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El-Shanshory M, Hablas NM, El-tahlawi R, Awny S, Aboonq MS, Al Jaouni SK, Abdel-latif TM, Abdel-Gawad AR, Okashah AM, Fakhreldin AR, Baghdadi H, El-Allaf H, Shebel Y, El-Sawy SA, Albeihany A, Mahmoud HS, Sayed AA, Abu-Elnaga MAM, Nabo MMH, El-Dardear A, Abdel-Rahman IM, El Sayed SM, Mahmoud AA. Al-hijamah (the triple S treatment of prophetic medicine) significantly increases CD4/CD8 ratio in thalassemic patients via increasing TAC/MDA ratio: a clinical trial. Am J Blood Res 2022; 12:125-135. [PMID: 36147606 PMCID: PMC9490105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/13/2022] [Indexed: 06/16/2023]
Abstract
Beta thalassemia is associated with decreased immunity possibly due to iron overload. Al-hijamah (Hijamah) is wet cupping therapy (WCT) of prophetic medicine. Prophet Muhammad Peace be upon him said: "The best among your treatments is Al-hijamah". Al-hijamah is a promising excretory treatment to clear blood of causative pathological substances. Al-hijamah is a three-step technique (skin suction, scarification and suction) i.e. triple S technique). Recently, we introduced Al-hijamah as a novel iron excretion therapy (through pressure-dependent filtration then excretion via the skin dermal capillaries) that significantly decreased serum iron overload and related oxidative stress using a physiological excretory mechanism (Taibah mechanism). Iron overload was reported to impair both humoral immunity and cell mediated immunity in patients with beta thalassemia. In this study, twenty patients having β-thalassemia major (maintained on iron chelation therapy) underwent a single session of Al-hijamah (30-60 minutes) using 4-5 sucking cups only. Another age and sex-matched control group of thalassemic patients received iron chelation therapy only. Al-hijamah enhanced the immunity of thalassemic patients in the form of increased CD4+ T cell count, from 124.10±36.98 to 326.20±57.94 cells/mm3, and an increased CD8+ T cell count from 100.30±36.98 to 272.40±46.37 cells/mm3. CD4/CD8 ratio significantly increased from 1.29 to 1.7 (P<0.001). There was a significant increase of ten times (P<0.001) in serum TAC/MDA ratio (reflects increased antioxidant capacity vs decreased oxidative load and stress) induced by Al-hijamah. After Al-hijamah, both CD4+ and CD8+ T cell counts significantly increased and positively correlated with TAC/MDA ratio (r = 0.246) and (r = 0.190), respectively. Moreover, CD4/CD8 ratio positively correlated with TAC/MDA after Al-hijamah (r = 0.285). In conclusion, Al-hijamah significantly increased CD4/CD8 ratio in thalassemic patients via increasing TAC/MDA ratio. Our study strongly recommends medical practice of Al-hijamah in hospitals for its immune potentiating effects in agreement with the evidence-based Taibah mechanism. Al-hijamah should be generalized for treating other immune-deficiency conditions. Al-hijamah-induced bloody excretion is so minimal and never aggravates the anaemic status.
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Affiliation(s)
- Mohamed El-Shanshory
- Prophetic Medicine Course and Research, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
- Department of Paediatrics, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | - Nahed Mohammed Hablas
- Department of Paediatrics, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | - Rehab El-tahlawi
- Department of Microbiology and Immunology, Zagazig Faculty of Medicine, Zagazig UniversityZagazig, Al-Sharkiyah, Egypt
| | - Shereen Awny
- Department of Internal Medicine, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | - Moutasem Salih Aboonq
- Department of Physiology, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Soad K Al Jaouni
- YAJ Chair for Prophetic Medicine Applications, King Abdul-Aziz College of MedicineJeddah, Saudi Arabia
| | | | | | - Ahmed M Okashah
- Academic Affairs Director and Consultant Clinical Immunologist, Al-Madinah Directorate of Health, Ministry of HealthAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Ahmed R Fakhreldin
- Department of Paediatrics, Aswan Faculty of Medicine, Aswan UniversityAswan, Egypt
| | - Hussam Baghdadi
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Hassan El-Allaf
- Department of Medical Physiology, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Yasmin Shebel
- Department of Paediatrics, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | - Samer A El-Sawy
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Amal Albeihany
- Department of Haematology, King Faisal Specialist Hospital and Research CenterAl-Madinah Al-Munawwarah, Saudi Arabia
| | | | - Anwar A Sayed
- Department of Medical Microbiology and Immunology, College of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Mostafa AM Abu-Elnaga
- Department of Anatomy and Embryology, College of Medicine, Al-Rayyan CollegesAl-Madinah Al-Munwwarah, Saudia Arabia
- Department of Anatomy and Embryology, College of Medicine, New Damietta, Al-Azhar UniversityEgypt
| | - Manal Mohamed Helmy Nabo
- Paediatrics Department, Al-Rayyan Medical CollegesAl-Madinah Al-Munawwarah, Saudi Arabia
- Division of Paediatric Cardiology, Paediatrics Department, Sohag Teaching Hospital, Ministry of HealthSohag, Egypt
