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Objective: Angina pectoris is characterized by chest pain due to reduced blood flow to the heart, often caused by narrowed coronary arteries. This review examines medicinal plants traditionally used in Iran to alleviate angina symptoms, exploring both historical and modern applications. The goal is to enhance understanding of potential natural remedies for this condition. Methods: This systematic review aimed to identify literature on the use of medicinal plants for angina pectoris. Searches were conducted across major scientific databases like Web of Science, PubMed, and Scopus, using keywords related to chest pain and herbal treatments. Articles included in the review were required to be in Farsi or English, focus on the effects of medicinal plants on angina, and be original research, reviews, or clinical trials, while excluding those with insufficient data or irrelevant content. Results: Traditional Iranian medicine incorporates a rich array of herbal remedies for various ailments, including angina pectoris. Among the most commonly employed medicinal plants in Iran are garlic (Allium sativum), coriander (Coriandrum sativum), asafoetida (Ferula assa-foetida), cumin (Cuminum cyminum), ajwain (Carum copticum), parsley (Petroselinum crispum), pomegranate (Punica granatum), ginger (Zingiber officinale), green pumpkin (Cucurbita pepo), orange (Citrus sinensis), banana (Musa spp.), guava (Psidium guajava), apple (Malus domestica), turmeric (Curcuma longa), borage (Borago officinalis), lavender (Lavandula angustifolia), aloe vera (Aloe vera), almond (Prunus dulcis), basil (Ocimum basilicum), and alfalfa (Medicago sativa). These plants have been historically utilized as potential remedies for chest pain in Iranian traditional medicine. Conclusion: The findings of this study suggest that traditional Iranian medicine offers a diverse array of medicinal plants with potential therapeutic benefits for angina pectoris. The identified plants exhibit a range of pharmacological properties, including anti-inflammatory, antioxidant, sedative, and antispasmodic effects. Additionally, these plants may contribute to improved blood circulation, potentially alleviating the symptoms of chest pain associated with angina. [ABSTRACT FROM AUTHOR]

Objectives: In holistic medicine, developing personalized treatment plans is challenging due to the multitude of possible therapy combinations. This study introduces the use of a statistical approach to identify the most effective herbal medicines prescribed in Persian medicine (PM) in a small-scale sample of patients with type 2 diabetes mellitus (T2DM). Methods: This prospective observational cohort study was conducted with 47 patients with T2DM referred to Behesht Clinic in Tehran, Iran. A physician prescribed individualized PM treatment for T2DM and related systemic issues. The fasting blood sugar (FBS) level of each patient was recorded at initial and two follow-up visits, with visit intervals and treatment modifications determined by patient health status. Patients who completed two follow-up visits were included in the final analysis (n = 27). Data were analyzed using R software. A general linear model was assumed for the mean response, along with an exponential covariance pattern model, to manage irregularly timed measurements. Results: Two fitted models showed that, after adjusting for confounders, the use of the "Diabetes Capsule" significantly reduced the average FBS by 17.14 mmol/L (p = 0.046). For each unit increase in the consumption of "Diabetes Capsule" or "Hab-e-Amber Momiai," the average FBS decreased by 15.22 mmol/L (p = 0.015) and 14.14 mmol/L (p = 0.047), respectively. Conclusion: It is possible to observe which medications are most effective, even when treatments are applied in a holistic and personalized fashion. Preliminary studies such as these may identify promising products for testing in clinical trials conducted under standardized conditions, to inform initial choices for future personalized treatments. [ABSTRACT FROM AUTHOR]

Background: One of the most widely used medicinal plants in Iranian traditional medicine, Rosa × damascena Herrm. (mohammadi flower) that the people of Kashan use as a sedative and to treat nervous diseases and constipation. In this research, the yield, chemical composition and antimicrobial activity of the essential oil of this plant were evaluated for the first time from Azaran region, Kashan. Methods: The essential oil was extracted by means of hydrodistillation (Clevenger), and its chemical compounds were identified and determined by GC/MS. The antimicrobial activity of the essential oil was determined by the diffusion method in agar, the minimum growth inhibitory concentration (MIC) and the minimum concentration capable of killing bacterial/fungal microorganisms (MBC/MFC). Results: The results showed that the yield of essential oil was 0.1586 ± 0.0331% (w/w). Based on the results of the chemical composition analysis of R. x damascena essential oil, 19 different compounds (98.96%) were identified. The dominant and main components of the essential oil were oleic acid (48.08%), palmitic acid (15.44%), stearic acid (10.17%), citronellol (7.37%) and nonadecane (3.70%). Based on the results of diffusion in agar, the highest zone of inhibition against Candida albicans (ATCC 10231) was ~ 9.5 mm. The strongest inhibitory activity of R. x damascena essential oil against Gram-negative Proteus mirabilis (ATCC 43071) was with the diameter of the inhibition zone (~ 9 mm), which was equal to the strength of rifampin (~ 9 mm). Conclusion: Therefore, this essential oil is a promising natural option rich in fatty acids, which can be a potential for the production of natural antimicrobials against infectious diseases, especially urinary tract infections. [ABSTRACT FROM AUTHOR]

Background: The utilization of complementary and alternative medicine (CAM) is experiencing a global surge, accompanied by the adoption of national CAM policies in numerous countries. Traditional Persian medicine (TPM) is highly used as CAM in Iran, and the ongoing scientific evaluation of its interventions and the implementation of evidence-based medicine (EBM) encounters various barriers. Therefore, comprehending the characteristics and interactions of stakeholders is pivotal in advancing EBM within TPM policies. In this study, we utilized both classical stakeholder analysis and social network analysis to identify key stakeholders and potential communication patterns, thereby promoting EBM in TPM policy-making. Methods: A cross-sectional nationwide stakeholder analysis was conducted in 2023 using snowball sampling. The interviews were carried out using a customized version of the six building blocks of health. Data were collected through semi-structured interviews. Stakeholders were assessed based on five factors (power, interest, influence, position, and competency). The connections and structure of the network were analyzed using degree, betweenness, closeness centrality, and modularity index to detect clusters of smaller networks. Results: Among twenty-three identified stakeholders, the Ministry of Health and Medical Education (MOHME) and the Public were the most powerful and influential. The Iranian Academy of Medical Sciences was the most competent stakeholder. Social network analysis revealed a low density of connections among stakeholders. Pharmaceutical companies were identified as key connectors in the network, while the Public, supreme governmental bodies, and guilds acted as gatekeepers or brokers. The MOHME and Maraji were found to be high-ranking stakeholders based on four different centrality measures. Conclusion: This study identifies powerful stakeholders in the network and emphasizes the need to engage uninterested yet significant stakeholders. Recommendations include improving competence through education, strengthening international relations, and fostering stronger relationships. Engaging key connectors and gatekeepers is essential for bridging gaps in the network. [ABSTRACT FROM AUTHOR]

Introduction: The aging procedure is an incremental reduction in the human systems, including the heart and respiration, blood vessels, endocrine glands, urinary-genital, and immune systems. This investigation evaluated the association between the Predicted Mean Vote (PMV) and Mizaj based on Persian medicine on thermal comfort of aging in sanatoriums in Mazandaran province in Iran. Methods: This research was accomplished at Rasht Azad University from June 2022 to December 2023 in sanatoriums of aging adults under actual circumstances. Ninety-six aging adults above 65 years old were included. PMV, weather moister, clothing cover, temperament (Mizaj) based on Persian medicine, and thermal comfort in 4 seasons were considered. Linear regression was used to evaluate the efficiency of the PMV index in estimating the thermal sensation of aging adults according to their Mizaj. Results: Temperament and sex shows a negative and significant relationship with thermal comfort (P<0.05). The regression model showed that individual characteristics such as temperament and gender affect the thermal comfort score and PMV (P<0.05). Conclusion: Therefore, to propose the desired coefficients in the correction of PMV values, we consider the effect of people's temperament and gender in the regression model. [ABSTRACT FROM AUTHOR]

Background: Previous researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time. Methods: A total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants' residences. Results: Approximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded "I don't know" to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime. Conclusion: This study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice). [ABSTRACT FROM AUTHOR]

