In vitro and in vivo studies of Dragon's blood plant (D. cinnabari)-loaded electrospun chitosan/PCL nanofibers: Cytotoxicity, antibacterial, and wound healing activities.

The D. cinnabari plant was loaded into the chitosan (Chn)/polycaprolactone (PCL) nanofibers in two forms: resin (D. cinnabari) and its ethyl acetate fraction. The Chn/PCL, Chn/PCL/D. cinnabari (CPD, 1, 3, and 5 %), and Chn/PCL/ethyl acetate extract D. cinnabari (CPED, 1, 3, and 5 %) showed no toxicity against human dermal fibroblast cells. The lactate dehydrogenase assay results indicated that the toxicity of pour, coated D. cinnabari, and CPED nanofibers were lower than 10 and 15 % after 1 and 3 days, respectively. The antibacterial results showed the inhibition zone for ethyl acetate extract D. cinnabari (ED-3 %), the Chn/PCL-2, and CPED3% nanofibers was 8.1, 7.4, 4.2, 5.1 mm, 12.8, 12.4, 21.7, 17.2 mm, and 24.7, 22.9, 37.1, 30.2 mm against S. aureus, B. subtilis, E. coli, and P. aeruginosa, respectively. The antibacterial activity results showed synergistic effect between the Chn/PCL and ethyl acetate extract D. cinnabari occurred. The diameter of wounds (1.50 × 1.50 cm diameter) made on the dorsal surface of rabbits reduced to 1.50 × 0.70, 0.50 × 0.30, 1.00 × 1.00, 0.60 × 0.50, 0.20 × 0.05, and 0.00 × 0.00 cm in the presence of ordinary gauze dressing, silver sulfadiazine, ED-3 %, Chn/PCL-2, CPD3%, and CPED3%nanofibers, respectively, after 14 days.

Efficacy and safety of add-on Viola odorata L. in the treatment of COVID-19: A randomized double-blind controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Severe Acute Respiratory Syndrome (SARS) due to the novel coronavirus has become the highest priority that threatens human health. This situation demands widespread vaccination and the innovation of new therapeutic methods. Despite drug discoveries, the need for approving new medicaments is felt because of adverse effects and lack of efficacy. Several medicinal plants including Viola odorata L. are recommended in traditional Persian medicine for alleviating respiratory infection symptoms. Recent studies showed anti-inflammatory, antioxidant, anti-asthmatic, antitussive, analgesic, and antibacterial activities of sweet violet. These enhance respiratory functions, reduce pulmonary inflammation, and decline mucous membrane edema. This study aimed to evaluate the efficacy of sweet violet syrup in alleviating the manifestations of COVID-19 infection. MATERIAL AND METHODS: A randomized parallel-group double-blind controlled trial was conducted at Al-Zahra general hospital, Isfahan, Iran. A total of 108 outpatients were enrolled in the study. The patients were randomly allocated to intervention and placebo groups, with 54 patients in each group. The allocation was concealed using sealed opaque envelopes. The intervention group received violet syrup and the control group received placebo syrup, an add-on to the conventional treatment. The outcomes were COVID-19 manifestations, such as dyspnea, cough, myalgia, headache, and diarrhea, considered as outcomes of the study and were evaluated twice using a visual analog scale before the intervention and after 7 days, at the end of the study. Patients were followed daily by phone calls to monitor proper drug consumption and possible side effects. RESULTS: No significant difference was between groups regarding demographic characteristics and vital signs before and after the treatment. Although all symptoms have improved significantly in both groups, patients who received violet syrup recovered faster and the mean severity scores of cough (P = 0.025), myalgia (P = 0.036), headache (P = 0.037), and diarrhea (P = 0.044) decreased greater in comparison to control group. CONCLUSION: This study, the first clinical trial on the effectiveness of Viola odorata on SARS-CoV-2 patients, showed that Viola odorata L. effectively controls prevalent manifestations of COVID-19 including cough, myalgia, headache, and diarrhea. Regarding this survey, the violet syrup can be mentioned as a complementary treatment for viral influenza-like infections in which cough, myalgia, headache, and diarrhea are prominent.

Saffron offers hepatoprotection via up-regulation of hepatic farnesoid-X-activated receptors in a rat model of acetaminophen-induced hepatotoxicity.

