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Background: Chronic rhinosinusitis is one of the most common diseases affecting the quality of life of patients. Patients suffer from high costs in the diagnosis and treatment of the disease. Frequent recurrence and failure of therapeutic protocols are among the most important issues in the management of this disease. In view of this, the use of traditional and complementary therapies to promote the treatment of this disease has been increasingly taken into account. Objective: Comparison of the effectiveness of the Persian Medicine Protocol with the conventional therapy in the treatment of chronic rhinosinusitis. Methods: A randomized clinical trial was conducted at Imam Reza Hospital in Mashhad, Iran from July 2016 to March 2017. For patients with chronic rhinosinusitis symptoms, endoscopy of the sinuses was performed by an ENT specialist and in the case of negative endoscopy, paranasal sinus CT scan was requested. A total of 42 patients with chronic rhinosinusitis were randomly assigned to two groups. The first group (classical) received systemic and intranasal cortisone, and the second group (traditional) received a therapeutic Persian medicine protocol including intranasal lavender oil, and Liquorice Marjoram Tea (L. M. tea) for six weeks. The symptoms of the patients were evaluated using the SNOT-22 questionnaire at the beginning of the study and at the sixth week. If no improvement occurs, treatment continued for 12 weeks. Data were analyzed by SPSS version 16, using ANOVA, independent-samples and paired-samples t-test, Wilcoxon signed-rank test, and simple linear regression. Results: In 20 patients in the traditional group, the decrease in SNOT score was observed as 56% after 6 weeks treatment (p=0.001), which is similar to the effect of the first group (classical). Although there was no statically significant difference between the two groups, in clinical terms, the difference in mean systemic symptoms such as confusion with 1.05 (p=0.5) and fatigue with 1.63 (p=0.01) had more improvement in the traditional group, and the difference in mean local symptoms such as nasal congestion with 2.37 (p=0.78) and runny nose with 1.95 (p=0.14) had a more decrease in the classical group. Conclusion: The results of this trial indicate the effectiveness of the Persian Medicine Protocol (including Lavender oil and L.M tea) in the treatment of chronic rhinosinusitis, especially on improving systemic symptoms. http://www.ephysician.ir Page 7018 Nevertheless more clinical studies are necessary to support the acquired results. Trial registration: This trial was registered at the Iranian Center for Clinical Trials (ID: IRCT2015112425217N1). Funding: This research is part of a PhD thesis and is funded by the Vice-Chancellor for Research at Mashhad University of Medical Sciences, Grant No. 931673.

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

Hematuria is one of the most important clinical manifestations, dating back in antiquity to more than a thousand years ago. In this paper, we tried to give a brief history of hematuria in Persian medicine and compare its similarities with Modern medicine. The importance of this issue is to give a better cognition of hematuria in the Persian medicine viewpoint in comparison with Modern medicine and also to understand the antiquity of hematuria, using simple and accessible therapies, provide a background for further studies in this field, and ultimately help improve Modern medicine in order to have a better treatment package, along with managing the costs.

