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Purpose Methods Results Conclusion Osteoarthritis (OA) is a common joint disease that progressively impairs joint function and mobility, especially in the elderly population. While traditional medicine has long cited the therapeutic properties of ostrich oil, scientific evidence supporting its efficacy in treating OA is limited. This study aims to evaluate the effects of ostrich oil on knee OA symptoms in a controlled clinical setting.In a double‐blind randomized clinical trial, we studied the efficacy of adjuvant therapy using ostrich oil to improve knee osteoarthritis symptoms. Ninety patients were randomly allocated to an intervention group and a control group. Both groups received 2 mL of ostrich oil or placebo twice daily per knee for two months. The effectiveness of adjuvant therapy was evaluated by measuring improvements in knee osteoarthritis symptoms. Statistical significance was set at p ≤ 0.05.The intervention group showed significantly lower knee joint pain scores compared to the control group for both right (1.33 ± 0.59 vs 2.30 ± 0.92, p = 0.001; baseline: 2.83 ± 0.76 vs 2.85 ± 0.94) and left knees (1.31 ± 0.60 vs 2.22 ± 0.83, p = 0.001; baseline: 2.75 ± 0.84 vs 2.81 ± 0.71). Similarly, knee joint stiffness was significantly reduced in the intervention group compared to the control group for both right (1.56 ± 0.74 vs 1.79 ± 0.78, p = 0.035; baseline: 2.18 ± 0.88 vs 2.21 ± 0.91) and left knees (1.45 ± 0.53 vs 1.70 ± 0.69, p = 0.021; baseline: 2.05 ± 0.79 vs 2.12 ± 0.75). The 6‐m walking time improved in both groups, with no significant difference between groups after two months (10.95 ± 3.28 s vs 12.30 ± 3.13 s, p = 0.76; baseline: 16.10 ± 6.24 s vs 15.45 ± 2.28 s).Symptoms of osteoarthritis, such as stiffness and pain in both knees, significantly reduced with ostrich oil treatment. However, in some criteria, no significant differences were observed between the treatment and control groups. [ABSTRACT FROM AUTHOR]

Objective: Researchers have considered medicinal oils to prevent and treat pediatric diseases. In the traditional Persian medicine (TPM) doctrine, anointment is widely used in order to avoid and treat diseases. This study aimed to evaluate and reconcile the uses of anointment in children in TPM and the new studies. Materials and Methods: Accordingly, TPM documents were scrutinized for anointments and their applications in pediatric disorders. Moreover, new studies were reviewed in Google scholar, PubMed, Medline, Scopus, and Web of Science until June 2022. Results: In the health preservation field, TPM scholars have recommended daily anointment with some oils like sweet almonds in the early months after birth to improve growth, strengthen the body, and prevent dry skin, and new studies have confirmed the effectiveness of some oils accordingly. In the treatment field, various oils are recommended, namely sweet almond oil for weight disorders, violet oil for insomnia, olive oil and chamomile oil for functional constipation, infantile colic and enuresis, and olive oil for diaper rash and atopic dermatitis and new studies have shown their effectiveness. Sweet almond, chamomile, violet, olive, and rose oils are among the most widely used oils in Persian medicine for children, which we have discussed in this study. Conclusion: Due to the non-invasive nature of anointment and the observation of minimal adverse effects in studies, it can be given attention for maintaining pediatric health and treating their diseases. [ABSTRACT FROM AUTHOR]

Lavender is one of the most appreciated aromatic plants, with high economic value in food, cosmetics, perfumery, and pharmaceutical industries. Lavender essential oil (LEO) is known to have demonstrative antimicrobial, antioxidant, therapeutic, flavor and fragrance properties. Conventional extraction methods, e.g., steam distillation (SD) and hydro-distillation (HD), have been traditionally employed to extract LEO. However, the low yield, high energy consumption, and long extraction time of conventional methods have prompted the introduction of novel extraction technologies. Some of these innovative approaches, such as ohmic-assisted, microwave-assisted, supercritical fluid, and subcritical water extraction approaches, are used as substitutes to conventional extraction methods. While other methods, e.g., sonication, pulsed electric field, and cold plasma, can be used as a pre-treatment that is preceded by conventional or emerging extraction technologies. These innovative approaches have a great significance in reducing the energy consumption, shortening the extraction time, and increasing the extraction yield and the quality of EOs. Therefore, they can be considered as sustainable extraction technologies. However, the scale-up of emerging technologies to an industrial level should also be investigated from the techno-economic points of view in future studies. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease is a chronic inflammatory disorder accompanied by occasional flare-ups, abdominal pain, and rectal bleeding. Persicaria bistorta Samp. is a medicinal plant repeatedly mentioned in traditional Persian medicine for the treatment of bleeding and tissue damage in different organs, including the intestines. The current study aimed to evaluate the effect of bistort root in an animal model of colitis. Freeze-dried aqueous extract of the plant (PB) was prepared and analyzed using liquid chromatography–mass spectrometry and high-performance liquid chromatography. The anti-inflammatory effect of oral PB (300, 500, and 700 mg/kg) was evaluated in acetic acid-induced colitis in Wistar rats compared with negative control and positive control (dexamethasone). The role of nitric oxide (NO), opioid receptors, Toll-like receptors (TLR-4), interleukin (IL)-1β, IL-6, TNF-α, NF-κB, myeloperoxidase, and intestinal tissue damage using immunohistochemistry staining for cyclooxygenase-2 (COX-2) were also assessed. A total of 29 compounds were identified in the extract. The gallic acid content of the extract was 4.973 ± 1.102 mg/g. PB significantly ameliorated the gross morphological damage from 4.66 ± 0.577 in negative control to 1.33 ± 0.56 in PB 700 (p < 0.001). Also, PB 700 lowered the levels of TNF-α (p < 0.01), TLR-4 (p < 0.001), NF-κB (p < 0.0001), IL-1β (p < 0.0001), and IL-6 (p < 0.0001) compared to the negative control. Additionally, while blocking NO and opioid pathways, the therapeutic effect of the extract was not significant, compared to the negative control, suggesting that PB 700 has exerted its therapeutic effect via these two pathways. However, further mechanistic and clinical studies are recommended to confirm PB as a natural treatment for colitis. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the most common endocrine-related reproductive disorder in women of reproductive age, accompanied by both the impairment of female fecundity and a risk of metabolic disorders. PCOS is emphasized as a worldwide concern due to its unknown etiology and lack of specific medications. The current study aimed to evaluate the effects of L-tartaric acid, an abundantly occurring compound in fruits, on the histostereological and hormonal changes caused by PCOS. Forty adult Sprague Dawley rats were randomly divided into four groups including controls (no intervention), Tartaric acid (40mg/Kg/day from day 21 onwards for 39 days), PCOS (21 days letrozole and then normal saline orally for 39 days), and PCOS + Tartaric acid. After treatments, the ovarian histostereological analysis as well as the level of reproductive hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, progesterone, and testosterone was measured. PCOS caused a significant decrease in the number of unilaminar, multilaminar, antral, and graafian follicles and increased follicular atresia (p-value < 0.001). Moreover, the weight and volume of ovarian tissue and related structures including cortex, medulla, and cysts increased significantly (p-value < 0.0001). However, corpus luteum volume was significantly decreased (p-value < 0.001). Although significant differences were found in some parameters with the control group (p-value < 0.05), the administration of tartaric acid restored the pathological effects of PCOS on the ovarian histostructure. Furthermore, tartaric acid improved the serum levels of LH, estradiol, progesterone, and testosterone (p-value < 0.05). The obtained findings may suggest tartaric acid as a novel strategy for PCOS management, although further studies are necessary. [ABSTRACT FROM AUTHOR]

