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Ulcerative colitis is a chronic inflammatory disease closely associated with immune dysregulation. Zhiqiao (Fructus aurantii), the nearly mature fruit of Citrus aurantium L., is widely used in traditional dietary therapy for intestinal health. Here, we extracted and purified neohesperidin from Zhiqiao and explored its alleviative effects on dextran sulfate sodium-induced colitis and related inflammatory pathways in mice. The results showed that neohesperidin administration significantly ameliorated symptoms of colitis and reduced the accumulation of inflammatory cytokines in mouse tissues and serum. Decreases in the TLR4, MyD88, and NF-κB p65 mRNA expression levels indicated that activity of the TLR4/NF-κB signaling pathway was downregulated. Molecular docking results showed that neohesperidin occupies the lipopolysaccharide-binding pocket of MD-2 and binds to the interacting surface of TLR4/MD-2 and that of the subsequently formed homodimer, thereby disrupting recognition of inflammatory ligands by the TLR4-mediated pathway. Neohesperidin holds promise for the adjunctive treatment of ulcerative colitis. [Display omitted] • High-purity Zhiqiao neohesperidin (NHP) obtained by aqueous two-phase extraction. • NHP protects mice from colitis better than sulfasalazine at the same dose. • NFκB suppressed by NHP, followed by pro/anti-inflammatory factors decrease/increase. • A TLR4 antagonist, NHP in silico can inhibit trigger of the TLR4/NF-κB signaling. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Citrus aurantium is widely used as traditional medicine, food and cosmetic industry. • A new seco tirucallane, was isolated from the differents parts of C. aurantium • Acetylation of acridones provided the hitherto not reported monoacetyl derivatives. • Significant cytotoxicity activity was recorded against human cancer cell lines with IC 50 of 32.33 and 44.52 μg/mL. Abstract Phytochemical studies on Citrus aurantium led to the isolation and characterization of a new seco tirucallane, namely 1 β -hydroxy-3,4-secotirucalla-4(28)-7,24-trien-3,21-dioic acid (1) , together with the previously reported compounds citracridone I (2), citruisinine II (3), citracridone II (4), 5-hydroxynoracronycine (5), citpressine II (6), citpressine I (7), buntamine (8), 8-hydroxy-6-methoxy-3-pentylisocoumarin (9), xanthyletin (10), clausarin (11), (E)-suberenol (12), transgleinadiene (13), methoxysuberenol (14), fridelin (15), lupeol (16), limonin (17), a mixture of stigmasterol and β -sitosterol (18) and β -sitosterol-3- O - β - d -glucoside (19). The structures of these compounds were determined by comprehensive spectroscopic analyses of 1D and 2D NMR and EI- and ESI-MS and comparison with the reported data. Above compounds are reported here from this species for the first time. In addition, acetylation of citracridone I (2) and citruisinine II (3) provided the hitherto not reported monoacetyl derivatives 2a and 3a , respectively. Crude extracts, isolated compounds and derivatives were submitted to bioassays. While compound 3 showed significant antioxidant activity with IC 50 of 45.5 μM, comparable to the positive control BHA with 44.2 μM, compounds 2a, 4 and 5 were significantly active in the urease inhibition assay with IC 50 s of 28.5, 25.5 and 29.9 μM comparable to the positive control Thiourea with 21.6 μM. Moreover, moderate to weak cytotoxicity activity was recorded for all tested compound against human large cell lung cancer cell line NCI-H460 and human squamous carcinoma cell line CAL-27 with IC 50 of 32.33 and 44.52 μg/mL, respectively, compared to Cisplatin and 5-Flurouracil displaying 19.00 and 17.79 μg/mL, respectively. [ABSTRACT FROM AUTHOR]

