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

Summary Cinnamon, from the genus Cinnamomum and Lauraceae family, has been used as a popular spice for thousands of years around the world. Many studies have shown therapeutic effects of cinnamon including its antimicrobial, antiviral, antifungal, antioxidant, antitumor, antihypertensive, antilipemic, antidiabetic, gastroprotective, and immunomodulatory effects. Due to popular use of cinnamon and several human reports on adverse events associated with short or long term use of cinnamon, we aimed to systematically review its human reports of adverse event. Databases including Medline, Scopus, Science Direct, Embase, PubMed Central and Google scholar were searched using the key words "cinnamon" or "cinnamomum" for clinical trials, case reports and case series. Also spontaneous reports about adverse effects of cinnamon were collected from five national and international spontaneous reporting schemes. Thirty eight clinical trials were found, five of them reported adverse events. Twenty case reports and seven case series, as well as, spontaneous reports including 160 adverse events were also included. The most frequent adverse events were gastrointestinal disorders and allergic reactions which were self-limiting in the majority of cases. The available data suggests that despite the safety of cinnamon use as a spice and/or flavoring agent, its use may be associated with significant adverse effects in medicinal uses with larger doses or longer duration of use and should be clinically monitored. [ABSTRACT FROM AUTHOR]

Summary Background & aims Multiple studies have evaluated the hypoglycemic effect of cinnamon in patients with diabetes mellitus (DM) type II, with conflicting results. Differences in Baseline Body Mass Index (BMI) of patients may be able to explain the observed differences in the results. This study was designed to evaluate the effect of cinnamon supplementation on anthropometric, glycemic and lipid outcomes of patients with DM type II based on their baseline BMI. Methods The study was designed as a triple-blind placebo-controlled randomized clinical trial, using a parallel design. One hundred and forty patients referred to Diabetes Clinic of Yazd University of Medical Sciences with diagnosis of DM type II were randomly assigned in four groups: cinnamon (BMI ≥ 27, BMI < 27) and Placebo (BMI ≥ 27, BMI < 27). Patients received cinnamon bark powder or placebo in 500 mg capsules twice daily for 3 months. Anthropometric, glycemic and lipid outcomes were measured before and after the intervention. Result Cinnamon supplementation led to improvement of all anthropometric (BMI, body fat, and visceral fat), glycemic (FPG, 2hpp, Hb A1C , Fasting Insulin, and Insulin Resistance), and lipids (Cholesterol Total, LDL-c and HDL-c) outcomes (except for triglycerides level). All observed changes (except for Cholesterol Total and LDL-c) were significantly more prominent in patients with higher baseline BMI (BMI ≥ 27). Conclusion Based on the study findings, cinnamon may improve anthropometric parameters, glycemic indices and lipid profile of patients with type II diabetes. These benefits are significantly more prominent in patients with higher baseline BMI (BMI ≥ 27). The trial protocol was registered in Iranian Registry of Clinical Trials database (registration ID: IRCT2017031133015N1). [ABSTRACT FROM AUTHOR]

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Aim: To evaluate the effect of topical formulation of Rosa damascena Mill. (R. damascena) oil on migraine headache, applying syndrome diffrentiation model.Methods and Materials: Forty patients with migraine headache were randomly assigned to 2 groups of this double-blind, placebo-controlled cross-over trial. The patients were treated for the first 2 consecutive migraine headache attacks by topical R. damascena oil or placebo. Then, after one week of washout period, cross-over was done. Pain intensity of the patients' migraine headache was recorded at the beginnig and ten-sequence time schadule of attacks up to 24h. In addition, photophobia, phonophobia, and nausea and/or vomitting (N/V) of the patients were recorded as secondary outcomes. Finally, gathered data were analysed in a syndrome differentiation manner to assess the effect of R. damascena oil on Hot- and Cold-type migraine headache.Results: Mean pain intensity of the patients' migraine headache in the different time-points after R. damascena oil or placebo use, was not significantly different. Additionally, regarding mean scores of N/V, photophobia, and phonophobia severity of the patients, no significant differences between the two groups were observed. Finally, applying syndrome differentiation model, the mean score of migraine headache pain intensity turned out to be significantly lower in patients with "hot" type migraine syndrome at in 30, 45, 60, 90, and 120min after R. damascena oil application compared to "cold" types (P values: 0.001, 0.001, <0.001, <0.001, and 0.02; respectively).Conclusion: It seems that syndrome differentiation can help in selection of patients who may benefit from the topical R. damascena oil in short-term relief of pain intensity in migraine headache. Further studies of longer follow-up and larger study population, however, are necessitated for more scientifically rigorous judgment on efficacy of R. damascena oil for patients with migraine headache. [ABSTRACT FROM AUTHOR]

