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Background: The purpose of this study was to investigate the efficacy and safety of Jollab monzej (JMZ), a Traditional Persian compound medicine, on multiple sclerosis-related fatigue (MSRF). Methods: We did a double-blind randomized controlled phase3 clinical trial on the JMZ syrup in fifty-six relapsing-remitting MS (RRMS) patients aged 18-55 years with moderate to severe fatigue using the Expanded Disability Status Scale (EDSS) score ≤ 6. We randomly assigned (1;1) participants to the JMZ syrup or placebo syrup groups treated for one month. Participants, investigators, and assessors were unaware of the assignments. The primary outcome was changes in the fatigue score on the Fatigue Severity Scale (FSS), at baseline and one month after treatment using the intention-to-treat (ITT) analysis. The secondary outcomes were changes in the score of Visual Analogue Scale (VAS), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Outcomes were measured at baseline, one month after treatment, and 2-week follow-up. Safety was detected in all participants. Results: We randomly assigned 56 participants to the JMZ group (n=28) and placebo group (n=28). Fatigue scores significantly changed in both groups; however, the JMZ group had a greater reduction in FSS score in the ITT analysis. The adjusted mean difference was 8.80 (Confidence interval (CI) 95%, 2.90-14.70, P = 0.00). The mean difference of VAS, BDI, and global PSQI scores were statistically significant (P=0.01, P₌0.00, P₌0.01; respectively). Regarding safety, mild adverse events (AEs) were reported. Conclusion: The results of our study revealed that the administration of JMZ syrup alleviated MSRF and also could improve depression and sleep disorders. [ABSTRACT FROM AUTHOR]

Increased incidence of Multiple Sclerosis (MS) calls for supporting complementary therapies in this field. Persian Medicine (PM) specialists present various assumptions to help patients through Mizaj (temperament) modification, but its confirmation requires scientific evidence. This study aimed at identifying the Mizaj of MS patients, and comparing it with their Mizaj before the onset of the disease, and with that of healthy people. Forty-two MS and fifty-four healthy subjects participated in the study as case and control groups. General and brain Mizaj in patients were identified by five PM specialists before and after the onset of the disease. Mojahedi Mizaj Questionnaire (MMQ) was completed by the two groups. The validity of MMQ was assessed using Mizaj diagnosis by PM specialists as the gold standard. T-test, McNemar-Bowker, Wilcoxon, and Chi-square (χ2) tests were used to compare the Mizaj of patients before and after the onset of the disease, and between the two groups (p<0.05). The sensitivity and specificity of MMQ for Hotness (75, 81%) and Coldness (75, 65%) were acceptable. There were no significant differences between patients and healthy subjects in terms of general Mizaj. But general and brain Mizaj of patients after developing MS inclined to coldness and dryness, although merely inclination of general Mizaj to coldness was significant (p=0.03). According to our results, the Mizaj of MS patients has an inclination toward coldness and dryness; Also, MMQ can be used as a validated scale for identifying the Mizaj of MS patients in future studies. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a prevalent sleep disorder that has not been well managed thus far. There are numerous medicaments for treatment of insomnia, but they have undesirable side effects that make herbal medicine a more viable option. Objectives: The effectiveness of a combination of Melissa officinalis L. (dry powder) and Nepeta menthoides Boiss. & Buhse (freeze-dried aqueous extract) on insomnia was evaluated. Design and Setting: Insomniacs who met the entry criteria participated in a triple-blind randomized placebo-controlled clinical trial at the Persian Medicine (PM) clinic in Tehran. Interventions: The subjects received either 1000 mg of M. officinalis plus 400 mg N. menthoides or a placebo nightly for four weeks in accordance with prescriptions from the pharmaceutical manuscripts on PM and the results of previous studies. Outcome measures: The Pittsburgh Sleep Quality Index (PSQI), sleep diary, and Insomnia Severity Index (ISI) were used for assessment of insomnia. Results: Comparison of the treatment and placebo groups showed a significant decrease in the mean difference of ISI (4.97 ± 4.69 vs. 1.60 ± 3.70; p =; 0.002) and total PSQI (4.14 ± 3.69 vs. 1.42 ± 2.81; p = 0.001) scores in the treatment group. A significant increase was also observed in total sleep time of treatment group (p < 0.001) based on the sleep diary. Conclusions: A combination of M. officinalis and N. menthoides Boiss. & Buhse could be an alternative sleep improvement therapy. [ABSTRACT FROM AUTHOR]

