Efficacy and safety of "Jollab Monzej" as a traditional persian compound medicine for the treatment of multiple sclerosis-related fatigue: A randomized placebo-controlled trial.

Background: The purpose of this study was to investigate the efficacy and safety of Jollab monzej (JMZ), a Traditional Persian compound medicine, on multiple sclerosis-related fatigue (MSRF). Methods: We did a double-blind randomized controlled phase3 clinical trial on the JMZ syrup in fifty-six relapsing-remitting MS (RRMS) patients aged 18-55 years with moderate to severe fatigue using the Expanded Disability Status Scale (EDSS) score ≤ 6. We randomly assigned (1;1) participants to the JMZ syrup or placebo syrup groups treated for one month. Participants, investigators, and assessors were unaware of the assignments. The primary outcome was changes in the fatigue score on the Fatigue Severity Scale (FSS), at baseline and one month after treatment using the intention-to-treat (ITT) analysis. The secondary outcomes were changes in the score of Visual Analogue Scale (VAS), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Outcomes were measured at baseline, one month after treatment, and 2-week follow-up. Safety was detected in all participants. Results: We randomly assigned 56 participants to the JMZ group (n=28) and placebo group (n=28). Fatigue scores significantly changed in both groups; however, the JMZ group had a greater reduction in FSS score in the ITT analysis. The adjusted mean difference was 8.80 (Confidence interval (CI) 95%, 2.90-14.70, P = 0.00). The mean difference of VAS, BDI, and global PSQI scores were statistically significant (P=0.01, P₌0.00, P₌0.01; respectively). Regarding safety, mild adverse events (AEs) were reported. Conclusion: The results of our study revealed that the administration of JMZ syrup alleviated MSRF and also could improve depression and sleep disorders.

Effect of oral administration of Triphala, a polyphenol-rich prebiotic, on scalp sebum in patients with scalp seborrhea a randomized clinical trial.

BACKGROUND: Although there are various therapeutic options to control oily skin, they have potential side effects and limitations especially in long-term use. Pre/probiotics may have beneficial effects in atopic dermatitis' acne, dandruff, and seborrhea, demonstrated by some clinical trials. This trial conducted to determine whether the herbal prebiotic Triphala is effective in reducing scalp sebum secretion in patients with scalp seborrhea. METHODS: In this 8 week patient and outcome assessor-blinded, placebo-controlled trial participants with scalp seborrhea aged 14-50 years were randomized to Triphala or placebo groups. 1 g of Triphala (standardized as 91.82 ± 0.5 mg gallic acid) or placebo (wheat flour) were administered BID. Scalp sebum levels were detected objectively using Sebumeter® sm 815, and treatment satisfaction was measured using a score between 0 and 100. [Registration no. IRCT2014070218332N1]. RESULTS: Eighty patients completed the study (40 in Triphala group and 40 in placebo group). Participants in the Triphala group experienced 25.34 scores (95% CI, 0.39-50.29: p = .047) more improvement in scalp sebum levels compared with the placebo group. The mean percentage of patients' satisfaction was 37.91 (24.88) in the Triphala group and 17.89 (25.80) in the placebo group (p = .001). CONCLUSION: Herbal prebiotic Triphala significantly reduced scalp sebum scores compared to placebo.

Introducing nano/microencapsulated bioactive ingredients for extending the shelf-life of food products.

The shelf-life of foods is affected by several aspects, mainly chemical and microbial events, resulting in a considerable decline in consumer's acceptance. There is an increasing interest to substitute synthetic preservatives with the plant-based bioactive ingredients which are safe and natural. However, full implementation of this replacement is postponed by some challenges associated with bioactive ingredients, including their low chemical stability, off-flavor, low solubility, and short-term effectiveness. Encapsulation could overcome these limitations. The present review explains current trends in applying natural encapsulated ingredients for food preservation based on a classified description including essential oils, plant extracts, phenolics, carotenoids, etc. and their application for extending food shelf-life mostly dealing with antimicrobial, ant-browning and antioxidant properties. Encapsulation techniques, especially nanoencapsulation, is a promising strategy to overcome their limitations. Moreover, better results are obtained using a combination of proteins and polysaccharides as wall materials than single polymers. The encapsulation method and type of encapsulants highly influences the releasing mechanism and physicochemical properties of bioactive ingredients. These factors together with optimizing the conditions of encapsulation process leads to a cost-effective and well encapsulated ingredient which is more efficient than its free form in shelf-life improvement. It has been shown that the well-designed encapsulation systems, finally, boost the shelf-life-promoting functions of the bioactive ingredients, mostly due to enhancing their solubility, homogeneity in food matrices and contact surface with deteriorative agents, and providing their prolonged presence over food storage and processing via increasing the thermal and processing stability of bioactive compounds, as well as controlling their release on food surfaces, or/and within food packages. To this end and given the numerous wall and bioactive core substances available, further studies are needed to evaluate the efficiency of many encapsulated forms of both conventional and novel bioactive ingredients in food shelf-life extending since the interactions and anti-spoiling behaviors of the ingredients in various encapsulation systems and foodstuffs are highly variable that should be optimized and characterized before any industrial application.

Comparison of clinical efficacy and safety of thermotherapy versus cryotherapy in treatment of skin warts: A randomized controlled trial.

