An approach to the milestones of spine surgery in Persian traditional medicine.

BACKGROUND: The diagnosis and treatment of spine disorders have been challenging for thousands of years in different nations and medical schools. Despite this long history, there are many information gaps in this regard. The current research deals with the milestones and progress of spine surgery from ancient times until now, emphasizing the innovations of sages in the Persian traditional medicine era. METHODS: The present study is based on searching original and library documents, data from databases such as PubMed, Scopus, and Science Direct, and search engines such as Google Scholar. RESULTS: In Persian traditional medicine, Rhazes (865-925 AD) was the first sage who applied spine surgery based on the innovative knowledge of Galen (second century AD) and Paulus Aegineta (seventh century AD). Hally Abbas (tenth century AD), by suturing two separated bones during spine surgery, and Albucasis (936-1013 AD), by inventing, describing, and drawing the surgical instruments involved in surgeries in this area, and also using cauterization in the treatment of children's hunchback, were the innovators of new methods. CONCLUSION: The modern knowledge of spine surgery is based on intelligent experiences and prominent thoughts from thousands of years worldwide. However, sometimes, these key points have remained hidden. This issue necessitates investigating this science in different schools and territories for comparative studies, identifying the firsts in the prominent points of this field, preserving the identity of sages and nations, and preventing scientific plagiarism.

Entwined African and Asian genetic roots of medieval peoples of the Swahili coast.

The urban peoples of the Swahili coast traded across eastern Africa and the Indian Ocean and were among the first practitioners of Islam among sub-Saharan people1,2. The extent to which these early interactions between Africans and non-Africans were accompanied by genetic exchange remains unknown. Here we report ancient DNA data for 80 individuals from 6 medieval and early modern (AD 1250-1800) coastal towns and an inland town after AD 1650. More than half of the DNA of many of the individuals from coastal towns originates from primarily female ancestors from Africa, with a large proportion-and occasionally more than half-of the DNA coming from Asian ancestors. The Asian ancestry includes components associated with Persia and India, with 80-90% of the Asian DNA originating from Persian men. Peoples of African and Asian origins began to mix by about AD 1000, coinciding with the large-scale adoption of Islam. Before about AD 1500, the Southwest Asian ancestry was mainly Persian-related, consistent with the narrative of the Kilwa Chronicle, the oldest history told by people of the Swahili coast3. After this time, the sources of DNA became increasingly Arabian, consistent with evidence of growing interactions with southern Arabia4. Subsequent interactions with Asian and African people further changed the ancestry of present-day people of the Swahili coast in relation to the medieval individuals whose DNA we sequenced.

Pertuzumab study in the neoadjuvant setting for HER2-positive nonmetastatic breast cancer in Australia (PeRSIA).

The pertuzumab study in the neoadjuvant setting for HER2+ nonmetastatic breast cancer in Australia (PeRSIA-ML39622) is an analysis of safety and effectiveness data from the pertuzumab patient registry. Although the prognosis of patients with early stage HER2+ breast cancer has been greatly improved by advances in chemotherapy approximately 25% to 30% of patients develop recurrent disease. Our study aimed to examine the effectiveness of neoadjuvant pertuzumab on surgical outcomes, describe the medium-term effectiveness outcomes of patients treated with pertuzumab, and describe the planned and actual anticancer treatment regimens that patients received. Deidentified data were collected from the patients' medical records and entered into REDCap, between March 2018 and July 2019 (n = 95). The adverse events (AEs) reported most frequently were diarrhea (20; 21.1%), rash (4; 4.2%), and LVSD (4; 4.2%; two patients during neoadjuvant treatment and two patients during adjuvant treatment). AEs, ≥Grade 3 were diarrhea (2; 2.1%) and LVSD (1; 1.1%). Following surgery, a breast pathological complete response (bpCR) was achieved in 65 patients (70.7%; 95% CI: 60.2%-79.7%) and total pathological complete response (tpCR) in 59 patients (64.1%; 95% CI: 53.4%-73.9%). All patients who did not achieve a tpCR obtained a partial response (33/92, 35.9%). Our study is the first to capture real-world data on the use of pertuzumab in the neoadjuvant setting in Australia. The effectiveness and safety data are consistent with those reported in clinical trials of pertuzumab in patients with HER2+ breast cancer, with no new safety concerns.

