Health Workforce Planning: Designing a Specialty and Subspecialty Supply Model for Iran.

Background: One of the approaches to health workforce planning is supply-based. It has been emphasized that countries should model health workforce based on evidence and their context. The objective of this study is to "design a supply health workforce planning model for specialty and subspecialty in Iran." Methods: This is a study using Walker and Avant's (2018) theory synthesis framework to construct the model. This method has three steps. According to the viewpoint of the research team and the needs of the country, the focal concept is determined. Then, a literature review was done to determine related factors and their relationships. In the third step, according to the review, the viewpoint of the research team, the rationale of the connection between components, and the graphic model were presented. Results: "Supply" was selected as the focal concept. In the literature review, 42 components were obtained from the systematic review, 43 components obtained from the study of other texts were combined with the opinion of the research team about the field of Iran, and the connections between them were determined. In the third step, the supply model was designed using the Stock and Flow method. Finally, by applying the "functional full-time coefficient", the number of full-time equivalent physicians was calculated. Conclusion: The presented model is an evidence-based model that follows stock and flow design. Stock is the number of specialties or subspecialties that exist in the labor market. Flow includes inflow and outflow according to the educational pathway in the context of Iran.

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

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

Effects of Komouni Formulation (Herbal Product of Persian Medicine) With a Low-Calorie Diet on Cardiometabolic Risk Factors in Overweight and Obese Women: A Triple-Blinded Randomized Clinical Trial.

Background: The prevalence of obesity has almost tripled since 1975, and obesity places a heavy economic burden on healthcare systems. There is a high tendency to use a variety of complementary medicine modalities for weight management among obese patients. Persian Medicine is an ancient medical school practiced for thousands of years in Iran. Found in reliable Iranian traditional resources, Komouni formulation (KF) is a compound medicine that can be effective in the treatment of obesity. It comprises black caraway (Bunium persicum Boiss.), anise (Pimpinella anisum L.), fennel (Foeniculum vulgare Miller), and ajwain (Trachyspemum ammi L.). Objectives: This study aimed to determine the effects of KF on anthropometric indices and metabolic parameters in overweight and obese women. Methods: This triple-blinded randomized controlled clinical trial was performed on 70 overweight or obese women aged 20 - 40 years, with a body mass index (BMI) of 25 - 34.9 kg/m2. The subjects were randomly divided into two groups (each group n = 35) to receive a calorie-restricted diet with 2 g/day (500 mg 30 minutes before breakfast, 1000 mg 30 minutes before lunch, and 500 mg 30 minutes before dinner) KF or placebo for 8 weeks. Anthropometric indices, food intake, and biochemical parameters were measured at baseline and after the intervention. Results: A total of 60 women (intervention = 30; placebo = 30) completed the trial. After the intervention, the KF group experienced a significant reduction in weight (-4.8 vs. -3.2 kg; P = 0.0001), BMI (-1.8 vs. -0.79 kg/m2; P = 0.0001), waist circumference (-5.28 vs. -3.20 cm; P = 0.004), hip circumference (-0.018 vs. -0.008 cm; P = 0.047), fasting blood sugar (-5.6 vs. 0.33; P = 0.025), and low-density lipoprotein (-11.7 vs. 6.7; P = 0.0001), compared to the placebo group. None of the patients in the intervention and placebo groups reported any side effects. Conclusions: Using KF, along with a calorie-restricted diet, can reduce cardiometabolic risk factors in overweight and obese women. However, further studies are needed to elucidate the efficacy of KF as a complementary therapy in obesity.

Berberine-induced glucagon-like peptide-1 and its mechanism for controlling type 2 diabetes mellitus: a comprehensive pathway review.

