooth and curved surfaces and ranged in size between 250 and 300 nm, with a zeta potential of 32 to 34 mV. FTIR analysis demonstrated that the drugs were loaded on the nanoparticles without significant alterations. The loading capacity and encapsulation efficiency of loading 5-ASA onto EU S100/CS NPs were 25.13 % and 60.81 %, respectively. Regarding HSP, these values were 38.34 % and 77.84 %, respectively. Drug release did not occur in simulated gastric fluid (SGF), while a slow-release pattern was recorded for both drugs in simulated intestinal fluid (SIF). In-vivo macroscopic and histopathological examinations revealed that both NPs containing drugs significantly relieved the symptoms of acetic acid (AA)-induced UC in Wistar rats. We conclude that the synthesized pH-sensitive 5-ASA/EU S100/CS NPs and HSP/EU S100/CS NPs offer promise in treating UC.
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Affiliation(s)
- Armana Abdollahy
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Majid Salehi
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Solmaz Mahami
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Andreas Bernkop-Schnürch
- Center for Chemistry and Biomedicine, Department of Pharmaceutical Technology, Institute of Pharmacy, Leopold-Franzens-University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Hamid Vahedi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Anneh Mohammad Gharravi
- Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
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Kancha MM, Mehrabi M, Bitaraf FS, Vahedi H, Alizadeh M, Bernkop-Schnürch A. Preparation, Characterization, and Anticancer Activity Assessment of Chitosan/TPP Nanoparticles Loaded with Echis carinatus Venom. Anticancer Agents Med Chem 2024; 24:ACAMC-EPUB-137522. [PMID: 38243949 DOI: 10.2174/0118715206279731231129105221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/22/2023] [Accepted: 11/07/2023] [Indexed: 01/22/2024]
Abstract
AIMS AND BACKGROUND Echis carinatus venom is a toxic substance naturally produced by special glands in this snake species. Alongside various toxic properties, this venom has been used for its therapeutic effects, which are applicable in treating various cancers (liver, breast, etc.). OBJECTIVE Nanotechnology-based drug delivery systems are suitable for protecting Echis carinatus venom against destruction and unwanted absorption. They can manage its controlled transfer and absorption, significantly reducing side effects. METHODS In the present study, chitosan nanoparticles were prepared using the ionotropic gelation method with emulsion cross-linking. The venom's encapsulation efficiency, loading capacity, and release rate were calculated at certain time points. Moreover, the nanoparticles' optimal formulation and cytotoxic effects were determined using the MTT assay. RESULTS The optimized nanoparticle formulation increases cell death induction in various cancerous cell lines. Moreover, chitosan nanoparticles loaded with Echis carinatus venom had a significant rate of cytotoxicity against cancer cells. CONCLUSION It is proposed that this formulation may act as a suitable candidate for more extensive assessments of cancer treatment using nanotechnology-based drug delivery systems.
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Affiliation(s)
- Maral Mahboubi Kancha
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Bitaraf
- Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Morteza Alizadeh
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Andreas Bernkop-Schnürch
- Department of Pharmaceutical Technology, University of Innsbruck, Institute of Pharmacy, Center for Chemistry and Biomedicine, Innsbruck, 6020, Austria
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Mahami S, Salehi M, Mehrabi M, Vahedi H, Hassani MS, Bitaraf FS, Omri A. pH-sensitive HPMCP-chitosan nanoparticles containing 5-aminosalicylic acid and berberine for oral colon delivery in a rat model of ulcerative colitis. Int J Biol Macromol 2023:125332. [PMID: 37302632 DOI: 10.1016/j.ijbiomac.2023.125332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/06/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
Ulcerative colitis (UC) with continuous and extensive inflammation is limited to the colon mucosa and can lead to abdominal pain, diarrhea, and rectal bleeding. Conventional therapies are associated with several limitations, such as systemic side effects, drug degradation, inactivation, and limited drug uptake, leading to poor bioavailability. These restrictions necessitate drug delivery to the colon so that the drug passes through the stomach unchanged and has selective access to the colon. The present study aimed to formulate 5-aminosalicylic acid (5-ASA) and berberine (BBR) in chitosan nanoparticles cross-linked by HPMCP (hydroxypropyl methylcellulose phthalate) as a colon drug delivery system for UC. Spherical nanoparticles were prepared. They showed appropriate drug release in the simulated intestinal fluid (SIF), while the release did not occur in the simulated gastric fluid (SGF). They improved disease activity parameters (DAI) and ulcer index, increased the length of the colon, and decreased the wet weight of the colon. Furthermore, histopathological colon studies showed an improved therapeutic effect of 5-ASA/HPMCP/CSNPs and BBR/HPMCP/CSNPs. In conclusion, although 5-ASA/HPMCP/CSNPs showed the best effect in the treatment of UC, BBR/HPMCP/CSNPs, and 5-ASA/BBR/HPMCP/CSNPs were also effective in vivo study, and this study anticipated they could be helpful in future clinical applications for the management of UC.
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Affiliation(s)
- Solmaz Mahami
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Science, Shahroud, Iran
| | - Majid Salehi
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran; Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Science, Shahroud, Iran.
| | - Hamid Vahedi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Maryam Sadat Hassani
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Science, Shahroud, Iran
| | - Fatemeh Sadat Bitaraf
- Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abdelwahab Omri
- The Novel Drug & Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON P3E 2C6, Canada.
