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Background The aim of the present study was to examine the safety and efficacy of a topical formulation of Citrullus colocynthis in patients with painful diabetic polyneuropathy ( PDPN). Methods The study was designed as a two-arm double-blind randomized placebo-controlled clinical trial using a parallel design. Sixty patients with PDPN were randomly allocated to receive either a topical formulation of C. colocynthis or placebo (1:1 allocation ratio) for 3 months. Patients were evaluated before and after the intervention using the neuropathic pain scale, electrodiagnostic findings, World Health Organization Biomedical Research and Education Foundation ( BREF) quality of life ( WHOQOL-BREF) scores, and reported adverse events. Results There was a significantly greater decrease in mean pain score after 3 months in the C. colocynthis (−3.89; 95% confidence interval [ CI] −3.19, −4.60) than placebo (−2.28; 95% CI −1.66, −2.90) group ( P < 0.001). Mean changes in nerve conduction velocity of the tibial nerve, distal latency of the superficial peroneal nerve and sural nerve, and sensory amplitude of the sural nerve were significantly higher in the intervention than placebo group ( P < 0.001) in favour of the intervention. In the different domains of WHOQOL-BREF, there was a significant improvement only for the mean score in the physical domain. Conclusions Application of a topical formulation of C. colocynthis fruit extract can decrease pain in patients with PDPN. It also may have some uncertain effects on nerve function and the physical domain of quality of life, which require further investigation in studies with larger sample sizes and of longer duration. [ABSTRACT FROM AUTHOR]

Neuropathic pain is supposed to be a post-renaissance described medical entity. Although it is often believed that John Fothergill (1712-1780) provided the first description of this condition in 1773, a review of the medieval Persian medical writings will show the fact that neuropathic pain was a medieval-originated concept. “Auojae Asab” [Nerve-originated Pain] was used as a medical term in medieval Persian medical literature for pain syndromes which etiologically originated from nerves. Physicians like Rhazes (d. 925 CE), Haly Abbas (d. 982 CE), Avicenna (d. 1037 CE), and Jorjani (d. 1137 CE) have discussed multiple aspects of nerve-originated pain including its classification, etiology, differentiating characteristics, different qualities, and pharmacologic and non-pharmacologic treatments. Recognizing medieval scholars' views on nerve-originated pain can lighten old historical origins of this concept. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome is known as the most common entrapment neuropathy. Conservative treatments cannot reduce the symptomatic severity satisfactorily; therefore, effectiveness of Linum usitatissimum L. (linseed) oil on carpal tunnel syndrome, as a complementary treatment, was evaluated in the current study. Linseed oil is a well-known preparation in Iranian traditional medicine and its analgesic, anti-inflammatory and anti-oxidative effects have been shown in previous studies. Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted. One hundred patients (155 hands) with idiopathic mild to moderate carpal tunnel syndrome aged between 18 and 65 years old were randomized in two parallel groups. These two groups were treated during 4 weeks with topical placebo and linseed oil. In addition, a night wrist splint was prescribed for both groups. Symptomatic severity and functional status were measured using Boston Carpal Tunnel Questionnaire. In addition, median sensory nerve conduction velocity, motor distal latency, sensory distal latency and compound latency as electrodiagnostic parameters were measured at baseline and after the intervention period. Results: After the intervention, significant improvement was observed regarding Boston Carpal Tunnel Questionnaire symptomatic severity and functional status mean differences (p <0.001) in the linseed oil group compared with those in the placebo group. Also, regarding the mean differences of both groups, significant improvement of nerve conduction velocity of the median nerve was seen in the linseed oil group by a value of 2.38 m/sec (p < 0.05). However, motor distal latency and sensory distal latency of the median nerve showed no between-group significant changes (p = 0.14 for both items). Finally, compound latency was improved slightly in the case group, comparing mean differences between the groups (p <0.05). No significant adverse events were reported from using linseed oil. Conclusions: It seems that linseed oil could be effective in the management of mild and moderate carpal tunnel syndrome, especially in improving the severity of symptoms and functional status. In addition, its effect on electerodiagnostic parameters, especially on the nerve conduction velocity, can be considered as a valuable point. [ABSTRACT FROM AUTHOR]

