Medicinal herbs in the treatment of neuropathic pain: a review

Chronic neuropathic pain is a common significant and debilitating problem that presents a major challenge to health-care. Despite the large number of available drugs, there are no curative conventional treatments for neuropathic pain. Nowadays, more attention has been focused on the herbal formulation in the field of drug discovery. Therefore, we performed an extensive review about herbal drugs and plants that exhibited protective effects on neuropathic pain. In this review, the beneficial effects of each plant in different neuropathic pain model, either in animals or in patients are reported. Moreover, the possible involved mechanisms for the protective effects are discussed. The more common plants which are used for the treatment of neuropathic pain are included as: Acorus calamus, Artemisia dracunculus, Butea monosperma, Citrullus colocynthis, Curcuma longa, Crocus sativus, Elaeagnus angustifolia, Ginkgo biloba, Mitragyna speciosa, Momordica charantia, Nigella sativa, Ocimum sanctum, Phyllanthus amarus, Pterodon pubescens Benth, Rubia cordifolia and Salvia officinalis. Furthermore, the most pathways which are known to be involved in pain relief by means of herbal remedies are anti-oxidant activity, anti-inflammatory, anti-apoptotic, neuroprotective and calcium inhibitory actions.In conclusion, this review suggests that some herbal plants can be suitable candidates for the treatment of neuropathic pain

Overexpression of MiR-183/96/182 Triggers Retina-Like Fate in Human Bone Marrow-Derived Mesenchymal Stem Cells (hBMSCs) in Culture

Retinal degeneration is considered as a condition ensued by different blinding disorders such as retinitis pigmentosa, age-related macular degeneration, and diabetic retinopathy, which can cause loss of photoreceptor cells and also lead to significant vision deficiencies. Although there is no efficient treatment in this domain, transplantation of stem cells has been regarded as a therapeutic approach for retinal degeneration. Thus, the purpose of this study was to analyze the potential of human bone marrow-derived mesenchymal stem cells (hBMSCs) to differentiate into photoreceptor cells via transfection of microRNA (miRNA) in vitro for regenerative medicine purposes. To this end, miR-183/96/182 cluster was transfected into hBMSCs; then, qRT-PCR was performed to measure the expression levels of miR-183/96/182 cluster and some retina-specific neuronal genes such as OTX2, NRL, PKC alpha, and recoverin. CRX and rhodopsin (RHO) levels were also measured through qRT-PCR and immunocytochemistry, and subsequently, cellular change morphology was detected. The findings showed no changes in the morphology of the given cells, and the expression of the neuroretinal genes such as OTX2, NRL, and PKC alpha. Moreover, recoverin was upregulated upon miR-183/-96/-182 overexpression in cultured hBMSCs. Ectopic overexpression of the miR-183 cluster could further increase the expression of CRX and RHO at the messenger RNA (mRNA) and protein levels. Furthermore, the data indicated that the miR-183 cluster could serve as a crucial function in photoreceptor cell differentiation. In fact, miRNAs could be assumed as potential targets to exploit silent neuronal differentiation. Ultimately, it was suggested that in vitro overexpression of miR-183 cluster could trigger reprogramming of the hBMSCs to retinal neuron fate, especially photoreceptor cells. keywords: DIFFERENTIATION; DELETION; CRX; PHOTORECEPTORS; FIBROBLASTS; MATURATION; EPITHELIUM; MICRORNAS; MIR-182; PROTEI

An Audit of Emergency Department Accreditation Based on Joint Commission International Standards (JCI)

