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Objective: In the absence of targeted antidotes for chlorine gas poisoning, a common yet concerning problem, this study investigates the effect of Wet Cupping Therapy (WCT, or "Hijamat") on the recovery process in chlorine-induced reactive airway dysfunction syndrome (RADS) patients. Materials and Methods: This randomized controlled trial enrolled 24 patients experiencing acute inhalation of chlorine poisoning in Tehran, Iran (2020-2021). Patients were randomly divided into control (n=12, receiving conventional treatment) and intervention (n=12, receiving conventional treatment plus WCT) groups. Signs and symptoms were assessed pre-intervention, and in the first hour, first week, and first month post-intervention. Results: Medical records of 24 patients, including 3(12.5%) men and 21(87.5%) women, with a mean age of 42.92 years old, were evaluated. Baseline characteristics were similar between the groups. WCT significantly improved symptoms (dyspnea, cough, chest tightness, etc.) within the first hour (p=0.003) compared to the controls, with no future significant changes during the first week and first-month post-WCT. Comparison between the groups revealed substantial differences in the following variables: dyspnea scale (p=0.009), respiratory rate (p=0.026), cough (p=0.001), breath shortness (p=0.006), chest tightness (p=0.002), chest pain (p=0.010), substernal burning (p=0.015), throat sore (p=0.005) and hoarseness (p=0.027). Peak flow meter readings, reflecting lung function, were also significantly higher in the WCT group at all time-points (p<0.007). Conclusion: WCT may offer a rapid and sustained improvement in pulmonary and respiratory symptoms following acute chlorine inhalation injury. [ABSTRACT FROM AUTHOR]

Objective: Male infertility is a common issue that affects people worldwide and presents challenges in terms of treatment. In recent times, there has been significant interest in the use of herbal remedies as a potential solution for male infertility. In this study, we aimed to assess and compare the effects of clomiphene, carrot seed, and education based on traditional Persian medicine on the sperm parameters in idiopathic male infertility. Materials and Methods: Sixty male patients experiencing infertility were randomly divided into four groups: Clomiphene, Clomiphene + Carrot, Clomiphene + Lifestyle modification, and Clomiphene + Carrot + Lifestyle modification. In the herbal group, patients received four capsules of carrot seeds, for a total of 2 g daily for 90 days. Meanwhile, subjects in the Clomiphene group were administered one tablet of clomiphene, containing 50 mg, per day for a duration of 90 days. Sperm parameters were analyzed at the beginning and end of the study. Results: After the 90-day intervention, the groups that received clomiphene combined with carrot and lifestyle interventions showed significant improvements in various sperm parameters. These improvements were statistically significant compared to the control group. Conclusion: The combination of carrot seeds along with clomiphene and education based on traditional Persian medicine was found to improve sperm parameters in cases of idiopathic male infertility without any adverse effects. [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. [ABSTRACT FROM AUTHOR]

Background: Currently, there is no agreed-upon data collection tool for comprehensively structured documentation of Iranian traditional medicine (ITM) from the information management perspective. As ITM practice varies significantly from current medicine in diagnosis and treatment approaches, it is not appropriate to use data platforms or information systems developed for current medicine. Consequently, the collected data are non-comparable, reducing the verdicts' generalization. Therefore, this research aims to create a minimum data set (MDS) for unified reporting of ITM diseases and interventions. Methods: This multi-phased method study was performed from December 30, 2022 to March 20, 2023. The first phase involved a literature review, the second phase utilized the Delphi technique, and the third phase focused on validating the MDS-ITM. A list of potential data items was prepared after searching scientific databases, and grey literature, as well as reviewing existing information systems, forms, and websites related to ITM. A modified Delphi technique, including a two-round survey, was then employed. A panel of 34 individuals with clinical and research experience in ITM, was selected via purposeful sampling to rate the importance of candidate data items for inclusion in the ITM-MDS using a 5-point Likert scale. Items with an agreement level of 80% or more were deemed acceptable for inclusion in the final ITM-MDS. Finally, the content validity of the developed MDS was assessed using the content validity ratio (CVR) and content validity index (CVI) criteria. Results: Consensus was reached on an ITM-MDS containing 291 items grouped into seven categories: Patient admission, past medical history, six principles of health preservation, objective signs, subjective symptoms, examination of body systems, and care plans. Conclusions: The development of this MDS will enable ITM care settings to exchange information and share resources more easily. It also provides an inclusive dataset and structured documentation of medical records. This MDS can contribute to delivering high-quality care and improving clinical decision-making. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to characterize the prevalence, pattern of herbal use, and related factors among diabetic patients in Tabriz, Iran. Methods: A descriptive cross-sectional study was carried out on 322 diabetic patients with random cluster sampling of specialized and subspecialized clinics in Tabriz, Iran. Binary logistic regression analysis was performed to evaluate the association between predictor variables (sociodemographic and disease-related characteristics and patient preference for treatment type) with herb use Interviews were conducted using a structured questionnaire from October 1, 2022, to April 23, 2023. Data was analyzed using SPSS software. Results: Out of 322 patients, 155 individuals (48.1%) used herbal medicines to lower their blood sugar. The most commonly used herbs included Urtica dioica L. (51.6%), Abelmoschus esculentus L. (14.8%), Eryngium planum L. (11%), Trigonella foenum-graecum L. (9%) and Cinnamomum verum (9%). The chance of herb use in women was 1.64 times (adjusted odds ratio (AOR) = 1.64, 95% confidence interval (CI) = 1.06 to 2.55) higher than men. With each passing year of diabetes diagnosis, the probability of using herbal medicines increased by 5% (AOR = 1.05, 95% CI = 1.01 to 1.08). Diabetic patients who use herbal medicines significantly prefer to use their conventional medications alongside herbal remedies (P-value < 0.001) and only a small percentage of them prefer to rely solely on herbs. Conclusions: Some of the diabetic patients in Tabriz, Iran, use herbal medicines for managing diabetes. Female gender, longer duration of diabetes, and patients who prefer to use both treatment (conventional and traditional) methods were identified as predicting factors for herbal medicinal use among diabetic patients. [ABSTRACT FROM AUTHOR]

