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Background: Non-melanoma skin cancer (NMSC) is the most common type of cancer in the world. In traditional Persian medicine (TPM), various types of temperament ( Mizaj ) are considered to diagnose, treat, and prevent a variety of illnesses. The present study aimed to evaluate the temperament of patients with NMSC in comparison with a control group., Methods: A case-control study was conducted in 2018 at the Dermatology Clinic of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 110 patients, aged ≥20 years with confirmed NMSC (case group), and 181 individuals without NMSC (control group) were enrolled in the study. The temperament of the participants in both groups was evaluated using Mojahedi's Mizaj questionnaire. The data were analyzed using SPSS software, and P<0.05 was considered statistically significant., Results: The results showed that the odds ratio of developing NMSC was 2.62 (95%CI: 1.42-4.83, P=0.002) times higher in individuals with dry temperament than other types of temperament. Moreover, the odds ratio of patients with a history of chronic skin ulcers and other types of cancer was 35.7 (95%CI: 11.9-107.15, P<0.001) and 5.22 (95%CI: 1.43-19.06, P=0.012) times higher, respectively, than the control group., Conclusion: Temperament is associated with NMSC, particularly the dry temperament type, and should be considered a risk factor., Competing Interests: Dr. Fatemeh Sari Aslani, as the Editorial Board Member, was not involved in any stage of handling this manuscript. A team of independent experts was formed by the Editorial Board to review the editor’s article without her knowledge., (Copyright: © Iranian Journal of Medical Sciences.)

Background: Dentists are prone to professional burnout due to the nature of their work but this phenomenon could be prevented. Professional burnout has a great impact on different aspects of human life. No study has been published on determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine (TPM). The current study intends to touch upon this issue for the first time., Methods: In order to conduct this Cross-Sectional study based on a randomized sampling method, 145 dentists completed the 22-item Maslach Burnout Inventory questionnaires (MBI), and the 20-item Salmannejad Mizaj questionnaire. The study started since February, 2020 and ended in August, 2020 in Yazd, Iran. A total of 120 valid questionnaires were collected, with a response rate of 82.76%. Data analysis was performed using descriptive statistics, mean and standard deviation, analytical tests (including student t-test, one-way analysis of variance) by Spss17 (Chicago, USA) software., Results: Overall, 8.3% of responders had high emotional exhaustion, while 65.8% and 33.3% had moderate depersonalization and reduced personal accomplishment, respectively. With respect to the results, dentists with cold and dry temperaments experienced a higher level of burnout in emotional exhaustion while dentists with warm and wet temperaments had a higher level of burnout in depersonalization and reduced personal accomplishment dimensions. There was an insignificant difference between age, gender, work experience, number of working days per week, number of patients per day with the dimensions of burnout. Pearson correlation coefficient indicated there was a positive correlation between avoidance job and emotional exhaustion (r = - 0.22, p = 0.016)., Conclusion: Based on the findings, it may conclude there was no significant difference in professional burnout between different temperaments among dentists., (© 2022. The Author(s).)

Persian Medicine (PM) or Humoral Medicine is a traditional school of medicine with thousands of years of prolific history. The concept of Mizaj (temperament) and hot-cold theory is one of PM's most important foundations. In the clinical setting, Mizaj represents individual differences in phenotypical, psychological, spiritual, and physiological functions. Mizaj has a crucial role in determining the treatment plan, to the point that a similar disease in patients with different Mizaj types may demand different treatments. In this chapter, the role of hot and cold theory in the diagnosis and treatment of diseases to develop an integrative medical approach is discussed., (© 2021. Springer Nature Switzerland AG.)

Introduction Mizaj or temperament is a main concept in Persian Medicine (PM), which the process of diagnosis, treatment and preventive prescriptions are developed based on it. In this study, the articles written on the concept of Mizaj were reviewed. Method Credited electronic resources, including Pubmed, Scopus, Cochrane Library and web-of-science were searched using keywords Temperament, Mizaj, Mizadj, Midzaj and Mezaj (with the concept of Mizaj in Persian and/or Greek medicine). Search results were limited to English articles, published in 1995-2017. The articles in which temperament had the psychoanalytic aspect or was based on Ayurveda or Chinese/Korean medicine were removed. A team of four PM experts evaluated the method and the results. Results Among the total of 32 articles were published in this field, 14 were review articles, 2 were on animal subject, 14 were on human subject and 2 were surveys for designing questionnaire for people's Mizaj assessment. Most of review studies were just new versions of ancient Persian texts translated into English and the innovations on the subject were few. Studies on animal subject and developing questionnaires were also limited. In some human studies, use of standard questionnaires and homogenous methodology in Mizaj assessment was not considered. Conclusions It seems that studies on temperaments have increased in the past few years but are still at the forefront. In human studies a homogenous method for evaluating temperament has not been used and some of them failed to address the main concept of Mizaj in PM. Therefore, it is necessary to use the original category of Mizaj and to design standard method.

Background: Personalized medicine, an emerging approach, considers individual differences to tailor treatments optimally. Persian medicine (PM) incorporates individual differences through Mizāj (temperament). A comprehensive understanding of each Mizaj type's characteristics is essential in designing standardized diagnostic tools. Objectives: This study aims to explore the attributes of one of the most significant Mizaj groups, namely cold-wet Mizaj, and its subtypes, including cold-wet Su-e-Mizaj (dystemperament), as well as phlegm dominance in PM sources. Methods: Persian medicine literature, including the Canon of Medicine, was reviewed for relevant concepts. Reliable scientific databases, including PubMed, Scopus, and MagIran, were searched using keywords such as Mizaj, temperament, Su-e-Mizaj, dystemperament, cold-wet dystemperament, phlegm, and Balgham. The obtained results were studied and categorized. Results: Out of the 196 articles obtained related to Mizaj, 16 investigated indices. No studies were found on the indices of coldwet Mizaj and phlegm dominance separately. PM sources exhibit high congruence in describing the characteristics of cold-wet Mizaj. Specifically, emphasis is placed on characteristics such as coldness and softness of the skin to the touch, high fat mass, pale and white complexion, excessive body secretions, weakness and slowness of physical and physiological actions, low vitality, timidity, poor memory, and slow-wittedness. In cold-wet dystemperament, symptoms are more severe, and in the presence of phlegm, a feeling of heaviness is also mentioned as a specific symptom. Conclusions: By compiling indices of cold-wet Mizaj/dystemperament and phlegm dominance, this study can contribute to the development of standardized PM questionnaires, facilitating a personalized approach to the diagnosis and treatment of diseases. [ABSTRACT FROM AUTHOR]

Introduction: The aging procedure is an incremental reduction in the human systems, including the heart and respiration, blood vessels, endocrine glands, urinary-genital, and immune systems. This investigation evaluated the association between the Predicted Mean Vote (PMV) and Mizaj based on Persian medicine on thermal comfort of aging in sanatoriums in Mazandaran province in Iran. Methods: This research was accomplished at Rasht Azad University from June 2022 to December 2023 in sanatoriums of aging adults under actual circumstances. Ninety-six aging adults above 65 years old were included. PMV, weather moister, clothing cover, temperament (Mizaj) based on Persian medicine, and thermal comfort in 4 seasons were considered. Linear regression was used to evaluate the efficiency of the PMV index in estimating the thermal sensation of aging adults according to their Mizaj. Results: Temperament and sex shows a negative and significant relationship with thermal comfort (P<0.05). The regression model showed that individual characteristics such as temperament and gender affect the thermal comfort score and PMV (P<0.05). Conclusion: Therefore, to propose the desired coefficients in the correction of PMV values, we consider the effect of people's temperament and gender in the regression model. [ABSTRACT FROM AUTHOR]

