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Ulcerative colitis (UC) is a common chronic inflammatory disease. Although the current medication can greatly help to control the disease, the complications of these drugs have led to complementary treatments being taken into consideration. Ramak is a compound herbal preparation that is traditionally used in Persian medicine for intestinal ulcers and chronic diarrhea. Therefore, a clinical trial was conducted to evaluate the efficacy of Ramak , as a complementary treatment, for the management of UC. Forty patients with UC were randomly allocated to either Ramak or placebo capsules (250mg, once a day) for 10 weeks. Patients in both groups also received conventional treatment. The Simple Clinical Colitis Activity Index (SCCAI) was the primary outcome measure. Also, within- and between group comparisons were made based on 6 different items of SCCAI. There was a significant between group difference regarding SCCAI total scores at 4th, 6th, 8th, and 10th weeks (p < 0.05). Also, the time course showed stability of SCCAI total score in the Ramak group (p = 0.20). In addition, a significant difference was shown regarding the urgency of defecation and general health scores of the Ramak group vs. the control group (p < 0.001 and p = 0.03, respectively). It appeared that complementary treatment with Ramak may prevent symptom aggravation. Moreover, Ramak improved defecation urgency. However, further clinical trials with a larger cohort and longer intervention time are warranted for better decision making in clinical practice. [ABSTRACT FROM AUTHOR]

Lime Salve (L.S) has been well documented from the 9th to the 19th century AD by traditional Iranian medicine (TIM) as an effective remedy for burn healing. The present study was undertaken to evaluate the healing effect and related underlying mechanisms of Lime Salve in a model of deep second-degree thermal burn in male Wistar rats. L.S was made up of a combination of refined calcium hydroxide powder, beeswax and sesame oil and its quality control was assessed. A deep second-degree burn was created by a hot plate in 48 male Wistar rats. Afterwards, they were randomly divided into four groups including normal saline (C group), L.S (T group), basement of formulation composed of beeswax and sesame oil (B group) and silver sulfadiazine (S group). On days 5, 10, 17 and 24, the wounds were digitally photographed by a camera and after sacrifice of the rats, skin samples were obtained for performing qRT-PCR, immunohistochemistry staining and histological examination. L.S prominently augmented the wound closure rate, neovascularization on day 10 and collagen formation on days 17 and 24 in comparison with the C group. Furthermore, the Salve-exposed specimens showed a significant higher epithelialization during the experiment with a peak on day 24. qRT-PCR also showed that on day 10, VEGF and TGF-β1 genes were significantly higher in the T group as compared with the C group. Also, MMP-9 and MMP-2 genes had a significant peak of expression on day 17 and rapid reduction of expression on day 24. Expression levels of IL-6 and TNF-α genes peaked on day 10 in the T group, followed by a progressive reduction until the end of the examination. L.S could effectively accelerate the healing process of deep second-degree burn wounds and therefore, it may be recommended as a promising topical medication for treating burn wounds in the future clinical trials. Image 1 [ABSTRACT FROM AUTHOR]

Chickpea oil (Cicer arietinum L.) is considered to have anti-inflammatory properties and is of therapeutic importance. It has been used topically in Persian medicine and compared other treatments and it is easily available and low cost. In clinical practice patients applying chickpea oil have expressed their satisfaction. Given the lack of valid scientific studies, this randomised controlled trial was conducted to evaluate the effect of topical chickpea oil on knees affected by osteoarthritis. Patients (n = 75) referred to the rheumatology clinic with a diagnosis of osteoarthritis of the knee were randomly assigned into three groups; chickpea oil, piroxicam gel or paraffin and were treated for three months. Patients self-medicated massaging the oil into the affected knee twice a day for three months. Physical activity, stiffness and pain were measured at baseline and at the end of 3th month. The groups were compared at the end of treatment. WOMAC scores showed significant reduction in pain, stiffness, and difficulty in activity in the chickpea oil group compared with the piroxicam or paraffin group (p < 0.05). VAS mean pain scores were 5.42 for the placebo group, compared wih 3.92 for the piroxicam group and 3.88 the chickpea oil group, which was significantly different (P < 0.001). No adverse effects were reported by patients. The results of this study demonstrated that chickpea oil could be effective in relieving pain, reducing motion stiffness, and increasing activity in osteoarthritis patients. [ABSTRACT FROM AUTHOR]

Objectives: The roots and rhizomes of licorice (Glycyrrhiza glabra L.) are used in traditional Persian medicine for the treatment of numerous diseases. A chronic cough is a non-specific reaction to irritation anywhere in the respiratory system. It usually lasts for more than eight weeks. The current study aimed to evaluate the effect of a modified traditional Persian medicine preparation, licorice pastille, in healing a chronic cough.Methods: Through a randomized, double-blinded, placebo-controlled clinical trial was performed in a respiratory disease clinic in Shiraz, Iran; between October 2016 and December 2017. Seventy participants with a chronic cough took part in the trial. The outcome measures were as the daily cough scores (the score being logged via patient symptoms, diary, and the visual analogue scale) and the quality of life measure of chronic cough according to the Leicester Cough Questionnaire.Results: At baseline, there were no significant differences in the demographic or clinical (cough score) characteristics between the two groups. There was complete adherence to protocol in both groups but, the drop-out rate was 4 patients in the placebo and 6 ones in the intervention groups. The results at the end of the trial (Week 2) and follow-up (Week 4) demonstrated the efficacy of the licorice pastille in terms of the cough severity score against the placebo group. This item showed a significant decrease in the intervention group (1.2 ± 0.93) comparing to the placebo one (1.8 ± 1.03) at follow-up time. No major side effects were reported during the study and follow-up time.Conclusions: Licorice pastille could be a promising choice in the treatment of a chronic cough of unknown origin. [ABSTRACT FROM AUTHOR]

