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Objectives Local anesthetic and antinociceptive activity of eugenol, as the main ingredient of clove, was determined in previous researches. This study aimed to assess the efficacy of its topical nanoemulsion gel vs. placebo in controlling pain caused by arteriovenous fistula (AVF) needling in patients undergoing hemodialysis (HD). Design In this double-blinded cross-over trial, the patients were randomly allocated to eugenol gel 4% (n = 34) and placebo gel (n = 34) groups. For each patient, a tip of finger unit of gel was applied 2 cm around the insertion site of hemodialysis needles. After 10 min, AVF needling was done. AVF needling-related pain was assessed using visual analogue scale (VAS) immediately after the puncture. All patients were tested at three different states: (1) before using any intervention; (2) after using either the eugenol or placebo gel; and (3) after crossing over the groups. Results There was a significant difference between the mean of patients’ pain severity score in the three states (p = 0.001). It was reported as low as 3.29 ± 0.67 in patients who received eugenol nanoemulsion. Also, the highest pain severity score (5.03 ± 0.57) was reported at the no-intervention state. Conclusions It seems that topical application of eugenol nanoemulsion may significantly decrease AVF cannulation related pain intensity score in patients undergoing HD. However, further studies with larger sample size and longer intervention period should be done for better judgment on its efficiency and safety.

To evaluate the efficacy and safety of myrtus communis L. solution in the treatment of dandruff and to compare it with ketoconazole.This double-blind randomised clinical trial was conducted at Shiraz University of Medical Sciences, Shiraz, Iran, from December 2015 to August 2016, and comprised patients with dandruff aged 18-60 years visiting the dermatology out-patient clinic. The subjects were randomised into two equal groups. The treatment group received myrtus communis L. solution and a placebo shampoo, while the control group received ketoconazole shampoo and a placebo solution. The total duration of the study for each subject was one month and subjects in both groups used their respective interventions 8 times during that period. The parameters studied were pruritus, erythema, severity of scaling, and the extent of scalp involvement. All subjects underwent scalp scaling tests at the beginning, after 10 days and at the end of the 30th day. SPSS 21 was used for data analysis.Of the 90 individuals, there were 45(50%) in each of the two groups. However, 74(82%) subjects completed the third visit and, of them, there were 37(50%) in each group. Both groups showed significant improvement in all outcome measures (p0.001). There were no significant differences between the groups in terms of efficacy, satisfaction rate and side effects (p0.05 for each outcome).Myrtus solution was found to be effective in the treatment of dandruff.

Background: Ulcerative colitis is the most common form of inflammatory bowel disease worldwide, which presents with superficial ulcers in the rectum and colon. The aim of this study was to assess the effectiveness of rose oil soft capsules over placebo on the clinical outcomes in moderate to severe ulcerative colitis. Materials and Methods: This study was a pilot randomized, double-blind clinical trial, and the 40 patients were assigned into rose oil and placebo groups (n=20 per group). All patients were instructed to use their prescribed two soft capsules three times daily for two months. The clinical symptoms, quality of life the patients, and calprotectin level were evaluated via partial Mayo clinic score, irritable bowel disease questionnaire (IBDQ-9), and calprotectin kit as primary outcome measures. Results: The mean age of the participants was 41±10 years. Most of them (53.6%) were male, and the remaining (46.4%) were female. The demographic and baseline data showed no differences between the two groups. Partial Mayo clinic scores decreased in both groups after the treatment, but the difference between the rose oil and placebo groups was not statistically significant (P=0.99). IBDQ-9 score also increased in both interventions before and after the treatment (P=0.012), though the differences between these two groups were not statistically significant (P=0.61). There were no significant differences between the two study groups either in terms of calprotectin level (P=0.219). Conclusion: This study showed that rose oil might improve ulcerative colitis clinical outcomes, but for a better evaluation, it is imperative to conduct experiments with a large sample size and longer follow-up observation. [GMJ.2019;8:e1307]

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.

Introduction Considering the known pharmacological effects of Allium iranicum and the use of this herb in traditional Persian medicine (TPM) as an antihemorrhoid agent, we evaluated the efficacy of A. iranicum leaf extract cream for management of hemorrhoids in a double blind randomized placebo control trial. Methods Eighty patients with symptomatic hemorrhoids were randomly allocated to three groups to receive topical leek cream or placebo cream or routine cream for the management of hemorrhoids (antihemorrhoid) for a period of 3 weeks. Bleeding severity (primary), pain, defecation discomfort, anal itching severity, and overall subjective improvement (secondary) were assessed as outcomes of this study. Results A significant reduction was observed in the bleeding severity, anal pain, defecation discomfort and anal itching of all patients. The leek cream group had significantly less bleeding severity than standard antihemorrhoid and placebo groups at the end of the study (0.26 ± 0.75, 0.83 ± 1.09, 0.35 ± 0.93, respectively P = 0.04). The number of patients with more than 50% subjective improvement was also significantly more in the leek cream group compared to other groups (12, 5, 6, respectively P = 0.04). The mean reductions in pain, defecation discomfort and anal itching showed no significant difference between the three groups ( P = 0.07, 0.39, 0.33, respectively). Conclusion The current study showed significantly better outcomes for the leek group compared to the standard antihemorrhoid and placebo groups for bleeding severity and overall subjective improvement. However, there was no difference among topical use of leek, routine antihemorrhoid and placebo creams symptomatic relief of pain, defecation discomfort and itching. This trial was registered by Iranian Registry of Clinical Trials with the code: IRCT2014010816143N1 and also registered in ClinicalTrials.gov with identifier: NCT02301052 .

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., Premda nam je razvoj moderne medicine pomogao bolje negoli je to bilo u prošlosti detektirati i tretirati bolesti, napose u polju kirurgije, povijest bi medicine mogao biti okidač koji nam može pomoći u korištenju zanemarenih aspekata prijašnjeg znanja, a za unapređenje suvremene znanosti. Budući da su povijesni tekstovi koji se usko fokusiraju na anorektalne bolesti rijetki, ali oni koji postoje sadrže kratku diskusiju u polju, ova studija nastoji detaljno prikazati Avicenin pristup anorektalnim bolestima. Zbog toga smo prikazali 17. poglavlje trećeg sveska Avicenina Kanona medicine, „O bolestima anusa“, i usporedili njegove poglede na klasifikaciju i dijagnozu te pristup anorektalnim bolestima s onima moderne proktologije. Avicena je detaljno raspravljao o anorektalnim bolestima kao što su hemoroidi, rascjep (fisura), perianalni apsces i kanal (fistula), rektalni prolaps, fekalna inkontinencija i analni svrbež. U nastavku predstavljamo trave koje je Avicena koristio za tretiranje spomenutih bolesti. Naše istraživanje pokazuje da Avicenini pogledi na klasifikaciju i dijagnozu te pristup anorektalnim bolestima imaju malo fundamentalnih razlika s modernom medicinom. Zatim su dokazani farmakološki efekti nekih trava koje je preporučivao Avicena i koji se koriste u sadašnjoj medicini. Dakle srednjovjekovno znanje može biti dalje znanstveno proučavano za razvijanje novih terapijskih mogućnosti za anorektalne bolesti