Effect of a Persian medicine preparation, Ma'aljobon, on constipation in patients with hypertension.

BACKGROUND: Constipation is a common and prevalent digestive problem. Forcing and straining due to constipation may have a negative effect on some parts of the body, including the heart. The aim of the study was to evaluate the effect of Ma'aljobon (a kind of whey) on functional constipation in hypertensive patients. MATERIALS AND METHODS: The present double-blind, placebo-controlled randomized clinical trial was a part of the study about the effect of Ma'aljobon on stage 1 hypertension, performed in 2017-2018. Hypertensive patients accompanying constipation were included in the study. Patients were randomly divided into two groups: Group A (n = 19) received 25 g of Ma'aljobon powder and Group B (n = 22) received 25 g of maltodextrin powder, twice a day for 6 weeks. The number and quality of defecation during a day were evaluated at baseline and at the end of the study within and between groups. Data were analyzed by SPSS software (version: 17) using Chi-square or Fisher's exact test. P <0.05 was considered as significant level. RESULTS: Forty-one patients had inclusion criteria, of whom 34 patients completed the study (19 in Group A and 15 in Group B). The mean ± standard deviation age of patients was 53.86 ± 8.92 years (range: 34-80 years). Before intervention, there was no significant difference between the two groups with respect to constipation; however, after 6 weeks' treatment, the frequency of constipation was significantly different between groups (P < 0.001). At the end of 6th week, constipation in the Group A was improved completely in terms of the number of defecation and stool consistency; but, in the Group B, eight (53.33%) patients still suffered from constipation (P < 0.001). No specific complications were reported in both groups. CONCLUSION: Ma'aljobon can improve constipation in hypertensive patients without any adverse effect.

The organizational culture of Iran University of Medical Sciences from the viewpoint of faculty members.

Background: It has been widely acknowledged that change and constant modification is the key to survive for any organization among their rivals. Since success in implementing changes in the organization strongly depends on the organizational culture, this study aims to assess the organizational culture in Iran University of Medical Sciences. The results of this study can be beneficial in initiating a movement towards the third - and fourth generation of universities. Methods: This study is descriptive-correlational. The Organizational Culture Assessment Instrument (OCAI) was employed to collect data. A questionnaire was sent to the faculty members via email, and the responses were collected and analyzed. Results: Out of the 982 faculty members, 189 participated (20.7%) in this study. Analysis showed that the organizational culture of the university is congruent and harmonious and in the current state, it is primarily hierarchical (31%) and market-oriented (28%) with emphasis on stability and control in the organization. Whereas, faculty members tend to move the organizational culture of the university towards adhocracy (30%) and clan culture (29%). Conclusion: University administrators must strengthen the culture of innovation and creativity based on the needs of the market. This only can be achieved by supporting teamwork in their move towards desired change.

Comparison of quince with vitamin B6 for treatment of nausea and vomiting in pregnancy: a randomised clinical trial.

This trial was performed to compare quince (Cydonia oblonga) fruit with vitamin B6 on 76 pregnant women with a gestational age of 6-14 weeks and mild-to-moderate nausea and vomiting (NVP) (40 in the quince and 36 in the B6 group). The 'Pregnancy-Unique Quantification of Emesis' (PUQE-24) scale was used to examine the severity of NVP. The quince syrup (1 tablespoon/TDS) or vitamin B6 tablets (20 mg/TDS) were used as intervention for 1 week. The mean (±SD) age was 27.5 (±5.2) years. The score of the PUQE was decreased from 9.5 (± 2) at baseline to 5.2 (±2.3) on the 7th day and 5.3 (±2.6) on the 14th day (p < .001) in the quince group. In the other group, the scores were 8.4 (±1.8), 7.3 (±2.4) and 7.7 (±3.8), respectively (p = .001). The change in symptoms were more marked in the quince group (p < .001). Quince syrup seems to be a suitable treatment for NVP. Impact statement What is already known on this subject: Pregnancy-induced nausea and vomiting (NVP) is one of the most common problems during gestation. Treatment is mainly symptomatic, ranging from dietary changes and oral pharmacological treatment to hospitalization in severe forms. In early pregnancy, the use of chemical drugs is avoided, so there is an increasing tendency to use alternative therapies. According to the literature review in Iranian Traditional Medicine (ITM), the quince fruit (Cydonia oblonga) can be useful in NVP. Quince has a wide range of pharmacological activities including antioxidant, antibacterial, antifungal, anti-inflammatory, hepatoprotective and antidepressant effects. ITM literature suggests some therapeutic effects of the quince fruit on important organs like brain, heart, liver and stomach. What the results of this study add: The results of this study demonstrated the significant efficacy of quince in comparison with vitamin B6. What the implications are of these findings for clinical practice and/or further research: This fruit is also safe to be administered in pregnant women suffering from NVP.