The current systematic review and meta‐analysis was conducted to evaluate the effects of kiwifruit intake on anthropometric indices and key cardiometabolic parameters. Related articles were found by searching PubMed, ISI Web of Science, and Scopus to detect relevant Randomized Clinical Trials (RCTs) and novel systematic reviews relating to kiwi consumption in adults, up to August 2023. The weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using a random‐effects model. Heterogeneity, sensitivity analysis, and publication bias were assessed and reported using standard methods. Six RCTs were included in the meta‐analysis. Analyzing overall effect sizes demonstrated a significant reduction in low‐density lipoprotein cholesterol (LDL) levels (WMD: −9.30 mg/dL; 95% CI: −17.56 to −1.04, p =.027), whereas no significant alterations of triglycerides (TG) (WMD: −12.91 mg/dL; 95% CI: −28.17 to 2.34, p =.097), total cholesterol (TC) (WMD: −7.66 mg/dL; 95% CI: −17.85 to 2.52, p =.141), high‐density lipoprotein cholesterol (HDL) (WMD: 2.87 mg/dL; 95% CI: −0.36 to 6.11, p =.141), fasting blood glucose (FBG) (WMD: 1.06 mg/dL; 95% CI: −1.43 to 3.56, p =.404), C‐reactive protein (CRP) (WMD: 0.15 mg/dL; 95% CI: −0.40, 0.70, p =.0598), body weight (BW) (WMD: 0.85 kg; 95% CI: −1.34 to 3.04, p =.448), body mass index (BMI) (WMD: 0.04 kg/m2; 95% CI: −0.75 to 0.83, p =.920), and waist circumference (WC) (WMD: 0.18 cm; 95% CI: −1.81 to 2.19, p =.855) were found. Our findings suggest that consuming kiwifruit does not have a significant impact on anthropometric indices and cardiometabolic factors, except for LDL‐C levels. [ABSTRACT FROM AUTHOR]

Objective: Echium amoenum (EA) and Foeniculum vulgare (FV) might be beneficial for the management of Premenstrual syndrome (PMS) due to their possible effects on sex hormones and neurotransmitters such as serotonin. This study aimed to investigate the effect of a combination of Echium and Fennel on the severity of physical and psychological symptoms of PMS. Materials and Methods: This triple-blinded, randomized, controlled trial was conducted on 80 women. The subjects were assigned to two groups of intervention (receiving EA 2 g/day and FV 1 g/day, in the second two weeks of the cycle, in two consecutive cycles) and placebo control. The data collection tools included the PSST, DRSP, and SF36 questionnaires. Results: Between-group differences in all subscales of DRSP were significant at one- and two-month time points (p<0.05). Bleeding volume was significantly increased in the intervention group, compared to the placebo group, two months after the intervention (p<0.05). Between-group comparison of the changes demonstrated significant differences in all subscales of SF36, except for limitations in usual role activities due to emotional problems (p=0.07). Conclusion: Consumption of EA and FV combination improved the quality of life in women with PMS and exerted favorable changes in PMS symptoms. [ABSTRACT FROM AUTHOR]

Introduction Gastroesophageal reflux disease (GERD) is a common complaint, which reduces patients' quality of life. Because of the unknown origin of the disease, its common treatments are limited to reducing the acid secretion, but a prolonged use of acid secretion inhibitors can lead to considerable side effects. There is a growing tendency to use herbal remedies in conjunction with, and as an alternative to, conventional drugs. According to Traditional Persian Medicine (TPM), Lallemantia royleana (Benth) seeds (LRS) may be a beneficial remedy for alleviating GERD symptoms. Objectives To assess the effect of LRS as a possible treatment for GERD. Methods In this pilot clinical trial study, 92 eligible volunteers were assigned to a 4-week treatment with 6 grams LRS syrup twice a day. Outcomes were recorded in a self-report questionnaire, which was filled at the baseline and after the treatment period. Primary outcomes were the difference in effect before and after treatment on three outcome measurements: 1) mean frequency of symptomatic days per week; 2) mean intensity of main symptoms of GERD (based on a self-reported 10-degree scale subjective questionnaire); and 3) quality of life related to GERD. Results 84 patients completed the trial. After 4-week consumption of LRS, the intensity and frequency of complaints about reflex were decreased (7 ± 2.1 to 2.5 ± 2.7 degrees and 4.9±2.2 to2.1 ±2.5 days/week, respectively; P<0.001). Also, the patient's quality of life improved (3.7±0.7 to 2.1±1.1;P<0.001). No serious side effect was observed during the study. Conclusion L.royleana might be an effective and safe herbal drug for alleviating GERD symptoms. [ABSTRACT FROM AUTHOR]

Abstract Background The utilization of complementary and alternative medicine (CAM) is experiencing a global surge, accompanied by the adoption of national CAM policies in numerous countries. Traditional Persian medicine (TPM) is highly used as CAM in Iran, and the ongoing scientific evaluation of its interventions and the implementation of evidence-based medicine (EBM) encounters various barriers. Therefore, comprehending the characteristics and interactions of stakeholders is pivotal in advancing EBM within TPM policies. In this study, we utilized both classical stakeholder analysis and social network analysis to identify key stakeholders and potential communication patterns, thereby promoting EBM in TPM policy-making. Methods A cross-sectional nationwide stakeholder analysis was conducted in 2023 using snowball sampling. The interviews were carried out using a customized version of the six building blocks of health. Data were collected through semi-structured interviews. Stakeholders were assessed based on five factors (power, interest, influence, position, and competency). The connections and structure of the network were analyzed using degree, betweenness, closeness centrality, and modularity index to detect clusters of smaller networks. Results Among twenty-three identified stakeholders, the Ministry of Health and Medical Education (MOHME) and the Public were the most powerful and influential. The Iranian Academy of Medical Sciences was the most competent stakeholder. Social network analysis revealed a low density of connections among stakeholders. Pharmaceutical companies were identified as key connectors in the network, while the Public, supreme governmental bodies, and guilds acted as gatekeepers or brokers. The MOHME and Maraji were found to be high-ranking stakeholders based on four different centrality measures. Conclusion This study identifies powerful stakeholders in the network and emphasizes the need to engage uninterested yet significant stakeholders. Recommendations include improving competence through education, strengthening international relations, and fostering stronger relationships. Engaging key connectors and gatekeepers is essential for bridging gaps in the network.

