Al-hijamah (wet cupping therapy of prophetic medicine) significantly and safely reduces iron overload and oxidative stress in thalassemic children: a novel pilot study
Authors El-Shanshory M, Hablas NH, 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
Received 9 April 2018
Accepted for publication 24 June 2018
Published 14 December 2018 Volume 2018:9 Pages 241—251
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Justinn Cochran
Peer reviewer comments 2
Editor who approved publication: Dr Martin Bluth
Mohamed El-Shanshory,1,2 Nahed M Hablas,2 Yasmin Shebl,2 Ahmed R Fakhreldin,3 Mohamed Attia,4 Hamdi H Almaramhy,5 Hussam Baghdadi,6 Mongi Ayat,1,6 Amal Albeihany,7 Amr El-Dardear,1,8,9 Hoda Ali Ibrahim,10 Hany Salah Mahmoud,11 Manal Mohamed Helmy Nabo,12,13 Salah Mohamed El Sayed1,6,14
1Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia; 2Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt; 3Department of Pediatrics, Aswan Faculty of Medicine, Aswan University, Aswan, Egypt; 4Department of Clinical Pathology, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt; 5Department of Surgery, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 6Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 7Department of Hematology, King Fahd Hospital, Ministry of Health, Medina, Saudi Arabia; 8Department of Pediatrics, Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 9Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt; 10Department of Biochemistry, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt; 11Scientific Center for Experimental and Research Studies, Cairo, Egypt; 12Division of Pediatric Intensive Care Unit, King Fahad Hospital, Ministry of Health, Medina, Saudi Arabia; 13Division of Pediatric Cardiology, Pediatrics Department, Sohag Teaching Hospital, Ministry of Health, Sohag, Egypt; 14Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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.
Keywords: thalassemia, Al-hijamah, iron chelation therapy, oxidative stress, clearance, Al-hijamah indices
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]