Efficacy of Herbal Medicines on Lung Function in Asthma: a systematic review and meta-analysis of randomized controlled trials

Objectives

The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients.

Methods

A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inverse-variance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity.

Results

As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD 3.73, 95% CI 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I² = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD 5.16; 95% CI 2.68-7.63) compared to children (WMD = 1.27; 95% CI -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically.

Conclusion

Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. This improvement is more likely to be observed amongst adults.

The effects of Cynodon dactylon (Poaceae family) and Dolichos biflorus (Fabaceae family) extracts on decreasing size and excretion of kidney and urinary tract stones: a randomized, double-blind controlled trial

OBJECTIVES

Given high and growing prevalence rate of urolithiasis in most societies as well as the problems caused by this issue, it is necessary to apply more cost-effective and safer therapeutic methods, which are accessible for all the individuals worldwide. Therefore, this study aimed to investigate efficacy of herbal medicines named Cynodon dactylon and Dolichos biflorus on solving and excretion of renal and urinary tract stones in patients with urolithiasis.

METHODS

This study included 96 patients with urolithiasis who were randomly allocated into three groups. The first group received the extract of D. biflorus seeds (1,600 mg), the second group received extract of C. dactylon rhizome (1,600 mg) and the third group received placebo for 21 days. In this study, we used an hydroalcoholic extract of D. biflorus and C. dactylon prepared by Soxhlet method. For each patient, the size of the stones, the amount of calcium in the urine, the number of stones excreted and their chemical substance type were measured.

RESULTS

In this study, changes were observed at the significance level in the interventions groups of 1 and 2, and the placebo group in the left kidney, so that changes in size of the stone in left kidney as intergroup were significantly different in these three groups (p=0.02). The mean of changes in stone size in left kidney in the group C. dactylon was 3.78 ± 7.1 and in the group D. biflorus, it was 0.27 ± 0.6.

CONCLUSIONS

A significant difference in the results of this study show that C. dactylon rhizome and D. biflorus seed extracts are able to decrease the size of the stone and can be effective on kidney stones excretion.

Physicochemical Properties, Antioxidative and Antibacterial Activities of the Persian Medicine-Based Maolasal Honey: An Experimental Study

Background: Maolasal is a honey-induced product which may lead to several beneficial effects from the Persian Medicine (PM) point of view. Heating process as a major step of Maolasal preparation may decrease the honey quality and deteriorate thermal treatment indicators of honey. Methods: This study was conducted on four honey samples (from different floral sources). Maolasal preparation process was done according to one of the most important PM references “Gharabadin Kabir”. Thermal treatment indices, antibacterial and antioxidative activities of products were measured. Results: The 5-Hydroxymethylfurfural (HMF) concentrations of PM-based Maolasal samples of polyfloral, monofloral, and sugar honey were higher than 40 mg/kg; while PM-based Maolasal sample of monofloral honey had acceptable HMF concentration (38.9 mg/kg). Proline content of all samples decreased thorough Maolasal preparation and simple heating processes in all samples and these reductions were greater in monofloral honey and sugar honey Maolasal samples.  Maolasal preparation processes decreased diastase activity of all samples. Although Maolasal preparation process led to sucrose content reduction in the three Maolasal samples, sucrose content of Maolasal sample of monofloral honey was higher than its raw sample. Maolasal preparation process increased total phenolic content of all samples. Finally, Maolasal preparation process led to an increase in antibacterial and antioxidant activities of all the samples. Conclusion: Maolasal samples reduced diastasis activity and proline content and increased HMF concentration. Maolasal preparation process may lead to an increase in antibacterial and antioxidative activities of honey which may be helpful for special preventive/therapeutic medicinal objectives.

Herbal Therapies for Weight Gain and Metabolic Abnormalities Induced by Atypical Antipsychotics: A Review Article

Psychosis is a state of mind that makes it difficult to determine what is real and what is not. Psychosis can have serious negative effects. Like many psychiatric phenomena, psychosis has a variety of causes, such as schizophrenia, bipolar disorder, and psychotic depression. Antipsychotic medications, psychotherapy, and social support are the most common treatments. Antipsychotic drugs reduce the symptoms of psychosis by changing brain chemistry. Based on the mechanism of action, antipsychotics have two groups, typical and atypical. Most people who take antipsychotics experience side effects. People taking typical antipsychotics tend to have higher rates of extrapyramidal side effects, but some atypical drugs, especially olanzapine, are associated with the risk of significant weight gain, diabetes, and metabolic syndrome, which, in turn, increases the risk of atherosclerotic cardiovascular disease and premature death. Physical exercise, diet regimen, psychoeducation, monotherapy, or switching to an alternative antipsychotic are strategies to correct metabolic aberrates in atypical antipsychotic users. In light of several successful studies on the use of medicinal plants to control metabolic syndrome, this article briefly reviews the studies on some herbal medications for the management of metabolic disorders associated with atypical antipsychotics and discusses probable mechanisms. Therefore, we searched the Cochrane, Scopus, PubMed, and Google Scholar databases for works published before July, 2022, on the effect of herbal medications on antipsychotic-related metabolic abnormalities in animals or humans. We recommend that some herbal medicines may be efficient for regulating the metabolic changes related to atypical antipsychotics due to their multipotential action, and more efforts should be made to make herbal drug treatments more effective. We hope this review will be a reference for research on developing herbal therapeutics for metabolic alterations in antipsychotic customers.

Achievements in Hypothyroidism Treatment with Herbal Medicine: A Systematic Review of Randomized Controlled Trials

BACKGROUND

Hypothyroidism is a common endocrine disease in the world that causes morbidity and mortality due to its association with metabolic diseases, especially in old age, and longterm treatment with levothyroxine causes many side effects for patients. Treatment with herbal medicine can regulate thyroid hormones and prevent side effects.

OBJECTIVE

The purpose of this systematic review is the evaluation of the effect of herbal medicine on the signs and symptoms of primary hypothyroidism.

METHODS

PubMed, Embase, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials were searched until 4 May, 2021. We selected randomized clinical trials (RCTs) that have assessed the effect of herbal medicine on hypothyroidism.

RESULTS

Out of 771 articles, 4 trials with 186 participants were included. In one study, Nigella sativa L. caused a significant decrease in weight (P=0.004) and body mass index (BMI) (P=0.002). TSH levels were reported to be decreased and T3 increased in the treatment group (P =0.03) (P=0.008), respectively. In another study on Nigella sativa L., results did not show a significant difference between the two groups (p=0.02). A significant decrease in total cholesterol (CHL) and fasting blood sugar (FBS) was reported in participants with negative anti-thyroid peroxidase (anti-TPO) antibodies. In patients with positive anti-TPO antibodies, a significant increase in total cholesterol and FBS was observed in the intervention group (p=0.02). In the third RCT, T3 in the ashwagandha group at 4 and 8 weeks significantly increased by 18.6% (p=0.012) and 41.5% (p < 0.001), respectively. A noticeable increase was found in the T4 level from baseline by 9.3% (p= 0.002) and 19.6% (p < 0.001) at 4 and 8 weeks, respectively. TSH levels fell remarkably in the intervention group compared to placebo at 4 weeks (p <0.001) and 8 weeks (p <0.001), respectively. In the last article selected, Mentha x Piperita L. showed no significant difference in fatigue scores between intervention and control groups at the midpoint (day 7), while fatigue scores improved in the intervention group in all subscales compared to the control group on day 14.