The effect of a combination of Malva sylvestris and Althaea digitata flower powder in prevention of acute radiation proctitis was assessed in patients undergoing radiation therapy (RT) for prostate cancer. This double-blind randomized controlled study was conducted at three centers in Iran. Before starting RT, patients (N = 65) received a 4 g packet of flower powder or placebo to use 3 times a day as an infusion from the first day of RT and for five consecutive weeks including the three weeks of RT. They were visited by a physician 3 times during this period. Acute morbidity was classified according to the Radiation Therapy Oncology Group (RTOG) criteria. Severity of proctitis symptoms was assessed by Visual Analog Scale (VAS) with 10 points. Non-statistical significant differences were observed between the groups in relation to RTOG grade criteria (grade 0: drug 22.8% (N = 8), placebo 10% (N = 3), difference 12.8%; grade 1: drug 65.8%, placebo 64.4%, difference 1.4%; grade 2: drug 11.4% (N = 8), placebo 26.6% (N = 4), difference 15.2%. (P = .059)) According to VAS, the most common complaint was anal burning and diarrhea in the flower powder group showing a significant decrease in these symptoms at the end of the study as compared to the placebo; flower powder (1.56 ± 1.07) vs placebo (3.82 ± 1.67) for burning (P < .05) and flower powder (1.06 ± 0.58) vs placebo (1.95 ± 0.79) for diarrhea (P = .046). The flower powder prevented anal discomfort and diarrhea induced by prostate radiotherapy, although there were no significant differences between the two groups in RTOG. No serious side effects were reported, so the combination could be suggested for patients who cannot tolerate symptoms of proctitis after further studies. [ABSTRACT FROM AUTHOR]

Background: Mucositis is the most common complication of radiotherapy in patients with head and neck (H and N) cancers. Objectives: This study surveyed the efficacy of a herbal compound containing Alcea digitata Alef and Malva sylvestris L. in prevention of radiation-induced mucositis in patients with head and neck cancer. Methods: In the present study, a total of 23 patients were examined and assigned to 2 groups. The herbal drug and the placebo (provided from Avicel) were administered for 7 weeks, from the beginning of radiotherapy to 2 weeks after the completion of the treatment. During weekly visits, mouth pain score (MPS) was assessed, using visual analog scale (VAS) and severity of mucositis was checked by investigators. Results: Patients in control group showed more severe mucositis from second week, compared with drug group (p < 0.0001). The effect of herbal compound, time and the time-drug's interaction on mucositis, and MPS were significant (p < 0.0001); hence, the severity of mucositis and the mean of MPS in control group was significantly more severe in comparison with drug group (p < 0.0001) in weekly cut. The effect of time was significant only in control group (p < 0.0001); and in drug group, there was no significant difference in severity of mucositis and MPS during the study (p = 0.2366). Conclusions: Therefore, not only the severity of mucositis and the average of MPS were significantly lower in drug group compared with control group, but also they were invariant during the study and showed no uptrend. [ABSTRACT FROM AUTHOR]

This study compared the therapeutic effect of flax seed oil topical gel and hand splint in the treatment of carpal tunnel syndrome. This study was a randomized clinical trial. Forty-nine patients, 96 hands, with mild to moderate idiopathic carpal tunnel syndrome were divided into 2 groups randomly. One group was treated by topical gel and the other group by hand splint. Intensity of symptoms and function before and after intervention was measured via Boston Carpal Tunnel Questionnaire. After intervention, the ANCOVA showed a significant difference between the symptom and function scores of the 2 groups. In both cases, recovery was higher in the gel group (P < .001). The topical use of flax seed oil gel is more effective in the improvement of symptoms and function of patients with mild to moderate carpal tunnel syndrome as compared with hand splint, and it can be introduced as an effective treatment. [ABSTRACT FROM AUTHOR]

Multiple Sclerosis (MS) is a neurological disorder with an increasing global prevalence and severe complications. MS14® is a Persian-medicine-derived natural product with herbal and marine origin which has shown beneficial effects in the management of MS complications. In this study, its effect on physical activity of MS patients was investigated. A triple-blind placebo-controlled clinical trial was conducted. Participants used either MS14 capsule or placebo 3 times a day for 3 weeks. At baseline and end of the study, physical activity indices were assessed using international physical activity questionnaire (IPAQ). Secondary outcome measures were Fatigue Severity Scale (FSS), timed 10 m walk, Ashworth scale, and Timed Get up and Go. A total number of 80 MS patients completed the study. At the end of study, improvement of general physical activity (p -value=0.047) and Timed 10 m walk index (p -value=0.003) in the MS14 group was significant when compared to placebo. No serious adverse effects were observed in this study. Considering the improvement of some physical activity indices, MS14® is seems to be a safe natural product which could be considered as a supplementary treatment in MS patients. Future larger trials are suggested to further evaluate its efficacy. [ABSTRACT FROM AUTHOR]