Background: Mizaj (Temperament) is a concept to express individual differences in Persian medicine and according to this theory, there is a relationship between Mizaj type and the abilities of different body organs. This cross-sectional study aimed to investigate the relationship between the type of Mizaj and the memory score (Quotient). Methods: The target population was the 18 to 38 years old students of Babol University of Medical Sciences. Mojahedi's Mizaj questionnaire (MMQ) was used for determining the whole Mizaj. The physical Persian version of Wechsler Memory Scale III (WMS III) was used to assess memory score. The collected data were analyzed by SPSS Version 22 and the chi square (x2) and t-test were run and p- value 0.05 was considered as significant difference. Results: Forty-two of participants were females and 18 were males. The average age of them was 23.6 (21-27). The average of Memory Quotient (MQ) was 122.1 ± 5.7. The average of MQ in warm Mizaj was 125.46 ± 1.2 and in cold Mizaj was 118.79 ± 6.5. The difference between two groups is statistically significant (p< 0.001). The average of MQ in dry Mizaj was 124.16 ± 2.67 and in wet Mizaj was 118.40 ± 7.64. The difference between two groups is statistically significant (P= 0.005). Conclusion: The results showed there are significant relationship between memory score and warm/cold Mizaj and dry/wet Mizaj. It means students with warm or dry Mizaj had better memory score than students with cold or wet Mizaj. This relation was also detected between subtypes of memory and Mizaj expect between working memory and dry/wet Mizaj. These results are in accordance with theories in PM which indicate people with warm Mizaj and dry Mizaj have better memory and people with cold Mizaj and wet Mizaj have weaker memory and are more at risk of memory dysfunction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To elicit symptoms, risk factors, and habits existing before or right after blood pressure elevation in newly diagnosed patients with hypertension from the traditional Persian medicine perspective. METHODOLOGY: This was a concurrent nested mixed-method study conducted in 2018. We included newly diagnosed cases of hypertension (BP≥140/90 mmHg in two consecutive screenings) in the study. In contrast, those who had a history of hypertension or used anti-hypertension medication were excluded. The participants were surveyed and interviewed to identify their temperament and extract their recent experiences with hypertension. The sampling followed the criterion-based purposive technique, and the sample size was defined based on qualitative data saturation. The recorded interviews were transcribed and coded according to Persian medicine until no new code emerged. RESULTS: Twenty participants were interviewed, and two themes were extracted: (i) primary or predisposing factors, such as warm temperament, change of residence, improper eating habits, abrupt cessation of exercise, psychological factors, and irregular sleep patterns, and (ii) early symptoms that occur at the first sign of rising blood pressure, including digestive complaints and changes in body excretion, psychological manifestations, and unclassifiable general symptoms. CONCLUSION: Physicians are advised to pay attention to these items when taking a history from patients to prevent hypertension and treat it at its early stages.

Background: Introduction: Mizaj is the basis of attention to individual differences in Persian Medicine (PM). Regarding the importance of Mizaj for health preservation and treating diseases, it is necessary to achieve a standard tool for Mizaj identification. The purpose of this study was to design a standard self-reporting Mizaj identification questionnaire for elders. Methods: In this exploratory sequential study, criteria of Mizaj identification were extracted by reviewing PM literatures and interview with PM experts and elders. The primary questionnaire was designed and its validity and reliability were assessed, using weighted Kappa statistics, Pearson correlation coefficient (PCC) assessment, receiver operating characteristic (ROC) curve and determining the specificity and sensitivity of cut-off points. Results: Among the 101 items in the primary questionnaire, 73 items had acceptable reliability. The final 20-item questionnaire was obtained after the criterion validity and PCC assessment. The sensitivity and specificity of this questionnaire were 83% and 88% for warmness, 49% and 80% for moderate in warmness-coldness, 72% and 91% for coldness, 57% and 78% for wetness, 30% and 79% for moderate in wetness-dryness, and 81% and 67% for dryness, respectively. Conclusion: The first standard Mizaj identification questionnaire for elders was designed in this study. It is recommended as a supplementary diagnostic tool for clinicians and researchers in PM. Also, the people with age over 60 can use it to identify their own Mizaj and then, choose the suitable PM or Unani medicine lifestyle recommendations based on their Mizaj.

Introduction: The process of aging is a gradual decrease in the function of the body's systems, including the heart and blood vessels, respiration, urinary-genital system, endocrine glands, and the body's immune system. This study aimed to assess the effect of Temperament based on Persian medicine on the thermal comfort of aging in sanatoriums in Mazandaran province in Iran. Methods: This cross-sectional study was conducted at Rasht Azad University from June 2022 to December 2023. In the field section, the living space (sanatoriums) of older people who are under actual conditions (without interfering with the temperature conditions) in the mild and humid plain climate of Iran was investigated. Ninety-six aging adults above 65 years old were included. Sex, age, temperament (Mizaj) based on Persian medicine, and thermal comfort in four seasons were assessed. Results: Ninety-five participants were included, and 54 (54.5%) were aging females. The distribution of Mizaj regarding sex was similar (P=0.647), and most of the participants, 49 (51.6%), had a cold temperament. There was a significant relationship between Temperament and thermal comfort (P<0.01). There was a significant relationship between gender and thermal comfort (P<0.01). Conclusion: The results showed that the Temperament and gender of aging adults can play a central role in determining the amount of coverage of people and their thermal comfort. More long-term studies are needed to investigate more precisely the effect of Temperament on people's thermal sensations. [ABSTRACT FROM AUTHOR]

Background: Introduction: Mizaj is the basis of attention to individual differences in Persian Medicine (PM). Regarding the importance of Mizaj for health preservation and treating diseases, it is necessary to achieve a standard tool for Mizaj identification. The purpose of this study was to design a standard self-reporting Mizaj identification questionnaire for elders. Methods: In this exploratory sequential study, criteria of Mizaj identification were extracted by reviewing PM literatures and interview with PM experts and elders. The primary questionnaire was designed and its validity and reliability were assessed, using weighted Kappa statistics, Pearson correlation coefficient (PCC) assessment, receiver operating characteristic (ROC) curve and determining the specificity and sensitivity of cut-off points. Results: Among the 101 items in the primary questionnaire, 73 items had acceptable reliability. The final 20-item questionnaire was obtained after the criterion validity and PCC assessment. The sensitivity and specificity of this questionnaire were 83% and 88% for warmness, 49% and 80% for moderate in warmness-coldness, 72% and 91% for coldness, 57% and 78% for wetness, 30% and 79% for moderate in wetness-dryness, and 81% and 67% for dryness, respectively. Conclusion: The standard Mizaj identification is recommended as a supplementary diagnostic tool for clinicians and researchers in PM. Also, the people with age over 60 can use it to identify their own Mizaj and then, choose the suitable PM or Unani medicine lifestyle recommendations based on their Mizaj. [ABSTRACT FROM AUTHOR]

This study aimed to explore potential relationships between dietary patterns aligned with cold or hot temperaments and cardiovascular parameters among healthy individuals. This randomized clinical trial was conducted in 2020 with 65 healthy volunteers. Participants were categorized into two groups, specifically as hot or cold temperaments. In the initial phase, we measured body temperature, systolic and diastolic blood pressure, and conducted the Heart Rate Variability (HRV) test. Subsequently, participants received a three-day diet plan with a similar nature to their body temperament (second phase). The same measurements were repeated after three days. Following this, participants returned to a normal daily diet for three days. In the third phase, they received a diet plan of the opposite nature to their temperament for another three days, and the same battery of tests was conducted at the study's conclusion. In both the cold temperament group during the second phase and the hot temperament group during the third phase, mean body temperature, heart rate, systolic and diastolic blood pressure were significantly lower than in other phases (P < 0.05). Additionally, HRV indexes, including RMSSD, SDNNInd, and QT, were significantly higher during the second phase for the cold temperament group and the third phase for the hot temperament group compared to other phases (P < 0.05). Irrespective of individual body temperament, the consumption of a cold-natured diet led to a significant decrease in mean body temperature, heart rate, systolic and diastolic blood pressure. This effect may be attributed to the activation of the parasympathetic nervous system.