Background & Objective: Capparis spinosa is a plant belonging to the genus Capari which is important for medicinal purposes. It is also known as a multipurpose plant in Persian medicine. In this study, we searched for natural active ingredients in mouthwash for immunocompromised patients and examined the antifungal plus antibacterial properties of the hydroalcoholic extract of the root of the Capparis plant against Streptococcus mutans (S. mutans) PTCC 1683 and Candida albicans (C. albicans) ATCC-10231 was investigated. Materials & Methods: Ethanol extracts of plant roots were extracted by the percolation method. The diameter of the growth inhibition zone of C. albicans and S. mutans extracts was measured using the well plate method. Minimum inhibitory concentrations (MICs) were calculated for bacterial and fungal strains. In addition, the minimum sterilization concentration (MBC) and minimum sterilization concentration (MFC) of the extract were investigated using the broth microdilution method. The results were compared with an antibacterial and antifungal drug of 0.2% chlorhexidine nystatin. Results: The results for both pathogens revealed that the diameter of the growth inhibition zone increased with elevation of the extract concentration. The MIC and MBC of S. mutans extract were 62.5 and 62.5 mg/ml, compared to 0.39 and 0.39 mg/ml for chlorhexidine. The MIC and MFC of the plant against the fungus C. albicans were 7.812 and 31.25 mg/ml, compared to 0.25 and 1.25 μg/ml for nystatin. Conclusion: The ethanol extract of the Caparis plant had an antifungal effect on C. albicans and an antibacterial effect on S. mutans. However, the inhibitory and lethal effects against bacterial and fungal strains were lower than those of nystatin and chlorhexidine. [ABSTRACT FROM AUTHOR]

Introduction: The process of aging is a gradual decrease in the function of the body's systems, including the heart and blood vessels, respiration, urinary-genital system, endocrine glands, and the body's immune system. This study aimed to assess the effect of Temperament based on Persian medicine on the thermal comfort of aging in sanatoriums in Mazandaran province in Iran. Methods: This cross-sectional study was conducted at Rasht Azad University from June 2022 to December 2023. In the field section, the living space (sanatoriums) of older people who are under actual conditions (without interfering with the temperature conditions) in the mild and humid plain climate of Iran was investigated. Ninety-six aging adults above 65 years old were included. Sex, age, temperament (Mizaj) based on Persian medicine, and thermal comfort in four seasons were assessed. Results: Ninety-five participants were included, and 54 (54.5%) were aging females. The distribution of Mizaj regarding sex was similar (P=0.647), and most of the participants, 49 (51.6%), had a cold temperament. There was a significant relationship between Temperament and thermal comfort (P<0.01). There was a significant relationship between gender and thermal comfort (P<0.01). Conclusion: The results showed that the Temperament and gender of aging adults can play a central role in determining the amount of coverage of people and their thermal comfort. More long-term studies are needed to investigate more precisely the effect of Temperament on people's thermal sensations. [ABSTRACT FROM AUTHOR]

Background and Aim: COVID-19 pulmonary manifestations vary from mild pneumonia to acute respiratory distress syndrome. Regarding the lack of specific treatment, its wide range of clinical manifestations, and especially the similarity of manifestation to different types of pneumonia in Persian medicine references, this research wants to review pneumonia from the viewpoint of traditional Persian medicine. Methods: In this review study, the keywords of "zat-alrrieh", and "awram-e-rieh" were searched in the most important Persian medicine references. The results were classified and concluded. Results: In traditional Persian medicine references, diagnosis of diseases is mainly according to clinical manifestations of each patient. In those references, pneumonia is considered as hot inflammation of the lung. There are different clinical manifestations and treatments concerning the pathologic Khelt (Humor) and stage of the disease. The goals of treatments are regulating Mizaj (Temperament), excretion of pathologic Khelt, and body empowerment. In addition to diet modification and oral medication, topical medication such as anointment, poultice, enema, cupping, gargling, and aromatherapy and manual therapies such as bloodletting are recommended to treat pneumonia. Conclusion: Due to the similarity of manifestations of pneumonia especially emerging COVID-19 pneumonia to described pneumonia in Persian medicine references and the reports of successful experiences in the application of traditional treatment, clinical trials to evaluate the effect of Persian medicine treatments especially as a treatment package are recommended. [ABSTRACT FROM AUTHOR]

Teucrium persicum Boiss. an Iranian endemic plant is used in Iranian traditional medicine. E-cadherin transmembrane protein participates in adherens junctions and is the main partner for β-catenin protein. The GC-MS analysis was used to detect the chemical constituents of the methanolic extract. Its effects on the transcription of the E-cadherin encoding gene, cellular levels, and localization of E-cadherin protein in PC-3 cells were investigated. About 70 chemical constituents were identified. Indirect immunofluorescence microscopy and western blotting results revealed the restoration of E-cadherin protein at cell adhesion contact sites in cells treated with T. persicum extract. Gene expression studies revealed that the extract increased the transcription of the E-cadherin encoding gene in PC-3 cells. These results suggest that T. persicum extract may contain potent compounds that provide further support for the anticancer properties of T. persicum. Surely, detailed molecular investigations are needed to find the mechanism(s) behind these effects. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of dietary modifications based on complementary and alternative Iranian medicine (CAIM) in patients with secondary-progressive multiple sclerosis (SPMS). Design: In this randomized controlled trial, 70 SPMS patients were randomized to receive either a moderate-nature diet based on Persian medicine (as intervention) or usual diet plus health-related diet recommendations (as control) for 2 months. Serum high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), State-Trait Anxiety Inventory (STAI), Global Pain Scale (GPS), Gastrointestinal Symptom Rating Scale (GSRS), anthropometric measurements, and quality of life (QOL) were assessed at baseline and end of trial. Analysis of covariance was performed, and the results were adjusted for potential confounders using SPSS v.14. Results: All participants completed the study for 2 months. There were significant improvements across the mean changes of hs-CRP (−0.1 ± 0.2 mg/L for intervention vs. −0.01 ± 0.13 mg/L for control; padjusted = 0.012), MFIS (−11.0 ± 11.8 vs. −0.7 ± 9.9; padjusted <0.001), GSRS (−19.9 ± 16.3 to 1.2 ± 17.5; padjusted <0.001), GPS (padjusted = 0.032), and QOL (padjusted <0.05). No significant difference was observed across the ESR, EDSS, STAI, and anthropometric measurements. Conclusion: Dietary modifications based on CAIM may improve inflammation and clinical manifestations in SPMS patients. Nonetheless, further trials are required to confirm these findings. Clinical Trial Registration: IRCT20181113041641N2. [ABSTRACT FROM AUTHOR]

Rhazes, or Abū Bakr Muḥammad ibn Zakariyyā al-Rāzī (854-925 CE), was an Iranian physician, philosopher and chemist. He learned medicine more through the hospital and so-called clinical observations and, therefore, spent more time on his studies; this can be seen in his works and writings. He used the writings of medical predecessors and cited them in his writings. He followed and completed their works and sometimes wrote critiques on their works. In his written medical works, Rhazes has paid special attention to various diseases, notably tumors and cancer. It is noteworthy that over a thousand years ago, a skilled physician presented his explanation and treatment strategies for nasal cancer and tumor status. [ABSTRACT FROM AUTHOR]

Background: Hyperbilirubinemia is a common problem in neonates that causes hospitalization. The aim of this study was to investigate the effects of concentrated pomegranate juice (CPJ) consumption by breastfeeding mothers on neonatal hyperbilirubinemia. Materials and Methods: In this open-labeled, add-on, randomized clinical trial, 86 breastfeeding mothers and their neonates were allocated into two groups. In the control group, neonates received phototherapy. Besides neonates' phototherapy in the intervention group, their mothers received CPJ (1 tablespoon [15 g] three times a day) up to discharge. The bilirubin level was the primary outcome. The duration of phototherapy, the duration of hospital stay, and the need for exchange transfusions were secondary outcomes. Results: CPJ reduced the bilirubin level of hospitalized neonates within 48 h after consumption (P = 0.048, standard mean difference = 0.648). It also resulted in reduced duration of hospital stay and faster discharge of the neonates. Furthermore, in 48 h after discharge, bilirubin was significantly lower in the CPJ group (P = 0.003, partial eta squared = 0.123). Conclusion: Compared to the control group, consumption of CPJ by lactating mothers whose infants underwent phototherapy resulted in lower bilirubin levels, shorter hospital stay, and faster discharge. [ABSTRACT FROM AUTHOR]

