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Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions. Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Purpose - Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. Insurance coverage increases the accessibility of services and is an important factor in health services utilization. Assessing patient satisfaction will be helpful in detecting quality gap and bottlenecks of service providing processes. The purpose of this paper is to to assess the satisfaction of complementary insurance schema of Iran Veterans and Martyrs Affair Foundation (VMAF) for receiving outpatient visits. Design/methodology/approach - This was a cross-sectional study. The study population was veterans and their families and as well as Martyrs' families. In this survey, 1,823 cases were selected using the random sampling method. Data were gathered by a questionnaire. The questionnaire validity and reliability was tested. The questionnaires were completed based on telephone interviewing. The questionnaires were completed for the last family use of complementary insurance for receiving medical services. The SPSS statistical software was used for data analysis. Findings - A total of 1,823 cases used their complementary insurance that were studied. About 32.9 percent of studied cases were Martyrs' families and the others were veterans and their family members. The satisfaction level was assessed from different dimensions: respondents were highly satisfied from outpatient visits. The satisfaction of process of receiving visit payment was the lowest. The factors associated with the risk of dissatisfaction are tested by using logistic regression. Analysis indicated that living in rural areas and being a martyr family increase the risk of dissatisfaction from the distance to an outpatient center. Originality/value - Satisfaction is a multi-dimensional factor that reveals different aspects of services. It is possible that the satisfaction level in different dimensions of care was not the same. This study indicated that complementary health care insurance provided by the VMAF is good from care receivers' perspective. But some consideration is necessary for improving that access of under-coverage population in remote districts and rural areas and process of receiving visit payment. [ABSTRACT FROM AUTHOR]

Background. As the second leading cause of death in women in the world, breast cancer has several physical and psychological effects. Nowadays, nonclinical approaches such as patient empowerment have been considered by physicians along with clinical care. Given the increasing number of breast cancer women worldwide, promoting the empowerment of these patients is one of the key factors affecting their survival and quality of life. Therefore, because of no comprehensive research on the empowerment needs and related improvement strategies, this study is aimed at determining the empowerment status of breast cancer patients referred to the Shahid Motahari Breast Cancer Clinic in Iran, Shiraz, and at providing strategies to improve their empowerment in 2021. Methods. This applied study was conducted in two phases. In the quantitative phase, 310 Cancer-Related Patient Empowerment Scale questionnaires (Persian format) were distributed among the studied patients selected through the random sampling method in the clinic, and the items with "unacceptable status" became the basis for determining the empowerment strategies through the scoping review and semistructured interviews with 22 medical staff and patients through the thematic analysis. The collected data were analyzed using the SPSS 20.0 and MAXQDA10 software. Results. The mean score of the participants' empowerment strategies was 3.58. The results showed that trust in the physician, family support, and spiritual beliefs could affect the empowerment of the studied patients. Moreover, the participants needed empowerment strategies in 11 scale items with unacceptable status, for which 46 strategies were determined in the scoping review and interview phase. Conclusion. The results of this study provided useful strategies for empowering breast cancer patients, the most important of which were classified into five categories of financial support, informational support, interaction with the physician, occupational support, and complementary therapies, the use of which by the stakeholders could help to improve the patients' quality of life while improving their empowerment. [ABSTRACT FROM AUTHOR]

Background: Although acupressure is proposed to boost sleep quality and alleviate anxiety in various disorders, no trials have yet documented these consequences in burn victims. Considering the high importance of managing sleep quality and anxiety among burn patients utilizing adjunctive non-pharmacological measures, this study sought to investigate the impacts of acupressure on sleep quality and anxiety among a population of Iranian patients with burn injuries. Methods: This trial was performed on 72 patients with second- or third-degree burns, who were divided into two equal arms to receive routine care plus 10-minute acupressure on either real acupoints (i.e., Yintang and Shen men) or sham points for three consecutive nights. Sleep quality and anxiety were investigated at baseline (T1) and on the fourth day (T2) by using St. Mary's Hospital Sleep Questionnaire (SMHSQ) and Spielberger's State-Trait Anxiety Inventory for State Anxiety (STAI-S), respectively. Results: The mean scores of SMHSQ and STAI-S were significantly lower in the real acupressure arm at T2 (P < 0.001 in two cases), implying better sleep quality improvement and higher anxiety alleviation. Also, the reduction in mean changes of SMHSQ and STAI-S scores from T1 to T2 was significantly more in the real acupressure arm (P < 0.001 in two cases). Conclusion: Acupressure, as a low-cost complementary method, could be potentially helpful in enhancing sleep quality and decreasing the anxiety of burn patients. Additional long-term trials are required to identify the sustainability of the findings. Trial Registration No: IRCT20130424013110N13 (Registration date: 19/03/2021, https://www.irct.ir/trial/55076). [ABSTRACT FROM AUTHOR]

