A review of the medicinal plants effective on headache based on the ethnobotanical documents of Iran

Headache is one of the ten most common reasons for consulting with a doctor. Healthcare community is seeking to identify nature-based drugs with no side effects and a higher efficiency for treating headache. This review article introduced the plants used to treat headache in ethnobotany and traditional culture of different regions of Iran. The key words consisting of ethnobotany, ethnopharmacology, ethnomedicine, phytopharmacology, traditional medicine, phytomedicine, and Iran, accompanied with headache, pain and analgesic, were used to search for relevant publications in PubMed, Web of Science, Scopus, Islamic World Science Citation Center, and Magiran. Overall, 59 medicinal plants from 29 families are used to treat headache specifically in Iranian traditional medicine. Most plants presented in this study were analgesic and anti-inflammatory, and affected the inflammation and cortical vascular contractile dysfunction. Because of the widespread use of traditional medicinal plants and wide acceptance of herbal drugs and traditional medicine, large studies in pharmacy and pharmacology areas are recommended to inform pharmaceutical industries

The protective effects of ginger on the development of coronary atherosclerosis: An experimental animal study

The use of ginger extracts has been recently suggested to be effective for prevention of establishing and development of coronary atherosclerosis due to its antioxidant and anti-inflammatory components. In the present study, the effect of standardized ginger extract on the development of experimentally induced atherosclerosis in animal models was investigated. The study protocol was consist of three groups of male rabbits (n = 5 each group) that were randomly divided to three groups to fed a common stock diet (containing bran and fresh vegetables) plus high cholesterol pack, or stock diet plus ginger (0.1 g/kg body weight/day) (group II) together with cholesterol, or only stock diet as the atheroma control for 75 days. Atheroma was graded macroscopically by mean graticule count percent. The degree of experimental cholesterol atherosclerosis was graded on an arbitrary scale of 0 to 4, and serum level of total cholesterol was also measured. The atherosclerotic lesion area was macroscopically smaller in rabbits that consumed ginger in comparison with the lesion area in those animals no received ginger extract (43.26 ± 8.7 mm2 versus 82.3 ± 7.9 mm2, p<0.001). Microscopically, the mean grading in coronary artery of rabbits received high cholesterol diet without ginger was 3.1±0.56, while in the group received high cholesterol diet plus ginger was 1.6±0.85 with a significant difference. Regarding effects of ginger on total cholesterol level and considering nonsignificant cholesterol level at baseline, the level of cholesterol after 75 days reached 66.72±0.12 mg/dL in the control group, 776±40.55 mg/dL in group fed high cholesterol without ginger, and 446±23.97 mg/dL in the group fed ginger with a significant level in high cholesterol plus ginger group than in high cholesterol alone group (p<0.001). Ginger can effectively protect the development of atherosclerosis manifested by lowering serum cholesterol level, as well as reducing infarct size and grade

Partitioned solution of an unsteady adjoint for strongly coupled fluid-structure interactions and application to parameter identification of a one-dimensional problem

Unsteady fluid-structure interaction (FSI) simulations are generally time-consuming. Gradient-based methods are preferred to minimise the computational cost of parameter identification studies (and more in general optimisation) with a high number of parameters. However, calculating the cost function’s gradient using finite differences becomes prohibitively expensive for a high number of parameters. Therefore, the adjoint equations of the unsteady FSI problem are solved to obtain this gradient at a cost almost independent of the number of parameters. Here, both the forward and the adjoint problems are solved in a partitioned way, which means that the flow equations and the structural equations are solved separately. The application of interest is the identification of the arterial wall’s stiffness by comparing the motion of the arterial wall with a reference, possibly obtained from non-invasive imaging. Due to the strong interaction between the fluid and the structure, quasi-Newton coupling iterations are applied to stabilise the partitioned solution of both the forward and the adjoint problem

Effect of extract of Varthemia persica DC on whole blood acetylcholinesterase activity in rats

Varthemia persica DC. is an aromatic plant, from the Asteraceae family, wildly growing in the central provinces of Iran. Sesquiterpene lactones that are found in Varthemia species have protective effect against organophosphates toxicity. This study aimed to assess the Effect of Varthemia persica extract on acetylcholinesterase (AChE) activity. In this study, 0.4 mg normal saline was injected intra peritoneally in 12 control rats. 0.4 ml ethyl paraoxon was injected intraperitoneally in the reference group. In positive control group, after ethyl paraoxon injection, 0.4 ml pralidoxime was injected. In the first group (test 1) ethanolic Varthemia persica suspension was injected. In the second group (test 2), during the 6 days before toxin injection, daily injection of Varthemia persica was made. In test 3 group, suspension injection was repeated in 5 following days. In test 4 group, dichloroethanic suspension was injected. And in the last group (test 5) a high dose of suspension (1g/ml) was injected. The blood sample was collected 30 minutes after final injection. AChE activity was measure. The results showed that AChE activity was significantly improved only in the second and third groups and in other test groups, Varthemia persica suspension don't improved AChE activity. Based on the present finding it seems that the Varthemia persica extract is only effective if it used frequently and a single dose even in high dose is not effective