Background: The utilization of complementary and alternative medicine (CAM) is experiencing a global surge, accompanied by the adoption of national CAM policies in numerous countries. Traditional Persian medicine (TPM) is highly used as CAM in Iran, and the ongoing scientific evaluation of its interventions and the implementation of evidence-based medicine (EBM) encounters various barriers. Therefore, comprehending the characteristics and interactions of stakeholders is pivotal in advancing EBM within TPM policies. In this study, we utilized both classical stakeholder analysis and social network analysis to identify key stakeholders and potential communication patterns, thereby promoting EBM in TPM policy-making. Methods: A cross-sectional nationwide stakeholder analysis was conducted in 2023 using snowball sampling. The interviews were carried out using a customized version of the six building blocks of health. Data were collected through semi-structured interviews. Stakeholders were assessed based on five factors (power, interest, influence, position, and competency). The connections and structure of the network were analyzed using degree, betweenness, closeness centrality, and modularity index to detect clusters of smaller networks. Results: Among twenty-three identified stakeholders, the Ministry of Health and Medical Education (MOHME) and the Public were the most powerful and influential. The Iranian Academy of Medical Sciences was the most competent stakeholder. Social network analysis revealed a low density of connections among stakeholders. Pharmaceutical companies were identified as key connectors in the network, while the Public, supreme governmental bodies, and guilds acted as gatekeepers or brokers. The MOHME and Maraji were found to be high-ranking stakeholders based on four different centrality measures. Conclusion: This study identifies powerful stakeholders in the network and emphasizes the need to engage uninterested yet significant stakeholders. Recommendations include improving competence through education, strengthening international relations, and fostering stronger relationships. Engaging key connectors and gatekeepers is essential for bridging gaps in the network. [ABSTRACT FROM AUTHOR]

Chronic and acute liver diseases are considered a global issue and their medical treatments are commonly challenging to manage. Traditional medicines have used natural products for thousands of years to prevent and treat various diseases. Recent studies have revealed that the pharmacological impacts of herbs are primarily determined by their phytochemical constituents. Therefore, understanding plant chemistry is crucial for the therapeutic use of medicinal plants. In this review, we first introduced some medicinal plants that have the potential to be beneficial for treating liver diseases and disorders, based on Traditional Persian Medicine (TPM) textbooks. Subsequently, we investigated the secondary metabolites of these medicinal plants by analyzing pharmacological research collected from electronic databases. We also discussed their scientific and family names. According to TPM textbooks, 77 medical plants have been identified for the treatment of liver defects, belonging to 43 different families. Their secondary metabolites were studied through data obtained from electronic databases such as Google Scholar, PubMed, Science Direct, and Web of Science. These findings suggest that natural plant extracts hold promise for the prevention and treatment of liver diseases. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the effects of chamomile (Matricaria chamomilla L.) on sleep in this systematic review and meta-analysis of clinical trials. Methods: PubMed, Scopus, Web of Science, and Cochrane Library were searched until August 2023. All clinical trials that investigated the effects of chamomile on sleep, either in healthy or diseased adults, were eligible to enter the study. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool weighted mean differences (WMD) and 95 % CI for the outcomes assessed by at least three studies with relatively consistent participants. Results: The systematic review included ten studies (772 participants). Meta-analysis was conducted for the Pittsburgh Sleep Quality Index (PSQI) score and sleep length. A significant reduction in PSQI score (WMD: −1.88, 95 %CI: −3.46, −0.31, I2: 88.4 %, n = 5) was found. For other outcomes, meta-analysis was not conducted. Sleep onset latency or ease of getting to sleep were improved in three of the four studies. Daytime functioning measures, including fatigue severity index or postpartum fatigue scale, did not change in all three studies. Sleep efficiency did not change in two studies and deteriorated in one. The number of awakenings after sleep or staying asleep was improved in two of the three studies. No adverse events were reported in any of the studies although passive surveillance was used to assess adverse effects except in one study. Only one study surveyed the blinding success and tested the purity and/or potency of the used products. Conclusion: Chamomile improved sleep, especially the number of awakenings after sleep or staying asleep; however, it did not lead to an improvement in the duration of sleep, percentage of sleep efficiency, and daytime functioning measures. Future studies are suggested to assess objective measures.

BACKGROUND: Living with HIV requires lifelong care to support engagement with and adherence to antiretroviral therapy. The Middle East and North Africa region provides access to ART, but research is lacking on the lived-experiences of people living with HIV. Globally, complementary and alternative medicine (CAM) is increasingly used by patients who need support alongside receiving medical treatment for chronic conditions. This study aims to examine the frequency and reasons behind the use of CAM, as well as identify its associated factors among people living with HIV in Shiraz, Iran. METHODS: In this cross-sectional study, a total of 320 patients (aged 18-70 years) with a confirmed diagnosis of HIV residing in Fars province and diagnosed between 1999 and 2019 were recruited randomly through their clinical record numbers from five HIV treatment centers. They were surveyed on their quality of life and CAM use via the Short-Form Health Survey questionnaire (SF-36) and a semi-structured survey of CAM use. The data analysis for this study involved the use of Chi-squared test, independent t-test, and multiple logistic regression model. RESULTS: Of 287 patients, 89.22% reported using CAM in the previous year. CAM use was more prevalent among those with a family history of CAM use (94.3% vs. 81.8%, p = 0.023). Frequent reasons for using CAM were reported to be sexual dysfunction (32.4%), depression (28.3%), thirstiness (23.3%), and nausea (17.5%). Quality of life, as measured via the SF-36 questionnaire in all its 8 sub-domains, did not differ among those who used CAM versus those who did not (61.5 ± 27.6 vs. 58.1 ± 30.9, p = 0.626). CONCLUSION: CAM was used among a majority of people living with HIV in Shiraz, Iran. People who used CAM appeared to experience a similar quality of life relative to those who did not use CAM. Future studies on the modalities of engagement with CAM can improve patient-physician shared decision-making and increase lifelong care options for people living with HIV.

Objectives: This study aims to assess the efficacy of local heat therapy (Kaiy) in alleviating symptoms of mild to moderate idiopathic carpal tunnel syndrome (CTS). Methods: A single-blind clinical trial was conducted involving patients with mild and moderate idiopathic carpal tunnel syndrome. A total of 120 patients were randomly assigned to either the intervention or control group. Both groups utilized a medical wristband during nighttime. The intervention group received pen moxa as a local heat therapy tool (Kaiy) applied to the wrist region. The Boston questionnaire was employed for assessment. Results: Heat therapy using Kaiy (pen moxa) significantly improved symptom severity (P≤0.0001), functional status (P≤0.0001), and pain scores (P≤0.0001) in patients with mild to moderate CTS compared to those in the control group without heat therapy. Conclusion: This study demonstrates the positive impact of heat therapy (Kaiy) as a non-surgical approach for reducing pain, symptom severity, and functional impairment in CTS patients. Integrating complementary and alternative medicine with conventional treatment modalities could enhance symptom management with minimal side effects.