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]

Objective: Ma'aljobon is used in Persian medicine (PM) as a natural antihypertensive product. This study aimed to evaluate the hypotensive effect of Ma'aljobon in patients with uncontrolled grade 1 primary hypertension (HTN). Materials and Methods: This double-blind, placebo-controlled clinical trial included 114 patients (20-80 years) with uncontrolled grade 1 primary HTN. After obtaining informed consent, the participants were randomly divided into two groups and administered with 25g of Ma'aljobon or maltodextrin twice daily for six weeks. Systolic and diastolic blood pressures (SBP and DBP, respectively) were analyzed. Results: A total of 97 patients (52.3±10.7 years, %53.6 female) completed the study. In the Ma'aljobon group, SBP decreased from 150.3±12.3 to 130.6±12.1 mm Hg, and DBP decreased from 93.3±8.2 to 80.1±6.6 mm Hg (p<0.001). In the control group, SBP decreased from 147.6±11.2 to 138.7±14.4 mm Hg, and DBP decreased from 86.6±7.7 to 82.2±8.2 mm Hg (p<0.001). There was a significant difference in the changes of SBP and DBP between the two groups over time (p<0.001). No adverse events were observed. Conclusion: Ma'aljobon has a stronger hypotensive effect than placebo in patients with HTN and can be recommended as an addon therapy for uncontrolled HTN. [ABSTRACT FROM AUTHOR]

Background and objective: Endometriosis is a common and complex gynecological condition. (Cymbopogon citratus (DC.) Stapf (lemongrass) has been mentioned in Iranian traditional medicine references for uterus disorders. This study aimed to assess the effects of a lemongrass oil vaginal cream on pain levels, mass size, and overall health profiles in endometriosis patients. Methods: In this single-arm, before-and-after clinical trial, participants with endometrial cysts larger than 2 cm and experiencing dysmenorrhea were treated with lemongrass oil vaginal cream for two months. Their pain and health status were assessed using the Visual Analogue Scale (VAS) and the Endometriosis Health Profile Questionnaire (EHP-30) before and after the treatment. Transvaginal ultrasounds were also performed to measure the size of the cysts before and after the intervention. Results: The intervention led to a significant reduction in pain scores (p<0.001). Additionally, 8 out of 11 domains of the EHP-30 questionnaire showed significant improvement. The average size of endometriomas decreased from 39.9 mm to 31.3 mm (p<0.001). Conclusion: This study indicated that lemongrass oil vaginal cream could alleviate pain in endometriosis patients, enhance their overall health and reduce the size of endometrioma. However, rigorous clinical trials with randomized designs and control groups are necessary to validate these results. [ABSTRACT FROM AUTHOR]

Context: Traditional medicine (TM) is widely used and holds significant potential for increasing Primary Health Care (PHC) coverage and achieving universal health coverage (UHC), especially in developing countries. Persian medicine (PM), an ancient form of TM, encompasses lifestyle principles known as "Hifz-o-Siha," which aim to maintain and improve health. This study seeks to explore whether lifestyle modifications based on PM can effectively promote health within the framework of PHC. Methods: We conducted searches across various databases, including Science Direct, Scopus, PubMed, and Google Scholar. Our search terms included Traditional medicine, Persian, Iranian, Health maintenance, Education, and Primary health care. Results: Three randomized clinical trials conducted between 2017 and 2019 examined the impact of educating individuals about PM's lifestyle principles on their quality of life and healthcare utilization. The results indicated significant improvements in all measured outcomes. Furthermore, six clinical trials focused on PM dietary modifications in the treatment of conditions such as obesity, infertility, nephrotic syndrome, and non-alcoholic fatty liver disease. In all these studies, PM diets demonstrated significant efficacy compared to conventional medicine. Conclusions: Lifestyle modifications based on PM recommendations have the potential to positively influence PHC and promote overall health. However, the incorporation of PM into national health systems faces challenges, primarily due to the limited availability of supporting evidence. [ABSTRACT FROM AUTHOR]

