The effect of wet cupping therapy on the clinical symptoms of adult-onset asthma: a randomized clinical trial.

Background/aim: Asthma is an inflammatory disease of the lungs. Cupping therapy is a traditional method used in Persian medicine for treating various ailments. This study aimed to evaluate the anti-asthmatic effects of wet cupping therapy (WCT) in patients with mild to moderate asthma. Materials and methods: This is a randomized clinical trial conducted on 103 asthma patients who were referred to Loghman Hakim Hospital, Tehran, Iran. The diagnosis of the disease was confirmed by a pulmonologist based on the patient's history and clinical examinations. The patients who were treated with common asthma medications were assigned to intervention and control groups. The intervention group underwent one session of WCT in the region between two shoulders on one of the 17th, 19th, and 21st days of the lunar month. The clinical signs of all patients were gathered based on the asthma control test questionnaire before the intervention and in the first, second, fourth, sixth, and eighth weeks after the intervention. The scores of the five questionnaire items and the mean total treatment score (MTTS) were compared between the two groups. Additionally, the satisfaction scores of the participants in the two groups were compared. Results: Of 103 patients, 82 patients completed the study. The mean total treatment score (MTTS) was not significantly different between the control and intervention groups at the beginning of the study (p = 0.06). In the intervention group, the MTTS was 11.44 before WCT, while it was significantly increased (24.24) eighth week after the intervention (p < 0.001). However, the MTTS in the intervention group was significantly higher than the control group in the first week (p <0.001). In addition, at the end of the trial, the subjects' satisfaction scores in the WCT and control groups were 7.48 and 4.53, respectively (p < 0.001). Conclusion: Wet cupping therapy can be an efficient therapeutic method to ameliorate respiratory complications of asthma patients.

Knowledge, attitude, and practice of Iranian adults toward Persian Medicine: a national survey.

BACKGROUND: Previous researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time. METHODS: A total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants' residences. RESULTS: Approximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded "I don't know" to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime. CONCLUSION: This study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice).

Fractional Exhalation Nitric Oxide (FeNO) changes in cystic fibrosis patients induced by compound honey syrup: a pretest-posttest clinical trial.

OBJECTIVE: To evaluate the effect of Persian medicine Syrup 'compound honey syrup (CHS)' on fractional exhalation nitric oxide (FENO) changes in patients with cystic fibrosis (CF). STUDY DESIGN: We conducted a before-after clinical trial on 70 CF patients. All patients received classical treatments for CF along with CHS (including honey, Ginger, cinnamon, saffron, cardamom and galangal), 5-10 cc (depending on the age and weight of patients) in 100 cc of warm boiled water twice a day, 30 min after meals. In this clinical trial, before and 12 weeks after the start of the CHS, FeNO test was evaluated. RESULTS: From 70 patients were enrolled, 44 patients completed this 12-week course of treatment. At the end of the study, changes in FeNO was significantly different before and after treatment (P-value < 0.05). At the end of the study, no dangerous side effects of CHS was reported. CONCLUSIONS: This study revealed that CHS can be effective as a complementary and safe drug in the medication of CF patients.

Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I).

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

Effects of a polyherbal formulation on inflammation and histopathological alterations in mice with ovalbumin-induced allergic asthma.

Objective: Allergic asthma is a complex inflammatory disorder that affects the airways. As an ancient medical system, Iranian Traditional Medicine (ITM) recommends a polyherbal formula called "Monzej-e-balgham" for the treatment of asthma. In the present investigation, the antiasthmatic effects of "Monzej-e-balgham" were examined in a murine model of allergic asthma. Materials and Methods: Twenty-eight Balb/c mice weighing 15-20 g were allocated into 4 groups. As negative and positive controls, groups I and II received phosphate-buffered saline (PBS) and ovalbumin (OVA) solutions, respectively. Groups III and IV were first sensitized with OVA and then respectively treated with "Monzej-e-balgham" (63 mg/kg) and budesonide. Finally, bronchoalveolar lavage fluid (BALF) and lung tissues of the animals were collected and used for eosinophil counting, Th2 type interleukins (IL-5, IL-13, and IL-33) measurement, and histological examinations. Results: "Monzej-e-balgham" significantly reduced the number of eosinophils and the levels of IL-5, IL-13, and IL-33 in BALF specimens compared to OVA-sensitized group (p<0.05). It also ameliorated histopathological changes of the lung tissues such as goblet cells hyperplasia and mucus overproduction in comparison to group II. Interestingly, the results of the "Monzej-e-balgham"-treated group were comparable with those obtained for budesonide-inhaled mice. Conclusion: The present data indicated a mechanism that involves Th2 inflammatory responses in allergic asthma and suggested a polyherbal mixture for the treatment of this disease.