Diabetic neuropathy is probably the most common complication of diabetes mellitus. Secondary preventive measures for diabetic neuropathy with delaying, stopping or even reversing progressive course of neuropathy, pain control and prevention of ulceration can play important role in diabetic patients care. Oxidative stress plays an important role in pathogenesis of diabetic neuropathy. Treatments for diabetic neuropathy have been mainly focused on two purposes, pain control and repair of nerve injury. Therapeutic options for nerve injuries may not improve or even exacerbate painful symptoms. On the other hand most of treatments for pain control have little or no effect on nerve function. As a result of mentioned discrepancy between 'nerve protection' and 'pain control' in the treatment of painful diabetic neuropathy, it is hypothesized that Citrullus colocynthis as a therapeutic agent with simultaneous antioxidative and anesthetic effects can play an important role in treatment of painful diabetic neuropathy. Previous in vitro and animal studies of C.colocynthis demonstrated its 'antioxidative', 'anesthetic' and 'antiulcerogenic' effects. A randomized controlled double-blind clinical trial is needed to evaluate this hypothesis. [ABSTRACT FROM AUTHOR]

Throughout history, opium has been used as a base for the opioid class of drugs used to suppress the central nervous system. Opium is a substance extracted from the opium poppy (Papaver somniferum L.). Its consumption and medicinal application date back to antiquity. In the medieval period, Avicenna, a famous Persian scholar (980-1037 AD) described poppy under the entry Afion of his medical encyclopedia Canon of Medicine. Various effects of opium consumption, both wanted and unwanted are discussed in the encyclopedia. The text mentions the effects of opioids such as analgesic, hypnotic, antitussive, gastrointestinal, cognitive, respiratory depression, neuromuscular disturbance, and sexual dysfunction. It also refers to its potential as a poison. Avicenna describes several methods of delivery and recommendations for doses of the drug. Most of opioid effects described by Avicenna have subsequently been confirmed by modern research, and other references to opium use in medieval texts call for further investigation. This article highlights an important aspect of the medieval history of medicine. [ABSTRACT FROM AUTHOR]

Despite the well-known history of hypertension research in the modern era, like many other cardiovascular concepts, main points in the medieval concept of this disease and its early management methods remain obscure. This article attempts to make a brief review on the medieval origin of the concept of this disease from the Hidāyat of Al-Akhawayni (?-983 AD). This article has reviewed the chapter of "Fi al-Imtela" (About the Fullness) from the Hidāyat al-Muta'allimin fi al-Tibb (The Students' Handbook of Medicine) of Al-Akhawayni. The definition, symptoms and treatments presented for the Imtela are compared with the current knowledge on hypertension. Akhawayni believed that Imtela could result from the excessive amount of blood within the blood vessels. It can manifest with symptoms including the presence of a pulsus magnus, sleepiness, weakness, dyspnea, facial blushing, engorgement of the vessels, thick urine, vascular rupture, and hemorrhagic stroke. He also suggested some ways to manage al-Imtela'. These include recommendations of changes in lifestyle (staying away from anger and sexual intercourse) and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar). Al-Akhawayni's description of "Imtela," despite of its numerous differences with current knowledge of hypertension, can be considered as medieval origin of the concept of hypertension. [ABSTRACT FROM AUTHOR]

Our aim is to assess the effect of cinnamon powder capsules on insulin resistance, anthropometric measurements, glucose and lipid profiles, and androgens of women with polycystic ovarian syndrome (PCOS). Out of 80 women that were diagnosed as PCOS by Rotterdam Criteria, 66 were enrolled in this randomized double-blind placebo-controlled clinical trial. All of the PCOS women were taking medroxy progesterone acetate 10 mg/day for the last 10 days of their menstrual cycles. The cases were randomly allocated to 2 groups. The women in the first group were treated by cinnamon powder capsules 1.5 g/day in 3 divided doses for 12 weeks and the second group by similar placebo capsules. Anthropometric measurements, fasting blood sugar, fasting insulin, blood glucose 2 hr after taking 75 g oral glucose, HbA1c, testosterone, dehydroepiandrosterone sulphate, homeostatic model assessment for insulin resistance, triglyceride, and cholesterol (low-density lipoprotein, high-density lipoprotein, and total) before and after the intervention were evaluated and compared as outcome measures. Fasting insulin (p = .024) and homeostatic model assessment for insulin resistance (p = .014) were reduced after 12 weeks in the cinnamon group compared with the placebo. There was also a significant decrease in low-density lipoprotein in cinnamon group (p = .004) as compared with baseline that caused significant difference with placebo (p = .049). However, changes in other outcome measurements did not lead to statistically significant difference with placebo. The present results suggest that complementary supplementation of cinnamon significantly reduced fasting insulin and insulin resistance in women with PCOS. [ABSTRACT FROM AUTHOR]

