Comparison the effects of topical application of olive and calendula ointments on Children's diaper dermatitis: A triple-blind randomized clinical trial

Current use of medicinal plants for children's diseases among mothers in Southern Romania

There is a limited number of studies focusing on ethnomedical practices in children, particularly in Eastern Europe. Romania has a rich history of using medicinal plants in ethnopediatric care, and our objective was to identify the medicinal plants currently employed in treating childhood illnesses in the southern region of the country. Material and methods Our investigation used structured interviews, focusing on respondent demographics, local names of therapeutically employed herbs, the specific plant part(s) utilized, methods of preparation and administration, and local folk indications of taxa. A total of 326 mothers with children aged 0 to 18, hospitalized in the "Grigore Alexandrescu" Children Emergency Hospital Bucharest and residing in Southern Romania, were enrolled in the study. Use Value Citation Index (UVc), Informant Consensus Factor (Fic), and Fidelity Level (FL) were calculated. Results Twenty-five plants were identified for treating children's diseases in Southern Romania. The majority of informants resided in urban areas, and mothers primarily acquired knowledge from family members and healthcare professionals. The herbs most frequently employed were Mentha spp. (UV = 0.509) for diarrhea, Matricaria spp. (UV = 0.301) for skin infections (Fic = 0.99) and digestive diseases (Fic = 0.98), and Calendula officinalis L. (UV = 0.365) for skin diseases (Fic = 0.99). Less utilized were Raphanus raphanistrum subsp. sativus (L.) Domin in respiratory diseases, Prunus avium (L.) L. stalks in urinary tract ailments, Helianthus annuus L. in ear infections, Allium sativum L. in intestinal parasitosis, Viola tricolor L. in hives, Triticum aestivum L. in dermatitis and Allium ursinum L. as a tonic. In 184 cases herbal treatment was used in conjunction with conventional medications. Education level correlated with the number of employed plants and the variety of treated ailments, while residency (rural vs. urban) did not. Both residency and education influenced plant procurement methods: rural background and, surprisingly, higher education were linked to a preference for harvesting rather than purchasing plants. Conclusion Botanical remedies are still commonly used in the treatment of pediatric diseases in Southern Romania, although the variety of taxa seems reduced compared to the past. Further exploration is essential to unlock the maximum benefits of ethnopediatric practices.

The effect of topical application of breast milk and education on preventing diaper dermatitis in children in rural areas

PURPOSE

This study aimed to ascertain the impact of topical breast milk and diaper-area care instruction on the prevention of diaper dermatitis in rural settings.

DESIGN AND METHODS

This was a pre-test-post-test experimental study with forty-eight 6-18-month-old children and their mothers. Participants were randomly assigned to three groups: two experimental groups (Group A: breast milk, Group B: education) and one control group (Group C). Data were collected face-to-face through home-visits. A sociodemographic data and diaper-area care practices form and The Scale for Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants were used for data collection.

RESULTS

There was a statistically significant difference between children who used breast milk application to prevent dermatitis compared to children whose parents received diaper-area care education and a control group (p = 0.002).

CONCLUSIONS

It was determined that topical breast milk application and diaper-area care education given to mothers were effective in preventing diaper dermatitis, and the application of breast milk was found to be safe and more effective than education.

PRACTICE IMPLICATIONS

These findings highlight the need for education, information and practical solutions to prevent and appropriately treat diaper dermatitis.

The effect of oral capsule of Ocimum basilicum leaf extract on sleep quality and insomnia severity in menopausal women: A randomized clinical trial

One of the complications of menopause is sleep disorders, which affect women's health. Ocimum basilicum contains compounds that may affect sleep. The aim of this study was to determine the effect of an oral capsule of O. basilicum leaf extract on sleep quality and the severity of insomnia in menopausal women. This triple-blind, randomized clinical trial study was performed on 60 Iranian menopausal women aged 40 to 65 years. Subjects were randomly assigned into two groups of intervention (each capsule containing 250 mg of O. basilicum extract and 250 mg Avicel) per day for 1 month and placebo. The Pittsburgh Sleep Quality and Insomnia Intensity Index were used to assess sleep quality and severity of insomnia before, 2 weeks after and 1 month after the intervention. There was no statistically significant difference in the baseline variables between the intervention and placebo groups (p > .05). The total sleep quality scores in the two groups of intervention and placebo were 6.2 ± 0.3 versus 9.3 ± 0.3 (p < .001) and 3.7 ± 0.3 versus 9.1 ± 0.3 (p = .015) 2 weeks and 1 month after the intervention, respectively. The total insomnia severity scores in the two groups of intervention and placebo were 9.0 ± 0.3 versus 12.1 ± 0.3 (p < .001) and 5.6 ± 0.5 versus 11.0 ± 0.5 (p < .001) 2 weeks and 1 month after the intervention, respectively. Consumption of O. basilicum capsules improved sleep quality and insomnia in menopausal women. This study was approved (code IR.MUMS.NURSE.REC.1398.070) by the Ethic committee of Mashhad University of Medical Sciences and registered at the Iranian Registry of Clinical Trials, with the No. IRCT20200104046001N1 in January 2020.