Effect of Herbal Medicine Formulation (Compound Honey Syrup) on Quality of Life in Patients With COPD: A Randomized Clinical Trial.

Background: Chronic obstructive pulmonary disease (COPD) as one of the health-threatening problems imposes many economic costs on health systems. Today, there is a greater tendency to use complementary and alternative therapies in the treatment of diseases. This study aimed to evaluate the efficacy of a Persian herbal formulation in patients with COPD. Materials and Methods: This randomized clinical trial was conducted on 76 patients with mild-severe COPD assigned to 2 groups (in each group n=38) for 8 weeks. The interventional group received Compound Honey Syrup (CHS), consisting of combination of honey and extracts of five medicinal plants (i.e., ginger, cinnamon, saffron, cardamom, and galangal) and the control group received a placebo. The COPD Assessment Test (CAT), St George's Respiratory Questionnaire (SGRQ), and lung function test were used before and after. Results: Seventy-six patients, 88.6% male and 55.7% under 60 years of age, completed the course of treatment. At the end of the study, the overall score of the CAT questionnaire was significantly different between the first and fourth week (P=0.029). Meanwhile the findings of SGRQ questionnaire were significantly different between the interventional and control groups at other times (P=0.001). FEV1 and FEV1/FVC were found to be significantly different between two groups in weeks 4 and 8 (P <0.05). At the end of the study, no side effects of CHS were reported. Conclusion: Based on the data presented herein, CHS could be effective as a complementary and safe drug in increasing the quality of life of with COPD.

The Most Competent Plant-Derived Natural Products for Targeting Apoptosis in Cancer Therapy.

Cancer is a challenging problem for the global health community, and its increasing burden necessitates seeking novel and alternative therapies. Most cancers share six basic characteristics known as "cancer hallmarks", including uncontrolled proliferation, refractoriness to proliferation blockers, escaping apoptosis, unlimited proliferation, enhanced angiogenesis, and metastatic spread. Apoptosis, as one of the best-known programmed cell death processes, is generally promoted through two signaling pathways, including the intrinsic and extrinsic cascades. These pathways comprise several components that their alterations can render an apoptosis-resistance phenotype to the cell. Therefore, targeting more than one molecule in apoptotic pathways can be a novel and efficient approach for both identifying new anticancer therapeutics and preventing resistance to therapy. The main purpose of this review is to summarize data showing that various plant extracts and plant-derived molecules can activate both intrinsic and extrinsic apoptosis pathways in human cancer cells, making them attractive candidates in cancer treatment.

Comparison of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade-I spondylolisthesis patients: A double-blind randomized controlled trial.

OBJECTIVES: The effects of different physiotherapy protocols on patients suffering from grade-I spondylolisthesis have been thus far examined in a limited number of clinical trials. Therefore, the main purpose of this study was to compare the effects of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade-I spondylolisthesis patients. METHODS: This study was a double-blind randomized controlled trial (RCT) with a test-retest design and parallel groups. A total of 26 patients with grade-I spondylolisthesis were thus randomly assigned to experimental group (13 patients, lumbar segmental stabilization exercises) and control group (13 patients, general exercises). Subsequently, pain, functional disability, kinesiophobia, translational motion, angular motion and slip percentage of the vertebra were investigated. RESULTS: Of the 120 people recruited in this study, only 26 patients were eligible. According to pre/post-intervention comparison, a statistically significant decrease was observed in the experimental group in terms of pain (p = 0.000), functional disability (p = 0.004), kinesiophobia (p = 0.002), translational motion (p = 0.043) and angular motion (p = 0.011), but not for slip percentage (p = 0.122). Considering the control group, a statistically significant decline was reported for pain (p = 0.043) and functional disability (p = 0.002). However, no significant differences were found for other variables in the control group. With regard to inter-group comparison, there was no statistically significant difference between the two groups regarding the given variables except for kinesiophobia (p = 0.040). CONCLUSION: Both lumbar segmental stabilization and general exercises led to reduction in pain and functional disability of patients with grade-I spondylolisthesis. Therefore, lumbar segmental stabilization exercises seemed to be better than general ones with reference to improving kinesiophobia and intervertebral movements.