Objectives: To examine the safety and efficacy of Citrullus colocynthis (C. colocynthis) topical formulation to treat patients suffering from painful diabetic polyneuropathy (PDPN). Materials and Methods: The study was designed to be a two-arm, double-blind randomized placebo-controlled clinical trial, using a parallel design. Sixty patients with painful PDPN were randomly assigned to receive either the topical formulation for C. Colocynthis (1:1 allocation ratio) or receive the placebo, throughout the duration of the experiment, three months. Patients were then evaluated both before and after the intervention in terms of the Neuropathic Pain Scale, electro-diagnostic findings, World Health Organization BREF quality of life scores and any reported adverse events. Results: The mean changes in pain score were significantly higher in the C. Colocynthis group (3.89, CI: 3.19-4.60) than the scores observed in the placebo group (2.28, CI: 1.66- 2.90) (p value< 0.001). Mean changes in nerve conduction velocity of the tibial nerve, distal latency of the superficial peroneal and sural nerve, as well as sensory amplitude of the sural nerve in the intervention group were statistically significantly higher than those observed in the placebo group (p value< 0.001). No statistically significant differences were seen between the mean changes in values of any other nerve conductions. In the different domains of WHOQOL-BREF, only the mean change in scores of physical domain had shown any significant improvements, when compared to the placebo group Conclusion: Application of topical formulation of C. Colocynthis fruit extract has been shown to significantly decrease pain in patients suffering with PDPN. However, it also may have some uncertain and unknown effects on nerve functions and the physical domain of quality of life. As a result further investigations into studies with larger samples and of longer duration are required, before applications of this formulation is widely used as a viable treatment method.(Clinical Trials.gov ID: NCT02155361) [ABSTRACT FROM AUTHOR]

Objectives: Use of complementary and alternative medicine is a growing phenomenon, especially in Middle Eastern countries. This study aimed to evaluate the prevalence, types and associated factors of the use of complementary and alternative medicine in children with hepatic and gastrointestinal disorders in Shiraz, Iran Materials and Methods: In this cross-sectional study, 210 parents of children, attending a pediatric gastroenterology and hepatology clinic, affiliated to Shiraz University of Medical Sciences, completed a self-administered questionnaire including their prior experience and factors associated with the use of complementary and alternative medicine. Results: In total, 103 patients (49%) used complementary and alternative medicine in the course of their hepatic and gastrointestinal disorders. Also, 74 patients (71.8%) using complementary and alternative medicine selected herbal remedies. The increasing age of the infant significantly though slightly promoted the use of complementary and alternative medicine with an odds ratio of 1.06 per year of increased age (p=0.037). Patients with a positive experience of complementary and alternative medicine (62.1% vs. 40.2% of users and non-users, respectively, p=0.040) and those recommended on the use of complementary and alternative medicine by healthcare providers (24.3% vs. 6.6% of users and non-users, respectively, p=0.001) were significantly more likely to use complementary and alternative medicine, compared to others. Conclusion: This study demonstrated the high prevalence of the use of complementary and alternative medicine (especially herbal remedies) in pediatric patients with hepatic and gastrointestinal disorders, which was independently and significantly associated with a previous positive experience of herbal remedies, recommendations by healthcare providers and the infant's increasing age. [ABSTRACT FROM AUTHOR]

This study aims to determine the prevalence, types, and associated factors for the use of herbal remedies in hemodialysis patients. Two hundred participants were selected by stratified sampling and were systematically interviewed. One hundred and twenty-six patients (63%) had used herbal remedies some time since their initiation of dialysis treatment. The users of herbal remedies had a significantly older age than nonusers, but no other significant differences were observed. The most prevalent complaints that led to herbal remedies use were gastroenterological complaints, flushing, and excessive thirst. Cichorium intybus, Borage officinalis, Mentha longifolia, and Matricaria recutita were the most prevalently used herbs in our patients. More study should be done on safety and efficacy of these herbs for hemodialysis patients. [ABSTRACT FROM AUTHOR]