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Gohari Mahmoudabad A, Gheybi F, Mehrabi M, Masoudi A, Mobasher Z, Vahedi H, Gharravi AM, Bitaraf FS, Rezayat Sorkhabadi SM. Synthesis, characterization and hepatoprotective effect of silymarin phytosome nanoparticles on ethanol-induced hepatotoxicity in rats. Bioimpacts 2023; 13:301-311. [PMID: 37645028 PMCID: PMC10460772 DOI: 10.34172/bi.2023.24128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 06/25/2022] [Accepted: 09/13/2022] [Indexed: 08/31/2023]
Abstract
Introduction Silymarin proved to be a beneficial herbal medicine against many hepatic disorders such as alcoholic liver disease (ALD). However, its application is restricted due to its low bioavailability and consequently decreased efficacy. We herein used a nano-based approach known as "phytosome", to improve silymarin bioavailability and increase its efficacy. Methods Phytosome nanoparticles (NPs) were synthesized using thin film hydration method. NPs size, electrical charge, morphology, stability, molecular interaction, entrapment efficiency (EE %) and loading capacity (LC %) were determined. Moreover, in vitro toxicity of NPs was investigated on mesenchymal stem cells (MSCs) viability using MTT assay. In vivo experiments were performed using 24 adult rats that were divided into four groups including control, ethanol (EtOH) treatment, silymarin/EtOH treatment and silymarin phytosome/EtOH, with 6 mice in each group. Experimental groups were given 40% EtOH, silymarin (50 mg/kg) and silymarin phytosome (200 mg/kg) through the gastric gavage once a day for 3 weeks. Biochemical parameters, containing ALP, ALT, AST, GGT, GPx and MDA were measured before and after experiment to investigate the protective effect of silymarin and its phytosomal form. And histopathological examination was done to evaluate pathological changes. Results Silymarin phytosome NPs with the mean size of 100 nm were produced and were well tolerated in cell culture. These NPs showed a considerable protective effect against ALD through inverting the biochemical parameters (ALP, ALT, AST, GGT, GPx) and histopathological alterations. Conclusion Silymarin phytosomal NPs can be used as an efficient treatment for ALD.
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Affiliation(s)
- Arezoo Gohari Mahmoudabad
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Gheybi
- Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Alireza Masoudi
- Department of Pharmacology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zeinab Mobasher
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamid Vahedi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Anneh Mohammad Gharravi
- Tissue Engineering and Stem Cell Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Bitaraf
- Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
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Enayatrad M, Mahdavi S, Aliyari R, Sahab-Negah S, Nili S, Fereidouni M, Mangolian Shahrbabaki P, Ansari-Moghaddam A, Heidarzadeh A, Shahraki-Sanavi F, Fateh M, Khajeha H, Emamian Z, Behmanesh E, Sheibani H, Abbaszadeh M, Jafari R, Valikhani M, Binesh E, Vahedi H, Chaman R, Sharifi H, Emamian MH. Reactogenicity within the first week after Sinopharm, Sputnik V, AZD1222, and COVIran Barekat vaccines: findings from the Iranian active vaccine surveillance system. BMC Infect Dis 2023; 23:150. [PMID: 36899326 PMCID: PMC10000357 DOI: 10.1186/s12879-023-08103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the reactogenicity effects of COVID-19 vaccines, used in Iran. METHODS At least 1000 people were followed up with phone calls or self-report in a mobile application within 7 days after vaccination. Local and systemic reactogenicities were reported overall and by subgroups. RESULTS The presence of one or more local and systemic adverse effects after the first dose of vaccines was 58.9% [(95% Confidence Intervals): 57.5-60.3)] and 60.5% (59.1-61.9), respectively. These rates were reduced to 53.8% (51.2-55.0) and 50.8% (48.8-52.7) for the second dose. The most common local adverse effect reported for all vaccines was pain in the injection site. During the first week after the first dose of vaccines, the frequency of the pain for Sinopharm, AZD1222, Sputnik V, and Barekat was 35.5%, 86.0%, 77.6%, and 30.9%, respectively. The same rates after the second dose were 27.3%, 66.5%, 63.9%, and 49.0%. The most common systemic adverse effect was fatigue. In the first dose, it was 30.3% for Sinopharm, 67.4% for AZD1222, 47.6% for Sputnik V, and 17.1% for Barekat. These rates were reduced to 24.6%, 37.1%, 36.5%, and 19.5%, in the second dose of vaccines. AZD1222 had the highest local and systemic adverse effects rates. The odds ratio of local adverse effects of the AZD1222 vaccine compared to the Sinopharm vaccine were 8.73 (95% CI 6.93-10.99) in the first dose and 4.14 (95% CI 3.32-5.17) in the second dose. Barekat and Sinopharm had the lowest frequency of local and systemic adverse effects. Compared to Sinopharm, systemic adverse effects were lower after the first dose of Barekat (OR = 0.56; 95% CI 0.46-0.67). Reactogenicity events were higher in women and younger people. Prior COVID-19 infection increased the odds of adverse effects only after the first dose of vaccines. CONCLUSIONS Pain and fatigue were the most common reactogenicities of COVID-19 vaccination. Reactogenicities were less common after the second dose of the vaccines. The adverse effects of AZD1222 were greater than those of other vaccines.
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Affiliation(s)
- Mostafa Enayatrad
- Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Sepideh Mahdavi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Roqayeh Aliyari
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sajad Sahab-Negah
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sairan Nili
- Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Fereidouni
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Parvin Mangolian Shahrbabaki
- Department of Critical Care, Razi Faculty of Nursing and Midwifery, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Abtin Heidarzadeh
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariba Shahraki-Sanavi
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansooreh Fateh
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamidreza Khajeha
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Emamian
- Health Technology Incubator Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elahe Behmanesh
- Health Technology Incubator Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Sheibani
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Maryam Abbaszadeh
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Reza Jafari
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Maryam Valikhani
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Ehsan Binesh
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Hamid Vahedi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Science, Shahroud, Iran
| | - Reza Chaman
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
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Hosseinzadeh A, Sahab-Negah S, Nili S, Aliyari R, Goli S, Fereidouni M, Alami A, Shati M, Ahmadnezhad E, Mehravaran S, Fateh M, Khajeha H, Emamian Z, Behmanesh E, Mahdavi S, Enayatrad M, Mangolian Shahrbabaki P, Ansari-Moghaddam A, Heidarzadeh A, Shahraki-Sanavi F, Hashemi Shahri SM, Dehghan M, Amini Moridani M, Sheibani H, Abbaszadeh M, Jafari R, Valikhani M, Binesh E, Vahedi H, Chaman R, Khodashahi R, Amini M, Jabbari Azad F, Rezaeitalab F, Amel Jamehdar S, Eshraghi A, Sharifi H, Hashemi Bajgani SM, Mahdavi A, Jafarzadeh A, Farokhnia M, Ebrahimi S, Pardakhti A, Ghaderi E, Soltani H, Jadidoleslami S, Arianejad A, Gavili H, Moradveisi B, Motamedi D, Zare H, Kazemi T, Emamian MH. COVID-19 cases, hospitalizations and deaths after vaccination: a cohort event monitoring study, Islamic Republic of Iran. Bull World Health Organ 2022; 100:474-483. [PMID: 35923277 PMCID: PMC9306382 DOI: 10.2471/blt.22.288073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated with either AZD1222 Vaxzevria, CovIran® vaccine, SARS-CoV-2 Vaccine (Vero Cell), Inactivated (lnCoV) or Sputnik V. Methods We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0-542.7) for contracting COVID-19; 55.8 (95% CI: 51.4-60.5) for hospitalization; and 4.1 (95% CI: 3.0-5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61-0.80) with AZD1222; 0.73 (95% CI: 0.62-0.86) with Sputnik V; and 0.73 (95% CI: 0.63-0.86) with CovIran®. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69-0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.