Background: Basil is a widely used herb in Persian medicine and is gaining recognition as a functional food worldwide. Aim of the study: This trial aimed to assess the effectiveness of a traditional formulation of basil oil in comparison with diclofenac gel in treating knee osteoarthritis, considering its established anti-inflammatory, anti-nociceptive, and anti-oxidative properties. Materials and methods: One hundred eligible patients were equally randomized to the traditional basil oil (containing sesame oil) and diclofenac gel groups. They used their respective topical treatments thrice daily for 4 weeks. Various measurements were taken at the beginning of the study, 2, and 4 weeks after starting the intervention, including the 8-m walk test, knee pain (based on visual analog scale), flexion angle of the knee joint, analgesic consumption, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Results: No significant differences were observed between the basil oil and diclofenac gel groups in any of the measured outcomes. However, significant improvements were noted within each group for most variables. Conclusion: Topical application of the traditional formulation of basil oil appears to improve clinical symptoms and certain functional indicators of knee osteoarthritis to a similar extent as diclofenac gel. This suggests that basil oil could be considered an effective management option for this condition. Clinical Trial Registration: https://irct.behdasht.gov.ir/, identifier IRCT2017081711341N7. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is a prominent etiological factor for liver cirrhosis worldwide. It is frequently associated with obesity, diabetes, dyslipidemia, and hypertension. The objective of this study is to assess the efficacy and safety of ginger (Zingiber officinale Roscoe) supplementation in patients with type 2 diabetes mellitus (T2DM) who have NAFLD. In a two-arm, double-blind, placebo-controlled clinical trial, seventy-six patients diagnosed with both T2DM and NAFLD were randomly assigned to receive either ginger powder capsules (1000 mg, twice daily) or placebo capsules (administered in the same manner) for a period of three months. Anthropometric measurements, blood pressure readings, biochemical profiles, and imaging parameters were assessed before and after the intervention. Safety measures were also evaluated. In both the ginger and placebo groups, there was a significant reduction in mean body mass index (BMI), waist and hip circumferences, as well as liver transaminase levels. Moreover, significant improvements in mean systolic and diastolic blood pressures were observed in the ginger group (p = 0.02 and < 0.0001, respectively). Within the ginger group, there was a decrease in serum insulin levels and insulin resistance (HOMA-IR) (p = 0.002 and 0.004, respectively). Furthermore, the ginger group exhibited an improvement in serum HDL-cholesterol level (p = 0.01). However, there were no significant changes in the assessed inflammatory markers or the indices obtained from fibroscan imaging, including steatosis percent and controlled attenuation parameter. This study demonstrates that ginger supplementation can significantly improve mean systolic and diastolic blood pressures. However, it does not have a significant impact on inflammatory markers or fibroscan imaging indices. Nonetheless, the three-month use of ginger improves serum insulin level, insulin resistance (HOMA-IR), and HDL-cholesterol level compared to baseline values. Further investigations with longer durations and larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

• Chamomile ointment significantly lowers the incidence of post-dural puncture headache (PDPH) compared to a placebo. • PDPH rates were significantly lower in the chamomile group at 6 hours (3.5% vs. 7.18%) and 12 hours (7.6% vs. 20%) after spinal anesthesia. • Both groups had comparable analgesic consumption, nausea/vomiting frequency, and adverse events. Post-dural puncture headache (PDPH) is a common complication after spinal anesthesia, affecting patient recovery. This study evaluated the prophylactic effect of topical chamomile ointment on PDPH in women undergoing elective cesarean section. In a randomized, double-blind, placebo-controlled clinical trial 148 pregnant women were randomized into two parallel groups and received 3cc of the chamomile or the placebo ointment on the forehead of the participants 20 minutes before the start of spinal anesthesia, and then 2 and 4 hours after that. The primary outcomes were the incidence rate of headache, and its severity assessed by a numeric rating scale (NRS), while secondary outcomes included analgesic consumption, frequency of nausea/vomiting, and adverse events. Chamomile ointment exhibited significant preventive effects on PDPH incidence compared to placebo. The chamomile group demonstrated lower rates of PDPH at 6 hours (3.5% vs. 7.18%, p = 0.021) and 12 hours (7.6% vs. 20%, p = 0.028) after spinal anesthesia. Analgesic consumption, frequency of nausea/vomiting, and adverse events were comparable between the groups. Topical chamomile ointment demonstrated significant preventive effects on PDPH incidence compared to placebo. Chamomile ointment could be a promising adjunctive approach to prevent PDPH, enhancing patient comfort and potentially reducing the need for analgesics. Further investigation is needed to explore its mechanisms and broader applications. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the efficacy of local heat therapy (Kaiy) in alleviating symptoms of mild to moderate idiopathic carpal tunnel syndrome (CTS). Methods: A single-blind clinical trial was conducted involving patients with mild and moderate idiopathic carpal tunnel syndrome. A total of 120 patients were randomly assigned to either the intervention or control group. Both groups utilized a medical wristband during nighttime. The intervention group received pen moxa as a local heat therapy tool (Kaiy) applied to the wrist region. The Boston questionnaire was employed for assessment. Results: Heat therapy using Kaiy (pen moxa) significantly improved symptom severity (P=0.0001), functional status (P=0.0001), and pain scores (P=0.0001) in patients with mild to moderate CTS compared to those in the control group without heat therapy. Conclusion: This study demonstrates the positive impact of heat therapy (Kaiy) as a non-surgical approach for reducing pain, symptom severity, and functional impairment in CTS patients. Integrating complementary and alternative medicine with conventional treatment modalities could enhance symptom management with minimal side effects. [ABSTRACT FROM AUTHOR]

Traditional Persian Medicine (TPM) has a thousand-year history and a holistic approach that respects personal characteristics in its diagnosis and management. The objective of this study was to explore the concepts of personal and precision medicine in traditional Persian and modern medicine. A qualitative study design with a content analysis approach was conducted. Purposive and snowball sampling approaches were used to select participants. Then, we approached experts in various fields, including TPM, genetics, epidemiology, physiology, pharmacy, and general medicine. In the beginning, we summarized the concept of personalized medicine (PM) and asked them how many similarities and differences they might find between TPM and PM. A semi-structured questionnaire with six parts was used to collect data. The duration of each interview varied from 30 to 65 min. The interviews and experts’ viewpoints were recorded via an online platform and transcribed verbatim. The data analysis process involved several sequential steps: initial familiarization, coding, theme generation, theme review, theme definition and naming, and final writing. After coding all texts and extracting issues, categories and conceptual frameworks were created by interpreting the content. To analyze the data, the content analysis approach assisted by MAXQDA 2018 software was used. More than 70% of participants showed a favorable attitude in all evaluated parts. Approximately 80% of participants agreed that there are parallels between TPM and precision medicine; for example, in TPM and precision medicine, patients are treated with respect to their characteristics. More than 80% of participants thought temperamentology may help with patient diagnosis and treatment. They also suggested that TPM concepts could be used to improve and accelerate the implementation of precision medicine. The majority of participants acknowledged the use of phenotypes to reduce the reliance on genetics in precision medicine. However, several participants expressed skepticism. According to the participants, these concepts will not be beneficial unless TPM aligns with modern medicine. In addition, there must be scientific evidence confirming the association between different genes and temperaments. The advent of precision medicine does not mean disregarding TPM; rather, the concepts of TPM can be used in precision medicine. For example, phenotype can assist in reducing the reliance on genetics in precision medicine. Because phenotype, as an important concept in TPM, is the external manifestation of the genotype. In addition, like precision medicine, TPM can help to provide personalized medical treatment based on people's temperament.