CONCLUSION

Some herbal remedies, including Nigella sativa L., ashwagandha, and Mentha x Piperita L., can improve the signs and symptoms of primary hypothyroidism, but using a more extensive and advanced methodology will provide us with more complete results.

Herbal Medicines for Idiopathic Male Infertility: A Systematic Review

BACKGROUND

Various medications, surgeries, and assisted reproductive techniques are used to treat male infertility, but the high cost and low effectiveness have made these methods unpopular. The use of herbal medicines such as Withania somnifera, Ceratonia siliqua, Nigella sativa and Alpinia officinarum for the treatment of male infertility has become highly popular in recent years.

OBJECTIVE

We conducted this systematic review to evaluate the recent scientific evidence regarding herbal medicines used to treat idiopathic male infertility (IMI).

METHODS

Online literature resources were checked using different search engines, including ISI, Web of Knowledge, Medline, PubMed, Scopus, and Google Scholar. Date restrictions were applied to 2020, and the publication language was restricted to English and Persian. The risk of bias was evaluated using the Cochrane method.

RESULTS

Out of 851 articles, 14 trials with 1218 participants were included. Of the 15 plants and medicinal products introduced in the selected studies, 12 cases were effective in treating male infertility. Each of these plants or products affects specific components of male fertility for which various mechanisms were mentioned, but most of them had antioxidant effects. No serious side effects were reported.

CONCLUSION

Whitania somnifera roots, Alpinia officinarum, Nigella sativa seeds, Tomato, and Ceratonia siliqua and the formulation of Xperm, PHF, Churna Ratnam, Svaguptadi Churna, Y virilin capsule, manix capsule, and Tradafertil tablet revealed successful outcomes in treatment of idiopathic male infertility.

Mina Svar: A tool for measuring social impact

Background

Each year, numerous initiatives are carried out to improve the outcomes for youth living in vulnerable areas. However, the impact of these initiatives is rarely measured, partly because there is no reliable, valid, relevant and easy-to-use tool available to measure the impact of social investments from the youth perspective. Mina Svar is an app co-created with youth that aims to address this gap.

Methods and results

Save the Children led the collaboration in defining a measurement framework. Experts from Save the Children, researchers from Linköping University, and representatives from Accenture, Skandia and Apoteket as well as youth themselves were involved in an iterative process. Five interconnected areas were identified as central: democracy and influence, education, work, housing and neighbourhood, and health. The first version of Mina Svar included 34 items. Researchers from Uppsala University were involved to help with testing the psychometric properties of Mina Svar in a sample of 237 youths. We examined the tool’s internal consistency, content validity and structure validity. Analyses showed that all the subscales except democracy and influence had good internal consistency (0.70 and higher). However, inspection of individual items revealed that several items lacked clarity and many items did not comprehensively reflect the related constructs as intended. Confirmatory factor analysis suggested a poor fit for the proposed model (CFI = 0.52 TLI = 0.56, and RMSEA = 0.103). Currently, we are going through a second iterative process to increase the reliability and validity of Mina Svar. The work involves refining the framework, rewriting ambiguous items, generating new items, and re-examining the psychometric properties of the revised version.

Conclusions

Mina Svar is a promising short multidimensional survey tool which offers a potential solution to tackle the problem with measuring the impact of social investments from the youth perspective.

Key messages

• Mina Svar is an app-based assessment tool co-created with youths living in vulnerable areas.

• Mina Svar is a promising short multidimensional tool which offers a potential solution to tackle the problem with measuring the impact of social investments.

Parents’ experiences of an antenatal visit being part of a home visiting program in deprived areas

Background

There are considerable health divides between residential areas in many Swedish cities. In more disadvantaged areas children grow up with poorer health outcomes than the country average. To meet the greater needs of children growing up in these areas through proportionate universalism, an extended home visiting program has been delivered. A novel part of this program has been the social worker and nurse later conducting home visits meeting the parents at the maternity care clinic before childbirth. The aim of this study was to explore parents’ experiences of that antenatal visit.

Methods

Semi-structured interviews were carried out with nine mothers and three fathers around 3 months postpartum. Nine of the participants were foreign-born and a translator was used for four of the interviews. The interviews were recorded and transcribed verbatim and the data was analyzed with thematic analysis with an inductive approach.

Results

The parents’ overall experiences are comprised in the main theme: ‘A feeling of security and care for the whole family'. This main theme is derived from the three following themes: 1) ‘Staff - a trustworthy source of information'. Parents perceived the staff as experienced and knowledgeable and appreciated obtaining information about practical things and about the Swedish system; 2) ‘Access to emotional support'. Several parents expressed the need for emotional support and valued that by meeting the staff they knew they had someone to turn to; 3) ‘Becoming familiar with the staff'. It was appreciated to know who will come to your home as this gave parents an increased sense of security.

Conclusions

Initiating the program through introducing home visiting staff at a scheduled antenatal visit benefited parents, by giving them useful information and social support. The visit also seems to be indirectly beneficial as it contributes to building trust for the staff and the rest of the program.

Key messages

• Initiating an extended home visiting program at a scheduled antenatal visit benefited parents, by giving them useful information and social support.

• Initiating an extended home visiting program at a scheduled antenatal visit contributed to building parents’ sense of trust for the staff and the rest of the program.

The role of individual level health resources on health outcomes of newly settled migrants in Sweden

Background

Structural barriers such as inadequate housing, lack of employment opportunities, and discrimination are known to adversely affect the health of newly settled refugee migrants. However, these barriers remain largely unresolved and unaddressed. Given the difficulties in addressing these structural barriers, there is therefore a need to better understand how individual level health resources, may influence health and mitigate ill health in the early post-migration phase. The aim of this study was to explore the association between health and individual health resources such as health literacy, self-efficacy, emotional and practical social support in newly settled refugee migrants.

Methods

The sample consisted of 600 Arabic speaking newly settled migrants with a refugee background, recruited from Swedish Civic Orientation program. The study questionnaire included measures on self-rated health, psychological well-being, health literacy, social support, and self-efficacy.

Results

Multivariate binary logistic regression showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. Lack of practical support and demographic variables such as gender, education, and type of residence permit were not as imperative for the studied health outcomes.

Conclusions

Individual level health resources may play an important role for the general and psychological well-being of newly settled migrants. Promoting health literacy in newly settled migrants and facilitating attainment of social support may not only positively influences their health in the often challenging establishment phase, but also enhance the prospects of later health and social integration.