The Effect of Emergency Department Overcrowding on Efficiency of Emergency Medicine Residents’ Education

Introduction: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO) on the training of emergency medicine residents (EMR) is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR’s education. Methods: In this cross-sectional study, the effects of overcrowding on EMR’s education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs.  The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS). The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. Results: 130 questionnaires were filled out during 61 shifts. 47 (77.05%) shifts were overcrowded. The attend’s ability to teach was not affected by overcrowding in the resuscitation room (p=0.008). The similar results were seen regarding the attend’s training ability in the acute care unit. Conclusion: It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs

Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation

Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH2O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. Results: 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male). The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH2O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH2O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH2O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039). The relationship between CVP and 5 cmH2O (p = 0.279), and 10 cmH2O (p = 0.292) PEEP changes were not dependent on the baseline level of CVP. Conclusion: The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard

Anti-hyperelipidemic effects of sumac (Rhus coriaria L.): Can sumac strengthen anti-hyperlipidemic effect of statins?

People believe that sumac is used as reducing fat. In the present study, the hypolipidemic effect of sumac fruits was compared with lovastatin in patients suffered hypercholesterolemia. In a randomized double-blinded-controlled trial, 172 patients diagnosed as hypercholesterolemia (high LDL level) and indicated for lipid-lowering schedules were randomly allocated to receive lovastatin (20 mg/day) or a combination of lovastatin (20 mg/day) and sumac (1 gram equivalent to a teaspoon/day, soluble in water). Immediately before initial assessment and also after a 3- month period of drugs prescription, the level of serum lipid profile was measured in both intervention groups by enzymatic assay and serum LDL level was determined using the Friedewald's equation. At baseline, the mean level of LDL was 149.26±22.36 mg/dL in the group received combination therapy, and 146.25±19.89 mg/dL in the group received lovastatin alone with no significant different (p=0.352). However, following administration of the two treatment schedules, the level of LDL was significantly more reduced in combination treatment group compared with another group that the serum level of LDL after 3-month study period was 105.75±21.21 mg/dL in combination therapy group and 117.04±15.78 mg/dL in single therapy group (p≤0.001). The positive response rate in the two groups was 93.0% and 75.6%, respectively (p=0.002). Using Multivariable logistic regression model, the use of sumac combined with statin led to higher response rate indicated by lowering serum LDL level (p=0.019). Sumac has a potential role in lowering LDL level especially when combined with anti-hyperlipidemic drugs as statins

Rehydration: Comparison of Isotonic and Hypotonic Saline with Dextrose in Children

Introduction: Early rehydration with bolus fluid can be life saving. We compared isotonic saline with a hypotonic fluid which was composed of saline 0.9%, dextrose, and bicarbonate in our clinical setting.Materials and Methods: 71 children entered to this study , 41 cases received isotonic saline and the remaining 30 cases received hypotonic fluid which was composed of 750 cc saline 0.9%, 28 cc bicarbonate 7.5%, and 222cc dextrose 5% for resuscitation fluid challenge at a dose of 20ml/kg over 20 minutes that could be repeated up to 3 times as needed. Serum sodium (Na), potassium (K), blood sugar (BS) and bicarbonate (HCo3) were measured before initiating rehydration and after 3 hours. T independent test was used to compare the values between the two groups and T paired test in each group in SPSS 16. The level of significance was set at 0.05.Results: Serum Na, K, BS, and HCo3 were 134±5, 3.8 ±0.6, 90±16, and 11.6±3.6 before and 135±4, 3.7±0.5, 73±13, and 15±3 three hours after rehydration in the isotonic group, respectively.In the isotonic rehydrated group, BS drop and HCo3 rise significantly (p&lt;0.001). Serum Na, K, BS, and HCo3 were 134±6, 3.6±0.6, 91±15, and 10.1±1.9 before and 136±3, 3.6±0.4, 94±10, and 15±2 three hours after rehydration in the hypotonic saline group, respectively. Serum sodium increased 2meq/dl (p&lt;0.04) and bicarbonate increased 4.9 meq/l (P&lt; 0.001).Conclusions: The hypotonic serum containing 115meq/l of sodium chloride combined with 25meq/l of sodium bicarbonate and dextrose 1.1% is not associated with a decrease in BS or hyponatremia. It also increases serum HCo3 prominently.Keywords: Hypotonic Solutions; Isotonic Solutions; Dehydration; Child

Phytopharmacology and phytotherapy of regulatory T cells: A new approach to treat multiple sclerosis