The development of a nomogram model for the individualized prediction of diaper dermatitis risk in pediatric hospitalized children aged 1-36 months

AIMS AND OBJECTIVE

To develop a nomogram model for individualized prediction of diaper dermatitis in pediatric hospitalized infants and toddlers aged 1-36 months.

BACKGROUND

Diaper dermatitis is a common skin health problem in pediatrics, which brings pain and discomfort to the child. However, there is a scarcity of risk prediction tools for diaper dermatitis in infants and toddlers hospitalized in pediatrics.

DESIGN

A cross-sectional study.

METHODS

210 cases each for caregivers and hospitalized children aged 1-36 months were selected as the research objects. A prediction nomogram model was established based on the risk factors according to the results of univariate analysis and multivariate logistic regression analysis. The predictive performance of the nomogram model was evaluated by discrimination and calibration. The clinical utility of the model was evaluated by decision curve analysis. This study was reported using the TRIPOD checklist.

RESULTS

41 hospitalized children with diaper dermatitis with a prevalence of 19.52%. The risk factors included: age in months, diarrhea, history of diaper dermatitis, without prophylactic application of buttock protection products, frequency of diaper change per day ≤6.6 times, and the level of caregivers' knowledge of infantile diaper dermatitis. The results showed that the C-index of the nomogram model was 0.891(95% CI: 0.832, 0.950), the calibration curve manifested a satisfactory consistency, and the net benefit was satisfactory.

CONCLUSIONS

The nomogram has a good predictive ability and satisfactory clinical utility, which is useful for pediatric medical staff screening high-risk patients with diaper dermatitis.

RELEVANCE TO CLINICAL PRACTICE

The prediction nomogram model can help pediatric medical staff to calculate the risk probability of diaper dermatitis in pediatrics, formulate interventions timely, and optimize pediatric DD standardized care protocols. NO PATIENT OR PUBLIC CONTRIBUTION: the children's caregivers enrolled in this study only for the data collection.

Evaluating Potentials of Species Rich Taxonomic Groups in Cosmetics and Dermatology: Clustering and Dispersion of Skin Efficacy of Asteraceae and Ranunculales Plants on the Species Phylogenetic Tree

BACKGROUND

The medicinal properties of plants can be predicted by virtue of phylogenetic methods, which nevertheless have not been utilized to explore the regularity of skin-related bioactivities of ethnomedicinal plants. We aim to investigate the distribution of skin efficacy of Asteraceae and Ranunculales plants on the species-level Tree of Life.

METHODS

The clinical efficacy data of 551 ethnomedicinal species belonging to Ranunculales, as well as 579 ethnomedicinal species of Asteraceae, were systematically collected and collated; these therapeutic data fell into 15 categories, including skin disease/cosmeceutical. The large phylogenetic tree of all China angiosperm species was used to detect the phylogenetic signals of ethnomedicinal plants by calculating the D statistic, phylogenetic diversity (PD), net relatedness index (NRI), and nearest taxon index (NTI). Of all Chinese ethnomedicinal plants of Ranunculales and Asteraceae, 339 (61.5% of all ethnomedicinal species) and 382 (66.0% of all) are used for skin problems. In Ranunculales, a clustered structure was suggested by the NRI value for skin uses. In Asteraceae, the skin utility was not clustered; Artemisia, Aster, Cremanthodium, Ligularia, and Saussurea are the most used Asteraceae genera for skin issues.

RESULTS

The clustering structure was identified in Artemisia, and the skin efficacy in other genera was of overdispersion (NRI < 0). NTI values and D statistics largely agree with NRI. When compared with PD values of different therapeutic categories, the PD value of the skin category was relatively high in Cremanthodium, Ranunculales, Asteraceae, and Artemisia, suggesting the enormous efficacy space in the new taxa of these taxonomic groups.