A Historical Review of Persian Medicine Studies into Saliva Manifestations for Potential Applications for Diagnosis and Management of Metabolic Syndrome.

BACKGROUND AND OBJECTIVES: Regarding the development of diagnostic tests based on saliva and the prevalence of metabolic syndrome (MetS), the aim of this study is to review Persian Medicine manuscripts in the field of saliva manifestations, its relation to metabolic syndrome, and treatment recommendations. METHODS: This study is a mini-review. We investigated the canon of medicine and some important Persian medical or pharmaceutical manuscripts from the 9th to the 19th centuries. PubMed and Google Scholar databases were explored for finding relevant information about the relationship between saliva and metabolic syndrome and its treatment. RESULTS: Studies have suggested that maldigestion is one of the important causes of MetS. Sialorrhea may be an early symptom of maldigestion. Attention to sialorrhea and its treatment may be useful in the prevention and treatment of metabolic syndrome based on PM sources. In PM, sialorrhea is treated with 3 major approaches: lifestyle modification along with simple or compound medicines. CONCLUSION: Saliva manifestations could be considered as early symptoms of metabolic syndrome. As mentioned in WHO strategies, traditional medicine can be used along with modern medicine due to its effectiveness in the management of various ailments.

The Effect of a Chickpea-Based Persian Diet on Cancer-Related Fatigue in Breast Cancer Patients: A Semi-Experimental Study.

BACKGROUND: Cancer-related fatigue (CRF) is one of the most common symptoms associated with cancer or its treatment. OBJECTIVES: The aim of the current study was to evaluate the effect of chickpea-based diet (Nokhodab) on CRF in female breast cancer patients undertaking routine treatment. METHOD: Forty female patients with diagnosis of breast cancer were enrolled. The patients were asked to use a chickpea-based Persian diet daily for the period of 3 weeks. Symptom assessment was made for all women by the Cancer Fatigue Scale (CFS) and the Fatigue Severity Scale (FSS) questionnaires and Visual Analogue Scale (VAS). RESULTS: CRF decreased significantly at the end of the study, compared to the beginning (p < 0.05). Mean of CFS was 40.72 before the intervention, while showing a significant decrease to 33.38 at the end of our study (p = 0.001). A comparison of FSS and VAS before and after intervention shows that FSS and fatigue VAS mean scores have a significant decline at the end (p < 0.001). CONCLUSIONS: Nokhodab, as an available diet, could be a good choice for relieving CRF in breast cancer women. Traditional/complementary medicine may present some effective therapeutic suggestions for cancer complications.

Traditional and modern aspects of hemorrhoid treatment in Iran: a review.

Hemorrhoidal disease is a prevalent anorectal condition which is generally not managed well with current pharmacologic interventions. However, in Iranian traditional medicine (ITM) there are numerous plants with hemorrhoid-healing properties. The present research assembled plants with hemorrhoid-healing properties in ITM; their related pharmacological effects, phytochemical constituents and mechanisms of action in the modern medicine were also gathered. For this purpose, leading ITM textbooks were searched for plants with hemorrhoid-healing effects. Further, in vitro, in vivo and clinical studies on the most cited species were considered using scientific databases. Studying ITM textbooks revealed 37 medicinal plants with hemorrhoid-healing effects. Among the mentioned herbal medicines, six species, including Allium ampeloprasum, Phyllanthus emblica, Aloe vera, Terminalia chebula, Vitis vinifera and Commiphora mukul, had the largest number of related pharmacological effects documented in scientific databases. These herbs from ITM should be considered as important resources for producing novel drugs for hemorrhoid treatment.

Formulation of an aloe-based product according to Iranian traditional medicine and development of its analysis method.

