Efficacy and safety of add-on Viola odorata L. in the treatment of COVID-19: A randomized double-blind controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Severe Acute Respiratory Syndrome (SARS) due to the novel coronavirus has become the highest priority that threatens human health. This situation demands widespread vaccination and the innovation of new therapeutic methods. Despite drug discoveries, the need for approving new medicaments is felt because of adverse effects and lack of efficacy. Several medicinal plants including Viola odorata L. are recommended in traditional Persian medicine for alleviating respiratory infection symptoms. Recent studies showed anti-inflammatory, antioxidant, anti-asthmatic, antitussive, analgesic, and antibacterial activities of sweet violet. These enhance respiratory functions, reduce pulmonary inflammation, and decline mucous membrane edema. This study aimed to evaluate the efficacy of sweet violet syrup in alleviating the manifestations of COVID-19 infection. MATERIAL AND METHODS: A randomized parallel-group double-blind controlled trial was conducted at Al-Zahra general hospital, Isfahan, Iran. A total of 108 outpatients were enrolled in the study. The patients were randomly allocated to intervention and placebo groups, with 54 patients in each group. The allocation was concealed using sealed opaque envelopes. The intervention group received violet syrup and the control group received placebo syrup, an add-on to the conventional treatment. The outcomes were COVID-19 manifestations, such as dyspnea, cough, myalgia, headache, and diarrhea, considered as outcomes of the study and were evaluated twice using a visual analog scale before the intervention and after 7 days, at the end of the study. Patients were followed daily by phone calls to monitor proper drug consumption and possible side effects. RESULTS: No significant difference was between groups regarding demographic characteristics and vital signs before and after the treatment. Although all symptoms have improved significantly in both groups, patients who received violet syrup recovered faster and the mean severity scores of cough (P = 0.025), myalgia (P = 0.036), headache (P = 0.037), and diarrhea (P = 0.044) decreased greater in comparison to control group. CONCLUSION: This study, the first clinical trial on the effectiveness of Viola odorata on SARS-CoV-2 patients, showed that Viola odorata L. effectively controls prevalent manifestations of COVID-19 including cough, myalgia, headache, and diarrhea. Regarding this survey, the violet syrup can be mentioned as a complementary treatment for viral influenza-like infections in which cough, myalgia, headache, and diarrhea are prominent.

Monotheistic and spiritual style literature in traditional medicine's resources.

The basis for success of Iranian Gnostics, poets and scientists were moral teaching, attention to origin and searching for specific goals in creation of human and creatures as well as finding some of his essence in studying all phenomena regarding the creation of universe by divine attitude. There is no surprise that such relationship was bilateral and according to his promise to those who truly follow him such that he will show the right path of learning to human in order to obtain the secrets of life. This relationship has resulted in growth of famous Iranian scientists such as Rhazes, Ahvazi, Avicenna, Ferdousi and… at the beginning of the second millennium. Thus, goal of this research is to study the style of writing in original resources of traditional medicine. In order to increase the accuracy of this study, an electronic database version of traditional medicine resources has been prepared. Writing style of Alhavi book (by Rhazes), Kamel-al-Sanaah (by Ahvazi), Canon of Medicine (by Avicenna) and Zakhireye Khwarazmshahi (by Jorjani) was considered. This task was accomplished by searching using related key words such as God, creator, magnificent, omnipotent, transcendent, omniscient and many other similar words and then encoding them. Finally, content analysis of these words was performed. Hundreds of monotheistic words and many small and great texts related to monotheistic literature have been encountered in the literature, and some are mentioned in the following. Rhazes has started some parts of Alhavi by remembering the name of merciful God and saluting his prophets and has mentioned "God" for more than 570 times and the word "God willing" for more than 215 times. Ahvazi has written his book called Kamel-al-Sanaah by using monotheistic literature, so that both volumes of book are started by remembering the name of God and saluting his prophets. In the introduction of first volume of his book, he has acknowledged God due to conferring logic and wisdom to human and has used the word "God" more than 230 times in his book. He has also referred to a famous testimony of Hippocrates and added some more issues in relation to medical ethics. Avicenna has started the Canon of Medicine in five volumes by remembering God and saluting his prophets. When referring to points related to having specific goal in structure of body organs, he immediately has praised God. Jorjani also has followed up the same attitude of three mentioned writers. We have found out that any of the Iranian poets, Gnostics and scientists who have studied nature have reached to the same conclusion from their own point of view, meaning, they all have observed permanent emergence of God in all phenomena of universe. Poets considered the beauties of nature, Gnostics studied mental issues and scientists of natural sciences explored the physiology and anatomy of human body; however, all of them referred to beauty, magnificent, discipline and having goal in creation of universe and all of its phenomena in their books. They have written their valuable books by benefiting monotheistic literature and have published their research results by inference of seeking God and paved the way for next generations. They experienced the usefulness of cumulative effects of spirituality, religion and health on performance and thereby emphasizing the need to incorporate spirituality and religion in teachings curriculums.