Introduction: A growing number of studies have thus far showed the association between type 2 diabetes mellitus (DM) and the intestinal microbiome homoeostasis. As reported, the gut microflora can be significantly different in patients with type 2 DM (T2DM) compared to those in healthy individuals.Methods: The authors collected the relevant articles published until 2022 and these are carefully selected from three scientific databases based on keywords.Discussion: This review highlights research on the anti-diabetic properties of berberine (BBR)-induced glucagon-like peptide-1 (GLP-1), as a glucose-lowering factor and a balance regulator in the microbial flora of the intestines, which plays an important role in adjusting the signalling pathways affecting insulin secretion.Results: Considering the anti-diabetic characteristics of the BBR-induced GLP-1, BBR makes a promising complementary treatment for reducing the clinical symptoms of DM by reducing the hyperglycaemia. Berberin might be a safe and effective drug for T2DM with little or no adverse effects.HighlightsBerberine induces GLP-1 insulin secretion by PLC2 pathway in the intestinalBerberine-induced GLP-1 decreases mitochondrial stress and relocates cytochrome c out of the mitochondria.Berberine induces GLP-1 secretion in the intestine by altering the bacterial profile, thus could possibly lighten diabetes symptomsBerberine-induced SCFA production, SCFA causes GLP-1 secretion from the intestinal L-Cell.Preventing mitochondrial damage, reducing adipose tissue fat, and reducing oxidative stress are thus among the results of BBR-induced GLP-1.The lower costs of BBR, and its limited side effects and higher availability, make it a promising supplementary medicine for DM.

Approaches and Components of Health Workforce Planning Models: A Systematic Review.

Background: To date, there is still no uniformity in forecasting models for health workforce planning (HWFP). Different countries use various HWFP models, some of which are context-specific. The objective of this systematic review is to determine approaches and components of HWFP models. Methods: A systematic review of studies published in English and Persian between 2004 and 2021 was performed by searching PubMed Central, MEDLINE, Web of Science, Scopus, Eric, and Elmnet databases. Articles that assessed HWFP models, focused on health service delivery, used input-output models, and a clear formulation process were included. Articles that scored ≥20 points on the "strengthening the reporting of observational studies in epidemiology" checklist were considered of acceptable quality for inclusion. Results: Twenty articles were included for qualitative synthesis based on the inclusion and exclusion criteria. Most studies used the mixed method approach "supply and demand", whereas target- and needs-based approaches were used less frequently. The number of components used to estimate supply, demand, needs, and targets were 42, 32, 11, and 6, respectively. In addition, several unique factors used in the various HWFP models were identified. Conclusion: Different approaches are used in HWFP models, which is indicative of the lack of consensus on this topic. High diversity in the identified factors is related to the approach used and the context in which the model is applied.

Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine.

Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains-which are similar to moxibustion usages-have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended. Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; 21(4):354-360.

Pro-inflammatory diet, cardio-metabolic risk factors and risk of type 2 diabetes: A cross-sectional analysis using data from RaNCD cohort study.

BACKGROUND: Inflammation and cardiometabolic risk factors can be involved in developing type 2 diabetes mellitus (T2DM). This study aimed to investigate and compare the association between a pro-inflammatory diet and cardiometabolic risk factors in patients with T2DM and non-T2DM cases. METHODS: In this cross-sectional population-based study, considering the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort, patients with T2DM (n = 785) and non-T2DM cases (n = 8254) were included. The dietary inflammatory index (DII) was calculated using a food frequency questionnaire (FFQ) and was classified into four groups (quartiles) with lowest to highest scores. Logistic regression analysis was conducted to determine the association between DII and cardiometabolic risk factors in both groups. RESULTS: The participants were 9,039 (4140 men and 4889 women) with a mean age of 47.4 ± 8.2 years; the mean body mass index (BMI) and DII were 27.49 ± 4.63 kg/m2 and - 2.49 ± 1.59, respectively. After adjustment for confounding factors, we found that DII can increase the risk of T2DM by 61% (95% CI 1.27 to 2.05, P < 0.001). A comparison of two groups revealed that the association of DII, obesity/overweight and dyslipidemia were also significant in both diabetic (P < 0.05) and non-diabetic cases (P < 0.05). However, no significant association was found between DII, MetS, and hypertension in either of the groups. The association between DII and cardiovascular diseases (CVDs) was only significant in diabetic patients (1.65; 95%CI: 1.02 to 2.65, P = 0.04) and T2DM showed an interaction with the association between DII and CVDs. CONCLUSION: Inflammatory potential of diet may increase the risk of T2DM. Although it can increase the risk of some cardiometabolic risk factors in both diabetic and non-diabetic cases, its effects were greater among patients with T2DM. However, further prospective studies are required to confirm these associations.

