Efficacy and safety of Plantago major seeds in patients with diabetic nephropathy: A randomized open-labeled controlled clinical trial.

BACKGROUND: Diabetic Nephropathy (DN) is characterized by albuminuria and a declining glomerular filtration rate (GFR) in diabetic patients. Plantago major (plantain) seed powder is traditionally used in these patients. Despite emerging and promising pre-clinical evidence, no clinical study investigated the potential efficacy of this intervention in patients with DN, which is the aim of this study. METHODS: In a randomized clinical trial 60 DN patients were recruited from November 2022 to March 2023 and randomly assigned to the plantain group that received standard treatment (Losartan 25 mg twice a day) and plantain seeds' powder (10 gm sachet twice a day) plus sweet almond and the control group was received only standard treatment for 60 days. Proteinuria, as per 24-hour urinary protein, as well as fasting blood sugar (FBS), blood urea nitrogen (BUN), serum creatinine, serum potassium, and quality of life score were measured at baseline and after 60 days as study outcome measures. RESULTS: Proteinuria was significantly decreased from 165.04 mg to 135.84 mg (p = 0.026) in the plantain group. The mean level of proteinuria was significantly lower in the plantain group (135.84 vs. 192.04, p = 0.039) compared to the control group after treatment. The plantain group showed more increase in quality of life score after treatment (33.89±9.67 vs 38.28±10.72, p = 0.041). Other outcomes showed no significant difference between the two study groups. CONCLUSION: Adjuvant supplementation with plantain seeds powder may decrease proteinuria in patients with diabetic nephropathy. Further studies with larger sample sizes and longer duration are needed to confirm these results.

Comparison of the Effects of Govarcin Herbal Capsule and Metoclopramide for Alleviating Gastrointestinal Symptoms in Patients with Functional Dyspepsia: A Randomized Double-blind Clinical Trial.

BACKGROUND: Functional dyspepsia (FD) is felt as a discomfort or pain on the center line or upper abdomen. In this study, we investigated the effect of Govarcin herbal capsule on FD so that if it is effective, it can be used in the treatment of patients with this disease. METHODS: Totally, 106 patients enrolled in a double-blind, clinical trial study. The participants had FD and were divided into two groups receiving Govarcin and Metoclopramide by block randomization. The patients were treated for four weeks, taking one Govarcin capsule or Metoclopramide tablet after each meal. The rate of improvement in patients was assessed by mitigation of clinical symptoms, including epigastric pain, fullness, discomfort, nausea, vomiting and heartburn. Also, before and after intervention, we used Nepin questionnaire and ROME III. SPSS statistics 25 software was used for data analyzing. RESULTS: Clinical symptom score changes between Govarcin and Metoclopramide patients' groups showed that there was no significant difference in any of the clinical symptom scores (except for heartburn, p-vale=0.012) between the study groups. Nepean score in Govarcin group before and after treatment was 19.3±4.8 and 8.9±2.8, respectively (p-value<0.001). For Metoclopramide group, these values were 19.8±3.5 and 9.4±2.1 respectively (p-value<0.001). No significant difference was found in terms of Nepean score between the Govarcin and Metoclopramide groups (p-value=0.995). CONCLUSION: Govarcin herbal capsule can be used to remedy symptoms in patients with FD. It seems that Guarcin is as effective as metoclopramide in fighting symptoms of FD as no significant difference in efficacy has been demonstrated between them.

Effects of Iranian Polyherbal Syrup (Zufa syrup) on oxygen saturation and clinical symptoms in suspected patients with COVID-19: a triple-blinded, randomized, placebo-controlled trial.