Asthma is a chronic respiratory disease that affects more than 300 million people worldwide. Refractory asthma (RA) is characterized by poor control despite adequate treatment. Conditions like RA have led to a renewed interest in non-conventional approaches to managing asthma such as those used in Traditional Persian medicine (TPM). The aim of this trial was to test a TPM formulation including Plantago major seed and Almond gum powder for asthma. Current patients with RA received 5 g of herbal combination (2 g of Plantago major and 3 g of Almond gum powder) which was added to their conventional treatment 3 times a day for 4 weeks. Outcome measures were taken at baseline and 4 weeks including lung function testing and asthma questionnaires: the Asthma control test (ACT) and Asthma quality of life questionnaire (AQLQ). 28 participants with average age of 54.7 ± 11.2 years were enrolled in the study. 4 participants withdrew from the trial due to reactions to the herbal formulation. There were increases in FEV 1 and FVC post-intervention compared to baseline (p < 0.01). The number of participants with wheezing decreased compared to baseline (p < 0.01). There were also improvements in cough, dyspnea, sleep quality and ACT. AQLQ results showed improvements in total, physical, emotional and social impact scores (p < 0.01). The results demonstrate that a combination of Plantago major seed and Almond gum is well-tolerated and potentially beneficial for patients with RA. Further research is warranted to ascertain the mechanisms and therapeutic effects of these ingredients. [ABSTRACT FROM AUTHOR]

Objective: Sesame oil is an herbal product that has been used to treat the joints pain in several traditional medicines. In this study, we evaluated the efficacy of topical sesame oil versus diclofenac gel in patients with knee osteoarthritis (OA).Methods: One hundred and four patients were randomly enrolled in two arms of the trial. Patients were treated by topical sesame oil or diclofenac (three times a day) for 4 weeks. Outcome measures were knee pain via visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, knee joint's flexion angle, 8-meter walk test and number of used analgesics. Patients were evaluated at baseline, 2 and then 4 weeks after the intervention.Results: At the follow-up visits, sesame oil was not inferior to diclofenac regarding scores of WOMAC pain, 8-meter walk test, and knee flexion angle. Although, its non-inferiority was not proved regarding scores of VAS, WOMAC stiffness, and WOMAC total at the 4th week. Moreover, sesame oil was not inferior to diclofenac regarding consumed analgesics.Conclusion: It seems that the topical sesame oil was non-inferior to diclofenac gel on the reduction of the knee OA pain and improvement of some indicators of its function. [ABSTRACT FROM AUTHOR]

Background: Cancer is one of the most prevalent diseases associated with heavy complications in treatment. Mucotoxic cancer therapies such as head and neck radiotherapy and some of the chemotherapy agents may lead to oral mucositis. In addition to its economic consequences, mucositis also affects patients' quality of life. In Traditional Persian Medicine (TPM) manuscripts, several medicaments have been suggested for the treatment of mucositis., Objective: Considering the public welcome for herbal medicine, the current evidence-based review study is conducted to investigate the herbal remedies which have been proposed for oral mucositis in TPM., Methods: At first, a comprehensive survey was done on Qanon fi al-Teb, which is the most important textbook of TPM; then the scientific name of the herbs was authenticated according to the botanical textbooks. At last, data banks including Scopus, Pubmed, Web of science and Science direct were investigated for possible relevant properties of each medicinal plant in the literature., Results: In total, 30 herbs are introduced in this study. According to the registered documents, 18 herbs are reported to have antioxidant, anti-inflammatory, antimicrobial, anti-nociceptive and wound healing properties of which the therapeutic effect of only a few herbs including Glycyrrhiza glabra, Malva sylvestris, Morus nigra, Punica granatum, and Solanum nigrum were directly evaluated against oral mucositis on the literature., Conclusion: Despite the lack of human studies on mucositis for the other discussed herbs, their related pharmacological properties can be considered for new natural drug discovery supported by medieval and traditional experiments., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objectives: Recently, more attention has been paid to herbal treatment in chronic rhinosinusitis (CRS) patients. Chamomile (Matrricaria chamomilla) has extensive clinical uses in traditional-Persian medicine for its therapeutic properties. This study aimed to evaluate the effects of chamomile extract on the clinical symptoms of patients with CRS in a university hospital., Materials and Methods: In a randomized double-blind placebo-group clinical trial, 74 CRS patients were examined by an otolaryngologist blinded to the study groups, and the effects of treatment (according to SNOT-22 questionnaire) and possible complications recorded. Statistical analysis performed using SPSS software version 21, and level of significance considered as P < 0.05., Results: Of the 74 patients (31 females and 43 male), 37 cases randomized in the intervention and 37 cases in the placebo group. The Lund-Mackay score, clinical findings in endoscopic nasal examination and mean score of the SNOT-22 were not significantly different at baseline visit between the two study groups. The adjusted mean score of quality of life during the four time periods in the intervention group (34.3, confidence interval of 95%: 31.8-36.7) was significantly lower than that of control group (45.9, confidence interval of 95%: 43.5-48.4) (P-value = 0.001). Also, clinical improvement in endoscopic nasal examination was significant in intervention group compared with placebo group., Conclusion: Chamomile extract is effective in further reducing the clinical symptoms and improving the quality of life of CRS patients., (Copyright © 2020. Published by Elsevier Inc.)

Introduction: Pomegranate is known as a functional food which has multiple health-promoting activities. It has been assessed for patients with metabolic syndrome. Specifically, an antidiabetic activity of its juice and plausible mechanisms for its action have been shown in multitudinous studies. The aim of this study was assessing the effects of complementary treatment with pomegranate seed powder (PSP) oral supplementation on patients with type 2 diabetes mellitus (T2DM)., Methods: Sixty patients were treated for 8 weeks by 5 g PSP or placebo, twice daily. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol, and triglyceride (TG) were recorded as the outcome measures at the beginning and after the intervention. The findings were analyzed using the independent t test and Mann-Whitney U test., Results: After 8 weeks, the mean differences of FBG, HbA1c, cholesterol, and TG were significantly decreased in the PSP group when compared with the placebo group (p value <0.05). In addition, post-intervention values of FBG and HbA1c were significantly lower in patients treated with PSP compared to the placebo group (p values = 0.02 and 0.01, respectively). However, the latter comparison regarding cholesterol and TG showed no significant differences (p values = 0.51 and 0.26, respectively)., Conclusion: It seems that complementary treatment with PSP may have beneficial effects on FBG and HbA1c of patients with T2DM. However, its effect on TG and cholesterol was equivocal., (© 2020 S. Karger AG, Basel.)