COVID-19 is a pandemic viral infection that has become a challenge for health systems worldwide having no definite antiviral treatment yet. The aim of this study is to evaluate the effect of a Persian-based method of needling (Ghamz with needle) on the clinical symptoms of COVID-19 patients as a pilot study. We conducted a single-blind randomized controlled clinical trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection (COVID-19) by rRT-PCR method using a nasal swab. Nineteen patients who met the inclusion criteria were randomly allocated to receive Ghamz with needle in the intervention group and sham treatment group. The procedure was performed in six points (three bilateral), based on traditional Persian medicine (TPM) texts, compatible with LU5, LU7, and SP6 Chinese points with a duration of 20 minutes, every day, till the patients were discharged from the hospital. The clinical symptoms, laboratory data, and radiological findings were evaluated before and after the interventions in both groups. The results revealed that after comparing the values of the change in the study parameters, despite the significant improvement in the dyspnea (p=0.037) and O2 saturation (p=0.044) of the Ghamz group, no statistically significant difference was observed between Ghamz and sham groups using a visual analog scale (dyspnea: MD: -3.66, 95% CI: -6.49 to 0.84 vs MD: -2.20, 95% CI: -4.60 to 0.20, p= 0.217; O2 saturation: (MD: 2.61, 95% CI: -1.97 to 14.02 vs MD:4.50, 95% CI: -0.49 to 9.49, p=0.163). The radiological findings showed a better improvement in the intervention group than in the sham treatment group. In conclusion, Ghamz with needle in the mentioned points was not effective significantly in relieve the symptoms of the patients with COVID-19. However, further studies with larger samples are recommended.

Different parts of Pistacia species are traditionally used to treat various skin problems. Traditional experiences can be a good basis for research on the therapeutic effects of medicinal plants. The active compounds of plants can be identified and used in different disorders in an innovative way. There are several studies that have evaluated the Pistacia species for dermatological disorders. However, despite the valuable effects of the Pistacia species on skin disease, there is no comprehensive review of the dermal effects of these plants. So, in this study, current evidence regarding the dermatological effect of the Pistacia species has been reviewed. Electronic databases including PubMed, Scopus, and Google Scholar were searched for in vivo, in vitro, and clinical studies that examined dermatological effects of Pistacia species. According to the review, most of the evidence of dermatological effects in the Pistacia genus comes from preliminary studies on wound healing, cutaneous leishmaniasis, inflammation caused by UV rays and photo-protection, hyperpigmentation disorders, and atopic dermatitis. The Pistacia genus was implicated in 3 clinical studies and 30 in vivo/in vitro studies showing several mechanisms that go beyond its dermatological effects. The traditional medicinal effects of these herbs are supported by some scientific evidence. The potential protective/therapeutic effects of these herbs need to be studied further so that they can be considered as possible future candidates for use in skin care products.

BackgroundBasil is a widely used herb in Persian medicine and is gaining recognition as a functional food worldwide.Aim of the studyThis trial aimed to assess the effectiveness of a traditional formulation of basil oil in comparison with diclofenac gel in treating knee osteoarthritis, considering its established anti-inflammatory, anti-nociceptive, and anti-oxidative properties.Materials and methodsOne hundred eligible patients were equally randomized to the traditional basil oil (containing sesame oil) and diclofenac gel groups. They used their respective topical treatments thrice daily for 4 weeks. Various measurements were taken at the beginning of the study, 2, and 4 weeks after starting the intervention, including the 8-m walk test, knee pain (based on visual analog scale), flexion angle of the knee joint, analgesic consumption, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire.ResultsNo significant differences were observed between the basil oil and diclofenac gel groups in any of the measured outcomes. However, significant improvements were noted within each group for most variables.ConclusionTopical application of the traditional formulation of basil oil appears to improve clinical symptoms and certain functional indicators of knee osteoarthritis to a similar extent as diclofenac gel. This suggests that basil oil could be considered an effective management option for this condition.Clinical Trial Registration:https://irct.behdasht.gov.ir/, identifier IRCT2017081711341N7.

Multimedia conveys educational concepts and materials in an easier, wider, and more attractive way, along with text, sound, image, and video, to overcome the limitations caused by educational methods. The aim of the current research is to produce and evaluate digital multimedia based on the decide, design, develop, and-evaluate (DDD-E) model in the field of teaching depression treatment in traditional Persian medicine. The study was quantitative, and the professors and doctoral students of the two fields of medical education and traditional Persian medicine were the subjects of the present study. In this research, the DDD-E model was used to produce a training package for the treatment of depression in traditional Persian medicine. This study was conducted in four phases: decision-making, planning, development, and evaluation. The final evaluation was done in two stages. First, it was evaluated by preparing a checklist of educational multimedia production stages based on the original DDD-E model, and in the second stage, a QAMLM questionnaire was used to evaluate the final product. The results of the evaluation showed that, according to the evaluators, quality components were generally observed in multimedia production. There was a complete consensus among the experts regarding the quality of content matching the goal and attention to learning results (Kappa coefficient = 1). Regarding the quality of media selection components (Kappa coefficient = 0.383), Paying attention to cultural and social factors (Kappa coefficient = 0.395) There was the least consensus. The overall score of the multimedia produced was equal to 58.4, according to experts. The multimedia was produced in terms of content, education, and technology to provide training to general practitioners in order to improve practical knowledge and use the recommendations of traditional Persian medicine to adjust the treatment patterns of patients with depression.

Complementary Alternative Medicine (CAM) has been widely used globally, but limited data are available on the use of CAM in Cardiovascular Disease (CVD). The present study aimed to evaluate CAM use in CVD patients. The present cross-sectional study was performed in Shiraz, Iran, during the summer of 2021. Cardiovascular patients aged ≥ 18 years were included in the study. Demographic information on left ventricular ejection fraction and satisfaction with CAM utilization was collected using validated questionnaires. A total of 304 patients (194 males and 110 females) were recruited for this study. The frequency of patients identified as CAM users was 56.9% (n = 173). Patients with implanted pacemakers were less likely to use CAM than others (OR = 0.50, p = 0.031). Meanwhile, the likelihood of CAM utilization was approximately 2 and 4 times higher in the patients categorized in class I of the New York Heart Association (NYHA) functional classification compared to those in the second and third classes, respectively. Most CAM users used herbs, dietary supplements, and praying to prevent diseases, while Traditional Persian Medicine (TPM) remedies and acupuncture were more commonly used to treat acute and chronic illnesses, respectively. Praying for health, herbal therapy, and dietary supplementation were the most popular CAM types utilized by Iranian CVD patients. However, future investigations seem to be required to determine the exact physiological impacts, probable adverse effects, and long-term benefits of CAM therapies in this population.