Dietary insulin index and load in relation to cardiometabolic risk factors in patients with type 2 diabetes mellitus: A cross-sectional study on the RaNCD cohort study.

OBJECTIVES: The aim of the present study was to evaluate the link between the dietary insulin index (DII) and dietary insulin load (DIL) and cardiometabolic risk factors in patients with type 2 diabetes mellitus (T2DM). METHOD: In this cross-sectional population-based study, 827 participants with diabetes were included based on the RaNCD (Ravansar Non-Communicable Disease) cohort study baseline data. DII and DIL were calculated based on standard formulas using food insulin index values published earlier. Logistic regression analysis was used to determine the association of DII and DIL with cardiovascular risk factors. RESULTS: A significantly direct association was shown between DII and metabolic syndrome (MetS; odds ratio [OR], 1.32; 95% confidence interval [CI], 1.05-2.50). The odds of developing abdominal obesity in patients with the highest DII were almost twice as high as those with the lowest DII (OR, 2.06; 95% CI, 1.02-4.99). Patients in the top quintile of DIL had twice the odds of being obese than those in the bottom quintile. Furthermore, positive associations were found between DIL and both MetS (OR, 1.98; 95% CI, 1.10-4.21) and waist circumference (OR, 2.90; 95% CI, 1.10-7.20). CONCLUSION: Higher DII and DIL were positively related to greater risks for both MetS and abdominal obesity among patients with T2DM. Additionally, higher DIL was associated with a higher risk for obesity in the Ravansar population. However, further prospective investigations are needed to clarify the cause-and-effect link between DII, DIL, and cardiovascular risk factors in patients with T2DM.

Efficacy of hydrotherapy, spa therapy, and balneotherapy for psoriasis and atopic dermatitis: a systematic review.

BACKGROUND: Atopic dermatitis (AD) and psoriasis are chronic inflammatory diseases that have significant skin complications. OBJECTIVE: The purpose of this systematic study was to evaluate the evidence obtained from human studies on the effects of hydrotherapy, spa therapy, and balneotherapy in psoriasis and atopic dermatitis. METHODS: The present systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements. Also, for this study databases such as Embase, PubMed, Scopus ProQuest, and sciences direct database were searched from the beginning to April 2021. RESULTS: All human studies that examined the effect of balneotherapy, spa therapy, and hydrotherapy on psoriasis and atopic dermatitis were published in the form of a full article in English. In the end, only 22 of the 424 articles met the criteria for analysis. Most studies have shown that balneotherapy, spa therapy, and hydrotherapy may reduce the effects of the disease by reducing inflammation and improving living conditions. In addition, the results of the Downs and Black score show that seven studies received very good scores, three studies received good scores, nine studies received fair scores, and three studies received poor scores. CONCLUSIONS: The results of studies also showed that hydrotherapy leads to an improvement in the PASI score index. Nevertheless, more clinical trials are needed to determine the mechanism of action of hydrotherapy on these diseases.

The roles of quercetin in diabetes mellitus and related metabolic disorders; special focus on the modulation of gut microbiota: A comprehensive review.