Jundishapur is one of the most important centers for transferring medical knowledge from Persian civilization to Islamic civilization. The studies of this hospital-university center in recent decades have gone through at least three different periods. The third round of Jundishapur studies focuses on new findings and lesser-known reports. The book Adab alTabib and its author reports on the ninth century AD about Jundishapur provides new information to researchers in this field that has not been reported so far. The author’s description of this book provides a new picture of the relationship between the Jundishapur Hospital-Training Center and Baghdad, which can be a good reflection of its management, and the transfer of physicians and researchers from Iran to the Center of Islamic Civilization. This information shows how, with the strengthening of Baghdad as a scientific center, Jundishapur slowly lost its importance, and doctors and researchers preferred to migrate to Baghdad for more income. This migration can be considered the second great scientific migration of Iranians in history. [ABSTRACT FROM AUTHOR]

In government-controlled media, serving governments' economic, political, or ideological interests often diverts media health policies from their primary target of promoting public health, making them ineffective. Understanding the growth of this diversion in countries' political and social contexts over a long period demands a multi-layer historical analysis. Thus, to explore the roots of this diversion in government-controlled media, we examined the development process of health policy making in Iranian mass media. We conducted and analyzed interviews with 21 media experts and health policy makers through causal layered analysis, including litany, system, discourse, and metaphor layers. Results indicate that the "absence of stable management" and "health programs' low quality" undermined achievements of health policy making, including establishing the Health Policy Council and two health channels. We identified "lack of comprehensive strategy," "policymakers' inadequate knowledge," "insufficient financing," and "extensive government intervention" as underlying social causes of ineffective health programs. In addition, the Islamic ideological approach to health issues has been revealed as the dominant discourse. Interview data imply that conflicts between modern medicine and Iran's traditional medical knowledge make it difficult for media health policy makers to achieve their strategic aims. This study provides insights into the challenges of health policy making in government-controlled mass media. [ABSTRACT FROM AUTHOR]

Pistacia atlantica Desf. (Baneh) is a native tree in many areas of Iran such as Zagros mountains and Sistan va Baluchestan Province. It is famous mostly due to its oleo-gum resin and there are many studies on its effects on gastrointestinal disorders and musculoskeletal problems. However, the oil from its fruits is also of use in local communities as a part of their food and for therapeutic purposes such as analgesic effects on joint pains. Osteoarthritis is a widespread form of joint pain in older adults. This double-blinded randomized clinical trial aimed to compare the effects of Baneh fruit oil on knee osteoarthritis with topical diclofenac. Ninety-two patients with primary knee osteoarthritis were randomly divided into two groups and asked to rub a fingertip of Baneh ointment or diclofenac on their knee 3 times a day for four weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analog Scale (VAS) were completed at the beginning, fourth and eighth weeks. The data was analyzed in SPSS software and intention to treat (ITT) analysis was performed. A P-value less than 0.05 was considered statistically significant. After 4 weeks, all parameters improved significantly in both groups but the pain (based on VAS and KOOS), activity, and quality-of-life showed statistically more improvement in the Baneh group (P = 0.001, P < 0.001, and P = 0.009, respectively). Four weeks after stopping the interventions, all parameters in both groups were still significantly better than the baseline (P ≤ 0.05). However, improvement in pain (VAS and KOOS) and activity was stayed better in the Baneh group (P = 0.028, P = 0.001, and P = 018, respectively). Only one case of temporary itching was reported. This study revealed that Baneh oil had a positive effect on relieving the symptoms of knee osteoarthritis, however, more clinical trials with longer duration of treatment and larger sample sizes are recommended. [Display omitted] • Pistacia atlantica L. fruit (Baneh) oil is commonly used to treat joint pain in many areas of Iran. • Baneh oil showed significantly greater effectiveness in alleviating knee osteoarthritis pain compared to diclofenac gel. • Daily activity and quality of life were also improved more in the Baneh group. • The improvement lasted at least for four weeks in both groups. • No severe adverse effect was reported by using Baneh oil. [ABSTRACT FROM AUTHOR]

In traditional Persian medicine (TPM), people often use herbal infusions as a dosage form to treat diseases related to hyperglycemia, known as 'dam-kardeh'. Traditionally, herbal preparations of Eryngium bungei Boiss. (E. b), Tragopogon buphthalmoides (DC.) Boiss. (T. b), Salvia hydrangea DC. ex Benth. (S. h), and Juniperus polycarpos K. Koch. (J. p) are used to manage diabetes in Iran. However, there is no evidence of their effectiveness in controlling glucose levels and their mechanisms remain unclear. Aim of the study: This study aimed to investigate whether traditional doses of plant infusions can have hypoglycemic and/or anti-hyperglycemic effects during fasting and/or postprandial states and establish the basis for future research on their potential mechanisms of action. The effects of traditional doses of herbal extracts on blood glucose levels in STZ-NA-induced hyperglycemic rats were investigated in 2-h acute tests during fasting and postprandial states (with a glucose load). In addition, the potential inhibitory effect in vitro of enzymes involved in relevant pathways, such as gluconeogenesis (fructose-1,6-bisphosphatase, FBPase and glucose-6-phosphatase, G6Pase), carbohydrate breakdown (intestinal α-glucosidases), and insulin sensitivity (protein tyrosine phosphatase 1B, PTP-1B) was evaluated. Acute toxicity tests were carried out and HPLC-SQ-TOF was used to analyze the chemical profiles of the plant extracts. In the fasting state, T. b, S. h , and E. b were as effective as glibenclamide in lowering blood glucose levels in hyperglycemic rats. Moreover, all three suppressed G6Pase and FBPase enzymatic activity by 90–97% and 80–91%, respectively. On the other hand, significant postprandial hypoglycemic efficacy was observed for E. b , S. h , and T. b. Based on the AUC values, T. b caused a reduction comparable to the therapeutic efficacy of repaglinide. When investigating the possible mechanisms of action involved in this activity, E. b , S. h , and T. b showed significant inhibition of PTP-1B in vitro (>70%). Finally, all plant extracts showed no signs of acute toxicity. Several compounds that may contribute to biological activities were identified, including phenolic acids and flavonoid glycosides. The present study supports the traditional use of T. b , E. b and S. h for the control of diabetes in the fasting and postprandial state. Moreover, these plants were found to be rich in bioactive compounds with hypoglycemic and antihyperglycemic activities. On the other hand, J. p , showed a modest effect only in the fasting state and after 90 min. Further studies are needed to expand these results by analyzing the chemical composition and using complementary experimental models. [Display omitted] • Eryngium bungei , Tragopogon buphthalmoides , and Salvia hydrangea regulated blood glucose levels in hyperglycemic rats. • All extracts showed no signs of acute toxicity. • The extracts suppressed the enzymatic activity of G6Pase, FBPase, and PTP-1B in vitro as possible mechanisms of action. • Phenolic acid and flavonoid glycosides were identified by HPLC-SQ-TOF as the major compounds in three extracts. [ABSTRACT FROM AUTHOR]

Background: One of the most important aromatic species of the Apiaceae family is Heracleum persicum Desf. ex Fisch., C.A.Mey. & Avé-Lall, which used as a spice and condiment in food. It is widely used in traditional Iranian medicine due to its anti-toxic properties. The aim of this study was to evaluate the essential oil of this plant in terms of content and ingredients, cytotoxicity and antimicrobial activity. Methods: The fruit of H. persicum was collected in June 2019 from Maragheh region of Kashan, Iran. The essential oil was extracted by water distillation using Clevenger for 3 h. Identification analysis of H. persicum fruit essential oil (HPFEO) components was performed using gas chromatography-mass spectrometry (GC–MS). Evaluation of the effect of the HPFEO on the growth and proliferation of ovarian cancer cell line (OVCAR-3) was performed using MTT colorimetric method. Its antimicrobial activity was evaluated by agar diffusion method, minimum inhibitory concentration (MIC) and minimum bactericidal/fungal lethality concentration (MBC/MFC). Results: The results of analysis of the HPFEO by GC–MS showed that there were 35 compounds with 99.54% relative content. Hexyl butyrate (35.24%), octyl 2-methylbutyrate (11.65%), octyl isobutyrate (9.23%), and octyl acetate (8.42%) were the predominant compounds. Examination of cell survival showed that the viability of cells decreased depending on the concentration of the HPFEO in 24 h and had value of IC50 ~ 12.08 μg/ml against OVCAR-3 cell line. The strongest inhibitory activity of the HPFEO was against Gram-negative bacteria Pseudomonas aeruginosa and Salmonella paratyphi-A serotype (MIC < 62.50 μg/mL). Also, the strong inhibitory and lethal activity of this essential oil against Candida albicans (MIC and MBC 250 μg/mL was one degree weaker compared to nystatin (MIC = 125 μg/mL). Conclusions: Thus, HPFEO, in addition to its traditional use, may have a strong and potential potential for the production of anti-proliferative and antimicrobial drugs. [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]