Background: Chronic vertigo is a frustrating and expensive disease affecting individuals and society. Scientists of Traditional Persian Medicine (TPM) have a long held belief that there is a common type of vertigo originated from the stomach known as gastric related vertigo (GRV) and there are present, simple and low-cost treatments for GRV based on its categorization. Objective: To develop a valid tool for assessing GRV and determining the prevalence of this type of vertigo. Methods: In this cross-sectional study, a questionnaire was designed based on GRV indices. To determine the intra-rater reliability, a test-retest method was used and kappa coefficient was measured by Statistical Package for the Social Sciences software (SPSS, version 17). Content validity ratio (CVR) and content validity index (CVI) for each question were calculated by using Lawshe table. The reliable version of the questionnaire was assessed in a sample of 135 patients with a chronic true vertigo which lasts more than three months and aged between 18 and 65 years. This study was conducted in the outpatient clinics of several university hospitals in Tehran, Iran, between May 2016 and November 2017. Results: A valid 30-item questionnaire with CVR more than 0.62, CVI more than 0.78 and kappa coefficient more than 0.7 was the main achievement of this study, which can be useful for assessment of GRV in future clinical trials. The study showed that 98 participants (72.59%) had at least one criterion of GRV. Conclusion: According to the high prevalence of GRV among patients who suffer from chronic vertigo, more studies in this field including clinical trial are suggested. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Carthamus tinctorius L., known as Kafesheh (Persian) and safflower (English) is vastly utilized in Traditional Medicine for various medical conditions, namely dysmenorrhea, amenorrhea, postpartum abdominal pain and mass, trauma and pain of joints. It is largely used for flavoring and coloring purposes among the local population. Recent reviews have addressed the uses of the plant in various ethnomedical systems. Objective: This review was an update to provide a summary on the botanical features, uses in Iranian folklore and modern medical applications of safflower. Methods: A main database containing important early published texts written in Persian, together with electronic papers was established on ethnopharmacology and modern pharmacology of C. tinctorius. Literature review was performed on the years from 1937 to 2016 in Web of Science, PubMed, Scientific Information Database, Google Scholar, and Scopus for the terms "Kafesheh", "safflower", "Carthamus tinctorius", and so forth. Results: Safflower is an indispensable element of Iranian folklore medicine, with a variety of applications due to laxative effects. Also, it was recommended as treatment for rheumatism and paralysis, vitiligo and black spots, psoriasis, mouth ulcers, phlegm humor, poisoning, numb limbs, melancholy humor, and the like. According to the modern pharmacological and clinical examinations, safflower provides promising opportunities for the amelioration of myocardial ischemia, coagulation, thrombosis, inflammation, toxicity, cancer, and so forth. However, there have been some reports on its undesirable effects on male and female fertility. Most of these beneficial therapeutic effects were correlated to hydroxysafflor yellow A. Conclusion: More attention should be drawn to the lack of a thorough phytochemical investigation. The potential implications of safflower based on Persian traditional medicine, such as the treatment of rheumatism and paralysis, vitiligo and black spots, psoriasis, mouth ulcers, phlegm humor, poisoning, numb limbs, and melancholy humor warrant further consideration. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Plantago major has been used widely since ancient times, to manage a wide range of diseases including constipation, coughs and wounds. The aim of this study is to review the traditional application, botanical characterization, pharmacological activities, phytochemistry effects and toxicity of Plantago major. In this review study, medicinal properties of Plantago major are collected from credible pharmacopeias, textbooks of traditional Persian medicine (TPM) belonging to the 10-18th century AD, such as "The Canon of Medicine", "Makhzan-Al-Advia" and so on. Moreover, electronic databases including Scopus, Medline and Web of science were explored for this purpose. Plantago major has been prescribed in various forms such as roasted seeds, decoction, syrup, liniment, gargle, rectal enema, vaginal suppository, eye and nasal drop for each illness by TPM scholars. Some of its traditional properties including wound healing, antipyretic, antitussive, anti-infective, anti-hemorrhagic, antiinflammatory, diuretic, laxative, astringent and hemostatic have been confirmed in recent researches. Phytochemical investigations showed that Plantago major contains volatile compounds, triterpenoids, phenolic acids and flavonoids. Modern pharmacological studies have proven some of the traditional applications of Plantago major. Nevertheless, more investigations are required on this plant, because it has the potential to be used to produce various natural medications. [ABSTRACT FROM AUTHOR]

Background: Depression is one of the five most-common diseases globally, and is expected to be the second leading cause of disability by 2020 and its economic and social burden is a major problem worldwide. Objective: The aim of this research was to elucidate the causes and symptoms of depression according to Persian Medicine (PM) and classic medicine. Methods: In this study, works that were investigated were the Canon of Medicine, Al-Hawi Fi Teb, Kamel Al-Sina'a, Zakhireh Kharazmshahi and Exir A'azam. Classic medicine sources investigated were Kaplan and Sadock's Synopsis of Psychiatry and related articles in the Web of Science, Medline, Scopus, SID and Magiran. Research was done from January through April 2017, using keywords. Results: To explain the biologic causes, various factors including humoral dystemperaments, cold and hot dystemperaments of chief organs especially heart and brain and some qualitative and quantitative changes in medical spirit should be considered. According to manuscripts some mental-emotional events in life can cause these changes. They independently may cause depression. Semiologically some symptoms and signs happen consequently to in the above-mentioned causes which are in common with depression signs and symptoms including grief, crying, low libido, weight loss, appetite and sleep disorders, exhaustion, slow cognitive processing, indecisiveness and willingness to die. Conclusion: The major biological causes of depression is a group of dystemperamental syndromes (hot, cold, dry, and wet) on different bodily structures (humors, organs, and spirits). So preventive and therapeutic strategies for depression couldn't be the same for all patients and the treatment should be designed according to the exact diagnosis. [ABSTRACT FROM AUTHOR]