Medicinal Herbs in Iranian Traditional Medicine for Learning and Memory.

BACKGROUND: A few factors such as age, stress, and emotions may lead to impaired learning, memory loss, amnesia, and dementia or threats like schizophrenia and Alzheimer's disease (AD). Iranian traditional medicine (ITM) recommends some herbs and herbal preparations for the treatment or prevention of CNS problems. METHODS: In this study, scientific evidence related to the effectiveness of ITM herbal medicine on memory, learning and AD is reviewed. The scientific evidence of plant efficacy was searched in electronic databases including PubMed, Scopus, SID, Science Direct, and Google Scholar by keywords such as memory, Alzheimer, amnesia, learning and scientific plant names from 1969 to 2014. RESULTS: The findings of this study confirmed the effectiveness of certain ITM medicinal plants on enhancing memory and learning or in the treatment/prevention of amnesia and AD. Some ITM plants like Melissa officinalis, Crocus sativus and Nigella sativa showed improving effects on memory and the treatment of AD in clinical trials. In some cases, active principles responsible for the efficacy of these plants on memory were also determined. DISCUSSION: Most of the studies on ITM plants were designed in animal models and a few herbs were evaluated in clinical trials on AD. Furthermore, there are insufficient or no investigations on certain herbal medicines used in ITM to confirm their effectiveness on memory and learning. Therefore, further experimental and clinical studies are necessary to evaluate the effectiveness of these plants on memory and AD as well as determining their active components.

Thermal Image-Based Temperament Classification by Genetic Algorithm and Adaboost Classifier.

Background: Temperament (Mizaj) determination is an important stage of diagnosis in Persian Medicine. This study aimed to evaluate thermal imaging as a reliable tool that can be used instead of subjective assessments. Methods: The temperament of 34 participants was assessed by a PM specialist using standardized Mojahedi Mizaj Questionnaire (MMQ) and thermal images of the wrist in the supine position, the back of the hand, and their whole face under supervision of the physician were recorded. Thirteen thermal features were extracted and a classifying algorithm was designed based on the genetic algorithm and Adaboost classifier in reference to the temperament questionnaire. Results: The results showed that the mean temperature and temperature variations in the thermal images were relatively consistent with the results of MMQ. Among the three body regions, the results related to the image from Malmas were most consistent with MMQ. By selecting six of the 13 features that had the most impact on the classification, the accuracy of 94.7 ± 13.0, sensitivity of 95.7 ± 11.3, and specificity of 98.2 ± 4.2 were obtained. Conclusions: The thermal imaging was relatively consistent with standardized MMQ and can be used as a reliable tool for evaluating warm/cold temperament. However, the results reveal that thermal imaging features may not be only main features for temperament classification and for more reliable classification, it needs to add some different features such as wrist pulse features and some subjective characteristics.

A Novel Pulse-Taking Device for Persian Medicine Based on Convolutional Neural Networks.

Background: In Persian medicine (PM), measuring the wrist pulse is one of the main methods for determining a person's health status and temperament. One problem that can arise is the dependence of the diagnosis on the physician's interpretation of pulse wave features. Perhaps, this is one reason why this method has yet to be combined with modern medical methods. This paper addresses this concern and outlines a system for measuring pulse signals based on PM. Methods: A system that uses data from a customized device that logs the pulse wave on the wrist was designed and clinically implemented based on PM. Seven convolutional neural networks (CNNs) have been used for classification. Results: The pulse wave features of 34 participants were assessed by a specialist based on PM principles. Pulse taking was done on the wrist in the supine position (named Malmas in PM) under the supervision of the physician. Seven CNNs were implemented for each participant's pulse characteristic (pace, rate, vessel elasticity, strength, width, length, and height) assessment, and then, each participant was classified into three classes. Conclusion: It appears that the design and construction of a customized device combined with the deep learning algorithm can measure the pulse wave features according to PM and it can increase the reliability and repeatability of the diagnostic results based on PM.

