Herbal Treatment of COPD and Asthma According to Persian Medicine: a Review of Current Evidence.

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases. The current therapeutic outcomes are not satisfactory and may cause adverse events such as cardiovascular complications. In this study, we aimed to discuss some effective medicinal herbs for the management of COPD. Materials and Methods: In this review, we looked for effective medicinal herbs for productive cough with thick and sticky mucus in Persian medicine sources such as Qanoon fi al-Teb, Exir Azam, and Zakhire Kharazmshahi. Then, to find relevant evidence about them, the data sources (PubMed and Google Scholar) were searched in the English language without time restriction from inception up to March 2022. Results: We found that Zataria multiflora, Thymus vulgaris L, Glycyrrhiza glabra L., Crocus sativus L., Nepeta bracteata Benth., and Hyssopus officinalis have beneficial effects on COPD due to their properties including anti-inflammatory and antioxidant activity. In addition, considering asthma COPD overlap (ACO), medicinal herbs including Cordia myxa, Adiantum capillus-veneris, Cinnamomum verum, Viola odorata, Borago officinalis, Linum usitatissimum and Vitis viniferia L. were found to have useful effects on asthma. Conclusion: Considering the mentioned beneficial mechanisms of action of these medicinal herbs, they could be used as a complementary therapy in COPD and asthma. However, more experimental and clinical research should be done to confirm their clinical effects.

Clinical Efficacy of Persian Medicine Diet Combined with Western Medicine-Based Diet on Proteinuria in Pediatric Nephrotic Syndrome: A Randomized Controlled Clinical Trial.

Introduction: Nephrotic syndrome (NS) is a common chronic kidney disorder during childhood. The most important characteristic of this disease is proteinuria. The Persian medicine (PM) has important dietary recommendations for strengthening the kidney function and treatment of this disease. The aim of this study was to investigate the effect of a diet including PM recommendations and general principles of Western medicine. Materials and Methods: Twenty children with nephrotic syndrome were randomly divided into intervention and control groups and monitored for one month. The control group received a diet based on the general principles of Western medicine. In the intervention group, in addition to the Western medicine diet, dietary recommendations of PM were also prescribed including the pomegranate (Cydonia oblonga mill.), quince (Cydonia oblonga mill.), and whole grains (wheat and barley). A 24-hour dietary questionnaire was applied and anthropometric and biochemical indices including spot urine protein (proteinuria), albumin (Alb), urea, creatinine (Cr), total cholesterol (TC), and triglyceride (TG) were measured before and after the study. Results: The amount of protein intake reduced significantly in the diet of both groups but the differences between the two groups were not significant. Proteinuria reduced significantly in both the Western and PM groups; however, proteinuria was significantly lower in the Persian medicine group compared to the control group. TC and Cr levels reduced significantly in the intervention group, although the changes were not significant compared to the control group. Conclusion: The results of this study showed that adding dietary recommendations of the Persian medicine to the general rules of the Western medicine diet reduced proteinuria and improved the combat against nephrotic syndrome.

Efficacy of the barley-based remedy, a Persian medicine formula, in coronavirus disease 2019 (COVID-19) hospitalized patients: An open-labeled randomized controlled trial.

Background: With the pandemic of coronavirus disease 2019 (COVID-19), and the growing attention of people around the world to the use of traditional and complementary medicines to control of the disease, evaluating the effectiveness of these treatments has received special attention. Aim: This study aimed to assess the clinical efficacy of a barley-based (Hordeum vulgare) remedy combined with conventional medicine in comparison to the conventional therapy in confirmed COVID-19 patients. Materials and methods: Seventy COVID-19 patients were randomly divided into barley-based remedy plus conventional medicine (barley-based remedy group) and conventional therapy (control group). Both groups were treated for 5 days. The outcomes were oxygen saturation, main symptoms (fever, respiratory rate, cough, and fatigue), and laboratory data (lymphocytic count, and CRP); they were measured for 6 days. Results: In comparison to the control group, the oxygen saturation level in the barley-based remedy group significantly increased, from the second day of the intervention (P < 0.05). The herbal remedy significantly improved fatigue from the third day (P < 0.05). Meanwhile, the severity and frequency of cough between the groups were not significantly different. The herbal remedy had no significant effect on the CRP and the lymphocytic count of every time points of measurement. The average of respiratory rate and temperature of patients were in the normal range in both groups during the intervention. Conclusion: Barley-based remedy could significantly enhance the blood oxygen saturation and reduce fatigue. However, it needs to be confirmed by large sample size trials.