CONCLUSION

By resolving the distribution of therapeutic effects of Ranunculales/Asteraceae taxa, the importance of phylogenetic methods in mining botanical resources with skin utilities is validated.

Comparative Evaluation of the Effect of Aloe Vera Gel, Olive Oil, and Compound Aloe Vera Gel-Olive Oil on Prevention of Pressure Ulcer: A Randomized Controlled Trial

Background

One of the most common problems in the intensive care units (ICUs) is pressure ulcers (PUs). The present study aimed to evaluate the effectiveness of aloe vera gel, olive oil, and compound aloe vera gel-olive oil in the prevention of PUs.

Materials and Methods

This randomized clinical trial was conducted on 240 patients. They were randomly divided into four groups, aloe vera gel (n = 60), olive oil (n = 60), aloe vera gel-olive oil combination (n = 60), and control (n = 60). Braden scale and National Pressure Ulcer Advisory Panel scale were used to collect data. The intervention was performed for 30 days. In the intervention and control groups, the patient received routine care. In each intervention group, 10-15 ml of olive oil or aloe vera gel or a combination of olive oil and aloe vera was rubbed into body areas under pressure.

Results

There were no PUs detected in all groups before the intervention; after the intervention, 12 patients in the olive group, 20 patients in the aloe vera group, 10 patients in the aloe vera-olive combination group, and 22 patients in the control group developed PUs. The results reported 40% of the patients with stage 1 PU and 10% of them with stage 2.

Conclusion

Due to the effectiveness of olive oil and aloe vera-olive oil combination in preventing PU, it is recommended to use these herbal compounds in preventing PU on ICU patients.

The effect of olive cream on pain and healing of caesarean section wounds: a randomised controlled clinical trial

OBJECTIVE

This study was performed to determine the effect of olive cream on the severity of pain and healing of caesarean section wounds.

METHOD

This study is a parallel randomised clinical trial that was conducted on women who had caesarean sections at Ayatollah Taleghani Hospital in Arak, Iran. Women were assigned to intervention, placebo and control groups by a block randomisation method. Women in the intervention and placebo groups were asked to use olive cream and placebo cream, respectively, twice a day from the second day after surgery to the tenth day. The wound healing score and pain intensity score were assessed using the REEDA and VAS scales, respectively, before and at the end of the intervention.

RESULTS

The intervention group consisted of 34 women, the placebo group of 34 women and the control group of 35 women. We found a statistically significant difference between the intervention and placebo groups, intervention and control groups, and placebo and control groups in terms of the pain intensity (p<0.05 in all three cases). Also, we found a statistically significant difference between the intervention and placebo groups, and intervention and control groups in terms of the scores of wound healing on the tenth day after surgery (p<0.05 in both cases).

CONCLUSION

Olive cream can be effective in relieving pain and enhancing caesarean section wound healing, and since no specific side effects were reported, the use of olive cream is recommended.

A new therapeutic horizon in diaper dermatitis: Novel agents with novel action

Objective

This review looks at novel combinations of topical agents (i.e., zinc gluconate, zinc oxide, dexpanthenol, and taurine) that target a combination of mechanisms in diaper dermatitis.

Methods

A literature search of published studies was conducted using the search terms "diaper dermatitis", "treatment of diaper dermatitis in infants", "treatment of diaper dermatitis in adults", "nonsteroidal", "nonantibiotic", "antiinflammatory", "moisturizer", and "treatment for irritation". A total of 207 related articles were screened, and those categorized as clinical trials and reviews were studied and compared. Articles with common themes were categorized, summarized, and presented herein.

Results

Diaper dermatitis, also referred to as diaper rash, napkin dermatitis, and nappy rash, is the most common skin eruption in infants and toddlers. In the last several years, there have been several technologic advances in diaper design to lessen the severity of diaper dermatitis symptoms. However, due to the unique environment of the diaper area, children and adults continue to have recurring symptoms of diaper dermatitis. Both commercially available products and certain home remedies are considered effective for managing sensitive and delicate skin in the diaper area. These topical agents create a protective barrier over the skin and reduce the impact of external irritants, which cause the reddening and burning sensation often associated with diaper dermatitis.

Conclusion

A range of therapeutic strategies for preventing and controlling diaper dermatitis are summarized in this manuscript.