Context: As breast cancer treatment going forward, need for supportive strategies grows. That creates an important call to summarize what has been done regionally. Objectives: In this study, we systematically reviewed articles that proceeded rehabilitation and supportive care in breast cancer patients in Iran to present a research map of rehabilitation research in the past 10 years in Iran. Data Sources: All articles published from January 2006 to October 2015 were included. All of the breast cancer studies in Iran were searched in 3 English (Web of Science, PubMed, and Scopus) and 2 Persian databases (SID and IranMedex). Study Selection: All papers related to rehabilitation in breast cancer were included and categorized into 5 subgroups including qualitative, instrument, lymphedema, interventional, and observational studies. Three reviewers (two surgeons and an epidemiologist) screened the primary search and divided it into subgroups. Data Extraction: Tworeviewers used a checklist to critically appraise the full text of the selected articles. The necessary information of retrieved articles was extracted and recorded in the designed data extraction spreadsheet in Excel software. Results: A total of 194 articles (102 in English and 92 in Persian) were assessed for eligibility of inclusion in the review, of which, 121 were excluded, and 73 studies were kept. The included studies consisted of 14 on qualitative design, 5 studies in the translation and validation of research instruments, 7 articles in the field of lymphedema, 20 articles about different intervention modalities on breast cancer patients (including education, social status, psychological, exercise, etc.), and 27 observational studies about anxiety, depression, quality of life, sexual function, emotional distress, complementary medicine, lifestyle, etc. Conclusions: Most of the reviewed studies insisted on a prevalence of physical, psychological, functional, and spiritual problems of breast cancer survivors and their caregivers. Designing a mega project to offer a palliative and rehabilitation service package according to the needs of Iranian patients may become a priority in their health care system. [ABSTRACT FROM AUTHOR]

Although mainstream allopatic medicine is the dominant model in Iran, many other kinds of healing are currently also being used. This paper aims to describe some aspects of prayer healing in Iran. This study has been carried out using participatory observation and in-depth interviews with fourteen healers who worked in Tehran. Also one hundred and seventy patients who referred to healing centers were interviewed through random sampling. The findings are summarized in terms of a description of some personal characteristic of healers, the methods of healing, healer–patient communication patterns and, finally, some consequences of visiting a prayer healer. The findings indicate that, despite the increasing growth in scientific medicine, traditional healing is still alive. It is a cultural way of coping with health problems. This essay also makes several suggestion for future research. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is a very common chronic disease among children. As for its treatment, in recent years there is an increased tendency towards supplemental treatments. Hence, many of these patients are administered complementary and alternative treatments including herbal medicine. Methods:Through a cross-sectional study, we evaluated the common herbal remedies used in asthmatic children referred to the allergy clinic of Sarvar Children's Hospital in Mashhad. All data related to the patients (i.e., age, sex, and history of all remedies consumed as well as the responsible persons prescribing the pertinent medications) were recorded in a checklist. Results: In this study, 582 asthmatic children with the average age of 41.7±77.4 months were evaluated. The overall herbal remedies usage was %59.8. There was no significant differences between age groups, sex, or asthma severity and herbal remedy usage. Thirty-seven different herbal remedies were prescribed to the patients, the most common herb was thymes (%65.3) followed by a four-seed herbal mixture (%23.6), Plantago major (%12) and Cydonia oblonga (quince) (%10.8). Conclusion:Limited information is available regarding complementary and alternative medicine in asthmatic children in Iran. The present study showed the high prevalence of herbal medicine usage in asthmatic children in this region. Hence, further studies should determine the clinical benefits of these remedies. [ABSTRACT FROM AUTHOR]

