Long-term pulmonary functional status following coronary artery bypass grafting surgery

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire's. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 +/- 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 +/- 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 +/- 1.5 that reached to 6.2 +/- 2.5 and 4.8 +/- 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG

Is herbal therapy safe in obesity? A case of apium graveolens (Celery) induced hyperthyroidism

BACKGROUND: Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss. CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges. CONCLUSION: Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term. © 2016,.Isfahan University of Medical Sciences(IUMS). All rights reserved

Therapeutic effects of Crocus sativus: An overview of systematic reviews

Background and aims: Crocus sativus is of medicinal plants possessing many beneficial effects in treatment of various disorders. This study aimed to overview the therapeutic effects of Crocus sativus on the basis of reviews and systematic reviews. Methods: Computerized search of review articles was performed using PubMed, Google Scholar, Scopus and Web of Science, Medline database from 1996 to 2015. Results: Searches identified 8 reviews and systematic reviews of therapeutic effects of Crocus sativus. Despite remarkable difference in interventions, and type of studies carried out on this plant (in vivo and in vitro), it seemed to have many therapeutic effects on the treatment of various types of diseases. In all the reviews, the objectives were similar, e.g. inhibition of growth of cancer cell lines, analgesic activity, improvement of health condition and treatment of some disease but the type of study (in vivo and in vitro) (animal studies: rat, mouse, guinipig, rabbit) and content was quite different. The most common effects of Crocus sativus were anti-carcinogenesis, tumoricidal, anti-depressant, antihypertensive, anticonvulsant, antitussive, anti-genototoxic and cytotoxic effects, anti-Alzheimer’s, antitussive, anxiolytic, aphrodisiac, antioxidant, anti-nociceptive, anti-inflammatory, relaxant activity, and effects on the gastrointestinal tract, on ocular blood flow and on retinal function, effect on coronary artery diseases, and hypnotic, and anesthetic effects. Conclusion: The results of various studies on Crocus sativus showed that it has a lot of therapeutic effects on the treatment of various types of diseases. However, to be able to use these results in our daily life, additional clinical trials with larger sample size and longer duration may be required to evaluate its toxicity and safety in each and every case of its therapeutic effects

DIFFUSING CAPACITY FOR LUNG CARBON MONOXIDE (DLCO) IN CHEMICAL LUNG INJURIES DUE TO THE USE OF MUSTARD GAS IN THE POISONED SOLDIERS OF IRAN-IRAQ WAR 2006

Objectives: To assess the Mustard gas exposure effects on pulmonary system, particularly on diffusing capacity for lung carbon monoxide (DLCO) and simple spirometry. Methodology: Sixty-five sulfur mustard-poisoned soldiers from Mostazafan and Janbazan organization were referred to our center in 2005. Complete history, physical examination, chest X ray, Echocardiography, Arterial blood gas, high - resolution computerized tomography, diffusion capacity for lung carbon monoxide and spirometry of these were performed and compared this result with normal value. Results: The mean value of indices in studied injured subjects was: Spirometry: forced expiratory volume in one second (FEV1) = 70.4, Forced vital capacity (FVC) = 66.5, EFE 25-75=81.1, FEV1/FVC=101.9, Flow 25% = 28.7, Flow 50%=72.9, Flow 75%=100.1, Sample volume: Functional residual capacity of lungs (FRC) = 131.5, residual volume (RV) = 157.3, RV/TLC=169.1, Total lung capacity (TLC) = 91.3, KCO=131.6, TLCO=116.3. No significant correlation was observed between TLCO values with HRCT, echocardiography, ABG and spirometry values (P>0.05). Conclusion: We recommend TLCO & RV/TLV tests to assess severity of Injuries as there is no a suitable criterion to measure the real consequences of mustard gas on affected combatants. and Biological markers are also needed to determine cause-effect relations

Use of lipid-lowering medicinal herbs during pregnancy: A systematic review on safety and dosage

BACKGROUND: Hyperlipidemia is one of the important diseases in pregnancy that causes fetal abnormalities during pregnancy and after the birth. Unfortunately, the usual anti-fat drugs are associated with high morbidity in fetus and due to people's inclination towards taking herbs, it is required to identify side effects of medicinal herbs in pregnancy. The aim of this study was to present hypolipidemic herbs that would not any complications for mother and fetus. METHODS: In this review article, the major electronic databases such as EBSCO, Central Register of Controlled Trials (CENTRAL), China Network Knowledge Infrastructure (CNKI), Cochrane, Google scholar, MEDLINE, SciVerse, Scopus, and Web of Science were searched using the key words “herbal” and “hyperlipidemia”, “herbal” and “pregnancy” matched by MeSH from their respective inceptions till September, 2016. Total of 1723 publications (145 review articles, 855 original research articles, and 723 abstracts) about the effect of herbals on hyperlipidemia and 682 publications (200 abstracts, 423 original research articles, and 59 review articles) about the effect of herbals in pregnancy were retrieved. At the end, a list of medicinal plants effective on hyperlipidemia alongside their effects on pregnancy was developed. Finally, the plants effective on hyperlipidemia and safe during pregnancy were determined and their dosage, complications, mechanism of action, and side effects were reported. RESULTS: A total of 110 effective herbs on hyperlipidemia were identified and complications of 95 plants in pregnancy were studied. At last, among the 55 selected plants effective on hyperlipidemia and examined for pregnancy, we reported 12 herbs with their dosage and special considerations that can be used to treat hyperlipidemia during pregnancy. CONCLUSION: Some medicinal plants can be used to treat hyperlipidemia during pregnancy without any significant side effects both on mother or fetus

Systematic review on safety and drug interaction of herbal therapy in hyperlipidemia: a guide for internist.