Multidrug-resistant bacteria pose major challenges for clinicians. Essential oils hold great promise for the development of new and effective anti-infective treatments. This study investigated the chemical composition and antibacterial activity of essential oils extracted from the barks of Citrus sinensis , Citrus limon , and Citrus aurantium. The essential oils from citrus peels were obtained by hydrodistillation using a Clevenger apparatus and analyzed by gas chromatography–mass spectrometry (GC-MS). Antibacterial activity was assessed by both agar diffusion and broth microdilution methods. We tested these essential oils against six bacterial strains, including four clinical multidrug-resistant bacteria: extended-spectrum β-lactamase-producing Escherichia coli , carbapenem-resistant Acinetobacter baumannii, ceftazidime-resistant Pseudomonas aeruginosa , and methicillin-resistant Staphylococcus aureus , in addition to two reference bacterial strains, Escherichia coli (EC) ATCC 25922 and Staphylococcus aureus (SA) ATCC 29213. The chemical analysis revealed the presence of 26 compounds, with D-Limonene being the dominant one. The essential oils demonstrated significant antibacterial properties against all examined bacterial strains. They exhibited low MICs, ranging from 110 µg/mL to 140 µg/mL, against EC ATCC 25922, carbapenem-resistant Acinetobacter baumannii , extended-spectrum β-lactamase-producing Escherichia coli, and ceftazidime-resistant Pseudomonas aeruginosa. Moreover, they also effectively inhibited SA ATCC 29213 and methicillin-resistant Staphylococcus aureus at slightly higher MICs, ranging from 200 µg/mL to 220 µg/mL. In this report, we demonstrate the significant antibacterial activity of citrus peel essential oils against multidrug-resistant bacteria. This could be the result of synergistic interactions between the various natural chemical compounds, encouraging their use in the discovery of new antibacterial drugs. • Infeions caused by multidrug-resistant bacteria pose a growing challenge for healthcare professionals and drug discovery efforts. • We reported the chemical composition and antibacterial activity of essential oils extracted from the peels of Citrus sinensis, Citrus limon , and Citrus aurantium against multidrug-resistant bacteria. • The chemical analysis revealed the presence of 26 compounds with potential pharmacological properties, with D-limonene being the dominant one. • Essential oils extracted from citrus peels exhibited strong antibacterial activity. [ABSTRACT FROM AUTHOR]

Background The aim was to investigate the effect of aromatherapy using Citrus aurantium blossom essential oil on premenstrual syndrome in university students. Methods In this double-blind clinical trial controlled on 62 students from March 2016 to February 2017. The intervention with 0.5% of C. Aurantium blossom essential oil and control was inhalation of odorless sweet almond oil in the luteal phase of the menstrual cycle. The screening questionnaire (PSST) for PMSwas filled out before and also one and two months after the intervention. Results Mean score of overall symptoms of PMS between the Bitter orange and control groups In the first (p < 0.003) and second months (p < 0.001) of the intervention was significant. Besides, decreased the mean score of psychological symptoms in the intervention group (p < 0.001), but on physical symptoms and social function was not significant (p > 0.05). Conclusion The aromatherapy with Citrus aurantium blossom improved the symptoms of premenstrual syndrome. [ABSTRACT FROM AUTHOR]

Introduction This trial compared the effects of lavender and bitter orange on anxiety in postmenopausal women. Methods This trial was conducted in 2015. Eligible postmenopausal women were allocated into one of two intervention groups or a control group (n = 52 per group) in a 1:1:1 ratio using a randomized block design. Intervention groups received 500 mg capsules containing only bitter orange or lavender flower powder, and the control group received 500 mg capsules containing starch. The Spielberger's State -Trait Anxiety Inventory (STAI) was used before and eight weeks after starting the intervention. Data analyses were based on intention to treat. Results A one-way ANOVA showed no significant difference in mean state anxiety (P = 0.254) and trait anxiety (p = 0.972) score among the three groups before the intervention. The general linear model, adjusted for baseline state and trait anxiety scores and confounding factors, showed significant differences among the groups in the mean state anxiety (P = 0.010) and trait anxiety (p = 0.041) score after eight weeks of treatment. Bitter orange significantly reduced the mean state-anxiety scores compared with the control group [Adjusted Mean Difference (aMD): −1.99 (95% Confidence Interval, −3.64 to −0.34)]. Lavender significantly reduced the mean state-anxiety scores compared with the control group as well [aMD: −2.45 (95% CI -4.13 to −0.77)] and Bitter orange significantly reduced the mean trait-anxiety scores compared with the control group [aMD: −1.76 (95% CI -3.45 to −0.06)]. Lavender significantly reduced the mean trait-anxiety scores compared with the control group as well [aMD: −2.05 (95% CI -3.76 to −0.33)]. There was no significant difference between bitter orange and lavender groups after intervention in the mean trait-anxiety (p = 0.731) or state-anxiety (p = 0.578) scores. Conclusion The positive effect of bitter orange and lavender on anxiety in postmenopausal women suggests that they can be used to decrease anxiety in such women. [ABSTRACT FROM AUTHOR]

