Chronic pelvic pain syndrome: Highlighting medicinal plants toward biomolecules discovery for upcoming drugs formulation

Chronic pelvic pain syndrome (CPPS) can be triggered by a various types of gynecological, gastrointestinal, urological, and musculoskeletal disorders. Recently, the role of the central nervous system has proven to be an integral part on the development of any chronic pain syndrome, including CPPS. However, owing to the complex and heterogeneous etiology and pathophysiology of CPPS, the establishment of effective therapeutic interventions remains challenging for both physicians and patients. Nonetheless, recent studies have pointed that medicinal plants and their secondary metabolites can be effectively used in CPPS therapy, besides contributing to restore the patients' quality of life and potentiate the conventional CPPS management. In this sense, this review aims to provide a careful overview on the biomedical data for the use of medicinal plants use and their secondary metabolites on CPPS management.     

Assessment of Left Ventricular Viscoelastic Components Based on Ventricular Harmonic Behavior

Background: Assessment of left ventricular (LV) function with an emphasis on contractility has been a challenge in cardiac mechanics during the recent decades. The LV function is usually described by the LV pressure-volume (P-V) relationship. Based on this relationship, the ratio of instantaneous pressure to instantaneous volume is an index for LV chamber stiffness. The standard P-V diagrams are easy to interpret but difficult to obtain and require invasive instrumentation for measuring the corresponding volume and pressure data. In the present study, we introduce a technique that can estimate viscoelastic properties, not only the elastic component but also the viscous properties of the LV based on oscillatory behavior of the ventricular chamber and it can be applied non-invasively as well. Materials and Methods: The estimation technique is based on modeling the actual long axis displacement of the mitral annulus plane toward the cardiac base as a linear damped oscillator with time-varying coefficients. Elastic deformations resulting from the changes in the ventricular mechanical properties of myocardium are represented as a time-varying spring while the viscous components of the model include a time-varying viscous damper, representing relaxation and the frictional energy loss. To measure the left ventricular axial displacement ten healthy sheep underwent left thoracotomy and sonomicrometry transducers were implanted at the apex and base of the LV. The time-varying parameters of the model were estimated by a standard Recursive Linear Least Squares (RLLS) technique. Results: LV stiffness at end-systole and end-diastole was in the range of 61.86–136 dyne/g.cm and 1.25–21.02 dyne/g.cm, respectively. Univariate linear regression was performed to verify the agreement between the estimated parameters, and the measured values of stiffness. The averaged magnitude of the stiffness and damping coefficients during a complete cardiac cycle were estimated as 58.63±12.8 dyne/g.cm and 0 dyne.s/g.cm, respectively. Conclusion: The results for the estimated elastic coefficients are consistent with the ones obtained from force-displacement diagram. The trend of change in the estimated parameters is also in harmony with the previous studies done using P-V diagram. The only input used in this model is the long axis displacement of the annulus plane, which can also be obtained non-invasively using tissue Doppler or MR imaging.     

The effects of aquatic exercise on body composition and nonspecific low back pain in elderly males

[Purpose] The purpose of this study was to investigate the effect of aquatic exercises on nonspecific low back pain (LBP) in elderly males. [Subjects and Methods] Thirty-two elderly men aged 65 or older were recruited and randomly allocated to two groups: aquatic training (3 d/wk for 12 wk) or a control group. Body mass index (BMI), percentage of body fat (PBF), waist-hip ratio (WHR), and trunk muscle mass were measured before and after training. [Results] The results suggested that all obesity variables including BMI, WHR, and PBF of the aquatic training group were decreased significantly, while the trunk muscle mass of the aquatic training group was increased significantly. Furthermore, low back pain was decreased in the subjects after the intervention. [Conclusion] The water-based program improved LBP and body composition in the elderly men.Key words: Elderly, Low back pain, Body composition     

Investigating the effect of aqueous extract of Chicorium intybus L. leaves on offspring sex ratio in rat