Objectives: Bacterial vaginosis (BV) is a common condition among women of reproductive age. Short-term antibiotic treatments are often clinically effective, but recurrence after treatment is frequent. The high recurrence rate and increasing antibiotic resistance highlight the need for new treatment methods. This study aimed to evaluate the effectiveness of a vaginal gel containing Rheum turkestanicum Janisch in comparison to metronidazole for the treatment and prevention of BV recurrence. Study Design: This study was a randomized, triple-blinded, controlled trial involving 30 women. Married women aged 18 to 50 years who had been diagnosed with BV and did not meet any exclusion criteria were randomly allocated to the intervention or control groups. The intervention group received R. turkestanicum vaginal gel and R. turkestanicum capsules, while the control group received metronidazole vaginal gel and placebo capsules. Both groups underwent treatment for 7 days. Main Outcome Measures: Variables such as demographic data, bacterial vaginosis patients’ signs and symptoms, Amsel’s criteria, and Nugent score were compared and examined before and after treatment with rhubarb and metronidazole in the patients. Results: The initial assessment, conducted 10 days after treatment, showed significant improvement in each control and treatment group, but there was no significant difference between the two groups. However, the evaluation of recurrence status 30 days later indicated that the intervention group (using R. turkestanicum vaginal gel and R. turkestanicum capsules) was significant to metronidazole in treating recurrence. Conclusion: Rheum turkestanicum has the potential to be offered as a novel treatment for BV. [ABSTRACT FROM AUTHOR]

Background and objective: Endometriosis is a common and complex gynecological condition. (Cymbopogon citratus (DC.) Stapf (lemongrass) has been mentioned in Iranian traditional medicine references for uterus disorders. This study aimed to assess the effects of a lemongrass oil vaginal cream on pain levels, mass size, and overall health profiles in endometriosis patients. Methods: In this single-arm, before-and-after clinical trial, participants with endometrial cysts larger than 2 cm and experiencing dysmenorrhea were treated with lemongrass oil vaginal cream for two months. Their pain and health status were assessed using the Visual Analogue Scale (VAS) and the Endometriosis Health Profile Questionnaire (EHP-30) before and after the treatment. Transvaginal ultrasounds were also performed to measure the size of the cysts before and after the intervention. Results: The intervention led to a significant reduction in pain scores (p

Eating disorders are debilitating, life-threatening, and costly mental disorders that significantly impair physical health and adversely affect psychosocial functioning. Nowadays, six main feeding and eating disorders are identified in diagnostic systems, and Bulimia nervosa is one of them. The aim of this paper is twofold: First, it seeks to shed light on the concept of bulimia as understood by the Persian school of medicine. This study has attempted to consider the roots of this disease within this tradition. It will compare the concept of bulimia nervosa in conventional medicine with that of Canine appetite disease in Persian medicine in the Islamic Golden Era (9th-12th centuries). Secondly, it will analyze and show the evolution of the term bulimia throughout history. For this purpose, Avicenna’s Canon of Medicine, primary PM resources, and important databases were reviewed using the related keywords. Although these diseases are in the category of emerging mental illness, evidence suggests that its roots can be found in Persian medicine. The comparison made between the definition of Canine appetite in this school and modern definitions of Bulimia nervosa shows striking similarities between the two diseases, suggesting that both are the same disease.

Abstract Background Biofilm formation has a crucial role in the cariogenic virulence of Streptococcus mutans, which leads to resistance to common antibacterials. The antimicrobial resistance crisis has led to increased research about traditional natural products. Purpose Quercus infectoria extract (QI extract) and nano hydrogels containing QI extract (QI-NH) and tannic acid (TA-NH) were evaluated against this pathogen. Methods QI extract was analyzed by HPLC and the physiological characteristics of nanohydrogels were assessed by SEM, FTIR, zeta potential, DLS and determination of release kinetics and encapsulation efficiency. Determination of MIC and MBC of the material and their anti-biofilm effect was done by the microtiter method and on the extracted tooth surface. The properties of extracts and nano hydrogels in the expression of genes codifying glucosyltransferases (gtfB, gtfC and gtfD) and glucan binding protein B (gbpB) were quantified. Their toxicity was tested by the MTT method against the KB cell line. Results According to HPLC, 55.18% of QI extract contained TA. The encapsulation efficiency of QI-NH and TA-NH was equal to 60% and 80%, respectively. SEM and FTIR exhibited that QI extract and TA were successfully entrapped in the networks resulting from the chemical bonding of chitosan and TPP. The average size of QI-NH and TA-NH was 70.45 and 58.43 nm, and their zeta potential was 6.17 ± 2.58 and 0.25 ± 0.03 mv, respectively. PDI

ABSTRACT Introduction Methods Results Conclusion Melasma, also known as chloasma, is a common skin disorder characterized by acquired hyperpigmentation. Many patients with this condition prefer using herbal remedies instead of chemical agents. This study aims to review clinical trials conducted on the effectiveness of herbal remedies in treating melasma.In this scoping review, we searched the PubMed, Scopus, Web of Science, Cochrane, SID, and Magiran databases until August 2024. We designed the search strategy using MeSH database keywords “melanosis,” “herbal medicine,” “plant extracts,” “complementary therapies,” “traditional medicine,” “Persian medicine,” “clinical trials,” and their Entry Terms. We then reviewed and summarized the relevant articles.We found a total of 21 clinical trials examining the effectiveness of herbal remedies in treating melasma. The literature review revealed that licorice, rhubarb, a mixture of melon seed and chickpea, sorrel, Aloe vera leaf gel, parsley, tomato, fern, olive, pine bark, and Indian gooseberry had positive effects in treating melasma. Licorice is the most extensively studied herbal remedy for melasma treatment. Some patients who used licorice, rhubarb, and parsley experienced redness and skin allergies.Few studies have evaluated the effectiveness of herbal remedies in treating melasma. Further research, including clinical trials, systematic reviews, and meta‐analyses, is necessary to assess the efficacy of herbal remedies and natural products, as well as their potential adverse effects. [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]

