Galen Medical journal
Volume:6 Issue: 4, 2017

Medical ethics has been contemplated upon by practitioners since ancient times. Avicenna’s notes on medical ethics are presented in the third chapter of the manuscript “Fi Bayan al-hajat Ela al-Teb va al-Atteba va Vasayahom” (meaning: “on needs to medicine and physicians and their recommendations”) by Qutb al-Din Shirazi’s (1236-1311 CE), one of the main commentators on Avicenna Canon of Medicine. Avicenna refers to several ethical subjects which can be expressed in three main domains: considering patient interests, communication skills, and adhering to the characteristics of professional excellence. Although there are similarities between the classical medical ethics recommendations and ethics recommendations raised by Avicenna, significant moral differences can be considered between the two views.

In the era of recombinant DNA technology, production of recombinant vaccines in green plants has emerged as an effective approach addressing the problems of traditional vaccine production. Various antigens expressed in different plant species have been so far tested for the production of efficient oral vaccines against human and livestock diseases. However, recombinant vaccines have not yet found a prominent place in pharmaceutical market. There are still many challenges to be addressed to pave the road for commercial production of plant-based recombinant vaccines. Regarding increasing growth in laboratory studies and field trials for development of plant-based vaccines, this review paper provides a comprehensive overview on the topic of plant-derived vaccines and related issues.

Nausea and vomiting of pregnancy (NVP) is one of the prevalent pregnancy complaints. This study was conducted to review the medicinal plants mentioned in Traditional Persian Med­icine (TPM) for the treatment of NVP. A literature research was conducted on a number of main references of TPM, including the books of al-Qanun fī al-Teb, Zakhireye Kharazmshahi, Tadbir-al-Habali al- Atfal al-Sabiban and Makhzan-al-Adviah. Then, medicinal plants mentioned in TPM for treatment of NVP were determined and searched in electronic databases, including PubMed and Google Scholar to find studies that confirmed their efficacy. The search terms were ‘‘vomiting’’ or ‘‘nausea’’ or “emesis” and “pregnancy” and the name of each herb. Data were collected for the years 1990–2016. The findings included 10 plants. Citrus limon (Lemon), Citrus medica L. (Citron), Cydonia oblonga (Quince), Elletaria cardamomum (Cardamom), Mentha spicata L. (Spearmint), Menatha piperita (Mint), Myristica fragrans Houtt (Nutmeg), Pistacia lentiscus Linn. (Mastic), Punica granatum L. (Pomegranate), Malus domestica Borkh (Apple), and Piper cubeba L. are the most recommended medications for NVP. There is evidence in human studies for some of these medicinal plants (Mentha Piperita L., Citrus limon, Elletaria cardamom, and Cydonia oblonga Mill). The other mentioned herbs have not been evaluated during pregnancy. There is limited evidence to safely recommend these plants for NVP. Although some human studies have suggested the antiemetic effects of TPM remedies, their safety is not sufficiently documented in modern literature. Scientific studies on these medicinal plants during pregnancy are warranted to determine their safety.

Asthma is a chronic relapsing airways disease that represents a major public health problem worldwide. With the high incidence of asthma, there has been a surge in the use of complementary therapies, such as compound honey syrup in Traditional Persian Medicine, in the treatment of asthma. The aim of this study was to evaluate the efficacy and safety of Iranian poly herbal formulation (compound honey syrup) in the treatment of mild to moder­ate pediatric asthma. The study was a randomized clinical trial that was conducted on 80 patients with mild to moderate asthma assigned to two groups (n=40 for each group) for eight weeks. Control and experimental groups received classical treatment of asthma with fluticasone spray; in case of worsening of symptoms, salbutamol spray was used for short term. The experimental group also received compound honey syrup (the combina­tion of honey and an extract of the following five medicinal plants: ginger, cinnamon, saf­fron, cardamom, and galangal). Asthma Control Questionnaire (ACQ) items and total scores of ACQ were evaluated before and after treatment. To this end, 72 patients complet­ed this study. There was no significant difference between the experimental and the control groups in baseline data such as age, sex, body mass index, ACQ items, and ACQ scores. Total scores and all items of ACQ, with the exception of forced expiratory volume in one second (FEV1%), were significant between groups (P

Knowledge about sexual health is one of the basic needs of young couples. The present study aimed to develop and validate the Sexual Health Education Needs Assessment Questionnaire (SHENAQ). This study was a sequential explorato­ry mixed method. In the qualitative phase, In-depth interviews were conducted with 38 en­gaged and married men and women and 9 key informants. After a literature review, in the quantitative phase, validity properties of the SHENAQ were assessed.
Sexual health education needs consists of 4 themes “Suitable content for education “,” Characteristics of competent educators”, “Appropriate technologies in education” and” Educational convenient features”. The content validity ratio (CVR) and content validity index (CVI) of the instrument were 0.91 and0.83 respectively. SHENAQ was designed with 46 items. The instrument’s in­ternal consistency was confirmed by alpha coefficient 0.863 and stability assessment through the test-retest was 0.824.
SHENAQ is culturally sensitive with satisfactory va­lidity and reliability and could be used to increase the effectiveness of premarital education.