Neurological sicknesses are serious, multifactorial, debilitating disorders that may cause neurodegeneration. Neuroprotection is the protection of the structure and capacity of neurons from affronts emerging from cell injuries instigated by an assortment of specialists or neurodegenerative diseases. Various neurodegenerative diseases, including Alzheimer's, Parkinson's, and epilepsy, afflict many people worldwide, with increasing age representing the leading risk factor. Crocin is a natural carotenoid compound which was found to have therapeutic potentials in the management of the neurological disease. In this review, we focused on the restorative capabilities of Crocin as a neuroprotective agent. The general neuroprotective impact and the various conceivable basic components identified with Crocin have been examined. In light of the substantial proof indicating the neuro-pharmacological viability of Crocin to different exploratory standards, it is concluded that Crocin exerts direct antioxidant, antiapoptotic and anti-inflammatory activities by multiple signaling pathways. Besides, Crocin was found to elevate dopamine level in the brain during the experimental model of Parkinson's disease. Thus, this compound has been demonstrated to be a promising option for the treatment of neurodegenerative diseases, with few adverse effects. It ought to be further considered as a potential contender for neuro-therapeutics, concentrating on the mechanistic and clinical evidence for its effects. Image 1 [ABSTRACT FROM AUTHOR]

Although the development of modern medicine has helped us detect and treat diseases better than in the past, especially in the field of surgery; the history of medicine may be a trigger that can help us use neglected aspects of prior knowledge for the advancement of modern-day science. Since historical papers that have specifically focused on anorectal diseases are rare, but those that exist contain brief discussions in this field, the current study aims to present a detailed review of Avicenna’s approach to anorectal diseases. Therefore, we reviewed On the Diseases of the Anus, the 17th chapter of the third volume of the Canon of Medicine written by Avicenna, and compared his views on the classification and diagnosis of, and the approach to anorectal diseases with that of modern proctology. Avicenna discussed in detail about anorectal diseases such as hemorrhoid, fissure, perianal abscess and fistula, rectal prolapse, fecal incontinence, and pruritus ani. In addition, we introduce herbs which Avicenna used to treat these diseases. Our findings show that Avicenna’s views on the classification and diagnosis of, and the approach to anorectal diseases have few fundamental differences with modern medicine. In addition, the pharmacological effects of some of the herbs that were recommended by Avicenna, and are used in current medicine are proven. Thus the Medieval knowledge can be further scientifically investigated to develop new therapeutic options for anorectal diseases. [ABSTRACT FROM AUTHOR]

Chrysin is a promising phytochemical that is categorized under the class of flavonoids based on its chemical structure. Naturally, it is widely present in propolis, honey, passion fruit, and even in mushrooms and other plant sources, whereas its synthetic counterparts are also being employed for pharmacological purposes. It has widely been employed in treatment of various degenerative disorders and provides cytotoxic and anti-inflammatory functions. Its antioxidant and disease preventing abilities are attributed to its structural diversity arising in ring-A and absence of oxygenation in B and C ring. In this review, the scientific studies are being reported emphasizing benefits and its allied health claims on chrysin in numerous metabolic malfunctions. Graphical abstract of chrysin sources and its health claims Unlabelled Image [ABSTRACT FROM AUTHOR]

Introduction: Hyperthyroidism is a common endocrinology condition that could affect several aspects of the patient's life., Case Presentation: We present a 27-year-old woman who was sent to the traditional Persian medicine (TPM) clinic with a diagnosis of uncontrolled chronic hyperthyroidism (lower levels of thyroid-stimulating hormone (TSH) and higher levels of T3 and T4) and its complications, such as developing exophthalmos, palpitations, anxiety, sleep problems, hair loss, and dry skin. The patient was under treatment with prednisolone and methimazole for up to 1 year, but no acceptable improvement was achieved. The patient received a package of TPM recommendations, which included lifestyle modification, Melissa officinalis herbal tea, and Persian barley water. The patient was followed for 1 year. After 2 months of follow-up of the patient, the level of TSH increased, and the level of T3 and T4 decreased. In addition, the patient's symptoms, including exophthalmos, palpitation, anxiety, sleep disturbance, and dryness of the skin, were improved considerably. After 3 months of consumption of the TPM-based regime and prescription, the serum levels of TSH, T3, and T4, of the patient were in normal ranges. In a 1-year follow-up of the patient, the patient's condition was stable and her thyroid function tests were normal. We hereby present the following case to be in line with the CAse REports (CARE) checklist., Conclusion: It appears that TPM lifestyle recommendations, M. officinalis herbal tea, and Persian barley water were effective in treating the patient with uncontrolled hyperthyroidism. We recommend further studies and clinical trial designs in this regard., (© 2024 S. Karger AG, Basel.)