Measurement of Transcription, Translation, and Other Enzymatic Processes During Cell-Free Expression Using PERSIA.

We developed the PERSIA technique with an interest in quantifying proteins as they are being produced during a cell-free synthesis reaction. A short 6-amino acid sequence added to a protein of interest reacts with a fluorogenic reagent (ReAsH), yielding a measure of protein concentration in close to real time. We combine this measurement with simultaneous fluorescent detection of mRNA production, quantifying both transcription and translation. Alternatively, we combine simultaneous measurement of protein synthesis and that protein's enzymatic activity. We have found these simple capabilities enabling for multiple applications, including sequence-structure-function studies and target-specific assessment of drug candidate compounds.

Pulmonary Circulation Discovery Before Ibn Nafis-Ancient Persian and Greek Theories: A Narrative Review.

Importance: The recognition of the pulmonary circulation is a complex evolution in medical history and draws on theories across eras and cultures. Observations: This narrative review summarizes evidence suggesting that the recognition of pulmonary circulation is older than the time of Ibn Nafis. The theory of pulmonary circulation originated in ancient Persia (ad 224-637), was overshadowed by Greek theory from the 11th century, and reestablished by Ibn Nafis in the 13th century. Conclusions and Relevance: The findings of this review may help contextualize the story of the discovery of pulmonary circulation in ancient Persian and Greek theories before Ibn Nafis.

PARADISE OF WISDOM: INDIAN MEDICAL CONCEPTS IN A PERSIAN ISLAMIC MEDICAL TEXT

Antique traditional medical theories created by old medical doctrines and their historical background have been significantly mentioned today by medical historian scholars. Persia and India had many interactions in different perspectives, such as knowledge, religion, and traditions. One of the most considerable aspects of the relationship between Indians and Persians is the transmission of basic theories of their medical doctrines. As it is reported in many historical texts from the first ages of the Islamic era in Iran, a large number of medical texts were gathered from contiguous civilizations in Iran by order of the Abbasid Caliph. They were then translated into Arabic, Syriac, and Persian. So, Persian physicians and authors used them that way. One of the earlier physicians who reflected the viewpoints of Indian medicine in his famous medical textbook entitled "Paradise of Wisdom" is Ali ibn Sahl Rabban al-Tabari (3rd century A.H./9th century A.D.). Persian physicians in the Islamic golden age (8th to 16th A.D.) played an astonishing role in the development of medical knowledge in several aspects through physician innovations and expression and evaluation of different ideas about medicine. In this regard, some of the Indian medical theories were expressed by a famous Persian physician, Ali ibn Sahl Rabban al-Tabari. Ali ibn Sahl Rabban al-Tabari was a Persian physician of the 3rd century A.H./9th century A.D. He wrote the book Firdous al-Hikmah (or Paradise of Wisdom), the first encyclopedia of Islamic medicine in Iran. The book introduces and describes the basics and therapeutic procedures adopted in Indian medicine, along with procedures of Persian and Greek medical doctrines, by discussing the basic medical theories in these three doctrines. In this paper, we discuss the reflection of traditional Indian medicine as described in Firdous al-Hikmah and its influence on later medical texts.

Assessing the Physiological Effects of Traditional Regional Diets Targeting the Prevention of Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials Implementing Mediterranean, New Nordic, Japanese, Atlantic, Persian and Mexican Dietary Interventions.

Traditional regional diets are considered as sustainable dietary patterns, while many have been examined with regard to their health benefits. The aim of the present systematic review was to aggerate all evidence on the physiological effects of regional diets among adults at high risk for cardiovascular disease (CVD). Three databases were searched for randomized controlled trials (RCTs) implementing any regional diet (Mediterranean (MedD), Persian, Southern European Atlantic, Japanese, Chinese, new Nordic, or other) while examining cardiovascular risk factors among adults at increased risk. Primary outcomes included anthropometric indices and secondary outcomes involved blood lipid concentrations, glucose metabolism, inflammation and other markers of CVD progression. Twenty RCTs fulfilled the study's criteria and were included in the qualitative synthesis, with the majority implementing a MedD. Adherence to most of the regional diets induced a reduction in the BW and anthropometric indices of the participants. The majority of RCTs with blood pressure endpoints failed to note a significant reduction in the intervention compared to the comparator arm, with the exception of some new Nordic and MedD ones. Despite the interventions, inflammation markers remained unchanged except for CRP, which was reduced in the intervention groups of one new Nordic, the older Japanese, and the Atlantic diet RCTs. With regard to blood lipids, regional diet interventions either failed to induce significant differences or improved selective blood lipid markers of the participants adhering to the experimental regional diet arms. Finally, in the majority of RCTs glucose metabolism failed to improve. The body of evidence examining the effect of regional dietary patterns on CVD risk among high-risk populations, while employing an RCT design, appears to be limited, with the exception of the MedD. More research is required to advocate for the efficacy of most regional diets with regard to CVD.