The search for effective anti-inflammatory agents with minimal side effects using mixture of natural products extracts is an important area of research. The aim of the present study was to investigate the in vivo synergetic effects on the acute anti-inflammatory responses using binary combinations of essential oils at different volume ratios. Two plants were utilized: the aerial parts of Artemisia campestris (A.c) and the fruit peels of Citrus aurantium (C.a). The results demonstrated the existence of interesting synergistic effects for the mixture ratios C.a/A.c = 80/20, 70/30, 60/40 and 50/50 "v/v". Among these, the most significant synergistic effect, particularly strong synergism, was observed for the 70/30 mixture ratio, with CI values of 0.24, 0.33, and 0.27 for doses of 100, 200, and 400 mg/kg, respectively. However, an antagonist effect was observed for the mixture ratio C.a/A.c = 90/10. The dose reduction index (DRI) analysis revealed that the dose of C.a can be reduced by 7.09-fold, and similarly, the dose of A.c can be reduced by 9.64-fold in the combination, compared to the ED 50 values of each essential oil. The favorable DRI (>1) indicates a potential for dose reduction, leading to a reduction in toxicity. The findings support the potential application of these plants extracts in the management of inflammation and highlight the importance of optimizing the mixture ratios to achieve greatest synergistic effects. Moreover, these findings may have significant implications for food and pharmaceutical industries, particularly in terms of economic efficiency and reduced toxicity. • Synergistic effects obtained for mixture ratios C.a/A.c = 80/20, 70/30, 60/40, 50/50. • The highest synergism effect was recorded for the mixture ratio of 70/30. • For 70/30 ratio, CI = 0.24, 0.33 and 0.27 for 100, 200 and 400 mg/kg, respectively. • Antagonist effect was obtained for mixture ratio C.a/A.c = 90/10. • Referring to DRI, C.a and A.c doses can be reduced by 7.09 and 9.64-folds. [ABSTRACT FROM AUTHOR]

In the current study, the aim is to investigate regulation of water balance especially deteriorating in the heat conditions due to low water uptake and resistance to drought conditions by decreasing water deficit through transpiration in sour orange seedlings under arid or semi-arid conditions. The current study was conducted under greenhouse conditions, at three different water deficit cycles (once per 2 days, four days and eight days). As antitranspirant matters, silicon surfactant (0.01% and 0.02%), Fatty acids (0.2% and 0.4%) and PEG 6000 (polyethylene glycol) (5% and 10%) were applied through spraying the leaves. The effects of the water shortage and antitranspirant treatment on the plant height (cm), stem diameter (mm), leaf and root dry weight (%), total chlorophyll (chlorophyll a+b) (mg.g-1), carotenoid (mg.g-1), membrane permeability (%), relative water content (RWC) (%) and lipid peroxidation (MDA) (nmol.g-1) were studied. The results obtained revealed that increasing irrigation water interval, the plant height decreased to a great extent, when compared to more frequent irrigation. While PEG was found to be more effective in terms of increasing the plant height, fatty acid was found to be more effective in terms of increasing the stem diameter. Membrane permeability increased parallel to increasing drought. Both the antitranspirants and the drought conditions decreased RWC more than the control. While MDA decreased with antitranspirant treatments, it exhibited an important increase in 8-day water deficit cycle. While different antitranspirants decreased transpiration, the plant growth was not negatively affected from this situation. It was observed that the use of antitranspirants in drought conditions resulted in positive outcomes in the reducing of leaf water loss. [ABSTRACT FROM AUTHOR]