Key messages

• Individual level health resources may play an important role for the general and psychological well-being of newly settled migrants.

• Promoting health literacy and facilitating attainment of social support in the early post-migration phase is important for health of migrants.

The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial

Objectives

Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics.

Methods

The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed.

Results

The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial.

Conclusion

In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

Dolichos Biflorus, Useful Food for Patients with Kidney Stones

Abstract:

Urolithiasis is a common problem worldwide manifested with recurrent intermittent pain episodes, which today is increasing due to changes in lifestyle patterns, including sedentary and consumption of protein, fat, and fiber-free foods, as well as stress. Today, the role of nutrition in the formation of kidney stones as well as in its prevention is recognized as a key factor. Dolichos Biflorus is one of the most famous plants that are known as a useful food in the prevention and treatment of kidney stones. In this review study, electronic databases of PubMed, Scopus, Cochrane, Google Scholar, and Web of science and Persian medicinal books such as Al- Hawi, Al-Shamel fi-Alsenaat Altebbiah, Makhzan-al-Advia, and Tohfat al Momenin were searched to identify all the studies reporting the effects of Dolichos Biflorus on kidney stones. Dolichos Biflorus seeds contain effective substances in preventing kidney stones formation. These substances include Citrate, Magnesium, Potassium, and Vitamin B6. A protein has been identified in Dolichos Biflorus grain that has antiseptic and inhibitory stone formation properties. In several studies, the effect of Dolichos Biflorus extract on the dissolution of kidney stones and their prevention has been investigated. Dolichos Biflorus seeds can be used as a useful and effective food in patients with kidney stones, in addition to its nutritional role, as a harmless drug to prevent stone production.

Comparing the effects of a herbal drug based on Echium Amoenum with fluvoxamine in the treatment of adolescents with obsessive-compulsive disorder

BACKGROUND

Obsessive-compulsive disorder (OCD) is a severe and debilitating neuropsychiatric condition. Although selective serotonin reuptake inhibitors, tricyclic antidepressants, and cognitive-behavioral therapy are the first-line medication and treatment for OCD, an estimated 30% of patients are treatment-resistant, and complete functional recovery is rare. Natural products as adjuvant or alternative therapies should be examined to find safer and more effective ways to manage OCD.

OBJECTIVE

To investigate the potential benefits of a combined herbal drug based on Echium amoenum in the treatment of OCD.

METHODS

Design and Setting: In the psychiatric clinics of Mashhad University of Medical Sciences, 40 patients who met the criteria for obsessive-compulsive disorder based on DSM-5 were studied in a parallel double-blind randomized clinical trial.

INTERVENTION

Subjects were randomly assigned to receive Echium amoenum-Melissa officinalis syrup and fluvoxamine or placebo syrup and fluvoxamine for 8 weeks.

OUTCOME MEASURES

The efficacy of treatment and recurrence of disease were surveyed and compared according to Yale-Brown Obsessive Compulsive Scale at weeks 0, 4, and 8.

RESULTS

Evaluation at the 4th and 8th week showed no significant differences between the two groups (p-value = 0.11, p-value = 0.445, respectively). At the 8th week of treatment, patients in the intervention group showed a remarkable reduction in scores on the Yale-Brown Obsessive-Compulsive Scale questionnaire (p- value= 0.003), and patients in the control group didn't ((p- value= 0.180).This study showed that the E.amoneum-M.officinalis syrup was not significantly more efficacious than fluvoxamine tablet, but the intervention group showed a significant improving trend (p-value= 0.001).

CONCLUSION

While monotherapy is usually the gold standard methodology, combination or augmentation therapy may also be of merit. Consequently, studies with larger sample sizes and the inclusion of para-clinical assessments such as serologic tests can further shed light on the mechanism of action of the E.amoneum- M.officinalis syrup and deepen our understanding of its effects.

Clinical Evidence for the Effectiveness of Herbal Medicines in the Treatment of an Obsessive- Compulsive Disorder: A Review Study

BACKGROUND

Obsessive-compulsive disorder (OCD) is a potentially debilitating disease that affects 1-4% of the general population. It is characterized by the presence of obsessions and compulsions which interfere with the individual's life and functioning. Although conventional treatments such as drug therapies and cognitive behavioral therapy exist for OCD, these treatments are not universally successful and can cause side effects, which has created a demand for alternative and complementary therapies.

METHODS

In this review, we summarize randomized clinical trials on the effectiveness of herbal medicines for the treatment of OCD, and review the possible mechanisms of action for these medicines. A search in PubMed, Scopus, and The Cochrane Library found 1022 studies, of which 7 were included in our review.

RESULTS

The studies that we found were conducted over 6 to 12 weeks, and had an average sample size of 37. The plant species studied included Crocus sativus, Echium amoenum, Hypericum perforatum, Silybum marianum, Valeriana officinalis, and Withania somnifera. The trials demonstrated the effectiveness of all plants as treatments for OCD except H. perforatum. The phytochemicals found in these plants produce their effects through a variety of means such as inhibiting the reuptake of monoamines, GABAergic effects, and neuroendocrine modulation. The small number of studies and their small sample sizes, poor methodology, and lack of replication highlight the need for further research into herbal medicines for the treatment of OCD.

CONCLUSION

Overall, herbal medicines can be used as stand-alone therapies for OCD or in conjunction with other methods.

Edible Medicinal Plants on Facilitating Childbirth: A Systematic Review

BACKGROUND

Despite advances and the availability of newer drugs to facilitate childbirth, the interest in using natural treatments is on the rise. More than 20 percent of pregnancies require induction of labor, which is associated with side effects and increased risk of cesarean surgery. For this reason, the use of medicinal plants is considered healthier.

OBJECTIVE

The present study is a systematic review of the role of oral herbs in facilitating childbirth.

METHOD

This review was conducted via searching the Medline/PubMed, Google Scholar, Scopus, and SID databases. The review began systematically and with no time constraints. It lasted until December 29, 2020.

RESULTS

Twenty clinical trials investigated the impact of edible plants on increasing cervical readiness, stimulating labor onset, reducing pain intensity, and shortening the duration of labor. Five studies have revealed the positive impact of saffron. Two studies reported the same effect by chamomile. Three studies showed the positive impact of boiled dill seeds, and two studies showed the impact of date and date syrup. Another study reported the impact of Descurainia Sophia, and six studies also showed the positive effect of castor oil on uterine stimulation, strengthening and relieving labor pains, which eventually lead to facilitating labor. One study also showed no improvement in bishop score after consumption of primrose capsules.

CONCLUSION

The positive effect of edible medicinal plants on facilitating childbirth has been shown in the mentioned studies. However, more studies with a larger sample size are needed, and there is also a need for a more detailed study of the possible mechanisms of plant effects.