Rhus coriaria L., a new candidate for controlling metabolic syndrome: a systematic review.

OBJECTIVES: Rhus coriaria L. (RC) is a deciduous shrub with several pharmacological activities. Evidence of the effects of RC on weight, hyperlipidaemia, hypertension and diabetes mellitus have been presented in this study. Books, thesis and internet-based resources such as PubMed, Web of Science, Scopus, EMBASE, Cochrane, Ovid and Google Scholar were searched for the English, Arabic and Persian literature from 1966 to 2020 (December). The keywords were Rhus coriaria L., Sumac, metabolic syndrome and all its medical conditions (hyperlipidaemia, hypertension, obesity and diabetes mellitus). The inclusion criteria were full-text animal and human studies conducted on RC to evaluate its efficacy on any components of metabolic syndrome (MetS). Jadad scale was used to assess the quality of evidence. KEY FINDINGS: Reviewing 23 relevant studies demonstrated that RC is able to decrease the level of blood glucose, glycated haemoglobin, serum insulin and insulin resistance. Studies on hyperlipidaemia and obesity have very contradicting results, and there is no definite conclusion on the effect of RC on lipid profile. However, the hypotensive and effect of RC was confirmed in the existing studies. SUMMARY: According to the literature, RC can be considered as a promising curative candidate for MetS. However, further studies with larger sample size and higher methodological quality are needed.

The Efficacy of Plantago major Seed on Liver Enzymes in Nonalcoholic Fatty Liver Disease: A Randomized Double-Blind Clinical Trial.

OBJECTIVE: This study aims to evaluate the effects of Plantago major (P. major) seed on liver enzymes and ultrasound patterns in nonalcoholic fatty liver disease (NAFLD). DESIGN: In this randomized double-blind placebo-controlled clinical trial, 74 patients with NAFLD were administered either 2 g P. major or placebo twice daily for 12 weeks. All patients were advised to follow the recommendations for daily exercise and diet modification. Levels of liver enzymes as well as other laboratory indexes were measured at the beginning of the study and after 12 weeks. Indeed, the alteration in ultrasound grade was evaluated in NAFLD patients. RESULTS: Sixty-three participants completed the study in the intervention and control groups. The mean age of participants was 43.3 (±8.927) and 38.7 (±8.48) years in the intervention and control groups, respectively. P. major group showed significant reduction in alanine aminotransferase (ALT) (47.32 ± 21.77 IU/L vs. 50.03 ± 21.19, P = 0.021), aspartate aminotransferase (AST) (28.29 ± 10.49 IU/L vs. 32.03 ± 13.30, P = 0.004), triglyceride (TG) (200.93 ± 106.741 mg/dl vs. 183.75 ± 73.96, P = 0.001), waist circumference (WC) (101.25 ± 9.27 cm vs. 101.18 ± 8.63, P = 0.027), and grade of fatty liver in ultrasonography (P = 0.038), comparing to the placebo group. There was no significant difference between the two groups regarding serum levels of fasting blood sugar (FBS), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, and other outcomes. CONCLUSION: P. major supplementation with a daily dose of 2 g for 12 weeks improved serum levels of ALT, AST, and TG in patients with NAFLD. Further studies with a larger sample size are recommended.

Effect of Cedar (Ziziphus spina-christi) topical solution in mild to moderate acne vulgaris: a randomized clinical study.

BACKGROUND: Acne is the most prevalent skin disease in the world and antibiotics as its standard treatments have limited and also adverse effects. Cedar (Ziziphus spina-christi) has medicinal properties like antibacterial activity and is used topically for treatment of some kinds of skin problems in Persian medicine. The aim of this study was to evaluation the efficacy of topical cedar solution of acne vulgaris. METHODS: Eighty patients aged between 15-45 years with mild to moderate acne vulgaris were conducted in this randomized, double blind trial. The participants were allocated to receive the topical cedar solution plus clindamycin 1% or topical placebo plus 1% clindamycin solution for six weeks. Patients were evaluated at the beginning of the study, second, sixth and eighth weeks after intervention for the acne severity index (ASI) and total acne lesions counting (TLC). Data was analyzed by SPSS software with Mann-Whitney U test. RESULTS: From 105 subjects 68 people completed the study (33 persons in cedar group and 35 persons in placebo group). The mean and standard deviation of the age was 26.1 ± 7.5 years and 22 subjects (32.4%) were male. TLC and ASI in the sixth and eighth weeks in cedar group were significantly less than in placebo group (p < 0.001). Topical cedar solution had no serious side effects. CONCLUSION: The topical cedar solution plus clindamycin 1% was more effective and safe than placebo plus 1% clindamycin for the treatment of acne vulgaris.