OBJECTIVES: The most important toxicity of acetaminophen is hepatotoxicity. Farnesoid X-activated receptors (FXR) are one of the nuclear receptor superfamily members which have a pivotal role in the bile acid regulation. The objective of the present study was to examine the role of FXR in mediating the hepatoprotective effects of saffron. METHODS: Male Wister rats were randomly allocated into five groups including a control, vehicle, acetaminophen and two saffron extract groups of 150 and 300 mg/kg/day. The liver function and hepatic FXR expression were evaluated using biochemical assay and real time RT-PCR, respectively. Data analysis was performed using the one-way ANOVA followed by Duncan's multiple range test. RESULTS: Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) of the acetaminophen group were significantly higher than the control group whereas those of the extract-treated groups were significantly lower than those of the acetaminophen group. The real time RT-PCR findings showed a non-significant down-regulation of FXR mRNA expression, however, a dose-dependent FXR up-regulation was seen in the groups treated with 150 and 300 mg/kg of the extract for 2.67 (p=0.002) and 10.22 (p=0.0001) fold, respectively. CONCLUSION: The main finding of the present study was that the hepatic FXR up-regulation had an important role in saffron hepatoprotective activity.

New mechanistic insights into hepatoprotective activity of milk thistle and chicory quantified extract: The role of hepatic Farnesoid-X activated receptors.

OBJECTIVE: Farnesoid-X-activated receptors (FXR) are key modulators of liver regeneration. Milk thistle and Chicory are known as potent protective remedies in several liver disorders. The objective of this work was to examine the role of FXR in the hepato-healing properties of milk thistle (MTE) and chicory extracts (CE) in a rat model of acetaminophen-induced hepatotoxicity. MATERIALS AND METHODS: Male Wistar rats were randomly divided into seven groups including control, vehicle, acetaminophen (500 mg/kg/day, oral), acetaminophen plus oral MTE 200 and 400 mg/kg/day, and acetaminophen plus oral CE 500 and 1000 /kg/day for 28 days. Liver function and histology as well as the pattern of hepatic FXR expression were assessed after 4 weeks. RESULTS: Administration of acetaminophen was associated with a significant elevation of liver transaminase along with the architectural injuries. In contrast, chronic concomitant administration of both MTE and CE significantly restored the liver function and structural abnormality. The main molecular findings of the study revealed that the lower doses of both MTE and CE led to a marked upregulation of hepatic FXR expression. CONCLUSION: Discovery of the involvement of the nuclear modulating pathways in hepatoprotective activity of the extracts, providesa new mechanistic insight which needs further investigations.

Effect of rose oil on Gastroesophageal Reflux Disease in comparison with omeprazole: A double-blind controlled trial.

BACKGROUND AND OBJECTIVE: Gastroesophageal reflux disease (GERD) as one of the most common ailments of gastrointestinal system diminishes quality of life and impairs physical functioning and work productivity. Proton-pump inhibitors (PPIs), such as omeprazole play a more dominant role in amelioration of GERD symptoms; nonetheless, there is a growing concern about their side effects. According to traditional Persian medicine (TPM), the use of rose oil is recommended to alleviate GERD symptoms. MATERIALS AND METHODS: Therefore, a randomized double-blind controlled trial was performed on 70 subjects who were randomly enrolled in two groups and received either rose oil softgel or omeprazole capsule combined with the placebo. Data were collected within 3 sessions of visit using the Mayo-gastroesophageal reflux questionnaire (GERQ). RESULTS: Although, our findings showed that reflux symptoms were decreased in both groups after receiving medicine and the decrement was significant in treatment group, before and after the intervention, this decrease was not significant between two groups. CONCLUSION: Given that the rose oil used in this study was produced according to the Iranian method and effective ingredients of Rosa damascena were preserved in sesame oil in production process, it seems that effectiveness of this product can be due to its tonic and enlivening properties. Consumption of rose oil soft capsule alleviates cardinal GERD symptoms similar to omeprazole. It seems that rose oil can have the same effects as PPIs in treatment of GERD but with no side effects due to its different mechanisms of action.

Formulation, Standardization, and a Preliminary Before-After Clinical Trial on Effect of a Traditional Herbal Formula (Maqliasa) on Manifestations of Ulcerative Colitis.

