Protective and therapeutic effects of licorice in rats with acute tubular necrosis.

OBJECTIVES: Various protective and therapeutic effects such as antioxidant, anti-inflammatory, anticancer, antihistaminic, and antibacterial effects have been depicted for licorice. However, its biological effects in the kidney are still not clear. Therefore, we aimed to investigate the efficiency of licorice in rats with gentamicin (GM)-induced acute tubular necrosis. DESIGN AND METHODS: Rats were randomized into the control group (only saline for 12 days), licorice group (licorice for 12 days), GM group (GM for 12 days), GM + licorice group, and licorice-treated GM group (licorice for 12 days after taking GM for 12 days). Blood urea, creatinine, and uric acid levels were measured and histopathological analyses of the kidneys were performed. The oxidative side of oxidant-antioxidant balance was evaluated by detecting lipid peroxidation (LPO) and total peroxide levels, and antioxidative side was determined by measuring total antioxidant capacity (TAC) and reduced glutathione (GSH) levels in plasma and kidney tissues. RESULTS: The oxidant-antioxidant balance seemed to be shifted to the oxidative side in the GM group when compared with the control and GM + licorice groups. In GM group, biochemical profiles showed a remarkable increase in blood uric acid, urea, and creatinine levels, and depletion of renal tissue and plasma TAC and GSH levels. In addition, histopathologic studies revealed severe acute tubular necrosis, congestion, and hyaline casts, verifying GM-induced nephrotoxicity. Licorice was effective in reduction of blood urea, creatinine, and uric acid levels, and also effective in decreasing the tubular necrosis score. Licorice treatment also significantly reduced LPO and total peroxide levels, and increased TAC and GSH levels in both renal tissue and blood. Moreover, these changes in rats subjected to the combined therapy (GM + licorice) were significantly less than those of GM group. CONCLUSIONS: Licorice ameliorates GM-induced nephrotoxicity and oxidative damage by scavenging oxygen free radicals, decreasing LPO, and improving antioxidant defense.

Brain death revisited: it is not 'complete death' according to Islamic sources.

Concepts, such as death, life and spirit cannot be known in their quintessential nature, but can be defined in accordance with their effects. In fact, those who think within the mode of pragmatism and Cartesian logic have ignored the metaphysical aspects of these terms. According to Islam, the entity that moves the body is named the soul. And the aliment of the soul is air. Cessation of breathing means leaving of the soul from the body. Those who agree on the diagnosis of brain death may not able to agree unanimously on the rules that lay down such diagnosis. That is to say, there are a heap of suspicions regarding the diagnosis of brain death, and these suspicions are on the increase. In fact, Islamic jurisprudence does not put provisions, decisions on suspicious grounds. By virtue of these facts, it can be asserted that brain death is not absolute death according to Islamic sources; for in the patients diagnosed with brain death the soul still has not abandoned the body. Therefore, these patients suffer in every operation performed on them.

Prolidase activity dysregulation and its correlation with oxidative-antioxidative status in chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a consequence of an underlying chronic inflammatory disorder of the airways that is usually progressive and causes dysregulation in the metabolism of collagen. Prolidase has an important role in the recycling of proline for collagen synthesis and cell growth. OBJECTIVE: We measured and compared prolidase activity in healthy individuals with COPD patients to find out that whether its activity might reflect disturbances of collagen metabolism in the patients. We also investigated oxidative-antioxidative status and its relationship with prolidase activity in this disease. METHODS: Thirty voluntary patients with COPD and 30 healthy control subjects with similar age range and sex were included into the study. Plasma prolidase activities, total antioxidant capacity (TAC) and lipid peroxidation (LPO) levels were measured in the patient and control groups. RESULTS: Plasma prolidase activity and TAC levels were significantly lower, and LPO levels were significantly higher in the patients than those in the control subjects (P<0.05, P<0.001, and P<0.001, respectively). Significant correlations were detected between plasma prolidase activity and TAC and LPO levels in the patients group (r=0.679, P<0.001; r=-426, P<0.05, respectively). CONCLUSIONS: The results suggest that oxidative-antioxidative balance and collagen turnover are altered by the development of COPD in human lungs, and prolidase activity may reflect disturbances of collagen metabolism in this pulmonary disease. Monitoring of plasma prolidase activity and oxidative-antioxidative balance may be useful in evaluating fibrotic processes and oxidative damage in the chronic inflammatory lung disease in human.

Some principles of Islamic ethics as found in Harrisian philosophy.