Background: Cancer patients frequently turn to complementary and alternative medicine (CAM) to mitigate the adverse effects of conventional cancer treatments, alleviate stress, manage comorbidities, and address the cancer itself. This systematic review aims to investigate descriptive studies conducted in Iran, focusing on the prevalence and methods of CAM use among cancer patients. Methods: A thorough search of PubMed, Scopus, Google Scholar, Web of Science, Magiran, and the Scientific Information Database (SID) was conducted in both English and Persian from inception to July 2023. Inclusion criteria targeted studies exploring the frequency and patterns of CAM utilization among Iranian patients across diverse cancer types. Results: A total of 604 articles were found in the preliminary search, and 14 were included in this review. Among the 3,990 participants in the included studies, a weighted average of 51.83% (range 4.6%-100%) had used at least one CAM method. The most commonly used CAM methods were prayer (41.8%), medicinal herbs (30.1%), traditional and folk treatments (27.2%), bloodletting (17.3%), and hydrotherapy (13%). Patients reported using CAM for various reasons, including their beliefs, desire to cure the disease, reduce stress, positive past experiences, and improve physical condition. On average, 39% of patients informed their physicians about their CAM use. Conclusion: The findings underscore the relatively prevalent adoption of CAM by Iranian cancer patients. Given the low rate of disclosure to physicians, there is a compelling need for healthcare system vigilance and monitoring to ensure comprehensive patient care.

Background: In the context of Persian traditional medicine, there are several therapeutic strategies for managing diseases, ranging from lifestyle changes to herbal remedies. Objectives: Given the application of Persian traditional medicine in the management of chronic diseases, the burden of chronic illnesses, and the public's recourse to traditional medicine specialists, this study aimed to assess the cost-effectiveness of traditional medicine dietary regimens for the treatment of non-alcoholic fatty liver disease from the perspective of the payer. Methods: In this study, we investigated the cost-effectiveness of providing nutrition counseling for lifestyle modification (changes in the aforementioned Setteh-e-Zarurieah) by a traditional medicine specialist compared to receiving counseling from a nutritionist for non- alcoholic fatty liver disease from the payer's perspective. The outcomes measured were changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, body mass index (BMI), and the grade of fatty liver. Cost and effectiveness data were entered into Excel software, and the ICER ratio was calculated. Results: The results indicated that the dietary regimen prescribed by Persian traditional medicine when compared to the nutritionist's recommended diet, resulted in a lower decrease in AST and ALT enzymes but led to a greater decrease in BMI (mean change = 0.42) and a significant change in the grade of fatty liver (OR = 9.75). Since the costs of tests, ultrasounds, and visits were equal in both groups, the cost difference was zero. In the first scenario, where traditional medicine is considered an alternative therapy and liver enzymes are the primary focus, providing nutritional counseling services by Persian traditional medicine may not be cost-effective. However, if we consider the grade of fatty liver and BMI as the primary variables, providing nutritional counseling services by Persian traditional medicine may be cost-effective. Conclusions: Based on the available evidence, the treatment of fatty liver using Persian traditional medicine can be considered an effective and cost-effective complementary (or alternative) intervention. Considering the long-term costs imposed by the health system and insurance organizations, it is predicted that adding visits to Persian traditional medicine specialists may reduce overall healthcare system costs. [ABSTRACT FROM AUTHOR]

AbstractIn this manuscript, we conducted a comprehensive review of the diverse effects of peppermint on human health and explored the potential underlying mechanisms. Peppermint contains three main groups of phytochemical constituents, including essential oils (mainly menthol), flavonoids (such as hesperidin, eriodictyol, naringenin, quercetin, myricetin, and kaempferol), and nonflavonoid phenolcarboxylic acids. Peppermint exhibits antimicrobial, antioxidant, anti-inflammatory, immunomodulatory, anti-cancer, anti-aging, and analgesic properties and may be effective in treating various disorders, including gastrointestinal disorders (e.g., irritable bowel syndrome, dyspepsia, constipation, functional gastrointestinal disorders, nausea/vomiting, and gallbladder stones). In addition, peppermint has therapeutic benefits for psychological and cognitive health, dental health, urinary retention, skin and wound healing, as well as anti-depressant and anti-anxiety effects, and it may improve memory. However, peppermint has paradoxical effects on sleep quality and alertness, as it has been shown to improve sleep quality in patients with fatigue and anxiety, while also increasing alertness under conditions of monotonous work and relaxation. We also discuss its protective effects against toxic agents at recommended doses, as well as its safety and potential toxicity. Overall, this review provides the latest findings and insights into the properties and clinical effects of peppermint/menthol and highlights its potential as a natural therapeutic agent for various health conditions. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) is the most common disease of joints. The management of OA is challenging due to the efficacy and safety of treatments. In recent decades, traditional herbal medicines have been introduced for treatment of disease. Delphinium denudatum Wall. (Jadwar) is a medicinal herb with a long-lasting usage in traditional Persian medicine for joint diseases. The present study aimed to investigate the effect of Jadwar on pain and symptoms of knee OA. Methods: In this randomized double-blind placebo-controlled trial, 104 patients with knee OA were randomly assigned into two groups of intervention and control. While the intervention group received one Jadwar capsule (500 mg) twice a day for four weeks, the control group received placebo capsules. The primary outcomes, including pain, stiffness, and physical activity were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and the Visual Analogue Scale (VAS) at baseline two and four weeks after the intervention. Results: Ninety-four participants completed the study. Considering the time of interaction, after four weeks, data analysis revealed a significant decrease in the VAS score (37.23±12.58 vs. 57.87±13.21), total WOMAC score (24.83±9.70 vs. 49.17±12.89), WOMAC pain score (7.19±2.90 vs. 12.40±4.46), stiffness (2.06± 0.845 vs. 4.11±1.14), and physical function (15.57±7.25 vs. 32.66±9.78) in the intervention group compared to the control group (P

Background and purpose: In Persian medicine, it is believed that the creation of life and its continuation depends on Innate Moisture, and natural human death occurs when this moisture ends. Despite the use of this term in medical texts, there is no acceptable understanding of this concept. The purpose of this research was to provide a systematic summary of data about Innate Moisture from the perspective of traditional physicians in different centuries, to explain that and enable more use of this concept in clinical setting. Materials and methods: The keywords in this study were as follows: Innate Moisture, Original Moisture, Moisture, al-Rotuba al-Ghrizia, al-Rotuba al-Asliyyah, Innate Humidity, and Natural Moisture in both Persian and English. We used Rodgers' evolutionary concept analysis which consists of a series of overlapping steps whose main goal is to clarify the concept. Results: In medical books, Moisture is considered from two perspectives: Moisture as an accident (quality) and Moisture as a substance (moist substance). Innate Moisture is present as a moist substance in the human body. The nature of Innate Moisture is less discussed in sources, but physicians are in agreement about its role as a main basis for the continuation of human life. Conclusion: Innate Moisture can be divided into two types; original (originated from zygote) and non-original (originated from nutrition). Non-original Innate Moistures are considered as alternative for original Innate Moisture so that the original Innate Moisture is reduced less and remains as long as the natural life of the person continues.