Possible Early Examples of Medical Tourism.

Health tourism has hundreds of years of history, most notably in visitors traveling to thermal baths. Medical tourism, a type of health tourism, has rapidly expanded in the last quarter century by patients travelling abroad to health centers for medical treatment. Because of lack of records in ancient times, the history of tourism for actual medical treatment is unknown. In Ottoman archives, medical treatment consent forms of patients were officially documented. We analyzed these existing records to identify foreign citizens who came to the Ottoman Empire for medical treatment. In our screening of Konya Ser'iye registration records, we found medical consent forms for three non-Ottoman foreign citizens. All three patients had the same medical illness and came to Konya for medical treatment. Therefore we emphasized that those patients searched for the name of doctor who was an authority on that illness. This study indicates that medical tourism may have occurred well before the 20th century.

Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes.

BACKGROUND: Diabetic foot self-care refers to a group of self-management behaviors that can reduce the incidence of foot ulcers and amputations. It is necessary to have a valid and reliable standard tool to measure foot self-care in diabetic patients. This study aimed to evaluate the psychometric properties of the Persian version of the Diabetic Foot Self-Care Questionnaire of the University of Malaga, Spain (DFSQ-UMA) in Iran. METHODS: This cross-sectional study was conducted with 407 diabetic patients who were selected using a convenient sampling method. Construct validity was assessed by exploratory (with 207 patients) and confirmatory (with 200 patients) factor analyses. Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients. RESULTS: In the exploratory factor analysis, three factors with eigenvalues of 3.84, 2.41, and 2.26 were extracted that together explained 56.74% of the total variance of diabetic foot self-care. A Cronbach's alpha of 0.865 was found for the total instrument. CONCLUSIONS: The Persian version of the DFSQ-UMA has good validity and reliability, and given its good psychometric properties, it can be used in future studies.

Persian version of the Barkin Index of Maternal Functioning (BIMF): a cross-cultural adaptation and psychometric evaluation.

BACKGROUND: Postpartum maternal functioning has the potential to affect the quality of interaction between mother and child. A proper assessment of maternal functioning requires a comprehensive and accurate tool. The objective of this study was to prepare a Persian version of the Barkin Index of Maternal Functioning (BIMF) and evaluate its psychometric properties in order to determine its applicability in Iranian mothers. METHODS: The BIMF was translated into Persian and then culturally adapted for Iranian women. After evaluating face and content validity, to perform factor analysis, a cross-sectional study was conducted using the Persian version of BIMF. The data was collected from two unique groups of 250 mothers (in all 500 mothers) who had infants 2 to 12-months old and who were selected using a two-stage cluster sampling method. Factor analysis, Pearson's correlation, intra-class correlation coefficients (ICC), composite reliability (CR) and Cronbach's alpha were employed in order to evaluate structural validity and reliability. RESULTS: Exploratory factor analysis resulted in a five-factor structure consisting of 20 items. Subsequently, confirmatory factor analysis (X 2/ df = 1.61, RMSEA = 0.050, GFI = 0.91, CFI = 0.91) confirmed that the Persian version had satisfactory goodness of fit. Reliability and internal consistency were confirmed with a CR of 0.77, an ICC of 0.87 and a Cronbach's alpha of 0.81. CONCLUSIONS: The findings indicated that the Persian version of the BIMF is a valid and reliable instrument for assessing maternal functioning among Iranian mothers.

Early description of amniotomy in medieval Persia.