The Efficacy of Rosa damascena on Liver Enzymes in Nonalcoholic Fatty Liver Disease: A Randomized Double-Blind Clinical Trial.

OBJECTIVE: This study aimed to appraise the potential effects of Rosa damascena preparation on nonalcoholic fatty liver disease (NAFLD). DESIGN: In the randomized, double-blind placebo-controlled clinical trials, seventy-four patients with NAFLD were prescribed either 1 g Rosa damascena powder or placebo three times in a day for 12 weeks. All patients were provided the lifestyle modification instructions and recommended following them precisely. ALT, AST, FBS, and lipid profiles were measured at the baseline after 12 weeks of studying. The Mann-Whitney U test was correctly used to compare the changes of variables among the groups. RESULTS: Seventy-two patients completed the study in two groups. Sixty-seven patients were men, and the mean ± standard deviation of age was 40.11 ± 9.05 years. The Rosa damascena group showed a considerable decrease in the serum ALT (23.83 ± 24.82 vs. 16.19 ± 27.41, p=0.042), waist circumference (99.73 ± 10.01 vs. 101.52 ± 8.84, p=0.003), triglyceride (TG) (186.29 ± 76.75 vs. 184.47 ± 73.05, p=0.001), cholesterol (167.47 ± 34.48 vs. 184.11 ± 33.54, p=0.001), low-density lipoprotein (LDL) (99.17 ± 28.66 vs. 107.52 ± 25.42, p=0.001), and elevation in serum high-density lipoprotein (HDL) (41.85 ± 6.56 vs. 39.20 ± 5.00, p < 0.007) compared to the control group. Improving fatty liver degree due to liver ultrasound was higher in the Rosa damascena group than the control group (p=0.001). CONCLUSION: Rosa damascena meaningfully improves liver function in NAFLD. Hence, it can be recommended along with lifestyle modification for these patients. Further studies are recommended with a larger sample size.

Complications of leech therapy.

OBJECTIVE: The principle of the use of leeches is associated with traditional medicine of many countries and its application has different philosophies for use in different areas of the body. Leeches, with all the benefits, can have dangers. MATERIALS AND METHODS: A review of complications of leech therapy was done based on English articles indexed in the databases up to July 1, 2018. A strategic search has done independently by members of the research team and then all of the articles were +categorized by subject. RESULTS: Related articles were mostly case-reports. Complications were divided into five categories including infection, allergy, prolonged bleeding, migration, and others. Infection is the most-reported complication related to leech therapy and Aeromonas spp. has the most participation in infections. CONCLUSION: Leech therapy can be a therapeutic complementary method if the possible complications are managed properly.

Abu-Sahl al-Masihi (died circa 1010 AD): The Persian physician in the early medieval era.

In the early medieval era, in the time which is called the Islamic Golden Age, medicine flourished through the practice of Persian physicians (9th to 12th century AD). Abu-Sahl al-Masihi (died circa 1010 AD) was one of the physicians in that period who had great influence on the progress of medicine by his own writings as well as his influence on great scholars like Biruni and Avicenna as their teacher. He was a polymath and had many writings in various fields of science, in particular medical sciences. Some of his manuscripts in medicine were Al-Mia fil-Tibb (Book of the Hundred), Kitab al-Teb al-Koli (The General Medicine), Ezhar al-Hekmat Allah Ta'ala fi Khalgh al-Ensan (God's Mystery on the Creation of Man), Resalat al-Adwiya (Treatise of Drugs), Osool Elm Nabz (the Principles of Pulse), and Resala f i Tahqiq Amral-Waba' (On the determination of the matter of infectious diseases). As a sign of his impact in Persian medicine, many later physicians (until 19th century) referred to and cited his works in their manuscripts several times.

A Randomized, Triple-Blind, Placebo-Controlled, Add-On Clinical Trial to Evaluate the Efficacy of Emblica officinalis in Uncontrolled Hypertension.