Objectives: Hot flashes are unpleasant long-term complications of breast cancer. This study aimed to evaluate the effects of a traditional Persian medicine containing extracts of Cichorium intybus L. (chicory) and Fumaria parviflora L. (Fumitory) extract syrup (CFS) compared with placebo when used as intended. Design: Randomized, double-blind, placebo-controlled clinical trial. Setting/Location: The Oncology Ward of Shahid Modarres Hospital (Tehran, Iran). Subjects: Breast cancer survivors undergoing hormone deprivation therapy. Interventions: Patients were randomly allocated to receive 5 mL CFS or placebo syrup three times a day, for 4 weeks. Outcome measures: The co-primary outcomes were self-reported daily hot flashes frequency and severity scores assessed using self-reported daily dairies, including 1 week of baseline data. Results: Of the 148 patients screened, 137 were eligible, and 96 were randomly allocated to receive either CFS (n = 48) or placebo (n = 48). All participants who returned their dairies were compliant and analyzed as randomized in the a priori per-protocol analysis. After 4 weeks of treatment, both the mean daily hot flashes frequency and severity score had reduced by 57% in the CFS group and 10% in the placebo group. The overall weekly mean daily hot flashes frequency (effect size ηp2 0.221, p < 0.001, n = 66) and severity scores (effect size ηp2 0.160, p = 0.001, n = 66) were significantly lower in the CFS group compared with the placebo group (one-within one-between repeated-measures analysis of variance adjusted for baseline). CFS was well tolerated, with similar proportions of serious and nonserious adverse events occurring in both groups. Conclusions: This is the first study to report the effects of chicory or fumitory for the treatment of hot flashes. The findings provide preliminary evidence that CFS can improve hot flashes in breast cancer survivors undergoing hormone deprivation therapy. More research is warranted to confirm its effectiveness, safety, and mechanisms of action. Clinical Trial Registration: IRCT20210226050506N1. [ABSTRACT FROM AUTHOR]

Introduction: To improve the capabilities of general practitioners (GPs), who constitute an essential segment of the healthcare system in Iran, it is necessary to identify their information needs about Persian medicine. This survey-based study aimed primarily to determine the information needs of GPs in Isfahan city about Persian medicine, and secondarily to evaluate the assocaition between their workshop attendance and information needs. Methods: This applied study employed a descriptive survey research method. The research population consisted of all GPs in Isfahan city, out of which a sample of 204 participants was selected using stratified random sampling. The data collection tool was a researcher-made questionnaire, containing seven different domains related to Persian medicine. The questionnaire was distributed among the participants after its validity, content, and reliability were confirmed. All descriptive and inferential statistical analyses were performed using SPSS version 21. Results: A total of 177 GPs completed the questionnaire. The mean information need score was found to be highest for the domain of nutritional substances (72.2) and lowest for the domain of treatment measures (61.7). There was no significant relationship between the participants’ information needs and their age, work experience, gender, and employment status. However, variables such as previous participation in Persian medicine workshops and the desire to participate in future workshops exhibited a significant relationship with information needs. Conclusion: Responsible officials at the Iranian Ministry of Health and Medical Education (such as the deputies for public health and curative affairs) and traditional medicine specialized groups should periodically hold training workshops to meet GPs’ information needs. It is also necessary to repeat retraining courses for GPs at regular intervals. [ABSTRACT FROM AUTHOR]

Leukemia is a prevalent cancer that severely affects children, and standard chemotherapy often leads to severe gastrointestinal symptoms and neutropenia. This study aimed to discover alternative treatments to prevent neutropenia in pediatric leukemia patients and minimize chemotherapy-related complications. This randomized, placebo-controlled trial was conducted on 52 children between the ages of 3 and 18 years who were suffering from acute leukemia and undergoing chemotherapy. The study included a case and control group. A traditional wheat bran product called "Wheat Saviq" was given to the case group with Jollab syrup, while refined wheat flour and a placebo were given to the control group. For 1 month, both groups received a daily dose. Symptoms, weight, and blood cell count were measured before and after the trial. After the intervention, the pain, constipation, and bloating scores in the intervention group were lower than in the control group. Furthermore, the intervention group significantly increased white blood cells (WBC) and red blood cells (RBC). These findings suggest that incorporating wheat bran into the diet of pediatric leukemia patients has great potential in alleviating gastrointestinal symptoms and enhancing immune function. This randomized trial showed that consuming Wheat "Saviq" and Jollab syrup effectively reduced gastrointestinal symptoms and improved certain laboratory findings in children with leukemia undergoing chemotherapy. Furthermore, the results align with traditional Persian medicine (TPM) texts and further support the potential benefits of wheat bran for digestion and immune system health. IRCT registration number: IRCT20220410054474N1. Registration date: 2022-05-24, 1401/03/03., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

What is known and Objectives: Present study evaluated the safety profile and efficacy of G‐Rup® syrup (100 mg/ml ginger extract plus 150 mg/ml honey) in symptomatic treatment of knee osteoarthritis (OA). Methods: Patients diagnosed with knee OA were randomly assigned (1:1) to receive either of a 30 ml twice daily regimen of G‐Rup® syrup or placebo over a 12‐week period. Primary endpoints of the study comprised of an improvement in the joint's stiffness, physical functioning and pain score, assessed by WOMAC questionnaire and the visual analog scale (VAS). Secondary objectives comprised of safety and tolerability of the syrup by patients. Results and discussion: The 30 ml twice‐daily regimen of G‐Rup® syrup was safe and well tolerated by patients. Moreover, in whole studied time points, treatment with G‐Rup® syrup could significantly Power the VAS score (p < 0.001) whereas improving WOMAC total score (p < 0.001) and pain (p < 0.001), physical functioning (p < 0.001), and stiffness sub‐scores (p = 0.006) compared to the placebo receiving group. What is new and Conclusion: Based on obtained results, the G‐Rup® syrup, composed of a combination of honey and ginger, may be a proper supplementary choice, along with routine therapeutic regimens, for improvement of symptomatic treatment of OA. [ABSTRACT FROM AUTHOR]

Insomnia and sleep disorders are common and can be severe amongst patients with cancer, especially during chemotherapy. The aim of this study was to evaluate the efficacy of lettuce seed syrup in breast cancer patients who suffer from insomnia or disordered sleep. This pilot study was a double-blinded randomized controlled clinical trial conducted in Shoha-e-Tajrish Hospital (Tehran, Iran) from September 2018 to June 2019. 50 adult patients with breast cancer with insomnia or sleep disorders were enrolled. Participants were randomly allocated to lettuce seed syrup (5 mL twice daily), or placebo syrup at the same dose for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality before and after the intervention. Compared to placebo, the mean of the total PSQI score decreased significantly in participants who received lettuce seed syrup (p=0.014). In addition, there were statistically significant reductions in the mean scores of subject quality sleep (p=0.002), sleep duration (p=0.038), habitual sleep efficacy (p=0.029) and sleep disturbance (p=0.032) in patients who received lettuce seed syrup. Lettuce seed syrup may improve self-reported sleep quality in participants with breast cancer. Larger trials are indicated in diverse samples of participants with caner to learn if these finds are generalizable. [ABSTRACT FROM AUTHOR]