Background: Mizaj is an individualized viewpoint in Persian Medicine (PM) that is used for the prevetion of diseases and also treatment. Evaluating Mizaj in the two domains of hotness-coldness, and wetness-dryness, 10 criteria have been introduced, most of them are qualitative. To achieve valid and reliable questionnaires, the weight of these criteria must be determined in assessing the Mizaj. Methods: In a cross-sectional study with Delphi method, 10 indices were extracted from PM references and sent to PM experts via e-mail. They were asked to score the weight of each index in determining the Mizaj from 0 to 10. The scores ranked and comparing previous preliminary studies, criteria of major and minor were proposed. Results: Out of 147 invited PM experts, 122 completed the tables. Based on scores, physical functions, physique, and responsiveness of organs obtained the highest scores in the field of hotness-coldness. In wetness-dryness muscle/fat mass and sleep/wakefulness received the highest scores from the viewpoint of experts. Conclusion: Physical functions, physique (Anthropometry), responsiveness of organs and psychic function can be used as major criteria in Mizaj assessment methods in the hotness-coldness field. In the field of wetness-dryness, muscle/fat mass, sleep/wakefulness, tactile condition and physique (anthropometry) can be considered as major criteria.

Background: Mizaj is an individualized viewpoint in Persian Medicine (PM) that is used for the prevetion of diseases and also treatment. Evaluating Mizaj in the two domains of hotness-coldness, and wetness-dryness, 10 criteria have been introduced, most of them are qualitative. To achieve valid and reliable questionnaires, the weight of these criteria must be determined in assessing the Mizaj. Methods: In a cross-sectional study with Delphi method, 10 indices were extracted from PM references and sent to PM experts via e-mail. They were asked to score the weight of each index in determining the Mizaj from 0 to 10. The scores ranked and comparing previous preliminary studies, criteria of major and minor were proposed. Results: Out of 147 invited PM experts, 122 completed the tables. Based on scores, physical functions, physique, and responsiveness of organs obtained the highest scores in the field of hotness-coldness. In wetness-dryness muscle/fat mass and sleep/wakefulness received the highest scores from the viewpoint of experts. Conclusion: Physical functions, physique (Anthropometry), responsiveness of organs and psychic function can be used as major criteria in Mizaj assessment methods in the hotnesscoldness field. In the field of wetness-dryness, muscle/fat mass, sleep/wakefulness, tactile condition and physique (anthropometry) can be considered as major criteria. [ABSTRACT FROM AUTHOR]

Background: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj. Methods: Four PM experts determined the Mizaj of 121 participants. Those who had ≥70% agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression. Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. Cold-Mizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj. Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination.

Objectives: According to Persian medicine (PM), the uterus is an important organ in women, responsible for purifying the blood and nourishing the fetus. Each organ has a specific temperament distinct from the whole-body temperament based on PM. Dystemperament occurs when body or organ Mizaj (Persian word for temperament) deviates from what is considered normal, resulting in malfunction. Many gynecological disorders described in PM and conventional medicine, including infertility, recurrent miscarriage, oligomenorrhea/amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence, and pelvic pain, are considered to be associated with uterine dystemperaments. Hence, proper management of such disorders requires precise diagnosis and treatment of uterine dystemperaments. Accordingly, this review study aimed to collect and categorize these symptoms from PM texts and other relevant articles. Methods: In this study, we reviewed 10 well-known PM references, including Canon in Medicine (Al-Qanun Fi al-Teb), the Great Panacea (Exir-e A’zam), the Treasure of Kharazmshah (Zakhireh Kharazmshahi), the Perfect Book of the Art of Medicine (Kamel alSana’a al-Tebbiya), Akbari’s Medicine (Tebb-E-Akbari), Gharshi’s Commentary on Canon of Medicine (Sharh-e Qarshi bar Qanun), Commentary on Hippocrates’ Aphorisms (Sharh-e Fosul-e Boqraat), Summary of Experiences (Kholasa-tut Tajarob), Description of Signs and Symptoms (Sharh-e Asbab va Alamat), and Aghili’s Treatments (Mo’alejat-e Aghili). Moreover, Scopus, PubMed, Web of Science, SienceDirect, and Google Scholar databases were queried with the keywords ‘mizaj’, ‘temperament’, ‘uterus’, ‘uterine’, ‘cold/hot or warm’, and ‘dry/wet’, while Persian databases of Magiran, Iran Medex, and SID were searched using keywords ‘mizaj’, ‘rahem’, ‘garm’, ‘sard’, ‘tar’, and ‘khoshk’ to extract signs and symptoms associated with uterine temperament and dystemperament. Results: Five indicators were specified in the articles and PM sources for determining the temperament and dystemperament of the uterus as follows: 1) Menstrual blood characteristics (including amount, temperature, color, odor, flow rate, and consistency); 2) Uterine discharge characteristics (including amount, consistency, color, odor, and accompanied symptoms, especially burning and itching); 3) Fertility and pregnancy status (including infertility, abortion, etc.); 4. Other characteristics of the female reproductive system (including pubic hair, menarche age, sexual desire and quality of intercourse, and vaginal and cervical condition on vaginal examination); and 5) General symptoms (including the ten PM indicators of whole-body Mizaj). Conclusions: PM sources have described the characteristics of uterine temperament and dystemperament in detail. These indices can be used for more effective diagnosis, treatment, and even prevention of gynecological diseases, as well as designing and validation of standard tools for determining uterine temperament and dystemperament.

Background: In Persian medicine (PM), measuring the wrist pulse is one of the main methods for determining a person's health status and temperament. One problem that can arise is the dependence of the diagnosis on the physician's interpretation of pulse wave features. Perhaps, this is one reason why this method has yet to be combined with modern medical methods. This paper addresses this concern and outlines a system for measuring pulse signals based on PM. Methods: A system that uses data from a customized device that logs the pulse wave on the wrist was designed and clinically implemented based on PM. Seven convolutional neural networks (CNNs) have been used for classification. Results: The pulse wave features of 34 participants were assessed by a specialist based on PM principles. Pulse taking was done on the wrist in the supine position (named Malmas in PM) under the supervision of the physician. Seven CNNs were implemented for each participant's pulse characteristic (pace, rate, vessel elasticity, strength, width, length, and height) assessment, and then, each participant was classified into three classes. Conclusion: It appears that the design and construction of a customized device combined with the deep learning algorithm can measure the pulse wave features according to PM and it can increase the reliability and repeatability of the diagnostic results based on PM.

