JOURNAL OF ADVANCED BIOMEDICAL SCIENCES
Year:2020 | Volume:10 | Issue:2|Papers Count:21

Liver fibrosis is a disease that is created due to the excessive accumulation of extracellular matrix proteins such as collagen. Advanced liver fibrosis leads to cirrhosis and eventually to liver cancer which are irreversible conditions. Hence, attention to initial stages of disease and its treatment has a vital role in these patients. Synthetic drugs utilized to remedy liver diseases often have side effects and thus, treatment method should be changed to alternative medicines, especially herbal remedies or their derivatives. Today alternative medicine has gained special attention, because of their lasting term curative power and poor side effects. In this review, we explained some plant-derived compounds which play an effective role in healing of liver injuries. We also somewhat mentioned the mechanism of action of these components. Future works should focus on the molecular pathways these compounds in order to determine the potential applications of these medicines...

Background & Objective: Nitric oxide gas is important in regulating blood vessel dilation, and consequently, blood pressure. Nitric oxide is continuously produced by endothelial cells known as a compound that plays an important role in the cardiovascular system. Also, Interleukin-17 (IL-17) is a pro-inflammatory cytokine that can mediate protective innate immunity to pathogens or contribute to the pathogenesis of inflammatory diseases. In the current study, the plasma levels of nitric oxide and serum level of IL-7 were assessed before and after Ramadan month in fasting people, aimed at the scientific investigation of the possible preventing effects of fasting for cardiovascular disease. Materials & Methods: The present study 61 fasting man (30-60 years old) were selected and blood samples were collected from each one day before and one day after Ramadan month. Serum levels of Nitric oxide and IL-17 were measured in two groups by ELIZA kits. Results: The results of this study shown the serum level of nitric oxide was significantly increased in individuals before and after Ramadan month (from 16. 17  1. 15  mol/L to 22. 17  1. 46  mol/L, respectively) (P<0. 0001). Also, the results indicate that serum level of IL-17 was statistically different in two groups (from 58. 25  10. 59 pg/ml to 15. 98  4. 66 pg/ml, respectively) (P<0. 0001). Conclusion: The results of this study showed that nitric oxide and IL-17 levels decreased during the Ramadan month and so it can be concluded the fasting of Ramadan may have positive effects on cardiovascular and immune factors of the body.

Background & Objective: The early identification of risk factors by screenings methods, as low-cost diagnostic tests with high survival rates, has always been of paramount importance for cancer diagnostics, especially in breast cancer. Since knowledge, attitude, and practice studies offer a desirable way to examine the status and make predictions, this study aims to design a valid and reliable instrument to assess breast cancer risk factors, symptoms, and screening methods. Materials & Methods: The Waltz method was used to develop the questionnaire. The exploratory factor analysis with a sample size of 390 and the confirmatory factor analysis were carried out using Amos software and SPSS 22, respectively. The reliability of the instrument was also assessed on 30 women over a one-month interval using the Cronbach's alpha and test-retest method. Results: The preliminary 87-item was finally developed into three sections: attitude (14 items and 2 factors with CVI=0. 92, CVR= 0. 72 and α = 0. 76, ) knowledge (16 items and 5 factors with CVI= 0. 99, CVR= 0. 85 and alpha 0. 87) and practice checklist (8 items and CVI = 0. 94 and CVR =1). Conclusion: The results suggested desirable psychometric properties of the questionnaire and its strength and validity in evaluating knowledge, attitude, and practice for identifying factors influencing breast cancer.

Background & Objective: Nano titanium dioxide particles (TiO2) are chemical compounds that are widely used in industrial and foodstuff such as cosmetics, toothpaste, colored materials, and non-fat milk whitening. Vitamin E (Vit E) is a dietary compound that functions as an antioxidant scavenging free radicals. The goal of this study was to carry out the protective effect of vitamin E on histomorphometry, oxidative stress factors and biochemical parameters as well as testosterone concentration. Materials & Methods: In the present study, 35 adult male mice were divided into 7 control and experimental groups. The experimental groups received TiO2 at 2. 5, 5 and 10 doses, and the positive control group received vitamin E (100 IU) mg/kg alone (by gavage tube). After treatment, animals were euthanized by cervical dislocation and testes samples were taken. The level of p<0. 05 was considered significant. Results: The results of histomorphometry revealed that the weight of testis and body, testicular capsule thickness, seminiferous tubules diameter, germinal epithelium height, spermiogenesis and meiotic indices were reduced while sertoli cells and repopulation index had no significant changes. Also, biochemical results showed the Malondialdehyde was enhanced and it diminished the total antioxidant capacity, catalase enzyme activity, protein content, as well as testosterone concentration. (p<0. 05). Conclusion: The TiO2 nanoparticles caused detrimental pathologic effects when used at the highest doses. However, vitamin E could ameliorate the toxic effects of TiO2-induced on testicular tissue in experimental animals.

