Journal Article

Al-hijamah

Almaramhy, Hamdi H, Hablas, Nahed M, Ibrahim, Hoda Ali, Nabo, Manal Mohamed Helmy, Albeihany, Amal, Attia, Mohamed, Baghdadi, Hussam, Dardear, Amr El, Sayed, Salah Mohamed El, Shebl, Yasmin, Ayat, Mongi, Mahmoud, Hany Salah, Shanshory, Mohamed El, Fakhreldin, Ahmed R

2018

Overview

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[+ or -]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[+ or -]551.633 ng/mL to 2,825.300[+ or -]558.94 ng/mL), significantly decreased oxidative stress by 68.69% (P<0.05; serum malondialdehyde dropped from 42.155[+ or -]12.42 to 13.195[+ or -]0.68 nmol/L), exerted pharmacological potentiation to ICT and significantly increased total antioxidant capacity (P<0.001) by 260.95% (from 13.195[+ or -]0.68 nmol/L to 42.86[+ or -]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. Keywords: thalassemia, Al-hijamah, iron chelation therapy, oxidative stress, clearance, Al-hijamah indices

• Publisher: Dove Medical Press Limited
• Subject: Antioxidants (Nutrients) / Care and treatment / Catheterization / Clinical trials / Deferasirox / Ethical aspects / Evidence-based medicine / Ferritin / Health / Health aspects / Oxidative stress / Retirement benefits / Surgery / Thalassemia