Although neonatal jaundice occurs in 60% of term infants, very little evidence is available on how to prevent it. Given the ethno-medical use of chicory aroma water (CAW) for the management of jaundice by Iranian pregnant women, the aim of this study was to evaluate whether the frequent CAW consumption was associated with fewer jaundice symptoms after 40 days. A single blind randomized controlled trial was designed to enroll participants from Lolagar Hospital, Tehran, Iran. Pregnant women (n=80) were randomly divided into two groups. The trial group was provided with common diet and an instruction to consume CAW. The control group was maintained on common diet. The proportion of phototherapy and mean value of bilirubin were measured and compared between the two groups. (IRCT registry number: IRCT2017041633475N1) There was no statistically significant difference in the mean value of bilirubin between the women with frequent CAW consumption compared with the control. Also, the intake of CAW was not associated with a marked improvement in the need for phototherapy (P > 0.05). The findings of this study highlighted that the intake of CAW by pregnant women failed to ameliorate neonatal jaundice.

In this research, the beneficial effects of oral administration of Hypericum perfo­ratum (HP) on serum glucose and lipids, hepatic enzymes and the amount of malondialdehyde in Streptozotocin-induced diabetic rats are studied.
In this experi­mental study, 32 male rats where randomly divided into 4 groups of control, treatment-control, diabetic and treatment-diabetic. HP was orally administered to treatment groups over a period of 6 weeks. Serum glucose levels, triglyceride, total cholesterol along with HDL and LDL were all evaluated prior to initiation of the treatment, and at 3rd and 6th (last) week of treatment initiation, and in the end of the treatment, malondialdehyde and aminotransferase enzymes of the liver were evaluated. regarding serum glucose levels and body weight measured in the 3rd and 6th week, the treatment-diabetic group didn’t show a significant change compared to the diabetic group, regarding serum total cholesterol and LDL levels, a significant decrease was observed and regarding serum HDL, a significant increase was documented. Furthermore, treating the treatment-diabetic group with HP did not result in any significant decrease in serum triglyceride, malondialdehyde or alanine aminotransferase but, in fact, did cause a significant decrease in aspartate aminotransferase. Oral administration of HP did in fact have a beneficial effect on lowering serum levels of total cholesterol, LDL and the hepatic enzyme as­partate aminotransferase and on raising the levels of HDL in diabetized rats with Streptozotocin.

Lifestyle factors, including environmental and occupational exposure, have a key role in reproductive health status and may impact fertility. Formaldehyde (FA) is a suspected reproductive toxicant, which may cause significant adverse effects on the reproductive system. This study was aimed at detecting the impact of FA and the possible protective role of vitamin E on the male reproductive system in rats.
Thirty-two adult male Wistar rats were randomly divided into four groups: control rats, rats treated with vehicle (corn-oil), rats treated with 10 mg/kg/day FA (FAt), and rats treated with FA plus 30 mg/kg/day vitamin E plus vehicle (FAt vitamin E) for two weeks. After treatment, sex hor­mone levels were examined using ELISA. Moreover the count, morphology, and motility of sperm, were observed. The sperm count and the percentage of rapid progressive sperm were significantly decreased in rats in the FAt-treated group compared with those in the control and vehicle-treated groups (p0.05). The findings of this study revealed that FA exposure had a negative impact on sperm parameters and some reproductive hormones in rats and vita­min E attenuated the deleterious impact of FA on the reproductive system of adult male rats.

MicroRNAs (miRNAs) are key gene regulators that are involved in many bi­ological and also pathological processes, including breast cancer. Breast cancer is the most common form of malignancies in women and requires new therapies and biomarkers. Different signaling pathways, such as Phosphoinositide 3-kinase (PI3K) signaling pathway are involved in breast cancer and can be new candidates for targeted therapies based on miRNAs. The aim of this study was to predict miRNAs targeting Phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) and serine/threonine kinase 1 (AKT1) genes of PI3K cascade bioinformatically and to analyze their expression in breast cancer.
Bioinformatic software and tools were used to predict miRNAs targeting PIK3CA and AKT1 genes. MCF-7 and MCF-10A cell lines were cultured as breast cancer and control cells respec­tively. RNA extraction, cDNA synthesis, and quantitative real-time PCR were performed. REST 2009® was utilized to analyze the expression of miRNAs and their target genes.
The results of our bioinformatic predictions indicated that miR-576-5p, miR-501-3p, and miR-3143 can be the first candidate miRNAs targeting PI3K signaling pathway. Data analyses demon­strated that PIK3CA and AKT1 genes were up-regulated while all bioinformatically predicted miRNAs were down-regulated in MCF-7 cell line compared to the normal cells. The results of our study demonstrated that PIK3CA and AKT1 can be targeted by miR-576-5p and miR-501-3p respectively. Furthermore, miR-3143 can target both mRNAs. Since these miRNAs target oncogenes, they can be proposed for new complementary targeted therapies in breast cancer patients.