Impact of Althaea Officinalis extract in patients with atopic eczema: a double-blind randomized controlled trial

Background

Althaea Officinalis introduced as an emerging anti-inflammatory agent with immunomodulatory effects that may suppress the symptoms of atopic eczema. In this study, we aimed to investigate the impact of liposomal formulation of Althaea Officinalis flower extract compared with steroids for atopic eczema treatment.

Methods

In this randomized, double-blind controlled trial phase II, forty patients with moderate to severe allergic atopic eczema confirmed by skin prick test were enrolled in the study from October 2018 to January 2019. Steroids on the lesions of the left side of the body and topical Althaea Officinalis extract (intervention) or eucerin as a topical placebo on the lesions of the right side of the body were tested. SCORAD (SCORing Atopic Dermatitis) was assessed at the baseline, and two, and four weeks after completing the trial. Data were analyzed by SPSS version 22.

Results

In the active treatment group, after two weeks, the SCORAD was significantly lower in the left side (recovery with steroid treatment) (p < 0.001), and after 4 weeks the SCORAD was lower on both sides, and there were no significant differences between two sides (similarity between Althaea Officinalis and steroid effects). In the control group, the SCORAD score was significantly lower on the left side (steroid) after two and four weeks (p < 0.001). There was no side effect and reaction to drugs.

Conclusions

Considering the potential side effects of steroids, and the similar efficacy of Althaea Officinalis flower extract, using this component may be accompanied by higher benefits in patients with atopic eczema.

Trial registration

IRCT2016102323235N5.

Therapeutic potential of active components of saffron in post-surgical adhesion band formation

BACKGROUND

Abdominal adhesions are common and often develop after abdominal surgery. There are currently no useful targeted pharmacotherapies for adhesive disease. Saffron and its active constituents, Crocin and Crocetin, are wildly used in traditional medicine for alleviating the severity of inflammatory or malignant disease.

PURPOSE

The aim of this study was to investigate the therapeutic potential of the pharmacological active component of saffron in attenuating the formation of post-operative adhesion bands using different administration methods in a murine model.

MATERIAL METHOD

saffron extract (100 mg/kg), Crocin (100 mg/kg), and Crocetin (100 mg/kg) were administered intraperitoneally and by gavage in various groups of male Wistar rat post-surgery. Also three groups were first treated intra-peritoneally by saffron extract, Crocin, and Crocetin (100 mg/kg) for 10 days and then had surgery. At the end of the experiments, animals sacrificed for biological assessment.

RESULT

A hydro-alcoholic extract of saffron and crocin but not crocetin potently reduced the adhesion band frequency in treatment and pre-treatment groups in the mice given intra-peritoneal (i.p) injections. Following the saffron or crocin administration, histological evaluation and quantitative analysis represented less inflammatory cell infiltration and less collagen composition, compared to control group. Moreover, the oxidative stress was significantly reduced in treatment groups.

CONCLUSION

These findings suggest that a hydro-alcoholic extract of saffron or its active compound, crocin, is a potentially novel therapeutic strategy for the prevention of adhesions formation and might be used as beneficial anti-inflammatory or anti-fibrosis agents in clinical trials.

TAXONOMY

Abdominal surgeries/post-surgical adhesions.

The Effects of Herbal Medicines on Women Sexual Dysfunction: A Systematic Review

Sexual health plays an important role in the women's health and quality of life. Sexual health management is a prerequisite for physical and psychological health of women. Sexual desire, arousal, and orgasm are three factors of female sexual response. So far many different methods has been known for the treatment of female sexual dysfunction, however none of them are not an efficacious therapy. Generally, use of herbal medicine is a safe and effective therapeutic method in the treatment of women with sexual dysfunction. The role of herbal and nutritional supplementation in female sexual function has attracted researchers' interest in recent years. This study aimed to the evaluation of the studies focusing on the herbal medicine on women sexual function and the assessment of its effectiveness.

Assessment tools for screening the mental health of refugee minors: from preschool to adolescence

The high number of asylum seekers in Sweden highlighted the need to develop and evaluate structured assessment tools for children and adolescents. In a series of studies, we aimed to explore the utility of (i) the Strengths and Difficulties Questionnaire with a trauma supplement of six items (SDQ-T) for preschool children; (ii) the Children's Revised Impact of Events Scale (CRIES-8) with unaccompanied refugee adolescents; and (iii) the Refugee Health Screener (RHS-13) with refugee adolescents. Parents of two- to six-year-olds (N = 61) were asked to complete the SDQ-T, and refugee adolescents were asked to complete the CRIES-8 (N = 208) and, in a separate study, the RHS-13 (N = 29) during the routine health checks. Focus-group interviews were conducted with the nurses who used the SDQ-T. The nurses felt the SDQ-T contributed to a more structured and informative conversation about the child's mental health. The SDQ total difficulties showed good internal consistency (α=.82). A significant proportion of children scored above the clinical cut-off and SDQ scores correlated with the number of post-traumatic stress symptoms measured using the trauma supplement (rho=.29). The findings suggest the SDQ-T is a useful tool in this clinical setting. The CRIES-8 was feasible to use, showed good internal consistency and its factor structure was confirmed. However, an independent assessment of test-retest reliability (N = 48) and longitudinal invariance (N = 284) indicated potential instability. It could be the CRIES-8 does not perform well when used with the unaccompanied refugee adolescent population over time, or that PTSD symptoms are less stable within this group given the multiple stressors in everyday life related to acculturation stress, family separation and living arrangements. The RHS showed excellent internal consistency (α=.96) and correlated with symptoms of post-traumatic stress disorder (r=.41).

Using a simple direct-to-consumer marketing strategy to increase participation in parenting programs

Low participation in evidence-based parenting programs not only presents a major challenge for population trials where a minimum level of intervention exposure is necessary to detect population-level impact, but also undermines the incorporation of these programs into routine practice settings. As part of a large population trial, we aimed to increase participation in a series of parenting seminars by using a simple direct-to-consumer marketing strategy, i.e., redesigning the program flyer.

We captured parents' attention by affirming that “parenting is not always easy”, highlighted the potential benefits of participation, clarified what participation entailed, and addressed some of the common barriers such as the stigma associated with participation in parenting programs. Because fathers and mothers were shown to have different needs, we tailored the flyers to mothers and fathers separately.

Testing the flyers on a small sample of parents showed that both mothers and fathers perceived the flyers as relevant. As expected, mothers were more likely to express interest in the program when they saw the flyer which focused on benefits related to dealing with child behavioural problems and featured a mother-child dyad, while fathers preferred the flyer which highlighted the benefits related to dealing with emotional problems, and featured a father-child dyad.

Next, following the same procedure that was used to deliver the original flyers over the first 18 months of the project, we used the new flyers to inform parents about the upcoming seminars over the next 24 months. The preliminary results showed that although the average number of parents participating in each seminar had initially decreased from about seven to four, after the introduction of the new flyers, the number increased consistently and reached an average of nine parents during the last 6-month period.