BACKGROUND: Ulcerative Colitis (UC) is a chronic condition that represents a group of intestinal disorders causing prolonged inflammation of the digestive tract. Nowadays, efforts to investigate new remedies have led to a committed movement toward the integration of traditional and complementary medicine into mainstream medicine. In Traditional Persian Medicine (TPM), Maqliasa is one of the most frequent gastrointestinal prescriptions which is claimed to be effective in both remission and recurrent phases of UC. OBJECTIVE: The aim of this pilot study was to examine the effect of Maqliasa on UC symptoms. METHODS: Through a non-randomized before-after uncontrolled clinical trial, 13 outpatients with active UC were enrolled in the study. They continued their conventional drug regimens plus Maqliasa capsules (2 capsules t.i.d.) for 28 days. Three visits were arranged for each patient- the first admission, day 14th admission and day 28th admission. The patients were evaluated by Lichtiger Colitis Activity Index. Wilcoxon signed-rank test was used for statistical analysis. RESULTS: The Lichtiger colitis activity index improved in the study group was compared to the corresponding baseline values: baseline score: 7.8 ± 0.5; after two weeks: 5.9 ± 0.6 (P=0.002); after four weeks: 3.6 ± 0.5 (P=0.001). CONCLUSIONS: This study showed the promising effect of Maqliasa in the treatment of active UC. However, due to some of the limitations of the study, conducting future high-quality randomized clinical trials would be crucial.

Effects of Some Lamiaceae Species on NO Production and Cell Injury in Hydrogen Peroxide-induced Stress.

Nitric oxide (NO) is a key mediator that plays an important role in pathogenesis of various chronic diseases like Alzheimer's disease and Parkinson's disease. Additionally, there is a great attitude for finding natural compounds, which could control and inhibit NO production in pathological conditions. Therefore, we were encouraged to investigate the effects of some Lamiaceae species on NO production and cell injury during oxidative stress in PC12 cells. In this study, cell death determined by MTT assay and NO levels were evaluated using Griess assay. PC12 cells were exposed to total metanolic extracts of three Scutellaria and one Nepeta species. The results revealed that Nepeta laxiflora (N. laxiflora) could protect PC12 cells from hydrogen proxide-induced oxidative stress and all of the plants inhibited NO production in that condition except Scutellaria tournefortii (Sc. tournefortii). In addition, Scutellaria multicaulis (Sc. multicaulis) was meanwhile subjected to fractionation using different organic solvents. The dichloromethan and ethyl acetate fractions of Sc. multicaulis could protect PC12 cells from oxidative stress injury. However, NO production was restrained by the hexane and dichloromethane fractions. Considering the results, N. laxiflora, Scutellaria nepetifolia (Sc. nepetifolia), and Sc. multicaulis are good candidates for further investigations in neuroprotection and anti-inflammation studies.

Omega-3 Fatty Acids and Cholesterol Have a Main Role in Antidepression Diet of Iranian Traditional Medicine.

Depression is one of the major health problems of our world. Recent studies have revealed the relationship between diet and depression. In Iranian traditional medicine, there is a therapeutic diet that is recommended in melancholic diseases like depression. One of the main components of this diet is meat. Meats are divided into 2 groups: recommended and abstinent. The aim of this study was to clarify the logic of this diet through comparing nutritional elements of the 2 groups with each other. For this purpose, prominent books on Iranian traditional medicine were searched for abstinent and recommended meats traditionally prescribed for depressed patients. The results of each group were compared with the other by using Mann-Whitney Test (SPSS version 16). The results showed that recommended meats contain higher amounts of polyunsaturated fatty acids ( P = .01) especially omega-3 ( P = .03). Both groups contain high amounts of cholesterol. Iranian traditional medicine recommends consumption of meats that contains cholesterol with omega-3 fatty acids in depression.

Non-polyphenolic compounds of a specific kind of dried grape (Maviz) inhibit memory impairments induced by beta-amyloid peptide.

OBJECTIVES: Although grape has been recently the topic of many investigations, Maviz (a kind of dried one) has remained neglected. The aim of this study was to assess anti-Alzheimer activity of Maviz. METHODS: To reach this goal, total phenolic content (TPC) of ethanolic (Eth) and aqueous (Aq) extracts were determined and radical scavenging activity was assayed by 2,2-diphenyl-1-picrylhydrazyl. Chemical compositions of each extract were also determined via GC-Mass. Behavioral changes were studied via passive avoidance and Morris water maze in Aß-induced model of Alzheimer's disease. Catalase (CAT) and superoxide dismutase (SOD) determination were also done on rats' hippocampus. RESULTS: The results showed that seed Eth extract has a high level of TPC and radical scavenging activity. However, this extract had surprisingly no effect on memory and CAT and SOD activities. In contrast, fruit Aq and Eth extracts (containing furfurals as major compounds) inhibited memory impairment (P < 0.001) and elevated brain levels of CAT and SOD(P < 0.05). CONCLUSION: It seems that Maviz non-phenolic compounds-most probably 5-hydroxymethylfurfural and other similar derivatives-are responsible for these actions.