Considerable research has been done in the past few decades to treat ischemic heart disease (stroke). Although drug therapies can improve heart disease and reduce mortality in heart failure, none is able to regenerate damaged heart tissue. Therefore, stem cell-based therapies are considered as new approaches to correcting heart tissue remodeling. Since the depletion of cardiac muscle cells at the beginning of the myocardial infarction act as a stimulus for myocardial remodeling, the ability to replace these cells with their healthy counterparts is an effective treatment for many types of cardiovascular diseases. In this study, we reviewed the advances made in the treatment of myocardial infarction through cell therapy.

Background & Objective: Diabetes is a chronic disease in which the production or function of insulin is impaired. This hormone is secreted by pancreatic beta cells and its main function is to lower blood glucose. Probiotics are living microorganisms that strengthen and balance the intestinal microbial flora and have beneficial effects on host health. Materials & Methods: In this study, 32 mice were divided into four groups: the first group (nondiabetic control), the second group (diabetic control), the third group (diabetic mice treated with Lactobacillus Plantarum), and the fourth group (diabetic mice treated with glibenclamide). After blood sampling and serum isolation, serum glucose, and insulin levels were measured using enzymatic kit and ELISA, respectively. Also, sections of the pancreas were prepared and the average diameter of the Langerhans Islands was examined. Results: The results showed a significant decrease in glucose levels in the treatment group with Lactobacillus Plantarum compared with the diabetic control group (P <0. 05), which is similar to glibenclamide. Moreover, in the group treated with Lactobacillus Plantarum, insulin levels did not change significantly compared to the diabetic group. Pancreatic histological examination also showed that this probiotic also affected the improvement of pancreatic tissue. Conclusion: The results suggest that Lactobacillus Plantarum has positive effects on the control of blood glucose in diabetic mice with Aloxone and may be used as a drug supplement to control blood glucose.

Background & Objective: Clients are at the heart of the health system and their satisfaction indicates the correctness of the services. Therefore, the purpose of this study was to determine the factors relevant to the development of the status of responding to expectations in Alishahr Comprehensive Health Services Center in 2018. Materials & Methods: The present study is qualitative in the form of directed content analysis. Results: According to the respondents, the four components of response time, the factor of manpower in response, the management factor in response, the factor of equipment and facilities in responding to the respondents are the most important factors in the satisfaction of the respondents. Accordingly, the factor of speed, accuracy in doing client's affairs (90. 9%) is the most important factor of time component; The factor of behavior with concerning clients, the responsiveness and responsibility for the client's business and having tolerance and a positive desire to deal with the client (90. 1%) are the most important factors of manpower; Transparency and proper information and quality of service (quality of service) (86. 4) The most important factor of the management component; Finally, the factors of cleanliness of the workplace (creating a pleasant and elegant environment) and the physical appearance of the staff, the heating and cooling system, the proper sanitary, adornment and health and safety of the work environment (77. 3%) are the most important factors of the equipment component and facilities. Conclusion: Considering the results of this study that the provision of services in some cases is not optimal, it is suggested that by establishing a proper referral system and monitoring, it will increase the satisfaction of the clients.