Objectives: To evaluate the effectiveness of a Persian Medicine herbal formula and a Traditional Chinese Medicine intervention (acupuncture) on the improvement of weight and anthropometric indices of overweight patients. Methods: This study was a randomized placebo-controlled double-blind clinical trial. A total of 200 overweight patients were randomly divided into 4 groups receiving either (1) Herbal capsule, (2) placebo capsule, (3) acupuncture, or (4) sham acupuncture. Herbal capsules were filled with hydroethanolic extract of Cuminum cyminum L. seed, Apium graveolens L. seed, Ruta graveolens L. seed, Trachyspermum ammi (L.) Sprague seed, Origanum majorana L. leaf, and sodium tetraborate and placebo capsules with avicel. Patients received two 500mg capsules or 12 acupuncture sessions over 8 weeks. Study outcomes, consisted of weight, body mass index (BMI), anthropometric indices including chest, arm, wrist, waist, hip, and leg circumferences, and waist/hip ratio (WHR), were evaluated 3 times: before treatment, after 4 weeks, and after 8 weeks. Results: The herbal formula significantly reduced weight, BMI, WHR, and chest and waist circumferences compared to the placebo capsule (P < 0.05). Furthermore, acupuncture improved all study outcomes, except WHR, compared to sham acupuncture (P < 0.05). Despite the effects of herbal formula and acupuncture were the same on WHR and chest, waist, and leg circumferences (P < 0.05), acupuncture reduced weight, BMI, and arm, wrist, and hip circumferences more than herbal formula (P < 0.05). Conclusion: Complementary and alternative therapeutic methods, such as herbal treatments and acupuncture, show promising effects in improving weight and anthropometric indices of overweight patients. [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. [ABSTRACT FROM AUTHOR]

Background: Biofilm formation has a crucial role in the cariogenic virulence of Streptococcus mutans, which leads to resistance to common antibacterials. The antimicrobial resistance crisis has led to increased research about traditional natural products. Purpose: Quercus infectoria extract (QI extract) and nano hydrogels containing QI extract (QI-NH) and tannic acid (TA-NH) were evaluated against this pathogen. Methods: QI extract was analyzed by HPLC and the physiological characteristics of nanohydrogels were assessed by SEM, FTIR, zeta potential, DLS and determination of release kinetics and encapsulation efficiency. Determination of MIC and MBC of the material and their anti-biofilm effect was done by the microtiter method and on the extracted tooth surface. The properties of extracts and nano hydrogels in the expression of genes codifying glucosyltransferases (gtfB, gtfC and gtfD) and glucan binding protein B (gbpB) were quantified. Their toxicity was tested by the MTT method against the KB cell line. Results: According to HPLC, 55.18% of QI extract contained TA. The encapsulation efficiency of QI-NH and TA-NH was equal to 60% and 80%, respectively. SEM and FTIR exhibited that QI extract and TA were successfully entrapped in the networks resulting from the chemical bonding of chitosan and TPP. The average size of QI-NH and TA-NH was 70.45 and 58.43 nm, and their zeta potential was 6.17 ± 2.58 and 0.25 ± 0.03 mv, respectively. PDI < 0.3 of nano hydrogels indicated the favorable polydispersity of nanohydrogels. MIC of QI extract, QI-NH and TA-NH were 937.5, 30 and 10 µg/ml, respectively. Also their MBIC50 was 35.1, 2.1 and 0.95 µg/ml, respectively, and the extracts and nano hydrogels restrained the biofilm maturation on enamel. The pivotal genes of S. mutans in biofilm formation were significantly less expressed by treatment with QI-NH and TA-NH than others. Based on the MTT test, QI-NH had less acute toxicity than QI extract and TA-NH. IC50 of QI-NH was calculated as 775.4 µg/ml, while it was equal to 3.12 µg/ml for chlorhexidine as a common antibacterial agent. Conclusion: QI-NH, a new formulation derived from traditional anti-caries, can be a safe and efficient option to combat dental biofilm. [ABSTRACT FROM AUTHOR]

The article focuses on evaluating the efficacy of Persian-FACT, a traditional herbal medicine compound, in treating functional dyspepsia through a randomized, double-blind, placebo-controlled trial. Topics include symptom improvement in dyspepsia and associated syndromes, comparative analysis of Persian-FACT and placebo effects, and reductions in gastrointestinal symptoms such as bloating and reflux.

Eating disorders are debilitating, life-threatening, and costly mental disorders that significantly impair physical health and adversely affect psychosocial functioning. Nowadays, six main feeding and eating disorders are identified in diagnostic systems, and Bulimia nervosa is one of them. The aim of this paper is twofold: First, it seeks to shed light on the concept of bulimia as understood by the Persian school of medicine. This study has attempted to consider the roots of this disease within this tradition. It will compare the concept of bulimia nervosa in conventional medicine with that of Canine appetite disease in Persian medicine in the Islamic Golden Era (9th-12th centuries). Secondly, it will analyze and show the evolution of the term bulimia throughout history. For this purpose, Avicenna’s Canon of Medicine, primary PM resources, and important databases were reviewed using the related keywords. Although these diseases are in the category of emerging mental illness, evidence suggests that its roots can be found in Persian medicine. The comparison made between the definition of Canine appetite in this school and modern definitions of Bulimia nervosa shows striking similarities between the two diseases, suggesting that both are the same disease. [ABSTRACT FROM AUTHOR]