Background: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj. Methods: Four PM experts determined the Mizaj of 121 participants. Those who had ≥70% agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression. Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. ColdMizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj. Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination. [ABSTRACT FROM AUTHOR]

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

Background: Non-melanoma skin cancer (NMSC) is the most common type of cancer in the world. In traditional Persian medicine (TPM), various types of temperament (Mizaj) are considered to diagnose, treat, and prevent a variety of illnesses. The present study aimed to evaluate the temperament of patients with NMSC in comparison with a control group.Methods: A case-control study was conducted in 2018 at the Dermatology Clinic of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 110 patients, aged ≥20 years with confirmed NMSC (case group), and 181 individuals without NMSC (control group) were enrolled in the study. The temperament of the participants in both groups was evaluated using Mojahedi’s Mizaj questionnaire. The data were analyzed using SPSS software, and P

The concept of mizaj corresponds to the idea of personalized medicine and is the main diagnostic principle of Persian medicine (PM). This study aims to investigate diagnostic tools for the detection of mizaj in PM. In this systematic review of articles published before September 2022, articles were searched for in the Web of Science, PubMed, Scopus, Google Scholar, SID databases, and gray literature. The titles of the articles were screened by researchers and relevant articles were selected. Abstracts were reviewed by two reviewers to select final articles. Subsequently, the articles found were critically evaluated by two reviewers according to the CEBM method. Finally, article data were extracted. Of the 1812 articles found, 54 were included in the final evaluation. Of these, 47 articles were related to the diagnosis of whole body mizaj (WBM). WBM was diagnosed in 37 studies using questionnaires and 10 using expert panels. In addition, six articles examined the mizaj of organs. Only four of these questionnaires were found with reported reliability and validity. There were two questionnaires for assessing WBM, but neither had sufficient reliability and validity. Questionnaires that assess organs had weak designs and lacked sufficient reliability and validity. [ABSTRACT FROM AUTHOR]

Objectives: According to Persian medicine (PM), the uterus is an important organ in women, responsible for purifying the blood and nourishing the fetus. Each organ has a specific temperament distinct from the whole-body temperament based on PM. Dystemperament occurs when body or organ Mizaj (Persian word for temperament) deviates from what is considered normal, resulting in malfunction. Many gynecological disorders described in PM and conventional medicine, including infertility, recurrent miscarriage, oligomenorrhea/amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence, and pelvic pain, are considered to be associated with uterine dystemperaments. Hence, proper management of such disorders requires precise diagnosis and treatment of uterine dystemperaments. Accordingly, this review study aimed to collect and categorize these symptoms from PM texts and other relevant articles. Methods: In this study, we reviewed 10 well-known PM references, including Canon in Medicine (Al-Qanun Fi al-Teb), the Great Panacea (Exir-e A'zam), the Treasure of Kharazmshah (Zakhireh Kharazmshahi), the Perfect Book of the Art of Medicine (Kamel al-Sana'a al-Tebbiya), Akbari's Medicine (Tebb-E-Akbari), Gharshi's Commentary on Canon of Medicine (Sharh-e Qarshi bar Qanun), Commentary on Hippocrates' Aphorisms (Sharh-e Fosul-e Boqraat), Summary of Experiences (Kholasa-tut Tajarob), Description of Signs and Symptoms (Sharh-e Asbab va Alamat), and Aghili's Treatments (Mo'alejat-e Aghili). Moreover, Scopus, PubMed, Web of Science, SienceDirect, and Google Scholar databases were queried with the keywords 'mizaj', 'temperament', 'uterus', 'uterine', 'cold/hot or warm', and 'dry/wet', while Persian databases of Magiran, Iran Medex, and SID were searched using keywords 'mizaj', 'rahem', 'garm', 'sard', 'tar', and 'khoshk' to extract signs and symptoms associated with uterine temperament and dystemperament. Results: Five indicators were specified in the articles and PM sources for determining the temperament and dystemperament of the uterus as follows: 1) Menstrual blood characteristics (including amount, temperature, color, odor, flow rate, and consistency); 2) Uterine discharge characteristics (including amount, consistency, color, odor, and accompanied symptoms, especially burning and itching); 3) Fertility and pregnancy status (including infertility, abortion, etc.); 4. Other characteristics of the female reproductive system (including pubic hair, menarche age, sexual desire and quality of intercourse, and vaginal and cervical condition on vaginal examination); and 5) General symptoms (including the ten PM indicators of whole-body Mizaj). Conclusions: PM sources have described the characteristics of uterine temperament and dystemperament in detail. These indices can be used for more effective diagnosis, treatment, and even prevention of gynecological diseases, as well as designing and validation of standard tools for determining uterine temperament and dystemperament. [ABSTRACT FROM AUTHOR]

Persian Medicine (PM) is a holistic medical system with a unique theoretical base and practical knowledge. Considering its different paradigm and background philosophy compared to conventional medicine, understanding its fundamental principles is necessary for more accurate and efficient clinical practice. One of its fundamental theories is the concept of “Takhalkhol (porosity) and Takasof (condensity)” which has a significant impact on medical practice. This critical issue has been investigated in recent studies to evaluate the density of the body organs as a diagnostic tool. Despite its importance, no distinct section of the leading Persian Medicine sources has been dedicated to elaborating this basic concept. In this study, we have presented this crucial concept based on PM sources and current literature to reveal its clinical relevance in the realm of its clinical relevance in diagnosis and disease management. The relation between porosity and condensity and other issues such as body composition, Mizaj (temperament), and nutrition has been discussed.

Abstract Background Dentists are prone to professional burnout due to the nature of their work but this phenomenon could be prevented. Professional burnout has a great impact on different aspects of human life. No study has been published on determination of professional job burnout and temperament (Mizaj) from the viewpoint of Traditional Persian Medicine (TPM). The current study intends to touch upon this issue for the first time. Methods In order to conduct this Cross-Sectional study based on a randomized sampling method, 145 dentists completed the 22-item Maslach Burnout Inventory questionnaires (MBI), and the 20-item Salmannejad Mizaj questionnaire. The study started since February, 2020 and ended in August, 2020 in Yazd, Iran. A total of 120 valid questionnaires were collected, with a response rate of 82.76%. Data analysis was performed using descriptive statistics, mean and standard deviation, analytical tests (including student t-test, one-way analysis of variance) by Spss17 (Chicago, USA) software. Results Overall, 8.3% of responders had high emotional exhaustion, while 65.8% and 33.3% had moderate depersonalization and reduced personal accomplishment, respectively. With respect to the results, dentists with cold and dry temperaments experienced a higher level of burnout in emotional exhaustion while dentists with warm and wet temperaments had a higher level of burnout in depersonalization and reduced personal accomplishment dimensions. There was an insignificant difference between age, gender, work experience, number of working days per week, number of patients per day with the dimensions of burnout. Pearson correlation coefficient indicated there was a positive correlation between avoidance job and emotional exhaustion (r = − 0.22, p = 0.016). Conclusion Based on the findings, it may conclude there was no significant difference in professional burnout between different temperaments among dentists.

Background: In recent years, research on how traditional medicine works and the relationship between medicine and classical medicine has increased. In this regard, the use of metabolomics is one of the main candidates that can reflect the state of the body's basic metabolism and may be able to explain a new way to explain the function of traditional medicine by evaluating its effect based on evidence and modernizing it under the supervision of new sciences. Materials and methods: In this review study, in an advanced search from papers published in English language from 2003 to 2020 with key words of "traditional medicine", "temperament" and "metabolomics" in the databases of PubMed, Medline, Science Direct, Cochrane, Embase is used. Result: Animal and human studies conducted to relate the concepts of Traditional Chinese Medicine and metabolomics. The results of studies showed the specific metabolic profile in subtypes of diseases based on theory of Chinese Medicine. In field of Persian Medicine (PM), limited researches have been published on the differentiation of proteomics and metabolites of individuals with different Mizaj. Conclusion: Metabolomics has a potential role to establish a new approach to understanding the main concepts of PM such as Mizaj, classifications of diseases and effectiveness of traditional formula on humans with different Mizaj. Given that most of the research work is focused on herbal medicines and diseases and the important issue of temperament in human samples has done less work, it seems that in modernizing traditional medicine using new approaches such as metabolomics, the first step should be the basics of this medicine should be removed. [ABSTRACT FROM AUTHOR]