This study has been conducted with the aim to identify factors affecting the management of pharmaceutical supply chain in Iran.
This study was of a combined(quantity–quality)type. The assessment tool was a Likert scale-based five-option questionnaire. Content validity assessment was obtained at 0.89 according to the CVR, and construct validity was at 0.971 using factor analysis.KMO statistics was very high and indicative of a correlation of scale items.In terms of reliability of assessment in re­searcher-made tools, the selected items were analysed, and the results obtained showed that the applied scales enjoyed significant reliability.The sample for the survey was100experts in the pharmaceutical system of the country’s Food and Drug Administration, pharmaceutical companies, technical officer of pharmacies and the ministry of health and medical education. They were selected by purposive stratified non-random sampling and snowball methods. The data was analysed by exploratory factor analysis using SPSS and LISREL.
The re­sults of the current study indicated a pattern with significant and direct relationship between independent and dependent variables of medicine supply chain management. The most im­portant indicators of medicine supply chain management in order of priority were distribu­tion management with impact factor, IT management, pharmaceutical structure, pharmaceuti­cal structure programming, coordination, enterprise resource planning, logistics management, knowledge management, financial management, globalization, customer relationship manage­ment, and medical insurance system.
According to the patterning indexes, it can be mentioned that the representative model has had a good fit, and a desirable compliance between a structural model with experimental data and expert opinion has been provided.

Sexual activity makes up a significant portion of anybody’s life: it plays a crucial role when it comes to having full physical, mental, and psychological health. This part of life-style has been emphasized as an essential need in Persian Medicine (PM) literature [1]. PM sages –such as Rhazes (865-925 AD)– have discussed different types of sexual disorders in their books, offering their own therapeutic methods [2]. Nevertheless, the recent increasing trend of sexual disorders and related complications e.g., infertility, has posed a serious challenge to the physicians and a growing burden to health care systems.
Putting emphasis on having a healthy sex life, PM underlines proper regimen and normal digestive system without which negative consequences on both potency and fertility may occur [3]. Moreover, accomplishment of sexual desire and normal sexual function is conditioned upon the well-being of vital organs i.e., heart, brain, liver, and genital system. Not only in traditional literature but also in current studies the relation between cardiovascular diseases and sexual disorders has been mentioned [4].
Avicenna (980-1037 AD) (Figure 1), the great Persian scholar of the Islamic Golden Age, is known as one of the pioneers of modern science of cardiology. He has discussed sexual disorders in the third volume of his masterpiece, Canon of Medicine.
In the chapter on “noghsan-e-bah” (sexuality weakness), Avicenna discusses different sexual disorders and their proper remedies. For instance, he goes on to cover erectile dysfunction, mentioning its cardiovascular origin [5]. Avicenna precisely describes the clinical features of impotence/infertility with cardiovascular origin: “…If the decrease in the stamina of intercourse is from a cardiac origin, erection would happen less, and ejaculation may occur in a non-erectile state. The pulse would be soft and weak –body temperature drops under the normal degree…” [6].
Avoidance of grief and improving body weakness using meat juice are the basic treating approaches in this case. As for the pharmacotherapy, application of fragrant herbs such as sandalwood, rose, and musk has been emphasized. Apple, lemon balm, and borage drinks are repeated prescriptions of Iranian physicians in this regard. In addition, pearls, amber, coral, silk, cloves, white behen, mastic, valerian, and cinnamon are the most common components that are used in combination forms for treating cardiogenic infertility/impotency [7].
Establishing such a link in between cardiac diseases and infertility in PM is not far from the current evidence. For instance, it has been revealed that serum testosterone level is significantly decreased in men with chronic heart failure [8]; this could inevitably pose negative effects on fertility. On the other hand, some clinical evidences have shown that using a formulation (Loboob) which increases the cardiac [and other vital organs’] stamina is effective in treatment of infertility [9]. In addition, at least some –if not all– of the medicinal plants used for managing sperm abnormalities in PM have cardiotonic properties [10]. With this regard, we suggest more rigorous investigations to well understand the concept of cardiac infertility and its underlying mechanisms.