Effect of Ustukhuddus Alavi, a multi-herbal product, on the cognitive performance of adolescent female students.

ETHNOPHARMACOLOGICAL RELEVANCE: Ustukhuddus Alavi is a polyherbal formula which is introduced by Persian medicine scholars. It is traditionally used to treat brain disorders and is claimed to do so by preprocessing and cleansing the waste products from the brain. According to Persian medicine, the disposal of brain waste products is necessary for optimal cognitive performance. AIM OF THE STUDY: Sustaining optimal cognitive performance is crucial for ideal quality of life and higher academic achievements in high school students. The objective of this study was to determine the effects of this multi-component herbal product on the cognitive performance and salivary cortisol levels of adolescent female students. MATERIALS AND METHODS: The effect of a 6-week randomly assigned Ustukhuddus Alavi versus placebo administration on cognitive performance was assessed by the paced auditory serial addition test (PASAT) at the baseline and after the 3- and 6-week intake of Ustukhuddus Alavi or placebo and the one-month follow-up in 86 healthy female high school students in grades 10 and 11. Additionally, we measured the levels of salivary cortisol of the students pre- and post-intervention. RESULTS: Significant mean difference between the Ustukhuddus Alavi and placebo groups in three of the paced auditory serial addition test (PASAT) subscales, namely mental health (p-value = 0.006), sustained attention (p-value = 0.001) and mental fatigue (p-value = 0.001), were observed after six weeks. We also found a significant difference between the mean salivary cortisol level of the two groups after the intervention (p-value = 0.047). CONCLUSIONS: These findings reveal that the intake of the multi-ingredient herbal product Ustukhuddus Alavi for six weeks can be helpful for cognitive function and cortisol levels in female high school students. These positive effects seem to be related to the increase in sustained attention and the decrease in mental fatigue.

The effect of family-centered empowerment program on the family caregiver burden and the activities of daily living of Iranian patients with stroke: a randomized controlled trial study.

Dependence of stroke survivors regarding the ability to perform activities of daily living imposes a burden on family caregivers. The study evaluated the effect of the family-centered empowerment program on the ability of Iranian patients with stroke to perform activities of daily living, as well as on family caregiver burden. In this randomized controlled trial study, a total of 90 pairs of patients with stroke and their family caregivers was selected and randomly assigned to the intervention or control groups. Patients and their family caregivers participated in four family-centered empowerment program sessions over four consecutive days while the patient was hospitalized. The difference in the ability of patients with stroke in the intervention and control groups to perform activities of daily living was not significant 2 weeks after the intervention. However, the ability of patients with stroke in the intervention group to perform activities of daily living increased significantly 2 months after the intervention compared with the control group: 66 ± 35.95 and 51.31 ± 36.28, respectively (p = 0.047). Two weeks after the intervention, the family caregiver burden significantly decreased in the intervention group (29.55 ± 15.38) compared with the control group (38.77 ± 18.53 and p = 0.012). The burden in the intervention group also decreased 2 months after the intervention compared with the control group: 22.95 ± 15.68 and 36.11 ± 18.88, respectively (p < 0.001). Nurses can use the family-centered empowerment program to improve the quality of life of patients with stroke, and to reduce the burden of family caregivers.

Estimating the Cutoff Points of Time-Dependent Risk Factors by Using Joint Modeling of Longitudinal and Time-to-Event Data: A 14-Year Follow-up Study-Tehran Lipid and Glucose Study.