Background: In Persian medicine (PM), measuring the wrist pulse is one of the main methods for determining a person's health status and temperament. One problem that can arise is the dependence of the diagnosis on the physician's interpretation of pulse wave features. Perhaps, this is one reason why this method has yet to be combined with modern medical methods. This paper addresses this concern and outlines a system for measuring pulse signals based on PM. Methods: A system that uses data from a customized device that logs the pulse wave on the wrist was designed and clinically implemented based on PM. Seven convolutional neural networks (CNNs) have been used for classification. Results: The pulse wave features of 34 participants were assessed by a specialist based on PM principles. Pulse taking was done on the wrist in the supine position (named Malmas in PM) under the supervision of the physician. Seven CNNs were implemented for each participant's pulse characteristic (pace, rate, vessel elasticity, strength, width, length, and height) assessment, and then, each participant was classified into three classes. Conclusion: It appears that the design and construction of a customized device combined with the deep learning algorithm can measure the pulse wave features according to PM and it can increase the reliability and repeatability of the diagnostic results based on PM. [ABSTRACT FROM AUTHOR]

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools. [ABSTRACT FROM AUTHOR]

The quality of sleep changes with age and a reduction in sleep duration is observed in the elderly. Mizaj (temperament) is a fundamental theory in traditional Persian medicine. It is defined as all sides of personality describing a person’s morphological, psychological, and physiological situations. Although the evidence showed that temperament and sleep quality are related, no research has evaluated this issue statistically so far. Hence, this study aimed to evaluate the correlation between sleep quality and temperament. This cross-sectional study included 1,359 elderly people (aged 60) in Tabriz, Iran in 2019. An interviewer accomplished the Tabriz Older People Survey (TOPS), Temperament and Sleep Quality Test, and Pittsburgh Sleep Quality Index (PSQI). A p value less than 0.05 was considered as significant. Our findings indicated that there was a significant relationship between global PSQI and wet temperament (p value = 0.036). In addition, hot-cold temperament was statistically related to demographical items like gender, marital status, and occupational status (p value ≤ 0.05). A similar statistically significant relationship was also seen for wet-dry temperament (p value ≤ 0.05). Moreover, the global PSQI score in female and illiterates subjects and those who lived in detached houses was high, meaning that the sleep quality was poor in these groups. According to our findings, Mizaj affects the quality of sleep in older adults. Also, living conditions of the elderly, such as gender, type of residence, level of education, and job, affect the Mizaj of the elderly people.

Objective: Nutrition is one of the most important factors today in prevention and maintaining health, as well as in treatment of diseases. Despite many efforts, the challenges related to nutrition are becoming more and more common every day. Persian medicine is one of the oldest medical approaches in the world, and nutrition has a special and fundamental place in this medical thought. So much so, that a large portion of Persian medicine is related to nutrition. Individualized nutrition in Persian medicine based on temperament (Mizaj) is well in correspondence today with the topic of nutrigenomics or nutrigenetic, or epigenetic, and strongly proposes a unique model of nutrition in a strategic way. This study focuses to describe the importance of nutrition based on individualized temperament from the perspective of Persian medicine and the findings of modern one. Materials and Methods: This study is a narrative literature review using keywords including Persian medicine, Traditional Persian medicine, temperament (Mizaj), nutrition, individualized nutrition, individualized medicine, precision nutrition, functional food, bioactive food, nutrigenomics, nutrigenetic, epigenetic, and TEF, in Persian and English were used to explore related articles in databases such as Pub Med and also using Google Scholar, without any time constraints. Extracted articles were carefully studied. Also, Persian medicine books and conventional medicine ones were studied. The relevant content were collected, reviewed and the results were written in the form of individualized nutrition, based on temperament. Findings: According to the principles of Persian medicine, the temperament of every healthy person is based on a balanced and specific range. Maintaining this range and its balance is cornerstone to a healthy person. On the other hand, and from view point of Persian medicine, all foods and drinks have their own temperament too. A review of modern scientific sources also shows that these topics have been considered by common medical science and in these sources, topics such as individualized nutrition and individualized medicine along with topics such as nutrigenomics, epigenetic, and nutrigenetic have been addressed. Also, the discussion about the quality of the effect of foods on the body of people, which has been presented in the form of functional food, is in accordance with the statements of Persian medical scholars about possession of different temperaments for foods. Conclusion: Findings of this article strongly suggests that, what current medicine emphasizes today on individualized nutrition that is essential to promote human health, which is known in the traditional Persian medicine, as personal temperament. Thus combination of traditional Persian medicine recommendations (in the form of holistic medicine), and modern medical science recommendations (in the form of analytic medicine), is essential to accelerate developments in the medical sciences. [ABSTRACT FROM AUTHOR]

Increased incidence of Multiple Sclerosis (MS) calls for supporting complementary therapies in this field. Persian Medicine (PM) specialists present various assumptions to help patients through Mizaj (temperament) modification, but its confirmation requires scientific evidence. This study aimed at identifying the Mizaj of MS patients, and comparing it with their Mizaj before the onset of the disease, and with that of healthy people. Forty-two MS and fifty-four healthy subjects participated in the study as case and control groups. General and brain Mizaj in patients were identified by five PM specialists before and after the onset of the disease. Mojahedi Mizaj Questionnaire (MMQ) was completed by the two groups. The validity of MMQ was assessed using Mizaj diagnosis by PM specialists as the gold standard. T-test, McNemar-Bowker, Wilcoxon, and Chi-square (χ2) tests were used to compare the Mizaj of patients before and after the onset of the disease, and between the two groups (p<0.05). The sensitivity and specificity of MMQ for Hotness (75, 81%) and Coldness (75, 65%) were acceptable. There were no significant differences between patients and healthy subjects in terms of general Mizaj. But general and brain Mizaj of patients after developing MS inclined to coldness and dryness, although merely inclination of general Mizaj to coldness was significant (p=0.03). According to our results, the Mizaj of MS patients has an inclination toward coldness and dryness; Also, MMQ can be used as a validated scale for identifying the Mizaj of MS patients in future studies. [ABSTRACT FROM AUTHOR]

Persian Medicine (PM) is a holistic medical system with a unique theoretical base and practical knowledge. Considering its different paradigm and background philosophy compared to conventional medicine, understanding its fundamental principles is necessary for more accurate and efficient clinical practice. One of its fundamental theories is the concept of “Takhalkhol (porosity) and Takasof (condensity)” which has a significant impact on medical practice. This critical issue has been investigated in recent studies to evaluate the density of the body organs as a diagnostic tool. Despite its importance, no distinct section of the leading Persian Medicine sources has been dedicated to elaborating this basic concept. In this study, we have presented this crucial concept based on PM sources and current literature to reveal its clinical relevance in the realm of its clinical relevance in diagnosis and disease management. The relation between porosity and condensity and other issues such as body composition, Mizaj (temperament), and nutrition has been discussed. [ABSTRACT FROM AUTHOR]

Background and Objectives: In spite of all scientific advances in the diagnosis and treatment of infectious diseases, the increasing incidence and prevalence of non-communicable and chronic diseases are among the challenges of policymakers in the field of prevention and treatment in medicine, the main reason for which is modern lifestyle, especially regarding nutrition. Despite the existence of various strategies and methods in the field of nutrition in conventional medicine, human societies encounter many issues and problems in the field of prevention and treatment of diseases caused by malnutrition and improper diets. In this regard, Persian medicine has effective strategies and practical methods, one of which is the nutrition program based on temperament, which will be described in the present study. Methods: In this descriptive review study, written sources of early and late Persian medicine scholars, Tebe Noor Comprehensive software (version 1.5), and PubMed and Google Scholar scientific databases were examined. Relevant data were extracted, filtered, categorized, and written. Results: Regarding food recommendations and beverages according to the diverse temperaments of human beings, there are several views and suggestions in the statements of Persian medicine scholars. By summarizing and reasoning and inference based on the sources of Persian medicine, a single, appropriate, and practical solution can be proposed to suggest dietary measures appropriate to various human temperaments in order to maintain and promote health and prevent and treat diseases. Conclusion: Based on the principles of Persian medicine and conclusion drawn from the opinions of Persian medicine scholars, food is offered to individuals based on two important factors, including individual characteristics or temperament as well as food quality or temperament. Accordingly, for a cold and dry temperament in a healthy state, it is recommended to have foods or beverages with warmer and wetter temperament. Certainly, it does not mean that these individuals should not eat cold and dry foods in a healthy state. Rather, their general desire for daily or weekly foods is better to be toward warmth and wetness; the level of desire for warmth and wetness depends on the degree to which an individual’s temperament deviates toward cold and dryness. Likewise, appropriate dietary measures can be suggested for other temperaments.

