Objective

Complementary and alternative medicine (CAM) use has an increasing trend around the world. Despite the wild application of CAM in patients with coagulation disorders, its efficacy is still questioned by many studies. The aim of this study was to determine the frequency and types of CAM usage, and the factors affecting CAM use among patients with bleeding disorders.

Methods

This cross-sectional study investigated the usage of CAM with a standard validated questionnaire in coagulopathic patients who were referred to Dastgheib Hospital, an educational therapeutic center affiliated to the Shiraz University of Medical Sciences in Shiraz, Southern Iran.

Results

Between December 2015 and May 2016, 75 patients were included in this survey. Severe hemophilia A and rare bleeding disorders were the most frequent among our participants. Overall, nearly half of the studied population (49.3%) used at least one CAM product or practices. The most common products were multivitamin (29.3%), followed by folic acid (21.3%) and chamomile (12%). 32% of the patients resorted to faith healing. The main reasons of using CAM were reported to be increased general health, correction of anemia and thrombocytopenia and control of bleeding tendency.

Conclusion

CAM is being used frequently in patients with coagulation disorders like many other chronic illnesses all around the world. Due to emerging concern regarding the safety and possible interaction with the conventional medicine, it is necessary to develop basic data about the hematologic effects of these methods in order to use them more safely.

Background

Rheum ribes L. is a plant native to China, Iran, Turkey, India, and a few other countries. Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine. An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children, and underlines a need for safe, efficient and valid options.

Objective

The purpose of this study is to evaluate the efficacy of R. ribes syrup as a complementary medicine for treatment of shigellosis in children.

Design, Setting, Participants and Interventions

This randomized, double-blind, placebo-controlled trial started with a group of 150 children aged between 12-72 months with suspected Shigella dysentery. R. ribes syrup or placebo syrup was administered to the intervention and control groups, respectively for 5 days. In addition, the standard antibiotic treatment (ceftriaxone for the first 3 days and cefixime syrup for 2 further days) was administered to both groups.

Main Outcome Measures

Body temperature, abdominal pain, need for antipyretics, defecation frequency, stool volume and consistency and microscopic stool examination were recorded as outcome measures. Any observed adverse effects were also recorded.

Results

Mean duration of fever and diarrhea in the R. ribes group was significantly lower than that in the placebo group (P = 0.016 and 0.001, respectively). In addition, patients in the R. ribes group showed shorter duration of need for antipyretics and shorter duration of abdominal pain (P = 0.012 and 0.001, respectively). However, there were no significant differences between the two groups regarding the microscopic stool analyses. Furthermore, no adverse effect was reported.

Conclusion

R. ribes syrup can be recommended as a complementary treatment for children with Shigella dysentery.

Trial Registration

Iranian Registry of Clinical Trial: IRCT2014070518356N1.

Background

Amiodarone is a useful antiarrhythmic drug. Phlebitis, caused by intravenous amiodarone, is common in patients in coronary care units (CCUs).

Objective

The aim of this study was to evaluate the effect of topical chamomile on the incidence of phlebitis due to the administration of an amiodarone infusion into the peripheral vein.

Design, Setting, Participants and Interventions

This was a randomized, double-blind clinical trial, conducted on 40 patients (n = 20 per group) in two groups—an intervention group (chamomile ointment) and a control group (lanoline, as a placebo), hospitalized in the CCUs and undergoing an amiodarone infusion into the peripheral vein over 24 h. Following the cannulation and commencement of the infusion, placebo or chamomile ointment was rubbed in, up to 10 cm superior to the catheter and repeated every eight hours for three days. The cannula site was then assessed based on the phlebitis checklist.

Main Outcome Measures

The incidence and time of occurrence of phlebitis, relative risk, severity of phlebitis were the main outcome measures.

Results

Nineteen patients (19/20) in the control group had phlebitis on the first day of the study and one patient (20/20) on the second day. In the intervention group, phlebitis occurred in 13 cases (13/20) on the first day and another two (2/7) was found on the second day. The incidence of phlebitis was significantly different between two groups (P = 0.023). The cumulative incidence of phlebitis in the intervention group (15/20) is significantly later and lower than that in the control group (20/20) during two days (P = 0.008). Two patients in the intervention group did not develop phlebitis at all during the 3-day study. Also, the relative risk of phlebitis in the two groups was 0.68 (P = 0.008 5). A significant difference was not observed with regard to phlebitis severity in both groups.

Conclusion

It seems that phlebitis occurred to a lesser extent and at a later time frame in the intervention group compared to control group. Topical chamomile may be effective in decreasing the incidence of phlebitis due to an amiodarone infusion.

Trial Registration

This protocol was registered in the Iranian Registry of Clinical Trials (IRCT2014042017361N1).

Objective

This study evaluated the responses of some antioxidant parameters in selected tissues of Plasmodium berghei-infected mice treated with cysteine-stabilized peptide fraction (CSPF) of aqueous extract of Morinda lucida leaf.

Methods

Fifty-six mice were randomly divided into seven groups. Group A (normal control) was uninfected and received 5% dimethyl sulfoxide (DMSO). Mice in Groups B (negative control), C, D, E and F were inoculated with P. berghei NK65 and were administered with 5% DMSO and 15.63, 31.25, 61.5 and 125 mg/kg body weight of CSPF respectively. Group G animals, were also inoculated with P. berghei NK65, and received 20 mg/kg body weight of chloroquine. The administration lasted for three days, after which malondialdehyde (MDA) concentration and various antioxidant parameters in selected tissues of mice were determined on days 4 and 8 post-inoculation.

Results

The results revealed that MDA concentration was significantly increased (P < 0.05) in the tissues of the negative control and chloroquine-treated groups. The increased MDA concentration was reduced by CSPF in a dose-dependent manner, which was significant (P < 0.05) at higher doses. The activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase and the concentration of reduced glutathione were significantly reduced (P < 0.05) in the tissues of the negative control animals compared to the normal controls. This observed reduction in the negative control animals was reverted in a dose-dependent manner in infected animals given CSPF, even to the range of the normal controls at highest dose, as did chloroquine.

Conclusion

The results suggest that CSPF of M. lucida leaf extract may induce the antioxidant defense system in vivoagainst Plasmodium species infection.