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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. Bypass graft surgery of the coronary artery has a significant effect on the creation and development of sexual dysfunction among male patients. The previous studies have demonstrated that date palm pollen (DPP) increases the count and quality of sperm. Additionally, it has been shown that DPP has a protective effect against myocardial infarction and cardiac remodeling. Therefore, this is the first study investigating the impact of DPP (Phoenix dactylifera L.) on managing male sexual dysfunction after coronary artery bypass graft. Methods. This randomized, double-blind, placebo-controlled clinical trial was conducted on 60 patients (DPP group n = 30, control group n = 30) of Iranian men after coronary artery bypass graft. Two parallel groups were randomly generated from the study participants. The intervention group was prescribed 3 grams of the powder of DPP twice a day (9 AM and 9 PM) for two months, while the control group received the same prescription of the placebo powder. Results. The DPP consumption significantly increased the International Index of Erectile Function (IIEF) (from 23.21 to 46.57) and the Hurlbert Index of Sexual Desire (HISD) (from 59.39 to 64.45) scores over time in the intervention group. However, there were no significant changes in the control group. Conclusion. Daily intake of 6 g DPP for two months exhibited beneficial effects on the symptoms of male sexual dysfunction in patients who have undergone coronary artery bypass graft (CABG). [ABSTRACT FROM AUTHOR]

Background: Classification of disease and interventions in traditional medicine (TM) is necessary for standardised coding of information. Currently, in Iran, there is no standard electronic classification system for disease and interventions in TM. Objective: The current study aimed to develop a national framework for the classification of disease and intervention in Persian medicine based on expert opinion. Method: A descriptive cross-sectional study was carried out in 2018. The existing systems for the classification of disease and interventions in TM were reviewed in detail, and some of the structural and content characteristics were extracted for the development of the classification of Iranian traditional medicine. Based on these features, a self-administered questionnaire was developed. Study participants (25) were experts in the field of Persian medicine and health information management in Tehran medical universities. Results: Main axes for the classification of disease and interventions were determined. The most important applications of the classification system were related to clinical coding, policymaking, reporting of mortality and morbidity data, cost analysis and determining the quality indicators. Half of the participants (50%) stated that the classification system should be designed by maintaining the main axis of the World Health Organization classification system and changing the subgroups if necessary. A computer-assisted coding system for TM was proposed for the current study. Conclusion: Development of this classification system will provide nationally comparable data that can be widely used by governments, national organisations and academic researchers. [ABSTRACT FROM AUTHOR]

Background. Iranian traditional medicine (ITM) is a holistic medical system that uses a wide range of medicinal substances to treat disease. Reorganization and standardization of the data on ITM concepts is a necessity for optimal use of this rich source. In an initial step towards this goal, we created a database of ITM materia medica. Main Body. Primarily based on Makhzan al-Advieh, which is the most recent encyclopedia of materia medica in ITM with the largest number of monographs, a database of natural medicinal substances was created using both text mining methods and manual editing. UNaProd, a Universal Natural Product database for materia medica of ITM, is currently host to 2696 monographs, from herbal to animal to mineral compounds in 16 diverse attributes such as origin and scientific name. Currently, systems biology, and more precisely systems medicine and pharmacology, can be an aid in providing rationalizations for many traditional medicines and elucidating a great deal of knowledge they can offer to guide future research in medicine. Conclusions. A database of materia medica is a stepping stone in creating a systems pharmacology platform of ITM that encompasses the relationships between the drugs, their targets, and diseases. UNaProd is hyperlinked to IrGO and CMAUP databases for Mizaj and molecular features, respectively, and it is freely available at http://jafarilab.com/unaprod/. [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]

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]

The article presents a study that compares the impacts of some of the recommendations of natural medicaments mentioned in manuscripts of traditional Persian medicine (TPM) with lactulose, on functional chronic constipation. The study included 100 patients that were evaluated over recommendations from TPM as intervention group versus lactulose as control with questionnaire for three months. It informs that the study showed that schemes were as effective to manage constipation.

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]

Considering the fact that liver is one of the most important organs in our body, it deserves special attention and protection. Among various recommended supplements, complementary and alternative medicines particularly herbal remedies have received much attention owing to their truly healing properties. This review profits from Iranian traditional medicine and presents advantageous herbal guide directions for liver protection. According to credible Iranian medical literature such as Al Qanun Fil Tibb, Al-Havi and Makhzan-al-Aadvia, a wide spectrum of plants have been found to be useful for cleansing and protecting the liver. Some herbs such as ghafes ( Agrimonia eupatoria ), kasni ( Cichorium intybus ), anar ( Punica granatum ), darchin ( Cinnamomum zeylanicum ), za'feran ( Crocus sativus ), gole-sorkh ( Rosa damascena ) and zereshk ( Berberis vulgaris ) appeared to get strong consideration and were well documented as outstanding liver tonics. We conducted a comprehensive review of available Iranian medical resources such as scientific information database and medical sciences databases which cover all in vitro and in vivo studies of medicinal plants as liver tonics and hepatoprotective candidates. Literature survey was accomplished using multiple databases including PubMed, ISI web of knowledge, and Google Scholar. [ABSTRACT FROM AUTHOR]

