Single item presenteeism question: Reliability and validity of Persian version in participants with low back pain

BACKGROUND

Single item presenteeism question (SIPQ) is a rating scale to assess the impact of low back pain (LBP) on presenteeism.

OBJECTIVE

To translate the SIPQ into Persian language (SIPQ-P) and evaluate the reliability and validity of the SIPQ-P in participants with LBP.

METHODS

In the first stage, the English SIPQ was translated into Persian language in a cross-sectional design following standard forward-backward approach with expert panel review and pilot testing. In the second stage with a prospective cohort design, 100 participants with LBP (84 male and 16 female, mean age±SD: 33.9±11.2 years) participated. Participants were asked to answer the SIPQ-P and rate their LBP from 0 to 10 according to the numerical pain rating scale (NPRS) for concurrent criterion validity. To evaluate the convergent construct validity of SIPQ, participants completed Persian Functional Rating Index (PFRI). For the divergent validity, the Spearman's correlation test was used to evaluate the association between the SIPQ-P and education. For the test-retest reliability, 50 participants answered the SIPQ-P after 7 days. Fifty healthy participants (mean age±SD: 24.24±8.07 years) answered the SIPQ-P for evaluating discriminant validity.

RESULTS

There was a significant difference between the SIPQ-P score of participants and the healthy participants (p <  0.001). The concurrent criterion validity was demonstrated by a significant correlation between the SIPQ-P and pain NPRS (Spearman's rho = 0.46, p <  0.001). The Spearman correlation coefficient showed a significant correlation between the SIPQ-P scores and the Persian FRI (r = 0.56, p <  0.001). There was no correlation between the SIPQ-P score and the education level (r = -0.001, p = 0.99). The ICCagreement was 0.77 indicating a very good test-retest reliability.

CONCLUSIONS

This study showed that the Persian version of SIPQ is a reliable and valid scale to assess the effect of LBP on presenteeism in Persian speakers with LBP.

Rhazes, a pioneer in contribution to trials in medical practice

Medical history explains that Persian physicians used scientific methods based on clinical experiences and observations for treatment from pre-Islamic time (before 637 AD) and centuries later (in the Islamic era). Rhazes was one of the Persian physicians acknowledged as a pharmacist, chemist and prominent scientific writer on various subjects of medicine and philosophy. In this study, we aimed to investigate clinical experiences, as well as the ethical and critical views of Rhazes in medical practice. Rhazes promoted ethics in the medical profession. He expressed critical key points about ancient written texts. He broke ancient physicians' taboos in medical theories and evaluated them based on his own experiences. He designed animal and preclinical evaluations for his theories and also performed the first clinical trials with control groups in the history. His critical views about medical sciences as well as his beliefs in experiments resulted in many medical, chemical and pharmaceutical findings. Therefore, in history, he can be considered as the pioneer in using trials and experiments for approving medical methods.

MHC haplotype diversity in Persian Arabian horses determined using polymorphic microsatellites

Previous research on the equine major histocompatibility complex (MHC) demonstrated strong correlations between haplotypes defined by polymorphic intra-MHC microsatellites and haplotypes defined using classical serology. Here, we estimated MHC diversity in a sample of 124 Arabian horses from an endangered strain native to Iran (Persian Asil Arabians), using a validated 10-marker microsatellite panel. In a group of 66 horses related as parent-offspring pairs or half-sibling groups, we defined 51 MHC haplotypes, 49 of which were new. In 47 of the remaining 58 unrelated horses, we could assign one previously identified MHC haplotype, and by default, we gave provisional haplotype status to the remaining constellation of microsatellite alleles. In these horses, we found 21 haplotypes that we had previously defined and 31 provisional haplotypes, two of which had been identified in an earlier study. This gave a total of 78 new MHC haplotypes. The final 11 horses were MHC heterozygotes that we could not phase using information from any of the previously validated or provisional haplotypes. However, we could determine that these horses carried a total of 22 different undefined haplotypes. In the overall population sample, we detected three homozygous horses and one maternally inherited recombinant from 21 informative segregations. Virtually all of the horses tested were MHC heterozygotes, and most unrelated horses (98%) were heterozygous for rare microsatellite-defined haplotypes found less than three times in the sampled horses. This is evidence for a very high level of MHC haplotype variation in the Persian Asil Arabian horse.