AIM: Artificial rupture of the amniotic membranes during the labor, which is called amniotomy, is a common procedure in modern obstetric and midwifery protocols. There is no definite agreement regarding the timing of amniotomy in a delayed labor. In this study, we have discussed the history of amniotomy in medieval Persia mentioning the Persian medicine recommendations in this regard. METHODS: We studied main Persian medicine textbooks such as Canon of Medicine by Avicenna to investigate the history of labor management and amniotomy indications. In addition, amniotomy in current literature was studied using PubMed and Google Scholar databases. RESULTS: Persian medicine has recommended artificial rupture of membranes for labor augmentation based on its own theories. Methods for facilitation of the labor have been divided into two groups: one group before and the other during the labor. Avicenna has carefully explained the indication of amniotomy. He has recommended artificial rupture of membranes in cases of intact membranes with cervical dilatation and fetal descent. A needle or a kind of surgical knife called Mabzaa had been introduced for this procedure. CONCLUSIONS: It seems that Iranian physicians are the first scholars who have introduced the amniotomy for labor management in the 11th century. Persian medicine recommendations for labor facilitation should be considered in future studies.

Celestial and mythical origins of the citadel of Bukhara.

Narshakhi's The History of Bukhara, an account from the tenth century AD that has been narrated as a mythical and strange story about the formation of the citadel of Bukhara, has received scanty scholarly attention. This study addresses some of the unknown semantic and symbolic origins of Iranian citadels and fortresses through an analysis of documented legends and other classical sources. This analysis shows that the citadel (qal'a) was built based on the conceptual archetype of the Utopia of Kangdiz (Siavosgerd) and the geometric shape of Banat Na'sh (Big Dipper), which has played a symbolic role in protecting and guarding in Persian cosmology. This celestial analogy can explain the causes and origins of the irregular shape of some other Iranian citadels.

THE MODEL OF CLINICAL REASONING IN APPROACH TO FEBRILE INFECTIOUS DISEASES IN MEDIEVAL PERSIA

Reviewing ancient manuscripts of Persian medicine (PM) reveals that there have been some basic principles for decision-making in epidemic infectious diseases that existed in the past. These PM rules for clinical reasoning were applied through a personalized approach along with public health advice in such situations. Currently, the coronavirus pandemic has been the biggest problem in the world. Its mainstay of treatment is based on preventative measures and symptomatic treatments. Meanwhile, traditional medical systems for providing preventive, supportive, and rehabilitative care to patients have received more attention than before. Thus, the specific individual approach considered by PM scholars for clinical courses of epidemic infectious diseases may help shed more light on the spread of knowledge on epidemic diseases in ancient Persia.

Ab-10%υ¯ Mans .-10%υ¯r ῌasan Qamari: Promoter of the Medical School of Razi (Rhazes).

The medical history of Iran and Islam is marked by the presence of renowned physicians, some of whom are not well known outside Iran. Abυ¯ Man⋅υ¯r ῌasan ibn Nυ¯h Qamari Bukhara 'i was an Iranian physician living in the fourth century AH (10th century CE). The scientific works of this sage indicate his skill and expertise in medical science. He was a man of such scientific stature that the renowned Iranian philosopher and physician, Avicenna, use may have been one of his disciples. Qamari may be credited as one of the promoters of the medical school of Muhammad Ibn Zakariyya Razi. Some of his works, including Al-Tanwir Fi 'Istilahat Al-Tibbiyyah and Al-Ghina and Al-Muna are still extant. In this paper, his scientific life and works, based on primary sources, have been studied in order to shed light on his role in formation of the Muslim Medical School.

Almond as a nutraceutical and therapeutic agent in Persian medicine and modern phytotherapy: A narrative review.

Sweet almond (Prunus dulcis (Mill.) D.A.Webb) is a known nut, which has long been used in several ethnomedical systems, especially in Persian medicine (PM) for its nutritional and therapeutic activities. In this study, we aimed to provide a summary on traditional uses, phytochemistry, and pharmacological activities of sweet almond. Thus, we reviewed textbooks of PM and electronic literature on traditional medicine. Moreover, the available data on the usage of sweet almond were searched in electronic databases to find articles on its pharmacological properties and phytochemistry. According to phytochemical investigations, this plant contains macronutrients, micronutrients, essential oils, various phenolic compounds, and phytosterols. Current pharmacological studies represent that Prunus dulcis has several biological activities including prebiotic, antimicrobial, antioxidant, antiinflammatory, anticancer, hepatoprotective, cardiometabolic protection, nootropic, anxiolytic, sedative-hypnotic, and nervous-improving effects. Further clinical trials and meta-analysis are required to draw a definitive conclusion on the efficacy and therapeutic activities of almond.