BACKGROUND: Currently, people are more interested to traditional medicine. The traditional formulations should be converted to modern drug delivery systems to be more acceptable for the patients. In the present investigation, a poly herbal medicine "Ayarij-e-Faiqra" (AF) based on Iranian traditional medicine (ITM) has been formulated and its quality control parameters have been developed. METHODS: The main ingredients of AF including barks of Cinnamomum zeylanicum Blume and Cinnamomum cassia J. Presl, the rhizomes of Nardostachys jatamansi DC., the fruits of Piper cubeba L.f., the flowers of Rosa damascena Herrm., the oleo gum resin of Pistacia terebinthus L. and Aloe spp. dried juice were powdered and used for preparing seven tablet formulations of the herbal mixture. Flowability of the different formulated powders was examined and the best formulations were selected (F6&F7). The tablets were prepared from the selected formulations compared according to the physical characteristics and finally, F7 was selected and coated. Physicochemical characters of core and coated AF tablets were determined and the HPLC method for quantitation of aloin as a marker of tablets was selected and verified according to selectivity, linearity, precision, recovery, LOD and LOQ. RESULTS: The results showed that core and coated AF tablets were in agreement with USP requirements for herbal drugs. They had acceptable appearance, disintegration time, friability, hardness, dissolution behavior, weight variation and content uniformity. The amount of aloin in tablets was found 123.1 mg/tab. The HPLC method for aloin determination in AF tablets was verified according to selectivity, linearity (5-500 µg/ml, r2:0.9999), precision (RSD: 1.62%), recovery (108.0%), LOD & LOQ (0.0053 & 0.0161 µg/ml). CONCLUSIONS: The formulated tablets could be a good substitute for powder and capsules of AF in ITM clinics with a feasible and precise method for its quality control. Ayarij-e-Faiqra formulation.

Efficacy of a traditional Persian medicine preparation for radiation-induced xerostomia: a randomized, open-label, active-controlled trial.

BACKGROUND: Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced xerostomia. OBJECTIVE: Synthesizing the traditional use of Alcea digitata and Malva sylvestris with their known beneficial effects from recent studies, we evaluated the efficacy of the herbs in the quality of life (QOL) of HNC patients with radiation-induced xerostomia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study is a randomized, double-arm, open-label active-controlled clinical trial. We evaluated the effect of A. digitata and M. sylvestris on QOL of HNC patients with radiation-induced xerostomia compared with Hypozalix (artificial saliva). Patients were enrolled from the Imam Hossein Hospital's oncology clinic in Shahid Beheshti University of Medical Sciences, Tehran, Iran. MAIN OUTCOME MEASURES: Primary outcome measures in this trial were changes in patients' QOL assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N 35). RESULTS: Between-group analysis showed that the intervention group patients obtained significantly lower (better) total EORTC QLQ-H&N 35 scores as compared to the control group at the end of the intervention period (P = 0.007). Mean scores of dry mouth of EORTC QLQ-H&N 35 was also significantly lower (better) in the intervention group as compared to the control group (P = 0.017). CONCLUSION: Traditional Persian medicine preparation of hollyhocks and common mallow should be considered as a suitable treatment for xerostomia and improving QOL in HNC patients with radiation-induced xerostomia. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov with Identifier: NCT02854358.

Effect of Descurainia sophia (L.) Webb ex Prantl on Adult Functional Constipation: A Prospective Pilot Study.

Chronic constipation is a common gastrointestinal disorder that effects an estimated 12% to 30% of general population worldwide. Descurainia sophia L. known commonly as flixweed acts as first-line medical treatment for constipation in Iranian traditional medicine. The aim of this study was to assess the efficacy and safety of this remedy for treating functional constipation by standard assessments. The Rome III criteria for functional constipation were the basis for diagnosis. All participants underwent a 4-week treatment. The primary end point was the proportion of patients achieving ≥3 complete spontaneous bowel movements per week. Secondary outcome measures included Patient Assessment of Constipation-Symptom items, Bristol Stool Form Scale, numbers of laxatives/week used by patients, and reported adverse effects. Thirty-five patients completed the program with no important adverse effect. Fifty-four (4%) patients had ≥3 complete spontaneous bowel movements per week. Descurainia sophia is safe and effective in the treatment of chronic functional constipation.

Effect of an orally formulated processed black cumin, from Iranian traditional medicine pharmacopoeia, in relieving symptoms of knee osteoarthritis: A prospective, randomized, double-blind and placebo-controlled clinical trial.