The seeking and use of Complementary and Alternative Medicine (CAM) modalities by people to treat mental disorders has increased and it is necessary for psychologists to have the necessary information in this field. This study aims to evaluate the use and perception of CAM by Iranian psychologists. This cross-sectional study was conducted on 100 psychologists selected by the census in 2019. Data collection tools consisted of four sections of the demographic section, the CAM questionnaire for psychologists, awareness of CAM, and use of CAM. The validity and reliability of this questionnaire were confirmed. The mean (standard deviation) scores of attitude and educational needs were 40.45 (11.36) and 33.93 (5.96), respectively. Only 19.25% of psychologists had sufficient knowledge of CAM, and most of them (56.34%) reported that there is an educational need for CAM. In this study, 64% of psychologists used CAM for themselves. There was a significant relationship between the attitude toward CAM modalities and the suggestion of CAM to the clients (p=0.025). There was also a significant relationship between the use of CAM by psychologists and the suggestion of these modalities to their clients (p<0.001). Psychologists had not sufficient awareness about CAM and had a moderate attitude. Most of the psychologists reported that there is educational need for CAM. Therefore, it is necessary to design and implement appropriate training courses for psychologists toward CAM modalities. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available. Aim: Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep. Design: A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up. The intensities of pain, fatigue, and sleep disturbance were measured using a 0–10 scale at nine-timepoint; baseline, weekly during the intervention, and the follow-up period. Then, the mean scores of the three symptoms were calculated as the symptom cluster intensity at each timepoint. IRCT.ir IRCT20150302021307N5. Setting/participants: Adults with cancer (n = 273) who reported all three symptoms at three oncology centers in Iran. Results: The odds of clinical improvement (at least 30% reduction in symptom cluster intensity from baseline) increased with dose-escalation significantly [(OR = 17.37; 95% CI = 3.87–77.90 for 60-min doses); (OR = 11.71; 95% CI = 2.60–52.69, for 30-min doses); (OR = 4.36; 95% CI = 0.94–20.32, for 15-min doses)]. The effect durability was significantly shorter at 15-min doses compared to 30- and 60-min doses. The odds of improvement for doses 3×/week was not significant compared to doses 2×/week (OR = 12.27 vs OR = 8.34); however, the effect durability for doses 3×/week was significantly higher. Conclusions: The findings indicated that dose-escalation increases the efficacy of massage for the pain-fatigue-sleep symptom cluster. Although the 60-min doses were found to be more effective, the 30-min doses can be considered more practical because they are less costly and time-consuming. Our findings can be helpful to develop massage guidelines in palliative care settings. Trial registration: Iranian Registry of Clinical Trials, IRCT20150302021307N5. [ABSTRACT FROM AUTHOR]