Introduction. Emblica officinalis (EO) has some cardiovascular effects, and there are some animal studies that show its antihypertensive effect. This study was conducted to determine the effect of combination of EO with standard therapy on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with uncontrolled hypertension. Materials and Methods. This was a randomized, triple-blind, placebo-controlled, 8-week study. Ninety-two patients with uncontrolled hypertension despite taking hypotensive drugs were randomly assigned into two groups to take EO (500 mg/TDS after meal) or placebo in combination with standard antihypertensive drugs. After 2, 4, 6, and 8 weeks of intervention, SBP and DBP and heart rate (HR) were measured. Data were analyzed by SPSS software using repeated measures ANOVA. Results. Eighty-one patients (41 in the drug group and 40 in the placebo group) completed the study for 8 weeks and were analyzed. The mean ± standard deviation of age was 53.64 ± 10.01 years. SBP decreased as 15.6 ± 8.23% in the EO group and 6.3 ± 7.49% in the placebo group (P < 0.001). DBP decreased as 12.3 ± 7.87% and 3.88 ± 7.98%, respectively (P < 0.001). Time effect was not significant, but the group effect was significant (F = 13.875, P=0.001 for systolic BP and F = 18.948, P < 0.001 for diastolic BP). No side effects were reported during the study. Conclusion. Eight-week combination therapy of EO with standard antihypertensive drugs significantly reduced the SBP and DBP more than placebo in patients with uncontrolled hypertension.

Effects of Valeriana officinalis (Valerian) on tension-type headache: A randomized, placebo-controlled, double-blind clinical trial.

OBJECTIVE: Tension-type headache is the most frequent type of headache. Considering the effectiveness of Valeriana officinalis (Valerian) in treatment of some types of headache, the effect of valerian root was studied in patients with tension-type headache. MATERIALS AND METHODS: The current study is a double-blind randomized clinical trial that was conducted in Shams Hospital of Mashhad University of Medical Sciences, Mashhad, Iran, from January to June 2018. We included 88 participants with tension-type headache and randomly assigned them to intervention and control group by block randomization in a 1:1 ratio. The intervention group received Sedamin® capsule (530 mg of valerian root extraction) while the placebo group received 500 mg of breadcrumbs both given as two capsules daily for a month -after dinner. The headache impact on activity of daily livings performance, headache disability, and headache severity were measured using questionnaires in baseline and one month after intervention in both groups. RESULTS: The average age (±SD) of the participants was 34.9 (±8.7) years old. After one month, the impact of headache on daily livings performance, significantly reduced in intervention group (mean=51.2) versus the placebo (mean=57.0), (p<0.001). There was a significant reduction in disability in intervention group (mean=22.9) compared to the placebo (mean=27.4) (p<0.001) and the severity score showed significant reductions in intervention group (mean=3.5) versus the placebo group (mean=5.1) (p<0.001). CONCLUSION: The present trial showed that valerian capsule could reduce the headache impact on daily livings performance, disability and severity of tension-type headache.

Effect of Onopordon acanthium L. as Add on Antihypertensive Therapy in Patients with Primary Hypertension Taking Losartan: a Pilot Study.

Purpose: Onopordon acanthium L. is known for its medicinal properties. Our recent study showed that its seed extract is a novel natura angiotensin-converting-enzyme inhibitor (ACEI). This study was carried out to investigate its possible antihypertensive effects in patients receiving losartan. Methods: This uncontrolled clinical trial was carried out among 20 patients (30-60y) with uncontrolled hypertension despite receiving 50 mg losartan (stage I & II) in two hospitals in Iran. After completing informed consent, patients were treated by 2 capsules [each 1g of Onopordon acanthium seed extract (OSE)] as add-on therapy, two times per day. Results: 18 patients completed the study (50.94 ±8.37y). Mean systolic blood pressure (SBP) at the baseline was 151.9 ± 13.74mmHg and at the end of the study, it was 134.6 ± 18.25 mmHg and mean diastolic blood pressure (DBP) was 97.41 ± 10.36 at the baseline and was 85.71 ± 7.481 after 8 weeks. OSE significantly reduced SBP and DBP at the end of 8 weeks (P=0.003, 95% CI: -19.7, -15.1; P=0.0006, 95% CI: -10.23, -13.15; respectively). No evidence of hepatic or renal toxicity was detected. Conclusion: Based on the results of this study OSE has antihypertensive property with no significant adverse effects. However, because of the low number of samples, this medication may be not safely administered. The results of this study could be the basis for further studies with larger sample size. IRCT registration number: IRCT2013020712391N.