Background & Objective: One of the most common malignancies among Iranian women is breast cancer. One of the strategies in the field of cancer prevention is the activation of an inherent and acquired cancer immune system that has the power to differentiate and select an action. Today, due to the side effects of therapies, numerous attempts have been made to discover natural compounds that have selective power in limiting cancers. The purpose of the present study was to evaluate the anti-tumor function of ferutinin as a ferula-derived plant compound on MDA-MB-231 cell line in breast cancer cells. Materials & Methods: MTT test was used to study the toxicity of ferutinin against breast cancer cells and compare it with normal cells. Moreover, the morphologic investigation of Ferutinin-treated MDA cells was accomplished with microscopic observations, and the expression of the apoptotic gene was carried out by Real-time PCR. Results: The results demonstrate that the viability of MDA cells after 24, 48, and 72 hours’ treatment with ferutinin (100 μg / ml) were reported 62.2, 51.8, and 41.73 percent respectively. Furthermore, the gene expression of Catalase increased with the dose-dependent manner in a concentration of 30 μM whereas no cytotoxic effects of ferutinin were observed on normal HDF cell line. Conclusion: Regarding the lack of cytotoxic effects of ferutinin on normal HDF cells, it is suggested that ferutinin could be an appropriate therapeutic alternative in patients with breast cancer and oxidative stress consequences.

Background & Objective: The influenza virus causes hundreds of deaths in the world. Despite the availability of some authorized vaccines for all age groups and its approved beneficial effects, the influenza is still a major problem for public health. Materials & Methods: In this study, the adjuvant of MF59 was developed by methylglycol-chitosan. The physico-chemical characteristics and immune response stimulation of novel adjuvant were measured in combination with the influenza virus. Results: The new adjuvant was produced with a nano-droplet diameter of 156 and Zeta potential of 29. The pH of adjuvant was not significantly changed for two years. Immunization of mice with developed adjuvant makes more HAI titer than MF59 adjuvant. Conclusion: The favorable characteristics of physico-chemical properties and lack of local side effects of developed adjuvant as well as its strong humoral immunity can introduce it as a novel MF59 adjuvants.

Background & Objective: Modern human suffers from a kind of religious non-alignment along with a health crisis. The aim of this study was to investigate the relationship between religious commitment and commitment to health behaviors with the aim of highlighting the role of spirituality crisis in a health crisis. Materials & Methods: This cross-sectional study was conducted and 310 people in the city of Fasa over 18 years, were randomly selected and then, Worthington religious commitment questionnaire as well as the self-made questionnaire for their commitment to health behavior were completed. Data were analyzed using multiple linear regression and Pearson correlation coefficient by SPSS software version 22 and STATA version 13. Results: Multiple linear regression analysis showed that crude and adjusted odds ratio of religious commitment in a prediction of commitment to health were 1. 53 and 1. 68 respectively. Among four independent variables, education, gender, and occupation were not good predictors for health commitments (P> 0. 05) and only age was significant (p<0. 05). Conclusion: It seems that in the current situation, the commitment to health behaviors is a consequence of the commitment to religious behavior and other factors. Therefore, the combined role of religious commitment and other factors should not be overlooked in the pathology of health behaviors.

Background & Objective: self-medication is considered as one of the main social, health and economic problems of various communities including Iran. The aim of the study was to investigate the prevalence and factors affecting the self-medication in people referred to the health centers of Fasa. Materials & Methods: This cross-sectional descriptive-analytical study was performed on 2000 individuals referring to the health centers in Fasa city, half of them were living in the rural areas. Sampling was done in three steps including caste, social level and random sampling methods. Data were analyzed using mean, standard deviation, frequency, and percentage. Chi-square and logistic regression tests at α = 0. 05 were also applied to evaluate the relationship between the variables. Data were analyzed using SPSS version 22. Results: The studied populations included 726 males (36. 3%) and 1274 females (63. 7%) with the mean age of 37. 36 years. 1087 (54. 4%) were remarked as self-medication which was higher in rural than in the urban areas (p<0. 05). Furthermore, it was found that self-medication was lower among the university students, soldiers, and employees than the high school students (p<0. 05). However, no significant correlation was found between self-medication and educational status. The chance of selfmedication among those advised by pharmacists was also higher (OR=0. 25). The most frequent factors influencing the self-medication were the cost of treatment (58. 28%), mistrusting the physician diagnosis (77. 51%) and recovery based on previous experiences (81/87%). Conclusion: Concerning the high prevalence of self-medication in Fasa, the complementary training programs on the side effects and consequences of self-medication are crucial for people especially living in the rural areas. Providing sufficient physicians and other medical staff as well as improving the quality of health services in the villages are also essential. Restricting purchase of drugs without proper prescriptions can also reduce the self-medication in the community to some extent.