Introduction: Epidermolysis bullosa (EB) is a rare inherited genetic skin disorder with severe skin itching and recurrent blisters and erosion. There is no effective and specific therapy for all types of EB., Objectives: The aim of this study was to evaluate a topical formulation of henna (Lawsonia inermis Linnaeus) in the management of wounds and the itching sensation in patients with EB., Methods: This is a pilot single-arm clinical trial. Nine patients with recessive dystrophic EB, with the age range of 5 to 32 years were enrolled in the study. The patients were instructed to apply the topical 1% henna ointment once daily on two erosions and on also two sites with moderate to a severe itching sensation. The total duration of the intervention was 4 weeks with weekly follow-up visits. Patient global impression of improvement, visual analog scale, and clinical global impression of improvement were used for assessing the wound healing process and itching discomfort., Results: There was a significant improvement in the skin symptoms of epidermolysis bullosa including skin redness, itching, burning, and local warmness (P < 0.05). Local pain decreased during the study period, but this was not statistically significant (P < 0.19). One patient reported moderate xerosis of skin after continuous usage., Conclusions: It seems that the topical formulation of henna may be effective in the management of itching, burning, stringing, and cutaneous warmness sensation in patients with EB. Further controlled studies with larger sample sizes are recommended to better evaluate this formulation., Competing Interests: Competing interests: The authors declare that there is conflict of interest, in the way that two individuals listed in authors’ list, MMP and ZP, suffer from DEB and they participated in this clinical trial, but they did not have any role in response evaluation of the drug., (©2022 Niazi et al.)

Background: Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics., Methods: The current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12-70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire., Results: A significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value<0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001)., Conclusion: Topical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics., Competing Interests: Declaration of Competing Interest The author’s confirm that there is no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Finding non-systemic antipyretic option in cancer patients who simultaneously receive several other drugs seems be logical. This study was designed to evaluate complementary therapy with Viola odorata L. oil for fever control in febrile neutropenic children., Methods and Materials: In a randomized placebo controlled clinical trial, 41 febrile children were divided into two groups. Children in the active drug group received viola oil (20 drops) to be rubbed on the peripheral margin of the patient umbilicus. Primary outcome measure of the study was the mean axillary temperature in the 30, 60, and 240 minutes after the intervention., Results: The mean temperature reduced significantly in the viola group after 30 minutes of administration (p =0.005), while there was no significant change in the placebo group (p =1.00). The number of patients who received paracetamol as the rescue treatment was significantly lower in the viola group than that in the placebo group (5 vs. 17, p =0.001)., Conclusion: The results of our study showed the safety and efficacy of complementary therapy with Viola odorata L. oil for fever control in febrile neutropenic children during hospital course., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: This study investigated the biochemical, histopathological and physiological effects of Citrullus colocynthis on peripheral neuropathy in rats with streptozotocin (STZ)-induced diabetes., Methods: Seventy adult male Sprague-Dawley rats were included in the present study. Diabetes was induced in 60 rats, with a single intraperitoneal injection of STZ (65 mg/kg). After 4 weeks, the diabetic rats were assessed for neuropathy. Then, the diabetic rats with neuropathy were randomly divided into 6 groups for a 4-week treatment with gabapentin, oral administration of C. colocynthis fruit pulp powder (100 and 300 mg/kg per day), topical preparations as oil-based solution and ointment, or placebo. Changes in metabolic, physiological, biochemical and histological parameters were considered as treatment outcomes., Results: Metabolic outcomes (body weight and blood glucose level) were improved in the C. colocynthis-treated groups as compared to placebo. Tail-flick and hot-plate tests also had lower latency in the C. colocynthis-treated groups. Measurement of oxidative stress markers (malondialdehyde, superoxide dismutase and catalase) showed the antioxidant effect of C. colocynthis. Histological evaluation of the sciatic nerve showed that C. colocynthis decreased the number of demyelinated and degenerated nerve fibers. Among the C. colocynthis-treated groups, the one receiving 100 mg/kg power per day orally had the best treatment outcomes., Conclusion: The present study showed that C. colocynthis fruit, through its antioxidant and hypoglycemic activities, has a positive effect in the treatment of diabetic neuropathy., (Copyright © 2019 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.)