Background: Fever is the most common reason for children's visits to medical centers. Its management is an essential duty of a pediatric nurse. The aim of this study was to determine the effect of body wash with Marshmallow plant on children's fever. Methods: This parallel clinical trial was performed on 92 children aged 6 months to 10 years with a tympanic temperature above 38.3 °C. Participants were randomly assigned to groups. Simultaneously with receiving acetaminophen, body wash was performed in the control group with lukewarm water and in the intervention group with white Marshmallow extract. The children's temperature; from the beginning of the study was checked and recorded every 15 min in the first hour and in the 4th and 6th hours. The time duration to resolve fever, the frequency of afebrile children at different times of the study, and the value of temperature reduction were primary outcomes. Heart rate, the need to administer the next dose of acetaminophen, and the time of fever recurrence were recorded as secondary outcomes. Results: The mean time duration to resolve fever in the intervention group was shorter than in the control group (B = 8.181, 95% CI 3.778–12.584, p < 0.001). The frequency of the children without fever was higher in the intervention group during different times of the study (p < 0.001). The mean value of temperature reduction in the intervention group was higher than the control group (B = -0.27 °C, 95% CI: -0.347 to -0.193, P < 0.001), although, after adjusting the effect of confounding variables it was not significant (P = 0.127). The mean of adjusted heart rate change (p = 0.771), the time of fever recurrence (P = 0.397), and the frequency of children requiring the next dose of acetaminophen (p = 0.397) did not show a significant difference between the groups. Conclusion: Body wash with Marshmallow extract reduced children's fever in a shorter period of time and to some extent a greater extent than the control group without side effects. Therefore, it can be used as an effective and safe complementary method to help reduce fever. However, more studies are necessary for this field. Trial registration: Registration in Iranian Clinical Trials (RCTs) on 31.08.2020 with registration code: IRCT20200809048345N1. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Complementary and alternative medicine has been increasingly used to treat chronic illnesses, such as diabetes mellitus. However, various limitations in terms of their application and efficacies exist. Furthermore, there is still much to be done to discover the right herbal medicine for diabetes. Aim of the study This paper aims to evaluate previous herbal studies on the management of diabetes mellitus, to address their strengths and weaknesses and propose a general framework for future studies. Approach and methods Data sources such as PubMed, ScienceDirect, Scopus, SpringerLink, and Wiley were searched, limited to Iran, using 36 search terms such as herbal, traditional, medicine, and phytopharmacy in combination with diabetes and related complications. Reviewed articles were evaluated regarding the use of botanical nomenclature and included information on (1) identity of plants and plant parts used, (2) the processing procedure, and (3) the extraction process. The main outcomes were extracted and then surveyed in terms of the efficacies of herbs in the management of diabetes mellitus. Then a comparative study was performed between Iranian and non-Iranian studies with respect to herbs best studied in Iran. Results Of the 82 herbs studied in Iran, only six herbs were endemic and 19 were studied in detail. Although most of the reviewed herbs were found to decrease the level of blood glucose (BG) and/or glycated hemoglobin (HbA1C) in both Iranian and non-Iranian studies, information on their pharmacological mechanisms is scarce. However, the level of HbA1C was measured in a limited number of clinical trials or animal studies. Available information on both short- and long-term use of studied herbs on diabetes related complications and functions of involved organs as well as comorbid depression and/or simultaneous changes in lifesyle is also insufficient. Furthermore, little or no information on their phytochemical, toxicological, and herb–drug interaction properties is available. It is worth noting that the efficacy of the reviewed herbs has been studied scarcely in both humans and animals regarding both Iranian and non-Iranian studies. A significant number of reviewed articles failed to cite the scientific name of herbs and include information on the processing procedure and the extraction process. Conclusions Treatment of diabetes mellitus as a multifactorial disease using herbal medicines requires a comprehensive approach. In order to discover the right herbal medicine for the management of diabetes many other important factors than the levels of BG, HbA1C and insulin should be considered. According to our criteria, all the reviewed herbs suffered from inadequate investigation in human, animal and in vitro models in this respect, whereas they are worth investigating further. However, more research on endemic plants and the traditional history of herbal medicine is warranted. In our opinion, the pharmacological, toxicological, and phytochemical information should be obtained before clinical trials. Furthermore, information such as botanical scientific nomenclature, side effects, and toxicity will improve the quality and validity of publications in herbal research. In particular, designing a database covering all valid information about herbs and/or diseases will decrease unnecessary costs and increase the efficiency of research. [ABSTRACT FROM AUTHOR]