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Affiliation(s)
- Ali Hosseinzadeh
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Sajad Sahab-Negah
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Sairan Nili
- Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Islamic Republic of Iran
| | - Roqayeh Aliyari
- Ophthalmic Epidemiology Research Center, 7 Tir Square, Shahroud University of Medical Sciences, Shahroud 3614773947, Islamic Republic of Iran
| | - Shahrbanoo Goli
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Mohammad Fereidouni
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Islamic Republic of Iran
| | - Ali Alami
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
| | - Mohsen Shati
- Department of Epidemiology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Elham Ahmadnezhad
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Shiva Mehravaran
- School of Computer Mathematics and Natural Sciences, Morgan State University, Baltimore, United States of America
| | - Mansooreh Fateh
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Hamidreza Khajeha
- Ophthalmic Epidemiology Research Center, 7 Tir Square, Shahroud University of Medical Sciences, Shahroud 3614773947, Islamic Republic of Iran
| | - Zahra Emamian
- Health Technology Incubator Center, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Elahe Behmanesh
- Health Technology Incubator Center, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Sepideh Mahdavi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Mostafa Enayatrad
- Bahar Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | | | - Alireza Ansari-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Abtin Heidarzadeh
- School of Medicine, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Fariba Shahraki-Sanavi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Seyed Mohammad Hashemi Shahri
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Islamic Republic of Iran
| | - Mahlagha Dehghan
- Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran
| | | | - Hossein Sheibani
- Imam Hossein Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Maryam Abbaszadeh
- Imam Hossein Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Reza Jafari
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Maryam Valikhani
- Imam Hossein Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Ehsan Binesh
- Imam Hossein Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Hamid Vahedi
- Imam Hossein Clinical Research Development Unit, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Reza Chaman
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Rozita Khodashahi
- Department of Infectious Diseases and Tropical Medicine, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Mahnaz Amini
- Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Farahzad Jabbari Azad
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Fariborz Rezaeitalab
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Saeid Amel Jamehdar
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Ali Eshraghi
- Department of Cardiology, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran
| | | | - Amin Mahdavi
- Cardiovascular Research Centre, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran
| | - Abdollah Jafarzadeh
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Mehrdad Farokhnia
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Islamic Republic of Iran
| | - Saeedeh Ebrahimi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Ophthalmic Epidemiology Research Center, 7 Tir Square, Shahroud University of Medical Sciences, Shahroud 3614773947, Islamic Republic of Iran
| | - Abbas Pardakhti
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Islamic Republic of Iran
| | - Ebrahim Ghaderi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
| | - Hasan Soltani
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Department of Epidemiology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sedigh Jadidoleslami
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Anoush Arianejad
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hamed Gavili
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Borhan Moradveisi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,School of Computer Mathematics and Natural Sciences, Morgan State University, Baltimore, United States of America
| | - Dina Motamedi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Hamed Zare
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Islamic Republic of Iran
| | - Toba Kazemi
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran.,Health Technology Incubator Center, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, 7 Tir Square, Shahroud University of Medical Sciences, Shahroud 3614773947, Islamic Republic of Iran
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7
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Vahedi H, Atefi M, Entezari MH, Hassanzadeh A. The effect of sesame oil consumption compared to sunflower oil on lipid profile, blood pressure, and anthropometric indices in women with non-alcoholic fatty liver disease: a randomized double-blind controlled trial. Trials 2022; 23:551. [PMID: 35804451 PMCID: PMC9264500 DOI: 10.1186/s13063-022-06451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in the world. There is strong evidence that dyslipidemia and other cardio-metabolic disorders are highly prevalent in patients with NAFLD. This trial aimed at examining the effect of sesame oil (SO) in the context of a weight loss program on lipid profile, blood pressure, and anthropometric indices in women with NAFLD. METHODS This randomized, double-blind, controlled trial was carried out on 60 women with NAFLD. Subjects were randomly assigned to the SO group (n = 30) and sunflower oil (SFO) group (n = 30), each person consuming 30 g of oil per day for 12 weeks. All the participants received a hypocaloric diet (- 500 kcal/day) during the study. Lipid profile, blood pressure, and anthropometric indices were assessed at pre- and post-intervention phases. RESULTS In total, 53 participants completed the study. Following 12 weeks of intervention, anthropometric indices (p < 0.001) and systolic blood pressure (SBP) (p < 0.05) were significantly decreased in both groups and diastolic blood pressure (DBP) was significantly decreased in So group (p = 0.03). There was no significant change in lipid profile in both groups (p > 0.05). After adjusting for confounders, DBP (p = 0.031) and total cholesterol (TC) divided by high-density lipoprotein cholesterol (HDL-C) (p = 0.039) in the SO group were significantly reduced compared to the SFO group (p < 0.05). CONCLUSIONS The present clinical trial revealed that SO and SFO may not differently affect anthropometric indices, SBP, and lipid profile except for TC/HDL-C. In addition, SO may be effective in improvement of DBP and TC/HDL-C compared to the SFO group. TRIAL REGISTRATION Ethical approval of this trial was obtained at Isfahan University of Medical Sciences with the reference number of IR.MUI. RESEARCH REC.1399.548 ( https://ethics. RESEARCH ac.ir/ProposalCertificateEn.php?id=158942&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true ), and it was registered before the start of the patient recruitment on December 12th, 2020 in the Iranian Registry of Clinical Trials (IRCT) with the registration number of IRCT20140208016529N6 .
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Affiliation(s)
- Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Islamic Republic of Iran
| | - Masoumeh Atefi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Mohammad Hassan Entezari
- Food Security Research Centre and Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran.