An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia

Hemorrhoids is one of the most common gastrointestinal diseases. There are several therapeutic options associated with some complications. Therefore, researchers look for traditional medicines as a potential resource for introduction of new natural drugs. The current study reports an evidence-based review of herbal remedies for hemorrhoids in traditional Persian medicine. A comprehensive survey about hemorrhoids on the most important manuscripts of traditional Persian medicine was done. Then, scientific data banks were searched for possible related properties of each herb in the conventional medicine. We reported some historical aspects of traditional Persian medicine view on classification, examination, and predisposing factors of hemorrhoids. In addition, we have reported 105 medicinal plants belonging to 51 families. More than half of the reported herbs exhibited anti-inflammatory and analgesic effects. Although lack of human studies regarding the mentioned herbs is noted, positive results from experimental findings can be considered for new drug discovery supported by traditional and medieval experiences.

Traditional neurotherapeutics approach intended for direct nose to brain delivery

ETHNOPHARMACOLOGICAL RELEVANCE

Nasal delivery systems have a significant role in Persian traditional medicine. Most of them were utilized for central nervous system (CNS)-related disorders. In modern medicine, nasal drug delivery systems for brain delivery are highly regarded.

AIM OF THE STUDY

Despite recent advances in drug delivery to the (CNS), delivery of therapeutics to the brain remains a major challenge because of the blood brain barrier (BBB). There are several mechanisms which regulate the drug transfer across the BBB. Local administration methods of therapeutic agents are often associated with adverse events, while the intranasal pathway has been suggested as a non-invasive alternative route to deliver drugs to the brain. This route can bypass the BBB and deliver drug molecules directly to the CNS. There are different nasal formulations have been addressed in Persian traditional pharmacopeias. The present review attempt to explore the famous and practical Qarabadin to find ancient nasal dosage forms.

MATERIALS AND METHODS

With an explore on traditional herbs in google scholar, scopus and science direct, we have found some original and review articles which have demonstrated our findings on the use of traditional herbs for CNS disorders. Four encyclopedia of multi-component formulations, including Qarabadin Salehi (1766), Qarabadin kabir (1781),Qarabadin Ghaderi (18th century), and Qarabadin Azam (1853), were searched for nasal formulations having CNS-related indications. Formulations were categorized based on dosage forms, and also, diseases which they were suggested for. While the names of illnesses were in ancient terminology of Traditional Medicine, they were translated to modern medical terminology by comparing their definitions, signs, and symptoms from two medical systems. Typical samples of each dosage form have been mentioned with details like amount of ingredients, scientific names of plants, and considerations pertaining to preparation or usage.

RESULTS

Among all traditional nasal formulations, seven types were found that is used for sicknesses relating to CNS including Saoot, Nafookh, Atoos, Nashoogh, Shamoom, Lakhlakheh, and Bakhoor.

CONCLUSIONS

The findings of this study reveal the physicochemical characteristics of each formulation, route of administration, and type of disease which they are suitable and also present some famous formulations.

Breastfeeding: A Review of Its Physiology and Galactogogue Plants in View of Traditional Persian Medicine

INTRODUCTION

The beneficial effects of breastfeeding for the infant and mother are well recognized. Many natural products are reputed to be galactogogue agents in major Traditional Persian Medicine (TPM) textbooks. The aim of this study is to review those medicinal plants that are reported to be effective in increasing breast milk in TPM and to compare the data from TPM texts with the findings of modern pharmacological and clinical research.

MATERIALS AND METHODS

Data on the medicinal plants used to increase breast milk were obtained from major TPM textbooks. A detailed search in PubMed, Science Direct, Scopus, Google Scholar, and Web of Science databases was performed to confirm the effects of medicinal plants mentioned in TPM on lactation in view of the identified pharmacological actions.

RESULTS

Foeniculum vulgare, Anethum graveolens, Pimpinella anisum, Nigella sativa, and Vitex agnus-castus are among the most effective galactogogue TPM plants. Many pharmacologically relevant activities have been reported for these herbs.

CONCLUSION

The use of traditional knowledge can pave the way toward finding effective phytopharmaceuticals for increasing breast milk.