Background & Objective: Silver nanoparticles (AgNPs) are increasingly used in nanomedicine and pharmacy due to their valuable properties. AgNPs are synthesized in various ways. The amount of drug binding to Human Serum Albumin (HSA) as the most abundant protein in the circulatory system would affect the drug’ s therapeutic concentration and its availability for intracellular targets. Thus, the purpose of this study was to investigate the effect of coating in the synthesis of AgNPs on their ability to interact with HSA. Materials & Methods: Fluorescence emission spectroscopy, circular dichroism (CD) spectroscopy, and Zeta potential analysis were used to study the structural effects of HSA after interaction with AgNPs with ethylene glycol dispersion matrix. AgNPs contains sodium citrate stabilizer and uncoated AgNPs. Results: The fluorescence quenching indicated that AgNPs with ethylene glycol dispersion matrix interacted with HSA with a higher binding constant value compared with two other AgNPs. The CD spectra indicated a reduction in α-helix content of HSA especially after the addition of AgNPs with ethylene glycol dispersion matrix (from 51. 45% to 41. 71%). The zeta potential analysis showed that the surface charge of HSA was reduced especially after the addition of AgNPs with ethylene glycol dispersion matrix (from-16. 73 mV to-11. 79 mV). Conclusion: This study showed that AgNPs with ethylene glycol dispersion matrix interact with HSA more strongly compared with two other AgNPs. This study indicated that the type of coating of AgNPs affects the HSA interaction and consequently affects the nanoparticles transportation and distribution in the blood.

Background & Objective: Production of Carbapenemase enzymes in Pseudomonas aeruginosa isolated from clinic, has challenged the treatment of these infections and due to its natural habitat in soil and aquatic environments. This study aimed to compare carbapenemase resistance genes (VIM, KPC, NDM and IMP) using similar protocol for the four above-mentioned genes in clinical and enviromemtal isolates by Real-Time PCR. Materials & Methods: The clinical isolates were isolated from two Tabriz Hospitals and environmental isolates from Nahnad and Spiran rivers. For their genotypic idententification we used universal primer of 16s rRNA. They were investigated for Carbapenemase production via phenotypic disk agar diffusion and combined disk methods and then Real-Time PCR was conducted using specific primers for the above-mentioned genes. Results: By phenotypic methods, 83. 3 percent of clinical and 0% of environmental isolates were Carbapenemase producers. However. both clinical and environmental isolates showed blaNDM-1, blaIMP, blaKPC and blaVIM genes by Real-Time PCR. Conclusion: This study showed that the carbapenemase enzymes’ genes in clinical and environmental isolates were checked for four KPC, VIM, NDM and IMP genes by similar protocol and the presence of above genes in environmental isolates. Furthermore, clinical ones revealed the possibility of bacteria spreading as a superbug increasingly.

Background & Objective: Osteoarthritis is the most common musculoskeletal disorder characterized by loss of articular cartilage, bone changes and synovial membrane inflammation. The aim of the present study was to investigate the effect of endurance training and stem cell infusion on PDGF and PDGFr gene expression in knee tissue of rats with knee osteoarthritis. Materials & Methods: To select the statistical sample, 37 male Wistar rats were randomly divided into five groups of seven: control (healthy), control (patient), stem cell, training and stem cell-training. The training program consisted of 25 to 29 minutes of running on the treadmill at 15 m / min for the first week, and every week 1 m/min was added until it reached 22 m / min in the eighth week. 48 hours after exercise training, samples were taken from the knee tissue. PDGF and PDGFr gene expression was measured by Real-Time PCR. One way ANOVA and Tukey post hoc test were used to determine the difference between groups. Results: The results of this study showed that PDGF and PDGFr gene expression levels increased in the patient group compared to the healthy group (P=0. 00, P=0. 00). Also, PDGF gene expression levels significantly decreased in the training, stem cell and training-stem cell groups compared to the patient group (P=0. 05, P=0. 025); However, PDGFr gene expression levels were significantly decreased only in the stem cell and training-stem cell group compared to the patient group (P=0. 043, P=0. 039). Conclusion: Growth factors such as PDGf exert their anabolic and anti-inflammatory effects to maintain chondrogenic potential by inhibiting the NF-κ B signaling pathway.