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
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8
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Atefi M, Entezari MH, Vahedi H, Hassanzadeh A. The effects of sesame oil on metabolic biomarkers: a systematic review and meta-analysis of clinical trials. J Diabetes Metab Disord 2022; 21:1065-1080. [PMID: 35673414 PMCID: PMC9167273 DOI: 10.1007/s40200-022-00997-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/30/2022] [Indexed: 11/26/2022]
Abstract
Background Clinical evidences showing the effects of sesame oil on metabolic biomarkers led to inconsistent results. Propose This meta-analysis was designed to examine the effects of sesame oil on metabolic biomarkers in adults, including the maximum number of clinical trials. Methods Google Scholar, PubMed, Web of Science, and Scopus were systematically searched to date up to July 2021 to identify eligible clinical trial studies. We obtained the pooled estimates of weighted mean differences (WMDs) with their 95% confidence intervals (CIs) using random-effects meta-analysis. Result Meta-analysis showed that sesame oil consumption significantly lowered the levels of fasting blood glucose (FBG) (WMD: -3.268 mg/dl; 95% CI: -4.677, -1.86; P < 0.001), and malondialdehyde (MDA) (WMD: -4.847 nmol/dL; 95% CI: -7.051, -2.698; P < 0.001) between the intervention and control groups. Also, this study showed sesame oil consumption significantly decreased HbA1C (WMD: -2.057%; 95% CI: -3.467, -0.646; P = 0.004), systolic blood pressure (SBP) (WMD: -2.679 mmHg; 95% CI: -5.257, -0.101; P < 0.001), diastolic blood pressure (DBP) (WMD: -1.981 mmHg; 95% CI: -3.916, -0.046; P = 0.045), body weight (WMD: -0.346 kg; 95% CI: -0.641, -0.051; P = 0.021), and body mass index (BMI) (WMD: -0.385 kg/m2; 95% CI:-0.721, -0.049; P = 0.025) after intervention. No significant effect was seen in serum insulin levels (p > .05). Conclusions The current study provided some evidence regarding the beneficial effects of sesame oil on metabolic biomarkers. Further studies are still required to confirm our results. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-00997-2.
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Affiliation(s)
- Masoumeh Atefi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, I.R. Iran
| | - Mohammad Hassan Entezari
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, I.R Iran
| | - Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, I.R Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, I.R Iran
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9
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Atefi M, Entezari MH, Vahedi H, Hassanzadeh A. Sesame Oil Ameliorates Alanine Aminotransferase, Aspartate Aminotransferase, and Fatty Liver Grade in Women with Nonalcoholic Fatty Liver Disease Undergoing Low-Calorie Diet: A Randomized Double-Blind Controlled Trial. Int J Clin Pract 2022; 2022:4982080. [PMID: 35685535 PMCID: PMC9159187 DOI: 10.1155/2022/4982080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background The type and amount of dietary fats play an important role in fat accumulation in the liver. Sesame oil (SO) is a good source of monounsaturated acids (MUFAs) and polyunsaturated fatty acids (PUFAs). Objective This trial aimed at examining the effect of SO consumption on the levels of liver enzymes and the severity of fatty liver in women with nonalcoholic fatty liver disease (NAFLD) undergoing a weight loss diet. Methods This randomized, double-blind, controlled trial was carried out on 60 women with NAFLD. Subjects were randomly assigned to the SO group (n = 30) and sunflower oil (SFO) group (n = 30), each person consuming 30 grams of oil per day for 12 weeks. All the participants received a hypocaloric diet (-500 kcal/day) during the study. Fatty liver grade and liver enzymes were assessed at pre- and postintervention phases. Results 53 patients completed the study. Significant reductions in body weight, body mass index (BMI), waist circumference (WC), and fatty liver grade were observed in both groups (P < 0.05). Following SO, significant decreases in serum aspartate and alanine aminotransferases (AST and ALT) were observed. After adjusting for confounders, ALT, AST, and fatty liver grade of the SO group were significantly reduced compared to the SFO group (P < 0.05). However, the changes in serum alkaline phosphatase (ALP) were not significant (P > 0.05). Conclusions The desired effects of weight loss were reinforced by the consumption of SO through improving fatty liver severity and serum ALT and AST levels in NAFLD patients. Moreover, low-calorie diets may lead to favorable outcomes for NAFLD patients through mitigation of obesity and fatty liver grade.
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Affiliation(s)
- Masoumeh Atefi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Entezari
- Food Security Research Centre and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Enayatrad M, Yavari P, Vahedi H, Mahdavi S, Etemad K, Khodakarim S. Urbanization Levels and Its Association with Prevalence of Risk Factors and Colorectal Cancer Incidence. Iran J Public Health 2021; 50:2317-2325. [PMID: 35223607 PMCID: PMC8826346 DOI: 10.18502/ijph.v50i11.7588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/12/2020] [Indexed: 11/24/2022]
Abstract
Background: Colorectal cancer is one of the most common cancers in the world. This study aimed to determine the relationship between risk factors and the incidence of colorectal cancer in Urbanization levels in Iran. Methods: This was a population-based study. Urbanization levels were determined using the census data of the Statistical Center in 2012. Data on risk factors for colorectal cancer were obtained from the information provided by the Iranian Non-Communicable Disease Control Center and the incidence of colorectal cancer from the data from the National Cancer Registry System. Negative binomial regression analysis was used to determine the relationship between colorectal cancer risk factors and urbanization levels with colorectal cancer incidence. For statistical analysis, SPSS and Stata software were used. A significant level of P≤0.05 was considered. Results: The relationship between urbanization levels and risk factors with the incidence of colorectal cancer, nutrition Status, tobacco use, and body mass index were not significant. There was a significant relationship between physical activity and incidence at different levels and between levels of urbanization and incidence rate, indicating a lower incidence rate of colorectal cancer at lower levels of urbanization. Conclusion: Colorectal cancer incidence is higher at higher levels of urbanization than lower levels. The difference between regions in terms of urbanization can have in flounce on access to facilities, health service, and counseling opportunities to modify the risk factors and access to proper screening and follow-up care.