Aim: Aromatherapy products, hydrosol beverages and distillates containing essential oils are widely used for cardiovascular conditions. Investigation of the possible activity of their major constituents with the cardiovascular-related receptors may lead to developing new therapeutics. It also may prevent unwanted side effects and drug-herb interactions., Materials and Methods: A list of 243 volatile molecules (mainly monoterpene and sesquiterpene) was prepared from a literature survey in Scopus and PubMed (2000-2019) on hydrosols and essential oils which are used for Cardiovascular Diseases (CVD) and its risk factors (diabetes mellitus and hyperlipidemia). The PDB files of the receptors (229 native PDB files) included alpha-glucosidase, angiotensin- converting enzymes, beta-2 adrenergic receptor, glucocorticoid, HMG-CoA reductase, insulin, mineralocorticoid, potassium channel receptors and peroxisome proliferator-activated receptoralpha, were downloaded from Protein Data Bank. An in silico study using AutoDock 4.2 and Vina in parallel mode was performed to investigate possible interaction of the molecules with the receptors. Drug likeliness of the most active molecules was investigated using DruLiTo software., Results: Spathulenol, bisabolol oxide A, bisabolone oxide, bergapten, bergamotene, dill apiole, pcymene, methyl jasmonate, pinocarveol, intermedeol, α-muurolol, S-camphor, ficusin, selinen-4-ol, iso-dihydrocarveol acetate, 3-thujanone, linanool oxide and cadinol isomers made a better interaction with some of the named receptors. All of the named molecules had an acceptable dug likeliness except for α-bergamotene. In addition, all of the named molecules had the ability to pass the bloodbrain barrier and it is possible to produce unwanted side effects., Conclusion: Some ingredients of essential oils might be active on cardiovascular-related receptors., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Obesity is a common health concern among all populations and age groups worldwide and is a risk factor that leads to a significant increase in mortality and cardiovascular diseases, type 2 diabetes, metabolic syndrome, stroke, and cancer. Disappointing results and weight regain after stopping lifestyle modification or drug therapy indicate the need for other methods of treatment to achieve better and longer effective results., Objective: In this study, the effects of the Apiaceae plants, including Carum carvi L., Bunium persicum Boiss., Cuminum cyminum L., Anethum graveolens L., Foeniculum Vulgare Mill. and Trachyspermum ammi L., in the TPM to treat obesity, were compared to a modern database, covering all in vivo and clinical trials on animal models or humans., Methods: In TPM sources, we used the keywords, "Saman-e- Mufrat", "Hazāl", and "Mohazzel". Each of the six plants was searched in the electronic databases, including Pubmed, Scopus, and Embase from 1975 to 1/1/2020 using keywords, namely "body mass", "body weight" and "obesity"., Results: The results indicated that six plants had reducing effects on body weight, BMI, fat mass, and appetite in almost all clinical studies on humans and some studies on animals., Conclusion: Since the TPM is a rich source of information about the medicinal properties and effects of medicinal plants, investigating the therapeutic effects of plants from the perspective of TPM can represent the vision of a new horizon in the treatment of many diseases., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Atopic dermatitis (AD) is a chronic inflammatory pruritic dermatologic disease in children. Malva sylvestris L. (M. sylvestris) is a medicinal plant, which is used as a remedy for eczema in traditional Persian medicine. Previous studies have shown the anti-ulcerogenic and anti-inflammatory activity of this plant., Objective: We designed a clinical trial to evaluate the efficacy of topical cream of the M. sylvestris extract in the management of children with AD., Methods: Fifty-one children with AD were randomly enrolled in two arms of a randomized, double- blind, controlled clinical trial. They were treated by topical cream of the M. sylvestris extract or placebo for a palm-sized surface (single fingertip unit, twice daily) for 4 weeks. The SCORing Atopic Dermatitis (SCORAD) score was set as the primary outcome measure., Results: There was a significant improvement in the severity of participants' dermatitis regarding skin thickening score, redness score, and total SCORAD score of the M. sylvestris group as compared with the placebo group (P= 0.009, P=0.01, and P=0.03; respectively)., Conclusion: According to the results of this clinical trial, it could be concluded that the topical use of M. sylvestris extract cream was effective in the reduction of AD symptoms in children., Trial Registration: This study is registered by the Iranian Registry of Clinical Trials with the code: IRCT20170107031814N2., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Proper and regular sweating plays a significant thermoregulatory role. It is a common perception that, sweating has other important homeostatic functions such as clearance of excessive micronutrients, waste products of metabolic processes, and toxins from the body, which helps to maintain human good health. In addition, sweating, thermotherapy, and sauna are commonly used to treat various diseases such as cardiovascular, respiratory and joint diseases. In traditional Persian medicine (PM) textbooks, sweating is considered a preventive care and treatment strategy as well. In this study, we aim to explain the beneficial effects of sweating in human health and its role in the management of various diseases, as well as introducing the therapeutic applications of some diaphoretic plants from the viewpoint of PM. We reviewed the most famous PM textbooks such as Kamil al-Sinaa al-Tibbiya , Al-Qānūn fī al-Tibb , Zakhireye Kharazmshahi , Kholasat al-Hikmat , Exir-e-Azam , and Hifzos-sihhat-e Naseri . Also, current evidence was searched in PubMed, Web of Science, Scopus, and other relevant databases related to the topic. The results of this study revealed that PM scientists believed proper sweating removes waste products and maintains the body's health, thus, any disturbances in the excretion of these waste products can cause diseases. They recommended the induction of sweating through hot and dry baths, sun bath, sand bath and also the use of diaphoretic herbs for the management of various diseases. Therefore, further researches are recommended to evaluate the effectiveness of these diaphoretic plants., (Copyright© 2020, Galen Medical Journal.)