The religious and social principles of patients' rights in holy books (Avesta, Torah, Bible, and Quran) and in traditional medicine.

Health protection and promotion in healthy people and restoring patients' health have been the most important themes in medicine and health throughout our history. Therefore, discussion of different aspects of patients' rights includes implementation of these objectives by the medical community, including physicians, nurses, pharmacists, etc., and the people in charge of health affairs. The principal objective of our research is the study of medical ideology and the approaches of our ancestors in relation to different aspects of patients' rights. To study the different ideologies of traditional medicine in relation to patients' rights, appropriate data were extracted from the original resources of traditional medicine and from religious books. By means of library research we studied these resources in addition to electronic versions of the Alhavi book (by Rhazes), the Kamel-al-Sanaah (by Ahvazi), the Canon of Medicine (by Avicenna), the Zakhireye Khawrazmshahi (by Jorjani), the Avesta, the Torah, the Bible, the Quran, and many other resources, and, finally, after searching, gathering, and encoding the findings, analyzed them qualitatively for thematic content. The holy Avesta book clearly insists on the competence of physicians and setting the appointment fee in accordance with peoples' income. The Old Testament (holy Torah) warned government officials who did not observe patients' rights. In the four gospels (holy Bible) the importance of treatment and taking care of the patient is stressed. After the emergence of Islam, medical students, before beginning the principal courses, had to study Islamic jurisprudence, ethics, logic sciences, natural sciences, geometry, astrology, calculus, and similar courses so that after purifying their soul they could enter the saintly profession of physicians. The holy Quran refers to saving the life of a human irrespective of social class, race, and religion, and insists on exemption of patients from physical activity, including the physical aspects of prayer. In these resources, some warnings are offered in relation to fake drugs, the lack of awareness of some physicians, the need for complete preparedness of medical society, and the need to manufacture appropriate drugs and offer a suitable medical service. This information is to familiarize medical and health authorities and persons receiving health services. According to the evidence available about traditional medicine, there was no specific difference between public and professional ethics, public and professional rights, or rights and ethics-ethics were no different from rights nor rights from ethics. So ethics are similar to the soul in the body of rights, and rights are similar to the litter of ethics, and they have developed in parallel with each other. Traditional medicine is community-based and preservation of the health of healthy people is given priority over the treatment of patients; there is insistence that "health rights" has wider scope than "patients' rights". It can be stated that health rights in Iran both before and after the emergence of Islam have been based on guidance from divine religions, observation of humanist ethics, passing suitable courses in the basic sciences, and an introduction to the practical piety of our ancestors, in addition to the syllabus of medical and health education.

The socio-political situation of Avicenna's time and his spiritual messages: on the occasion of 1031 st birth anniversary of Avicenna (23 August 980).

In the fourth century A.H. (tenth century AD) many thinkers, philosophers, jurisprudents, poets, and authors were present in different scientific, literary and health fields in ancient Iran and Islamic world that by their hard attempts the sciences and literature were safe from incidents and resulted in growth, development and innovation of Islamic sciences. Meanwhile, Avicenna was superior to all others and the most famous scientist. He was a great human that by attempting hard, perseverance, stability, patience, and believing in God could complete supreme scientific ranks and compiled encyclopedia of Canon of Medicine and besides gathering many written important issues that most of them were confiscated at libraries of kings. He added medical experiences of ancient Iran and especially Jondishapour University and also his personal experiences and finally Canon of Medicine by benefiting from monotheistic style and science based on faith was written. He has written a book that is regarded as root and basics of modern medicine and by completing it some infrastructure health viewpoints and common medicine were created. It is a kind of book that in spite of scientific advances and production of modern research tools many of its contents are replaced with modern methods of medicine and health, but still many of its health basic messages, research orientation and monotheism with great dynamic mode is considerable at world's medical references. The aim of this study is evaluate the political situation of Avicenna's time and a review of his Godly writings. This is a library study by using electronic version of Canon of Medicine and other related resources. Findings, include writing style of monotheistic literature, and freeing from nihilism and affiliating diseases to Satan, jinn and such issues. It is necessary that our students within course of Iranian and Islamic culture and civilization to be more familiar with monotheistic thoughts and activities of scientists like Avicenna.