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Affiliation(s)
- Mostafa Enayatrad
- Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Parvin Yavari
- Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Health & Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Vahedi
- Department of Clinical Sciences, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sepideh Mahdavi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Salehi M, Farzamfar S, Ehterami A, Paknejad Z, Bastami F, Shirian S, Vahedi H, Koehkonan GS, Goodarzi A. Kaolin-loaded chitosan/polyvinyl alcohol electrospun scaffold as a wound dressing material: in vitro and in vivo studies. J Wound Care 2021; 29:270-280. [PMID: 32421483 DOI: 10.12968/jowc.2020.29.5.270] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the application of a fabricated dressing containing kaolin for skin regeneration in a rat model of excisional wounds. METHOD In the present study, kaolin was loaded into electrospun polyvinyl alcohol (PVA)/chitosan polymer blend to develop a composite nanofibrous dressing. To make the yarns, kaolin with weight ratio of 5% was added to PVA/chitosan polymer blend and subsequently formed into nanofibres using the electrospinning method. Scaffolds were evaluated for to their microstructure, mechanical properties, surface wettability, water vapour transmission rate, water-uptake capacity, blood uptake capacity, blood compatibility, microbial penetration test, the number of colonies, and cellular response with the L929 cell line. Rats with full-thickness excisional wounds were treated with kaolin-containing and kaolin-free dressings. RESULTS The study showed that rats treated with the kaolin-incorporated mats demonstrated a significant closure to nearly 97.62±4.81% after 14 days compared with PVA/chitosan and the sterile gauze, which showed 86.15±8.11% and 78.50±4.22% of wound closure, respectively. The histopathological studies showed that in the PVA/chitosan/kaolin group, dense and regular collagen fibres were formed, while wounds treated with sterile gauze or PVA/chitosan scaffolds had random and loose collagen fibres. CONCLUSION Our results show the potential applicability of PVA/chitosan/kaolin scaffolds as a wound care material.
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Affiliation(s)
- Majid Salehi
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.,Tissue Engineering and Stem Cell Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Saeed Farzamfar
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Ehterami
- Department of Mechanical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zahrasadat Paknejad
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshid Bastami
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Behest University of Medical Sciences, Tehran, Iran.,Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadegh Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran.,Shiraz Molecular Pathology Research Center, Dr. Daneshbod Pathology Lab, Shiraz, Iran
| | - Hamid Vahedi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Arash Goodarzi
- Department of Tissue Engineering, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
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12
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Vahedi H, Bavafaetousi N, Zolfaghari P, Yarmohammadi M, Sohrabi MB. Association between serum folate levels and fatty liver disease. Clinical Nutrition Experimental 2020. [DOI: 10.1016/j.yclnex.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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13
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Alhassan Mohammed H, Mirshafiey A, Vahedi H, Hemmasi G, Moussavi Nasl Khameneh A, Parastouei K, Saboor-Yaraghi AA. Immunoregulation of Inflammatory and Inhibitory Cytokines by Vitamin D3 in Patients with Inflammatory Bowel Diseases. Scand J Immunol 2017; 85:386-394. [PMID: 28332200 DOI: 10.1111/sji.12547] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/10/2017] [Indexed: 12/30/2022]
Abstract
Inflammatory bowel disease (IBD) is a group of idiopathic, chronic and relapsing inflammatory conditions of the gastrointestinal tract, caused by an aberrant and exaggerated immunological response in the gut. Supplementation of vitamin D3 in patients with IBD exerts both direct and indirect regulatory roles on the naïve T cells, thereby maintaining a balance between inflammatory and inhibitory cytokines. The direct actions of vitamin D3 on naïve T cells result in the proliferation of more regulatory T cells and inhibitory cytokines such as IL-4, IL-10 and IL-5. The binding of vitamin D to dendritic cells (DCs) through vitamin D receptors inhibits the action of IL-12 on DCs, resulting in the downregulation of Th1 and Th17. On the other hand, this interaction favours Th2 and Treg upregulation and facilitates the maintenance of immune homoeostasis between inflammatory and inhibitory cytokines which is essentially significant in the management of patients with IBD. The aim of this review was to explore the current and mounting scientific evidence on the roles of vitamin D3 in immunoregulation of inflammatory and inhibitory cytokines in patients with IBDs. An extensive literature search was conducted using keywords such as Vitamin D3*, IBD*, inflammatory cytokines*, inhibitory cytokines*, naïve-T-cells* and antigen presenting cells* through PubMed, SCOPUS and MEDLINE search engines. The results of the accumulated bodies of research that have been conducted demonstrate that vitamin D3 plays a major role not only in the immunoregulation of cytokines involved in the pathogenesis of IBDs but also in many other inflammatory disorders.
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Affiliation(s)
- H Alhassan Mohammed
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran.,Department of Immunology, Faculty of Medical Laboratory Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - A Mirshafiey
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran
| | - H Vahedi
- Digestive Disease Research Institute (DDRI), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - G Hemmasi
- Department of Internal Medicine and Gastroenterology, Iran University of Medical Sciences, Tehran, Iran
| | - A Moussavi Nasl Khameneh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus, TUMS-IC, Tehran, Iran
| | - K Parastouei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus, TUMS-IC, Tehran, Iran
| | - A A Saboor-Yaraghi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran
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14
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Alhassan Mohammed H, Saboor-Yaraghi AA, Mirshafiey A, Vahedi H, Shiri-Shahsavar MR, Mousavi Nasl Khameneh A. Immunomodulatory and Immunosuppressive Roles of 1α,25(OH)2D3 in Autoimmune Diseases. Scand J Immunol 2017; 85:95-103. [PMID: 27896829 DOI: 10.1111/sji.12512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/12/2016] [Accepted: 11/23/2016] [Indexed: 12/31/2022]
Abstract
Autoimmune diseases are pathological conditions characterized by abnormal responses, accompanied by autoantibodies to self-molecules. The role of vitamin D in autoimmune diseases has increased significantly in the recent past from its functions in calcium and phosphate homoeostasis, and it is now involved in the regulations and proliferations of Th1 and Th17 lymphocyte. 1α,25(OH)2D3 is very important in ameliorations of inflammatory disorders arising from autoimmune diseases, but the mechanism by which this is performed is still a bone of contentions. This review aimed to highlight the existing facts about the roles of Vitamin D in the treatment and management of autoimmune diseases. An extensive online literature search was conducted using PubMed, MEDLINE and Scopus. Accumulated bodies of research evidence are available which demonstrates that Vitamin D has a very important part to play in the regulation of immune responses in autoimmune diseases. Some of the authors suggested that Vitamin D3 carry-out its immunosuppressive and immune modulatory action, through its actions on antigen-presenting cells and activated T and B cells with the help of Vitamin D receptors present on the each of these cells. Vitamin D supplementation assists in autoimmune disorders by making qualitative and quantitative changes in the immune system (downregulation of Th1 and upregulations of Th2 cells). This resulted in the body to be more tolerant of self and less likely to mount autoimmune responses.