Quercetin is a dietary flavonoid that can affect the balance between anti-oxidant defense system and oxidative stress. A number of studies showed the positive effects of quercetin on diabetes mellitus and related metabolic disorders through different pathways such as gut flora. However, findings are conflicting. In addition, it seems no studies have summarized all potential mechanisms of quercetin in diabetes mellitus, so far. Therefore, the aims of the present comprehensive review were to provide an overview on biological and biochemical characteristics of quercetin and investigate the effect of quercetin on diabetes mellitus and related metabolic disorders by focusing on its effects on the modulation of gut microbiota. For this purpose, findings of In vitro, animal studies, clinical trials, and review studies with the English language published until January 2021 were summarized. They were identified through electronic databases (PubMed, Scopus, and Cochrane Library) and Google Scholar. Findings showed that quercetin can be an effective component for improving glycemic status and other metabolic disorders related to diabetes mellitus based on In vitro and animal studies. However, environmental factors, food processing and using nanoformulations can affect its efficacy in human studies. Several potential mechanisms, including the modulation of gut flora are proposed for its actions. However, due to limited clinical trials and contradictory findings, more high-quality clinical trials are needed to make a decision on the efficacy of supplementation with quercetin as a complementary therapy for the management of diabetes mellitus, metabolic disorders, and modulating gut flora.

The effects of dietary supplements and natural products targeting glucose levels: an overview.

Identifying effective dietary supplements and medicinal herbs has attracted the attention of clinicians and researchers to complement the standard treatment in controlling diabetes mellitus. In the present overview, we aimed to collect studies with the highest level of evidence to shed light on detecting the most effective dietary supplements and medicinal herbs for controlling glycemic status. For the current overview, four electronic databases, including PubMed, Scopus, Web of Science, and Cochrane Library, were systematically searched from inception to 31 December 2020 and then updated until 1 October 2021 to obtain eligible meta-analyses on either dietary supplements or medicinal herbs and their effects on glycemic status. Fasting blood sugar (FBS) and Hemoglobin A1C (HbA1C) were considered as primary outcomes. Finally, ninety-one meta-analyses on dietary supplements (n = 55) and herbs (n = 36) were included. Evidence showed positive effects of chromium, zinc, propolis, aloe vera, milk thistle, fenugreek, cinnamon, ginger, and nettle on FBS and/or HbA1C. However, mostly the heterogeneity (I2) was high. Other supplements and herbs also showed no reduction in glucose levels or their effects were small. Although some dietary supplements and medicinal herbs showed a significant reduction in FBS and/or HbA1C, mostly their effects from the clinical point of view were not remarkable. In addition, due to high heterogeneity, publication bias, and a limited number of included studies in most cases further clinical trials are needed for making decision on anti-diabetic supplement efficacy.

Saffron as a promising therapy for diabetes and Alzheimer's disease: mechanistic insights.

The prevalence of both Alzheimer's disease (AD) and diabetes mellitus is increasing with the societies' aging and has become an essential social concern worldwide. Accumulation of amyloid plaques and neurofibrillary tangles (NFTs) of tau proteins in the brain are hallmarks of AD. Diabetes is an underlying risk factor for AD. Insulin resistance has been proposed to be involved in amyloid-beta (Aß) aggregation in the brain. It seems that diabetic conditions can result in AD pathology by setting off a cascade of processes, including inflammation, mitochondrial dysfunction, and ROS and advanced glycation end products (AGEs) synthesis. Due to the several side effects of chemical drugs and their high cost, using herbal medicine has recently attracted attention for the treatment of diabetes and AD. Saffron and its active ingredients have been used for its anti-inflammatory, anti-oxidant, anti-diabetic, and anti-AD properties. Therefore, in the present review paper, we take account of the clinical, in vivo and in vitro evidence regarding the anti-diabetic and anti-AD effects of saffron and discuss the preventive or postponing properties of saffron or its components on AD development via its anti-diabetic effects.

The effects of medicinal herbs on gut microbiota and metabolic factors in obesity models: A systematic review.

BACKGROUND AND AIMS: This systematic review of animal studies aimed to identify anti-obesity medicinal herbs with prebiotic properties, and investigate their effects on gut microbiota and metabolic disorders. METHODS: To obtain the relevant publications, four electronic databases were systematically searched up to June 2019. RESULTS: Out of 1949 publications, 20 articles met the inclusion criteria in this study. Apart from body weight, some cases (n = 11) had reported the effects of medicinal herbs on metabolic parameters, including lipid profile (n = 7) and glycemic status (n = 4). CONCLUSION: Although some medicinal herbs could be effective in modulating metabolic status and body weight, through making changes in the gut flora, further studies are needed to confirm the efficacy of such herbs in clinical trials.