Health-Related Quality of Life and Health Utility Values in Beta Thalassemia Major Patients Receiving Different Types of Iron Chelators in Iran.

Background: Thalassemia is a chronic, inherited blood disorder, which in its most severe form, causes life-threatening anemia. Thalassemia patients not only engage with difficulties of blood transfusion and iron chelating therapy but also have some social challenges and health threatening factors. There are some reports on quality of life in thalassemia patients around the world from southeast of Asia to Italy in Europe and United States. In this study, we tried to evaluate and compare Health Related Quality of life (HRQoL) and the health utility in beta thalassemia major patients receiving different types of iron chelators and living in different socio-economical situations. Subjects and Methods: EQ-5D-3L accompanied by a Visual Analogue Scale (VAS) questionnaire was used. The respondents were patients with beta thalassemia major that were at least 12 years old selected from 3 provinces of Sistan-Blouchestan, Fars and Mazandaran. Comorbidities including heart complication, Diabetes Mellitus and Hepatitis and also types of iron chelators (oral, injection, combination of both) were also asked. Cross tab and ANOVA analysis conducted to evaluate each dimension score and health utility differences between provinces, iron chelation methods, comorbidities, age group and gender. Results: 528 patients answered the questionnaires. The health utility of patients that received oral iron chelator were 0.87 ± .01 for oral iron chelators versus 0.81 ± .01 for injection dosage form (p<0.05). Increase in age was accompanied by decrease in health utility. Females faced more usual activity problems, anxiety and depression. Heart problems were more prevalent in males. Conclusion: This study suggests that the quality of life of beta thalassemia major patients is dependent on type of iron chelation treatment which they received, the gender they have, the comorbidities they suffer and socio-economical situations they live in.

Physiopathology of Dementia in Iranian Traditional Medicine.

Recently, an article published in this journal by Dr Seifaddini and colleagues. In that article, the authors tried to connect dementia, including Alzheimer's disease, with a condition mentioned in Iranian traditional medical condition, Raoonat and Homgh In this condition, intellectual functions of the brain are disturbed and therefore, learning and decision-making abilities are damaged. This condition is not age limited and affects thinking ability but not memory. On the other hand, there is a condition described in Iranian traditional medicine, which completely matches with Alzheimer's disease. This condition is explained under the title of Nesyan (forgetfulness). Nesyan has 5 subdivisions, one of which is caused by the inclination of the brain normal temperament to more coldness and dryness. By performing animal studies, we have recently shown that this kind of Nesyan is related with Alzheimer's disease. Studies on the traditional recommendations on treatment of this kind of Nesyan can be useful in treatment of Alzheimer's disease.

Impairment of Rat Spatial Learning and Memory in a New Model of Cold Water-Induced Chronic Hypothermia: Implication for Alzheimer's Disease.

Alzheimer's disease (AD) is a primary neurodegenerative disorder associated with progressive memory impairment. Recent studies suggest that hypothermia may contribute to the development and exacerbation of AD. The aim of this study was to investigate the role of chronic hypothermia on spatial learning and memory performance as well as brain immunohistochemical (IHC) and molecular changes. Four groups of male rats were placed in cold water (3.5 ± 0.5 °C) once a day for 1, 3, 6, and 14 days, four other groups were placed in warm water (32 °C) as the control groups to eliminate the effect of swimming stress, and one more group which comprised intact animals that were kept in a normothermic situation and had no swimming stress. Twenty-four hours after the last intervention, spatial learning and memory were assessed, using the modified Morris water maze. After the behavioral test, the rats' brains were removed for IHC and Western blotting. The results showed that memory retrieval is impaired after 14 days of cold water-induced hypothermia (CWH) (P < 0.05). IHC showed the formation of beta-amyloid plaques after a 14-day CWH. The molecular changes demonstrated that a 14-day CWH induces tau hyperphosphorylation, apoptosis, and reduces COX-II expression. Therefore, chronic CWH, independent of forced swimming stress, impairs learning and memory through molecular mechanisms similar to those of AD. In conclusion, CWH may serve as an important model to assess the role of hypothermia in AD pathogenesis.