Pakistan is among the top agricultural countries around the globe, but mycotoxin contamination causes a major commercial loss every year. The present study aimed to isolate the fungi and their mycotoxins present in contaminated feed of animals in the local market of Peshawar. The antifungal activity of certain plant extracts was to be tested against pathogenic fungi. TLC method was used for mycotoxin analysis and it was found that Aflatoxin G1, G2, B1 and B2 were present in different amounts both qualitatively and quantitatively based on samples. This study found the presence of contamination in all the tested feed samples. All ten samples were found positive for Aspergillus flavus. B1 toxin was found in high quantity in all ten samples, while G2 was found in a lower quantity as compared to other toxins such as G1, B1 and B2. The quantity of aflatoxin was from 48.6 to 284.7 ppb in 25 g of samples. In the case of antifungal potency, all plant extracts showed important antifungal potency against tested fungi. The MIC and MFC values noted ranged from 110 to 300 mg/ml and 100–300 mg/ml respectively. Citrus aurantium and Myrtus communis were absorbed to have antifungal potency against all test fungi. Citrus aurantium extracts were also found to inhibit the growth of Aspergillus flavus. According to the results of the present research, a variety of fungal strains and aflatoxins were present in animal feed in numerous parts of Peshawar, Pakistan and different plant extracts can be used in animal feed to reduce this type of contamination. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the metabolic, lipolytic, and cardiovascular responses to supplementation with p-synephrine alone and in combination with caffeine during resistance exercise (RE).Methods: Twelve healthy men performed a control RE protocol (6 × 10 repetitions of squats) and were randomly assigned (using a double-blind crossover design with random protocol sequencing) to a supplement sequence: p-synephrine (S; 100 mg), p-synephrine + caffeine (SCF; 100 mg of p-synephrine plus 100 mg of caffeine), or a placebo (P). Subjects reported to the lab at a standard time, consumed a supplement, sat quietly for 45 minutes, performed the RE protocol, and sat quietly for 30 minutes. Blood samples were collected at rest (T1), after sitting quietly for 45 minutes (T2), immediately following RE (T3), and 15 minutes (T4) and 30 minutes (T5) postexercise. Oxygen consumption (VO2) and heart rate (HR) data were collected throughout.Results: Serum glycerol was significantly elevated at T2 only in S and SCF and T3 to T5 in all treatments. Nonesterified fatty acid (NEFA) concentrations did not differ between treatments. Plasma glucose was significantly elevated compared to T1 with highest area under the curve values seen in SCF. Mean VO2 and energy expenditure (EE) were significantly higher in S and SCF through 30 minutes postexercise. Fat oxidation rates favored S and SCF between 25 and 30 minutes postexercise. Mean HR during RE was significantly highest in SCF.Conclusions: Supplementation with S and SCF increases lipolysis primarily at rest and increases VO2, EE, and fat oxidation rates 30 minutes following RE. No HR changes were observed unless caffeine was added. [ABSTRACT FROM AUTHOR]