Background: Complementary and Integrative Medicine (CIM) is often taken up by individuals seeking relief from different diseases. This study investigates the prevalence and associated factors of CIM use in patients with COVID-19. Methods: In this telephone-based, cross-sectional study, data on CIM usage were collected from COVID-19 patients from February till June 2020 in Fars province, Iran using a researcher-made checklist. Additionally, we asked about the patients' attitudes toward these treatments. Results: Out of 453 patients diagnosed with COVID-19, 400 (88.30%) responded to our calls and agreed to participate in the study. Among them, 276 patients reported using CIM to treat COVID-19 [prevalence: 69% (95% CI: 64.2 to 73.5)]. The most frequently used herbal medicine among COVID-19 patients was ginger (n = 273, 98.9%), thyme (n = 263, 95.3%), and black cumin (n = 205, 74.3%). Most of these patients were recommended to use herbal medicine by their families and friends (n = 96, 34.8%). Univariable logistic regression revealed that age under 50 years old, residency in urban areas (including the capital of the province and small cities), employment, academic education, and being an outpatient were statistically significant factors resulting in CIM usage. Multivariable logistic regression revealed that CIM use among outpatients was 3.65 times more than among inpatients. In addition, patients under 50 years old used CIM 85% more than older patients. Ultimately, only 9 (3.3%) patients consulted with their doctors regarding these medications. No side effects due to CIM use were reported. Conclusion: Many patients with COVID-19 used CIM, but few consulted with their physicians in this regard. Therefore, physicians should ask their patients about CIM usage, and patients should also report their use of CIM therapies during their medical visits. Furthermore, age and hospitalization status affected CIM use among patients with COVID-19. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Zataria multiflora Boiss. (ZM) is a thyme-like plant belonging to the Lamiaceae family that grows wild only in Iran, Pakistan and Afghanistan. This plant with the vernacular name of Avishan-e-Shirazi (Shirazi thyme) in Iran is a valuable medicinal and condimental plant. It has several traditional uses as an antiseptic, carminative, stimulant, diaphoretic, diuretic, anesthetic, anti-spasmodic and analgesic. Aim of the study: This paper reviews the ethnopharmacology, pharmacology, toxicology, modern pharmaceutical uses and phytochemistry of Zataria multiflora, and highlights the gaps in our knowledge deserving further research. Materials and methods: All relevant databases were searched for the terms “Zataria”, “Zataria multiflora”, “Shirazi thyme” and “Iranian thyme” without limitation up to 24th October 2012. Information on Zataria multiflora was collected via electronic search using Pubmed, Scopus, Web of Science and SID (for articles in Persian language), and local books on ethnopharmacology. Results: ZM has played an important role in Iranian traditional medicine. In light of the modern pharmacological and clinical investigations, ZM is a valuable medicinal and condimental plant that has anti-microbial, antioxidative, anti-inflammatory, spasmolytic and anti-nociceptive properties. The oil of ZM contains high percentages of oxygenated monoterpenes, in particular thymol and carvacrol, and exhibits excellent anti-microbial properties. Conclusions: Overall, antimicrobial property appears to be the most interesting studied biological effect of ZM. The lack of a comprehensive phytochemical analysis of ZM is an important limitation that can be noted regarding most of the previous studies. [Copyright &y& Elsevier]

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused patients with chronic diseases to face various challenges. The present qualitative study aimed to explore adherence to treatment in patients with coronary artery disease (CAD) during the COVID-19 pandemic. Methods: This qualitative content analysis was conducted from September 2020 to February 2021. Online in-depth interviews were conducted with 15 patients with CAD after discharge from Nemazi and Al-Zahra heart hospitals, Shiraz, Iran. Data management was done via MAXQDA 12 software using conventional content analysis based on the method proposed by Graneheim and Lundman. Results: The results revealed three main categories, nine subcategories, and 431 primary codes. The first category was 'improved self-care in the shadow of COVID-19' (Improving self-care due to fear of COVID-19, 'utilization of alternative strategies, and reinforcement of self-care beliefs). The second category was 'redefinition of support systems' (need for a support system, seeking for alternative support systems, and changes in social interactions). The last category was 'barriers to treatment adherence' (shortage of financial resources, need to adjust with working conditions, and mental conflicts). Conclusion: The results indicated that the COVID-19 threats encouraged the patients with CAD to adhere to their care principles. Nonetheless, the restrictions resulting from the pandemic caused problems in adherence to treatment. Thus, redefinition of the support systems in accordance with the present conditions are recommended. [ABSTRACT FROM AUTHOR]

Background: The present study aims to investigate the knowledge, attitude, and performance of Iranian Healthcare Professionals (HP) about Complementary and Alternative Medicine (CAM) modalities. Methods: This cross-sectional study was carried out on 210 HP in 2019. Samples were selected from healthcare centers, clinics, and hospitals using census sampling. Data collection tools included demographic information, attitude, knowledge, and the amount of use of CAM modalities. Data analysis was performed using SPSS ver. 24. Results: In this study, the response rate was 85.3% (n=209). A majority of respondents had a positive attitude toward CAM (n=166, 79%), but their level of knowledge was limited (n=154, 73.6%). The most commonly used CAM modalities were herbal medicine (93.2%), exercise therapy (75.4%), and hydrotherapy (75.2%), respectively, and the least commonly used ones were magnetic therapy (2.9%) and hypnosis (4.8%). The most important reasons for the use of CAM modalities by HP included fewer side effects than medical treatments (57.4%), its lowest cost than medical treatments (34.9%), non-serious disease with no need for referral to a clinic (32.1%), and its more convenient access than medical treatments (30.6%). The results showed that there was a significant relationship between the education level and the use of CAM modalities (p<0.05). There was also a significant relationship between the suggestion of CAM modalities and the amount of use of these modalities, and those who used these modalities would also have recommended them to their clients more frequently (p<0.05). Conclusion: The results showed that most of HP used at least one of the CAM modalities and had a positive attitude towards CAM. As the level of knowledge was limited, training courses should be implemented to increase health practitioner's level of knowledge on CAM. [ABSTRACT FROM AUTHOR]

