The Effect of Malva Sylvestris Cream on Episiotomy Pain and Healing: A Randomized Controlled Clinical Trial.

Background: Episiotomy is one of the common procedures during childbirth in Iran, which causes pain, discomfort, and scar in the perineum. This study aimed to pursue the effect of Malva Sylvestris cream on episiotomy pain and healing. Methods: This study was a double-blinded randomized-controlled clinical trial that was conducted from April to December 2021 at the Sina hospital in Ahvaz, Iran. Sixty women were selected and randomly assigned to control and intervention groups using block randomization. The main outcomes included pain assessment and episiotomy wound healing that are assessed by the Visual analog scale (VAS), and perineal healing scale included redness, edema, ecchymosis/bruising, discharge, approximation (REEDA). The cream was used twice a day for up to 14 days. The participants were followed on the first, seventh, and fourteenth days postpartum. Independent T-test, Mann-Whitney, and Chi-square, and Generalized Estimating Equations (GEE) model were used by SPSS software version 22 for data analysis. Statistically significant level was considered less than 0.05. Results: There were no significant statistical differences between the two groups in demographic characteristics (P>0.05). No significant statistical differences were found in both groups in terms of perineal healing (B=-0.05; P=0.89) and pain scores (B=0.15; P=0.56). However, the chance of external dysuria in the intervention group decreased by 77% (P=0.01). Conclusion: Despite showing the positive effect of Malva Sylvestris extract on wound healing in animal and in-vitro studies, this clinical study failed to show the positive effect of this extract on wound healing and pain relief of episiotomy. However, future clinical trials are needed to substantiate the above findings.Trial Registration Number: IRCT20190826044621N1.

Determination of the Effectiveness of Topical Product of Commiphora Mukul Oleo Gum Resin on Dermal Wound Healing: An Experimental Study.

In Persian Medicine, many plants have been used in wound healing for thousands of years, and recent evidence indicates the beneficial effects of plant extracts on healing skin wounds. Commiphora mukul oleo gum resin has been considered for a long time due to its various properties such as milk-enhancing, diuretic, and healing the mouth and larynx wounds. The present study aimed to evaluate the effect of Commiphora mukul oleo gum resin on wound healing in rats. Forty-two albino Wistar rats have randomly divided into six groups: The first group was without treatment, the second group was treated with Eucerin, the third group was treated with phenytoin cream %1, the fourth to sixth groups were treated with Commiphora mukul ointment 2%, 4%, and 8% respectively. Treatment was performed once a day for 14 days, and the wound area was measured daily. At the end of the experiment, blood samples were taken to measure vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF). The histological evaluation and the strength test of the repaired tissue were performed. The results showed that seven days after treatment, the wound area decreased significantly in the groups treated with mukul gum extract compared to the control groups (p0.05). At the end of the experiment, there was no significant difference in wound area reduction between the groups. Commiphora mukul gum extract increased VEGF and significantly improved skin elasticity. The results of this study indicate the Wound healing potential of Commiphora mukul.

The comparison of therapeutic effect of Clobetasol propionate lotion and squill extract in alopecia areata: a randomized, double-blind clinical trial.

Alopecia areata is a chronic inflammatory disease that characterized by round or oval patches of non-scarring hair loss. From the past, Urginea maritima (white squill) was used for the treatment of hair loss in Iranian traditional medicine. We aimed the comparison of Clobetasol lotion and squill extract efficacy in treatment of alopecia areata in a randomized, double-blind clinical trial. The 42 patients were randomized into two groups. Both groups received topical squill and clobetasol lotion twice daily lotion for 12 weeks. Clinical evaluation included size of patches (using 1×1 cm2 schablone), total number of grown hair and number of terminal hair was performed every 2 weeks. Re-growth of terminal coarse hairs was evaluated using a semi-quantitative regrowth score (RGS) (0: no regrowth, 1: growth of <25%, 2: growth of 25-50%, 3: growth of 51-75%, 4: growth of >75%). There were significant differences between RGS4 in two groups after 2- and 3-month treatment (P<0.05). At the end of follow-up period, the mean hair growth rates increased significantly from 6.5 to 11.3 in squill group (P = 0.031) and it improved significantly from 10.3 to 17.9 in clobetasol group (P = 0.001). There were no significant differences between mean hair growth rates in two groups after 3-month treatment (P = 0.969). The lotion 2% of U. maritima bulbs extract showed good effect in 45% patients with patchy alopecia areata and showed moderate effect on re-growth of terminal hairs.