Diagnostic accuracy and optimal cutoff points of risk factors is one of the important issues in medical decisions. In order to reassess the cutoff points of markers, longitudinal and time-to-event data of elderly individuals were collected repeatedly through 3 follow-up stages in the Tehran Lipid and Glucose Study. Time-dependent area under the ROC (receiver operating characteristic) curves (AUCs) based on the joint modeling of longitudinal and time-to-event data technique were measured. AUCs were considered to evaluate the discriminative potential of the models. The joint model produced higher AUC values than the Cox model; therefore, accuracy was improved although it is computationally complicated. The results had some differences with the thresholds reported in guidelines due to specificity to the population and/or the means of estimation methods. The estimated cutoff points with regard to sex can be used as a guideline for the Iranian elderly population.

Prediction of Brain Connectivity Map in Resting-State fMRI Data Using Shrinkage Estimator.

INTRODUCTION: In recent years, brain functional connectivity studies are extended using the advanced statistical methods. Functional connectivity is identified by synchronous activation in a spatially distinct region of the brain in resting-state functional Magnetic Resonance Imaging (MRI) data. For this purpose there are several methods such as seed-based correlation analysis based on temporal correlation between different Regions of Interests (ROIs) or between brain's voxels of prior seed. METHODS: In the current study, test-retest Resting State functional MRI (rs-fMRI) data of 21 healthy subjects were analyzed to predict second replication connectivity map using first replication data. A potential estimator is "raw estimator" that uses the first replication data from each subject to predict the second replication connectivity map of the same subject. The second estimator, "mean estimator" uses the average of all sample subjects' connectivity to estimate the correlation map. Shrinkage estimator is made by shrinking raw estimator towards the average connectivity map of all subjects' first replicate. Prediction performance of the second replication correlation map is evaluated by Mean Squared Error (MSE) criteria. RESULTS: By the employment of seed-based correlation analysis and choosing precentral gyrus as the ROI over 21 subjects in the study, on average MSE for raw, mean and shrinkage estimator were 0.2169, 0.1118, and 0.1103, respectively. Also, percent reduction of MSE for shrinkage and mean estimator in comparison with raw estimator is 49.14 and 48.45, respectively. CONCLUSION: Shrinkage approach has the positive effect on the prediction of functional connectivity. When data has a large between session variability, prediction of connectivity map can be improved by shrinking towards population mean.

Effect of health-belief-model-based training on performance of women in breast self-examination.

BACKGROUND: Breast cancer is the most common cause of cancer death among women in the world. With prevention and examinations, including breast self-examination, the death rate will be reduced. OBJECTIVE: The purpose of this study was to determine the effect of health-belief-model-based training on the performance of women in breast self-examination in the province of Fars (Iran). METHODS: An empirical study examined the effect of an eight-week training program based on the health belief model among 144 women who visited health care centers in the city of Abadeh in Fars Province (Iran) in 2015. Data gathered through researcher-made questionnaires including awareness, components of the health belief model, performance, and demographic information. IBM-SPSS software version 20, descriptive and inferential statistical tests such as T-test, chi-square, Mann-Whitney, and repeated measurements were used for data analysis. RESULTS: After the intervention, a significant difference was seen in average awareness, perceived susceptibility, and performance of women (p<0.05), while it was not significant in benefits constructs, perceived barriers, and perceived severity and practice guide. After intervention, the average score of awareness was increased significantly (p<0.001). Also, the average score of performance in breast self-examination showed a significant difference (p<0.001). CONCLUSION: Due to the low level of awareness of women about breast self-examination, using a health belief model with an increase of the perceived susceptibility could be effective in improving their performance in breast self-examination.

Effect of Breathing Technique of Blowing on the Extent of Damage to the Perineum at the Moment of Delivery: A Randomized Clinical Trial.