The results shows that program uptake can be increased using simple direct-to-consumer marketing strategies.

Strengths and Difficulties Questionnaire (SDQ) as an assessment tool for measuring emotional and behavioural problems in young children

Evaluation of new initiatives to tackle mental health problems in children requires instruments that are both valid and reliable. One such instrument is the Strengths and Difficulties Questionnaire (SDQ), an assessment tool for child emotional and behavioural problems. The instrument was developed by Goodman in the 1990's and is being used worldwide in both clinical settings and research projects.

However, previous studies on the SDQ have mainly focused on school-aged children and adolescents. We know very little about the usefulness of the SDQ for measuring preschool children's mental health problems. Using data from a large number of parents and preschool teachers of children aged 3-5 (&gt; 11 000 questionnaires), we tested the psychometric properties of the SDQ, examined the inter-rater agreement and provided cut-off points.

The original five-factor model of the SDQ was supported and it was shown to be a reliable instrument in the hands of mothers, fathers and preschool teachers. We also found significant, albeit poor, agreement (ICC) between parent and teacher ratings and good agreement between parents' ratings. Teachers reported lower levels of problems compared to parents. Compared to girls, boys were generally reported to have more problems. Thus, we provided separate cut-offs for each age group, gender and rater category.

The results suggest that SDQ can reliably be used for measuring emotional and behavioural problems in young children in community settings. They also suggest that parent and teacher reports are complementary; hence, reports from both types of informants should be considered when using the SDQ as a method to identify mental health problems within the child health services. However, inter-rater agreement between mothers and fathers was good, meaning that it may be sufficient to obtain data from a single parent informant.

Withdrawal Notice: Anti-cancer Effect of Urginea Maritima Bulb Extract In Vitro through Cell Cycle Arrest and Induction of Apoptosis in Human Breast Cancer Cell Lines

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The Effect of Resveratrol dose and Duration of Treatment on Blood Pressure in Patients with Cardiovascular Disorders: A Systematic Review

OBJECTIVE

Hypertension is an important risk factor that causes many deaths in the world every year. Researchers continue to undertake studies to find an effective drug for reducing blood pressure. One of the phytochemicals that recently attracted the attention of researchers is resveratrol-polyphenol, found in grapes. The purpose of this systematic review is to investigate the effect of resveratrol as a cardioprotective agent effective in reducing hypertension in patients with hypertension.

METHODS

Studies and clinical articles from databases Scopus, Pubmed, Ovid and Cochrane have been collected until September 2017; the keywords are Blood Pressure, Hypertension, Hypertensive, Cardiovascular, and Resveratrol.

RESULTS

Data from five studies with a total of 229 hypertensive and pre-hypertensive patients (men and women) showed that resveratrol plays an important role in reducing blood pressure.

CONCLUSION

Resveratrol appears to have anti-hypertensive effects, depending on the dose and duration of treatment. Researchers attribute one of the important blood pressure reducing mechanisms of resveratrol to increasing levels of NO. Based on the results of this systematic review, it is suggested that more clinical studies be conducted to find the appropriate dose and duration of treatment.

Analgesic Herbal Medicines in the Treatment of Knee Osteoarthritis: A Systematic Review

Background:

Osteoarthritis (OA) is a type of progressive rheumatoid disease, which leads to the degeneration of the articular cartilage, synovium, subchondral bone, tendons, and the surrounding ligaments.There are various treatments for knee OA, including pharmaceutical, nonpharmaceutical, and surgical treatments. Considering the chronic nature of the disease as well as the necessity for the long-term use of chemical medications, various side effects could occur that include gastrointestinal bleeding, hypertension, congestive heart failure, hyperkalemia, and kidney failure. Therefore, suitable treatments with fewer side effects should be recommended. Recent investigations suggest increased tendency in people to use Complementary and Alternative Medicine (CAM) for knee OA treatment.

Objective:

This systematic review aimed to assess the effectiveness and safety of herbal preparations for the treatment of OA.

Methods:

The searched databases were Cochrane, Scopus, and PubMed. All the selected papers pertained to randomized controlled trials until August 8, 2017 in English in which one or several specific herbs had been used in knee OA treatment.

Results:

We included 24 randomized trials (involving 2399 women and men). There were several different herbal medicines used within the included trials.

Conclusion:

The results show that the methods used in these trials may reduce symptoms and the extent of NSAID consumption and enhance the quality of life. Additional trials are suggested to investigate the safety and efficacy of herbs for the treatment of patients with OA.

Musculoskeletal Manifestations of Sarcoidosis: A Review Article

BACKGROUND

Sarcoidosis is a multisystem inflammatory disease with an etiology that is not clearly understood. Amongst the different organs that may be affected, the lungs are the most common. Musculoskeletal manifestations of the disease are uncommon.

OBJECTIVES

They include arthropathy, bone lesions, or myopathy, all of which may occur as initial symptoms or develop during the course of the disease.

METHODS

Articular involvement my present as arthralgia or arthritis. Skeletal complications usually develop in the chronic state of the disease. Muscular disease is rare and usually asymptomatic. Appropriate imaging modalities including X-ray, MRI, FDG-PET/CT assist in the diagnosis of rheumatic sarcoidosis. However, biopsy is necessary for definite diagnosis.

RESULT AND CONCLUSION

In most cases of musculoskeletal involvement, NSAIDs and corticosteroids are sufficient for symptomatic management. For more resistant cases immunosuppressive drugs (i.e., methotrexate) and TNF- inhibitors are used. Our aim is to review various types of musculoskeletal involvement in sarcoidosis and their existing treatment options.

Herbal medicines for suppressing appetite: A systematic review of randomized clinical trials

The suppression of appetite with herbal medicines has become very popular in recent years. We conducted this systematic review to evaluate the recent scientific evidence regarding herbal medicines that are used to suppress appetite. We retrieved clinical trials from PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Scientific Information Database, and IranMedex from January 1, 2013 to April 24, 2018. English and Persian language randomized clinical trials that used herbal medicines to suppress appetite in healthy or obese or overweight individuals were included. Risk of bias was assessed using Cochrane methodology. Out of 591 articles, 22 trials with 973 participants were included. One study on the Meratrim formulation which contained the Sphaeranthus indicus flower heads extract and Garcinia mangostana fruit, revealed longer-term evidence; while 6 studies on Ilex paraguariensis, Spinacia oleracea, Phaseolus vulgaris, Secale cereale, Sorghum bicolor and Plantago showed short-term evidence for suppressing appetite. No serious adverse events were reported. Despite some methodological concerns in the included studies, there is promising evidence for suppressing appetite with herbal medicines that needs to be confirmed in long-term clinical trials with adequate sample size and higher methodological quality with more attention to safety, effective dose and side effects.

Urtica dioica in comparison with placebo and acupuncture: A new possibility for menopausal hot flashes: A randomized clinical trial

OBJECTIVES

The purpose of this research was to investigate the effect of Urtica dioica in comparison with placebo, acupuncture and combined therapy on hot flashes and quality of life in postmenopausal women.