Multiple sclerosis (MS) is a disorder of central nervous system characterized by demyelination, inflammation, and axonal injury. Regulatory T cells (Tregs) have been defined as CD4+CD25+FoxP3+ T-cells that play a critical role in maintaining self-tolerance and preventing autoimmune diseases. Dysfunction and decreased numbers of Tregs may lead to MS. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role of Tregs in MS published from 2000 to February 2016. The medicinal plants and their derivatives, including Hypericum perforatum, Astragalus membranaceus, Pterodon emarginatus Vogel, curcumin, resveratrol, matrine, Bu Shen Yi Sui Capsule, and Hyungbangpaedok-san have been reported to regulate the function of Tregs in MS. The medicinal plants and their derivatives reported in this study might be useful for upregulation of Tregs through suppressing the activation of autoreactive T cells and hence controlling MS. They should be investigated in clinical trials to help to prevent and treat MS

تطابق برنامه های بازآموزی های برگزار شده در حوزه طب اورژانس با سرفصل های ضروری آموزشی در این رشته

Introduction: Currently, there is a lack of data on the agreement between the continuous medical education (CME) programs and the necessary training topics in the field of emergency medicine in Iran. The present study aimed to evaluate the mentioned agreement in CME programs held during 2010-2014, all over the country. Methods: In the present cross-sectional study, the data recorded regarding emergency medicine-related CME programs were extracted from continuous training database of the Ministry of Health. Then, 30 items from the most important topics taught in emergency medicine training were selected by 3 emergency medicine specialists. Subsequently, the agreement of the selected training topics and CME programs was evaluated regarding duration of training, annual changes, and efficiency. Results: During 2010-2014, a total of 10147 hours of CME programs were held in relation to emergency medicine topics in Iran, which were most frequently (1015 hours) related to surgical emergencies. The next most frequent emergency-related CME programs were in the fields of toxicology with 810 hours (8.0%), neurology with 700 hours (6.9%), pediatric emergencies with 695 hours (6.8%), internal medicine with 675 hours (6.7%), and cardiopulmonary resuscitation with 555 hours (5.5%). In addition, it was determined that none of the CME programs were in complete agreement with the expected standards. Cohen’s kappa test showed that the agreement between the current conditions of CME programs with the standard was only 46.7% (95% confidence interval: 40.9 – 52.55) which shows a weak agreement (p = 0.19). Conclusion: The findings of the present study show the weak agreement of the CME programs held in the field of emergency medicine with the expected standards. مقدمه: در حال حاضر اطلاع دقیقی از میزان تطابق دوره های بازآموزی رشته طب اورژانس با سرفصل های ضروری آموزشی این رشته وجود ندارد. لذا مطالعه حاضر در نظر دارد تا میزان تطابق بازآموزی های برگزار شده طی سال های 1389 تا 1393 با سرفصل های آموزشی رشته تخصصی طب اورژانس را مورد بررسی قرار داد. روش کار: در مطالعه مقطعی حاضر اطلاعات ثبت شده از بازآموزی های مرتبط با رشته تخصصی طب اورژانس از سامانه آموزش مداوم وزارت بهداشت جمع آوری گردید. سپس 30 آیتم از مهمترین مباحث آموزشی رشته طب اورژانس با نظر 3 متخصص طب اورژانس انتخاب شد و اقدام به ارزیابی تطابق بازآموزی ها از لحاظ مدت زمان آموزش، روند تغییرات سالیانه و کفایت با سرفصل های آموزشی رشته طب اورژانس گردید. يافته ها: طی سال های 1389 تا 1393 به طور مجموع، 10147 ساعت بازآموزی مرتبط با سرفصل های آموزشی رشته طب اورژانس ارائه شده بود. بیشترین فراوانی (1015 ساعت)  بازآموزی ها مرتبط با اورژانس های جراحی بود. در رتبه بعدی بازآموزی در زمینه اورژانس مسمومیت با میزان 810 ساعت (8/0درصد) اورژانس های نورولوژیک با میزان 700 ساعت (6/9 درصد)، اورژانس های اطفال با میزان 695 ساعت (6/8 درصد)، اورژانس های داخلی با 675 ساعت (6/7 درصد) و احیا قلبی ریوی با 555 ساعت (5/5 درصد) قرار داشتند. علاوه بر این مشخص گردید که هیچ یک از باز آموزی ها تطابق کامل با استانداردهای مورد انتظار ندارند. آزمون کاپای کوهن نشان داد میزان توافق بین وضعیت موجود بازآموزی ها با استاندارد تنها 46/7 درصد (با فاصله اطمینان 95 درصدی برابر 52/55-40/9) بود که در طبقه موافقت ضعیف قرار می گیرد (0/19=p). نتيجه گيری: یافته های پژوهش حاضر حاکی از توافق ضیف باز آموزی های انجام شده در حوزه طب اورژانس با استانداردهای مورد انتظار بود