Anti-Inflammatory and Restorative Effects of Olives in Topical Application

METHODS

A literature search was conducted (1990-2021) in Medline, Embase, CINAHL, Google Scholar, Science Direct, SID, IranDoc, and Magiran databases. From the 102 reviewed articles, 17 articles were selected to be included in the current article.

RESULTS

Various forms of olive have long been used to accelerate the healing of various wounds and skin damage such as diabetic foot ulcers, atopic dermatitis, diaper dermatitis, episiotomy wound, and nipple ulcer but there are still no credible documents or articles that provide reliable evidence of topical use.

CONCLUSION

According to the information obtained from the articles reviewed, olive oil appears to be an effective, safe, and available treatment. This study suggests that olive oil is an alternative remedy to minimize the frequent use of chemical-based treatments. More research may be beneficial to reach certainty in terms of curative properties of olive oil in similar or different injuries in different populations.

Evidence-based nursing intervention to reduce skin integrity impairment in children with diaper dermatitis: A systematic review

Diaper dermatitis often occurs in children. In Indonesia, the guidelines for managing this health problem are issued by each hospital in Indonesia, but there are no guidelines for formal prevention and management released by the Indonesian Health Ministry. This study aimed to propose the Air, Barrier, Cleansing, Diapering, Education (ABCDE) approach as an evidence-based independent nursing intervention to prevent and treat impaired skin integrity, particularly diaper dermatitis, in children by nurses. This systematic review was derived from multiple databases using the following keywords: “child,” “diaper dermatitis,” “diaper-free time,” “air,” "barrier,” “cleansing,” “diaper,” and “education.” From these keywords, 393 articles were collected and then filtered using inclusion and exclusion criteria to obtain the final articles to be analyzed. Thirty-one articles passed the criteria. The study found that the ABCDE approach was effective in preventing and treating diaper dermatitis in children. Its indicators of the approach were preventing or decreasing inflammation, repairing damage to the skin, and preventing reoccurrence. Based on the review and analysis of multiple aspects in Indonesia, the authors proposed a modification of the sequence to CBAD-E to implement the approach in Indonesian children. The intervention of the ABCDE approach matches Indonesian children’s situation, and therefore it can be implemented in Indonesia. Accordingly, this recommendation may be useful and feasible to be implemented by nurses in preventing and treating diaper dermatitis in children, thus decreasing its prevalence.

Anti-Inflammatory Activity of Calendula officinalis L. Flower Extract

The use of calendula for its lenitive properties’ dates to the XII century. This plant contains several bioactive compounds, including terpenoids, terpenes, carotenoids, flavonoids and polyunsaturated fatty acids. Calendula flower extract is used in soothing cosmetics, such as after-sun, sensitive skin and eye contour products. The anti-inflammatory properties of this ingredient were demonstrated in an animal model, but the mechanism of action is poorly understood. Therefore, our work explored the effect of a calendula flower extract on NO production, a pro-inflammatory radical produced by nitric oxide synthase (iNOS) and highly released by innate immune cells in inflammatory-related pathologies. NO production was evoked by the Toll-like receptor 4 agonist lipopolysaccharide (LPS) in macrophages, using concentrations that did not compromise cells viability. This ingredient exhibited a dose-dependent NO inhibition, reaching 50% at 147 μL/mL without cytotoxicity. Together with previous literature, these results provide experimental evidence on the anti-inflammatory properties of calendula flower extract, as well as its usefulness in cosmetics with soothing properties and adjunctive skin care in the treatment of the diseases associated with dysregulation of the NO signaling cascade.

Anti-Inflammatory and Photoaging-Protective Effects of Olea europaea through Inhibition of AP-1 and NF-[Formula: see text] B Pathways

Olea europaea is a beneficial edible plant with a number of biological activities like anti-inflammatory, anti-oxidant, antithrombic, antihyperglycemic, and anti-ischemic activities. The mechanisms behind the antiphotoaging and anti-inflammatory effects of Olea europaea are not fully understood. To investigate how an ethanol extract of Olea europaea (Oe-EE) exerts these effects, we explored its activities in human keratinocytes and dermal fibroblasts. We assessed the anti-oxidant effects of Oe-EE via 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2[Formula: see text]-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) assays and measured the expression levels of matrix metalloproteinases (MMPs), cyclooxygenase-2, interleukin (IL)-6, tumor necrosis factor (TNF)-[Formula: see text], and moisturizing factors. Antiphotoaging and anti-inflammatory mechanisms of Oe-EE were explored by assessing signaling molecule activation via immunoblotting. Oe-EE treatment decreased the mRNA expression level of MMPs, cyclooxygenase-2, IL-6, and TNF-[Formula: see text] and restored type I collagen, filaggrin, and sirtuin 1 expression in UVB-irradiated cells. Furthermore, Oe-EE inhibited the activities of several activator protein 1 regulatory enzymes, including extracellular signal-regulated kinase (ERK), p38, and c-Jun N-terminal kinase (JNK), and inhibited nuclear factor (NF)-[Formula: see text]B pathway signaling proteins. Therefore, our results indicate that Oe-EE has photoaging-protective and anti-inflammatory effects.