Background: In the context of Persian traditional medicine, there are several therapeutic strategies for managing diseases, ranging from lifestyle changes to herbal remedies. Objectives: Given the application of Persian traditional medicine in the management of chronic diseases, the burden of chronic illnesses, and the public’s recourse to traditional medicine specialists, this study aimed to assess the cost-effectiveness of traditional medicine dietary regimens for the treatment of non-alcoholic fatty liver disease from the perspective of the payer. Methods: In this study, we investigated the cost-effectiveness of providing nutrition counseling for lifestyle modification (changes in the aforementioned Setteh-e-Zarurieah) by a traditional medicine specialist compared to receiving counseling from a nutritionist for nonalcoholic fatty liver disease from the payer’s perspective. The outcomes measured were changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, body mass index (BMI), and the grade of fatty liver. Cost and effectiveness data were entered into Excel software, and the ICER ratio was calculated. Results: The results indicated that the dietary regimen prescribed by Persian traditional medicine when compared to the nutritionist’s recommended diet, resulted in a lower decrease in AST and ALT enzymes but led to a greater decrease in BMI (mean change = 0.42) and a significant change in the grade of fatty liver (OR = 9.75). Since the costs of tests, ultrasounds, and visits were equal in both groups, the cost difference was zero. In the first scenario, where traditional medicine is considered an alternative therapy and liver enzymes are the primary focus, providing nutritional counseling services by Persian traditional medicine may not be cost effective. However, if we consider the grade of fatty liver and BMI as the primary variables, providing nutritional counseling services by Persian traditional medicine may be cost-effective. Conclusions: Based on the available evidence, the treatment of fatty liver using Persian traditional medicine can be considered an effective and cost-effective complementary (or alternative) intervention. Considering the long-term costs imposed by the health system and insurance organizations, it is predicted that adding visits to Persian traditional medicine specialists may reduce overall healthcare system costs.

Background: Oxymel is a functional beverage with a rich historical background of use in multiple societies. Various simple and compound oxymels are prescribed in certain complementary and traditional medical systems, including traditional Persian Medicine. In recent years, numerous clinical and preclinical studies have been conducted in the pharmacy and food industry to investigate the efficacy of various oxymel formulations. This article aims to systematically review and summarize interventional studies on oxymel in both clinical research and animal models. Methods: Relevant articles were searched in Embase, MEDLINE, Web of Science Core Collection, Scopus, and Google Scholar from inception to July 2023 using the keyword “Oxymel” and its equivalents in other languages. Animal and human interventional studies were selected from the search results for review. Results: This review includes twenty studies, comprising twelve clinical trials, two case studies, and six animal studies. The most commonly reported actions of oxymel include positive effects on the cardiovascular system, as well as antioxidant and anti-inflammatory properties. Furthermore, compound oxymel formulations have demonstrated additional benefits depending on the inclusion of specific medicinal herbs. Conclusion: Based on our findings, oxymel appears to be a valuable functional food for healthy individuals and a potentially effective and safe treatment option for managing certain diseases such as asthma, obesity, and type 2 diabetes. However, further clinical trials with larger sample sizes and longer durations are needed to fully elucidate the potential side effects and benefits of both simple and compound oxymels in various disease states.

• The mean itching, dyspareunia, and dysuria score improved using CLOT-M cream. • Longer response of non-albicans Candida strains to CLOT-M cream. • CLOT-M group showed significant yeast culture improvement in 2nd follow-up visit. Vulvovaginal candidiasis is a common gynecologic infection, and recurring cases are yet incurable. This trial was based on Persian medicine to compare how effective marshmallow aqueous extract 4% plus clotrimazole 1% (CLOT-M) is compared to clotrimazole 1% vaginal creams on VVC. This study randomly assigned 100 women with VVC into two groups. The target group (n = 50) was treated with CLOT-M while controls (n = 50) with clotrimazole vaginal creams for seven consecutive nights. Different VVC symptoms and signs, and yeast culture from vaginal discharge were evaluated as the outcome measures before the intervention and 7 and 30 days after. The efficacy of CLOT-M vaginal cream was assessed during the 1st and 2nd follow-ups, indicating a significant decrease in mean itching (P = 0.001 for both comparisons) and dyspareunia score (P = 0.001 and P = 0.04, respectively) as compared to treatment with clotrimazole vaginal cream. Moreover, after 7 days of the intervention, patients in the CLOT-M group experienced significant improvement in mean dysuria score compared to those in the control group (P = 0.001). Neither cream caused any significant adverse events. It seems that CLOT-M vaginal cream had a significant effect on the VVC symptoms improvement, without any significant side effects. However, larger sample-sized trials are needed for more evidence-based judgment. [ABSTRACT FROM AUTHOR]

Background and Aim: Tinnitus is a common disorder of the auditory system with a rich history dating back to ancient times. This review aims to provide a historical perspective on tinnitus in Traditional Persian Medicine (TPM) by summarizing the views of TPM scholars on its etiology and treatment. Methods: A qualitative research (summative content analysis) was conducted, utilizing TPM texts to identify the historical perspectives of TPM scholars on tinnitus. The analysis focused on their understanding of tinnitus, its causes, and recommended treatments. Results: In TPM, tinnitus was referred to as Tanin and Davi. The accumulation of phlegm and internal gases in the head or ears was considered as the main cause of tinnitus, with sudden movement or ripple of these vapors leading to auditory nerve stimulation and resulting in tinnitus. TPM scholars recommended addressing the sources of these vapors, such as gastrointestinal issues, and promoting humeral balance through temperament modification and the use of medicinal herbs for treatment. Conclusion: The TPM view on tinnitus was similar to the Greco-Roman understanding of the disease, with Persian scholars expanding on its details. TPM scholars believed in addressing the underlying causes of tinnitus and promoting humeral balance to alleviate symptoms. These historical perspectives provide insight into traditional medical systems and their approaches to the management of health conditions. [ABSTRACT FROM AUTHOR]

Objectives: The most prominent microorganisms that cause hospital infections and acquire antibiotic resistance are Staphylococcus aureus and Pseudomonas aeruginosa. The present study aimed to compare the phenolic and flavonoid compounds of various Allium ampeloprasum and Allium porrum extracts and evaluate the antibacterial effects of these extracts against these two microorganisms.Methods : : The total phenolic and flavonoid contents of the acetone, methanol, aqueous, and hexane leeks extracts from A. ampeloprasum and A. porrum were measured. The antibacterial activity of these extracts against S. aureus and P. aeruginosa was tested using the disk diffusion method for 24, 48, and 72 hours. Further, the minimum inhibitory concentrations and the minimum bactericidal concentrations of these extracts for these two bacteria were evaluated and compared with those of common antibiotics.Results : : The aqueous extracts showed the highest phenolic and flavonoid contents and at concentrations of 35 and 40 mg per disk, showed the most antibacterial activity against S. aureus and P. aeruginosa; P. aeruginosa showed more sensitivity to the aqueous extracts than S. aureus.Conclusion : : Aqueous A. ampeloprasum and A. porrum extracts may prevent the growth of hospital pathogens, especially P. aeruginosa; our findings will aid the discovery of new antimicrobial substances against antibiotic-resistant bacteria.