Background: Ash-Kardeh is one of the few fermented foods without a dairy base in Iran, which is traditionally prepared from cereals and plants in the presence of microorganisms (mainly lactic acid bacteria). Purpose: This study aimed to assess the effects of Ash-Kardeh consumption on blood glucose, lipid profile, and blood pressure in type 2 diabetic patients. Methods: Forty-six patients with type 2 diabetes were studied in this randomized controlled clinical trial. Subjects were randomly allocated into intervention (n = 23) and control (n = 23) groups. Individuals of both groups received the usual treatment of diabetic patients, while those in the intervention group, in addition to the usual treatment, received 250 g of Ash-Kardeh daily for 6 weeks. Fasting blood glucose, blood pressure, and lipid profiles were measured before and after the intervention. Results: Compared to the control group, Ash-Kardeh consumption led to a significant decrease in fasting blood glucose (P = 0.003), total cholesterol (P = 0.025), triglyceride (P = 0.003), systolic (P < 0.001), and diastolic blood pressure (P = 0.014) in the intervention group. Also, a significant increase in the concentrations of high-density lipoprotein cholesterol (P = 0.048) was observed after Ash-Kardeh consumption. Conclusion: It seems that Ash-Kardeh consumption could improve high blood glucose, lipid profile, and hypertension in type 2 diabetic patients but does not affect low-density lipoprotein cholesterol concentrations. This study was registered on 2019-09-15 in the Iranian Registry of Clinical Trials (www.irct.ir) with the code number IRCT20170202032367N3. [ABSTRACT FROM AUTHOR]

Background: Shilajit has been widely used remedy for treating a numerous of illness such as bone defects in Iran traditional folk medicine since hundreds of years ago. The aim of the present study was to explore the effect of Shilajit on the osteogenic differentiation of human adipose-derived mesenchymal stem cells (ASCs) in two- (2D) and three-dimensional (3D) cultures. Materials and methods: ASCs were seeded in 3D 1% alginate (Alg) hydrogel with or without Shilajit (500 µg/mL) and compared with 2D cultures. Then, characterization was done using electron microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDX), alkaline phosphatase (ALP) activity, alizarin red staining and Raman confocal microscopy. Results: Adding Shilajit had no impact on the Alg scaffold degradability. In the 3D hydrogel and in the presence of osteogenic medium (OM), Shilajit acted as enhancer to increase ALP activity and also showed osteoinductive property in the absence of OM compared to the 2D matched groups at all time points (days 7 and 21 both P = 0.0006, for 14 days P = 0.0006 and P = 0.002, respectively). In addition, calcium deposition was significantly increased in the cultures exposed to Shilajit compared to 2D matched groups on days 14 (P < 0.0001) and 21 (P = 0.0003 and P = 0.003, respectively). In both 3D and 2D conditions, Shilajit induced osteogenic differentiation, but Shilajit/Alg combination starts osteogenic differentiation in a short period of time. Conclusion: As Shilajit accelerates the differentiation of ASCs into the osteoblasts, without changing the physical properties of the Alg hydrogel, this combination may pave the way for more promising remedies considering bone defects. [ABSTRACT FROM AUTHOR]

Background: Non-melanoma skin cancer (NMSC) is the most common type of cancer in the world. In traditional Persian medicine (TPM), various types of temperament (Mizaj) are considered to diagnose, treat, and prevent a variety of illnesses. The present study aimed to evaluate the temperament of patients with NMSC in comparison with a control group. Methods: A case-control study was conducted in 2018 at the Dermatology Clinic of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 110 patients, aged ≥20 years with confirmed NMSC (case group), and 181 individuals without NMSC (control group) were enrolled in the study. The temperament of the participants in both groups was evaluated using Mojahedi's Mizaj questionnaire. The data were analyzed using SPSS software, and P<0.05 was considered statistically significant. Results: The results showed that the odds ratio of developing NMSC was 2.62 (95%CI: 1.42-4.83, P=0.002) times higher in individuals with dry temperament than other types of temperament. Moreover, the odds ratio of patients with a history of chronic skin ulcers and other types of cancer was 35.7 (95%CI: 11.9-107.15, P<0.001) and 5.22 (95%CI: 1.43-19.06, P=0.012) times higher, respectively, than the control group. Conclusion: Temperament is associated with NMSC, particularly the dry temperament type, and should be considered a risk factor. [ABSTRACT FROM AUTHOR]

The Academy of Jundishapur was the world's first university established during the Sassanid Empire in old Persia. Some of the important features of this scientific center of the ancient world include a policy of tolerance, conducting annual international congresses, compiling the first comprehensive medical textbook, doing the hospital rounds, physician licensure exam, special attention to the ethics, and using an educational curriculum. Moreover, its unique style of education made Jundishapur a brilliant school in the history of science. This outstanding academy maintained its impact on the scientific movement of that era for four centuries. It finally declined after transmission to Baghdad medical school. In this study, we have discussed the features of the Jundishapur school which made it a successful model for medical education. [ABSTRACT FROM AUTHOR]

Antique traditional medical theories created by old medical doctrines and their historical background have been significantly mentioned today by medical historian scholars. Persia and India had many interactions in different perspectives, such as knowledge, religion, and traditions. One of the most considerable aspects of the relationship between Indians and Persians is the transmission of basic theories of their medical doctrines. As it is reported in many historical texts from the first ages of the Islamic era in Iran, a large number of medical texts were gathered from contiguous civilizations in Iran by order of the Abbasid Caliph. They were then translated into Arabic, Syriac, and Persian. So, Persian physicians and authors used them that way. One of the earlier physicians who reflected the viewpoints of Indian medicine in his famous medical textbook entitled “Paradise of Wisdom” is Ali ibn Sahl Rabban al-Tabari (3rd century A.H./9th century A.D.). Persian physicians in the Islamic golden age (8th to 16th A.D.) played an astonishing role in the development of medical knowledge in several aspects through physician innovations and expression and evaluation of different ideas about medicine. In this regard, some of the Indian medical theories were expressed by a famous Persian physician, Ali ibn Sahl Rabban alTabari. Ali ibn Sahl Rabban al-Tabari was a Persian physician of the 3rd century A.H./9th century A.D. He wrote the book Firdous al-Hikmah (or Paradise of Wisdom), the first encyclopedia of Islamic medicine in Iran. The book introduces and describes the basics and therapeutic procedures adopted in Indian medicine, along with procedures of Persian and Greek medical doctrines, by discussing the basic medical theories in these three doctrines. In this paper, we discuss the reflection of traditional Indian medicine as described in Firdous al-Hikmah and its influence on later medical texts. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is currently a major reason for disability worldwide. Therapeutic massage is one of the most popular non-pharmacological methods for managing chronic LBP (CLBP), and the Fateh method is a massage technique based on Iranian Traditional Medicine. Objectives: The current study aimed to compare the effects of Fateh massage with those of acupuncture and physiotherapy on relieving pain and disability in CLBP. Methods: Eighty-four patients with CLBP were categorized into groups that received Fateh massage, acupuncture, or physiotherapy. Each group included 28 randomly assigned patients who completed 10 sessions of therapy. Visual analogue scale (VAS) scores and Roland-Morris disability scores were evaluated at baseline, after intervention, and four weeks later. The findings were analyzed with SPSS software. Results: The baseline VAS and Roland-Morris scores of the three study groups did not indicate significant differences (p > 0.05). All three groups showed significant pre-post improvements in both scores (p < 0.05). At the end of the treatment sessions, the three groups showed no significant difference in the reductions in pain intensity and disability score (p = 0.05). Improvements in disability and pain between the first and third time points were significant in all three groups (p < 0.05 for each group). In addition, the results of massage, physiotherapy, and acupuncture groups were not significantly different (p > 0.05). No adverse events occurred in the patients. Conclusion: The effects of Fateh massage were comparable to those of acupuncture and physiotherapy in reducing pain and disability in patients with CLBP. [ABSTRACT FROM AUTHOR]