INTRODUCTION: One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women. MATERIALS AND METHODS: This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full-term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group) and valsalva maneuver (control group). In the control group, pushing was done with holding the breath. In the case group, the women were asked to take 2 deep abdominal breaths at the onset of pain, then take another deep breath, and push 4-5 seconds with the open mouth while controlling exhalation. From the crowning stage onward, the women were directed to control their pushing, and do the blowing technique. RESULTS: According to the results, intact perineum was more observed in the case group (P = 0.002). Posterior tears (Grade 1, 2, and 3) was considerably higher in the control group (P = 0.003). Anterior tears (labias) and episiotomy were not significantly different in the two groups. CONCLUSIONS: It was concluded that breathing technique of blowing can be a good alternative to Valsalva maneuver in order to reduce perineal damage in laboring women.

Correlation between health literacy and health-related quality of life in patients with hypertension, in Tehran, Iran, 2015-2016.

BACKGROUND AND OBJECTIVE: Hypertension is considered an important public health problem in developed and developing countries. This disease is closely associated with the quality of life of patients, and it seems that health literacy plays a role in this regard. Due to lack of information on the role of health literacy on the quality of life in patients with hypertension, this study has aimed to determine the correlation between health literacy and health-related quality of life in patients with hypertension. METHODS: This study is cross-sectional. The sample consisted of 400 patients with hypertension who were enrolled if available. To collect data, a demographic questionnaire (SF-36), Short Form Health Survey, and Health Literacy for Iranian Adults (HELIA) Inventory were used. Data were analyzed using SPSS software version 21 for descriptive and inferential statistics (e.g., mean, standard deviation, t-test, and Pearson correlation coefficient). RESULTS: The mean and standard deviation scores of health literacy and health-related quality of life were, respectively, 68.66 (±13.56) and 52.94 (±15.20). There was positive and significant correlation between health literacy and health-related quality of life (p<0.01, r=0.30). CONCLUSION: According to research findings, there was a significant positive correlation between health literacy and health-related quality of life. Given the importance of health literacy in the quality of life in patients with hypertension, it seems essential that nursing officials and policymakers take steps to promote patients' health and quality of life by using training programs appropriate for the patients' health literacy level.

Effect of Acupressure on Cervical Ripening.

BACKGROUND: Cervical ripening is one of the main stages of initiation labor. Acupressure in Chinese medicine is considered as an invasive technique, which through reliving oxytocin ripens the cervix. Acupoint Sanyinjiao (SP6) was selected in this study because it is the acupoint selected in gynecology and it is easy for women to locate and apply pressure without medical assistance. OBJECTIVES: The aim of this study was to determine the effect of acupressure on cervical ripening. PATIENTS AND METHODS: In this randomized clinical trial, 150 primigravida with term pregnancy who had referred to Deziani hospital in Gorgan were chosen and divided to three groups: in the first group acupressure was done by the researcher while in the second groups this was performed by the mother her self, and the third group served as a control and only received routine care. For both intervention groups the pressure was applied on Sp6 for about 20 minutes during one to five days. Elements were checked from cervical ripening at 48 and 96 hours after intervention and at the time of hospitalization. The tools for gathering information included demographic characteristics and midwifery history questionnaire, daily records and follow up forms. Content validity was used for validity of tools. Reliability of the observation check-list and physical examination was confirmed by inter-rater scores (inter observer), and daily records by test-re-test. Data was analyzed by analysis of variance (ANOVA), Kruskal-Wallis and Chi-squared tests (P ≤ 0.05). RESULTS: There was a significant difference between mothers' educations in the three groups. Most of the mothers (59.5%) in the researcher-performed acupressure group had secondary education. Cervical ripening was significantly different between the three groups after 48 hours (P ≤ 0.05), yet there was no significant difference after 96 hours and at the time of admission. Mean Bishop score was enhanced after 48 hours in the researcher-performed acupressure group (P ≤ 0.021) and the self-performed acupressure group (P ≤ 0.007) in comparison to the control group. CONCLUSIONS: The results showed that acupressure is a safe technique and leads to cervical ripening. Thus, regarding the desired results that were achieved when mothers applied acupressure themselves, it could be suggested that it is beneficial for mothers to be trained to apply this method at home.