Introduction: Despite thousands of years from creation of medical knowledge, it not much passes from founding the health care systems. Accreditation is an effective mechanism for performance evaluation, quality enhancement, and the safety of health care systems. This study was conducted to assess the results of emergency department (ED) accreditation in Shohadaye Tajrish Hospital, Tehran, Iran, 2013 in terms of domesticated standards of joint commission international (JCI) standards. Methods: This is a cohort study with a four months follow up which was conducted in the ED of Shohadaye Tajrish hospital in December 2013. The standard evaluation check list of Iran hospitals (based on JCI standards) included 24 heading and 337 subheading was used for this purpose. The effective possible causes of weak spots were found and their solutions considered. After correction, assessment of accreditation were repeated again. Finally, the achieved results of two periods were analyzed using SPSS version 20. Results: Quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities had the score of below 50%. The mean of total score for accreditation in ED in the first period was 60.4±30.15 percent and in the second period 68.9±22.9 (p=0.005). Strategic plans, head of department, head nurse, resident physician, responsible nurse for the shift, and personnel file achieved the score of 100%. Of total headings below 50% in the first period just in two cases, collection and analysis of data with growth of 40% as well as competency and capability test for staffs with growth of 17%, were reached to more than 50%. Conclusion: Based on findings of the present study, the ED of Shohadaye Tajrish hospital reached the score of below 50% in six heading of quality improvement, admission in department and patient assessment, competency and capability test for staffs, collection and analysis of data, training of patients, and facilities. While, the given score in strategic plans, head of department, head nurse, resident physician, responsible nurse for the shifts, and personnel file was 100%

بررسی علل شکایات بیماران مراجعه کننده به بخش اورژانس

Introduction: Evaluating the reasons of emergency patient dissatisfaction and trying to eliminate them is a step towards increasing the quality of care and profitability. Therefore, this study aimed to evaluate the reasons of patient dissatisfaction in the emergency department of Shohadaye Tajrish Hospital, Tehran, Iran. Methods: The present cross-sectional study was done in the time interval between March 2012 and October 2014. All the patients who had declared their dissatisfaction, whether written, verbal, or by phone, were included. Using a pre-designed checklist, data were gathered regarding characteristics of dissatisfaction including: type, reference, presentation, subject, and outcome and analyzed using SPSS version 21. Significance level was considered as p<0.05. Results: 123 cases of dissatisfaction were detected. In 31 (25.2%) cases the patient was right, in 41 (33.3%) the hospital was right and 51 (41.5%) cases had no outcome. The dissatisfactions were written in 23 (18.7%) cases, by phone in 17 (13.8%), and verbal in 83 (67.5%), which showed no significant correlation with the outcome (p=0.277). Only 31 (25.2%) cases were declared by the patients themselves which had no correlation with the outcome (p=0.747). However, there was a significant correlation between the type (p=0.025) and subject (p<0.001) of dissatisfaction with the outcome. Conclusion: The results of this study showed that most cases of dissatisfaction were assigned to the surgery group and nursing service. Low quality care and bad behavior of the staff were among the most common causes of patients’ dissatisfaction. In all cases of dissatisfaction regarding the neurosurgery service, internal medicine service, and admission unit, the patients have been right. In contrast, in all cases of triage and laboratory unit, the hospital has been right.مقدمه: بررسی علل شکایات از کادر درمانی و تلاش در رفع آن ها گامی در جهت رضایت هرچه بیشتر بیماران و افزایش بازدهی  بیمارستان میباشد، در این مطالعه بر آن شدیم به بررسی علل شکایات مراجعین بخش اورژانس بیمارستان شهدا تجریش بپردازیم. روش کار: مطالعه مقطعی حاضر از ابتدای شش ماهه نخست سال 1391 تا پایان شش ماهه اول سال 1393 در بخش اورژانس مركز آموزشی درمانی شهدای تجریش، تهران، ایران انجام پذیرفت. کلیه مراجعه کنندگان به بخش اورژانس بیمارستان که شکایت یا هر گونه مشکل خود را بصورت حضوری، مکتوب یا تلفنی به واحد شکایات مستقر در واحد اورژانس ابلاغ نموده بودند وارد مطالعه شدند. از طریق چک لیست از قبل طراحی شده نوع، منبع، نحوه ارائه، موضوع و نتیجه بررسی شکایت جمع آوری و توسط نرم افزار SPSS نسخه 21 و تست های آماری مربع کا و تست دقیق فیشر مورد تجزیه و تحلیل آماری قرار گرفتند. سطح معناداری p کمتر از 0/05 در نظر گرفته شد. يافته ها: مجموعا 123 عنوان شکایت در واحد شکایات بخش اورژانس ثبت شد. در 31 مورد (25/2درصد) حق با بیمار، در 41 مورد (33/3 درصد) حق با بیمارستان و  در 51 مورد (41/5 درصد) نتیجه شکایات بی نتیجه باقی ماند. در  23 مورد (18/7 درصد) شکایت بصورت کتبی، در 17 مورد (13/8 درصد) تلفنی و در 83 مورد (67/5 درصد) حضوری بود که ارتباط معنا داری بین آنها و نتیجه بررسی وجود نداشت (0/277=p). شکایت (25/2 درصد) توسط خود بیمار و 92 شکایت (74/8 درصد) توسط همراهان بیمار ثبت شد که ارتباط معنا داری با نتیجه بررسی نداشتند (0/747=p) . ارتباط معنی داری بین نوع (0/025=p) و موضوع شکایت (0/001>p) و نتیجه نهایی بررسی وجود داشت. نتيجه گيری: یافته های پژوهش حاضر حاکی از آن است که بیشترین شکایات در بخش اورژانس مربوط به گروههای جراحی و پرستاری بوده و از شایعترین علل نارضایتی کیفیت ضعیف ارائه مراقبت ها و برخورد نامناسب کارکنان گزارش شده است. در تمام شکایت های طرح شده از سرویس جراحی اعصاب، داخلی و واحد پذیرش حق به بیمار داده شد و در مقابل تمام شکایات مربوط به واحد تریاژ و آزمایشگاه، بیمارستان محق شناخته شده است