A meta-analysis of preclinical studies using antioxidants for the prevention of cisplatin nephrotoxicity: implications for clinical application

Cisplatin is an effective chemotherapeutic drug whose clinical use and efficacy are limited by its nephrotoxicity, which affects mainly the renal tubules and vasculature. It accumulates in proximal and distal epithelial tubule cells and causes oxidative stress-mediated cell death and malfunction. Consequently, many antioxidants have been tested for their capacity to prevent cisplatin nephrotoxicity. In this study, we made a systematic review of the literature and meta-analyzed 152 articles, which tested the nephroprotective effect of isolated compounds or mixtures of natural origin on cisplatin nephrotoxicity in preclinical models. This meta-analysis identified the most effective candidates and examined the efficacy obtained by antioxidants administered by the oral and intraperitoneal routes. By comparing with a recent, similar meta-analysis performed on clinical studies, this article identifies a disconnection between preclinical and clinical research, and contextualizes, discusses, and integrates the existing preclinical information toward the optimized selection of candidates to be further explored (clinical level). Despite proved efficacy, this article discusses the barriers limiting the clinical development of natural mixtures, such as those in extracts from Calendula officinalis flowers and Heliotropium eichwaldii roots. On the contrary, isolated compounds are more straightforward candidates, among which arjunolic acid and quercetin stand out in this meta-analysis.

The Anti-Inflammatory Properties of the Topical Application of Human Milk in Dermal and Optical Diseases

Methods

The various datasets including Ovid, PubMed, Google Scholar, Science Direct, Magiran, Irandoc, SID, and IranMedex were searched from 1990 to 2018. From the 119 reviewed articles, 20 articles were selected to be included in the current article.

Results

There is a consensus among the literature and ancient texts regarding the effectiveness of THM in curing the various types of skin damages, such as cord separation, atopic dermatitis, diaper dermatitis, conjunctivitis, scratches, insect bite, perineal ulcer, and nipple ulcer. However, the importance of its application has not been given much attention.

Conclusion

According to the information obtained from the articles reviewed, the THM appears to be an effective, safe, and available treatment compared to conventional chemical treatments. This study suggests THM as an alternative remedy to minimize the frequent use of chemical-based treatments. More research may be beneficial to reach certainty in terms of curative properties of THM in similar or different injuries in different populations.

Historical ethnobotanical review of medicinal plants used to treat children diseases in Romania (1860s-1970s)

BACKGROUND

Romanian ethnopediatrics has a long history of medicinal plant use. The main objective of the present review was to identify, collect, systematize, and prioritize the available bibliographical data related to medicinal plants traditionally used to treat various pediatric diseases in Romania during the 1860s-1970s.

METHODS

Information was mainly obtained by manual systematic search in various relevant historical works focused on the traditional use of medicinal plants in Romania (1860s-1970s), found in the Archives of Romanian Academy Library and National Romanian Library.

RESULTS

A total of 153 medicinal plants belonging to 52 families were identified as having ethnopediatric significance. The plant traditional indications, targeted body systems, parts used, and way of administration were provided. We have also proposed one index (expressed as percentage) in order to assess the ethnopediatric applicability area of species: ethnopediatric relative therapeutic versatility (ERTV), which was calculated on the basis of the number of distinct uses mentioned for a species. The species identified to have the highest ERTV scores were Dryopteris filix-mas (100%), Gratiola officinalis (85.71%), Allium sativum (71.42%), Eryngium planum (71.42%), Juglans regia (71.42%), Matricaria chamomilla (71.42%), Plantago major (71.42%).

CONCLUSIONS

The present study exposed for the first time to the international scientific community important ethnopediatric information contained in several local Romanian bibliographical resources that could guide the local and international researchers towards new directions of plant valorization.