Coronavirus disease 2019 (COVID-19) pandemic has caused an urgent need for investigating potential treatments. Traditional medicine offers many potential remedies that have been historically used and have the advantage of bypassing the cultural obstacles in the practice of medicine. We aimed to investigate the efficacy of Zufa syrup in the treatment of suspected patients with mild to moderate symptoms of COVID-19. This triple-blind randomized controlled trial recruited patients with evidence of COVID-19 on chest computed tomography without an indication of hospital admission from March 2020 until April 2020. Participants were assessed by a physician and completed a pre-specified form to assess the duration and severity of symptoms. Patients were randomized to receive Zufa syrup (a combination of herbal medicines: Nepetabracteata, Ziziphus jujube, Glycyrrhizaglabra, Ficuscarica, Cordia myxa, Papaver somniferum, Fennel, Adiantumcapillus-veneris, Viola, Viper's-buglosses, Lavender, Iris, and sugar) or identical-looking placebo syrup at a dose of 7.5 mL (one tablespoon) every 4 hours for 10 days. After applying the eligibility criteria, 116 patients (49.1% male) were randomized to trial arms with a mean age of 44.3. During the follow-up, Cough, dyspnea, headache, myalgia, anorexia, anxiety, and insomnia improved gradually in both groups, and showed no difference between Zufa syrup and placebo. Oxygen saturation and pulse rate had stable trends throughout the follow-up and were similar between study arms. No patient required hospital admission or supplemental oxygen therapy during the study period. To conclude, in patients with mild to moderate symptoms of COVID-19, Zufa syrup did not show any difference in symptomatology over a 10 days' period when compared with placebo. Due to potential effects of medicinal plants in the treatment of respiratory infections, further studies are warranted to clarify their role in COVID-19. The study was approved by the Ethics Committee of the Qom University of Medical Science (Ethics committee reference number IR.MUQ.REC.1398.165) on March 10, 2020 and was registered in Iranian Clinical Trial Center (approval ID: IRCT20200404046934N1) on April 13, 2020.

Preliminary results of effect of barley (Hordeum vulgare L.) extract on liver, pancreas, kidneys and cardiac tissues in streptozotocin induced diabetic rats.

Diabetes mellitus (DM) and its complications impose a significant burden on patients and the health care system. In the Traditional Persian Medicine (TPM), barley is recommended for treatment of DM. This study sought to assess the effect of barley seed aqueous extract on hepatic, pancreatic, renal and cardiac tissues in normal (non-diabetic) and Streptozotocin-induced diabetic rats. Twenty-one male Wistar rats were randomly divided into diabetic and non-diabetic groups. Diabetes was induced by single intraperitoneal injection of Streptozotocin. After one week, the diabetic and non-diabetic groups were randomly divided into control and barley seed extract subgroups namely N group (non-diabetic control rats), S group (seed extract treated non-diabetic rats), D group (diabetic control rats) and DS group (seed extract treated diabetic rats). After 6 weeks, all rats were sacrificed for histopathological analysis and specimens were stained routinely for histological studies. The abnormal histological signs significantly decreased in the DS group compared to D group. Also, protective effects of barley seed extract against histopathological changes were seen in S group compared to N group.These findings suggest that barley seed extract exerts a protective effect on different tissues in diabetes.

Anti-inflammatory activity of a natural herbal-marine drug (MS14 - SANT and SUSP) compared to sodium salicylate or methylprednisolone in a rat model for multiple sclerosis.

A natural compound of marine herbal origin has been used in Persian Traditional Medicine to relieve some symptoms of multiple sclerosis. The present study investigated the anti-inflammatory effects of a patented extracts of the traditional receipt (MS14). In this preliminary experiment, we used seven groups of six rats: the control group received vehicle, the two positive control groups were treated with either sodium salicylate (300 mg/kg) intraperitoneal (i.p.) or methyl prednisolon (MPN 10 mg/kg) i.p., while the test groups were treated with a solution centrifuged MS14 (SANT 100 mg/kg) and suspension of MS14 (SUSP 100, 150, 300 mg/kg) i.p. After thirty minutes, paw volume was measured by plethysmometer and immediately formalin solution was injected subcutaneously into the hind paw and after an hour, inflamed paw volume was measured. In days 2-8, the inflamed paw volume was measured and immediately drugs were injected i.p. The anti-inflammatory effect of MPN was significant only on days 5 and 6. The anti-inflammatory effect of SS was significant only on the 6th day, while the anti-inflammatory effect of SANT MS14 (100 mg/kg) was also significant only on the 6th day. SUSP MS14 (150 mg/kg) significantly reduced edema from second to 6th day. Intra-peritoneal injection of SUSP MS14 with 300 mg/kg was toxic, so excluded from the study. This research indicates that the MS14 possesses an anti-inflammatory effect after intra-peritoneal administration. Comparative anti-inflammatory effects of MS14 with Glucocorticoids in this study, may justify a possible mechanism for its action in multiple sclerosis, if further studies will provid strong statistically confirmatory effects in animals and safety human trials.