Objectives: Mizaj (temperament) refers to a concept in Persian medicine and is the basis for defining health and disease. Brain, as the most important organ of the body (Aza-e-raeiseh), controls vital functions. So far, no standardized questionnaire has been designed for distinguishing temperament in Persian medicine. Therefore, the aim of this study was to provide a reliable objective self-report questionnaire and a standardized diagnostic checklist for Mizaj identification via determining their reliability and validity in Persian medicine. Materials and Methods: This was an exploratory sequential study in which we designed a 121-item questionnaire, and a 20-item checklist as an item pool using Mizaj-related indices searched in Persian medicine references. The number of items for questionnaire and checklist finally reached 35 and 12 after qualitative and quantitative assessments (e.g., content and face validities). The test-retest reliability of each question of the questionnaire and checklist and their consistency were evaluated by participation based on the weighted and Fleiss’ kappa statistics, and intraclass correlation coefficient (ICC). The final version of the questionnaire and checklist were divided into two subscales (i.e., warm/cold and wet/dry), and the minimum and maximum scores were determined. Results: Significant findings of our data showed that the weighted and Fleiss’ kappa coefficients of the 35-item questionnaire (between 0.4 and 0.9) and 12-item checklist (between 0.4 and 0.8) were found in the study based on their reliability. The degree of reliability in the self-report questionnaire was assessed using weighted kappa (WK), where 6 items of the questionnaire were omitted due to a WK less than 0.6 and the number of items reached 35. While 2 items of the checklist with Fleiss’ kappa (FK)

The approach of personalized medicine has received a great deal of attention over the last century, emphasizing attention to the patient rather than the disease. Personalized medicine tries to plan the patient's condition and treatment method by considering the culture, personal preferences and experiences and health beliefs of the person as well as the values and lifestyle of the person, and even considering the psychosocial condition. Acknowledging the lack of knowledge of traditional medicine such as Persian, Chinese and Ayurvedic medicine about "Omixes", it can be argued that these medical paradigms have been emphasizing individual differences and their relationship with health for thousands of years. Many people know Iranian medicine as the famous theory of temperaments and quadrant humor. Without entering into a philosophical fallacy about the abrogation or obsolescence of this theory, from a practical point of view, it should be said that the separation of human beings and attention to their inherent differences and consequently the same functions and responses of their bodies, whether congenital (Intrinsic temperament) and whether under the influence of extrinsic and environmental factors (acquired temperament) is the basis of this thinking. Therefore, every human being, in turn, is an independent book that is influenced by his inner and outer and all direct and indirect biological factors of his life, and the spectrum of his health and illness is defined in this framework. In this study, the relationship between traditional persian medicine and personalized medicine has been studied. [ABSTRACT FROM AUTHOR]

Background: Temperament (Mizaj) determination is an important stage of diagnosis in Persian Medicine. This study aimed to evaluate thermal imaging as a reliable tool that can be used instead of subjective assessments. Methods: The temperament of 34 participants was assessed by a PM specialist using standardized Mojahedi Mizaj Questionnaire (MMQ) and thermal images of the wrist in the supine position, the back of the hand, and their whole face under supervision of the physician were recorded. Thirteen thermal features were extracted and a classifying algorithm was designed based on the genetic algorithm and Adaboost classifier in reference to the temperament questionnaire. Results: The results showed that the mean temperature and temperature variations in the thermal images were relatively consistent with the results of MMQ. Among the three body regions, the results related to the image from Malmas were most consistent with MMQ. By selecting six of the 13 features that had the most impact on the classification, the accuracy of 94.7 ± 13.0, sensitivity of 95.7 ± 11.3, and specificity of 98.2 ± 4.2 were obtained. Conclusions: The thermal imaging was relatively consistent with standardized MMQ and can be used as a reliable tool for evaluating warm/cold temperament. However, the results reveal that thermal imaging features may not be only main features for temperament classification and for more reliable classification, it needs to add some different features such as wrist pulse features and some subjective characteristics. [ABSTRACT FROM AUTHOR]

Objectives: Regarding the increasing prevalence of hypertension and its associated disabilities, it is beneficial for physicians to build on the potential of other medical schools like Persian medicine (PM) as it can provide useful knowledge of the factors leading to hypertension by identifying its pathogenesis in another medical attitude. Thus, the present study aimed at applying a strategy to prevent and treat hypertension. Materials and Methods: The current qualitative brief report was initiated by reviewing valid databases. Subsequently, the risk factors of hypertension were extracted using keywords such as "hypertension", "high blood pressure", "prevalence", "epidemiology", and "predisposing and risk factors". Then, each of these factors was conceptually matched to the fundamentals (4 qualities or Mizaj) of PM by Avicenna in his book named "The Canon of Medicine. Results: The known risk factors of hypertension were prone to occur in an individual before the onset of clinical hypertension due to his/her increased coldness (six items) and increased dryness (seven items). Given a few reports taking hypertension more associated with the warmth quality, it is probable that the patients with hypertension have a basically warm temperament, but they experience hypertension upon encountering with factors that result in increased coldness and dryness. Conclusions: Overall, the etiology and pathogenesis of hypertension can be better understood according to four qualities in PM. Therefore, hypertension is preventable in risky people by making modifications in lifestyle, and hence, changes in body qualities and orientation toward a relatively balanced state.

Objectives: Uterus is one of the most important organs of a woman which purifies the blood and carries a fetus and its function is related to the main organs like the brain, heart, liver, kidneys, and stomach. Uterine distemperaments are among the most important diseases of this organ and various symptoms are mentioned for them in Persian medicine (PM). Accordingly, the evaluation of these symptoms will help the diagnosis and treatment of different types of disorders related to the female reproductive system. Materials and Methods: This concept analysis qualitative study was conducted to collect and classify the symptoms of uterine distemperaments using a hybrid method and included theoretical, fieldwork, and analysis phases. In the theoretical phase, the resources of PM were reviewed, followed by interviewing the experts of PM and patients with uterine distemperament in the fieldwork phase. Finally, the guidelines were provided for diagnosing uterine warm and cold distemperaments. Results: The signs and symptoms of uterine distemperaments were classified into 5 general categories including menstrual blood characteristics (i.e., volume, consistency, color, smell, temperature, and outgoing speed), uterine discharges, pubic hair characteristics, other characteristics related to the female reproductive system, and the general symptoms. Eventually, the most important concepts were converted to a guideline of "Major and Minor Diagnostic Criteria for Uterine distemperaments". Conclusions: In general, the recognition of the symptoms of uterine distemperaments facilitates the prevention, diagnosis, and treatment of different types of gynecologic disorders. The results of the current study can be an appropriate basis for designing and standardizing diagnostic tools for uterine distemperaments and related diseases.