Background There are many ancient Persian works. We need to respect these works and study them to discover the hidden aspects. Objective The present study aims to review the medical poems in the old manuscript “Masnavi Sadriyeh” by Ali Akbar Hamadani. Methods In this review study, a search was first conducted in Google Scholar, Noor Mags, MagIran, Scientific Information Database (SID), Gisoom and ViraScience websites using the related keywords to collect information. Among the found articles, 52 articles were selected and reviewed. Then, the medical poems in the manuscript “Masnavi Sadriyeh” related to their findings were reported. Results Of 2766 verses in the poems, about 79 were related to medicine. Most of them were about the function of body organs such as eyes, eyelashes, teeth, throat, nose, brain, larynx, five senses, liver, lungs, etc. Conclusion The old manuscript Masnavi Sadriyeh favorably reflects the connection between historical, religious, and medical topics. [ABSTRACT FROM AUTHOR]

Background: Treatments for acute bronchitis is usually a supportive care to relieve upper respiratory symptoms. This study aimed to evaluate the effect of Plantago major syrup (PMS) on cough severity in acute bronchitis. Methods: Patients (20-75 years-old) referred to the clinic of infectious diseases in Ayatollah Rouhani Hospital, Babol, Iran with a complaint of cough and the Bronchitis Severity Scale (BSS) =5 entered the study. The patients randomly received PMS or placebo 30 ml/day for 10 days. Patients were visited before treatment and on days 5 and 10 after treatment. The primary outcome was BSS score and secondary outcome was the life quality that was measured by means of the Persian version of the Leicester Cough Questionnaire (LCQ) at the first visit and on the 10th day. Results: Of the 121 patients diagnosed with acute bronchitis, 80 eligible patients (42.87±11.75 years-old) were randomly divided into PMS and placebo groups. The BSS score in the PMS group after 10 days was significantly lower than that of the placebo group (P=0.001). Frequency of cough (P=0.001), sputum production (P=0.005), and chest wall pain (P=0.008) were significantly lower in the PMS group than in the placebo group. In terms of quality of life, all items, including psychological, physical, and social domains, as well as total scores, were altered significantly in the PMS group compared to placebo. During monitoring of side effects, no significant adverse effects were stated in either group. Conclusion: The study indicates the palliative effects of PMS in relieving the symptoms of acute bronchitis and improving quality of life. [ABSTRACT FROM AUTHOR]

Summary: The present study aimed to introduce Avicenna's views on pest control and the medicinal plants he proposed as natural pesticides. Also, we addressed the strategies that he leveraged to formulate and prescribe them, and, finally, we put his views into perspective with modern science. The data were collected using Al-Qanun Fi Al-Tibb (The Canon of Medicine) as well as scientific databases. According to Al-Qanun Fi Al-Tibb, 42 medicinal plants are described as natural pest control agents. After introducing the pest control properties of each plant, Avicenna explained the appropriate strategies for use of these plants. These strategies or formulations included incensing, spraying, spreading, rubbing, smudging, and scent-dispersing, which are equivalent to the modern pesticide formulations of fumigants, aerosols, pastes and poisoned baits, lotions, creams, and slow-release formulations, respectively. This study revealed that Avicenna introduced the pest control approach with natural plants in his book Al-Qanun Fi Al-Tibb and, thus, harnessed the power of nature to control nature. Future research is recommended to find the pest control merits of the presented medicinal plants, in order to incorporate them into pest control programs and reduce environmental pollution resulting from the complications of current synthetic pesticides. [ABSTRACT FROM AUTHOR]

The culture of practicing massage therapy in Traditional Persian Medicine (TPM) dates back more than a thousand years. In this article, the authors have tried to evaluate sports massage as a culture while reviewing massage in TPM texts. The types of massage, their functions, and their effects are presented in this study. There is also a brief comparison of the effects of sports massage in current studies. Today, massage has become a widely popular complementary medicine approach. Every year, 18 million Americans receive massages. There are different types of massage in various complementary medicine schools, such as Tuina massage (in Traditional Chinese Medicine) and abhyanga (in Ayurveda), which are related to Chinese and Indian medicine, respectively. In addition, modern therapeutic methods, such as chiropractic and Osteopathy, have their roots in massage.Massage is used in Traditional Persian Medicine under the titles of Dalk (to rub) and Ghamz (to squeeze). In Traditional Persian Medicine, massage serves as both a preventive and therapeutic measure for a variety of health conditions.