Evaluation of the efficacy of warm salt water foot-bath on patients with painful diabetic peripheral neuropathy: A randomized clinical trial.

OBJECTIVES: Pain relief is one of the main goals of treatment in Diabetic peripheral neuropathy (DPN). Abzan(foot- bath) is one of the effective ways to relief various types of pain in Persian Medicine (PM). DESIGN: This study is a randomized clinical trial (RCT) conducted on 60 patients of age range within 30 to 70 years, which were randomly divided into three groups. Group A (warm water bath):For one month each night before bedtime, they were asked to sit on a chair with trousers pulled up to about 5 cm above the ankles and both feet immersed in an electrical foot-bath that contained 5 liters of warm tolerable water (between 40 and 45 ° C) for 15 minutes without any massage. In Group B (salt water bath) was added and dissolved 250 grams of powdered mineral salt to their warm water. Other stages were similar to the group A. Group C (control) did not receive any interventions. Patients were evaluated prior to and following the intervention by the Douleur Neuropathique 4 questionnaire (DN4), The McGill Pain questionnaire and The World Health Organization Bref Quality of Life (WHOQOL-BREF) questionnaire. RESULTS: Decrease in DN4 score level in the salt warm water group was significant while The McGill questionnaire showed a significant decrease of pain level the same group. CONCLUSIONS: Application of a specific Abzan (salt water bath) may significantly decrease the pain of DPN patients.

Evaluating the effect of a herb on the control of blood glucose and insulin-resistance in patients with advanced type 2 diabetes (a double-blind clinical trial).

BACKGROUND: Different benefits of various herbal medicines in decreasing blood sugar have been reported in different clinical trials so far. Considering the growing tendency toward these combinations and the booming market, inappropriate advice is growing accordingly. Hence, it is necessary to evaluate the effects and possible complications of such combinations on health status and blood glucose control. METHODS: Two 38-subject groups were formed and a 12-week treatment program was administered for both groups. The inclusion criteria were failure to control blood glucose with two oral medicines, unwillingness to inject insulin. The medicine was prepared in capsules by Booali Company. Each capsule weighed 750 mg and contained nettle leaf 20% (w/w), berry leaf 10% (w/w), onion and garlic 20% (w/w), fenugreek seed 20% (w/w), walnut leaf 20% (w/w), and cinnamon bark 10% (w/w) all in powder. RESULTS: At the beginning of the study, there was no significant difference between the subjects regarding the evaluated parameters, but after the intervention, the level of glucose was significantly lower in fasting (P=0.0001) and 2-hour postprandial (P=0.002) levels. The level of glycated hemoglobin A1c (HbA1c) (P=0.0001) also decreased from 0.33±9.72 % to 0.20±8.39 %. Finally, the level of insulin resistance reduced from 1.9±4.1 to 1.4±2.6 (P=0.001) after consuming herbal medicine. CONCLUSION: According to the results of the current study, the herbal combination was effective in controlling blood sugar, and considering the reduction of HbA1c by 1.31 %, it seems that the herbal combination is an effective medicine to treat diabetes.

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.

Hijama (Wet Cupping or Dry Cupping) for Diabetes Treatment.

BACKGROUND: Diabetes is known as one of the most common diseases in the world and its treatment is one of the most important healthcare issues. Consequently, different treatment methods of complementary medicine and recent medicine have been used by scientific communities to control and predict the disease. This article considered the effects of dry cupping and wet cupping, based on traditional medicine and recent studies. METHODS: At first, the benefits of dry cupping and wet cupping were taken from some original books of Iranian traditional medicine, such as Canon of Medicine, Kholasat-al-hekma, Tib-e-Akbari and Exir-e-Azam. Then, the information about scientific articles was obtained by studying some of the Iranian traditional medicine journals and searching through PubMed, SID and Google Scholar. RESULTS: In traditional medicine, Hijama is divided into two kinds, namely wet cupping (with sharat, with incision, and blood giving) and dry cupping (without sharat, without incision). Dry cupping causes organ blood absorption, organ warming, and loss of organ humidity. The texts of Iranian traditional medicine refer to the Ziabites disease that its symptoms are like diabetes. This disease is divided into two types including warm and cold ziabetes. The treatments that are recommended for both types are dry cupping for cold ziabetes and wet cupping for warm ziabetes. In addition, according to scientific studies, dry cupping and wet cupping have been recommended for diabetes treatment. CONCLUSION: Dry cupping and wet cupping can be introduced as the complementary treatment methods beside other treatment methods.