The Historical Background of Plaster Cast

The pivotal role of plaster of Paris (POP) cast as an immobilization tool to promote healing in complex and/or other types of fractures is irrefutable. We clearly know that Antonius Mathysen extensively applied plaster cast during Crimea and/or other wars and reportedly saved thousands of lives. However, the exact origin of using POP in orthopedic cast is yet to be clear. In his famous report from Bandar-e Rig, a city in Iran, William Eton paved the way for the conclusion that POP cast might have originated from the Persian Empire. In this paper, we provide more supporting evidences which make the aforementioned claim more probable.

Morris Young, pioneer physician

This concise biography of Morris Young shows how he developed the medical services of the Anglo-Persian Oil Company in the first three decades of the twentieth century, and ended his career working with Sir Alexander Fleming at St Mary's Hospital in London. Young is an important figure in the history of medicine in Persia, and this biography introduces the achievements of this modest man who devoted his life to medicine.

[Greek science in the centre of the Dialogue between Orient and Occident ]

Most pre-Socratic Greek philosophers originated from Ionia, in Minor Asia, where Achaeans had been installed since the 11th century B. C. During the Age of Pericles, Empedocles of Agrigento, in Sicily, Leucippus and Democritus from Abdera, Anaxagoras of Clazomenae, active in Athens, and Socrates in Athens also took over philosophy and science in Continental Greece. Plato, Socrates’ disciple and founder of Academia, and his own disciple Aristotle, founder of the Lyceum, and his pupils, such as Theophrastus of Eresos, followed them. In the area of medicine and pharmacy, Hippocrates of Cos and his disciples and followers redacted between 450 and 300 B. C., what is known as Hippocratic corpus. Then came Galen from Pergamum who completed the theory of Humours, during the second century. Nestorian Christians, considered as heretical in the Byzantine Empire, were accepted in Sassanid Persia and carried Greek culture with them. After Arabic conquest and Baghdad City creation, in 762, they translated Hippocratic corpus in Arabic language so that Hippocratico-Galenic theory could pass in Arabic-Muslim world. It was then developed by Al-Kindi in Baghdad, Ibn Al-Jazzar in Kairouan, Razes or Avicenna, both Persians. The 11th and the 12th centuries were characterised by Latin translations, by Constantine the African in Monte-Cassino, Gerard of Cremona or Mark of Toledo. The School of Salerno created then the conditions for the fusion of Greek, Arabic and Jewish medicines. The creation of modern science from Greek philosophy was a consequence of a permanent dialogue between Orient and Occident.

Anesthesia and pain management in traditional Iranian medicine

Studying the history of science could help develop an understanding of the contributions made by ancient nations towards scientific advances. Although Iranians had an important impact on the improvement of science, the history of Iranian medicine seems not to have been given enough attention by historians. The present study focused on the history of anesthesia and pain management in Iranian medical history. In this regard, related books such as Avesta and Shahnameh were studied in order to obtain the history of anesthesiology in Iranian pre Islamic era. This subject was also studied in the famous books of Rhazes, Haly Abbas, Avicenna, Jorjani, MomenTunekaboni and Aghili from different times of the Islamic era. Scientific data bases such as PubMed, Scopus and Google Scholar were searched using key words "Iranian", "Persian", "pain management" and "anesthesia". It was discovered that pain management and anesthesiology were well known to the Iranians. Rhazes and Avicenna had innovations in this regard. Fourteen Mokhader (anesthetic) herbs, which were included in the collection of the previous knowledge of the 18th century entitled Makhzan al-Advieyh and used as the Persian Materia Medica, were identified and listed. This study introduces the history of anesthesiology and pain management at different periods in the history of Iran.

Early Description of Diet-Induced Blistering Skin Diseases in Medieval Persia: Avicenna's Point of View

Pemphigus is an autoimmune blistering skin disease that is strongly associated with different environmental factors. Among these, nutritional factors are considered to trigger pemphigus; however, their role may be underestimated. Investigated more recently in conventional medicine, this causative bond between dietary factors and blistering skin diseases was mentioned by Persian scholars such as Avicenna a thousand years ago. Avicenna, a well-known Persian physician and philosopher, who could be considered a pioneer in dermatology, discussed skin diseases in a chapter in The Canon of Medicine. He accounted for some nutritional triggers for skin blisters (mentioned as "hot swellings"), such as onion, garlic, leek, pepper, and wine. His precise description of causative factors based on principles of traditional Persian medicine (TPM) is appreciable and might well lead us to find more efficient ways for the prevention and treatment of blistering skin diseases.