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Affiliation(s)
- H Alhassan Mohammed
- Department of Pathobiology/Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran
| | - A A Saboor-Yaraghi
- Department of Pathobiology/Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran
| | - A Mirshafiey
- Department of Pathobiology/Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran
| | - H Vahedi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M R Shiri-Shahsavar
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus. TUMS-IC, Tehran, Iran
| | - A Mousavi Nasl Khameneh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus. TUMS-IC, Tehran, Iran
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15
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16
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Vahedi H, Khosravi A, Sadeghi Z, Aliyari R, Shabankhamseh A, Mahdavian M, Binesh E, Amiri M. Health-Promoting Lifestyle in Patients with and without Diabetes in Iran. Health Scope 2016. [DOI: 10.17795/jhealthscope-39428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Ebrahimi H, Sadeghi M, Amanpour F, Vahedi H. Evaluation of empowerment model on indicators of metabolic control in patients with type 2 diabetes, a randomized clinical trial study. Prim Care Diabetes 2016; 10:129-135. [PMID: 26795772 DOI: 10.1016/j.pcd.2015.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/16/2015] [Accepted: 09/19/2015] [Indexed: 12/21/2022]
Abstract
AIMS Diabetes education is a major subject in achieving optimal glycemic control. Effective empowerment approach can be beneficial for improving patients' health. The aim of this study was to evaluate the effect of empowerment model on indicators of metabolic control in patients with type 2 diabetes. METHODS a randomized controlled trial of 103 patients with type 2 diabetes were randomly assigned to either the intervention (empowerment approach training) or the control group (conventional training) 2014. Empowerment approach training were performed for the experimental group for eight weeks. Data collection tool included demographic information form and indicators of metabolic control checklist. Analysis was performed by one-way analysis of variance, chi-square test, paired t-test, independent t-test and multiple linear regression. RESULTS Before the intervention, two groups were homogeneous in terms of demographic variables, glycosylated hemoglobin (HbA1C), and other indicators of metabolic control. After the intervention, average HbA1C and other metabolic indicators except for LDL showed significant differences in the experimental group compared to the control group. CONCLUSION study results indicated the positive effects of applying the empowerment model on the metabolic control indicators. Therefore, applying this model is recommended to nurses and the relevant authorities in order to improve clinical outcomes in diabetic patients.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdi Sadeghi
- School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Farzaneh Amanpour
- Department of Epidemiology and Biostatistics, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Vahedi
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
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18
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Chaman R, Khosravi A, Sajedinejad S, Nazemi S, Fereidoon Mohasseli K, Valizade B, Vahedi H, Hosseinzadeh E, Amiri M. Smoking and Its Related Factors Among Iranian High School Students. Iran J Psychiatry Behav Sci 2015; 9:e1583. [PMID: 26834798 PMCID: PMC4733302 DOI: 10.17795/ijpbs-1583] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 03/13/2015] [Accepted: 05/04/2015] [Indexed: 11/25/2022]
Abstract
Background: In different studies, the prevalence of tobacco consumption has been growing in high schools boys. Objectives: This study was conducted to determine the prevalence of smoking and its related factors among Iranian high school students in 2011. Materials and Methods: In this cross-sectional study, 450 male students from 15 high schools of Shahroud (northeast of Iran) were selected for evaluation of the knowledge, attitude and practices (KAP) of students regarding tobacco consumption. Results: Overall, 51% (95% CI: 46.5 - 55.7) of the students had positive history of smoking for at least one time and 7.1% (95% CI: 5 - 10) of them were current smokers. The most prevalent source of information about smoking was TV and radio programs (48%) and friends were the second source (22%). Based on the students’ opinions, entertainment and smoker friends were the most important reasons for smoking tendency. There was significant statistical association between students smoking and positive family history of smoking (P value < 0.05). Conclusions: The prevalence of smoking experince was very high among high school students. The most prevalent source of information about smoking was Iranian broadcasting companies. Positive family history of smoking and smoker friends were the important motivating factors toward smoking.
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Affiliation(s)
- Reza Chaman
- Department of Social Medicine, Yasuj University of Medical Sciences, Yasuj, IR Iran
| | - Ahmad Khosravi
- Center for Health related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Sima Sajedinejad
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeed Nazemi
- Environmental Health, Department of Environmental Health, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Khadije Fereidoon Mohasseli
- National Secretariat of Tobacco Control, Center for Environmental and Occupational Health, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Behzad Valizade
- National Secretariat of Tobacco Control, Center for Environmental and Occupational Health, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Hamid Vahedi
- Internist and Gastroenterologist, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | | | - Mohammad Amiri
- Faculty of Public Health, Shahroud University of Medical Sciences, Shahroud, IR Iran
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Vahedi H, Lari J, Nasrabadi M, Halimi M. Chemical Constituents and Antimicrobial Activity of Crucianella sintenisii Growing Wild in Iran. Chem Nat Compd 2013. [DOI: 10.1007/s10600-013-0792-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Firoozbakhsh S, Seifirad S, Safavi E, Vahedi H, Zahedpouranaraki M. The etiologic diagnosis of chronic cough in patients attending a university affiliated cough clinic. Iran Red Crescent Med J 2011; 13:434-5. [PMID: 22737508 PMCID: PMC3371937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 11/23/2010] [Indexed: 11/24/2022]
Affiliation(s)
- Sh Firoozbakhsh
- Pulmonary and Critical Care Research Center,Tehran University of Medical Sciences, Tehran, Iran
| | - S Seifirad
- Pulmonary and Critical Care Research Center,Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Soroush Seifirad, MD, Pulmonary and Critical Care Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-935-6307402, Fax: +98-21-6658159, E-mail:
| | - E Safavi
- Pulmonary and Critical Care Research Center,Tehran University of Medical Sciences, Tehran, Iran
| | - H Vahedi
- Pulmonary and Critical Care Research Center,Tehran University of Medical Sciences, Tehran, Iran
| | - M Zahedpouranaraki
- Pulmonary and Critical Care Research Center,Tehran University of Medical Sciences, Tehran, Iran
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Vahedi H, Ansari R, Mir-Nasseri MM, Jafari E. Irritable bowel syndrome: a review article. Middle East J Dig Dis 2010; 2:66-77. [PMID: 25197516 PMCID: PMC4154827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 08/25/2010] [Indexed: 11/13/2022] Open
Abstract
Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder noted in the general population worldwide. Its chronic nature, signs and symptoms which vary periodically from mild to severe have many negative effects on the quality of life for the sufferer; therefore the appropriate treatment of these patients is highly important. Patients should be informed by their doctors that the nature of the disease is benign, and educated on how to deal with and control symptoms of the disease. This article sets out a review of recent studies on the prevalence of IBS in Iran and appropriate methods for management of patients affected by IBS.