Background: Obesity is a major public health problem and its occurrence is markedly increasing in developed and developing countries. However, few studies have investigated the use of natural products to treat obesity. The effects of taking a combination of oxymel and Zataria multiflora Boiss. (ZM), herein referred to as Zataria oxymel (ZO), on obesity, lipid profile and insulin resistance have not yet been studied., Objective: This study evaluates the effects of oxymel and ZO on obesity, lipid profile and insulin resistance., Design, Setting, Participants and Interventions: In this randomized, controlled, triple-blind trial, overweight patients were randomly divided into three groups and received doses of study compounds twice per day for twelve weeks. Group A received 0.75 g ZM in 10 mL oxymel in each treatment; group B received 1.5 g ZM in 10 mL of oxymel in each treatment and group C (control) only received 10 mL of oxymel in each treatment., Main Outcome Measures: Anthropometric parameters, including body mass index (BMI), waist circumference and hip circumference, were measured at the time of registration. Blood tests were carried out at the beginning and once again at end of the study. Blood parameters included fasting blood sugar (FBS), insulin levels, serum lipid profile (total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol) and liver enzymes (aspartate transaminase and alanine transaminase). Serum creatinine was also measured at the beginning of the project and in monthly intervals for three months. The homeostasis model assessment index was calculated as fasting insulin (μIU/mL) × FBS (mg/dL)/405., Results: The results showed that patients receiving ZO experienced significant reduction in waist circumference in groups A, B and C, respectively (P < 0.001) but no significant change in BMI. Group A also experienced reduction in hip circumference (P = 0.01). Groups B and C had reduction in the homeostatic model assessment of insulin resistance (P = 0.05 and P = 0.01, respectively), with no significant reduction in FBS. No effect on lipid profile, liver enzymes or serum creatinine was observed in the three groups., Conclusion: In this study, treatment with ZO and oxymel reduced insulin resistance, and waist and hip circumferences in overweight patients. Nonetheless, the traditional Persian use of ZO as a beverage to improve the anthropometric indices in overweight individuals still requires further research with a larger sample size., Trial Registration: Iranian Registry of Clinical Trials Code IRCT20171220037976N1., (Copyright © 2020. Published by Elsevier B.V.)

Background: Attention deficit hyperactivity disorder (ADHD) is a common, chronic, neurodevelopmental disorder that manifests in childhood with symptoms of hyperactivity, inattention, and impulsivity. Ma'aljobon (a kind of whey protein) that is derived from milk during cheese producing process is a popular dietary traditional product supposed to provide immune modulation and prevent neuropsychiatric disorder. We aimed to evaluate the efficacy of ma'aljobon in management of Attention-deficit/hyperactivity disorder (ADHD)., Materials and Methods: In this open-label randomized, double arm, and controlled clinical trial, sixty four patients with ADHD who referred to out-patient child and adolescent clinic of Khorshid Hospital of Isfahan , Iran, were randomly assigned in the intervention group ( ma'aljobon 25 g once daily plus standard conventional treatment (SCT)) or control group (SCT only) for a period of 8 weeks. Scores of the Strengths and Difficulties Questionnaire (SDQ) and Conners' Continuous Performance Test (CPT) were set as the outcome measures., Results: Parent reported hyperactivity scale of SDQ showed a significant decrease in the intervention group compared to the control group (P=0.04). However, no significant between groups differences were observed in other scales of parent-reported SDQ. Also, according to the results of CPT, there was a significant improvement in the intervention group regarding attention and focus score (P=0.01)., Conclusion: Ma'aljobon might be considered as a complementary remedy for improving hyperactivity, attention and focus of children with ADHD. However, further researches with larger sample size and longer duration should be done for achieving more reliable results., (Copyright© 2020, Galen Medical Journal.)

Objective: To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma., Methods: This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, from May the 1 st through November 30 th , 2016. The patients were randomly assigned to two groups using block randomization. The intervention group received topical sesame oil extracted from tahini (Ardeh) and the placebo group received cooking oil. Pain severity, pain sensitivity and heaviness of painful site were assessed., Results: Overall, we included 90 patients with traumatic limb injuries in this study who were randomized to two study groups. The mean age of the patients was 28.3 ± 6.8 (ranging from 25 to 35) years and there were 63 (70%) men and 27 (30%) women among the patients. In the sesame oil group, the mean changes in the pain severity (-1.53 ± 0.57, P<0.001), pain sensitivity (-1.45 ± 0.64, P<0.001) and heaviness of painful site (-1.56 ± 0.68, P<0.001) were significantly lower when compared to the placebo group in the second day of the intervention. None of the patients experience adverse drug effects., Conclusion: Our findings suggest that the topical use of sesame oil extracted from Tahini has a pain reliever effect on the skin after bruising and it helps prevent skin discoloration in patients with traumatic injuries of limbs.

As time goes on, a greater number of people experience an age of more than 60 years old and subsequently geriatric syndromes are increasingly more common. Despite recent improvements in modern healthy living, literature on traditional Persian medicine (TPM) about the prevention and treatment of such syndromes and healthy living of the elderly is hardly known. We aimed, in this study, to explore some traditional Persian sources and briefly explain their writers' beliefs on keeping healthy living for old people. We used several TPM sources and literature, and then based on these texts, we collected issues about geriatric temperament and syndromes and classified the results including exercise, nutrition, massage, bathing, aromatherapy, and sleeping. Our search yielded some recommendations about a healthy lifestyle for the elderly, which are in fact equivalent to primary, secondary, and tertiary preventive measures in modern medicine. Our results also showed that they believed such modifications would help the elderly to improve their geriatric conditions. In general, TPM provides some pieces of advice to prevent and treat geriatric syndromes that may be helpful in practice although the scope of their effectiveness remains to be examined in carefully designed randomized controlled trials., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)

Background and Aim: An Aphrodisiac includes any drug and food that arouses sexual instinct, induces venereal desire, and increases pleasure and performance. The present study was designed to clinically evaluate efficacy and safety of Herbal Based Syrup (HBS) composed of Tribulus terrestris L., Panax ginseng C.A. Meyer., Zingiber officinale Rosc, Ceratonia siliqua L., Papaver rhoeas L., and Palm tree pollen on sexual experience of men., Experimental Procedure: The study was designed as a double-blind randomized clinical trial. The main outcome measures were the responses obtained from using the Arizona Sexual Experience Scale (ASEX). The ASEX was completed by 100 married and seemingly healthy men before and after taking one dose of HBS or placebo and at least one sexual intercourse. In addition, possible side effects were observed. A split-plot ANOVA (SPANOVA) design was used for statistical analysis., Results: Results of analysis of data for each variable of the ASEX showed significantly lower scores in HBS-treated group compared to the placebo (control) group in items of desire, arousal, erection, orgasm and satisfaction (p < 0.05). No drug-related serious adverse events were observed., Conclusion: Results of this study indicated a significant improvement in sexual experience of men following consumption of HBS. Due to various complications reported about the use of chemical sexual drive enhancers, HBS can be introduced as an alternative with fewer side effects., Competing Interests: The authors declare that, there are no known conflicts of interest associated with this publication, and it should be mentioned that, no significant financial support has been received for the present work that could have influenced its outcome., (© 2020 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.)