Qutb al-Dīn Shīrāzī (1236-1311), Persian polymath physician in the medieval period

Qutb al-Dīn Shīrāzī, a great physician in the medieval period of the Iranian Islamic age, is also called Allāma (polymath) for his extraordinary expertise in almost all fields of contemporary sciences. The peaceful and cultural environment of his hometown and family contributed to his development despite a time of horror from Mongolian repeated invasions of the Islamic countries. Shīrāzī never ceased learning and researching and migrated widely in order to find scientists to learn from them. He worked in many centres as a teacher and researcher. He practised medicine and educated students, and his books on other fields of science reflect his comprehensive mastery of most of the basic sciences and the humanities. Shīrāzī 's social and political roles make him one of the paramount of Iranian elites who contributed to the re-establishment of the Iranian-Islamic civilisation after its destruction by the Mongolians in the thirteenth century.

Akhawayni (?-983 AD): A Persian neuropsychiatrist in the early medieval era (9th-12th Century AD)

The early medieval era is also called the Islamic Golden Age because of the significant rise in sciences, including medicine. Abū Bakr Rabi' ibn Ahmad Akhawayni Bukhāri (better known as Akhawayni) was one of the notable medical practitioners in his lifetime. His fame was in neuroscience and he became known as Pezeshk-e-Divanegan (Physician to the Insane). His only surviving book, Hidāyat al-Muta'allimin fi al-Tibb (The Students' Handbook of Medicine), is the first medical textbook in Persian, after Islam. Akhawayni gathered and categorized available knowledge on neuropsychiatry and added his own. He was the first to describe sleep paralysis and to suggest pragmatic rather than supernatural treatment. He was also the first to present fever cure and his descriptions of meningitis (Lisarghos in Hidāyat), mania, psychosis (Malikhulia), dementia (Ghotrab), etc., are close to current concepts.

Ibn al-Haytham (965-1039 AD), the original portrayal of the modern theory of vision

Abū ՙAlī al-Ḥasan ibn al-Ḥasan ibn al-Haytham, known in the West as Alhazen, was an Arab-Islamic scholar who helped develop the science of ophthalmology during the medieval era. He was the first to reject firmly the extramission theory of vision, which was prevalent during his time, and suggested that the eyes are the source of the light rays responsible for vision. Ibn al-Haytham in his book entitled Kitab al-Manazir (Book of Optics) explained vision based on light emanating from objects. In this study we review Ibn al-Haytham's life and introduce his major contribution to the field of ophthalmology, his theory of vision.

On pains of the kidney and the bladder in Kitāb al-Tajārib by Rhazes

Abū Bakr Muḥammad ibn Zakariyyā al-Rāzī (865-925), known in the West as Rhazes, was one of the pioneer figures of the golden age of Islamic science and medicine during the middle ages. Kiṭab al-Ḥāwī fī al-Ṭibb (Liber Continens), Kitāb al-Ṭibb al-Manṣūrī (Liber Medicinalis ad Almansorem) and Kitāb al-Judarī wa al-Ḥaṣba (Liber de Pestilentia) are his very well-known works in medicine. One of his books Kitāb al-Tajārib (The Book of Experiences/The Casebook), was written in Arabic and one of its copies is Ahmed III, Nr. 1975 manuscript in Topkapı Palace Library in Istanbul. A physician, Ali Munshi of Bursa, translated Kitāb al-Tajārib into Turkish in the 18th century and Hamidiye, Nr. 1013; Veliyuddin Efendi, Nr. 2487 and orum, Nr. 2909 manuscripts are the copies of its Turkish translation in different libraries in Turkey. Both the book and its Turkish translation contain 31 chapters; 30 of them concerning diseases from head to heel and the last one on pharmaceutics. The 21st chapter, fī awjā' al-kulā wa al-mathāna wa al-bāh, of Kitāb al-Tajārib is on pains of the kidney, and the bladder, and coitus. Evaluation and presentation of the cases in this chapter regarding the kidney and the bladder are the aims of this report.