Non-Drug Therapy and Prevention of Diabetes Mellitus by Dalk (Massage).

BACKGROUND: According to WHO estimation, the number of diabetic patients would reach about 591.9 million people in 2035. The tendency towards other kinds of treatment is increasing because of the high therapeutic expenditures and current medical complications. Positive results of massage in recent articles and the prominent role of dalk in Iranian traditional medicine led us to the present study review. METHODS: Studying Iranian traditional medicine textbooks, such as Canon of Ibn Sina, Kholasat Al Hekma of Aghili, Zakhireh-ye Khwarazm shahi of Jorjani, Alhavi of Razes and Kamel-al-sanaat of Ibn Abas were done on the topic of dalk discussion. Additionally, a search on "massage and diabetes mellitus" articles was done in motor search engines of PubMed, Google Scholars and the site of "Farhangestane Oloume Pezeshki". The data were eventually compared and evaluated. RESULTS: In Iranian traditional medicine, dalk means kneading or massage of the body. Depending on the quality and quantity of the performance, it was divided into different kinds. The mechanism of dalk is to increase the blood supply in organs and subsequently increasing organ's warmness and metabolism that lead to increased residues expulsion. Therefore, it could be advised to healthcare system as a means of treatment. On the other hand, for different diseases such as asthma, arthritis, insomnia, paralysis, DM, and constipation the effect of massage was evaluated and its positive results were confirmed. For example, in DM, its effects in decreasing FBS and HBA1C are shown. CONCLUSION: According to Iranian traditional medicine and latest articles, dalk as a non-drug therapy and prevention manner is recommended.

Abul- Hasan al-Tabari: a review of his views and works.

Abul-Hasan al-Tabari was a 10th century Persian physician born in Tabaristan. He was a creative and innovative physician who avoided emulating treatments without investigating and examining them. Tabari was an encyclopedist and had a holistic view to medicine. Investigation of the views of this great Persian scholar indicated that his scientific and moral characteristics contain: paying adequate attention to philosophy and medical ethics, citing other scholars' works, attention to the necessity of clinical and hospital training, emphasizing indigenous therapy and scientific and responsible treatment with medical faults and discovery of Sarcoptes scabiei. Tabari has written valuable articles on different medical sciences; however, he is especially famous for authoring the al-Mu'alajat al-Buqratiya (Hippocratic Treatments) - an important medical encyclopedia. Several of Al-Tabari's succeeding scholars and physician have referred to the al-Mu'alajat al-Buqratiya in their medical articles. The aim of this study is further introduction of this great physician and assessment of his theories and key works.

Seroepidemiology of Human Hydatidosis Using AgB-ELISA Test in Arak, Central Iran.

BACKGROUND: On the continuation of sorting the puzzle of the situation of hydatid disease in Iran and considering that so far no survey was conducted in this context in Arak City, Markazi Province central Iran, the present study was conducted to determine the seroprevalence of human hydatidosis using AgB-ELISA test. METHODS: Totally 578 serum samples randomly were collected from patients referred to hospitals and different health centers in the city and 3 nearby villages of Arak. All sera were examined by ELISA tests using AgB. Before sampling, a questionnaire was filled out for each case. Data were analyzed using Chi-square test and multivariate logistic regression for risk factors analysis. P<0.05 was considered significant. RESULTS: Cut-off value was calculated 0.32. Twenty cases (3.46%) were seropositive for hydatidosis in the region. This rate for females was 3.99% and for males 2.26%, respectively. There was no significant difference as regards all factors studied except location (P<0.001). As for job, farmers and ranchmen had the highest rate of infection as 6.67%. The seropositivity rate infection was 4.8% in illiterate people, which showed the highest rate. As regards residency, rural life showed significant difference with urban life (1.5% vs. 7 %). Age group of 40-49 yr old (6.25%) had the highest rate of positivity. CONCLUSION: The rate of prevalence in this region shows more or less the same range with other cities of Iran. Obtained result might assist the policy makers to take sanitary measures to control the disease.