Background & Objective: Nystatin is an antifungal antibiotic commonly used for treatment of candidiasis and widely used against oral mycosis. However, the efficacy of its conventional dosage forms for use in oral cavity is limited by the short residence time and bitter taste of formulation. This research aims to design an optimized formulation of oral mucoadhesive tablets containing nystatin. Therefore, it can be retained in the mouth for long periods and it can cover bitter taste of drug and improve patient’ s compliance. Materials & methods: The method of tablet preparation was direct compression. Sodium Carboxy Methyl Cellulose, Hydroxy Propyl Methyl Cellulose, Hydroxy Ethyl Cellulose, and Carbopol were used as mucoadhesive polymers. Different types of tablets were formulated using these polymers alone or in combination. The profile of drug released from each tablet was analyzed. The optimum formulation was selected and pharmaceutical analysis and mucoadhesive test were done on it. Results: The optimum mucoadhesive tablet formulation containing nystatin is prepared using sodium Carboxy Methyl Cellulose. In this formulation 70% of nystatin was released in the first 30 min. It has an acceptable mucoadhesive property. Conclusion: Nystatinmucoadhesive tablet containing sodium Carboxy Methyl Cellulose prepared by direct compression method could be used to adhere to the oral mucosa with great appeal and elongation contacting time with localized infection. Therefore, it can lead to the improvemen of the patient’ s compliance for treatment.

Background & Objective: The aim of this study was to evaluate the therapeutic effect of platelets lysate on leishmaniasis lesions. Materials & Methods: In this study, we used hamster as an animal model and Leishmania major to create an infection in vitro condition. The presence of Leishmania in the site of infection was confirmed by Real-time PCR. We investigated the effect of platelet, plasma, and platelets’ lysate on leishmaniasis lesions and finally, the therapeutic effects of these biomaterials were screened by histological methods. Results: Real-time PCR method confirmed the presence of parasites in the site of infection. The results of histopathological investigation revealed that in lesions treated with platelet, there were inflammatory response, tissue necrosis and high amount of Leishmania. The wounds extent in both groups treated with plasma and platelet lysate was significantly reduced. However, the result showed that the amounts of Leishmania were significantly reduced in lesions of hamsters treated with platelet lysate. Conclusion: The results showed that platelet lysate had a better and higher performance than other biomaterials in the treatment and healing of leishmanial lesions.

Background & Objective: Shigella is a gram-negative bacillus that has caused serious infection problems in developed and developing countries. The existence of beta-lactamase genes such as AmpC in Shigella species in one country has led to a variety of antibiotic resistance patterns, which can have very serious health risks for the community. The aim of this study was to investigate the prevalence of AmpC β-lactamase gene in S. sonnei strains and determine the prevalence of a spot mutation in this gene by RFLP method. Materials & methods: Sixty strains of S. sonei were detected using biochemical and microbiological tests. Subsequently, the amplification of ampC gene was performed by PCR method. Then, a point mutation analysis on this gene was performed on ampC gene positive strains. RFLP technique was performed using Hinf1 enzyme. Results: Among 60 isolates, 30 (50%) isolates were positive for ampC beta-lactamase gene. Furthermore, A to G point mutation was detected in 11 (37%) ampC gene carrying isolates. Conclusion: The results of this study showed an increasing rate in the prevalence of ampC gene and noticeable prevalence of A to G point mutation in the strains carrying this gene. This mutation may help increase resistance to cephalosporins.

Background & Objective: Enteric transmitted hepatitis A virus (HAV) and hepatitis E virus (HEV) are responsible for major cases of acute viral hepatitis globally. Both infections may be accompanied by morbidity and even mortality in their outbreaks. They usually cause self-limited infections with an exemption for HEV that may establish a prolonged infection, especially in immunocompromised patients. We conducted this study to evaluate seroprevalence of HAV and HEV in Hormozgan province to better understand their distributions in the general population. Materials & Methods: The total antibodies against HAV, IgG and IgM antibodies against HEV were evaluated by commercially available Enzyme-Linked Immuno-Sorbent Assay (ELISA) kits in serum sample of 562 females and males between 1 to 86 years old gathered from June 2016 to April 2017 from four major counties of the province. Results: Out of 562 tested participants, 398 of them were female. The mean age of the 562 tested individuals was 35. 74 ± 17. 06 years (range: 1-86 years). Total anti-HAV antibodies were detected in 524 (93. 2%) of individuals and 89 (15. 8%) of them had detectable IgG against HEV, while 9 (1. 6%) of subjects had anti-HEV IgM, too. Seropositivity rate of HAV and HEV was correlated with increasing age. Conclusions: As the results revealed, both viruses were endemic to the study area and the prevalence of HAV was practically high and the rate of HEV was considerable when compared with the rate in other parts of Iran.