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a 'deep-look' at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. This may be surprising, or thought of as a 'big' and 'groundless' claim, since John Harris has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). In this study I compare Harrisian teachings with major Islamic principles on 'Responsibility', 'Side-effects and Double-effects', 'Equality', 'Vicious choice, guilt and innocence', 'Organ transplantation and property rights' and 'Advance directives'.

N-terminal pro-brain natriuretic peptide in cases with metabolic syndrome and its relationship with components of metabolic syndrome and left ventricular mass index.

OBJECTIVE: In this study we investigated N-terminal pro-brain natriuretic peptide (Nt-proBNP) levels in patients with metabolic syndrome (MetS) and its relationship between MetS components. METHODS: Thirty nine recently diagnosed MetS cases and 59 control cases were included in the present study. Left ventricular mass index (LVMI) was calculated and Nt-proBNP was determined. RESULTS: Both groups were similar in terms of age and sex. Body mass index were significantly higher in MetS than non-MetS. LVMI measurements were not different between MetS and control groups (p=0.168). Nt-proBNP levels were similar in both groups (p=0.954). There was a significant correlation between Nt-proBNP and LVMI, age, serum LDL- and HDL-cholesterol levels. Nt-proBNP was independently related with age (beta=0.357, p=0.015) and LDL-cholesterol (beta=-0.255, p=0.049) in the multivariate analysis. CONCLUSIONS: Nt-proBNP levels don't have a significant increase in MetS. But there was a significant relationship between Nt-proBNP levels and age and LDL-cholesterol.

On the Ottoman consent documents for medical interventions and the modern concept of informed consent.

Information for patients prior to medical intervention is one of the principles of modern medical practice. In this study, we looked at an earlier practice of this principle. Ottoman judges had record books called sicil. One of the categories in sicils was the consent documents called riza senedi, which was a patient-physician contract approved by the courts. These contracts were especially for the protection of physicians from punishment if the patient dies. It is not clear whether patients were informed properly or not. Consent for minors was obtained from parents. However, a situation where an adult does not have the capacity to consent, was not clear in these documents. Any sign of free withdrawal of consent was not found in these records. Due to the legal system of Ottoman State, these contracts were related to Islamic law rather than modern civil law. We aim, in this paper, to present a legal practice, which is possible to consider as an early example of the informed consent practice.

Orthopaedic techniques of Sabuncuoglu in the 15th century Ottoman period.

Serefeddin Sabuncuoglu (1385-1468) was the author of the surgical textbook Cerrahiyyetü'l-Haniyye (Imperial Surgery). It was the first illustrated surgical textbook in the Turkish-Islamic medical literature. Cerrahiyyetü'l-Haniyye is significant because it includes Sabuncuoglu's color illustrations of surgical procedures, incisions, fracture dislocation reduction techniques, and instruments. There are only three handwritten copies. Two originally were written by Sabuncuoglu and are exhibited in Paris and Istanbul. The book was rediscovered in 1936, but some parts are suspected to be missing. The book currently consists of three chapters divided into 193 sections. The third chapter includes orthopaedics and traumatology, reduction techniques of lower and upper extremities, fractures and dislocations, and relevant Greek, Arabic, and Persian textbooks are cited. Sabuncuoglu also wrote about surgical treatment of congenital hand anomalies. He was the first to advise placing a wooden splint under the palmar side after hand surgery. We reviewed the sections of Cerrahiyyetü'l-Haniyye related to orthopaedics and traumatology. Compared with previous writings by Hippocrates, Ibn-i Sina, and Al-Zahrawi, there are no major differences in the treatment of fracture dislocations.

Children's rights and a sample study on accidents in children groups aged 0-5 years old in the light of parents' responsibility in Turkey.

OBJECTIVE: Most frequent reasons for the accidents seen in children under 5 years of age who have a right to be cared and protected are negligence and carelessness. In this study, judicial cases were compiled from children between the age of 0 to 5, who had been injured due to severe family negligence. METHODS: Files of cases were obtained from archives with file numbers, indicating cases obtained from the records of the hospital and police were studied retrospectively. The gender, age, and type of application of patients, the type of interference, and the results obtained from the procedure were studied. This study encompasses the results of cases at Osmangazi University Training, Practice and Research Hospital, Eskisehir, Turkey, between September 1999 and March 2001. RESULTS: Forty of 113 cases (35.4%) were due to poisoning from drugs. The main reasons were unawareness of children regarding the harm of drugs, putting drugs in reach of children and easy access to drugs from pharmacies without prescription. On the other hand, the recognition of international measures by the Turkish government is a guarantee for the children's rights. CONCLUSION: Our study implies that, as suggested by other researchers, the investigation of measures to prevent injuries due to negligence and the application of these measures will certainly improve the welfare of society.