Assessment of the Relationship between Galectin-3 and Ejection Fraction and Functional Capacity in the Patients with Compensated Systolic Heart Failure.

BACKGROUND: Galectin-3 is a soluble ß-galactoside-binding lectin released by activated cardiac macrophages. Galectin-3 has been proposed for diagnosis and prognosis of HF patients. OBJECTIVES: The present study aimed to investigate the relationship between galectin-3 as a biomarker and ejection fraction and functional capacity in the patients with compensated systolic heart failure. PATIENTS AND METHODS: In this study, serum levels of Galectin-3 were measured in 76 patients with compensated heart failure with New York Heart Association class I-IV and left ventricular ejection fraction < 45%. Galectin-3 was measured by an ELISA kit. Besides, echocardiography was used to evaluate left ventricular ejection fraction. Additionally, functional capacity was determined based on the patients' ability to perform a set of activities. After all, the data were analyzed used t-test, Kruskal-Wallis, one-way ANOVA, and chi-square test. P < 0.05 was considered as statistically significant. RESULTS: The patients' age ranged from 45 to 75 years, with the mean age of 63.85 ± 9 years. In addition 57.9% of the patients were male. The results revealed no significant correlation between Galectin-3 and age, body mass index, and estimated glomerular filtration rate. Also, no significant correlation was observed between Galectin-3 levels and left ventricular ejection fraction (P = 0.166) and functional capacity (P = 0.420). Yet, a significant difference was found between males and females regarding the mean of Galectin-3 (P = 0.039). CONCLUSIONS: The study results suggested that Galectin-3 could not be used as a marker of disease progression in the patients under treatment, which could probably be the result of medication use in these patients.

Iodine nutrition status and knowledge, attitude, and behavior in Tehranian women following 2 decades without public education.

OBJECTIVE: To evaluate the association of iodine nutrition status and knowledge, attitude, and behavior in Tehranian women after 2 decades without updating public education. DESIGN: Cross-sectional study. SETTING: Eight health care centers from 4 district areas of Tehran. PARTICIPANTS: A total of 383 women aged ≥ 19 years, randomly selected. MAIN OUTCOME MEASURES: Iodine concentration of 24-hour urine samples, iodine content of household salts, and knowledge, attitude, and practice scores regarding iodine nutrition and iodized salt. ANALYSIS: Multiple logistic regression was used to identify the association of knowledge, attitude, and practice scores with urinary iodine concentration (UIC) < 100 µg/L. RESULTS: The percentages of Tehranian women with high knowledge, attitude, and practice scores were 26%, 26%, and 14%, respectively. Practice score was significantly different between females with UIC < 100 and > 100 µg/L (P = .001). Risk of UIC < 100 µg/L in women of childbearing age (19-45 years) after adjustment of education level, region of residence, and iodine content of salt was significantly associated with intermediate practice score (odds ratio = 2.6; 95% confidence interval, 1.3-13.2). CONCLUSIONS AND IMPLICATIONS: Marginally suboptimal iodine status in women of childbearing age can be attributed to inappropriate practices, but not to knowledge and attitude.

The new nano-complex, Hep-c, improves the immunogenicity of the hepatitis B vaccine.