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Affiliation(s)
- H Vahedi
- 1Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - R Ansari
- 1Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - MM Mir-Nasseri
- 1Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - E Jafari
- 1Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
,Corresponding Author: Elham Jafari MD, MPH Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran 14117, Iran Tel: +98 21 82415173 Fax: +98 21 82415400
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Affiliation(s)
- H Vahedi
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Vahedi H, Merat S, Momtahen S, Kazzazi AS, Ghaffari N, Olfati G, Malekzadeh R. Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2008; 27:678-84. [PMID: 18248658 DOI: 10.1111/j.1365-2036.2008.03633.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Irritable bowel syndrome is the most common disorder diagnosed by gastroenterologists. Although several randomized-controlled trials have assessed the therapeutic role of antidepressant drugs, there is insufficient evidence to support their use. AIM To compare the effects of low-dose amitriptyline in the treatment of diarrhoea-predominant irritable bowel syndrome in a double-blind randomized-controlled trial. METHODS Fifty-four patients who fulfilled Rome II criteria for diarrhoea-predominant irritable bowel syndrome were included in this study. Organic causes were ruled out by standard laboratory and radiological tests, and rectosigmoidoscopy. Patients were randomly assigned to receive either 10 mg amitriptyline daily or placebo. Subjects were followed up for 2 months and symptoms were assessed using a questionnaire. Intention-to-treat and per-protocol analysis was performed. RESULTS Fifty patients completed the study. At 2 months, the amitriptyline group showed greater (P < 0.05) reduction in the incidence of loose stool and feeling of incomplete defecation. Patients receiving amitriptyline showed greater complete response, defined as loss of all symptoms, compared with those receiving placebo (68% vs. 28%, P = 0.01). Adverse effects were similar between the two groups. CONCLUSION Amitriptyline may be effective in the treatment of diarrhoea-predominant irritable bowel syndrome and at low dose is well tolerated.
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Affiliation(s)
- H Vahedi
- Digestive Disease Research Center, Shariati Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
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Vahedi H, Merat S, Rashidioon A, Ghoddoosi A, Malekzadeh R. The effect of fluoxetine in patients with pain and constipation-predominant irritable bowel syndrome: a double-blind randomized-controlled study. Aliment Pharmacol Ther 2005; 22:381-5. [PMID: 16128675 DOI: 10.1111/j.1365-2036.2005.02566.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Irritable bowel syndrome has been treated with selective serotonin reuptake inhibitors but there is not enough evidence from controlled trials to prove their effectiveness. AIM To compare the effects of fluoxetine and placebo in the treatment of pain and constipation-predominant irritable bowel syndrome in a double-blind randomized-controlled trial. METHODS Forty-four cases meeting Rome II criteria for irritable bowel syndrome with predominance of pain and constipation were included in this study. Organic causes were ruled out by detailed history, physical examination, laboratory tests and colonoscopy. Participants were then randomly assigned to receive either fluoxetine or placebo for 12 weeks. Symptoms addressed by the Rome II criteria were recorded during treatment and 4 weeks after termination of treatment. RESULTS Fluoxetine was significantly more effective than placebo in decreasing abdominal discomfort, relieving feeling and sense of bloating, increasing frequency of bowel movements and decreasing consistency of stool. Mean number of symptoms per patient decreased from 4.6 to 0.7 in the fluoxetine group vs. 4.5 to 2.9 in controls (P < 0.001). CONCLUSIONS Fluoxetine is an effective and well-tolerated short-term treatment for pain and constipation-predominant irritable bowel syndrome.
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Affiliation(s)
- H Vahedi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND Coeliac disease may easily mimic symptoms which are parts of the criteria used for diagnosing irritable bowel syndrome. AIM To find the frequency of coeliac disease among patients diagnosed as irritable bowel syndrome. METHODS During a period of one year, irritable bowel syndrome patients referred to a university clinic in Tehran were studied. For each patient, an asymptomatic sibling was enrolled as control. Serological tests for coeliac disease were performed in all patients and controls. If positive, duodenal biopsy was performed to confirm the diagnosis. Patients subsequently diagnosed as coeliac disease were placed on a gluten free diet and re-evaluated after 6 months. RESULTS One hundred and five cases of irritable bowel syndrome and 105 controls were enrolled. Coeliac disease was diagnosed in 12 of the irritable bowel syndrome patients and none of the controls. Eleven coeliac disease patients adhered to a gluten free diet. After 6 months, all 11 patients had significant improvement in symptoms and three were totally asymptomatic. Six allowed repeated endoscopy after 6 months of gluten free diet, of which five showed improvement in histological findings. CONCLUSIONS Coeliac disease is a common finding among patients labelled as irritable bowel syndrome. In this sub-group, a gluten free diet may lead to a significant improvement in symptoms. Routine testing for coeliac disease may be indicated in all patients being evaluated for irritable bowel syndrome.
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Affiliation(s)
- B Shahbazkhani
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Sotoudehmanesh R, Malekzadeh R, Vahedi H, Dariani NE, Asgari AA, Massarrat S. Second-line Helicobacter pylori eradication with a furazolidone-based regimen in patients who have failed a metronidazole-based regimen. Digestion 2002; 64:222-5. [PMID: 11842278 DOI: 10.1159/000048865] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM In developing countries the standard quadruple therapy containing metronidazole results in suboptimal eradication rates of Helicobacter pylori (<75%). In a retrospective study, we undertook to evaluate efficacy and tolerability of a furazolidone-based regimen (omeprazole, furazolidone, bismuth, and tetracycline) in patients who had previously failed the standard metronidazole-based regimen (omeprazole, metronidazole, bismuth, and amoxicillin). METHODS The records of H. pylori infected patients who were referred to outpatient clinic (from March 1999 to August 1999) and who underwent previous eradication regimens were studied. A total of 320 cases were noted to have received a metronidazole-based quadruple regimen. From these 320 patients, 80 were noted to have failed this regimen based on a urea breath test. These 80 patients were enrolled in the study and given the furazolidone-based regimen. Side effects were assessed at follow-up visits. At least 2 months after the end of each therapy regimen, a (14)C-urea test was performed in each subject to document the cure of the patients. RESULTS A total of 80 patients (39 males and 41 females) with a mean age of 43.8 +/- (SD) 13.3 years were studied. The H. pylori eradication rate was 90% with the furazolidone-based regimen. The side effects of this regimen were minor. CONCLUSIONS A furazolidone-based regimen is effective in patients who do not achieve cure of H. pylori infection with the metronidazole-based quadruple therapy. In areas where the metronidazole resistance is high, initial therapy with a furazolidone-based regimen is recommended.