Nowadays, the biosynthesis of metal nanoparticles (NPs) through eco-friendly, cost-effective, and sustainable methods has drawn considerable attention. In this study, the green synthesis of silver NPs using AgNO 3 salt and the peel extract of bitter orange (Citrus aurantium) as a reducing agent was modeled and optimized by central composite design (CCD). Accordingly, the process parameters including pH (7–11), time (0–4 h), and the ratio of extract/salt solution (0:100–20:80 v/v) were considered to model the responses including the spectrophotometric wavelength of maximum absorbance (λ max) and the maximum absorbance value at λ max (A max), which represented the size and concentration of Ag NPs, respectively. Additionally, the stabilizing effect of glycerol (ratio of glycerol to salt 0–10 g/g) on the optimum treatment was studied using spectrophotometric and SEM analyses. The results showed that the quadratic and linear models were acceptably fitted to the experimental responses of A max and λ max , respectively. The optimization results demonstrated that the optimal reaction parameters to achieve the maximum A max were pH = 10.92, time = 3.5 h and ratio of extract/salt = 17.94:82.06 (v/v). Furthermore, glycerol could favorably play a stabilizer role in the optimum biosynthesized Ag NPs during the reaction and 14 days of storage at room temperature. The ICP-OES and TEM analyses of the stabilized Ag NPs (with 2.5 g/g glycerol) showed the presence of Ag element as nanospheres with ∼20 nm in size. The Ag NPs had great antibacterial properties against Staphylococcus aureus and Escherichia coli. Therefore, the bitter orange peel extract and glycerol could be promisingly used as novel reducing and stabilizing agents, respectively, to synthesize nanosilver via an eco-friendly and economical green approach. [Display omitted] • Green synthesis of nanosilver using the bitter orange peel extract was investigated. • Central composite design was used to model and optimize the process parameters. • Glycerol favorably played a stabilizer role in the biosynthesized Ag NPs. • The ICP-OES and TEM analyses showed the presence of 20 nm Ag nanospheres. • These Ag NPs had great antibacterial properties against S. aureus and E. coli. [ABSTRACT FROM AUTHOR]

Aortic dissection in young patients presents a clinical and diagnostic challenge. Atypical symptoms of ascending aortic dissection can delay presentation and diagnosis. Here, we describe a patient with delayed diagnosis of an atypical presentation of ascending aortic dissection after using a synephrine-containing pre-workout supplement. The diagnosis was initially missed on computed tomography, but subsequently made on echocardiography. This is the first reported case of ascending aortic dissection in the setting of synephrine supplementation. This case illustrates a potential cardiovascular adverse effect of synephrine and highlights the need for clinical trials without conflicts of interest assessing its safety. < Learning objective: The aims of this report are to highlight the diagnostic challenge of an atypical presentation of ascending aortic dissection and to illustrate a potential cardiovascular adverse effect of synephrine supplementation.> [ABSTRACT FROM AUTHOR]

Citrus aurantium is traditionally used in various kidney problems like burning of urine, urinary hesitancy and renal colic. The main objective of the present work was to evaluate the protective role of Citrus aurantium against gentamicin induced renal damage, due to its free radical scavenging properties to present experimental facts for their traditional use. 200 mg/kg/day of ethanolic extract of the plant employed in combination with the toxic doses of gentamicin for twenty-one days. The group GC-au (animals treated with co-administration of Citrus aurantium and gentamicin) protected renal damage expected with gentamicin, assessed by known functional and morphological parameters, significantly different from group G (animals treated with gentamicin). All the renal functioning parameters including; Blood urea nitrogen, Serum creatinine, Serum uric acid, Creatinine clearance, Serum electrolytes, Body weight, Urinary volume, Enzyme excretions, Urinary protein excretions and histological examination was performed for each and every group animals. The plant extract proved to have nephroprotective potentials may because of its known flavonoid contents and antioxidant properties. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of Citrus limonum and Citrus aurantium essential oils (EOs) compared to 0.2% chlorhexidine (CHX) and 1% sodium hypochlorite (NaOCl) on multispecies biofilms formed by Candida albicans, Enterococcus faecalis and Escherichia coli. The biofilms were grown in acrylic disks immersed in broth, inoculated with microbial suspension (106 cells/mL) and incubated at 37°C / 48 h. After the biofilms were formed, they were exposed for 5 minutes to the solutions (n = 10): C. aurantium EO, C. limonum EO, 0.2% CHX, 1% NaOCl or sterile saline solution [0.9% sodium chloride (NaCl)]. Next, the discs were placed in sterile 0.9% NaCl and sonicated to disperse the biofilms. Tenfold serial dilutions were performed and the aliquots were seeded onto selective agar and incubated at 37°C / 48 h. Next, the number of colony-forming units per milliliter was counted and analyzed statistically (Tukey test, p ≤ 0.05). C. aurantium EO and NaOCl inhibited the growth of all microorganisms in multi-species biofilms. C. limonum EO promoted a 100% reduction of C. albicans and E. coli, and 49.3% of E. faecalis. CHX was less effective against C. albicans and E. coli, yielding a reduction of 68.8% and 86.7%, respectively. However, the reduction of E. faecalis using CHX (81.7%) was greater than that obtained using C. limonum EO. Both Citrus limonum and Citrus aurantium EOs are effective in controlling multi-species biofilms; the microbial reductions achieved by EOs were not only similar to those of NaOCl, but even higher than those achieved by CHX, in some cases. [ABSTRACT FROM AUTHOR]