Objective: This study investigated the biochemical, histopathological and physiological effects of Citrullus colocynthis on peripheral neuropathy in rats with streptozotocin (STZ)-induced diabetes., Methods: Seventy adult male Sprague-Dawley rats were included in the present study. Diabetes was induced in 60 rats, with a single intraperitoneal injection of STZ (65 mg/kg). After 4 weeks, the diabetic rats were assessed for neuropathy. Then, the diabetic rats with neuropathy were randomly divided into 6 groups for a 4-week treatment with gabapentin, oral administration of C. colocynthis fruit pulp powder (100 and 300 mg/kg per day), topical preparations as oil-based solution and ointment, or placebo. Changes in metabolic, physiological, biochemical and histological parameters were considered as treatment outcomes., Results: Metabolic outcomes (body weight and blood glucose level) were improved in the C. colocynthis-treated groups as compared to placebo. Tail-flick and hot-plate tests also had lower latency in the C. colocynthis-treated groups. Measurement of oxidative stress markers (malondialdehyde, superoxide dismutase and catalase) showed the antioxidant effect of C. colocynthis. Histological evaluation of the sciatic nerve showed that C. colocynthis decreased the number of demyelinated and degenerated nerve fibers. Among the C. colocynthis-treated groups, the one receiving 100 mg/kg power per day orally had the best treatment outcomes., Conclusion: The present study showed that C. colocynthis fruit, through its antioxidant and hypoglycemic activities, has a positive effect in the treatment of diabetic neuropathy., (Copyright © 2019 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.)

Traditional Persian medicine (TPM) proposes a different viewpoint to the chronic diseases. Diagnosis and implemented treatment are based on individual differences among patients. Constipation or Ea'teghal-e-batn is a condition in which the patient develops difficult or painful defecation. Based on TPM concepts, the fifirst digestion step starts from halq (oral cavity), and ends via defecation from the maq'ad (anus). Avicenna believed that four faculties, ha'zemeh (digestive), ja'zebeh (absorptive), ma'sekeh (retentive) and da'fe'eh (propulsive), are involved in the process of digestion and absorption of the ingested food and expelling the waste materials. The bowel movement and appearance of the stool is a measure for evaluating the gastrointestinal healthy function. Defecation should be with no pain and fecal material should have no burning and acuity. Low food intake or foods with dry temperament, dryness of gastrointestinal tract, diaphoresis and heavy exercise as well as intestine sensory loss were discussed as main causes of constipation. Management of constipation in TPM includes dietary schemes, oil massages and subsequently simple herbal medicines. According to TPM theories, the fifirst step in treating a disease is the elimination of disease causes (asbabe- maraz) and also providing the causes of health (asbab-e-sehhat). Health care providers should know the proper condition which the herbal medicines should be administered in and be able to guide the patients about the benefifits and hazards of herbal remedies, commonly used in their living origin.

Background: Dry eye disease is a disorder of the tear film. In this study, the effect of Viola odorata L. oily extract was examined for the treatment of patients suffering from dry eye disease., Methods: A randomised, double-blind, placebo-controlled study was designed. During the trial, Schirmer's test, tear breakup time, Oxford staining and the Ocular Surface Disease Index were assessed. Overall, 105 patients with dry eye symptoms between the ages of 18 and 60 years were allocated to the violet-almond oil, almond oil and placebo (1% w/v hydroxypropyl methylcellulose solution) groups. The treatment and placebo were administered intranasally, two drops three times a day for one month. The patients were followed up for four weeks. A total of 91 patients (32, 29 and 30 in the violet-almond oil, almond oil and placebo groups, respectively) completed the study., Results: At baseline, there was no difference between the three groups in terms of demographic data and the measurement parameters. After the intervention, the results revealed that the Schirmer's score without local anaesthesia and the tear breakup time results significantly improved in the violet-almond oil group. One-way ANOVA indicated a significant improvement in the Schirmer's score, tear breakup time and Ocular Surface Disease Index of the treatment group, as compared with the other groups (p < 0.05). However, the obtained results did not present any significant mean difference between and within the groups of the Oxford staining grade (p > 0.05)., Conclusions: This trial showed that the intranasally administered V. odorata L. oily extract enhances tear production and improves tear film stability., (© 2019 Optometry Australia.)

Water is the main component of our body and its balance is vital for maintaining normal physiology. Accordingly, adequate fluid intake in the daily diet is very important for a healthy life. Nevertheless, there is a controversy about what the suitable amount of water that we need to drink is. In this paper, we aimed to discuss this important issue based on the doctrine of traditional Persian medicine (TPM) and our clinical experience in a practical manner. [ABSTRACT FROM AUTHOR]

Microbial plaque is known to be the most important causative agent of periodontal disease. Since plaque control by mechanical methods is not enough to keep the gingival health in many people, attention has been brought to medicinal treatments, including mouthwashes. The purpose of this study was to investigate the efficacy of asafoetida versus chlorhexidine gluconate (CHG) mouthwash. This study was a double-blind randomized active-controlled clinical trial. One hundred and twenty six patients were randomly assigned into two groups of asafoetida and CHG mouthwashes. They were advised to use 15 ml of their prescribed mouthwash twice daily for a period of 7 days. Before enrollment and then at the end of the 7th day of intervention, the plaque index (PI) and modified gingival index (MGI) were measured. Moreover, safety measures were monitored during this period. After the intervention period, improvement of MGI mean difference was observed in both of the asafoetida and CHG groups (0.9 ± 0.7 vs. 0.4 ± 0.5, respectively). Also, there was an improvement regarding PI mean difference in both of the asafoetida and CHG groups (1.8 ± 0.6 vs. 0.9 ± 0.6, respectively). However, mean differences of MGI and PI in the asafoetida group showed a significant reduction, compared to the CHG group (P < 0.0001). It should be noted that no serious side effects were observed. Considering the results, it seems that asafoetida mouthwash can be recommended as an efficient herbal mouthwash for improving the indices of gingival health. However, future studies on larger cohorts with longer intervention periods are necessitated. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the antianxiety effect of Citrus aurantium aroma (neroli oil) inhalation on patients with acute coronary syndrome (ACS). Design: A double-blind, placebo-controlled randomized trial. Setting/Location: This study was conducted in the Coronary Care Unit of Torfeh Hospital in Tehran, Iran, from September 2017 to February 2018. Subjects: A total of 140 hospitalized ACS patients (mean age = 56.72 ± 11.38 years) Interventions: Eligible patients were randomly assigned to citrus aroma and placebo groups to receive inhalation aromatherapy 2 days after hospitalization. Citrus aroma was 30% essential oil of Citrus aurantium L. flowers in paraffin, which was administrated three times a day. The placebo group received paraffin similarly. Outcome measures: The rate of anxiety was measured at baseline and after intervention using the State-Trait Anxiety Inventory. Results: At baseline, citrus aroma and placebo groups were similar in demographic characteristics as well as anxiety scores. After intervention, mean anxiety scores in the two groups become significantly different; the scores were 34.66 ± 9.6 and 42.36 ± 6.4 for citrus aroma and placebo groups, respectively ( p  < 0.0001). No side effect was observed. Conclusions: According to the current findings, aromatherapy with Citrus aurantium L. aroma (neroli oil) may be a safe and efficient intervention and can be considered an easy and applicable method to reduce anxiety in patients with ACS.