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Affiliation(s)
- R Sotoudehmanesh
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Kaviani MJ, Malekzadeh R, Vahedi H, Sotoudeh M, Kamalian N, Amini M, Massarrat S. Various durations of a standard regimen (amoxycillin, metronidazole, colloidal bismuth sub-citrate for 2 weeks or with additional ranitidine for 1 or 2 weeks) on eradication of Helicobacter pylori in Iranian peptic ulcer patients. A randomized controlled trial. Eur J Gastroenterol Hepatol 2001; 13:915-9. [PMID: 11507355 DOI: 10.1097/00042737-200108000-00007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
INTRODUCTION One of the most economical and effective therapeutic regimens for eradication of Helicobacter pylori is the classic triple therapy with amoxycillin or tetracycline, metronidazole and a bismuth derivative. Addition of H2-receptor antagonists to these drugs may heighten the rate of eradication and shorten the duration. We therefore performed a randomized controlled trial comparing twice daily metronidazole, bismuth derivative and amoxycillin for 2 weeks with additional ranitidine for 1 or 2 weeks. PATIENTS AND METHODS In total, 240 adult patients with duodenal ulcer and H. pylori infection were randomly assigned to one of the following regimens: (1) amoxycillin 1 g bid, metronidazole 500 mg bid, bismuth sub-citrate 240 mg bid and ranitidine 300 mg bid for 1 week; (2) triple therapy without ranitidine for 2 weeks; or (3) triple therapy plus ranitidine 300 mg bid for 2 weeks. Side-effects of the drugs were evaluated two weeks after starting the treatment. The rapid urease test and histology from antrum and corpus, and/or 14C- urea breath test were used to determine H. pylori eradication six weeks after starting the treatment. RESULTS In total, 195 patients were followed up for 6 weeks. The most frequent drug side-effects were unpleasant taste (46%), dry mouth (41%) and fatigue (26%), which had an equal distribution in all treatment groups. Endoscopy and 14C- urea breath test were performed for 178 and 123 patients, respectively. Eradication of H. pylori was documented in 19/64 (29.7%), 29/63 (46%) and 50/68 (73.5%) of patients in groups 1, 2 and 3, respectively (P < 0.000001 for group 1 versus group 3; P < 0.0014 for group 2 versus group 3; difference not significant for group 1 versus group 2). An intention-to-treat analysis showed eradication rates of 19/80 (23.75%), 29/80 (36.25%) and 50/80 (62.5%) for groups 1, 2 and 3, respectively. At four weeks post-treatment, the most sensitive test for evaluation of eradication of H. pylori was histology. CONCLUSION Although combined use of an H2-receptor antagonist and twice daily triple therapy in a two-week regimen is more effective than two-week triple or one-week quadruple therapy in Iranian patients, none of these regimens is ideal in countries with a probable high rate of resistant and strongly toxic strains of H. pylori.
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Affiliation(s)
- M J Kaviani
- Gastroenterology Division, Internal Medicine Ward, Shiraz University of Medical Sciences, Shiraz, Iran.
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Malekzadeh R, Ansari R, Vahedi H, Siavoshi F, Alizadeh BZ, Eshraghian MR, Vakili A, Saghari M, Massarrat S. Furazolidone versus metronidazole in quadruple therapy for eradication of Helicobacter pylori in duodenal ulcer disease. Aliment Pharmacol Ther 2000; 14:299-303. [PMID: 10735922 DOI: 10.1046/j.1365-2036.2000.00709.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Furazolidone, an old but cheap antibiotic, was shown to be a good alternative to metronidazole in triple therapy for Helicobacter pylori eradication in areas where metronidazole resistant bacteria are common, but randomized studies are lacking. AIM A randomized controlled trial to determine the efficacy and safety of furazolidone compared to metronidazole in classic quadruple therapy for eradication of H. pylori infection in duodenal ulcer patients. METHODS Patients with endoscopically proven duodenal ulcer and positive urease test were randomized to receive ranitidine 300 mg, amoxycillin 1000 mg and bismuth subcitrate 240 mg b.d, with either furazolidone 200 mg b.d (RABF), or metronidazole 500 mg b.d. (RABM) for 2 weeks. Compliance and side-effects were monitored and recorded by table diary. H. pylori eradication was assessed at least 4 weeks after the completion of therapy with 14C-urea breath test. RESULTS A total of 106 patients were enrolled and 101 (59 male, 42 female, mean age=40 +/- 11 years) completed the study. Endoscopic findings and demographic data were comparable in both groups. Intention-to-treat eradication rates were 75% and 55% (P=0.03) and per protocol eradication rates were 82 and 56% (P=0. 006) in the RABF and RABM groups, respectively. Side-effects were reported by 13 patients (27%) in the RABF group (one stopped treatment) compared to five patients (10%) in the RABM group (P=0. 04). CONCLUSION Quadruple therapy containing furazolidone, instead of metronidazole, results in a significantly higher H. pylori eradication rate in Iranian duodenal ulcer patients.
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Affiliation(s)
- R Malekzadeh
- Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
The restless-legs syndrome is known to occur in a familial form. The paraesthesias, which are hard to define, are sometimes compared to a painful sensation that can be alleviated only by movement. The pathomechanism of the syndrome and its aetiology are still unknown. A 67-year old patient was admitted as an emergency with most severe pain in her legs. In her family the syndrome occurred in an autosomal dominant form. A long-standing history of abuse of various analgesics was known. Initially the symptoms could not be influenced by any of the various drugs given; even epidural bupivacaine showed no effect. Dramatic relief, however, was obtained by epidural morphine. The maintenance therapy with oral morphine sulfate provided equally good results.
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Affiliation(s)
- H Vahedi
- Institut für Anästhesiologie und operative Intensivmedizin, Zentralklinikum, Augsburg
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