A traditional belief in Iranian culture indicates that parental consumption of chicory leaves (Chicorium intybus L.) affects the gender of newborns. The aim of this study was to investigate the effect of aqueous extract of chicory on offspring sex ratio in rat. All rats in experimental groups 1 and 2 were i.p. injected with either 1.0 or 0.7 g/kg body weight (LD₅₀ = 2.244 g/kg) of an aqueous extract of chicory leaves for 30 days at 72 h intervals. The control rats were injected with distilled water in the same manner. After the 8th injection, blood pH, and Na⁺, K⁺, Ca²⁺ and Mg²⁺ serum levels, were measured in all groups. On day 30, all the rats were mated within and between groups. The results revealed that in comparison with the control group, there were significant increases (p < 0.01) in Na⁺ and K⁺ levels, as well as the sex ratio of male to female offspring (10.23%) in experimental group 1. Therefore, it can be concluded that the administration of chicory leaf extract has a significant effect on the sex ratio of the rat offspring. Copyright © 2010 John Wiley & Sons, Ltd.     

Effects of vitamin C and melatonin on cysteamine-induced duodenal ulcer in a cholestatic rat model: A controlled experimental study

Background: Superoxide dismutase (SOD) is one of the defense mechanisms against free radicals. Cysteamine is a cytotoxic agent, acting through generation of reactive oxygen species (ROS) such as hydrogen peroxide, hydroxyl radical, and superoxide, and may decrease defense activity of SOD against ROS and induce duodenal ulcer. Melatonin is a suicidal antioxidant that has a protective effect against ROS and cytoprotective effect through inhibition of the decrease in SOD activity.Objectives: The primary aim of this study was to assess the effects of pretreatment with vitamin C and melatonin on cysteamine-induced duodenal ulcer. Secondary aims were to compare the ulcerogenic effect of cysteamine and the antiulcer effects of vitamin C and melatonin.Methods: This study was performed in male Wistar rats (200-250 g) in 3 groups of equal size (n = 24): bile duct ligation-induced cholestasis (test), sham, and control groups. In the test and sham groups, laparotomy was performed under general anesthesia and the common bile duct was identified; in sham rats, the common bile duct was left in situ, but in test rats, the common bile duct was isolated and doubly ligated to induce cholestasis. Animals in each group were also divided into 4 equal subgroups (n = 6). These subgroups were treated with vitamin C plus cysteamine, melatonin plus cysteamine, cysteamine alone, and saline, respectively. All animals were euthanized via overdose of ether anesthesia 24 hours after the last injection of cysteamine or saline, and 0.5 mL of blood was collected from the heart ventricle. The duodenum was cut open, washed with saline, fixed, and prepared for calculation of ulcer index (Szabo method) and histopathologic assessment. SOD activity was measured using a branded enzyme kit.Results: In all 3 groups, animals treated with cysteamine had significantly increased mean (SE) ulcer index (test, 4.00 [0.10] vs 1.17 [0.30]; sham, 3.83 [0.16] vs 0.50 [0.22]; control, 3.67 [0.21] vs 0 [0]) and decreased SOD activity (test, 146.41 [2.16] vs 299.83 [1.94] U/mL; sham, 154.75 [2.02] vs 303.08 [0.35] U/mL; control, 157.08 [1.67] vs 314.50 [1.14] U/mL) compared with saline-treated rats (all, P < 0.001). In the test rats, ulcer index was significantly increased and SOD activity was significantly decreased compared with the sham and control groups (both, P < 0.001). Pretreatment with vitamin C and melatonin was associated with attenuation of ulcer index and increased SOD activity compared with rats treated with cysteamine alone (P < 0.001). There were no significant differences in ulcer index or SOD activity between groups administered vitamin C or melatonin.Conclusions: In this experimental study, pretreatment with melatonin or vitamin C in all rats produced significant attenuation of the ulcer index and enhanced SOD activity. Cysteamine-induced duodenal mucosal damage was greater in cholestatic rats compared with sham and control rats.     