AIM: Osteoarthritis is a global health problem, especially for the elderly. A good replacement for non-surgical treatments is the use of traditional medicines. We selected a revere plant (Nigella sativa L.), a widely utilized medicinal herb for the treatment of inflammatory conditions, from the Iranian traditional medicine (ITM) pharmacopoeia with proven anti-inflammatory and analgesic actions. METHODS: We performed a prospective, randomized, double-blind, and placebo-controlled clinical trial, in order to investigate whether the herb is useful in alleviating the symptoms of knee osteoarthritis. American College of Rheumatology clinical criteria were the basis of diagnosis, while the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was considered as the main outcome measure. One hundred and ten eligible patients were assigned to receive a placebo or an active intervention (2 g/day of processed N. sativa seed powder in divided doses). Acetaminophen tablets were the rescue medicine. Finally, 40 patients in the placebo group and 37 patients in the active group completed the trial and were included in the statistical analysis. RESULTS: Both cohorts demonstrated statistically significant within-group differences (P < 0.05) in some subscales that were more prominent in the active group without any considerable adverse effects. Nevertheless, KOOS score results and the mean number of acetaminophen tablets used by patients showed no statistically significant between-group differences. CONCLUSIONS: It can be concluded that future programmed studies with larger sample sizes, longer follow-up periods, and other forms of N. sativa seeds as an active intervention is necessary to evaluate its efficacy in relieving the symptoms of knee osteoarthritis.

Effect of Apium graveolens and Trachyspermum copticom on clinical symptoms of patients with functional dyspepsia.

OBJECTIVES: This study aimed at investigating the effect of Iranian traditional remedy prepared from Apium graveolens and Trachyspermum copticom (AT) on the severity and frequency of symptoms in patients with functional dyspepsia (FD). MATERIAL AND METHODS: In total, 150 FD patients were included in this randomized double-blind trial, based on the ROME III diagnostic criteria, and they were divided into three intervention groups namely, AT, Placebo and omeprazole. Then, severity and frequency of symptoms during this eight-week trial were measured. Obtained information was analyzed using Chi-square test and repeated measures test. RESULT: In general, the severity and frequency of symptoms after the 4th week significantly decreased in the AT group as compared to the omeprazole and placebo groups, and continued to reduce by the end of the eighth week. General reduction of symptom severity and frequency in the omeprazole group was significantly different from the placebo group by the end of the 4th and 8th weeks. With respect to each individual symptom, AT markedly improved symptoms, such as burning, pain, early satiation, fullness, bloating, belching and nausea, as compared to placebo-treated group. Moreover, AT significantly improved symptoms, like vomiting, and nausea, except for pain, as compared to omeprazole-treated subjects. CONCLUSION: According to the results, AT, as Iranian traditional remedy, was more effective than omeprazole and placebo in reducing the symptoms in FD patients.

Treatment of Atopic Dermatitis From the Perspective of Traditional Persian Medicine: Presentation of a Novel Therapeutic Approach.

There is a strong current trend for using complementary and alternative medications to treat atopic dermatitis. Atopic dermatitis is a common, chronic, pruritic, and inflammatory skin disease. It can have a profound, negative effect on patients' quality of life. Mild cases of atopic dermatitis can be controlled by the application of moisturizers and topical corticosteroids. However, in severe cases, application of immunosuppressive medication is unavoidable but it can have adverse effects. In traditional Persian medicine, diseases similar to resistant atopic dermatitis are treated with whey in combination with decoction of field dodder. Both whey and field dodder have anti-inflammatory properties. Consumption of whey can also aid skin repair, mitigate pruritus, and help combat the high level of stress experienced by patients. Therefore, it is hypothesized that consumption of traditional medicinal treatment of whey with decoction of field dodder can be applied as a complementary treatment for atopic dermatitis.

Effect of diet based on the principles of Iranian traditional medicine on cirrhosis (a clinical trial).