Prevention of hepatitis B requires a vaccine that stimulates the humoral and cellular immune responses in a balanced manner, particularly those associated with Th1 and cytotoxic T cells. Alum adjuvant is currently used in the hepatitis B vaccine formulations but it lacks the efficiency of establishing such immune responses. Therefore, for accessing a suitable vaccine to prevent this fatal disease, it is essential to design and construct a new adjuvant which can overcome the limitations of the alum adjuvant and can stimulate a strong Th1 response as used along with it. In the present study, the adjuvant effect of Hep-c, the first nano-complex which was synthesized by nanochelating technology to improve the immunogenicity of the vaccine against hepatitis B, had been evaluated. Female Balb/c mice were divided into 7 groups and were injected with 10µg/ml of the hepatitis B vaccine and different doses of Hep-c for 3 times. Groups merely treated with the vaccine, Hep-c or phosphate buffered solution were used as control. Total specific antibody, IgG1, IgG2a, IgG2b, IgM, interleukin-4 (IL-4) and interferon-gamma (IFN-γ) levels were examined by the ELISA method. The proliferative response of the splenocytes was evaluated using bromodeoxyuridine assay. Results showed that immunization with hepatitis B vaccine and Hep-c increased the lymphocyte proliferation and specific IgM and IgG2a compared to the hepatitis B vaccine immunized group. Also, this nano-complex significantly increased the IFN-γ and IL-4 cytokine levels compared to the hepatitis B vaccine immunized group. Our findings show that Hep-c can not only preserve the alum capacity to effectively stimulate production of the antibodies but also cover its inefficiency in inducing Th1 response and prompting cellular immunity. Thus, by boosting the performance of the hepatitis B vaccine, it seemed that this nano-adjuvant has the suitable potential to be used in the commercial HBS vaccine formulation.

Legume intake is inversely associated with metabolic syndrome in adults.

BACKGROUND: Studies on the association between legume intake and metabolic syndrome (MetS) are sparse. The objective of this study is to evaluate the association between legume intake, MetS, and its components. METHODS: This study was conducted on 80 subjects (48% female) with MetS as cases and 160 age and gender-matched healthy controls. Anthropometric measures, blood pressure, fasting blood glucose, and lipid profiles were evaluated by standard methods. Dietary data were collected using a food frequency questionnaire (FFQ) and legume intake was determined. MetS was defined according to the definition of the Adult Treatment Panel III. RESULTS: The mean (SD) intake of legumes was 1.4 (0.9) servings/week for cases and 2.3 (1.1) servings/week for control subjects (P < 0.05). After adjustment for potential confounders, decreases in mean systolic blood pressure, fasting blood glucose, and increase in HDL cholesterol levels were observed across increasing quartile categories of legume intake. After adjustments for life style and food groups, subjects in the highest quartile of legume intake had lower odds of having MetS compared with those in the lowest quartile [odds ratio (OR): 0.25; 95% CI: 0.11 - 0.64, P < 0.05], an association that weakened after adjustment for body mass index (BMI), but remained significant (OR: 0.28; 95% CI: 0.12 - 0.81, P < 0.05). CONCLUSIONS: Legume intake is inversely associated with the risk of having MetS and some of its components.

Predicting age at menopause from serum antimüllerian hormone concentration.

OBJECTIVE: We aimed to estimate age at menopause using serum antimüllerian hormone (AMH) concentration. METHODS: We randomly selected 266 study participants from a pool of 1,265 eligible women in the Tehran Lipid and Glucose Study cohort. We measured AMH levels three times at about 3-year intervals. There were 63 occurrences of menopause in our participants over an average of 6-year follow-up. We built an accelerated failure time model using serum AMH level at the start of follow-up to estimate age at menopause. The goodness of fit for the model was tested using Cox-Snell residuals and the Bland-Altman plot. RESULTS: We estimated ages at menopause for different levels of serum AMH concentration among women aged 20 to 49 years. For those who reached menopause, serum AMH concentrations about 6 years before the event provided fairly accurate estimates of the age at menopause. The Bland-Altman plot showed an acceptable agreement between predicted and observed values. CONCLUSIONS: Serum AMH concentrations can reasonably forecast the age at menopause for individual women.

Nonparametric estimation of survival function of HIV+ patients with doubly censored data.

In the analysis of follow-up studies of patients who have been or may be infected by the Type-1 human immunodeficiency virus (HIV-1), which causes the acquired immune deficiency syndrome (AIDS), one problem of interest is the estimation of distribution of the survival function when the origin and end points defining the survival time suffer interval censoring. In this paper, we have compared Kaplan-Meier, midpoint estimation and sun (1997), by analysis of a cohort study data of Iranian Injecting Drug Users (IDU) who became HIV infected through the using common infected syringe.