The concept of mizaj corresponds to the idea of personalized medicine and is the main diagnostic principle of Persian medicine (PM). This study aims to investigate diagnostic tools for the detection of mizaj in PM. In this systematic review of articles published before September 2022, articles were searched for in the Web of Science, PubMed, Scopus, Google Scholar, SID databases, and gray literature. The titles of the articles were screened by researchers and relevant articles were selected. Abstracts were reviewed by two reviewers to select final articles. Subsequently, the articles found were critically evaluated by two reviewers according to the CEBM method. Finally, article data were extracted. Of the 1812 articles found, 54 were included in the final evaluation. Of these, 47 articles were related to the diagnosis of whole body mizaj (WBM). WBM was diagnosed in 37 studies using questionnaires and 10 using expert panels. In addition, six articles examined the mizaj of organs. Only four of these questionnaires were found with reported reliability and validity. There were two questionnaires for assessing WBM, but neither had sufficient reliability and validity. Questionnaires that assess organs had weak designs and lacked sufficient reliability and validity.

Background and Objective: One of the essential concepts of the Persian medicine (PM) is temperament (mizaj), which have a special contribution in health maintenance. In the present study we aimed to investigate the association of the hand digit ratio with the temperament types and the symmetry of this ratio between the two hands in each group to see whether these properties have a potency to be applied as an index for mizaj identification. Methods: The study sample included 323 women aged between 20 to 32 years old. In order to obtain 2D:4D ratio, both hands were photographed from the palm side and then the length of index and ring fingers were measured using image J. Participants' temperament type was identified using a standard self-reported questioner. Findings: In respect of the digit ratio, there was no significant difference between the study groups neither in right nor in left hands (kruskal wallis test for right hand: chi-square=3.985, df=8 p=0.858; for left hand: chi-square=4.311, df=8 p=0.828). However, the results of paired sample t-test showed a significant higher digit ratio in the right hand compared to the left hand in the cold-moist group (t=3.28, df=66, p=0.002). Conclusion: The results of this study did not support the relationship between the digit ratio and temperament. However, individuals with cold-moist temperament showed asymmetry of the digit ratio. This finding suggests that the digit ratio asymmetry may has a potency to use as an index in the cold-moist mizaj identification. [ABSTRACT FROM AUTHOR]

Objectives: Mizaj (temperament) refers to a concept in Persian medicine and is the basis for defining health and disease. Brain, as the most important organ of the body (Aza-e-raeiseh), controls vital functions. So far, no standardized questionnaire has been designed for distinguishing temperament in Persian medicine. Therefore, the aim of this study was to provide a reliable objective self-report questionnaire and a standardized diagnostic checklist for Mizaj identification via determining their reliability and validity in Persian medicine. Materials and Methods: This was an exploratory sequential study in which we designed a 121-item questionnaire, and a 20-item checklist as an item pool using Mizaj-related indices searched in Persian medicine references. The number of items for questionnaire and checklist finally reached 35 and 12 after qualitative and quantitative assessments (e.g., content and face validities). The test-retest reliability of each question of the questionnaire and checklist and their consistency were evaluated by participation based on the weighted and Fleiss' kappa statistics, and intraclass correlation coefficient (ICC). The final version of the questionnaire and checklist were divided into two subscales (i.e., warm/cold and wet/dry), and the minimum and maximum scores were determined. Results: Significant findings of our data showed that the weighted and Fleiss' kappa coefficients of the 35-item questionnaire (between 0.4 and 0.9) and 12-item checklist (between 0.4 and 0.8) were found in the study based on their reliability. The degree of reliability in the self-report questionnaire was assessed using weighted kappa (WK), where 6 items of the questionnaire were omitted due to a WK less than 0.6 and the number of items reached 35. While 2 items of the checklist with Fleiss' kappa (FK) <0.2 were omitted and the number of items reached 12 items. WK coefficients of the 35-item questionnaire (between 0.4 and 0.9) and 12-item checklist (between 0.4 and 0.8) were found in the study, suggesting their reliability. The highest WK was found to be linked to sleep, and psychic and physical functions, suggesting the appropriateness of questions/items and design. The calculated ICC of the two stages for the warm/cold and wet/dry subscales of 35-item questionnaire was determined as 0.92 and 0.91, respectively, showing the stability of total score. ICC of the final score for the warm/cold subscale of the 35-item questionnaire was 0.88 (0.86 to 0.96), while this value was 0.91 for the wet/dry subscale (0.83 to 0.95). Conclusions: The present questionnaire and checklist were validated in terms of the design, reliability, and validity of a standard Mizaj determination questionnaire and checklist. The final questionnaire and checklist may be capable of distinguishing Mizaj of brain at the clinical and research levels for Persian medicine practitioners. [ABSTRACT FROM AUTHOR]

Acne is a multifactorial disease which causes many harmful physical and psychological effects for patients. Several therapies are used in conventional medicine for acne, but most of these methods are not stable and cause side effects. Therefore, it is considered to use complementary medicine alongside conventional therapies to achieve better results. In this article, a patient with chronic and severe acne is presented which is treated by a combination of temperament modification and leech therapy based on Persian medicine.

Objectives: Regarding the increasing prevalence of hypertension and its associated disabilities, it is beneficial for physicians to build on the potential of other medical schools like Persian medicine (PM) as it can provide useful knowledge of the factors leading to hypertension by identifying its pathogenesis in another medical attitude. Thus, the present study aimed at applying a strategy to prevent and treat hypertension. Materials and Methods: The current qualitative brief report was initiated by reviewing valid databases. Subsequently, the risk factors of hypertension were extracted using keywords such as "hypertension", "high blood pressure", "prevalence", "epidemiology", and "predisposing and risk factors". Then, each of these factors was conceptually matched to the fundamentals (4 qualities or Mizaj) of PM by Avicenna in his book named "The Canon of Medicine. Results: The known risk factors of hypertension were prone to occur in an individual before the onset of clinical hypertension due to his/her increased coldness (six items) and increased dryness (seven items). Given a few reports taking hypertension more associated with the warmth quality, it is probable that the patients with hypertension have a basically warm temperament, but they experience hypertension upon encountering with factors that result in increased coldness and dryness. Conclusions: Overall, the etiology and pathogenesis of hypertension can be better understood according to four qualities in PM. Therefore, hypertension is preventable in risky people by making modifications in lifestyle, and hence, changes in body qualities and orientation toward a relatively balanced state. [ABSTRACT FROM AUTHOR]