Background: Iranian traditional medicine, also known as Persian Medicine, is a holistic school of medicine with a long prolific history. It describes numerous concepts and the relationships between them. However, no unified language system has been proposed for the concepts of this medicine up to the present time. Considering the extensive terminology in the numerous textbooks written by the scholars over centuries, comprehending the totality of concepts is obviously a very challenging task. To resolve this issue, overcome the obstacles, and code the concepts in a reusable manner, constructing an ontology of the concepts of Iranian traditional medicine seems a necessity., Construction and Content: Makhzan al-Advieh, an encyclopedia of materia medica compiled by Mohammad Hossein Aghili Khorasani, was selected as the resource to create an ontology of the concepts used to describe medicinal substances. The steps followed to accomplish this task included (1) compiling the list of classes via examination of textbooks, and text mining the resource followed by manual review to ensure comprehensiveness of extracted terms; (2) arranging the classes in a taxonomy; (3) determining object and data properties; (4) specifying annotation properties including ID, labels (English and Persian), alternative terms, and definitions (English and Persian); (5) ontology evaluation. The ontology was created using Protégé with adherence to the principles of ontology development provided by the Open Biological and Biomedical Ontology (OBO) foundry., Utility and Discussion: The ontology was finalized with inclusion of 3521 classes, 15 properties, and 20,903 axioms in the Iranian traditional medicine General Ontology (IrGO) database, freely available at http://ir-go.net/ . An indented list and an interactive graph view using WebVOWL were used to visualize the ontology. All classes were linked to their instances in UNaProd database to create a knowledge base of ITM materia medica., Conclusion: We constructed an ontology-based knowledge base of ITM concepts in the domain of materia medica to help offer a shared and common understanding of this concept, enable reuse of the knowledge, and make the assumptions explicit. This ontology will aid Persian medicine practitioners in clinical decision-making to select drugs. Extending IrGO will bridge the gap between traditional and conventional schools of medicine, helping guide future research in the process of drug discovery.

Background: Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders., Objective: This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress., Design, Setting, Participants and Intervention: This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h., Main Outcome Measures: Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups., Results: Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007)., Conclusion: The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress., Trial Registration Number: IRCT2016102430459N1 on Iranian Registry of Clinical Trials., (Copyright © 2020. Published by Elsevier B.V.)

Objective: This pilot study aims to evaluate the effectiveness and safety of acupuncture in the treatment of chemotherapy-induced peripheral neuropathy (CIPN)., Methods: This study was a pilot randomized controlled trial, which was conducted with cooperation between Beijing University of Chinese Medicine (BUCM), China, and Tehran University of Medical Science (TUMS), Iran. Forty participants with CIPN were randomly assigned (1 : 1) to receive twelve sessions of acupuncture (20 minutes each session over 4 weeks) or take one 300 mg tablet of vitamin B1 and three 300 mg capsules of gabapentin per day for 4 weeks, after which both groups were followed up for 4 weeks. The primary endpoint was CIPN symptom severity measured by the Numerical Rating Scale (NRS). The secondary endpoints included sensory neuropathy grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE), neurophysiological assessment of CIPN by the nerve conduction study (NCS), and the patient overall satisfaction with treatment. Safety was assessed at each visit., Results: The NRS and NCI-CTCAE sensory neuropathy grading scales decreased significantly over time in both groups (both P < 0.001), with a significantly higher reduction in the acupuncture group ( P < 0.001 and P = 0.03, respectively). In addition, the acupuncture group showed a higher overall satisfaction with the treatment at the end of treatment and after 4 weeks follow-up, in comparison with the vit B1 and gabapentin group ( P = 0.01 and P = 0.001, respectively). The NCS (except for the latency of the sural nerve) in the acupuncture group improved significantly ( P < 0.05), while improvement in the vit B1 and gabapentin group was not observed ( P > 0.05)., Conclusion: Our study revealed that acupuncture, as a kind of traditional Chinese therapeutic method, is significantly effective and safe in the treatment of CIPN. Moreover, acupuncture is more effective than using vitamin B1 and gabapentin as the conventional treatment. Trial registration. This trial is registered with the Iranian Registry of Clinical Trials (IRCT20190615043900N1)., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Somayeh Iravani et al.)