Insomnia is a common complaint in outpatient clinics. It usually affects quality of life neg-atively, especially in severe cases. Nowadays, routine medical interventions comprise pharmacological approaches and cognitive behavioral therapy. Common medications used by afflicted patients are not competent enough in addition to their annoying side effects. It would naturally denote the need for considering novel strategies for treating insomniac patients. Approach to insomnia in traditional Persian medicine (TPM) has been cited in a scrutinized manner focusing on its main causes. Accordingly, its treatment is tailored based on the constitution of the patient, intensity of the disease, and type of the cause. In this paper we have discussed the causes of insomnia, diagnostic approach, and various medical interventions proposed in valid sources of TPM.

Objective: To investigate the effect of the Carum carvi (Bunium persicum Boiss) plant, a gas solvent, on resumption of bowel motility after caesarean section. Materials and methods: A randomized controlled trial was done on a group of 98 women undergoing elective caesarean section under general anesthesia in a university hospital. Patients in the intervention group (Group A) drank 10 ml of a syrup containing 8 g of Bunium persicum Boiss in 20 ml of syrup 6 to 7 hours after surgery. The control group (Group B) comprised 10 patients who drank 10 ml of placebo syrup 6 to 7 hours after surgery. Demographic characteristics, time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement, and length of hospital stay were compared between the two groups. Results: Compared with the control group, the intervention group had a significantly shorter mean time to hearing the first intestinal sounds (10.66 ± 2.38 vs. 19.54 ± 3.85 h), mean time to first flatus (13.91 ± 3.73 vs. 24.82 ± 5.83 h), mean time to first bowel movement (19.31 ± 4.63 vs. 30.70 ± 10.21 h), and mean length of hospitalization (31.70 ± 7.70 vs. 49.20 ± 10.16 h) (p < 0.05). No patients developed serious side effects associated with consumption of the syrup. Conclusion: The use of a gas solvent such as Bunium persicum Boiss after caesarean section can speed the resumption of postoperative bowel motility., (Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences.)

Background Diabetic patients are at increased risk for coronary artery disease. Since phytotherapy has been greatly common, finding safe and effective treatments is of importance. This study aimed to evaluate the effects of a Melissa officinalis L. based product (MO) in patients with type 2 diabetes. Methods A randomized double-blinded controlled study was conducted with 37 dyslipidemic diabetic patients, assigned to either MO or placebo (P) groups receiving two 500 mg capsules daily for 3 months. Finally, 32 cases completed the study and were included in the analysis; MO (n=16) and P (n=16). Results Safe and significant effects in terms of decreasing the serum level of triglyceride (TG) in all patients after 2 months (p-value=0.02) and in patients with higher baseline serum levels of TG (TG≥200 mg/dl) after 3 months (p-value=0.04) were shown in the MO group. However, no metabolic significant changes were seen compared to the control group. Significant decrease in both systolic and diastolic blood pressure from baseline values were also found in patients with higher systolic blood pressure (SBP≥130 mmHg) (p-value=0.02) and those with higher diastolic blood pressure (DBP≥85 mmHg) (p-value=0.02) in the MO group. Conclusion This study showed that MO might be safe and beneficial in decreasing the serum TG level in dyslipidemic diabetic patients. Although, larger long-term studies are required.

Background Despite growing demand for medicinal plants, there is little data about their use by patients with dyslipidemia. We aimed to determine the prevalence, pattern, and associated factors for the use of medicinal plants among patients with dyslipidemia. Methods A 17-item semi-structured questionnaire was filled out by 195 patients with dyslipidemia in a cross-sectional study carried out in two academic endocrinology clinics in Shiraz, Iran. The questionnaire comprised of three main domains of demographic data (6 questions), clinical data (2 of them), and data related to the use of medicinal plants (totally 9 questions). Results A total of 77.4% of patients took medicinal plants. The most common medicinal herbs used by dyslipidemic patients were Zataria multiflora, Cinnamomum zeylanicum, and Zingiber officinale. Duration of dyslipidemia was significantly longer in herbal users than non-herbal users (p=0.04). Patients believing that concomitant use of conventional drugs and herbal preparations had synergic positive effects in addition to those persuaded that herbal preparations possessed less side effects, were significantly more likely to use medicinal plants (p=0.008 and 0.005, respectively). Additionally, most of the medicinal herb users (87.4%) changed neither the pattern nor the dosage of their medications all during herbal preparations use. Conclusions This study demonstrated a high prevalence of medicinal plants' use among patients with dyslipidemia, which was associated with the duration of dyslipidemia, patients' viewpoints about herbal preparations' synergic positive effects, and their fewer side effects.