Addition of formoterol or montelukast to low-dose budesonide: an efficacy comparison in short- and long-term asthma control.

BACKGROUND: Asthma is a chronic inflammatory disease of the airways. Inhaled corticosteroids are very important in anti-inflammatory treatment, but to a great extent they cannot control asthma alone. In addition to corticosteroids, long-acting beta2 agonists and leukotriene antagonists are used for asthma control. OBJECTIVE: In this study, the effect of the addition of formoterol and montelukast on asthma control in patients with moderately persistent asthma who were symptomatic while using a low dose of inhaled budesonide was compared. METHODS: At the beginning of the study, 40 symptomatic patients with moderately persistent asthma used 400 microg/day budesonide for a 4-week training period, and were then divided randomly into two groups, each composed of 20 persons. For the first group's treatment regime, inhaled formoterol (9 microg) twice a day was added, and for the second group's treatment regime, one-dose oral montelukast (10 microg) was added. These patients were followed up for 8 weeks. The patients' peak expiratory flow (PEF) values measured in the morning and at night, changes in PEF, forced expiratory volume in 1 s, asthma symptom score and the symptom-relieving therapy used during the 12-week study period were recorded and evaluated in the clinic at the very beginning and at the end of each period. RESULTS: Before the study, the morning PEF value of the group for whom formoterol was added to budesonide (FB) was 266.3 +/- 59.3 liters/min, and in the group for whom montelukast was added to budesonide (MB), it was 262.8 +/- 53.8 liters/min (p > 0.05). After the 8-week treatment period, the morning PEF values were found to be 320.5 +/- 54.4 liters/min in the FB group and 293.3 +/- 52.4 liters/min in the MB group; at the end of the study, it was seen that although there was an increase in morning PEF of 54.2 +/- 15.2 liters/min in the FB group, there was an increase of only 30.5 +/- 25.3 liters/min in the MB group (p < 0.0001). Before the study, night PEF values were 287 +/- 56.6 liters/min in the FB group and 283 +/- 48.5 liters/min in the MB group (p > 0.05). At the end of the treatment, the night PEF values were found to be 331.5 +/- 56.1 liters/min in the FB group and 310 +/- 53.1 liters/min in the MB group. At the end of the study, it was observed that although there was an increase in night PEF of 44.5 +/- 23.3 liters/min in the FB group, there was an increase of only 27 +/- 24.1 liters/min in the MB group (p < 0.001). Although asthma symptom scores and the use of symptom-relieving drugs showed similarities between the two groups at the beginning of the study, after treatment, the FB group had better results than the MB group with respect to these two parameters (p < 0.0001 for both). It was also seen that the two treatments are tolerated equally well. CONCLUSION: FB treatment, which causes a considerable improvement in lung function, showed better asthma control than MB treatment in patients with moderately persistent asthma.

Effects of melatonin on oxidative-antioxidative status of tissues in streptozotocin-induced diabetic rats.

In view of the antioxidant properties of melatonin, the effects of melatonin on the oxidative-antioxidative status of tissues affected by diabetes, e.g. liver, heart and kidneys, were investigated in streptozotocin (STZ)-induced diabetic rats in the present study. Concentrations of malondialdehyde (MDA) and reduced glutathione (GSH), and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the tissues were compared in three groups of 10 rats each (control non-diabetic rats (group I), untreated diabetic rats (group II) and diabetic rats treated with melatonin (group III)). In the study groups, diabetes developed 3 days after intraperitoneal (i.p.) administration of a single 60 mg kg(-1) dose of STZ. Thereafter, while the rats in group II received no treatment, the rats in group III began to receive a 10 mg kg(-1) i.p. dose of melatonin per day. After 6 weeks, the rats in groups II and III had significantly lower body weights and higher blood glucose levels than the rats in group I (p < 0.001 and p < 0.001, respectively). MDA levels in the liver, kidney and heart of group II rats were higher than that of the control group (p < 0.01, p < 0.05, p < 0.01, respectively) and diabetic rats treated with melatonin (p < 0.05). The GSH, GSH-Px and SOD levels increased in diabetic rats. Treatment with melatonin changed them to near control values. Our results confirm that diabetes increases oxidative stress in many organs such as liver, kidney and heart and indicate the role of melatonin in combating the oxidative stress via its free radical-scavenging and antioxidant properties.