Mansur ibn Ilyas (1380-1422 AD): A Persian anatomist and his book of anatomy, Tashrih-i Mansuri

A Persian scholar, Mansur ibn Elyas, a late 14th century anatomist and physician from Shiraz, published his illustrated book on anatomy. Mansur's anatomy (Tashrih-i Badan-i Insan) was written following the Mansur's medical synopsis, Kefaye Mojahedieh. The book of Mansur is believed to be the first anatomical illustrated manuscript containing two-dimensional pictures of the human body. This 14th-century treatise is composed in Persian and is organized into five articles on the skeleton, nerves, muscles, veins and arteries, each illustrated with a full page diagram and with a final chapter including an image of a pregnant woman delivering a breech baby. These chapters have description part and related figure involving brief explanation. Mansur's illustrations were often used in other Persian or Arabic medical manuscripts for at least two centuries in Persia.

Evaluation of MT1XT20 Single Quasi-Monomorphic Mononucleotide Marker for Characterizing Microsatellite Instability in Persian Lynch Syndrome Patients

BACKGROUND

Colorectal malignancies with high microsatellite instability (MSI-H), either hereditary (Lynch syndrome) or sporadic, demonstrate better prognosis and altered response to 5FU chemotherapy. It is now recommended to perform MSI testing for all new cases of colorectal cancer regardless of being categorized as hereditary or sporadic. For MSI detection, immunohistochemistry or PCR-based protocols using a cohort of various sets of STR markers are recommended. Here we aimed to evaluate a simplified protocol using just a single STR marker, MT1XT20 mononucleotide repeat, for detection of MSI in Lynch syndrome patients. A Promega five-marker MSI testing panel and immunohistochemistry (IHC) were used as the gold standard in conjunction with MT1XT20.

MATERIALS AND METHODS

Colorectal patients with a positive history of familial cancers were selected by evaluating medical records. Based on Amsterdam II criteria for Lynch syndrome 20 families were short listed. DNA was extracted from formalin fixed paraffin embedded tumour and adjacent normal tissues resected from the index case in each family. Extracted DNA was subjected to MT1XT20 mononucleotide marker analysis and assessment with a commercially available five marker MSI testing kit (Promega, USA). IHC also was performed on tissue sections and the results were compared with PCR based data.

RESULTS

Eight (40%), seven (35%) and five (25%) cases were MSI positive using with the Promega kit, IHC and MT1XT20, respectively. Among the markers included in Promega kit, BAT26 marker showed instability in all 8 samples. NR24 and NR21 markers showed instability in 7 (87.5%), and BAT25 and MONO 27 in 6 (75%) and 5 (62.5%).

CONCLUSIONS

Although MT1XT20 was earlier reported as a valid standalone marker for MSI testing in CRC patients, we could not verify this in our Iranian patients. Instead BAT26 among the markers included in Promega MSI testing kit showed instability in all 8 MSI-H CRC samples. Therefore, it seems BAT26 could act well as a single marker for MSI testing in Iranian CRC patients.

The Discourse of Medicine in the Čahār Maqāla (Four Discourses) of Nezami Aruzi of Samarghand

Nezami Aruzi prepared Čahār Maqāla (Four Discourses) as a guide and admonishment for the rulers and kings. The fourth discourse of Čahār Maqāla with 12 anecdotes is devoted to the science of medicine and the characteristics of the physicians. The discourse presents the name of the eminent scientists, physicians, as well as Farsi and Arabic medical books that had professional acceptance in the medieval in Persia. The author has described how medicine was studied in the medieval in Persia and has presented notes on the physiology of the nervous system, pulse, uroscopy, fever, spiritual affairs and medical ethics. The current essay is a brief review of the medical subjects in Čahār Maqāla.

[A change to the traditional medicine in Persia?]

Until the 19th century, medicine in Persia is mainly based on the humoral theory. According to some authors, the introduction of anatomical pathology principles is due to the particular political and health circumstances of this century and the intellectual evolution of Persian physicians. By making a comparison between the text of Shirazi, the prominent Persian physician of the 19th century, and the writings of Avicenna on cholera and heyze (acute diarrhea), this article tests this hypothesis.