Abstract: p-Synephrine, the primary protoalkaloid in Citrus aurantium (bitter orange) and some other Citrus species, exists in nature in the l- or [R-(−)]-enantiomeric form, whereas synthetic p-synephrine is a racemic mixture of the l- and d-enantiomeric forms. Based on receptor binding, the synthetic form is believed to exert approximately half the pharmacological activity of the naturally occurring protoalkaloid. This difference occurs because the d- or [S-(+)]-form provides little or no binding to adrenergic receptors in contrast to the l-form. Receptor binding studies also provide an explanation for the differences in pharmacological effects between the isomers p-synephrine and m-synephrine. [Copyright &y& Elsevier]

Abstract: From April 2004 through October 2009, the FDA received 22 adverse event reports (AERs) involving products that were reported to contain Citrus aurantium (bitter orange) extract (BOE). During this same time, 10 clinical cases reports were published involving adverse events associated with products that contained BOE (C. aurantium) or its predominant alkaloid p-synephrine. A review and assessment of these reports was made. All products involved in these reports were poly-herbal and poly-alkaloidal in composition. The conclusion that BOE and p-synephrine are responsible for adverse events presented in these reports is unjustified, based on the presence of confounding factors, the paucity of detailed information in many reports, current knowledge of the pharmacokinetic and adrenoreceptor binding properties of p-synephrine, the high probability of concurrent but independent events, knowledge of dose–response relationships, and the widespread use of BOE containing supplements and p-synephrine containing juice and food products. [ABSTRACT FROM AUTHOR]

• Green synthesize of TiO 2 nanoparticles is using Citrus aurantium fruit peel extract for the first time. • The average size of the green synthesized nanoparticles is around 24−34 nm. • The bio synthesized TiO 2 nanoparticles have shown excellent antimicrobial, neuronal cell line and photocatalytic activities. Eco-friendly synthesis of nanoparticles is promising as a futuristic alternative for chemical and physical protocols. In the present investigation, TiO 2 nanoparticles were synthesised using the peel extract of Citrus aurantium fruit for the first time. The biosynthesised TiO 2 nanoparticles were characterized by various techniques such as X- ray diffraction (XRD), UV–vis spectrophotometer, Fourier Transform Infra-Red Spectroscopy (FT-IR), Field Emission Scanning Electron Microscope (FE-SEM), Energy dispersive X-ray (EDAX), Transmission Electron Microscope (TEM) and Atomic Force Microscope (AFM). The crystal structure and phase purity of TiO 2 nanoparticles were analysed using XRD. The optical properties and functional groups of TiO 2 nanoparticles were investigated with the help of UV visible absorption and FT-IR analysis. The morphology and topography of TiO 2 nanoparticles were examined through FE-SEM, TEM and AFM measurements. Biosynthesised TiO 2 nanoparticles were evaluated for their antimicrobial activities against Staphylococcus aureus and Staphylococcus epidermidis (Gram-positive), Pseudomonas aeruginosa and Klebsiella pneumonia (Gram- negative), Candida albicans and Aspergillus niger (Fungi) using agar well method. In addition, cytotoxicity study was performed through MTT assay, the cell cycle analysis, and apoptosis assays of cells by flow cytometry and DNA fragmentation analysis. The photocatalytic behaviour against methylene blue dye was studied. Results of the present study revealed that biosynthesised TiO 2 nanoparticles with an average size of 34 nm showed excellent antimicrobial, cell viability in PC12 cell lines (a combination of neuroblastic and eosinophilic cell lines) with IC 50 ranged between 31.2–62.5 μg/ mL and excellent photo degradation property. Therefore, the present study concluded that biosynthesised TiO 2 nanoparticles have potential antimicrobial, anti-apoptotic and photocatalytic behaviours towards neuronal cell lines. [ABSTRACT FROM AUTHOR]