The Early Report of Herpetic Whitlow by Bahal-Dawlah Razi in 15th Century CE.

A herpetic whitlow is a lesion (whitlow) on a finger or thumb caused by herpes simplex virus. It is a painful infection that typically affects the fingers or thumbs. Occasionally infection occurs on the toes or on the nail cuticle. Symptoms of herpetic whitlow include tenderness, swelling and reddening of the infected finger skin, fever and swollen lymph nodes. Although, it is believed that the first recorded observations were in 1909 CE by H. G. Adamson, in the medieval period, Bah?' al-Dawlah N?rbakhsh? Razi (1501 CE) described herpetic whitlow, under the title of Dakhes in Khulasat al-Tajarib (The Summary of Experience), his book on medicine. Some of Baha al-Dawlah's descriptions and his etiology of Dakhes are based on humoral theories and cannot be concurred with current medical concepts, but more symptoms and clinical manifestations are consistent with current definitions. It seems the earliest description of herpetic whitlow in the medical history.

Efficacy of a vaginal tablet as a Persian medicine product on vulvovaginal candidiasis: a double-blind, randomised, placebo-controlled trial.

Context: In Persian medicine, topical ingredients such as Rosa damascena Mill. (Rosaceae), are usually recommended for the treatment of uterine diseases. Scientific evaluation of these historical documents can be valuable for finding new potential use in conventional medicine.Objective: This clinical trial was performed to determine whether the use of the 'ward' vaginal tablet, which contains Rosa damascena, Punica granatum L. (Punicaceae), Querqus infectoria Oliv. (Fagaceae), Myrtus communis L. (Myrtaceae) and Nardostachys jatamansi (D.Don) DC. (Caprifoliaceae) could alleviate the symptoms of vulvovaginal candidiasis.Materials and methods: A parallel double-blinded placebo-controlled study was done. Eighteen to fifty-year-old women with vulvovaginal candidiasis were divided into the 'ward' and placebo groups, 46 individuals in each group. The 'ward' group received the 'ward' vaginal tablet containing 200 mg of dried extract. Placebo group received a placebo (composed of corn starch and lactose). One tablet was applied through the vagina for 7 consecutive nights.Results: Two weeks after medication administration, the vaginal discharge sample of patients was re-cultured; 29 patients (63.045%) in the 'ward' group and 6 (13.04%) patients in the placebo group had negative culture (p < 0.001). All clinical symptoms including itching, irritation, and vaginal discharge were significantly reduced in the 'ward' group compared with the placebo group following the intervention and the follow up (p < 0.05).Discussion and conclusions: The findings suggest the 'ward' vaginal tablet could ameliorate vulvovaginal candidiasis. Future larger studies are recommended due to compare the therapeutic effect of the 'ward' vaginal tablet with common treatments.

Strategies in traditional Persian medicine to maintain a healthy life in the elderly.

As time goes on, a greater number of people experience an age of more than 60 years old and subsequently geriatric syndromes are increasingly more common. Despite recent improvements in modern healthy living, literature on traditional Persian medicine (TPM) about the prevention and treatment of such syndromes and healthy living of the elderly is hardly known. We aimed, in this study, to explore some traditional Persian sources and briefly explain their writers' beliefs on keeping healthy living for old people. We used several TPM sources and literature, and then based on these texts, we collected issues about geriatric temperament and syndromes and classified the results including exercise, nutrition, massage, bathing, aromatherapy, and sleeping. Our search yielded some recommendations about a healthy lifestyle for the elderly, which are in fact equivalent to primary, secondary, and tertiary preventive measures in modern medicine. Our results also showed that they believed such modifications would help the elderly to improve their geriatric conditions. In general, TPM provides some pieces of advice to prevent and treat geriatric syndromes that may be helpful in practice although the scope of their effectiveness remains to be examined in carefully designed randomized controlled trials.