BackgroundLiving with HIV requires lifelong care to support engagement with and adherence to antiretroviral therapy. The Middle East and North Africa region provides access to ART, but research is lacking on the lived-experiences of people living with HIV. Globally, complementary and alternative medicine (CAM) is increasingly used by patients who need support alongside receiving medical treatment for chronic conditions. This study aims to examine the frequency and reasons behind the use of CAM, as well as identify its associated factors among people living with HIV in Shiraz, Iran.MethodsIn this cross-sectional study, a total of 320 patients (aged 18–70 years) with a confirmed diagnosis of HIV residing in Fars province and diagnosed between 1999 and 2019 were recruited randomly through their clinical record numbers from five HIV treatment centers. They were surveyed on their quality of life and CAM use via the Short-Form Health Survey questionnaire (SF-36) and a semi-structured survey of “CAM use.” The data analysis for this study involved the use of Chi-squared test, independent t-test, and multiple logistic regression model.ResultsOf 287 patients, 89.22% reported using CAM in the previous year. CAM use was more prevalent among those with a family history of CAM use (94.3% vs. 81.8%, p = 0.023). Frequent reasons for using CAM were reported to be sexual dysfunction (32.4%), depression (28.3%), thirstiness (23.3%), and nausea (17.5%). Quality of life, as measured via the SF-36 questionnaire in all its 8 sub-domains, did not differ among those who used CAM versus those who did not (61.5 ± 27.6 vs. 58.1 ± 30.9, p = 0.626).ConclusionCAM was used among a majority of people living with HIV in Shiraz, Iran. People who used CAM appeared to experience a similar quality of life relative to those who did not use CAM. Future studies on the modalities of engagement with CAM can improve patient-physician shared decision-making and increase lifelong care options for people living with HIV.

In Traditional Persian Medicine (TPM) saffron is used as an accompaniment agent “Mobadreq” in poly herbal formulations. According to TPM texts, “Mobadreq” is a substance (or drug) which facilitates access of drugs or food to the whole body or specific organs. This study investigated the effect of oral co-administration of Crocus sativus L. (saffron) on the absorption and some pharmacokinetic parameters of acetaminophen in rats. Two groups of Rats (n=6) were treated by 1: acetaminophen 10 mg/kg along with Crocus sativus 4 mg/kg (test group) and 2: 10 mg/kg acetaminophen (control). The plasma concentrations of acetaminophen after oral administration (at 0, 5, 10, 15, 20, 40, 60, 90, and 120 min) were monitored by an HPLC-UV method. Results indicated that the plasma concentration of acetaminophen in the test group was reached to the maximum concentration (Cmax) faster than control group. As a result, at 5 to 40 minutes after drug gavage, the concentration of acetaminophen in both groups was significantly different. It was also found that co-administration of acetaminophen and saffron significantly increased acetaminophen’s area under concentration curve (AUC0-60) in compare to the acetaminophen alone (p

Background and purpose: In Persian medicine, it is believed that the creation of life and its continuation depends on Innate Moisture, and natural human death occurs when this moisture ends. Despite the use of this term in medical texts, there is no acceptable understanding of this concept. The purpose of this research was to provide a systematic summary of data about Innate Moisture from the perspective of traditional physicians in different centuries, to explain that and enable more use of this concept in clinical setting. Materials and methods: The keywords in this study were as follows: Innate Moisture, Original Moisture, Moisture, al-Rotuba al-Ghrizia, al-Rotuba al-Asliyyah, Innate Humidity, and Natural Moisture in both Persian and English. We used Rodgers' evolutionary concept analysis which consists of a series of overlapping steps whose main goal is to clarify the concept. Results: In medical books, Moisture is considered from two perspectives: Moisture as an accident (quality) and Moisture as a substance (moist substance). Innate Moisture is present as a moist substance in the human body. The nature of Innate Moisture is less discussed in sources, but physicians are in agreement about its role as a main basis for the continuation of human life. Conclusion: Innate Moisture can be divided into two types; original (originated from zygote) and non-original (originated from nutrition). Non-original Innate Moistures are considered as alternative for original Innate Moisture so that the original Innate Moisture is reduced less and remains as long as the natural life of the person continues. [ABSTRACT FROM AUTHOR]

Background and aims: Today, due to the increasing use of natural and traditional medicinal products, control and standardization of herbal and traditional medicinal products is very important. As most of the traditional medicinal plants are not scientifically validated, scientific evaluation along with traditional knowledge is essential to obtain effective drugs with significant control over the quality of the product for commercial purpose. In traditional Persian medicine, various forms of medicine including one or a combination of several drugs are mentioned. Coriander Triphala widely prescribed as a purgative, gastrointestinal and mental tonic. Despite the widespread use of this drug, no significant control or standardization and documented pharmacognosy studies have been performed on it. Therefore this study is developed for this purpose. Methods: In this study, the traditional form of Coriander Triphala was prepared based on the pharmaceutics points mentioned in traditional medicine texts and quality control and pharmacognostic studies were performed. The associated fingerprints were performed by gas chromatography–mass spectrometry (GC-MS), and then one of the main components of the product was determined by as gas chromatography-flame ionization detector (GC-FID). Results: The spectrum of essential oils of Coriander Triphala and Coriander had 59.19% and 75.34% linalool, respectively. The microbial assay showed no undesirable results. The IR spectrum of Coriander Triphala at first day and 40 days later differed by 2%. Conclusion: Standardization of the product using GC-FID indicates the presence of 0.172 μg linalool in 100 g the Coriander Triphala product.

Introduction: Since December 2019, COVID-19 has caused a pandemic. The use of effective and safe complementary therapies can be helpful in COVID-19 treatment. Traditional Persian medicine (TPM) is a kind of traditional medicine based on more than a thousand years of Persian medical practice. The purpose of this research is to introduce TPM opinion for the study of COVID-19 pathophysiology. Materials and Methods: TPM literature was searched during centuries 4th to 13th AH, using these keywords: “Havaye vabaii” and “Homayat”; Databases (PubMed, PMC, Google Scholar, and Scopus) were also searched by: “fever”, “cough” “dyspnea”, etiology, pathophysiology of COVID-19. This research has been done in seven phases. Results: According to TPM resources, the human body is comprised of four primary elements: earth, water, fire, and air, and their combination makes humors (Khelt) and temperaments (qualities). The ingested food undergoes four stages of digestion to produce four humors in body including blood, phlegm, yellow bile, and black bile. The balance of four humors is effective in health maintenance. Persian Medicine physicians believe, that all diseases can be prevented and cured by modification and avoidance of etiologic factors. We tried to explain, that humors change in exposure to Coronavirus due to hepatic dysfunction and based on TPM texts. Conclusion: According to the results of the present research, some methods for effective prevention and treatment suggestions for COVID-19 can be proposed in the context of Persian medicine and based on the opinion of Persian medical scholars.