| | - Amr El-Dardear
- Prophetic Medicine Course and Research, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
- Paediatrics Department, Al-Rayyan Medical CollegesAl-Madinah Al-Munawwarah, Saudi Arabia
| | | | - Salah Mohamed El Sayed
- Prophetic Medicine Course and Research, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Ahmed Alamir Mahmoud
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
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El-Shanshory M, Hablas NM, Shebl Y, Fakhreldin AR, Attia M, Almaramhy HH, Baghdadi H, Ayat M, Albeihany A, El-Dardear A, Ibrahim HA, Mahmoud HS, Nabo MMH, El Sayed SM. Al-hijamah (wet cupping therapy of prophetic medicine) significantly and safely reduces iron overload and oxidative stress in thalassemic children: a novel pilot study. J Blood Med 2018; 9:241-251. [PMID: 30588142 PMCID: PMC6300367 DOI: 10.2147/jbm.s170523] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Thalassemia is a major health problem due to iron overload, iron deposition and oxidative stress-induced tissue damage. Here, we introduce Al-hijamah (a minor surgical excretory procedure) as a novel percutaneous iron excretion therapy. Al-hijamah is a wet cupping therapy of prophetic medicine, and prophet Muhammad, peace be upon him, strongly recommended Al-hijamah, saying: “The best of your treatment is Al-hijamah”. Aim of the study Our study aimed at investigating the safety, iron chelation, pharmacological potentiation and oxidant clearance effects exerted by Al-hijamah to thalassemic children. Patients and methods Ethical committee’s approval and patients’ written agreement consents were obtained. We treated 20 thalassemic children (15 males and five females aged 9.07±4.26 years) with iron chelation therapy (ICT) plus Al-hijamah (using sterile disposable sets and in a complete aseptic environment) vs a control group treated with ICT only. This clinical trial was registered in the ClinicalTrial.gov registry under the name “Study of the Therapeutic Benefits of Al-hijamah in Children with Beta Thalassemia Major” (identifier no NCT 02761395) on 30 January 2016. Results Al-hijamah was quite simple, safe, effective, tolerable (with no side effects) and time-saving procedure (30–60 minutes). A single session of Al-hijamah significantly reduced iron overload (P<0.001) in all thalassemic children. Al-hijamah significantly decreased serum ferritin by 25.22% (from 3,778.350±551.633 ng/mL to 2,825.300±558.94 ng/mL), significantly decreased oxidative stress by 68.69% (P<0.05; serum malondialdehyde dropped from 42.155±12.42 to 13.195±0.68 nmol/L), exerted pharmacological potentiation to ICT and significantly increased total antioxidant capacity (P<0.001) by 260.95% (from 13.195±0.68 nmol/L to 42.86±12.40 nmol/L through excreting reactive oxygen species). Moreover, therapeutic indices for evaluating Al-hijamah were promising. Conclusion Al-hijamah is a novel, safe, effective percutaneous iron excretion therapy through percutaneous iron excretion with minimal blood loss in agreement with the evidence-based Taibah mechanism. Al-hijamah is an effective outpatient hematological procedure that is safer than many pediatric procedures such as catheterization, hemofiltration and dialysis. Increasing the number of cups during Al-hijamah session or the number of sessions reduces iron overload more strongly. Medical practice of Al-hijamah is strongly recommended in hospitals.
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Affiliation(s)
- Mohamed El-Shanshory
- Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia, .,Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt
| | - Nahed M Hablas
- Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt
| | - Yasmin Shebl
- Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt
| | - Ahmed R Fakhreldin
- Department of Pediatrics, Aswan Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mohamed Attia
- Department of Clinical Pathology, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hamdi H Almaramhy
- Department of Surgery, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia
| | - Hussam Baghdadi
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia,
| | - Mongi Ayat
- Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia, .,Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia,
| | - Amal Albeihany
- Department of Hematology, King Fahd Hospital, Ministry of Health, Medina, Saudi Arabia
| | - Amr El-Dardear
- Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia, .,Department of Pediatrics, Faculty of Medicine, Taibah University, Medina, Saudi Arabia.,Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hoda Ali Ibrahim
- Department of Biochemistry, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Manal Mohamed Helmy Nabo
- Division of Pediatric Intensive Care Unit, King Fahad Hospital, Ministry of Health, Medina, Saudi Arabia.,Division of Pediatric Cardiology, Pediatrics Department, Sohag Teaching Hospital, Ministry of Health, Sohag, Egypt
| | - Salah Mohamed El Sayed
- Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia, .,Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia, .,Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt,
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