Treatment of Alzheimer's disease in Iranian traditional medicine.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease with a high prevalence in recent years. Dramatic growth in AD prevalence has increased the importance of more researches on AD treatment. History has shown that traditional medicine can be a source of inspiration to find new therapies. OBJECTIVES: This study tried to codify the recommendations of Iranian traditional medicine (ITM) by studying the main medical manuscripts. The second purpose was to compare these findings with new medical information. MATERIALS AND METHODS: Cardinal traditional medical and pharmacological texts from 10th to 18th century were searched for traditional terms of dementia (Nesyan, Fisad-uz-Zekr, Faramooshkari) focused on treatment methods. The findings were classified into three groups: lifestyle recommendations, dietary approaches, and drug therapies. These findings were compared with new medical findings. RESULTS: ITM has dietary recommendations for dementia such as increasing consumption of nuts, poultry and eggs, milk, and grape products (like raisin and currant). These compounds are full of unsaturated fatty acids, cholesterol, and polyphenolic compounds. New findings suggest that these substances can help in prevention and treatment of AD. ITM has some lifestyle considerations like increasing physical and mental activities, listening to music, attending musical feasts, and smelling specific perfumes. New medical findings confirm nearly all of these recommendations. Along with the aforementioned items, treatment with natural medicines is in the first line of traditional treatment of dementia. New investigations show that many of these herbs have antioxidant, anti-inflammatory factors and acetylcholine esterase inhibitory effects. A few of them also have N-methyl-D-aspartate (NMDA) blocking activity. When these herbs are put together in traditional formulations, they can comprehensively fight against the disease. CONCLUSIONS: More ethnopharmacological and ethnomedical studies on ITM antidementia therapy can be followed by fruitful results.

Comparison between Complementary Dietary Treatment of Alzheimer Disease in Iranian Traditional Medicine and Modern Medicine.

BACKGROUND: Dietary notifications have been introduced recently for Alzheimer Disease (AD). In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent). The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM) with novel medical outcomes. METHODS: 1) Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2) Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3) Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4) Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5) Comparing traditional and new dietary suggestions with each other. RESULTS: 1) Traditionally recommended foods are fattier than abstinent ones (P<0.001). There are meaningful differences between unsaturated fatty acids (UFAs) (P<0.001), saturated fatty acids (P<0.001), and cholesterol (P<0.05) of recommended foods and abstinent ones. 2) Traditionally recommended diet is also fattier than the abstinent diet (4.5 times); UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times); 3) Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4) Traditional recommended diet is in agreement with recent studies. CONCLUSION: ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD.

Effectiveness of compassionate mind training on depression, anxiety, and self-criticism in a group of Iranian depressed patients.

OBJECTIVE: The purpose of this study was to examine the effectiveness of compassionate mind training (CMT) on symptoms of depression and anxiety in Iranian depressed sufferers. METHOD: Nineteen depressed patients aged 20 to 40 (Beck Depression Inventory value ≥ 20) were randomly assigned into two groups. The experimental group participated in 12 sessions of group therapy based on Paul Gilbert's manual of CMT. The control group was given no intervention. The participants were assessed by Beck Depression Inventory-II (BDI-II), Anxiety Scale (AS), and Levels of Self-Criticism (LSCS) questionnaires at the beginning and immediately after the intervention. To follow-up the therapeutic effect of CMT, the three questionnaires were answered again by participants two months after the end of the intervention. Data were analyzed by independent samples t-test. RESULTS: The results revealed that CMT significantly decreases depression (P < 0.05) and anxiety score (P < 0.05) in the follow-up study, but not immediately after the intervention. Although CMT decreased self-criticism, this effect was marginally insignificant. CONCLUSION: The findings indicated that CMT could alleviatedepression and anxiety in a group of Iranian depressed patients.

Three years evaluation of drug shortages from educational pharmacies in tehran.

The effectiveness of any drug supply systems in providing a trustworthy supply of essential drugs is a critical issue. To evaluate this effectiveness, it is necessary to watch over the status of the essential medicines in any country impartially and continuously. Some countries and also the World Health Organization (WHO) have codified a list of minimum medicines needed for a basic health care system and published them in assortments as a list of essential medicines. The aim of this study was to give an evaluation of the shortages status in Iran and identify the strengths and weaknesses of policies made in Ministry of Health during the years 2005 to 2008 in providing the essential drugs based on the WHO list of essential medicines. The reports used in this retrospective study were collected from the central purchasing unit of one of the main chain drugstores in the country (13-Aban Pharmacy) every 2 to 3 weeks. In these reports, a drug is added to the list of shortages when the requested drug is not delivered. The reports were studied and the results were analyzed based on the WHO list of essential medicines and the national drug list of Iran. The shortages always included 20 to 40 medicines from the list of essential drugs compiled by WHO. Based on this finding, the Ministry of Health and particularly Food and Drug Organization can compile a National List of Essential Medicines and try to always supply them and prevent their shortage.