METHODS

In a double-blinded randomized controlled trial, patients were treated for 7 weeks then followed up 4 weeks. Seventy-two postmenopausal women who reported at least 20 hot flashes attacks per week were randomly allocated into one of the 4 groups of Urtica dioica 450 mg/day and acupuncture 11 sessions (A), acupuncture and placebo (B), sham acupuncture and Urtica dioica (C), and sham acupuncture and placebo (D). The primary outcomes were the change in hot flashes score from baseline to the end of treatment and follow up; and the change in the quality of life (MENQOL) from baseline to the end of treatment. Secondary outcomes included changes in FSH, LH, and ESTRADIOL levels from baseline to the end of treatment. The trial was conducted from October 2017 to July 2018 in Acupuncture clinic of a teaching hospital in Iran.

RESULTS

A total of 72 women 45-60 years old were enrolled, and 68 were included in the analyses. The median (IQR) hot flashes score decreased in the A group by 20.2 (31.7) and 21.1 (25.1), B group by 19 (18) and 17.3 (27), C group by 14.6 (25.4) and 20.8 (13), and D group by 1.6 (11.6) and 1 (13.3) at the end of treatment and follow up (P < 0.0001, P < 0.0001); no significant difference between A, B and C groups. The mean (SD) of MENQOL score decreased in the A group by 42.6 (21.1), B group by 40.7 (29.8), C group by 37.8 (26.8) and D group by 9.8 (14.3) at the end of treatment (P = 0.001); no significant difference between A, B and C groups.

CONCLUSIONS

Urtica dioica can decrease menopausal hot flashes and increase the quality of life of postmenopausal women better than placebo-sham control but same as acupuncture. The combination of Urtica dioica and acupuncture did not add to the effects of those therapies.

Abstract P4-01-02: Early detection of residual breast cancer through a robust, scalable and personalized analysis of circulating tumour DNA (ctDNA) antedates overt metastatic recurrence

Background:

Many breast cancer patients relapse after primary treatment but there are no reliable tests to detect distant metastases before they become overt. Here we show earlier identification of recurring patients through a scalable personalised ctDNA analysis. The method is applicable to all patients, and not limited to hot-spot mutations typically detected by gene panels.

Methods:

Forty-nine non-metastatic breast cancer patients were recruited following surgery and adjuvant therapy. Plasma samples (n=208) were serially collected semi-annually. Using the analytically validated SignateraTM workflow, we determined mutational signatures from primary tumour whole exome data and designed personalised assays targeting 16 variants with high sensitivity by ultra-deep sequencing (average &gt;100,000X). The patient-specific assay was used to detect the presence of the mutational signature in the plasma.

Results:

In 16 of 18 (89%) clinically-relapsing patients, ctDNA was detected ahead of metastatic relapse being diagnosed by clinical examination, radiological and biochemical (CA15-3) measurements, and remained ctDNA-positive through follow-up. Of the 2 patients not detected by ctDNA, one had a small local recurrence only (now resected) and the other had three primary tumours. None of the 31 non-relapsing patients were ctDNA-positive at any time point (n=142). Metastatic relapse was predicted by Signatera with high accuracy and a lead time of up to 2 years (median=9.5 months).

Conclusions:

The use of a scalable patient-specific ctDNA-based validated workflow detects breast cancer recurrence ahead of clinical detection. Accurate and earlier prediction by ctDNA analysis could provide a means of monitoring breast cancer patients in need of second-line salvage adjuvant therapy in order to prevent overt life-threatening metastatic progression.

Citation Format: Coombes RC, Armstrong A, Ahmed S, Page K, Hastings RK, Salari R, Sethi H, Boydell A-R, Shchegrova SV, Fernandez-Garcia D, Gleason KL, Goddard K, Guttery DS, Assaf ZJ, Balcioglu M, Moore DA, Primrose L, Navarro SL, Aleshin A, Rehman F, Toghill BJ, Louie MC, Zimmermann BG, Lin C-HJ, Shaw JA. Early detection of residual breast cancer through a robust, scalable and personalized analysis of circulating tumour DNA (ctDNA) antedates overt metastatic recurrence [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-01-02.

Therapeutic Aspects of Squill; An Evidence-Based Review

From ancient times, medicinal plants have been usually utilized to treat many disorders, but today, interest in these herbs is again aroused, because of their fewer side effects and low-cost. In traditional medicine, for many diseases, various medicinal herbs have been suggested so far. Drimia maritime, also named squill, is an important medicinal plant for the treatment of many diseases, especially respiratory diseases. In the current evidence-based study, we conducted a review of the general characteristics, ingredients, administration form, and side effects of squill in traditional medicine. For this purpose, traditional Persian medicine literatures and electronic databases were examined including PubMed, Scopus, and Google Scholar. Many compounds are isolated from D.maritima, including scillaren, scillirubroside, scillarenin, and bufadienolide glycosides. Oxymel is the most commonly used form of squill for various diseases, especially respiratory diseases. Besides, squill has been used in the treatment of cardiovascular, digestive, and dermatological disorders, it is also used against various cancer cells for its antioxidant and cytotoxic properties. Moreover, there is relatively reliable evidence of its benefits for bacterial and helminthic infections, rheumatism, edema, gout, abortion induction, healing of wounds and urine induction. It seems that supplementary studies are required to explore the bioactive agents and their effective mechanisms.

Skin inflammatory reactions to capsaicin in rheumatoid arthritis patients compared to healthy controls

OBJECTIVE

Previous studies have examined the role of sensory nerves and neural mediators in symmetrical joint inflammation and autoimmunity in rheumatoid arthritis (RA). In this study, we sought to examine the association between capsaicin skin test and disease activity in RA patients.

MATERIALS AND METHODS

Eighty RA patients (case group) and 20 healthy volunteers were enrolled in this experiment. The subjects in case group were calcified to newly diagnosed patients and those previously diagnosed with RA. A topical solution of capsaicin (0.075%) was applied on the volar forearm during the skin test, and evaluations were done after 5, 10, and 20 min. The parameters recorded in capsaicin skin test were time to tingling, area of induration (cm²), and area of redness (cm²).

RESULTS

A faster capsaicin skin reaction was observed in healthy controls compared to the case group (p=0.02). Newly diagnosed and previously diagnosed RA patients were not significantly different in terms of reaction latency (p=0.06). The redness area after 15 (p=0.04) and 20 (p=0.001) min was significantly larger in previously diagnosed RA patients than in newly diagnosed ones. The ​​area of redness and time to tingling did not show any difference between active and inactive RA patients, but after 15 and 20 min, the area of redness was significantly greater in inactive RA patients compared to active RA patients (p=0.01 and p=0.03, respectively).

CONCLUSION

This study suggested that capsaicin skin test is not an efficient tool for the examination of synovial inflammation and disease activity in RA.