Protective Effect of Diospyros kaki

Ischemic cerebrovascular disease is one of the most common causes of death in the world. Recent interests have been focused on natural antioxidants and anti-inflammatory agents as potentially useful neuroprotective agents. Diospyros kaki (persimmon) has been shown to exert anti-inflammatory, antioxidant, and antineoplastic effects. However, its effects on ischemic damage have not been evaluated. Here, we used an in vitro model of cerebral ischemia and studied the effects of hydroalcoholic extract of peel (PeHE) and fruit pulp (PuHE) of persimmon on cell viability and markers of oxidative damage mainly intracellular reactive oxygen species (ROS) induced by glucose-oxygen-serum deprivation (GOSD) in PC12 cells. GOSD for 6 h produced significant cell death which was accompanied by increased levels of ROS. Pretreatment with different concentrations of PeHE and PuHE (0–500 μg/mL) for 2 and 24 h markedly restored these changes only at high concentrations. However, no significant differences were seen in the protection against ischemic insult between different extracts and the time of exposure. The experimental results suggest that persimmon protects the PC12 cells from GOSD-induced injury via antioxidant mechanisms. Our findings might raise the possibility of potential therapeutic application of persimmon for managing cerebral ischemic and other neurodegenerative disorders

Hydroalcoholic extract of anchusa italica protects global cerebral ischemia-reperfusion injury via a nitrergic mechanism

Introduction: In stroke models, Inducible Nitric Oxide Synthase (iNOS) expression initiates cellular toxicity due to excessive Nitric Oxide (NO) generation. Anchusa italica is a medicinal herb with anti-inflammatory, antioxidant and neuroprotective properties. This study evaluated the antioxidant activity and NOS mRNA expression of the Hydroalcoholic Extract Of Anchusa Italica (HEAI) in an experimental stroke model in rats. Methods: The stroke model was induced by bilateral occlusion of both common carotid arteries for 60 min. Twenty-four hours after surgery, HEAI (50 and 100 mg/kg i.p.) was injected daily for 10 consecutive days. mRNA expression levels of NOS subtypes and hippocampal Brain-Derived Neurotrophic Factor (BDNF) were studied using real-time PCR. Besides, hippocampal tissue plus serum concentrations of NO and Malondialdehyde (MDA) were measured. Results: HEAI decreased MDA in both serum and hippocampal tissue and also reduced serum NO levels. Additionally, in the HEAI-treated groups, a down-regulation of iNOS mRNA expression, and an up-regulation of BDNF mRNA expression were observed. Conclusion: The results indicated that the administration of HEAI even after the onset of ischemia protects the brain from free radical injury and inflammation via a down-regulation of iNOS expression inhibiting NO production and an up-regulation of BDNF mRNA

Prediction and analysis of microRNAs involved in COVID-19 inflammatory processes associated with the NF-kB and JAK/STAT signaling pathways