Comparison of an Iranian Traditional Massage (Fateh Method) with Physiotherapy and Acupuncture for Patients with Chronic Low Back Pain: a Randomized Controlled Trial.

Background: Low back pain (LBP) is currently a major reason for disability worldwide. Therapeutic massage is one of the most popular non-pharmacological methods for managing chronic LBP (CLBP), and the Fateh method is a massage technique based on Iranian Traditional Medicine. Objectives: The current study aimed to compare the effects of Fateh massage with those of acupuncture and physiotherapy on relieving pain and disability in CLBP. Methods: Eighty-four patients with CLBP were categorized into groups that received Fateh massage, acupuncture, or physiotherapy. Each group included 28 randomly assigned patients who completed 10 sessions of therapy. Visual analogue scale (VAS) scores and Roland-Morris disability scores were evaluated at baseline, after intervention, and four weeks later. The findings were analyzed with SPSS software. Results: The baseline VAS and Roland-Morris scores of the three study groups did not indicate significant differences (p > 0.05). All three groups showed significant pre-post improvements in both scores (p < 0.05). At the end of the treatment sessions, the three groups showed no significant difference in the reductions in pain intensity and disability score (p > 0.05). Improvements in disability and pain between the first and third time points were significant in all three groups (p < 0.05 for each group). In addition, the results of massage, physiotherapy, and acupuncture groups were not significantly different (p > 0.05). No adverse events occurred in the patients. Conclusion: The effects of Fateh massage were comparable to those of acupuncture and physiotherapy in reducing pain and disability in patients with CLBP.

The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis.

Some medicinal herbs and their effective components showed positive effects on the features of the cardiometabolic syndrome (CMS). The aim of the present systematic review and meta-analysis is to examine the effects of silymarin on the components of CMS in adults. Four electronic databases including PubMed/Medline, Scopus, Web of Science, and Embase were systematically searched up to December 31, 2020 to identify all eligible clinical trials. A random-effect model using DerSimonian and Laird method was used to estimate the pooled weighted mean differences (WMDs) and the 95% confidence intervals (95%CIs). Finally, 11 clinical trials met the eligibility criteria. Our results demonstrated that silymarin significantly reduced the levels of fasting blood glucose (WMD: -17.96 mg/dL, 95% CI: -32.91, -3.02;I2 : 82.4%, p < 0.001), hemoglobin A1C (WMD: -1.25%, 95% CI: -2.34, 0.16; I2 : 92.9%, p Ë‚ 0.001), total cholesterol (WMD: -17.46 mg/dL, 95% CI: -30.98, -3.95; I2  = 62.9%, p = 0.006), triglyceride (WMD: -25.70 mg/dL, 95% CI: -47.23, -4.17; I2 :54.3%, p = 0.025), low-density lipoprotein-cholesterol (WMD: -10.53, 95% CI: -19.12, -1.94; I2: 37.5%, p = 0.119) and increased high-density lipoprotein- cholesterol (WMD: 3.36 mg/dL, 95% CI: 0.88, 5.84; I2 : 37.4%, p = 0.120) compared to placebo. However, its effects on BMI were not statistically significant. Silymarin can be an effective complementary therapy to improve most features of CMS. However, due to high heterogeneity and limited clinical trials in some parameters, further high-quality clinical trials are needed to confirm its efficacy.