Curcumin effects on myeloperoxidase, interleukin-18 and matrix metalloproteinase-9 inflammatory biomarkers in patients with unstable angina: A randomized clinical trial

OBJECTIVE

Inflammation along with oxidative stress plays an important role in the development, progression, instability and rupture of coronary atherosclerotic plaques. Several studies introduced curcumin (diferuloylmethane) as a wonderful chemical in Curcuma longa (turmeric) with appropriate anti-inflammatory and antioxidant effects. The effect of curcumin on inflammatory biomarkers was assessed in several clinical trials. This study was designed to evaluate the effect of curcumin on three pro-inflammatory biomarkers in patients with unstable angina.

MATERIALS AND METHODS

Forty patients with unstable angina who met the inclusion criteria, participated in this double-blind randomized clinical trial. Patients were randomly divided into two groups. The patients in the treatment group received nanocurcumin 80 mg per day for 5 days and the control group received placebo 80 mg per day for five days. Blood samples were obtained before the administration, and also 1, 2 and 4 days after taking the treatment. Serum concentrations of Myeloperoxidase (MPO), matrix metalloproteinase-9 (MMP-9) and interleukin 18 (IL-18) biomarkers were measured by ELISA.

RESULTS

There was no significant difference in concentration of these biomarkers before the administration and 1, 2 and 4 days after the start of the trial, between the two groups; however, the concentration of IL-18 on the first day significantly varied between the groups.

CONCLUSION

Based on the findings of this study, administration of nanocurcumin capsules at the dose of 80 mg per day for 5 days, did not significantly decrease inflammatory biomarkers in patients with unstable angina.

The effect of a natural vaginal product based on honey on the success of intrauterine insemination (IUI) in infertility treatment

OBJECTIVE

Due to high prevalence of infertility and increasing tendency towards complementary medicine, this study was conducted to investigate the effect of a vaginal natural product based on honey and 1% extract of Myristica fragrans on the extent of success of intrauterine insemination (IUI).

MATERIALS AND METHODS

This non-randomized clinical trial study with a historic control group, was performed on infertile women. In this trial, 159 patients were assigned to the intervention group, and 288 patients were recruited to the control group. All the participants received clomiphene or letrozole from the third up to seventh day of menstruation, and on days 6, 7, and 8, they received human menopausal gonadotrophin (HMG) injections. IUI was performed 36 hours after human chorionic gonadotrophin (HCG) injection. In the intervention group, a natural vaginal product was used besides the above treatments, from menstruation day 7 until the day before performing IUI. Sixteen days after IUI, serum beta HCG was measured to investigate chemical pregnancy, and six weeks following IUI, vaginal sonography was performed to investigate clinical pregnancy.

RESULTS

Analysis showed that the pregnancy rate was higher in the group that receiving the natural product compared to the control group. Chemical pregnancy rate was 18.1% vs. 15.4%, and clinical pregnancy rate was 15.2% vs. 13.8% for intervention and control groups, respectively; but, this difference was not significant.

CONCLUSION

It seems that the use of this vaginal product for a longer period of time and across several menses cycles before IUI, may produce more positive results. Further studies, however, are needed to be done.

Pistacia atlantica Desf. A review of its traditional uses, phytochemicals and pharmacology

Pistacia atlantica is the main herbal medicine that has been widely used in the Middle Eastern and Mediterranean areas since ancient time. Pistacia atlantica has been used for multiple purposes like stomach diseases, renal disorders, wounds and coughs. The aim of this study is to review its botanical characterization, traditional applications, photochemistry effects and pharmacological activities. Data in this review article was gathered from credible pharmacopeias, electronic databases such as Web of Science, Science Direct, PubMed, EMBASE, Scopus, EBSCO, Google Scholar, SID and Iran Medex and textbooks of Persian medicine such as Canon of medicine (Ibn-e Sina, 980-1037 AD) and Makhzan-al-Advia (Aghili, 18th century). The keywords were searched in Persian and English books on medicinal plants and traditional medicine. The results showed that P. atlantica has many medicinal properties such as antioxidant, antidiabetic, antihyperlipidemic, along with others. It can also be effective in gastrointestinal diseases. Thus, different new drugs can be formulated based on P. atlantica for the management of various diseases.

Effect of Pistacia atlantica kurdica gum on diabetic gastroparesis symptoms: a randomized, triple-blind placebo-controlled clinical trial

BACKGROUND

Gastroparesis is a recognized problem of type 1 and 2 diabetes mellitus that is defined by delayed gastric emptying. Due to insufficient satisfaction of current treatments, the use of complementary and alternative medicine in this field seems essential. According to Persian medicine, Pistacia atlantica gum has proper effect on gastrointestinal disorder specially stomach diseases.

OBJECTIVE

The aim of this study was to assess the effect of Pistacia atlantica gum on diabetic gastroparesis symptoms.

METHODS

A triple-blind randomized placebo-controlled trial on subjects with diabetic gastroparesis was conducted at the clinic of Imam Reza Hospital in Mashhad city in Iran, from November 2016 to May 2017. Fifty-four patients (16.7% males and 83.3% females) enrolled in the 8-week study and were randomly divided into two groups of intervention Pistacia atlantica and placebo groups. Both of the groups had received current dietary advice. Severity of gastroparesis symptoms was assessed with a Gastroparesis cardinal symptom index (GCSI) questionnaire. SPSS software version 16 was used to analyze the data and Generalized Estimating Equation (GEE) model, Independent-samples t-test, Paired-samples t-test, Mann-Whitney U test, and Wilcoxon signed-rank test were used to assess variables.

RESULTS

All gastroparesis symptoms of patients (14.6% diabetes type 1 and 85.4% diabetes type 2) including nausea/vomiting, postprandial fullness/early satiety, and bloating were significantly declined in each group during study (p<0.0001). Pistacia atlantica gum significantly reduced severity of gastroparesis symptoms including Postprandial fullness/early satiety (p=0.04), Bloating (p<0.0001), and GCSI scores (p=0.001) versus placebo. Systolic blood pressure (p=0.006), BMI (p=0.018), and HbA1c (p=0.038) significantly decreased in the Pistacia atlantica group after the intervention.

CONCLUSION

This study showed that daily consumption of Pistacia atlantica gum for one month improves diabetic gastroparesis symptoms.

TRIAL REGISTRATION

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the code of IRCT2016110630739N1.

FUNDING

This study was supported by funding (grant no.: 950153) from the Mashhad University of Medical Sciences Research Council, Mashhad, Iran.

Comparing the efficacy of therapeutic packages in Persian Medicine with Classical Medicine in overweight patients: a randomized clinical trial

BACKGROUND

Obesity is a major risk factor for many diseases. In Persian Medicine, much emphasis has been put on the balanced weight that maintains health. Therefore, the treatment of obesity is a top priority for health care in Persian and Classical Medicine.

OBJECTIVE

To compare the efficacy of therapeutic packages in Persian Medicine with Classical Medicine in overweight treatment.