• Anxiety is a multifactorial phenomenon in hospitalized patients with acute myocardial infarction. • Fatigue is the most common prodromal symptom of myocardial infarction. • Aromatherapy with Citrus aurantium as a sedative and soporific herb has been practiced in Iranian traditional medicine. • Aromatic oils can inhibit the γ-aminobutyric acid pathways and suppress the neurotransmitters, which makes them a good alternative for alleviating fatigue. • Aromatherapy with the essential oil of Citrus aurantium is an easy, inexpensive and harmless method that reduces anxiety and fatigue among patients with acute myocardial infarction. Anxiety and fatigue affect the clinical course and quality of life in patients with Acute Myocardial Infarction (AMI). Complementary therapies are recommended for managing these symptoms. The present study was conducted to evaluate the effects of Citrus aurantium aroma on anxiety and fatigue in patients with AMI admitted to coronary care units. In this triple-blind, randomized, controlled, clinical trial, 80 patients with AMI were allocated to a Citrus aurantium group and a placebo group (n = 40 per group) through stratified randomized blocks. From their second day of hospitalization and for two consecutive days, the subjects in the experimental and control groups inhaled three drops of Citrus aurantium essential oil or the placebo using absorbable patches connected to the inside of oxygen masks for 20 min. Anxiety and fatigue were measured in the patients using the Spielberger State-Trait Anxiety Inventory (STAI) and the Multidimensional Fatigue Inventory (MFI-20) 30 min before and 15 and 30 min after the interventions. There was a statistically significant difference between the Citrus aurantium and placebo groups concerning the mean changes in their anxiety and fatigue scores (P < 0.001 Citrus aurantium essential oil reduced anxiety and fatigue on all the four measurement occasions after the intervention compared to before. Aromatherapy with Citrus aurantium can be used as part of holistic care for managing the symptoms of AMI by nurses. [ABSTRACT FROM AUTHOR]

Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs. The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to five groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5)control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention. The mean pretest score of sleep quality was 2.91 ± 0.53 in the aromatherapy group, 2.84 ± 0.47 in the placebo aromatherapy group, 2.98 ± 0.59 in the acupressure group, 2.75 ± 0.41 in the placebo acupressure group and 2.88 ± 0.41 in the controls. ANOVA suggested no significant differences among these groups in the pretest (P = 0.746). The mean posttest score of sleep quality was 3.72 ± 1.84 in the aromatherapy group, 3.70 ± 1.83 in the placebo aromatherapy group, 7.35 ± 0.99 in the acupressure group, 2.67 ± 0.41in the placebo acupressure group and 2.72 ± 0.34 in the controls, suggesting significant differences among the five groups based on the ANOVA results showed significant differences among the five groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001). The present findings provided scientific evidence for the benefits of using different methods, including acupressure, for sleep quality in patients undergoing PCIs. IRCT201707248665N6. • Poor sleep quality is a common problem in patients undergoing PCI. • We compared acupressure effect vs. aromatherapy on sleep quality of patients undergoing PCI. • Acupressure may be an option for improving the sleep quality of patients scheduled for PCI. [ABSTRACT FROM AUTHOR]

Abstract: We report the case of a 52 year old woman that had an adverse reaction after taking a dry herbal extract of an unripe fruit of Citrus aurantium L. var. amara, as dietary supplement for weight loosing. The fruit is also known as zhi shi (in traditional Chinese Medicine) or bitter orange in other parts of the world. [Copyright &y& Elsevier]