The effect of thermotherapy in the treatment of skin warts in comparison to cryotherapy, as the standard conventional method, has remained uncertain. This study aimed to assess the clinical efficacy and safety of thermotherapy and cryotherapy in removing skin warts. This randomized controlled trial was conducted on 52 patients aged 18 years and over with ≤ 10 skin warts. The participants were randomly assigned into two groups to receive cryotherapy (every 2 to 3 weeks up to six sessions if required) or thermotherapy (one session). The patients in both groups were followed every 2 to 3 weeks for the first three months, and then three months after the last treatment session. The clearance rate was 79.2% in the thermotherapy group and 58.3% in the cryotherapy group with no significant difference (p = 0.212). The rate of scarring in the thermotherapy group was 20% (p = .018). A higher clearance rate was achieved in the thermotherapy group. However, this result was not statistically significant. There were some minimal post-treatment complications. Patients needed only one session of thermotherapy. Due to the risk of scarring, we suggest thermotherapy only as a suitable treatment method for palmoplantar warts.

Evaluation of a novel natural drop for treatment of chronic rhinosinusitis without nasal polyps: a single blind randomized trial.

BACKGROUND: The present study investigated the effectiveness of a Pimpinella anisum-based herbal medicine for treating chronic rhinosinusitis (CRS) without polyps in comparison to fluticasone nasal spray, in a single-blinded randomized trial. METHODS: Patients with CRS without nasal polyps were randomly assigned into 2 treatment groups: individuals in the first group (n = 26) received 2 drops of a P. anisum-based herbal medicine (Sinupim) in each nostril every 12 hours, while those in the second group (n = 22) received 2 puffs of fluticasone nasal spray in each nostril every 12 hours. Both groups used their designated treatments for 4 weeks. Patients were evaluated by the 22-item Sino-Nasal Outcome Test (SNOT-22) at the start of the trial and after the completion of their treatment. RESULTS: Although both treatments were effective in reducing patients' symptoms, there were significantly better results in the Sinupim group based on the SNOT-22 evaluation. Mean changes in computed tomography (CT) scan scoring in Sinupim and fluticasone groups before and after treatment were 2.22 ± 2.94 and 0.76 ± 1.39, respectively, which was significant within both groups (p < 0.05). Postnasal drip and nasal obstruction were more significantly improved in the Sinupim group. CONCLUSION: A P. anisum-based herbal medicine may be an effective treatment for sinusitis without polyps. However, its wide acceptance needs further investigation.

Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled study.

BACKGROUND: Tribulus terrestris as a herbal remedy has shown beneficial aphrodisiac effects in a number of animal and human experiments. This study was designed as a randomized double-blind placebo-controlled trial to assess the safety and efficacy of Tribulus terrestris in women with hypoactive sexual desire disorder during their fertile years. Sixty seven women with hypoactive sexual desire disorder were randomly assigned to Tribulus terrestris extract (7.5 mg/day) or placebo for 4 weeks. Desire, arousal, lubrication, orgasm, satisfaction, and pain were measured at baseline and after 4 weeks after the end of the treatment by using the Female Sexual Function Index (FSFI). Two groups were compared by repeated measurement ANOVA test. RESULTS: Thirty women in placebo group and thirty women in drug group completed the study. At the end of the fourth week, patients in the Tribulus terrestris group had experienced significant improvement in their total FSFI (p < 0.001), desire (p < 0.001), arousal (p = 0.037), lubrication (p < 0.001), satisfaction (p < 0.001) and pain (p = 0.041) domains of FSFI. Frequency of side effects was similar between the two groups. CONCLUSIONS: Tribulus terrestris may safely and effectively improve desire in women with hypoactive sexual desire disorder. Further investigation of Tribulus terrestris in women is warranted.

Stigma and its determinants among male drug dependents receiving methadone maintenance treatment.

BACKGROUND: The stigma attached to substance use is considered as a barrier to treatment, resulting in continued dependence and harmful consequences for the health of drug abusers and society. METHODS: In the current study, stigma and its relation with patient characteristics and secrecy was examined in people who were in treatment of drug dependency. Participants were 144 patients from two referral methadone treatment centers who completed a survey containing questionnaires about stigma, secrecy and other measures of drug use. RESULTS: Patients reported high levels of self-stigma and moderate levels of stigma-related rejection and perceived stigma as well as commonly using secrecy, as a way of coping. More experiencing of self -stigma was associated with unemployment, positive history of IV drug use, incarceration and heroin consumption, compared to opium use. IV drug users and unemployed persons also reported more contacts with stigma- related rejection. No association was found between stigma and previous history of treatment for substance abuse. CONCLUSION: Findings indicate stigma in individuals who are in the treatment for substance dependence and highlight the need for more studies to clarify all aspects of drug use stigma.

A single blind randomized clinical study: the efficacy of isotretinoin plus narrow band ultraviolet B in the treatment of psoriasis vulgaris.

In this randomized clinical trial, 39 patients with psoriasis vulgaris were randomized in two groups. Intervention group received narrow band ultraviolet B (NBUVB)+isotretinoin (0.5 mg/kg/day), control group received NBUVB+placebo. Psoriasis Area Severity Index (PASI) scoring was recorded at baseline and weeks 4, 10, and 14. Thirty-seven patients completed the study. According to recorded PASI scores the difference between efficacies of two treatments was not significant. Complete clearing was noticed in 14 and 13 patients in intervention group and controls. The mean cumulative NBUVB dose in intervention group and controls was 29.95 ± 16.11 vs. 45.77 ± 7.72J/cm(2) (P=0.004). Isotretinoin+NBUVB can reduce number of phototherapy sessions and cumulative NBUVB dose.