As a comprehensive and dynamic school, traditional Persian medicine is a collection of theoretical and practical sciences that Iranian scholars have used in different centuries to prevent and treat diseases and maintain health.Persian medical books refer to the benefits of Khadab and its preventive and therapeutic recommendations. One of the leading physicians is the Hakim Seyyed Isma’il Jurjani, who has discussed the effective combination of products in making Khadab and talks about the effects of Khadab on the beauty, health and strong hair. The use of Khadab is an ancient form of treatment in Iran. In fact, the employment of Khadab is a perfectly natural process used to improve skin and hair health and heal ailments. This study examines the prescriptions and combinations related to the types of Khadab and Hakim Seyyed Isma’il Jurjani’s recommendation on Khadab in Persian medicine. According to Hakim Jurjani, Khadabs are classified into several categories: those that turn hair into black, those that turn hair into red, tan or gold, and those that whiten hair. [ABSTRACT FROM AUTHOR]

The World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic on March 11, 2020. Since then, researchers have been investigating the efficacy and side effects of its medication, up until now. From the viewpoint of Persian medicine, some medications such as antihistamines may cause retention of secretions and lead to exacerbation and spread of the disease in the body. There are studies with conflicting results regarding the effectiveness of antihistamines in COVID-19. Systematic reviews found a lack of data on beneficial effect of antihistamine-decongestant-analgesic combinations for the common cold and a limited short-term effect of antihistamines on severity of overall symptoms. This prospective cohort study was designed to investigate the relationship between the use of antihistamines and the severity of COVID-19 symptoms. Three hundred patients with a diagnosis of COVID-19 participated in the study in Shiraz, Iran from December 4, 2021 until January 24, 2022. The interviews were conducted via phone call by a single interviewer. Patients were followed weekly for 4 weeks. We collected information by using a data collection form, containing demographic information, underlying disease, COVID-19 symptoms, treatment methods, medications, and a list of antihistamines and herbs that might have been used. Generalized estimating equations were applied to assess the relationship between the severity of COVID-19 and the use of antihistamines, taking into account potential confounding factors such as time and herbal consumption. The difference in the severity of COVID-19 disease in antihistamine users compared to nonusers was not significant in 4 weeks despite the higher baseline severity in nonusers. The comparison of two groups of antihistamine users and nonusers showed that there was a significant difference (p = 0.001) regarding the use of herbal medicines., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Irritable bowel syndrome (IBS) is associated with a high prevalence of anxiety and depression. This study aimed to evaluate the effects of a traditional Persian herbal formula containing Melissa officinalis, Pimpinella anisum, and Rosa damascena (MPR) on anxiety and depression in IBS patients with symptoms of constipation-predominant IBS (IBS-C)., Methods: This double-blind randomized clinical trial was conducted in Afzalipour Hospital via block randomization method. A total of 96 IBS-C patients (based on Rome IV criteria), aged 18-60 years, were included in this study. Participants received capsules containing either 500 mg of herbal formula or placebo (cornstarch) twice a day for four weeks Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale., Results: Forty-three patients in the intervention group and 45 patients in the control group completed this study. Except for the education level, there were no significant differences in the demographic characteristics between the two groups (P > 0.05). The mean levels of anxiety and depression, and total IBS symptom severity score showed no significant differences between the two groups at baseline (P > 0.05). After four weeks of treatment, the anxiety score considerably improvement in the treatment group (Cohen's d = -1.19, 95 % confidence intervals [CIs] -4.49 to 2.13), as did the depression score (Cohen's d = -1.93, 95 % CIs -4.32 to 2.79)., Conclusion: MPR considerably improved anxiety and depression in patients with IBS-C compared to the placebo without serious side effects., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Persian Medicine, which flourished in the Islamic Golden Age (9th to 12th century AD), considers the human body a unified whole whose organs are in constant interaction and equilibrium with each other. The skin is one of these interdependent organs that play an important role in protecting internal organs, and as an excretion route, it can expel substances that are not consumed by the body. Alternatively, the uterus, a vital organ in pregnancy, excretes excess body material during menstruation to maintain a woman’s health. This narrative study discussed the importance of aligning the structure and function of these two organs based on the main textbooks of Persian Medicine, especially those written during this historical period. Likewise, electronic databases were used for investigating related articles The skin and uterus are two excretory organs. When the secretion of excess material through menstruation is physiologically or pathologically impaired, the body transfers these substances to the skin as the organ associated with the uterus. Thus, the clinical manifestations of some skin diseases can be a sign of imbalance in the function of the uterus and its related organs. Consequently, the structural and functional similarities of both organs can provide a new guide in the approach to their participatory diseases in the integration of Persian and conventional medicine. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the prevalence and patterns of complementary and alternative medicine (CAM) usage amongst multiple sclerosis (MS) patients in Iran and to evaluate the perceived effectiveness. Methods: This was a descriptive cross-sectional study. Data were collected from 194 patients with MS at the neurology clinics affiliated with Shiraz University of Medical Sciences by a semi-structured questionnaire. Results: The prevalence of CAM usage was 67.9%. Herbal medicine was the most common CAM used among the patients (64.2%). Cupping therapy, relaxation therapies, acupuncture, leech therapy were the other common CAM modalities used. Although less commonly used, yoga had the highest perceived effectiveness. Conclusions: Due to the high prevalence of CAM usage, physicians should inform their patients about the advantages and disadvantages of CAM so as to help the patients make an informed choice. [ABSTRACT FROM AUTHOR]

Reviewing ancient manuscripts of Persian medicine (PM) reveals that there have been some basic principles for decision-making in epidemic infectious diseases that existed in the past. These PM rules for clinical reasoning were applied through a personalized approach along with public health advice in such situations. Currently, the coronavirus pandemic has been the biggest problem in the world. Its mainstay of treatment is based on preventative measures and symptomatic treatments. Meanwhile, traditional medical systems for providing preventive, supportive, and rehabilitative care to patients have received more attention than before. Thus, the specific individual approach considered by PM scholars for clinical courses of epidemic infectious diseases may help shed more light on the spread of knowledge on epidemic diseases in ancient Persia. [ABSTRACT FROM AUTHOR]

Background: Punica granatum L. (pomegranate) with astringent activities and Matricaria chamomilla L. (chamomile) with anti-inflammatory and antioxidant properties are natural remedies used for various skin disorders, including wound healing. Objectives: This study was conducted to evaluate the individual and combined wound healing activity of the methanol extracts of pomegranate and chamomile flowers. Methods: After preparing the menthol fraction of pomegranate and chamomile flowers, the content of total phenols, total tannins, and total flavonoids of fractions was measured. For standardization of pomegranate and chamomile fractions, Gallic acid and apigenin-7-O-glucoside contents of them were determined using high-performance liquid chromatography (HPLC). Moreover, their antioxidant activities were examined using DPPH and FRAP tests. The antimicrobial assay was performed against Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Three different concentrations of methanol fraction of each plant and one combination dose of fractions were investigated for their wound healing activities in an excision wound model on the rats' dorsum. Finally, histopathological studies were done at the end of the experiment. Results: Phytochemical examinations showed high amounts of phenolic compounds in pomegranate flowers, while chamomile flower fractions contained a high amount of total flavonoids. Both fractions, especially pomegranate, had potent antioxidant activity. The best results for wound closure were observed 7 days after wound induction. All treated groups exhibited superior wound contraction compared to their placebo at all measurement times. The combined form of pomegranate and chamomile had better wound healing properties compared to a single therapy, especially on time earlier to wound induction. Conclusion: This study represented high antioxidant and wound healing activities for methanol fraction of pomegranate and chamomile flowers, which could be related to their high content of phytochemicals. In comparison with single herb treatment, the combined form of these two fractions in lower concentrations accelerated wound closure. [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]

Aim: Artificial rupture of the amniotic membranes during the labor, which is called amniotomy, is a common procedure in modern obstetric and midwifery protocols. There is no definite agreement regarding the timing of amniotomy in a delayed labor. In this study, we have discussed the history of amniotomy in medieval Persia mentioning the Persian medicine recommendations in this regard. Methods: We studied main Persian medicine textbooks such as Canon of Medicine by Avicenna to investigate the history of labor management and amniotomy indications. In addition, amniotomy in current literature was studied using PubMed and Google Scholar databases. Results: Persian medicine has recommended artificial rupture of membranes for labor augmentation based on its own theories. Methods for facilitation of the labor have been divided into two groups: one group before and the other during the labor. Avicenna has carefully explained the indication of amniotomy. He has recommended artificial rupture of membranes in cases of intact membranes with cervical dilatation and fetal descent. A needle or a kind of surgical knife called Mabzaa had been introduced for this procedure. Conclusions: It seems that Iranian physicians are the first scholars who have introduced the amniotomy for labor management in the 11th century. Persian medicine recommendations for labor facilitation should be considered in future studies. [ABSTRACT FROM AUTHOR]