Objectives: Uterus is one of the most important organs of a woman which purifies the blood and carries a fetus and its function is related to the main organs like the brain, heart, liver, kidneys, and stomach. Uterine distemperaments are among the most important diseases of this organ and various symptoms are mentioned for them in Persian medicine (PM). Accordingly, the evaluation of these symptoms will help the diagnosis and treatment of different types of disorders related to the female reproductive system. Materials and Methods: This concept analysis qualitative study was conducted to collect and classify the symptoms of uterine distemperaments using a hybrid method and included theoretical, fieldwork, and analysis phases. In the theoretical phase, the resources of PM were reviewed, followed by interviewing the experts of PM and patients with uterine distemperament in the fieldwork phase. Finally, the guidelines were provided for diagnosing uterine warm and cold distemperaments. Results: The signs and symptoms of uterine distemperaments were classified into 5 general categories including menstrual blood characteristics (i.e., volume, consistency, color, smell, temperature, and outgoing speed), uterine discharges, pubic hair characteristics, other characteristics related to the female reproductive system, and the general symptoms. Eventually, the most important concepts were converted to a guideline of "Major and Minor Diagnostic Criteria for Uterine distemperaments". Conclusions: In general, the recognition of the symptoms of uterine distemperaments facilitates the prevention, diagnosis, and treatment of different types of gynecologic disorders. The results of the current study can be an appropriate basis for designing and standardizing diagnostic tools for uterine distemperaments and related diseases. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM), named Ziabites in Persian medicine (PM), was categorized as hot or cold Ziabites according to the Mizaj of patients. This study aimed to compare the Mizaj of patients with newly diagnosed type 1 DM (T1DM) with chronic cases and healthy children. Materials and Methods: In a case--control study, three groups including chronic T1DM patients (n = 31), newly diagnosed T1DM patients (n = 37), and healthy children as the control group (n = 80) were recruited. Mojahedi Mizaj Questionnaire was used to measure two subscales, hot/cold and wet/dry, of Mizaj for participants. The mean scores of the Mizaj subscales were compared between the groups. Cutoff values were determined using receiver operating characteristic analysis, and the corresponding odds ratio (OR) for each subscale was identified. Results: Overall 148 participants, with a mean age of 10.0 ± 6.2 years, were enrolled in the study. Analysis showed that the mean total heat and total dryness scores were significantly higher in new T1DM than that of chronic patients and healthy children (19.59 ± 1.7 vs. 16.6 ± 2.1 and 18.17 ± 1.9, P < 0.001 for hot/cold and 4.70 ± 1.0 vs. 4.09 ± 0.9 and 4.31±0.8, P = 0.02 for wet/dry). "Extra heat" based on the cutoff value of >18.5 was found to be a risk factor for T1DM (OR = 3.62, 95% confidence interval = 1.52-8.63). Conclusion: New T1DM patients have higher frequency of hot and dry Mizaj, which is consistent with the concept of hot Ziabites in PM. Most importantly, we found that "extra heat" in children can be considered as a risk factor for T1DM. [ABSTRACT FROM AUTHOR]

Traditional medicine has a long history of use in health maintenance and in disease prevention and treatment in different countries. Persian medicine (PM) is an old system rich in information about medicinal plants. Persian scientists have explained their beliefs about world phenomena by theory of quadruple temperaments as hot, cold, dry and moist. Makhzan al-Adviyah is one of the main PM herbal pharmacopeias. In this study, the useful medicinal plants for kidney, their temperament and suggested application were extracted from Makhzan al-Adviyah. Results obtained from this research showed that 66 plants with exact scientific name were mentioned in this pharmacopeia for kidney diseases. 65% of these plants have hot and dry temperaments which may be useful for restoring misbalanced temperaments of kidney diseases. From these plants, Pistacia lentiscus L. and Origanum vulgare L. showed beneficial effects to improve kidney disease through cellular and animal studies. Considering the long history and effectiveness of PM in the treatment of diseases, medicinal plants that presented in this study have important value for more research especially well designed clinical trials.

Background: Depression is one of the five most-common diseases globally, and is expected to be the second leading cause of disability by 2020 and its economic and social burden is a major problem worldwide. Objective: The aim of this research was to elucidate the causes and symptoms of depression according to Persian Medicine (PM) and classic medicine. Methods: In this study, works that were investigated were the Canon of Medicine, Al-Hawi Fi Teb, Kamel Al-Sina'a, Zakhireh Kharazmshahi and Exir A'azam. Classic medicine sources investigated were Kaplan and Sadock's Synopsis of Psychiatry and related articles in the Web of Science, Medline, Scopus, SID and Magiran. Research was done from January through April 2017, using keywords. Results: To explain the biologic causes, various factors including humoral dystemperaments, cold and hot dystemperaments of chief organs especially heart and brain and some qualitative and quantitative changes in medical spirit should be considered. According to manuscripts some mental-emotional events in life can cause these changes. They independently may cause depression. Semiologically some symptoms and signs happen consequently to in the above-mentioned causes which are in common with depression signs and symptoms including grief, crying, low libido, weight loss, appetite and sleep disorders, exhaustion, slow cognitive processing, indecisiveness and willingness to die. Conclusion: The major biological causes of depression is a group of dystemperamental syndromes (hot, cold, dry, and wet) on different bodily structures (humors, organs, and spirits). So preventive and therapeutic strategies for depression couldn't be the same for all patients and the treatment should be designed according to the exact diagnosis. [ABSTRACT FROM AUTHOR]

Arnebia, a sub cosmopolitan and important genus of the Boraginaceae family, comprises 25 species distributed among the world. Based on the studies of Persian medicine texts, there are some promising bioactivities for this genus that is unknown in modern medicine and some of them are still the basis of new remedies. This article presents Arnebia according to the most important ancient information by the most famous Persian medicine books like Makhzan Al Advieh, Tohfat Al-Momenin, Al-Qanun, Al-Seidaneh and Ekhtiarate Badiei. A search of electronic databases including PubMed, Scopus, Science Direct, and Google Scholar was done to find articles published between 1991 and 2017 on pharmacology and phytochemistry of Arnebia spp. In Persian medicine texts, Arnebia's different exclusive forms of preparations are effective for treatment of some disorders such as diarrhoea, amenorrhea, gout, kidney stone, jaundice, chronic fever and burn wounds. There are some activities that are the same in Persian and modern medicine research such as burn wound healing and fever amelioration. Phytochemical investigations on the title genus have led to characterization of many secondary metabolites. Naphthoquinones such as alkannins, shikonins, and their derivatives are the major constituents that have shown pharmacological activities in different Arnebia species. Among the major properties of Arnebia, only two of them (burn healing and fever amelioration) were investigated in modern medicine. The major aforementioned properties discussed in details in ancient sources might be a novel research sources leading to important discoveries in clinical usages of Arnebia. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM), named Ziabites in Persian medicine (PM), was categorized as hot or cold Ziabites according to the Mizaj of patients. This study aimed to compare the Mizaj of patients with newly diagnosed type 1 DM (T1DM) with chronic cases and healthy children. Materials and Methods: In a case–control study, three groups including chronic T1DM patients (n = 31), newly diagnosed T1DM patients (n = 37), and healthy children as the control group (n = 80) were recruited. Mojahedi Mizaj Questionnaire was used to measure two subscales, hot/cold and wet/dry, of Mizaj for participants. The mean scores of the Mizaj subscales were compared between the groups. Cutoff values were determined using receiver operating characteristic analysis, and the corresponding odds ratio (OR) for each subscale was identified. Results: Overall 148 participants, with a mean age of 10.0 ± 6.2 years, were enrolled in the study. Analysis showed that the mean total heat and total dryness scores were significantly higher in new T1DM than that of chronic patients and healthy children (19.59 ± 1.7 vs. 16.6 ± 2.1 and 18.17 ± 1.9,P < 0.001 for hot/cold and 4.70 ± 1.0 vs. 4.09 ± 0.9 and 4.31±0.8,P= 0.02 for wet/dry). “Extra heat” based on the cutoff value of >18.5 was found to be a risk factor for T1DM (OR = 3.62, 95% confidence interval = 1.52–8.63). Conclusion: New T1DM patients have higher frequency of hot and dry Mizaj, which is consistent with the concept of hot Ziabites in PM. Most importantly, we found that “extra heat” in children can be considered as a risk factor for T1DM.

"nTraditional Iranian Medicine (TIM) or Persian Medicine consists of the sum total of all the knowledge and practices used in diagnosis, prevention and elimination of diseases in Persia from ancient times to present. It is based entirely on practical experience and observations passed down from generation to generation."nTraditional medicine has the advantage of being considered as part of the culture therefore, bypassing cultural issues that may affect the practice of medicine. On the other hand, it can be used in conjunction with and as an aid to the conventional medicine. Development and promotion of traditional medicine could be considered as respect and honor to the culture and heritage of the people all around the world.