Introduction: The present study was conducted to evaluate the prevalence of trend and use of complementary and alternative medicine in patients referring to the Gastroenterology clinics in Mashhad. Methods: The present cross-sectional study was performed at Gastroenterology clinics affiliated with Mashhad University of Medical Sciences. The study began in December 2015 and ended in March 2017. The study subjects (n=751) were randomly selected from patients referring to Gastroenterology clinics in the city of Mashhad. Patients responded to the questions through interviews. The collected data were analyzed by SPSS-16 statistical software. Results: This study was conducted on 751 patients referring to gastroenterologists; of whom, 274 (48.36%) were male and 476 (38.63) were female. According to the results, the most popular complementary and alternative medicine treatments were respectively herbal medicine, cupping therapy and acupuncture. A significant difference was observed in the means at is faction with complementary and alternative medicine between those who believed in it and those who did not (p=0.001); but, no significant difference was detected in mean satisfaction with complementary and alternative medicine between patients with different occupations (p=0.193). There was also a significant difference in the number of patients between the group of patients receiving chemical medication and the group of patients receiving complementary and alternative medicine therapies (p=0.005). No significant difference was found in the level of satisfaction with complementary and alternative medicine between participants referring to the Gastroenterology clinics for different causes (p=0.431); nonetheless, the highest satisfaction was observed in patients with malignancy, and the lowest satisfaction was detected in patients with esophageal disorders. Conclusion: This study indicated the high prevalence of complementary and alternative medicine in Iran. The worldwide popularity of complementary and alternative medicine should not be overlooked, therefore; current medical treatment systems need to be revised and modified. [ABSTRACT FROM AUTHOR]

Background and Purpose: Phlebotomy has been broadly used as an assured and economical technique to tackle soft tissue lesions in ITM (Iranian Traditional Medicine), most Asian countries, Central Europe, and some parts of the US. In this study, phlebotomy was used for the treatment of Carpal Tunnel Syndrome (CTS) that is widely recognized as the most common neuropathy. This study aimed to investigate the effects of phlebotomy on the clinical and diagnostic findings of patients with CTS. Methods: This is a randomized clinical trial. For this analysis, an entire of 70 hands with CTS were studied, aged 20-60, and of every gender. The participants were divided into 2 groups: Control and Intervention. Within the control group, 35 were treated with a routine night splint for 3 months, and 35 patients in the intervention group, were received Fasd (Phlebotomy) of Osailem vein in addition to the routine night splint. The variables of which we evaluated were: pain, symptom severity, functional status, distal median nerve sensory latency, and distal median nerve motor latency. The pain has been evaluating by VAS Scale while the severity of symptoms and functional status of patients were evaluated by the Boston questionnaire, and the distal and motor nerve latency were evaluated through the diagnostic NCV test. Results: The results of the study demonstrated an incontestable improvement in symptom severity (p=0/0001) and functional status [Significant treatment effects for the Boston CTS-score (p=.0007)]. Additionally a serious decrease in Median nerve entrapment with NCV (p=0.015) of the intervention group in comparison with the control one. Pain severity of CTS symptoms (VAS), was also reduced significantly from 61.5 ± 20.5 mm to18.9 ± 15.7 mm after 3 months in the phlebotomy group and from 67.1 ± 20.2 mm to 52.7 ± 21.8 mm in the control group [group difference-33.8 mm (p<0.001). Conclusions: The results showed that the incorporation of phlebotomy (Fasd) treatment in an exceedingly routine therapy program would reduce the pain and symptom severity, improve the functional status of patients, and distal sensory and motor disturbance of the median nerve. Therefore, it is advised that phlebotomy (Fasd), as a convenient and low-cost complementary medicine technique could be employed within the treatment of CTS. [ABSTRACT FROM AUTHOR]