Objective: Cassia fistula L. fruit extract has been traditionally used in the treatment of pemphigus vulgaris (PV) lesions in Iran. The aim of this study was to determine the efficacy of C. fistula fruit gel on healing time of PV lesions in a clinical setting., Materials and Methods: This was a randomized, double-blind placebo-controlled clinical trial that was performed in dermatology ward at Saadi hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Right- or left- sided lesions of PV patients on standard systemic treatment were randomized for treatment with either C. fistula fruit gel or placebo prescribed twice daily. The largest diameter of each lesion was measured at the baseline (day 0) and on days 10 and 20. Epithelialization Index (EI), as outcome measure was calculated and compared between the two groups., Results: The present study comprised 20 patients, with overall 82 cutaneous lesions including 41 lesions in the C. fistula fruit gel group and 41 lesions in the placebo group. The EI in the C. fistula fruit gel group was significantly higher than that of the placebo group both on day 10 (65±28vs 30±34; p=0.001) and at the end of the study (91±22 vs 69±49; p=0.003)., Conclusion: Topical application of C. fistula fruit gel can be considered as an effective adjuvant therapy in treatment of PV., Competing Interests: No potential conflict of interest was identified in this study.

Background: Lipid-lowering effect of Rhus coriaria L. (Rhus) has been investigated in multiple animal studies with promising results. Nonetheless, its clinical efficacy has not been adequately examined., Objective: The aim of this study was to evaluate the lipid-lowering effects of Rhus among patients with hyperlipidemia., Design, Setting, Participants and Interventions: The study was designed as a two-arm, double-blind placebo-controlled randomized clinical trial, using a parallel design. Eighty patients with primary hyperlipidemia were randomly assigned to receive Rhus capsules or placebo for 6 weeks., Main Outcome Measures: The serum lipid levels, apolipoprotein-A1 (Apo-A1) and apolipoprotein-B (Apo-B) were measured., Results: Mean serum high-density lipoprotein cholesterol (HDL-C) and Apo-A1 levels were significantly increased in the Rhus group, compared with the placebo group, after 6 weeks of intervention (P = 0.001). The analysis of covariance test including age, gender, body mass index (BMI), and smoking as co-variables revealed that the increase in HDL-C and Apo-A1 levels remained significant, and increases in HDL-C were dependent on the increase in Apo-A1 levels. No significant difference was observed between Rhus and placebo groups in terms of mean reductions in total cholesterol, low-density lipoprotein cholesterol and triglyceride levels; however, more significant improvement was observed among obese patients (BMI ≥ 30 kg/m 2 )., Conclusion: The study showed significant increases in HDL-C and Apo-A1 levels in response to Rhus supplementation in patients with hyperlipidemia., Trial Registration: ClinicalTrials.gov ID: NCT02295293., (Copyright © 2017 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.)

Aim: To evaluate the efficacy of topical use of Matricaria recutita L oil in the treatment of enuresis in children., Methods: Eighty patients diagnosed as monosymptomatic nocturnal or daytime enuresis were allocated to receive Matricaria recutita L (chamomile) oil or placebo topically for 6 weeks in a double-blind randomized placebo-controlled trial with a parallel design. Patients were evaluated prior to and following 8 weeks of the intervention in terms of frequency of enuresis and any observed adverse events., Results: The mean frequency of enuresis at the first, second, and third 2 weeks was lower in the intervention group compared with the placebo group, and the differences were statistically significant (P < .001, P = .03, and P < .001, respectively). There was no report of any adverse event in the study groups., Conclusion: The findings of this study showed that the topical use of (chamomile) oil can decrease the frequency of nocturia in children with monosymptomatic nocturnal or daytime enuresis., (© The Author(s) 2015.)