Objective: Cassia fistula L. fruit extract has been traditionally used in the treatment of pemphigus vulgaris (PV) lesions in Iran. The aim of this study was to determine the efficacy of C. fistula fruit gel on healing time of PV lesions in a clinical setting., Materials and Methods: This was a randomized, double-blind placebo-controlled clinical trial that was performed in dermatology ward at Saadi hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Right- or left- sided lesions of PV patients on standard systemic treatment were randomized for treatment with either C. fistula fruit gel or placebo prescribed twice daily. The largest diameter of each lesion was measured at the baseline (day 0) and on days 10 and 20. Epithelialization Index (EI), as outcome measure was calculated and compared between the two groups., Results: The present study comprised 20 patients, with overall 82 cutaneous lesions including 41 lesions in the C. fistula fruit gel group and 41 lesions in the placebo group. The EI in the C. fistula fruit gel group was significantly higher than that of the placebo group both on day 10 (65±28vs 30±34; p=0.001) and at the end of the study (91±22 vs 69±49; p=0.003)., Conclusion: Topical application of C. fistula fruit gel can be considered as an effective adjuvant therapy in treatment of PV., Competing Interests: No potential conflict of interest was identified in this study.

Objectives: Psoriasis is a chronic inflammatory skin disease with a recurrent nature. Treatment of this disorder takes long due to patients' non-compliance and its severe side effects. Traditional Persian medicine (TPM) is an ancient medical system dating back to 6000 years ago, originating from Persian regions, the most important of which was Iran. This research is designated to determine the treatments and natural remedies that ancient Iranian scientists have used to treat lesions described with symptoms close to common modern psoriasis. One of the complexities of using TPM known diseases is describing and finding the current medical problems in the traditional medicine manuscripts. Materials and Methods: In this study, using TPM treatment books such as, Tebb-e- akbary, Exir-e-azam, Moalejat-e-Aghili and Alhavy, the symptoms of psoriasis were matched with diseases that were described with similar symptoms as psoriasis, such as Bahaq-e- asvad, baras-e- asvad, saafe, Guba. Search for herbal remedies was done using the keywords found in the main TPM manuscripts, especially in remedy (Mofradat) and treatment (Moalejat) TPM books. Herbs mentioned for different TPM keywords were investigated for effects on psoriasis. Searches were performed in the digital libraries and databases with the keywords including "Psoriasis", "keratinocytes", "inflammation" and "Skin disorder" without time limit. Results: According to Iranian humoral medical system, we introduced categorized lists of causes of diseases and the treatments used including mineral and herbal remedies and combinations used orally and topically and advises regarding lifestyle modification. [ABSTRACT FROM AUTHOR]

Aim: Bitumen is a natural substance effusing from rocks' notches in some highland areas; it has been known as an effective remedy for treating some illnesses. Considering pain relieving properties of bitumen in traditional Persian medicine (TPM) sources, this study aims to review the viewpoints of TPM sages regarding bitumen in the context of traditional Persian medicine. It also provides applicable information for interested researchers to conduct well-designed clinical trials and evaluate therapeutic effects of bitumen claimed in TPM sources., Material and Method: Various databases including Embase, SID, IRANDOC, IranMedex, Scopus and PubMed were searched with keywords "bitumen" and "Shilajit". Furthermore, main traditional Persian medicine sources including Avicenna's "Canon of medicine", "Continens Liber" by Razes, "The storehouse of medicaments" by Aghili, "Gift for the faithful" by Momen Tonekaboni and "Measure for medicine" written by Muhammad Akbar Shah Arzani were reviewed with Persian keywords "Moomiaii" and "Mumnaei" Results: According to TPM sources, bitumen was used by Iranian's physicians to treat a wide range of diseases. It was known especially as an effective remedy to improve gastrointestinal digestive problems., Conclusion: Bitumen is cited in traditional Persian medicine sources as an effective remedy for treatment of a wide range of diseases, especially GI disorders and bone pain. Recent studies showed the beneficial effects of bitumen in treatment of wound healing, however using it in medical practice for other health dilemma should be confirmed by conducting well-designed clinical studies in the future.

Quince (Cydonia oblonga Mill) is a popular medicinal herb in different traditional medicines. Concentrated quince fruit extract, also known as quince sauce (QS), is traditionally used for the treatment of a variety of gastrointestinal disorders. The aim of this study was to compare the efficacy of QS versus ranitidine on gastroesophageal reflux disease (GERD) in pregnant women. We compared the efficacy of 4 weeks of ranitidine (150 mg, twice daily) with the efficacy of QS (10 mg, after meals) on 137 pregnant women with GERD. Their General Symptom Score (GSS) and Major Symptom Score (MSS) were compared at the baseline, 2 weeks and 4 weeks after intervention. After 2 weeks of the study, the mean GSS score of the QS group was significantly lower compared with the ranitidine group (p = .036). Although, the GSS value at the end of the study had no difference between groups (p = .074). However, the MSS of the different symptoms of the two groups at 2 weeks and 4 weeks had no significant differences. It seems that the efficacy of QS for the management of pregnancy-related GERD is similar to ranitidine. Impact statement What is already known on this subject? Quince is a traditional gastric tonic, an appetiser, and a remedy for nausea/vomiting and epigastric pain. Also, there are several previous positive experiences about quince products for GERD treatment. What do the results of this study add? It seems that the efficacy of QS for the management of pregnancy-related GERD is similar to ranitidine. What are the implications of these findings for clinical practice and/or further research? QS can be suggested as an alternative medicine for pregnant patients with GERD.

Purpose: In Traditional Persian Medicine (TPM), different natural treatments have been suggested for skin damages such as Narcissus tazetta L. bulb application. New drug delivery systems such as niosomes have shown considerable increase transdermal drug delivery through stratum corneum, the main barrier against substances transport into skin. The aim of this study is preparation of niosomal formulations from N. tazetta bulb extract and evaluation of its in vitro wound healing effect., Materials and Methods: Non-ionic surfactant vesicles (NSVs or niosomes) were prepared by film hydration method from percolated extract of N. tazetta bulb. A number of 12 niosomal formulations (F1-F12) were prepared using different proportions of Span 60/Tween 60/cholesterol and 80% methanol-dissolved/aqueous PEN (percolation extract of N. tazetta) (30 and 50 mg/ml). Their morphology, particle size, physical and chemical stability and encapsulation efficiency was studied. In vitro wound healing effect of various concentrations of the best PEN niosomal formulation (F9) was evaluated in comparison to PEN on human dermal fibroblasts (HDFs)., Results: Increasing the aqueous/methanolic PEN concentration from 3 to 5% resulted size reduction of NSVs with statistically significant difference (p < 0.05). F9 showed the most physicochemical stability and was chosen for in vitro wound healing effect. This formulation exhibited significantly effects (p < 0.05) on cell proliferation in HDF cells at 1.562 and 3.125 μg/ml compared with the untreated cells using neutral red assay., Conclusion: Formulation of PEN in niosome carrier significantly decreased the gap width on human dermal fibroblasts. Graphical abstract Schematic processes of proliferation effect of narcisus tazetta bulb on fibroblast cells.