Background: Treatments for acute bronchitis is usually a supportive care to relieve upper respiratory symptoms. This study aimed to evaluate the effect of Plantago major syrup (PMS) on cough severity in acute bronchitis. Methods: Patients (20-75 years-old) referred to the clinic of infectious diseases in Ayatollah Rouhani Hospital, Babol, Iran with a complaint of cough and the Bronchitis Severity Scale (BSS) ≥5 entered the study. The patients randomly received PMS or placebo 30 ml/day for 10 days. Patients were visited before treatment and on days 5 and 10 after treatment. The primary outcome was BSS score and secondary outcome was the life quality that was measured by means of the Persian version of the Leicester Cough Questionnaire (LCQ) at the first visit and on the 10th day. Results: Of the 121 patients diagnosed with acute bronchitis, 80 eligible patients (42.87±11.75 years-old) were randomly divided into PMS and placebo groups. The BSS score in the PMS group after 10 days was significantly lower than that of the placebo group (P=0.001). Frequency of cough (P=0.001), sputum production (P=0.005), and chest wall pain (P=0.008) were significantly lower in the PMS group than in the placebo group. In terms of quality of life, all items, including psychological, physical, and social domains, as well as total scores, were altered significantly in the PMS group compared to placebo. During monitoring of side effects, no significant adverse effects were stated in either group. Conclusion: The study indicates the palliative effects of PMS in relieving the symptoms of acute bronchitis and improving quality of life.

Introduction: This study reevaluates the historical origins of occlusion therapy for amblyopia, focusing on the contributions of the 9th-century Islamic scholar, Ali ibn Sahl ibn Rabban al-Tabari (838–870 CE). Methods: The investigation delved into al-Tabari's writings, particularly "Firdous al-Hikma," to extract insights into his approach to addressing reduced vision in one eye.Additionally, the study examined subsequent advancements in occlusion therapy by scholars such as Thabit ibn Qurrah and Rhazes, building upon al-Tabari'sfoundational work. Results: Al-Tabari's reports contain significant insights into occlusion therapy for amblyopia, predating commonly attributed origins of the treatment. Within "Firdous al-Hikma," he outlines methods for addressing reduced vision, advocating for the covering of the healthier eye to promote the function of the weaker eye. These findings highlight the pioneering efforts of al-Tabari and his contemporaries in the Islamic civilization and challenge the conventional narrative surrounding the history of occlusion therapy. Subsequent advancements by scholars such as Thabit ibn Qurrah and Rhazes expanded upon al-Tabari's work, advocating for similar therapeutic approaches within the Islamic civilization. Their contributions further solidified the practice of occlusion therapy, laying the groundwork for its continued evolution and refinement in subsequent centuries. Discussion: Al-Tabari's contributions to occlusion therapy underscore the rich heritage of scientific inquiry in theIslamic civilization during the medieval period. This historical perspective sheds light on the diverse contributions to medical knowledge and practice outside of Western contexts and emphasizes the importance of recognizing and honoring these contributions in the broader history of medicine. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is one of the most common functional disorders of the gastrointestinal (GI) tract. Several pathophysiological mechanisms have been proposed for this disorder, but no effective treatment exists for all patients, making it a problematic chronic disease. The present article aims to review the perspective of Persian medicine (PM) scholars, including opinions on patients’ predisposing factors and lifestyle, on this disorder and compare it with recent findings. Methods: In this review, we searched the leading Persian medical books from the 10th to the 18th century AD regarding the pathophysiology and predisposing factors and the six essential health principles of the diseases with the most congruity with IBS. Moreover, we searched the Google Scholar, Science Direct, and PubMed databases for recent evidence on each item. Results: According to PM, this syndrome is a heterogeneous disorder resulting from various dystemperaments of the GI tract. Dystemperaments are due to accumulated waste material or excess humors in body organs or exposure to unsuitable weather or diet. Diet, mental status, exercise, body excretions, sleep, and weather are the six essential principles for maintaining health, and imbalance in any of them can cause many diseases, including IBS. Several of these lifestyle recommendations regarding the six essential principles of health are supported by recent research. Conclusion: PM strategies for preserving and restoring health through lifestyle modification in IBS patients may provide researchers with new viewpoints for exploration. [ABSTRACT FROM AUTHOR]

Objective: To assess the seasonal patterns of fruit consumption according to the perspective of Persian Medicine (PM) and compare these recommendations with those from modern nutrition science. Methods: A comprehensive literature search was conducted to identify valid Persian Medicine manuscripts that discuss the consumption of fruits in relation to seasons. Additionally, relevant literature in the field of nutrition science was reviewed to compare these findings. The data obtained from both sources were subjected to qualitative analysis to extract meaningful insights and draw conclusions. Results: Persian Medicine provides specific recommendations for fruit consumption based on the temperament of both the fruits and the seasons. These guidelines include suggestions for suitable fruits in each season and prohibitions based on their temperaments and the common seasonal disorders. In contrast, modern nutrition science does not offer a specific pattern for seasonal fruit consumption. The study found that fruits recommended for winter in Persian Medicine tend to have higher calorie content compared to fruits recommended in other seasons. This aligns with Persian Medicine's recommendation of consuming energy-rich foods in winter. Additionally, these winter fruits have lower water content, which is consistent with the cold and wet temperament associated with winter. Conclusion: Persian Medicine offers a unique perspective on seasonal fruit consumption based on the concept of temperament, which is absent in modern nutrition science. The study's findings highlight the potential benefits of aligning fruit consumption with seasonal and temperamental considerations, as recommended in Persian Medicine. [ABSTRACT FROM AUTHOR]

