Efficacy of Herbal Medicines on Lung Function in Asthma: a systematic review and meta-analysis of randomized controlled trials.

Objectives: The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients. Methods: A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inverse-variance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity. Results: As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD 3.73, 95% CI 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I2 = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD 5.16; 95% CI 2.68-7.63) compared to children (WMD = 1.27; 95% CI -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically. Conclusion: Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. This improvement is more likely to be observed amongst adults.

The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial.

Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

Evaluation of Sertoli cell autophagy associated with laminin, fibronectin, and caspase-3 proteins' alteration, following testicular torsion rat.

Autophagy is a vital process that maintains cellular homeostasis by joining lysosomes and providing energy production substrates. In testicular tissue, Sertoli cells play functional roles in spermatogenesis and steroidogenesis. It is well known that autophagy physiologically occurs in the Sertoli cells. Under pathological conditions, such as testicular torsion, autophagy can be activated under high-stress stimuli. It is worth noting that Sertoli cells receive autophagy-induced signals through some extracellular matrix proteins, e.g. laminin and fibronectin. The present study aims to evaluate Sertoli cells' autophagy-associated extracellular matrix proteins' alteration following testicular torsion in rat model. The animals were divided into two groups as sham and testicular torsion/detorsion groups. In the testicular torsion/detorsion group, testicular torsion was maintained for 6 hr, followed by detorsion for 14 days. The obtained results revealed that testicular torsion-induced oxidative stress leads to increased autophagy in Sertoli cells as well as the whole testicular tissue. Moreover, extracellular matrix proteins including laminin and fibronectin act as autophagy-regulating proteins, in which their expression levels are reduced and increased respectively. In addition, the level of caspase-3, as an autophagy inhibitory protein, did not increase significantly in the cytoplasm of Sertoli cells as opposed to whole testicular tissue, indicating that autophagy is active after testicular torsion in these cells.

Assessment of intelligence quotient score in children at the age of six with suspected congenital hypothyroidism: A retrospective cohort study.

Background: The clinical suspicion of Congenital Hypothyroidism (CH) is identified by abnormal results in the first test of Thyroid Stimulating Hormone (TSH) (5-9.9 mIU/L), and normal results in re-test (TSH<4 mIU/L). The CH has a contribution to physical and mental health. This study aimed to determine the Intelligence Quotient (IQ) score in children with suspected congenital hypothyroidism. Methods: This research is a retrospective cohort study conducted in Mashhad, Iran. The IQ scores of 1976 children at the age of 6 were considered as an outcome variable. The history of CH screening for each newborn was assessed, then all suspected CH newborns that diagnosed healthy in re-test were considered as an exposed group, the effects of this situation on IQ score was assessed using logistic regression. All analysis was performed in STATA. Results: The averages of IQ score (p<0.001), weight (p=0.024), and height (p<0.001) in the exposed group were lower than the unexposed group. The exposed group was related to those whose parental education was less or equal to 12 years (p<0.001). Similarly, the history of CH and maternal education for ≤12 years were detected as risk factors for having an IQ score of <90 in children. Conclusion: Aside from the link between parental education and clinical suspicion of CH in neonates, our findings underline the possible strong effect of CH status and maternal education for ≤12 years on reducing IQ scores in the next years of child life.

Assessing the risk factors before pregnancy of preterm births in Iran: a population-based case-control study.

BACKGROUND: Preterm birth is a major cause of prenatal and postnatal mortality particularly in developing countries. This study investigated the maternal risk factors associated with the risk of preterm birth. METHODS: A population-based case-control study was conducted in several provinces of Iran on 2463 mothers referred to health care centers. Appropriate descriptive and analytical statistical methods were used to evaluate the association between maternal risk factors and the risk of preterm birth. All tests were two-sided, and P values < 0.05 were considered to be statistically significant. RESULTS: The mean gestational age was 31.5 ± 4.03 vs. 38.8 ± 1.06 weeks in the case and control groups, respectively. Multivariate regression analysis showed a statistically significant association between preterm birth and mother's age and ethnicity. Women of Balooch ethnicity and age ≥ 35 years were significantly more likely to develop preterm birth (OR: 1.64; 95% CI: 1.01--2.44 and OR: 9.72; 95% CI: 3.07-30.78, respectively). However, no statistically significant association was observed between preterm birth and mother's place of residence, level of education, past history of cesarean section, and BMI. CONCLUSION: Despite technological advances in the health care system, preterm birth still remains a major concern for health officials. Providing appropriate perinatal health care services as well as raising the awareness of pregnant women, especially for high-risk groups, can reduce the proportion of preventable preterm births.