Historical literature on portal hypertension is mainly focused on the contemporary advances in therapeutic methods, especially surgical ones. However, it seems that the origin of the human knowledge on the portal system, its association with the caval system, obstructive pathologies in this system and the gastrointestinal bleeding due to hepatic diseases might be much older than previously believed. Avicenna provided a detailed anatomy of the portal venous system and its feeding branches in the Canon of Medicine. Soddat al-Kabed va al-Masarigha (liver and mesenteric occlusion) is also a disease presented by Avicenna with clinical, etiological and therapeutic descriptions suggesting the fact that Soddat al-Kabed va al-Masarigha has multiple similarities with the currently identified concept of "portal hypertension". He presented sense of heaviness in the liver area with or without mild pain, anemia, pale and inappropriate body color, and loose stool which can be complicated with ascites, infection, fever and abdominal pain as clinical manifestations of this disease. He has also suggested therapeutic approaches including laxative and diuretic herbs to help excreting the obstructive material into stool or urine.

Background: Herbal distillates have been used for many centuries as herbal medicines in Traditional Persian medicine. The main purpose of this study was to determine methanol and ethanol contents in commonly-used industrial herbal distillates produced by three famous factories in Khorasan Razavi, Mashhad, Iran (2014-2015)., Methods: Ninety herbal waters of ten types of most commonly used herbal distillates including Willow (Salix alba) , Ajava seeds ( Carum copticum ), Fennel ( Foeniculum vulgare ) , Poleigamander (Teucrium polium) , Forty plants, Peppermint (Mentha piperita) , Camel thorn (Alhagi camelorum) , Chicory (Cichorium intybus) , Fumitory (Fumaria officinalis) and Rose water (Rosa damascene) of three famous company in Mashhad were randomly bought from market. Methanol and ethanol contents of each sample were measured by Gas chromatography according to the standard method. Collected data were analyzed by SPSS using appropriate descriptive statistical tests., Results: The highest average amount of methanol of all tested distillates is for forty plants (46.06 mg/dl) and M. piperita (46.72 mg/dl) and the lowest for ajava seed (8.46 mg/dl). The maximum and minimum ethanol level was reported for rose water (0.39 mg/dl) and ajava seed (0.15 mg/dl), respectively., Conclusion: High methanol and ethanol concentrations may induce toxicity in people taking these products regularly for a long time. Therefore, considering the harmful effects of methanol and ethanol on human health, further studies are required for determining permitted levels of methanol and ethanol in herbal distillates., Competing Interests: Conflict of Interests The authors declare that there is no conflict of interests.

Background: Globally, female sexual dysfunction is a serious concern based on negative family and social consequences, high side effects of medications and lack of effective treatment. Thus, the evaluation of treatment approach for this problem is an important priority for healthcare systems. Sexual life and its related disorders are considered the main aspects of a healthy lifestyle in traditional Persian medicine (TPM)., Objective: The present study aimed to determine and compare the effects of food products containing Daucus carota, TPM-based training program, and a combination of these two interventions on the improvement of female sexual dysfunction., Methods: This randomized clinical trial was conducted on 96 women with sexual dysfunction based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), aged 18-35 years who referred to the Gynecology Clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during 2016 and 2017. The patients were randomly divided into three groups (n=32) and received the intervention over an eight-week period. The first group was provided with TPM-based sexual health training, the second group received 30 g of a traditional food product (wild carrot halva: mixed Daucus carota and several herbs with honey) on a daily basis, and the third group received a combination of this traditional food product plus education. Data analysis was performed using Chi square test, repeated measures ANOVA, two-way ANOVA, ANCOVA, post hoc Bonferroni, Friedman and Wilcoxon signed-rank test in SPSS version 11.5., Results: According to the results of this study, there was a significant difference in terms of sexual desire (p=0.002), lubrication (p=0.002), orgasm (p=0.004) and pain (p<0.001) after eight weeks of the intervention among the three groups., Conclusion: The use of two interventions of TPM including a food product containing Daucus carota and this product with TPM-based education improved desire, arousal, lubrication, orgasm, satisfaction and pain in females with sexual dysfunction. Furthermore, TPM-based education alone, led to the improvement of all domains of sexual dysfunction, except for pain in the females with sexual dysfunction., Trial Registration: The trial was registered at the Iranian Registry of Clinical Trials with the IRCT ID: IRCT2015122425681N1)., Funding: The present study was supported by a grant from the Research Council, Mashhad University of Medical Sciences, Mashhad, Iran (ref. no.: 941503)., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.

Plantago major has been used widely since ancient times, to manage a wide range of diseases including constipation, coughs and wounds. The aim of this study is to review the traditional application, botanical characterization, pharmacological activities, phytochemistry effects and toxicity of Plantago major. In this review study, medicinal properties of Plantago major are collected from credible pharmacopeias, textbooks of traditional Persian medicine (TPM) belonging to the 10-18th century AD, such as "The Canon of Medicine", "Makhzan-Al- Advia" and so on. Moreover, electronic databases including Scopus, Medline and Web of science were explored for this purpose. Plantago major has been prescribed in various forms such as roasted seeds, decoction, syrup, liniment, gargle, rectal enema, vaginal suppository, eye and nasal drop for each illness by TPM scholars. Some of its traditional properties including wound healing, antipyretic, antitussive, anti-infective, anti-hemorrhagic, anti-inflammatory, diuretic, laxative, astringent and hemostatic have been confirmed in recent researches. Phytochemical investigations showed that Plantago major contains volatile compounds, triterpenoids, phenolic acids and flavonoids. Modern pharmacological studies have proven some of the traditional applications of Plantago major. Nevertheless, more investigations are required on this plant, because it has the potential to be used to produce various natural medications., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.