Background & Objective: Hand contact dermatitis, with a one-year frequency of up to 10% and a lifetime prevalence of nearly 15% in the general population, typically involves inflammation of the dermis and epidermis layers. The aim of this study was to investigate and emphasize the anti-inflammatory properties of flaxseed oil as well as its historical use in traditional medicine, which could help support its potential effectiveness in treating hand eczema and improving the quality of life of patients. Materials & Methods: The research conducted was a triple-blind, randomized controlled trial involving 68 patients diagnosed with mild to moderate eczema. The participants were assigned to receive either 1 gram of topical flaxseed oil applied twice daily or a control cream, Eucerin, over a period of four weeks. The effectiveness of the treatment was evaluated by measuring the severity of eczema and the quality of life of the patients before and after the intervention. This assessment was carried out using the Hand Eczema Harshness Index (HECSI) and the Dermatology Life Quality Index (DLQI). Results: Based on the gas chromatography (GC) analysis, the flaxseed oil contained 1.9 grams of linoleic acid per 100 grams of oil. There was no substantial variance in the baseline demographic and clinical characteristics of the two study groups. HECSI and DLQI(14.71 ± 1.89) scores significantly improved in the flaxseed oil group compared to the control group (p=0.001). This effect was particularly pronounced among patients with mild and moderate eczema (p<0.001). Conclusion: Flaxseed oil can improve eczema indications and quality of life in contact dermatitis patients. However, further research with a larger sample size and comparison to topical steroids is recommended. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluated the anxiolytic and antidepressant effects of the hydroethanolic extract of common polypody rhizome (PEE) and the possible underlying mechanisms in mice subjected to chronic restraint stress (CRS). Topics discussed include the popularity of complementary and alternative medicine (CAM) for mental disorders, measurement of total phenolic and flavonoid content, and antioxidant and lipid peroxidation measurement.

Background: Personalized medicine, an emerging approach, considers individual differences to tailor treatments optimally. Persian medicine (PM) incorporates individual differences through Mizāj (temperament). A comprehensive understanding of each Mizaj type's characteristics is essential in designing standardized diagnostic tools. Objectives: This study aims to explore the attributes of one of the most significant Mizaj groups, namely cold-wet Mizaj, and its subtypes, including cold-wet Su-e-Mizaj (dystemperament), as well as phlegm dominance in PM sources. Methods: Persian medicine literature, including the Canon of Medicine, was reviewed for relevant concepts. Reliable scientific databases, including PubMed, Scopus, and MagIran, were searched using keywords such as Mizaj, temperament, Su-e-Mizaj, dystemperament, cold-wet dystemperament, phlegm, and Balgham. The obtained results were studied and categorized. Results: Out of the 196 articles obtained related to Mizaj, 16 investigated indices. No studies were found on the indices of coldwet Mizaj and phlegm dominance separately. PM sources exhibit high congruence in describing the characteristics of cold-wet Mizaj. Specifically, emphasis is placed on characteristics such as coldness and softness of the skin to the touch, high fat mass, pale and white complexion, excessive body secretions, weakness and slowness of physical and physiological actions, low vitality, timidity, poor memory, and slow-wittedness. In cold-wet dystemperament, symptoms are more severe, and in the presence of phlegm, a feeling of heaviness is also mentioned as a specific symptom. Conclusions: By compiling indices of cold-wet Mizaj/dystemperament and phlegm dominance, this study can contribute to the development of standardized PM questionnaires, facilitating a personalized approach to the diagnosis and treatment of diseases. [ABSTRACT FROM AUTHOR]

The culture of practicing massage therapy in Traditional Persian Medicine (TPM) dates back more than a thousand years. In this article, the authors have tried to evaluate sports massage as a culture while reviewing massage in TPM texts. The types of massage, their functions, and their effects are presented in this study. There is also a brief comparison of the effects of sports massage in current studies. Today, massage has become a widely popular complementary medicine approach. Every year, 18 million Americans receive massages. There are different types of massage in various complementary medicine schools, such as Tuina massage (in Traditional Chinese Medicine) and abhyanga (in Ayurveda), which are related to Chinese and Indian medicine, respectively. In addition, modern therapeutic methods, such as chiropractic and Osteopathy, have their roots in massage. Massage is used in Traditional Persian Medicine under the titles of Dalk (to rub) and Ghamz (to squeeze). In Traditional Persian Medicine, massage serves as both a preventive and therapeutic measure for a variety of health conditions. [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/aim: Asthma is an inflammatory disease of the lungs. Cupping therapy is a traditional method used in Persian medicine for treating various ailments. This study aimed to evaluate the anti-asthmatic effects of wet cupping therapy (WCT) in patients with mild to moderate asthma. Materials and methods: This is a randomized clinical trial conducted on 103 asthma patients who were referred to Loghman Hakim Hospital, Tehran, Iran. The diagnosis of the disease was confirmed by a pulmonologist based on the patient's history and clinical examinations. The patients who were treated with common asthma medications were assigned to intervention and control groups. The intervention group underwent one session of WCT in the region between two shoulders on one of the 17th, 19th, and 21st days of the lunar month. The clinical signs of all patients were gathered based on the asthma control test questionnaire before the intervention and in the first, second, fourth, sixth, and eighth weeks after the intervention. The scores of the five questionnaire items and the mean total treatment score (MTTS) were compared between the two groups. Additionally, the satisfaction scores of the participants in the two groups were compared. Results: Of103 patients, 82 patients completed the study. The mean total treatment score (MTTS) was not significantly different between the control and intervention groups at the beginning of the study (p = 0.06). In the intervention group, the MTTS was 11.44 before WCT, while it was significantly increased (24.24) eighth week after the intervention (p < 0.001). However, the MTTS in the intervention group was significantly higher than the control group in the first week (p <0.001). In addition, at the end of the trial, the subjects' satisfaction scores in the WCT and control groups were 7.48 and 4.53, respectively (p < 0.001). Conclusion: Wet cupping therapy can be an efficient therapeutic method to ameliorate respiratory complications of asthma patients. [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]

Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterised by high blood sugar (BS) levels due to impaired insulin production or insulin resistance. It is a global health concern with significant implications for morbidity and mortality. Persian medicine has long utilised natural remedies, such as Pistacia atlantica Desf., for various diseases. In this randomised clinical trial, the effects of P. atlantica oleoresin in the improvement of lipid profiles, glucose indices and blood pressure (BP) were assessed in patients with Type 2 DM. Materials and Methods: In this randomised, single‐blind, placebo‐controlled study, 42 patients with Type 2 DM were randomly allocated to receive either P. atlantica oleoresin or placebo capsule for 3 months. Patients were evaluated prior to and 12 weeks after the beginning of the intervention, in terms of changes in lipid profiles, glucose indices and BP. Results: After 3 months, the mean BP in patients with DM receiving P. atlantica oleoresin was significantly reduced compared with the baseline (p = 0.001). Also, these changes were significantly higher than those of the control group. The mean of total cholesterol (p = 0.89), low‐density lipoprotein (LDL) (p = 0.43) and triglyceride (TG) (p = 0.98) in the intervention group after 3 months was lower than that in the control group, but this difference was not statistically significant. Conclusion: After 3 months, there was no significant difference between the P. atlantica and control groups in terms of blood sugar and lipid profiles. The mean BP in patients with DM receiving P. atlantica oleoresin was significantly reduced compared with that in the beginning of the study. Also, these changes were significant compared with the control group. [ABSTRACT FROM AUTHOR]

Epidermolysis bullosa (EB) is an inherited disease that causes widespread symptoms characterized by extreme epithelial fragility. This study examined traditional, complementary, and integrative medicine (TCIM) usage among EB patients referred to clinics at Shiraz University of Medical Sciences between 2019 and 2020. We enrolled the patients with EB whose diseases were approved by a dermatologist and registered in the dermatology department and Molecular Dermatology Research Center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. A researcher-made data gathering form, including knowledge, beliefs, practice, and the experience of the safety of TCIM, was used to collect the data. Interviews were done by phone calls, and oral consent was obtained from patients or their parents. Overall, 68 patients were included in this study. In this regard, 79.4% of the patients used TCIM by themselves or their families to manage EB. Approximately, half of the patients were not aware of the effects of the herbal medicines they used. Among medicinal plants, chicory (20.6%), thyme (16.2%), and Persian cornflower (14.7%) had the most consumption. More than half of these patients believed that medicinal plants were a less harmful treatment, and 48.5% considered them effective. In conclusion, the study revealed high medicinal plant usage among EB patients, but limited knowledge about their effectiveness. Public awareness about the benefits and risks of these remedies needs to be increased.

The theory of connection between respiratory and gastrointestinal systems is a key topic in different types of traditional medicine. In this study, we discussed the history, main concepts of this theory along with related studies and its possible clinical applications. In this regard numerous scattered studies have shown a relationship between upper and lower respiratory disorders and gastrointestinal symptoms. Numerous epidemiologic, pathophysiologic and clinical evidence confirm the interrelationship and integrated functioning of the respiratory and gastrointestinal tracts. It seems that the holistic approach that emphasizes the link between the respiratory and gastrointestinal systems in traditional Persian medicine, is in line with the theory of united mucosa that has been considered in recent years. The interaction between the respiratory and gastrointestinal systems can occur through several mechanisms, including commonalities in embryonic sources, role of identical mediators and receptors, influence of common pathogens in the lungs and gut, similarity of microbiota patterns and changes, and same inflammatory and mucosal responses. We believe that this theory can provide new insight for the approaches to respiratory and gastrointestinal disorders in the light of holistic medical knowledge. Also, further research should be conducted to identify the exact paths and mechanisms of communication between respiratory and gastrointestinal systems.

Cough is one of the most prevalent symptoms of COVID-19, affecting over 60% of patients. This symptom significantly diminishes quality of life, causing fatigue, insomnia, dysphonia, musculoskeletal pain, and urinary incontinence. Honey Zufa herbal syrup is a well-known antitussive remedy in the Iranian market and was evaluated for its potential to alleviate this symptom. This study aimed to assess the efficacy and safety of Honey Zufa herbal syrup in treating acute cough resulting from mild to moderate COVID-19. A randomized controlled trial was conducted with 200 patients assigned to either the treatment group, receiving Honey Zufa herbal syrup, or the placebo group, receiving a placebo. Both groups also received standard cough control medications. Cough severity was measured using three different scoring systems. The impact of Honey Zufa on cough severity, the influence of other medications, and changes in laboratory parameters were monitored over a 14-day period. Honey Zufa herbal syrup significantly reduced cough severity compared to the placebo across all scoring systems. The treatment group experienced a greater reduction in cough severity than the placebo group. However, there was no significant difference between the groups in terms of antitussive medication regimens. Laboratory parameters remained stable, and no significant side effects were observed. Honey Zufa herbal syrup effectively reduces cough severity in patients with mild to moderate COVID-19, suggesting it could serve as a useful complementary and alternative treatment option for COVID-19-induced cough.