Indomethacin may reduce the incidence and severity of acute pancreatitis after ERCP

OBJECTIVES: Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Many medications have been used to prevent this complication. We aimed to evaluate the efficacy of rectally administered indomethacin for the prevention of post-ERCP pancreatitis. METHODS: During 18 months, all eligible patients who underwent ERCP were enrolled in this study. In a double-blind randomized trial, patients received a suppository containing indomethacin, 100 mg, or an inert placebo immediately before ERCP. Serum amylase levels and clinically pertinent evaluations were measured in all patients after ERCP. RESULTS: A total of 490 patients entered the trial, of which half received indomethacin. Twenty-two patients developed pancreatitis; seven cases in the indomethacin group and 15 in the placebo group (P=0.06). Pancreatic duct injection (OR=3.0, 95% CI: 1.3-7.4), pancreatic duct cannulation more than once (OR=4.2, 95% CI: 1.7-10.0), and age less than 60 yr (OR=2.7, 95% CI: 1.0-7.1) were shown to be significant risk factors for developing post-ERCP pancreatitis. In patients who underwent pancreatography with or without cholangiography, the risk of pancreatitis was significantly lower in the indomethacin group compared with the control group (P=0.01, RRR=88%, ARR=0.16, NNT=6). Moderate to severe pancreatitis was significantly higher in the placebo group (P= 0.03). CONCLUSIONS: This trial shows that rectal indomethacin given immediately before ERCP can reduce the incidence and severity of post-ERCP pancreatitis.     

The Efficacy of an Herbal Medicine, Carmint, on the Relief of Abdominal Pain and Bloating in Patients with Irritable Bowel Syndrome: A Pilot Study

Carmint contains total extracts of Melissa officinalis, Mentha spicata, and Coriandrum sativum, which have antispasmodic, carminative, and sedative effects. As abdominal pain/discomfort and bloating are commonly observed in patients with irritable bowel syndrome, we decided to evaluate the effectiveness of Carmint in relieving these symptoms in irritable bowel syndrome patients. We randomly assigned 32 irritable bowel syndrome patients to receive either Carmint or placebo, plus Loperamide or psyllium (based on their predominant bowel function), for 8 weeks. T-test analysis of the results showed that the severity and frequency of abdominal pain/discomfort were significantly lower in the Carmint group than the placebo group at the end of the treatment (P=0.016 and P=0.001, respectively), as were the severity and frequency of bloating (P=0.02 and P=0.002, respectively). This pilot study suggests that Carmint plus loperamide or Carmint plus psyllium (depending on the irritable bowel syndrome subtype) might be effective in these patients.     

Subcutaneous immunization with a novel immunogenic candidate (urease) confers protection against Brucella abortus and Brucella melitensis infections

Brucellosis is a world prevalent endemic illness that is transmitted from domestic animals to humans. Brucella spp. exploits urease for survival in the harsh conditions of stomach during the gastrointestinal infection. In this study, we examined the immune response and the protection elicited by using recombinant Brucella urease (rUrease) vaccination in BALB/c mice. The urease gene was cloned in pET28a and the resulting recombinant protein was employed as subunit vaccine. Recombinant protein was administered subcutaneously and intraperitoneally. Dosage reduction was observed with subcutaneous (SC) vaccination when compared with intraperitoneal (IP) vaccination. rUrease induced mixed Th1–Th2 immune responses with high titers of specific IgG1 and IgG2a. In lymphocyte proliferation assay, splenocytes from IP and SC‐vaccinated mice displayed a strong recall proliferative response with high amounts of IL‐4, IL‐12 and IFN‐γ production. Vaccinated mice were challenged with virulent Brucella melitensis, B. abortus and B. suis. The SC vaccination route exhibited a higher degree of protection than IP vaccination (p value ≤ 0.05). Altogether, our results indicated that rUrease could be a useful antigen candidate for the development of subunit vaccines against brucellosis.