Background & Objective: Resistin an adipocytokines secreted by adipocytes, is associated with insulin resistance and increases in obesity, cardiovascular disease and other inflammatory diseases. The aim of this study was to investigate the relationship between resistin levels, metabolic variables, and insulin resistance in patients with prediabetes / diabetes in an Iranian population. Material& Methods: This study was conducted on 75 patients with fasting plasma glucose (FPG)≥ 100 mg/dl in prediabetic/ diabetic group and 75 participants with FPG less than 100 mg/dl as control group. Plasma levels of resistin and insulin were measured by ELISA kit and other variables were determined by standard methods. Statistical analysis was performed using SPSS software, version 19. Results: Resistin levels, body mass index, triglyceride, cholesterol, FPG and insulin resistance were significantly higher in patients with pre-diabetes / diabetes compared with controls (P-value <0. 05). Serum resistin level was positively correlated with body mass index, FPG and insulin resistance (Pvalue <0. 05). Reverse correlations were found between resistin and HDL (P-value <0. 05). Conclusion: Higher levels of resistin in patients with type 2 diabetes / pre-diabetes in our study and significant association of resistin with glucose, insulin resistance, and BMI, indicate the pathophysiological role of this adipokin in the development of type 2 diabetes.

Background & Objective: Alzheimer’ s disease (AD) is a kind of neuropsychiatric disorder that gradually degrades the mental abilities. High level activity of protein tyrosine phosphatase (PTP) results in memory function loss and Alzheimer disease. Thus, the inhibition of PTP activity can be considered as a potential target for the discovery of anti-Alzheimer drug. In this study, using computational techniques anti-alzheimer drug candidates will be designed. Materials & Methods: The three-dimensional quantitative structure activity relationship (3D-QSAR) computational studies on PTP inhibitors were performed. Accordingly, comparative molecular field analysis (CoMFA), and comparative molecular similarity indices analysis (CoMSIA) methods were used to determine the required factors for the activity of these compounds. Distill module was applied for the alignment of molecules. A number of new active inhibitors have been proposed using the components of the CoMFA model. Molecular attachment studies were performed to investigate the inhibitory mechanism, identify bioactive conformer, and determine key interactions. Finally, ADMET studies (absorption, distribution, metabolism, digestion and toxicity) were performed on these inhibitors in a computer environment and compared with standard ranges. Results: The statistical parameters from the models (CoMFA: q2 =0. 653, r2ncv=0. 961, r2pred =0. 770, and CoMSIA: q2=0. 564, r2ncv = 0. 933, r2pred= 0. 746) indicate that the data are well fitted and have high predictive ability. Based on the information obtained from the constructed models, a novel set of tyrosine phosphatase inhibitors with new molecular frameworks have been introduced as new anti-Alzheimer's drug candidates. Conclusion: Computational techniques play a valuable role in drug design. Optimal r2pred and q2 statistical parameters led to the logical design of a number of new inhibitors of tyrosine phosphatase protein, which were introduced as new antimicrobial drug candidates.

Background & Objective: Polycystic ovary disease is an indicator of inflammatory factors caused by ovarian inflammation and an increase in the number of ovarian cysts. The aim of the present study was to investigate the effect of hydroalcoholic extract of chicory plant on inflammatory markers in polycystic ovary syndrome rats. Materials & Methods: In this study, adult female Wistar rats weighing 150-250 g were used and fed to the positive control group of metformin and negative control group via water gavage. At the end of blood sampling, serum levels of insulin, cholesterol, triglyceride and inflammatory factors interleukin-8 and TNFα were measured by ELISA. Results: The present study showed that 400 mg/kg abstract of chicory can significantly reduce sugar and insulin of blood and fat profile and inflammation factors IL8 and TNFα . Significance level was considered as p<0. 05 Conclusion: Given the positive effect of chicory abstract on serum concentration of sugar and insulin hormone and fat profile and inflammation factors in the rats with PCOS, this composition can be used as an alternative drug for treating this disease.