OBJECTIVES: Cirrhosis is associated with morbidity and mortality worldwide. Iranian traditional medicine (ITM) focused on nutritional intervention in order to improve liver function. The aim of this study was to assess the effectiveness of a diet designed based on ITM and current dietary recommendations. DESIGN: This controlled trial study was performed on 57 subjects with cirrhosis in 5 tertiary hospitals in Teharn, Iran. SETTING: Subjects were included if they were diagnosed with class A or B cirrhosis between October 2013 and December 2014. INTERVENTIONS: Subjects were randomly allocated into intervention (28 subjects) who received dietary and lifestyle recommendations based on ITM and controls (29 subjects) who received routine dietary and lifestyle recommendations for 3 months. Subjects were assessed at baseline and at the end of the intervention for anthropometric measures, liver function tests and cirrhosis severity scoring. MAIN OUTCOME MEASURES: Model for End-Stage Liver Disease (MELD), anthropometric measures, serum albumin, liver function tests, International Normalized Ratio and alkaline phosphatase as well as subjective findings. RESULTS: Mean age of the subjects was 51.19±11.88years. Weight reduction was observed in 41 subjects (22 subjects in intervention and 19 in control group). Dietary intervention resulted in a significant decrease in alanine aminotransferase (AST) (p=0.04) and significant resolution of icterus in sclera (p=0.02) in weight loss group and increase serum albumin in weight gain group (p=0.02). CONCLUSIONS: ITM recommendations could be beneficial for cirrhotic patients both for the purpose of weight reduction and weight gain.

Medical Mucilage Used in Traditional Persian Medicine Practice.

BACKGROUND: Mucilage compounds are pharmaceutically important polysaccharides that have an extensive range of applications, including binding agents, thickeners, water retention agents, emulsion stabilizers, suspending agents, disintegrates, film formers, and gelling agents. A historical approach to medical science written by Iranian scholars could help in identifying excellent ideas and provide valuable information in this field for proper application. The aim of the current study was to introduce some mucilage uses derived from traditional Persian medicine (TPM). METHODS: In this literature review, we assessed a few main traditional manuscripts of Iranian medicine, including the books Al Havi, Canon of Medicine, Qarabadine-kabir, Zakhireh-ye Khwarazm shahi, Tuhfat ul-Momineen and Makhzan-ul-Adwiah. The word "loab" in the aforementioned books were searched and all data about mucilage compounds were collected. RESULTS: The use of medicinal plants containing mucilage in Iran dates back to ancient times. In traditional Persian manuscripts, mucilage is one of the most cited applications of medicinal plants for therapeutic objectives. There are various mucilage-producing plants in TPM such as Malva silvestris, Linum usitissimum, Althaea officinalis, Plantago psyllium, Descureania sophia and Ziziphus vulgaris. They have been used traditionally via oral or topical routes for respiratory, gastrointestinal, urinary, musculoskeletal, and genital systems as well as skin disorders. Certain applications are unique and promising for today's chronic ailments. CONCLUSION: A scientific assessment of these valuable manuscripts would provide a better insight into the thoughts of the past sages and applicable for clinical use of the mucilage compounds. This may lead to research opportunities in the future.

Perception of Alzheimer Disease in Iranian Traditional Medicine.

CONTEXT: Alzheimer disease (AD) is the most common cause of dementia. In regards to the world's aging population, control and treatment of AD will be one of the major concerns of global public health in the next century. Alzheimer disease was not mentioned with the same phrase or its equivalent in traditional medical texts. The main of present paper was to investigate symptoms and causes of alzheimer disease from the view point of Iranian traditional medicine. EVIDENCE ACQUISITION: In this qualitative study, we searched reliable sources of Iranian traditional medicine such as Canon of Medicide by Avicenna (Al-Quanon fi- tibb), Aghili cure by Aghili's (Molajat-E-aghili), Tib-E-Akbari, Exire -E-Aazam and Sharh-E-Asbab and some reliable resources of neurology were probed base on keywords to find a disease that had the most overlap in terms of symptoms with alzheimer disease. By taking from the relevant materials, the extracted texts were compared and analyzed. RESULTS: Findings showed that alzheimer disease has the most overlap with Nesyan (fisad-e-zekr, fisad-e-fekr and fisad-e-takhayol) symptoms in Iranian traditional medicine. Although this is not a perfect overlap and there are causes, including coldness and dryness of the brain or coldness and wetness that could also lead to alzheimer disease according to Iranian traditional medicine. CONCLUSIONS: According to Iranian traditional medicine, The brain dystemperement is considered the main causes of alzheimer disease. By correcting the brain dystemperement, alzheimer can be well managed. This study helps to suggest a better strategy for preventing and treating alzheimer in the future.