Medical care of children during the golden age of Islamic medicine

During the Sassanid Empire in Persia (226-652 AD), there was a renaissance of humanistic sciences, including medicine, in the city of Gondi-Shapur. When the Islamic center of power moved to Baghdad in about 750 AD, physicians of Gondi-Shapur, including the dean of the medical school (a Nestorian Christian), gradually moved to Baghdad constructing hospitals and medical schools. Aided by the Persian and Nestorian Christians, the Islamic civilization ushered in what is considered to be the Golden Age of Islam from the 8th to 13th century AD. During this period, there were remarkable achievements in humanistic sciences including medicine by many physicians/authors whose medical textbooks were used for centuries in burgeoning medical schools in Europe. The medical texts written during the Golden Age of Islamic Medicine contain sections and chapters about the clinical conditions, diseases and medical care of children. It was during this era that the first treatise was written on the diseases of children and their care. This essay will describe, in brief, the writings about the conditions and diseases of children and their medical care, by three prominent Persian physicians of the Golden Age of Islamic Medicine: 1) Abubakr Muhammad Ibn Zakaria Razi, Rhazes (865-925 AD); 2) Ali ibn-al-Abbas al-Majusi or Haly Abbas (949-994 AD); and 3)  Abu Ali al-Husayn ibn Abd Allah ibn Sina or Avicenna (980-1037 AD).

Medicinal plants contain mucilage used in traditional Persian medicine (TPM)

CONTEXT

Conventional therapies using mucilage plants greatly used by practitioners in Iran. The usage of mucilages is rooted in traditional knowledge with a history of more than 4000 years. Scientific assessment of these historical documents could be valuable for finding new potential usage in the current medicine.

OBJECTIVE

This study assembled an inventory of mucilage plants considered important therapeutic aids for alleviating the ailments in ancient Persian medicine and compared therapeutic applications of ancient times with current findings of medicinal mucilages in the same plant species.

METHODS

A literature search compiled some main traditional manuscripts of Persian medicine, including the book of AlHavi, Canon of Medicine, Zakhireh-iKharazmshahi, Qarabadine-kabir, Tohfat ol Moemenin, and Makhzan-ol-advieh, and select mucilage plants used in treating the mouth and respiratory system disorders. Also, current investigations on related subjects were considered through a search of the Pub Med and Google Scholar databases.

RESULTS

In Iran, the application of medicinal plants contains mucilage date back to ancient times. In mentioned medieval Persian books, 20 medicinal plants containing mucilage were identified. Mucilages have been traditionally used via oral or topical routes for a variety of disorders. According to this study, most of the cited medicinal plant species were used for their mucilaginous, anti-inflammatory, and anti-oxidant effects.

CONCLUSIONS

A scientific evaluation of these historical documents can give an insight into the ideas of the past and be valuable in finding new data on clinical use of the mucilages that should lead to future opportunities to investigate their potential medicinal use.

Causes and risk factors of urinary incontinence: Avicenna's point of view vs. contemporary findings

PURPOSE

To extract the causes and risk factors of urinary incontinence from an old medical text by Avicenna entitled "Canon of Medicine" and comparing it with contemporary studies.

MATERIALS AND METHODS

In this study, etiology and risk factors of urinary incontinence were extracted from Avicenna's "Canon of Medicine". Commentaries written on this book and other old reliable medical texts about bladder and its diseases were also studied. Then the achieved information was compared with contemporary findings of published articles.

RESULTS

Urinary incontinence results from bladder dysfunction in reservoir phase. Bladder's involuntary muscles and voluntary external sphincter are two main components which are involved in this process. Urinary incontinence can exist without obvious structural and neuronal etiologies. According to Avicenna, distemperment of muscular tissue of bladder and external sphincter is the cause for urinary incontinence in such cases. Distemperment is the result of bothering qualities in tissue, i.e.: "wet" and "cold". They are the two bothering qualities which are caused by extracorporeal and intracorporeal factors. Interestingly, the positive associations of some of these factors with urinary incontinence have been shown in recent researches.

CONCLUSION

"Cold" and "wet" distemperment of bladder and external sphincter can be independent etiologies of urinary incontinence which should be investigated.&nbsp;