Context: Conventional therapies using mucilage plants greatly used by practitioners in Iran. The usage of mucilages is rooted in traditional knowledge with a history of more than 4000 years. Scientific assessment of these historical documents could be valuable for finding new potential usage in the current medicine. Objective: This study assembled an inventory of mucilage plants considered important therapeutic aids for alleviating the ailments in ancient Persian medicine and compared therapeutic applications of ancient times with current findings of medicinal mucilages in the same plant species. Methods: A literature search compiled some main traditional manuscripts of Persian medicine, including the book of AlHavi, Canon of Medicine, Zakhireh-iKharazmshahi, Qarabadine-kabir, Tohfat ol Moemenin, and Makhzan-ol-advieh, and select mucilage plants used in treating the mouth and respiratory system disorders. Also, current investigations on related subjects were considered through a search of the Pub Med and Google Scholar databases. Results: In Iran, the application of medicinal plants contains mucilage date back to ancient times. In mentioned medieval Persian books, 20 medicinal plants containing mucilage were identified. Mucilages have been traditionally used via oral or topical routes for a variety of disorders. According to this study, most of the cited medicinal plant species were used for their mucilaginous, anti-inflammatory, and anti-oxidant effects. Conclusions: A scientific evaluation of these historical documents can give an insight into the ideas of the past and be valuable in finding new data on clinical use of the mucilages that should lead to future opportunities to investigate their potential medicinal use. [ABSTRACT FROM AUTHOR]

The objective of the present study is recognizing and describing the relationship between different human temperaments and personality traits of experts of Charity Foundation for Special Diseases. Research methodology is descriptive-survey one. Data collection was conducted using a 5-choice questionnaire of Likert scale type for five-factor model of personality (Neo-FFI) and the temperament of each of the subjects was determined through interviews and questionnaires based on traditional Persian medicine. For this study, 108 samples were selected from research population and the questionnaires were distributed among them. Collected data was analyzed using factor analysis to test the validity of the questionnaire, path analysis and also diagnostic analysis (DA). The results indicate that there are various relationships between people's temperament and their personality, so that, choleric people have the highest openness to experience. In people with melancholic temperament, the greatest impact can be seen with regard to conscientiousness. In phlegmatic people, the least impact is seen on extraversion and ultimately in people with sanguine temperament, the greatest impact is to be observed on agreeableness of individuals. [ABSTRACT FROM AUTHOR]

Background and Aims: Antidepressant drugs are accompanied with high rate of adverse effects. Lavender is one of the most common herbal drugs mentioned in Traditional Persian literature with potential efficacy on mental disorders and less serious side effects. Thus, the aim of this study was to determine the efficacy of lavender on depression severity by preforming a systematic review and meta-analysis.Methods: Databases including PubMed, Scopus, Cochrane library, Embase and Web of science were searched for relevant articles till December 2020. Quality of studies were evaluated by Jadad scale and the Cochrane collaboration tool. Depression as endpoint measure or as a subscale of any valid assessment tool was subjected to quantitative data analyses. Both fixed and random effects meta-analysis were conducted for data synthesis.Results: Out of 342 screened studies, 17 articles were included in the meta-analysis. Results showed significant efficacy of lavender in decreasing depression scores compared to the control group (pooled Standardized Mean Difference (SMD)= -0.66, 95 % CI: -0.85 to -0.46;P < 0.001, I2 = 68.2 %;). Subgroup analysis proved that the effect of lavender was marginally more pronounced in participants with diagnosed depression (pooled SMD= -0.62, 95 % CI: -1.26 to 0.01, P = 0.055; I2 = 88.1 %) while its effect was statistically significant in patients having other diseases with concomitant depressive symptoms (pooled SMD= -0.65, 95 % CI: -1.84 to -0.46, P < 0.001; I2 = 52.1 %), and the oral route (pooled SMD= -0.56, 95 % CI: -1.07 to -0.05, P = 0.032; I2 = 85.2 %;) was the most effective route of administration.Conclusions: This systematic review and meta-analysis concluded that lavender has significant antidepressant effects. However, due to some limitations, further large clinical trials are recommended with more homogeneous populations and rigorous designs. [ABSTRACT FROM AUTHOR]