Because of reporting high side effects related to biosynthetic drugs, recent attention has been paid to the use of herbs instead of chemical drugs to balance serum lipids. The present systematic review aimed to evaluate the safety of herbal medicines and also to assess drug interaction in herbal therapy in treating hyperlipidemia. The international research databases including MEDLINE; Google scholar, Web of Science SciVerse Scopus (SCOPUS); EBSCO Academic Search; Cochrane Central Register of Controlled Trials (CENTRAL); and a Chinese database (China Network Knowledge Infrastructure [CNKI]) were searched from their respective inceptions up to September 2014 with the search terms of "hyperlipidemia", "herbal medicine", "medicine traditional", "extract plant", "Traditional Medicine" and "Chinese Herbal Medicine" without narrowing or limiting search elements. A total of 85 randomized clinical trials (RCTs) studies were finally assessed on human subjects. A notable number of herbal drugs that are commonly used as an anti-hyperlipidemia agent may be interacted with a variety of biosynthetic drugs. In this regard, the most common reported herb-drug reactions were related to anticoagulants, antidepressants, anti-epileptic, anti-inflammatory, and/or even antihypertension and anti-lipidemic drugs. Also, a considerable number of anti-lipidemic drugs of plants origin may be accompanied with metabolic disturbances and serious complications within pregnancy and breast feeding. The main fundamental principles for administration of these drugs include physicians' complete awareness of the effects and interactions of these drugs, educating people not taking these drugs arbitrarily, and closely monitoring the verification and distribution of the drugs in the society

Effect of scientific principles of gavage feeding in oral medicine administration on knowledge and function of nurses in intensive care unit (ICU)

Medication through an enteral feeding tube is one of the main cares in patients hospitalized in the intensive care unit continuously being a challenge. Correct delivery of medication through an enteral feeding tube requires specific knowledge and skills in this field. The nurse as the main responsible for administering a drug, has a very important role in this regard. This study was carried out as a quasi-experimental study on 90 cases of ICU nurses. First, using a questionnaire (pretest), the level of knowledge and practice in intensive care unit was measured. The training course for speech, along with a pamphlet and face to face, was held and again after a month their awareness and performance was measured by questionnaire (post-test).For analysis of data, SPSS software (version 21) and paired tests and chi-square was used. Results showed the mean score of nurses' knowledge prior to applying scientific principles (12/9889 ±2/04167) and their knowledge after that (19/3333±0/71893); mean performance score prior to applying scientific principles was significantly difference with the average score of their next performance (P=0/0001). Also results indicated that the average of all subscales of knowledge and practice (preparation, dosage forms, thumbs up and tubal obstruction, drug interactions and side effects) significantly increased after the application of scientific principles (P=0/0001). This study showed that the application of scientific principles in accordance with the instructions provided, significantly increases knowledge and practice of nurses

Anti-Candida activity of ethanolic extracts of Iranian endemic medicinal herbs against Candida albicans

It has long been known that herbs and their extracts have antimicrobial activities. Heracleum lasiopetalum Boiss., Satureja bachtiarica Bunge., Thymus daenensis Celak., Echiophora platyloba L., Dracocephalum multicaule Benth., Kelussia odoratissima Mozaff. and Achillea kellalensis Boiss. are Iranian endemic plant species that have been traditionally used as medicinal herbs and spices in different regions of Iran especially Central Zagross. Seven ethanolic extracts of endemic medicinal herbs and one extract of native medicinal herb (Stachys lavandulifolia Vahl.) collected from Chaharmahal va Bakhtiari province of Iran were assayed for the in vitro antifungal activity against Candida albicans (ATCC1023), using agar dilution methods. Most of the extracts showed relatively high anti-Candida activity against the tested fungi with the diameter of inhibition zone ranging between 8 and 17 mm. The extracts of S. bachtiarica and T. daenensis exhibited high inhibitory effect against C. albicans. The extracts of S. bachtiarica and T. daenensis were characterized using HPLC, the major components of S. bachtiarica and T. daenensis were carvacrol and thymol, respectively. The minimum inhibitory concentration (MIC) values for active extract range between 25 and 50 µg/ml. In conclusion, it can be said that the extract of some of the Iranian endemic medicinal plants (S. bachtiarica and T. daenensis) could be used as natural anti-Candida

Effects of black seed (Nigella sativa), ginger (Zingiber officinale) and cone flower (Echinacea angustifolia) on the immune system of rainbow trout, Oncorhynchus mykiss

This study was carried out to evaluate the effects of dietary essential oils of ginger (Zingiber officinale), black seed (Nigella sativa) and cone flower (Echinacea angustifolia) on the immune system of cultured rainbow trout, Oncorhynchus mykiss. A total of 360 fish were divided into 4 groups and 3 replicates each containing 30 fish. The fish were fed for 21 days with 1% of the herbal essential oils and with unsupplemented diet as the control group. Haematological and immune parameters including serum lysozyme, number of phagocytic bacteria, Hb, PCV, MCV, MCH, MCHC, number of RBC and WBC were studied. Treatments recorded enhancement in immune parameters compared to the control group. Significantly higher serum lysozyme level and phagocytic germs were detected in the groups fed black seed, ginger and cone flower (P0.05). The results of this study demonstrated that essential oils might strengthen the non-specific immunity of rainbow trout