Effect of Garlic (Allium sativum) Supplementation on Premenstrual Disorders: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Premenstrual disorders involve physical, behavioral, and mood variations that affect women of childbearing age and interfere with family relationships, household responsibilities, professional duties, and social activities. OBJECTIVES: Considering the side effects of conventional medications, their use is not recommended except in severe cases of premenstrual disorders. Nowadays, there is a tendency to use traditional and complementary medicine that offers various treatments. The purpose of the current study was to investigate the impacts of garlic as a herbal medicine on the severity of premenstrual symptoms. METHODS: This study was a double-blind, randomized, controlled trial. After identification of participants with moderate-to-severe PMS through the premenstrual symptoms screening tools questionnaire (PSST), they were randomly assigned to placebo (n = 64) or garlic (n = 65) groups. Each participant received one tablet daily for three consecutive cycles and logged the severity of their symptoms in the PSST questionnaire during the intervention period. RESULTS: There was no significant difference between the two groups in the baseline level of premenstrual symptoms before the intervention. After treatment with garlic for three consecutive cycles, the total score of the severity of premenstrual symptoms significantly (P < 0.001) reduced from 34.09 ± 7.31 to 11.21 ± 7.17. In the placebo group, this score changed from 33.35 ± 7.96 to 24.28 ± 7.22. The difference between mean changes in the two groups was 13.78, with a 95% Confidence Interval (CI) of 11.23-16.33. No serious side effects were observed in either group. CONCLUSION: Our findings highlight the potential effect of garlic in reducing the severity of premenstrual symptoms; therefore, the use of garlic can be considered as an alternative therapy in the prevention and treatment of premenstrual disorders.

The Effects of Sesame Consumption on Glycemic Control in Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trial.

OBJECTIVES: In recent years, diabetes has become a global health problem that creates a tremendous economic burden for many countries. Clinical trials evaluating the hypoglycemic effects of sesame consumption have produced conflicting results. This systematic review and meta-analysis was conducted to evaluate the effectiveness of sesame as a popular natural herb on glycemic indices in adults. METHODS: The search for related articles in PubMed, Scopus, Google Scholar, and Cochrane library was conducted through May 2021. Results were reported as weighted mean differences (WMD) with 95% confidence intervals (CI) using a random-effects model. RESULTS: A total of 605 studies were identified through online searching, and a total of eight RCTs representing 382 participants were included in this study. The meta-analyses revealed that sesame consumption significantly decreases serum fasting blood sugar (FBS): (WMD: -28.23 mg/dl; 95% CI (-39.16, -17.13), I 2 = 97.6%; 95% CI (96, 98)), and hemoglobin A1c (HbA1c): (WMD: -1.00%; 95% CI (-1.11, -0.88), I 2 = 0%; 95% CI (0, 79)) as compared to the control group. CONCLUSION: This study provides evidence of the hypoglycemic effects of sesame consumption, particularly in diabetic patients. Additional RCTs on sesame and its preparations should be conducted in different populations to increase generalizability.

Effect of Persian acupressure (Ghamz) on Patients with Knee Osteoarthritis: A Single-Blinded Parallel Clinical Trial.

BACKGROUND: Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. AIMS: To examine the potential efficacy of Ghamz on osteoarthritis outcomes. DESIGN: Clinical Trial. SETTINGS: Randomized, single-blind, sham-controlled clinical trial. PARTICIPANTS/SUBJECTS: Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. METHODS: Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). RESULTS: Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. CONCLUSIONS: This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.

The effect of Melissa officinalis syrup on patients with mild to moderate psoriasis: a randomized, double-blind placebo-controlled clinical trial.

OBJECTIVE: Psoriasis is an immune-mediated inflammatory skin disease. It can involve any body skin area, particularly the scalp, lower back, elbows, and knees. There are several topical and systemic therapies for the treatment. Nowadays, herbal medicines are popular treatments for dermatologic conditions. This two-arm parallel, randomized placebo-controlled clinical trial was conducted to examine the hypothesis of the efficacy of Melissa officinalis syrup on patients with mild-to-moderate Plaque psoriasis. RESULT: Among 100 patients, 95 participants completed the trial and five of them withdrew. The mean pruritus intensity and PASI scores decreased significantly in the intervention group compared to the placebo group (P < 0.001). The DLQI score in the intervention group increased post-treatment compared to pre-treatment (P = 0.029); however, there was no significant difference between the intervention and control group at the end of the study (0.065). TRIAL REGISTRATION: The trial was registered in the Iranian registry of clinical trials on November 9th, 2019 ( https://www.irct.ir/trial/43434 ; registration number: IRCT20191104045326N1).