Introduction: Oral mucositis (OM) is the most prevalent side effect in patients with head and neck cancer (HNC). It causes an obvious decrease in quality of life (QoL) in these patients, so different medications have been recommended for OM, however, without optimal response. This randomized trial aimed to assess the effects of a honey–lemon spray compared with benzydamine hydrochloride in prevention of radiation-induced OM in patients with HNC. Materials and Methods: Forty-six patients with HNC received external beam radiotherapy for 5 days per week. Patients were randomized to treatment with either benzydamine hydrochloride spray or honey–lemon spray for 5 weeks and continued for 1 week after the end of treatment. The oral cavity was examined weekly, with a score given to each site based on the degree of mucositis using a 4-point scale, and a mean mucositis score was calculated as the primary outcome. Occurrence of OM, pain, QoL, and adverse effects were defined as secondary outcomes. Patients, therapists, and outcome assessors were blinded to group allocation. Results: No significant group differences occurred in the mucositis score, pain, or QoL. Mucositis occurrence rates were higher in the benzydamine hydrochloride group compared with the honey–lemon group (hazard ratio = 2.1, 95% confidence interval: 1.1 to 4.2). Two patients in the honey–lemon group had mild nausea and burning throat; no adverse effects occurred in the benzydamine hydrochloride group. Conclusions: There were no significant group differences in mucositis severity between patients treated with honey–lemon spray and benzydamine hydrochloride. The potential preventive effects of honey–lemon spray need to be confirmed in further trials. The trial registration number is IRCT20161024030467N1. [ABSTRACT FROM AUTHOR]

Background: According to the instructions of Iranian traditional medicine (ITM), modification of breast milk through nursing mothers, is the first step in the treatment of infant disorders. In fact, maternal lifestyle, especially diet and eating habits, can change the quality and quantity of breast milk. The modern medical literature emphasizes that exclusive breastfeeding is the optimal nutrition for infants with gastroesophageal reflux disease (GERD). Objectives: The present study was conducted to evaluate the effect of maternal eating principles and diet based on ITM on infantile GERD symptoms. Methods: Exclusive-breastfeeding, under 5 -monthinfants with clinical diagnosis of GERDand their nursing mothers, were selected for this 6-weeks parallel randomized, controlled trial. All participants were randomly assigned to the intervention and the control group. The mothers of infants in the intervention group received ITM-based dietary principles, and feeding-positioning modifications were trained to the mothers of all infants of both groups, because of observation of ethical issues (not deprived of standard treatment). Age-Specific Questionnaire for Infants (GSQ-I) was used to assess the frequency and intensity of the GERD symptoms. Measuring the difference between the mean Composite Symptom Score (CSS) in week 0, 4, and 6, between the intervention group and the control group, was the main outcome of this study. Results: Both the intervention and control groups had statistically significant differences in themeanCSS of week 4 and 6 compared with baseline (P < 0.05). Also, there was a significant reduction of the mean CSS values in the intervention group compared to the control group (P < 0.05). Conclusions: Maternal eating principles and diet based on Iranian Traditional Medicine appears to affect the reduction of infantile GERD signs and symptoms. [ABSTRACT FROM AUTHOR]

In southern India, forming the Deccan Shiite governments (1098-895 AH / 1687-1489 AD), which was simultaneous with the Safavid reign in Iran, resulted in incremental Iranians’ immigration to this region. Among immigrants, Iranian Shiite physicians, due to their high medical knowledge and considerable skill, along with the support of the Shiite rulers, enhanced their status and settled in areas under the control of those governments, contributing to the festive medical production and developments there. The main objective of this research is to investigate the effect of the Iranian Shiite physicians, who migrated to the Deccan region, on the Shiite governments' medical advancements. The research hypothesis is that the Iranian physicians developed medicine by establishing Dar al-Shifa (medical schools and hospitals) and teaching and authoring medical books in Persian. Moreover, upon the invitation and support of the Adil Shahi, Nizam Shahi, and Qutb Shahi Shiite rulers, they were appointed as special physicians in the court, resulting in the flourishing and advancement of medical sciences in those areas. The research employed a descriptive-analytical research method and collected data by library resources. [ABSTRACT FROM AUTHOR]

Quṭb al-Din Shīrāzī (1236-1311 AD), the Persian polymath had great contributions to the fields of philosophy, mathematics, medicine, astronomy, music, literature, and Islamic studies. He lived during the Ilkhanid kingdom in Iran. He wrote an autobiography in the preface of his medical manuscript, al-Tuḥfa al-Sa‘dīya. He discussed his views on science and then, he explained his life story, in particular his education and contribution to science. He mentioned the reasons that led him to write al-Tuḥfa al-Sa‘dīya, his main medical work. As a great polymath, he traveled to many countries, and his words cleared the scientific atmosphere of 14th century AD. Also, he directly introduced his teachers and their abilities and works. Furthermore, scientists who worked on the Canon of Medicine had commentaries on this book, which were comprehensively introduced in this autobiography. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traditional medicine is a complete system, including diagnostic methods, etiology and treatment based on interpersonal differences. Owing to a lack of investigations in the field of Iranian traditional medicine as well as its many present challenges, certain studies in this area can prove quite practical in identifying and solving ongoing challenges. This study investigates the challenges of the health system in Iranian traditional medicine in the context of control levers. METHODS: The study was qualitative content analysis. A framework analysis, "Control Knob Approach", was considered appropriate to promote apprehension of challenges of health systems in Iranian traditional medicine. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 35 experts of Iranian traditional medicine. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis. RESULTS: Upon analysis of data by Iranian medicine experts, five main categories including financing, payment system, regulations, behavior and organization were defined alongside 13 subcategories. CONCLUSION: According to current challenges and the tendency of society to receive traditional medicine services, as well as the long history of traditional medicine in Iran, fair access to traditional medicine services should be provided. This access must be through the production of indigenous knowledge and the formulation of regulatory and educational policies and guidelines and the empowerment of relevant, healthy, effective, evidencebased and cost-effective forces. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of administration of the formulated Persian herbal syrup on improving the symptoms of patients with constipation-predominant irritable bowel syndrome (IBS-C). Methods: This study was conducted in 70 patients with IBS-C, who were recruited from 3 medical centers in Mashhad, Iran, from November 2017 to August 2018. Seventy patients were randomly assigned to 2 groups including treatment and placebo groups by block randomization, 35 cases in each group. Patients in the treatment group received 15 mL of anti-IBS syrup, thrice daily for 6 weeks and followed up for 4 weeks. Placebo syrup was also prepared through similar instruction, BP syrup without plant extract was used. Primary outcome induding IBS Symptom Severity Scale (IBS-SSS) questionnaire and secondary outcomes in terms of Hospital Anxiety and Depression (HADS) questionnaires, the Bristol Stool Form Scale (BSFS) were completed and evaluated at weeks 6 and 10, respectively. Safety indices were collected at the end of the treatment and Common Terminology Criteria for Adverse Events v4.0 (CTCAE) was used to evaluate the adverse events. Results: The response to treatment was 84.4% (27/32) in the treatment group and 46.4% (13/28) in the placebo group, respectively (P= 0.002). Compared with pre-treatment, a significant decrease was found on the IBS-SSS and BSFS scores after 6-week intervention in both groups (P<0.001). Moreover, IBS-SSS and BSFS scores in the treatment group were lower than the placebo group after the intervention (P=0.041). There was no significant difference in the anxiety and depression scores after treatment in both groups (P>0.05). Side effects reported in the treatment group included 2 cases of headache during the first week of the onset of the treatment, 1 case of drowsiness, 1 case of increase in menstrual bleeding, which did not result in discontinuation of the treatment. In the placebo group, 1 case of exacerbation of the disease was reported. Conclusions: Anti-IBS syrup significantly reduced the severity of IBS symptoms compared to placebo. However, there was a need for further investigation regarding the anxiety and depression scores. (Registration No. IRCT2017061034446N1). [ABSTRACT FROM AUTHOR]

Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of various anticancer regimens with different sensory-motor abnormalities in patients. The aim of this study was to examine the feasibility of using Costus sp. oil as a palliative treatment in such patients. Design: This was a pilot randomized placebo-controlled double-blind clinical study. Settings/Location: Imam Hossein Hospital, Tehran, Iran. Subjects: Patients 18–80 years of age undergoing chemotherapy treatment recently or during the last 6 months were enrolled after meeting the inclusion criteria. Interventions: The intervention group used Costus sp. as a topical ointment and the placebo group used topical paraffin for 4 weeks. Outcome measures: Feasibility of recruitment, including treatment acceptability (evaluated as number of patients leaving the study early), and compliance (defined as consumption of a minimum 80% of the ointment) with the intervention were assessed. Neuropathic pain change was defined as the secondary outcome, too. Results: Totally, 50 out of 73 participants were identified eligible and were randomly divided into intervention or placebo groups. There was no significant difference between groups in terms of sociodemographic data. At the end of the study, 24% (confidence interval [95% CI]: 9–45) (intervention group) and 12% (95% CI: 2–31) (placebo group) of patients revealed treatment unacceptability. Meanwhile, 12% (95% CI: 2–31) in the intervention group and 28% (95% CI: 12–49) in the placebo group did not show the compliance. Moreover, according to patients' records, pain reduction was higher in the intervention group compared to the placebo group (p = 0.001). Conclusions: This preliminary study showed that topical use of Costus sp. was feasible and acceptable in patients suffering from CIPN. [ABSTRACT FROM AUTHOR]

Introduction: Mizaj or temperament is a main concept in Persian Medicine (PM), which the process of diagnosis, treatment and preventive prescriptions are developed based on it. In this study, the articles written on the concept of Mizaj were reviewed. Method: Credited electronic resources, including Pubmed, Scopus, Cochrane Library and web-of-science were searched using keywords Temperament, Mizaj, Mizadj, Midzaj and Mezaj (with the concept of Mizaj in Persian and/or Greek medicine). Search results were limited to English articles, published in 1995–2017. The articles in which temperament had the psychoanalytic aspect or was based on Ayurveda or Chinese/Korean medicine were removed. A team of four PM experts evaluated the method and the results. Results: Among the total of 32 articles were published in this field, 14 were review articles, 2 were on animal subject, 14 were on human subject and 2 were surveys for designing questionnaire for people's Mizaj assessment. Most of review studies were just new versions of ancient Persian texts translated into English and the innovations on the subject were few. Studies on animal subject and developing questionnaires were also limited. In some human studies, use of standard questionnaires and homogenous methodology in Mizaj assessment was not considered. Conclusions: It seems that studies on temperaments have increased in the past few years but are still at the forefront. In human studies a homogenous method for evaluating temperament has not been used and some of them failed to address the main concept of Mizaj in PM. Therefore, it is necessary to use the original category of Mizaj and to design standard method. [ABSTRACT FROM AUTHOR]

Objectives:Momiai (shilajit, mummy, mumie, or mineral pitch) has been used traditionally in different medical systems for the treatment of a variety of ailments since hundreds of years ago. It is a natural substance found in different rocky parts of the world, formed by plants, mineral, and animal remains gradually. There is also worthwhile evidence supporting its oral use for bone repair in Persian medicine. The aim of this study was to evaluate the efficacy and safety of momiai in tibia fracture healing. Design: This study is a randomized double-blinded controlled trial. Settings/Location: Three different hospitals in Tehran, Iran. Subjects: Patients with age range of 18–60 years admitted due to new tibia fracture were enrolled after meeting the inclusion criteria. Interventions: The patients were divided into two groups randomly and received two 500 mg capsules of momiai or placebo for 28 days. Outcome measures: The process of bone healing was assessed by frequent X-ray radiographies and adverse effects were recorded. Results: Totally, 160 patients participated in the study either in two equal intervention or placebo groups. There was no significant difference between groups in terms of demographic and descriptive data. At the end of the study, the mean time of tibial bone union was 129 days in the experimental group, while it was 153 days in the placebo group (p < 0.049). There was no significant difference in the reported adverse effects between the two groups (p = 0.839). Conclusions: The current study showed that oral consumption of momiai after tibial shaft fracture surgery could be a promising option to reduce the healing time. [ABSTRACT FROM AUTHOR]

Objectives: The major problem in maintenance treatment of opioid use disorder is craving and relapse. The utilization of herbal compounds and complementary therapy for treatment of disease and addiction has been widely expanding. Considering the significant effect of Hab-o Shefa in detoxification phase, this clinical trial has explored the influence of this compound on maintenance treatment of opioid-dependent patients. This product is made of four herbs, including Datura stramonium L., Rheum palmatum L., Zingiber officinale Roscoe, and Acacia senegal L. Design: The authors conducted a two-group parallel randomized double-blind clinical trial on 81 opioid-dependent patients within 12 weeks. After medically assisted detoxification, participants were assigned randomly to Hab-o Shefa (n = 41) and placebo (n = 40). Outcome measures included craving assessed by craving beliefs questionnaire, self-reported opioid use, and lapse (any opioid-positive urine test) according to urinalysis and addiction severity index-lite questionnaire, retention in treatment, and depression and anxiety scores on the Hamilton's anxiety and depression scales. Results: Forty-one participants completed the study for 12 weeks, 21 subjects in the drug group and 20 subjects in the placebo group. The rates of opioid-positive urine tests and self-reported opioid use were significantly lower in Hab-o Shefa group (f = 8.41, p = 0.001). Hab-o Shefa also indicated a significant superiority over placebo in the effect of treatment by time interaction for craving (f = 5.91, p = 0.001), depression (f = 3.40, p = 0.01), and anxiety (f = 2.58, p = 0.035). The retention time was 66.6 days for drug group and 59.6 days for placebo one. Although the causes for dropping out in two groups were different, there was no significant difference (p = 0.623). The side effects of the two groups were not significantly different. Conclusion: Results indicated that Hab-o Shefa could be useful for opioid maintenance treatment, and it can also be considered as a new promising drug for prevention of craving and relapse. [ABSTRACT FROM AUTHOR]

Introduction: Chronic hand eczema (CHE) is a common skin inflammation with a complex pathophysiology. Due to its anti-inflammatory properties, Portulaca oleracea L. (purslane) is traditionally used in Persian medicine for skin ailments. This study aimed to evaluate the safety and efficacy of a standardized purslane extract (based on traditional Persian medicine) for adults with mild or moderately severe CHE., Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted at Razi Hospital in Iran from January to June 2022. Participants were randomly allocated to receive an oral purslane or placebo syrup plus topical Vaseline for four weeks. Seventy participants were randomly allocated into the intervention (n = 35) and placebo (n = 35) groups. The primary outcomes were the extent and severity of CHE symptoms over the four weeks after adjusting for age, gender and baseline score. Secondary outcomes were quality of life, symptom recurrence, treatment satisfaction, and adverse events., Results: After 4 weeks of treatment, compared to the placebo group (n = 31), the purslane group (n = 31) had significantly lower physician-reported fissure scores (adjusted mean difference (adjMD): -0.50, 95 %CI -3.93 to -0.34, p = 0.043), participant-reported itching (adjMD -0.51, 95 %CI -2.32 to -0.31, p = 0.041), dryness (adjMD -1.46, 95 %CI -2.89 to -0.03, p = 0.045), and total itching, dryness and thickness (adjMD -2.36, 95 %CI -6.23 to -1.51, p = 0.023) scores. Fourteen participants (purslane n = 10; placebo n = 4, p = 0.068) experienced adverse events of mild to moderate severity., Conclusion: Purslane has some promising effects for reducing the extent and severity of CHE symptoms, and no direct comparisons have been made with commonly used treatments. Future multicenter trials and mechanistic studies are warranted to establish the safety and effectiveness of purslane as a potential therapeutic agent for CHE., Trial Registration: Iranian Registry of Clinical Trials (IRCT20200707048040N1)., (Copyright © 2023. Published by Elsevier Inc.)