Background: Depression is the most common psychiatric disorder in the world. The conventional medications for depression, however, often have significant side effects. These adverse effects of conventional therapies, have motivated researchers to study alternative options including complementary and traditional treatments for solving the problem.Objective: To compare the efficacy of Nepeta menthoides Boiss. & Buhse freeze-dried aqueous extract with sertraline in the treatment of major depression.Design and Setting: From April to September of 2015, 72 patients from two psychiatry clinics of Shiraz University of Medical Sciences who met the criteria for major depression based on the structured clinical interview as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, participated in a two-armed double-blind randomized controlled trial.Intervention: Subjects were randomly assigned to receive Nepeta menthoides or sertraline for four weeks.Outcome Measures: Patients were evaluated in terms of the Beck Depression Inventory-II (BDI-II) total score and common side effects of medications at the base line, the second and fourth weeks, and two weeks following the intervention (i.e. in the sixth week).Results: The mean changes in the Beck Depression Inventory scores in Nepeta menthoides group were significantly higher in terms of the BDI-II scores diminution as compared to that of the control (p≤0.001). Two weeks follow up after intervention showed a lower recurrence rate in the Nepeta menthoides group (p≤0.001).Conclusion: Nepeta menthoides may have potential benefits in the control of mood in patients suffering from major depression. Sustention of antidepressant effect and delay in the recurrence of depression could be considered worthwhile using this herb. [ABSTRACT FROM AUTHOR]

Introduction Considering the known pharmacological effects of Allium iranicum and the use of this herb in traditional Persian medicine (TPM) as an antihemorrhoid agent, we evaluated the efficacy of A. iranicum leaf extract cream for management of hemorrhoids in a double blind randomized placebo control trial. Methods Eighty patients with symptomatic hemorrhoids were randomly allocated to three groups to receive topical leek cream or placebo cream or routine cream for the management of hemorrhoids (antihemorrhoid) for a period of 3 weeks. Bleeding severity (primary), pain, defecation discomfort, anal itching severity, and overall subjective improvement (secondary) were assessed as outcomes of this study. Results A significant reduction was observed in the bleeding severity, anal pain, defecation discomfort and anal itching of all patients. The leek cream group had significantly less bleeding severity than standard antihemorrhoid and placebo groups at the end of the study (0.26 ± 0.75, 0.83 ± 1.09, 0.35 ± 0.93, respectively P = 0.04). The number of patients with more than 50% subjective improvement was also significantly more in the leek cream group compared to other groups (12, 5, 6, respectively P = 0.04). The mean reductions in pain, defecation discomfort and anal itching showed no significant difference between the three groups ( P = 0.07, 0.39, 0.33, respectively). Conclusion The current study showed significantly better outcomes for the leek group compared to the standard antihemorrhoid and placebo groups for bleeding severity and overall subjective improvement. However, there was no difference among topical use of leek, routine antihemorrhoid and placebo creams symptomatic relief of pain, defecation discomfort and itching. This trial was registered by Iranian Registry of Clinical Trials with the code: IRCT2014010816143N1 and also registered in ClinicalTrials.gov with identifier: NCT02301052 . [ABSTRACT FROM AUTHOR]

Background: Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics.Methods: The current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12-70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire.Results: A significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value<0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001).Conclusion: Topical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics. [ABSTRACT FROM AUTHOR]