Aim: Considering traditional use of Tribulus terrestris in diabetes and proven antihyperglycemic and antihyperlipidemic effects of T terrestris in animal studies, we aimed to evaluate the efficacy of the hydroalcoholic extract of T terrestris on the serum glucose and lipid profile of women with non-insulin-dependent diabetes mellitus., Methods: Ninety-eight women with diabetes mellitus type 2 were randomly allocated to receive the T terrestris (1000 mg/d) or placebo for 3 months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin, and lipid profile., Results: Tribulus terrestris showed a significant blood glucose-lowering effect in diabetic women compared to placebo (P < .05). Also, the total cholesterol and low-density lipoprotein of T terrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels., Conclusions: The study showed preliminary promising hypoglycemic effect of T terrestris in women with diabetes mellitus type 2., (© The Author(s) 2016.)

Background: Considering folkloric use of Tribulus terrestris (T. terrestris) in diabetes and proven anti-hyperglycemic and anti-hyperlipidemic effects of T. terrestris in animal studies, we aimed to evaluate the efficacy of the hydro alcoholic extract of T. terrestris on the serum glucose and lipid profile of women with diabetes mellitus., Methods: Ninety-eight diabetic women were randomly allocated to receive the T. terrestris (1000 mg/day) or placebo for three months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin and lipid profile., Results: T. terrestris showed a significant blood glucose lowering effect in diabetic women compared to placebo (P<0.05). Also, the total cholesterol and low-density lipoprotein of the T. terrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels., Conclusion: This study showed preliminary promising hypoglycemic effect of T. terrestris in diabetic women.

Background: The present study investigated the difference between therapeutic responses of hot and cold temperament patients (based on traditional Persian medicine) with ulcerative colitis to pomegranate peel extract., Methods: Seventy-eight patients with moderate ulcerative colitis based on Lichtiger Colitis Activity Index (LCAI) criteria were randomized to receive an aqueous extract of the Punica granatum peel (6 gram per day) or placebo for four weeks. They were assessed before and after the intervention in terms of symptoms by LCAI scoring system. The results were compared in two therapeutic groups based on the patient s' temperament (cold and hot) which were diagnosed based on a previously validated questionnaire., Results: Therapeutic response was significantly higher in patients with hot temperament compared to patients with cold temperament in the P. granatum group (1.91±0.492 vs. -0.500±0.500, P=0.029)., Conclusion: This study showed the importance of considering syndrome differentiation and temperament in interpreting the effect of P. granatum peel extract on ulcerative colitis.

This study aimed to investigate the effect of violet syrup on cough alleviation in children with intermittent asthma. In a parallel, double-blind, randomized controlled trial, 182 children aged 2 to 12 years with intermittent asthma were randomly assigned 1:1 to receive violet syrup or placebo along with the common standard treatments in both groups (short-acting β-agonist). Both groups were evaluated in terms of the duration until cough suppression was achieved. No significant difference was observed in basic characteristics. The duration lasting to yield more than 50% cough reduction and 100% cough suppression was significantly less in the violet syrup group compared to placebo (P = .001, P < .001, respectively). There was no significant difference in therapeutic effects between boys and girls. There was a significant inverse correlation between the age of children and rate of cough alleviation and suppression by violet syrup. This study showed that the adjuvant use of violet syrup with short-acting β-agonist can enhance the cough suppression in children with intermittent asthma., (© The Author(s) 2015.)