Phytochemical analysis, antimicrobial, antioxidant activities and total phenols of Ferulago carduchorum in two vegetative stages (flower and fruit).

Ferulago carduchorum (Apiaceae family) is an endemic plant of Iran. The crude extract and four fractions of aerial parts of F. carduchorum in two vegetative stages (flower and fruit) were studied for their total phenolic contents, antimicrobial and antioxidant activities using folin-ciocalteu assay, micro dilution method and DPPH assay, respectively. The results indicated that the best antioxidant activity was determined in flower crude extract (IC50=0.44 mg/mL). The flower ethyl acetate fraction (FLE) showed better antimicrobial and antifungal activities than other fractions. So, FLE was selected for phytochemical investigations, resulting in isolation of a flavonoid (hesperetin). Hesperetin showed antimicrobial activity. The results showed that the antimicrobial and antioxidant effects during the flowering are obviously more than the fruit season.

In vitro antioxidant and free radical scavenging activity of four Alkanna species growing in Iran.

BACKGROUND: Medicinal plants are recognized as sources of natural antioxidants that can protect biological system from oxidative stress. OBJECTIVE: In this study, the antioxidant activities of four species of the Alkanna genus (Alkanna bracteosa, Alkanna frigida, Alkanna orientalis and Alkanna tricophila) were evaluated. MATERIALS AND METHODS: The dried roots of plant samples (100 g) were extracted separately by percolation method with MeOH/H2O (80/20) and four fractions were provided respectively with hexane, chloroform, ethyl acetate, butanol and water. Antioxidant activities were investigated by using 1,1-diphenyl-2-picrylhydrazyl, ferric thiocyanate and thiobarbituric acid methods and compared with quercetin (as positive control). RESULTS: The results indicated that the butanol fractions of four species had the highest antioxidant activity and radical scavenging activity compared with the other fractions studied (P < 0.05). The 50% effective concentration (half - effective doses) values of butanol fractions are less than quercetin and other fractions, so, these fractions showed potent antioxidant activity. This indicated that the active compounds in the root parts of Alkanna species dissolved in the butanol. All the fractions of four species of Alkanna had antioxidant activity, while, there were no significant differences (P > 0.05) between the total antioxidant activities of same fractions. The total antioxidant activity values of Alkanna fractions in a descending order are as follows: Butanol fraction > ethyl acetate fraction > total extract > hexane fraction > chloroform fraction > aqueous fraction. CONCLUSION: The antioxidant activities of butanol fractions of samples were higher than quercetin. This may be because most of the active compounds of Alkanna species dissolved in the butanol.

Anticoagulant activity of isolated coumarins (suberosin and suberenol) and toxicity evaluation of Ferulago carduchorum in rats.

CONTEXT: Ferulago carduchorum Boiss. & Hausskn. (Apiaceae) is known as Chavil in Persian which grows in west of Iran. Local people add Chavil to dairy and oil ghee as a natural preservative to extend the expiration date. OBJECTIVE: The goal of this survey is the safety evaluation of the total extract of F. carduchorum in rats by determining both oral acute and subchronic toxicities; furthermore, the anticoagulant activity of isolated coumarins was evaluated. MATERIALS AND METHODS: The aerial parts of F. carduchorum were extracted by the percolation method. The anticoagulant activity of isolated coumarins was evaluated and the total extract was used to investigate acute and subchronic toxicity in rats. In the subchronic toxicity model, doses of 250, 500, and 1000 mg/kg of the extract were administered to treated groups for 30 consecutive days by gavage. RESULTS: According to the results of acute toxicity, the LD50 of Chavil extract was more than 2000 mg/kg. The subchronic study showed no significant difference (p > 0.05) between the groups treated with extract and control groups in hematological (erythrocyte, total and differential leukocyte, hematocrit, hemoglobin, platelet count) and biochemical parameter (glucose, albumin, cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase) evaluations. The isolated coumarins (suberosin and suberenol) prolonged the prothrombin time (PT) at doses of 3 and 6 mg/kg compared with control (p < 0.05). The longest PT was for suberosin at 6 mg/kg (17.4 s). CONCLUSION: In conclusion, oral administration of the Chavil extract did not cause either acute or subchronic toxicities although the coumarins showed anticoagulant effect in rats.