METHODS

This randomized clinical trial was conducted at Ghaem Hospital in Mashhad, Iran, from August 22, 2016 to December 20, 2016. Sixty-nine overweight women with body mass index (BMI) of 27-29.9 and waist circumference more than 88 cm based on inclusion and exclusion criteria, were included in the study. To control bias in sampling, with considering that the age variable is an interventional factor in the process of effective treatment, in addition to using the random allocation method, the population were studied in three groups of 18-30 years old, 31-50 years old and >50 years old, who were classified by blocking method, and three types of treatment interventions were performed in each age group: Group A (Classical diet and orlistat), Group B (Persian diet and MDB) and Group C (classical diet and MDB). Calorie consumption was equivalent in the three groups. Blinding was done only for patients. The treatment period was three months in all three groups. Subsequently, we analyzed the effectiveness of the therapeutic packages on anthropometric index, body composition and laboratory parameters in the three groups. The data were analyzed using SPSS version 16. We used descriptive statistics, Kolmogorov-Smirnov, ANOVA, paired-samples t-test, non-parametric Wilcoxon test and regression methods for the analyses of primary and secondary outcomes.

RESULTS

Although anthropometric index and fat mass decreased highly significantly in all three intervention groups (p<0.001), the B group led to a further decrease in BMI (Mean ± SD: 1.61±1.03), weight (Mean ± SD: 4.79±2.26), waist circumference (Mean ± SD: 4.25±0.59) and Fat mass (Mean ± SD: 3.24±2.70), compared with the other two groups. Lipid profile and FBS in groups B and C had significant decrease before and after the intervention, but Group A had no significant effect before or after the intervention. Other laboratory parameters did not change significantly before or after the treatment in the three groups.

CONCLUSION

In this study, Classical Medicine and Persian Medicine had the same levels of effectiveness but Persian Medicine brought a greater reduction in body weight, fat mass%, lipid profile and fasting blood glucose than Classical Medicine during the study period. So Persian Medicine can be effective in weight loss as an alternative therapy, but more studies are needed.

TRIAL REGISTRATION

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: (IRCT 2016041927477N1).

FUNDING

This paper is supported by a grant from the Research Council, Mashhad University of Medical Sciences, Mashhad, Iran.

Effects of a food product (based on Daucus carota) and education based on traditional Persian medicine on female sexual dysfunction: a randomized clinical trial

Background

Globally, female sexual dysfunction is a serious concern based on negative family and social consequences, high side effects of medications and lack of effective treatment. Thus, the evaluation of treatment approach for this problem is an important priority for healthcare systems. Sexual life and its related disorders are considered the main aspects of a healthy lifestyle in traditional Persian medicine (TPM).

Objective

The present study aimed to determine and compare the effects of food products containing Daucus carota, TPM-based training program, and a combination of these two interventions on the improvement of female sexual dysfunction.

Methods

This randomized clinical trial was conducted on 96 women with sexual dysfunction based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), aged 18–35 years who referred to the Gynecology Clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during 2016 and 2017. The patients were randomly divided into three groups (n=32) and received the intervention over an eight-week period. The first group was provided with TPM-based sexual health training, the second group received 30 g of a traditional food product (wild carrot halva: mixed Daucus carota and several herbs with honey) on a daily basis, and the third group received a combination of this traditional food product plus education. Data analysis was performed using Chi square test, repeated measures ANOVA, two-way ANOVA, ANCOVA, post hoc Bonferroni, Friedman and Wilcoxon signed-rank test in SPSS version 11.5.

Results

According to the results of this study, there was a significant difference in terms of sexual desire (p=0.002), lubrication (p=0.002), orgasm (p=0.004) and pain (p<0.001) after eight weeks of the intervention among the three groups.

Conclusion

The use of two interventions of TPM including a food product containing Daucus carota and this product with TPM-based education improved desire, arousal, lubrication, orgasm, satisfaction and pain in females with sexual dysfunction. Furthermore, TPM-based education alone, led to the improvement of all domains of sexual dysfunction, except for pain in the females with sexual dysfunction.

Trial registration

The trial was registered at the Iranian Registry of Clinical Trials with the IRCT ID: IRCT2015122425681N1).

Funding

The present study was supported by a grant from the Research Council, Mashhad University of Medical Sciences, Mashhad, Iran (ref. no.: 941503).

Comparing the Effect of Psyllium Seed on Gastroesophageal Reflux Disease With Oral Omeprazole in Patients With Functional Constipation

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases. Several studies have been carried out on the treatment of symptoms associated with GERD. The present study aimed to compare the effect of Psyllium seed and oral omeprazole on GERD in patients with functional constipation. In this trial, 132 patients were divided into 2 groups. The impact of omeprazole and Psyllium seed on the treatment and recurrence of GERD was studied. Among the patients, the rate of response to treatment was 89.2% (n = 58) in the Psyllium seed group, while in omeprazole group, it was 94% (n = 63; P = .31). The recurrence rates of Psyllium seed and omeprazole groups were 24.1% (n =14) and 69.8% (n = 44), respectively (P < .001). The results showed that treatment of functional constipation by Psyllium seed in patients with GERD leads to improvement of GERD and its recurrences in comparison with omeprazole.

A review of effective herbal medicines in controlling menopausal symptoms

BACKGROUND

Acute menopausal syndrome especially hot flashes, is one of the most common gynecological problems during menopause. Due to the side effects of hormone therapy, herbal and complementary medicines are always of immense interest to people in the treatment and management of the symptoms and complications of menopause.

OBJECTIVE

The aim of this study was to investigate the mechanisms and effects of medicinal plants employed in the treatment of menopausal symptoms.

METHODS

This review article was carried out by examining clinical trial studies between the period of 1994 and 2016. The keywords, which include menopause, climacteric, hot flushes, flashes, herb and phytoestrogens were used to search for herbal medicines used in clinical trials for the treatment of menopausal symptoms using databases such as PubMed, Medline, Scopus, Google scholar, SID and Magiran.

RESULTS

The results of the study showed that the medicinal plants, which include Sage herb (Salvia officinalis), Lemon balm (Melissa officinalis), Valerina officinalis, Black cohosh (Cimicifuga racemosa), Fenugreek (Trigonella foenum-graecum), Black cumin (Nigella sativa), Vitex (Vitex agnus-castus), Fennel (Foeniculum vulgare), Evening primrose (Oenothera biennis), Ginkgo biloba, Alfalfa (Medicago sativa), Hypericum perforatum, Panax ginseng, Pimpinella anisum, Licorice (Glycyrrhiza glabra), Passiflora incarnata, Red clover (Trifolium pratense), and Glycine soja were effective in the treatment of acute menopausal syndrome with different mechanisms.

CONCLUSION

Medicinal plants can play an imperative role in the treatment of acute menopausal syndrome; however, further studies are required to buttress their efficacy in the treatment of acute menopausal syndrome.