COVID-19 is the cause of a pandemic associated with substantial morbidity and mortality. As yet, there is no available approved drug to eradicate the virus. In this review article, we present an alternative study area that may contribute to the development of therapeutic targets for COVID-19. Growing evidence is revealing further pathophysiological mechanisms of COVID-19 related to the disregulation of inflammation pathways that seem to play a critical role toward COVID-19 complications. The NF-kB and JAK/STAT signaling pathways are highly activated in acute inflammation, and the excessive activity of these pathways in COVID-19 patients likely exacerbates the inflammatory responses of the host. A group of non-coding RNAs (miRNAs) manage certain features of the inflammatory process. In this study, we discuss recent advances in our understanding of miRNAs and their connection to inflammatory responses. Additionally, we consider the link between perturbations in miRNA levels and the onset of COVID-19 disease. Furthermore, previous studies published in the online databases, namely web of science, MEDLINE (PubMed), and Scopus, were reviewed for the potential role of miRNAs in the inflammatory manifestations of COVID-19. Moreover, we disclosed the interactions of inflammatory genes using STRING DB and designed interactions between miRNAs and target genes using Cityscape software. Several miRNAs, particularly miR-9, miR-98, miR-223, and miR-214, play crucial roles in the regulation of NF-kB and JAK-STAT signaling pathways as inflammatory regulators. Therefore, this group of miRNAs that mitigate inflammatory pathways can be further regarded as potential targets for far-reaching-therapeutic strategies in COVID-19 diseases

Correlation of Heterozygote risk, Pathological risk and lifetime risk with Clinicopathologic Features in Iranian breast cancer patients

Breast cancer is a prevalent malignancy among women worldwide and a principle reason of death in Iranian women. In current study, 64 Iranian women diagnosed with breast cancer and classified into four age groups (65 years) were analyzed for correlation between heterozygote risk and lifetime risk with clinicopathological features. Nine patients were also investigated for BRCA1 germline mutations. Our results indicated that people with hetrozygosity risk over 30% more likely to infect invasive ductal carcinoma and utilization of Cyrillic software for Iranian family would open new sights towards the prediction, prognosis and mutation detection

MicroRNAs in Noise-Induced Hearing Loss and their Regulation by Oxidative Stress and Inflammation

Noise exposure (NE) has been recognized as one of the causes of sensorineural hearing loss (SNHL); which can bring about irreversible damage to sensory hair cells in the cochlea, through the launch of oxidative stress pathways and inflammation. Accordingly, determining molecular mechanism involved in regulating hair cell apoptosis via NE is essential to prevent hair cell damage. However, the role of microRNAs (miRNAs) in degeneration of sensory cells of the cochlea during NE has not been so far uncovered. Thus, the main purpose of this study was to demonstrate the regulatory role of miRNAs in oxidative stress pathway and inflammation induced by NE. In this respect, articles related to noise-induced hearing loss (NIHL), oxidative stress, inflammation, and miRNA from various databases of Directory of Open Access Journals (DOAJ), Google Scholar, PubMed; Library, Information Science & Technology Abstracts (LISTA), and Web of Science were searched and retrieved. The findings revealed that several studies had suggested that up-regulation of miR-1229-5p, miR451a, 185-5p, 186 and down-regulation of miRNA-96/182/183 and miR-30b were involved in oxidative stress and inflammation which could be used as biomarkers for NIHL. There was also a close relationship between NIHL and miRNAs, but further research was required to prove a causal association between miRNA alterations and NE, and also to determine miRNAs as biomarkers indicating responses to NE. Keywords: Noise; hearing loss; inflammation.; miRNAs; oxidative stress

Curcumin for the management of periodontal diseases: a review

Periodontal disease is one of the most common causes of tooth loss among adults. Research shows that inflammation is one of the crucial components in the initiation and progression of periodontitis. Various herbal medicines have recently been receiving attention for the management of periodontitis owing to their general safety and efficacy. Curcumin, a bioactive polyphenol extracted from Curcuma longa, has been shown to possess antioxidant, antimicrobial, anti-inflammatory and analgesic properties. Several studies have assessed the efficacy of curcumin against periodontal diseases. These studies have shown equivalent or even higher efficacy of curcumin compared to the commonly used medications for the management of periodontitis such as chlorhexidine. Herein, we review the experimental and clinical findings on the anti-periodontitis effects of curcumin and the pharmacological mechanisms underlying these effects