Background: Complementary and Alternative Medicine (CAM) have recently become more popular and accepted worldwide. One principal step to identify the status and organize strategies of CAM is evaluating the manner and the prevalence of its usage among people. This study aimed to investigate the prevalence of CAM modalities usage by the people of Babol, a central city in the North of Iran, in 2018. Methods: Using the original International CAM Questionnaire (I-CAM-Q), a questionnaire was redesigned in Persian (Farsi) with some changes such as adding special modalities in Iran and its validity and reliability were assessed. Six hundred households were evaluated using a cluster sampling method in 2018 spring by 12 trained interviewers. Results: Finally, 1770 questionnaires were correctly completed. A total of 110 participants (6.21% of the completed questionnaires) had visited CAM therapists in the last year, 109 persons (6.15%) had received prescriptions from physicians and paramedics to use CAM, and a total of 1032 people (58.30%) used herbs and herbal medicines in the last 12 months. Also, 1265 individuals (71.46%) had used CAM throughout their lives. The most popular methods were herbal medicine (65.76%), Persian Medicine (13.78%), water therapy (10.45%) and music therapy (8.36%). The use of CAM was more popular among women. Conclusions: The general use of CAM in Babol was similar to other studies, but there were fewer visits by CAM therapists and less frequent adoption of common methods including homeopathy, acupuncture, and energy therapy. It was found that CAM was mostly used for non-serious diseases such as cold and transient gastrointestinal disorders, a pattern that is different from other studies in this field. [ABSTRACT FROM AUTHOR]

Background: Although pregnancy and motherhood are enjoyable experiences, they are associated with numerous biopsychological changes requiring adaptation. The present study aimed to assess the effects of relaxing music on life distress and Maternal-Fetal Attachment (MFA) in pregnant women. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The research population included all Iranian pregnant women referring to Laleh Hospital in Tehran City, Iran, in 2020. In total, 30 women were selected using the convenience sampling method and randomly assigned into the intervention and control groups (n=15/group). The required data were collected using the Life Distress Inventory (LDI) and the Maternal-Fetal Attachment Scale (MFAS). The intervention group listened to relaxing music for twelve 45-50-minute sessions in the morning and during routine midwifery visits; however, the controls received no intervention. The collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS V. 22. Results: The obtained results indicated that the intervention group reported a lower level of life distress in the post-test, compared to the controls (P=0.0001, F=15.860). The intervention group also achieved a higher mean score on MFT, than the control group (P=0.0001, F=35.872). Conclusion: According to the present research findings, reproductive health, nursing professionals, and psychologists could recommend music as a complementary therapy to reduce stress and distress experienced by expecting mothers and to improve MFT. [ABSTRACT FROM AUTHOR]

Background. The unresponsiveness to conventional pharmacological treatments and their side effects have led patients with irritable bowel syndrome (IBS) to use complementary and alternative medicine such as herbal remedies. Beside, Zataria multiflora Boiss (ZM), Trachyspermum ammi L. (TA), and Anethum graveolens L. (AG) are being used as an antiseptic, carminative, and antispasmodic in traditional medicine. This trial investigated the efficacy and safety of a combination of ZM, AG, and TA essential oils in the treatment of IBS. Method. The present study was a randomized double-blind clinical trial with parallel groups in Iran. Patients in the control arm received three tablets of 10 mg hyoscine butylbromide daily for two weeks, and the intervention arm was daily treated with two 250 mg softgel capsules containing 180 mg of essential oils of ZM, AG, and TA for two weeks. Primary outcomes were the response rates based on the IBS Symptom Severity Scale (IBS-SSS), IBS Adequate Relief (IBS-AR), and IBS Global Assessment Improvement (IBS-GAI) at the end and two weeks after the end of the intervention. Secondary outcomes were the improvement rates in IBS-SSS scores, improving the quality of life, safety, and tolerability. Results. The posttreatment improvement percentage based on IBS-AR, IBS-GAI, and IBS-SSS scales was 83.9%, 75%, and 87% in the intervention group and 37.9%, 27.5%, and 34.4% in the control group, respectively (P < 0.001). Also, the improvement of the quality of life in the herbal medicine arm was significantly more than that in the control arm (P < 0.001). Conclusions. According to the results, the herbal medicine investigated in this study can be considered an appropriate alternative treatment for IBS. [ABSTRACT FROM AUTHOR]