A limited study on the perception and change in attitude about circumcision among health care professionals and their male family members.

OBJECTIVES: Millions of male children are circumcised throughout the world. We investigated the opinions and thoughts about the past and future aspects of circumcision by interviewing 100 male family members of the health care staff. METHODS: 100 male volunteers answered a questionnaire comprising questions about their personal observations, feelings, festivities and opinions about their own circumcisions as well as their views about the circumcision phenomenon as a parent, and the legality of circumcision. RESULTS: 81% of the volunteers in our study had been circumcised by traditional circumcisers. The rest had been circumcised by doctors (10%), barbers (7%) and sheikhs (2%). In 90% the circumcision took place at home, 7% in hospitals and in 3% in village squares. While 66% of the subjects do not remember anything, the remaining 33% reported some bad sensations like fear, pain and shame about their circumcisions, and 1 (1%) subject reported happiness. As a parent, they answered the questions on their preferences on the place and performer of the circumcision. 44% preferred to have circumcision performed in the hospital by a physician, 26% at home by a physician, and 30% at home by a circumciser. CONCLUSION: There are significant changes in the attitudes of people in Turkey on circumcision as a traditional culture, though its perception has remained unchanged.

Colored illustrations of obstetrics manipulations and instrumentation techniques of a Turkish surgeon Serafeddin Sabuncuoglu in the 15th century.

Serafeddin Sabuncuoglu (1385-1470) was the author of the first illustrated surgical textbook Cerrahiyyet'ül Haniyye (Imperial Surgery) in the Turkish-Islamic literature. In the obstetric section he gave detailed descriptions of normal and abnormal presentation, surgical manipulation of intrauterine foetal death and retained placenta. He wrote about previously described procedures and the obstetric culture of his time. Some authors have claimed that he only translated Abu Kasim-al Zahrawa (Albucasis)'s Al-Tasrif (Textbook of Surgery) and added the illustrations of the surgical techniques. Even if this is accepted, the illustrations are enough to entitle this work as a milestone. In this paper, we describe the contributions of this pioneer in obstetrics and compare his recommendations with the current practice.

The 'four principles of bioethics' as found in 13th century Muslim scholar Mawlana's teachings.

BACKGROUND: There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers Beachump and Childress formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'four principles' were presented by the authors as universal and applicable to any culture and society. Mawlana, a great figure in Sufi tradition, had written many books which not only guide people how to worship God to be close to Him, but also advise people how to lead a good life to enrich their personality, as well as to create a harmonious society and a peaceful world. METHODS: In this study we examined the major works of Mawlana to find out which of these 'four principles of bioethics' exist in Mawlana's ethical understanding. RESULTS: We have found in our study that all these principles exist in Mawlana's writings and philosophy in one form or another. CONCLUSIONS: We have concluded that, further to Beachump and Childress' claim that these principles are universal and applicable to any culture and society, these principles have always existed in different moral traditions in different ways, of which Mawlana's teaching might be presented as a good example.

The core concepts of the 'four principles' of bioethics as found in Islamic tradition.

Ethics can be described as a sub-branch of applied philosophy that seeks 'what is the right and the wrong, the good and the bad set of behaviours in a given circumstance'. Bioethics, however, is a quasi-social science that offers solutions to the moral conflicts arising in medical and biological science practice. There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers, Beauchamp and Childress, formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' which have almost always existed and govern the ethical behaviour of human societies, were presented by the authors as universal and applicable to any culture and society. These 'Four Principles' have been one of the most widely discussed issues in Biomedical Ethics with arguments for and against them. The authors' claim has been tested by research conducted in different cultures and societies. In this study we aim to explore the roots of the 'Four Principles' in Islamic tradition and culture, and show that this particular set of principles are not something new but only one of the latest formulations of age-old common sense principles. It is therefore concluded that these principles are already being applied in Islamic traditional and cultural societies.

Antenatal screening and its possible meaning from unborn baby's perspective.

In recent decades antenatal screening has become one of the most routine procedure of pregnancy-follow up and the subject of hot debate in bioethics circles. In this paper the rationale behind doing antenatal screening and the actual and potential problems that it may cause will be discussed. The paper will examine the issue from the point of view of parents, health care professionals and, most importantly, the child-to-be. It will show how unthoughtfully antenatal screening is performed and how pregnancy is treated almost as a disease just since the emergence of antenatal screening. Genetic screening and ethical problems caused by the procedure will also be addressed and I will suggest that screening is more to do with the interests of others rather than those of the child-to be.