Objective: There is increasing interest in complementary and alternative medicine generally, and especially by those affected by chronic diseases, such as diabetes mellitus. We aimed to determine the prevalence and pattern of complementary and alternative medicine use among patients suffering from diabetes mellitus in Shiraz, southern Iran. Another objective was to explore associated factors for use of complementary and alternative medicine among patients with diabetes mellitus., Methods: A 19-item semi-structured questionnaire (open- and close-ended) was administered to 239 patients with diabetes mellitus in this cross-sectional study. It was carried out in two outpatient diabetes clinics affiliated with the Shiraz University of Medical Sciences, Shiraz, Iran., Results: One hundred and eighty patients (75.3%) used at least one type of complementary and alternative medicine in the last year prior to the interview. Patients with diabetes mellitus who were living in a large family (≥5 members), not taking insulin, and believed that complementary and alternative medicine have synergistic effects with conventional medicine, were independently and significantly (P values: 0.02, 0.04, and 0.01, respectively) more likely to use complementary and alternative medicine. Most of the users (97.7%) reported use of herbal preparations, and 89.4% of users did not change their medication, neither in medication schedule nor its dosage., Conclusion: The use of complementary and alternative medicine, especially herbal remedies, is popular among diabetes patients in Shiraz, Iran. This use is associated with patients' family size, type of conventional medications and their view about concomitant use of complementary and conventional medicine.

Allium ampeloprasum subsp iranicum (Leek) has been traditionally used in antihemorrhoidal topical herbal formulations. This study aimed to evaluate its safety and efficacy in a pilot randomized controlled clinical trial. Twenty patients with symptomatic hemorrhoids were randomly allocated to receive the topical leek extract cream or standard antihemorrhoid cream for 3 weeks. The patients were evaluated before and after the intervention in terms of pain, defecation discomfort, bleeding severity, anal itching severity, and reported adverse events. A significant decrease was observed in the grade of bleeding severity and defecation discomfort in both the leek and antihemorrhoid cream groups after the intervention, while no significant change was observed in pain scores. There was no significant difference between the leek and antihemorrhoid cream groups with regard to mean changes in outcome measures. This pilot study showed that the topical use of leek cream can be as effective as a standard antihemorrhoid cream., (© The Author(s) 2015.)

Neuropathic pain is supposed to be a post-renaissance described medical entity. Although it is often believed that John Fothergill (1712-1780) provided the first description of this condition in 1773, a review of the medieval Persian medical writings will show the fact that neuropathic pain was a medieval-originated concept. "Auojae Asab" [Nerve-originated Pain] was used as a medical term in medieval Persian medical literature for pain syndromes which etiologically originated from nerves. Physicians like Rhazes (d. 925 CE), Haly Abbas (d. 982 CE), Avicenna (d. 1037 CE), and Jorjani (d. 1137 CE) have discussed multiple aspects of nerve-originated pain including its classification, etiology, differentiating characteristics, different qualities, and pharmacologic and non-pharmacologic treatments. Recognizing medieval scholars' views on nerve-originated pain can lighten old historical origins of this concept.

Background: Carpal tunnel syndrome is known as the most common entrapment neuropathy. Conservative treatments cannot reduce the symptomatic severity satisfactorily; therefore, effectiveness of Linum usitatissimum L. (linseed) oil on carpal tunnel syndrome, as a complementary treatment, was evaluated in the current study. Linseed oil is a well-known preparation in Iranian traditional medicine and its analgesic, anti-inflammatory and anti-oxidative effects have been shown in previous studies., Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted. One hundred patients (155 hands) with idiopathic mild to moderate carpal tunnel syndrome aged between 18 and 65 years old were randomized in two parallel groups. These two groups were treated during 4 weeks with topical placebo and linseed oil. In addition, a night wrist splint was prescribed for both groups. Symptomatic severity and functional status were measured using Boston Carpal Tunnel Questionnaire. In addition, median sensory nerve conduction velocity, motor distal latency, sensory distal latency and compound latency as electrodiagnostic parameters were measured at baseline and after the intervention period., Results: After the intervention, significant improvement was observed regarding Boston Carpal Tunnel Questionnaire symptomatic severity and functional status mean differences (p <0.001) in the linseed oil group compared with those in the placebo group. Also, regarding the mean differences of both groups, significant improvement of nerve conduction velocity of the median nerve was seen in the linseed oil group by a value of 2.38 m/sec (p < 0.05). However, motor distal latency and sensory distal latency of the median nerve showed no between-group significant changes (p = 0.14 for both items). Finally, compound latency was improved slightly in the case group, comparing mean differences between the groups (p <0.05). No significant adverse events were reported from using linseed oil., Conclusions: It seems that linseed oil could be effective in the management of mild and moderate carpal tunnel syndrome, especially in improving the severity of symptoms and functional status. In addition, its effect on electerodiagnostic parameters, especially on the nerve conduction velocity, can be considered as a valuable point.