Background: Cancer is considered one of the most important health issues in Iran. Regarding that Iranians have a positive attitude towards complementary medicine; the demand for this type of treatments is increasing. However, those undergoing this treatment often have limited awareness on it. Objectives: This study aims at determining the perspective of cancer patients on using complementary medicine. Methods: In this descriptive study, 176 cancer patients from all over the country were selected by purposeful sampling, according to the inclusion criteria and, then, completed demographic characteristics questionnaire and the Questionnaire on Integrating Complementary Medicine in Oncology Treatment. The data were analyzed, using SPSS software version 20. Results: More than half of the patients used complementary medicine and according to their viewpoints, using herbal medicine was considered their first priority. At the same time, 46% of the research samples consulted with care providers on how to use complementary medicine for cancer treatment. The most frequent referrals to specialists were referrals to complementary medicine experts. The researchers expected complementary medicine to improve their symptoms of anxiety, fatigue, and depression. Conclusions: The use of complementary medicine as a complementary approach in cancer patients can have an impact on the improvement of symptoms, which ultimately enhances the quality of life in patients. Due to the concerns about applying these approaches, it is necessary to train care providers in order to consider the perspective of cancer patients in this regard and to obtain their past medical history. [ABSTRACT FROM AUTHOR]

Background: Traditional Persian Medicine (TPM) is an ancient medical system that provides suggestions to improve the health of mothers and children during pregnancy and labor. Persian physicians believed that these instructions made labor easier, safer, and less painful. Methods: The present randomized clinical trial was conducted among women at 33–38 weeks of pregnancy in Tehran, Iran. TPM instructions consisted of diet, bathing, and application of oil from the 38th week of pregnancy to the onset of labor. The primary outcome was the duration of the active phase of labor. Results: The mean duration of the active phase was 331.60 ± 151.48 min for the intervention group and 344.40 ± 271.46 min for the control groups, but it was not statistically significant. The active phase was significantly shorter in women who had better compliance (p=0.03). The need for oxytocin augmentation was 53.3% in the control group and 38.5% in the intervention group (p=0.17). The rate of perineal infection was 13% in the control group and 0% in the intervention group (p=0.11). Conclusions: The active phase was not different in the intervention and control groups, but it was shorter in compliant women. It is possible that prolonged use of these recommendations in combination with a sitz baths and a larger sample size could result in more significant outcomes. [ABSTRACT FROM AUTHOR]

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Background: Guillain-Barre syndrome (GBS) is an acute immune-mediated peripheral neuropathy usually after an incident. This study was performed to investigate the basic epidemiologic features of GBS in south of Iran. Methods: We studied consecutive patients with GBS in Nemazi Hospital of Shiraz, southern Iran. Demographic characteristics of the subjects, i.e. age, sex, and length of hospital stay were extracted. Information regarding yearly admissions for the entire hospital was also gathered. The prevalence of GBS per 10,000 hospital admissions was calculated and stratified by sex and year. Yearly prevalence was compared using the odds ratio (OR) and 95% confidence intervals (CI). Results: From January 2000 to December 2009, 389 (232 males and 157 females) patients with GBS were admitted in our center. The mean age of patients was 29.8 ± 23.0 years and their mean length of hospital stay was 12.9 ± 11.6 days. The overall mortality rate was 6%. The ratio of admissions due to GBS to the total admissions was significantly higher in 2009, the year of an inEuenza A (H1N1) virus pandemic. Conclusion: There appears to be an increase in the incidence of GBS in Shiraz. This is in parallel with the increasing trend of some other autoimmune diseases. [ABSTRACT FROM AUTHOR]

The hypothesis that mitochondrial genes may implicate susceptibility to multiple sclerosis (MS) is supported by an increasing number of case reports on Leber’s hereditary optic neuropathy (LHON)-associated mitochondrial DNA (mtDNA) point mutations in patients with MS. A number of mtDNA mutations with primary pathogenic significance for LHON, a maternally inherited disease causing severe bilateral visual loss predominantly in young men, have been detected in patients with an MS-like phenotype. To evaluate the link between MS and LHON primary point mutations, we investigated 31 non-related Iranian clinically definite MS patients (23 females and 8 males) with optic nerve involvement, as well as 25 patients (16 females and 9 males) without involvement of the optic nerve as controls. Three patients had severe bilateral visual loss without any recovery. We searched for the presence of LHON mitochondrial mutations at nucleotide positions (np) 11,778, 3,460, and 14,484 by mutation-specific polymerase chain reaction and restriction fragment length polymorphism. Our results suggest that there is no association between Iranian patients with MS and mtDNA point mutations at np 11,778, 3,460, and 14,484. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]