A randomized double-blind active-controlled clinical trial on the efficacy of topical basil (Ocimum basilicum) oil in knee osteoarthritis.

Background: Basil is a widely used herb in Persian medicine and is gaining recognition as a functional food worldwide. Aim of the study: This trial aimed to assess the effectiveness of a traditional formulation of basil oil in comparison with diclofenac gel in treating knee osteoarthritis, considering its established anti-inflammatory, anti-nociceptive, and anti-oxidative properties. Materials and methods: One hundred eligible patients were equally randomized to the traditional basil oil (containing sesame oil) and diclofenac gel groups. They used their respective topical treatments thrice daily for 4 weeks. Various measurements were taken at the beginning of the study, 2, and 4 weeks after starting the intervention, including the 8-m walk test, knee pain (based on visual analog scale), flexion angle of the knee joint, analgesic consumption, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Results: No significant differences were observed between the basil oil and diclofenac gel groups in any of the measured outcomes. However, significant improvements were noted within each group for most variables. Conclusion: Topical application of the traditional formulation of basil oil appears to improve clinical symptoms and certain functional indicators of knee osteoarthritis to a similar extent as diclofenac gel. This suggests that basil oil could be considered an effective management option for this condition. Clinical Trial Registration: https://irct.behdasht.gov.ir/, identifier IRCT2017081711341N7.

Therapeutic effects of saffron (Crocus sativus L) on female reproductive system disorders: A systematic review.

The effect of Crocus sativus on several disorders has been discussed or even confirmed, but the efficacy of this herb on the female reproductive system has not been well presented. In this regard, this systematic review comprehensively discussed the efficacy of C. sativus and its main phytochemical compounds on the female reproductive system and its disorders for the first time. In this systematic review, scientific databases, including PubMed, Web of Sciences, Google Scholar, Scopus, and Scientific Information Database, were explored profoundly. In vivo, in vitro, and human studies published until the end of July 2023, which had investigated the pharmacological properties of C. sativus, crocin, crocetin, safranal, or picrocrocin on the female reproductive system, were selected. A total of 50 studies conducted on the effect of C. sativus on the female reproductive system were acquired. These studies confirmed the efficacy of C. sativus or its main phytochemical ingredients in several aspects of the female reproductive system, including regulation of sex hormones, folliculogenesis, ovulation, and protection of the ovary and uterus against several oxidative stress. Several retrieved studies indicated that this herb also can alleviate the symptoms of patients suffering from dysmenorrhea, premenstrual syndrome, menopause, polycystic ovary disease (PCOD), and sexual dysfunction. Furthermore, it is a promising candidate for future studies or even trials regarding ovarian and cervical cancers. This review concluded that C. sativus can improve the symptoms of several female reproductive system disorders, which is particularly due to the presence of phytochemical ingredients, such as crocin, crocetin, and safranal.

Medicinal Plants for Viral Respiratory Diseases: A Systematic Review on Persian Medicine.

Introduction: Many medicinal plants have been introduced in Persian medicine references for various respiratory disorders. Considering the growing interest in herbal medicines, this review aimed to introduce medicinal herbs recommended by Persian Medicine (PM) references for respiratory diseases and to discuss their activity against respiratory viruses. Methods: The medicinal plants recommended for respiratory disorders were extracted from the main PM textbooks. Subsequently, their activity against respiratory viruses was systematically investigated via queries of scientific databases. Results: Searching PM references for medicinal plants used in the management of respiratory disorders yielded 45 results. Of them, 18 possess antiviral activity against respiratory viruses. There were 29 in vitro studies (including studies on human cell lines) and 5 in vivo studies. Conclusion: This research demonstrated that many of the medicinal plants mentioned for the respiratory diseases in PM have considerable activity against respiratory viruses. However, human studies regarding the reported medicinal plants are scarce.

Efficacy of a Persian herbal medicine compound on coronavirus disease 2019 (COVID-19): A randomized clinical trial.

Background: The global attention to the capacities of traditional medicine for alleviating the clinical manifestations of COVID-19 has been growing. The present trial aimed to evaluate the efficacy and safety of a Persian herbal medicine formula among patients with COVID-19. Methods: The present trial was conducted in Afzalipour hospital, Kerman, Iran, from June to September 2020. Hospitalized COVID-19 patients were randomly divided into intervention (Persian herbal medicine formula + routine treatment) or control (only routine treatment) groups. The intervention group received both capsule number 1 and 2 every 8 hours for 7 days. Capsule number 1 contained extract of the Glycyrrhiza glabra, Punica granatum, and Rheum palmatum, and the second capsule was filled by Nigella sativa powder. Participants were followed up to 7 days. The primary outcome was the number of hospitalization days, while cough, fever, and respiratory rate, days on oxygen (O2) therapy, and mortality rate were considered as the secondary outcomes. Results: Eighty-two patients were enrolled to the study, while 79 cases completed the trial and their data were analyzed (mean age: 59.1 ± 17.1 years). Based on the results, the Persian medicine formula decreased the mean hospitalization days, so that the mean difference of length of hospitalization as primary outcome was 2.95 ± 0.43 days. A significant clinical improvement was observed regarding dyspnea, need for O2) therapy, and respiratory rate in the intervention group. No adverse effects were reported. Conclusion: The present study supported the use of the Persian medicine formula as an adjuvant therapy for hospitalized COVID-19 patients. Study registration: Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1. Study registration: Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1.

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

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

Mechanistic support of traditional Persian medicine for the treatment of acne vulgaris: A scoping review.

BACKGROUND: Acne vulgaris is one of the most prevalent skin diseases, which also contributes to many psychological problems. Despite the recent progress in the treatment of acne vulgaris, the necessity for discovering more effective solutions has motivated many lines of research on natural and medicinal plants. The Traditional Persian Medicine (TPM) introduced some plants and remedies for acne treatment. Given the universal welcome for herbal medicine, this review was performed to formally assess the evidence for herbal medicines for acne vulgaris in TPM. METHODS: The medicinal plants used in this study for treating acne vulgaris were selected based on common references to the plants in five famous textbooks of TPM from different time periods. Then, the anti-inflammatory and anti-microbial effects of these medicinal plants were investigated according to the recent literature available in five electronic databases including Scopus, Web of Sciences, PubMed, Google Scholar, and Science Direct. RESULTS: Twenty-one herbs were commonly references in traditional TPM texts as helpful for topical treatment of acne vulgaris. The data collected from the electronic databases demonstrated most of these plants (eg, Astragalus sarcocolla, Ficus carica, and Hordeum vulgare) have both anti-inflammatory and anti-microbial mechanisms, which may assist to treat acne vulgaris. CONCLUSION: This scoping review demonstrated many medicinal plants recommended by TPM books have therapeutic potential for acne vulgaris via multiple mechanisms.

Validity and reliability of the Persian version of the oropharyngeal Mucositis quality of life scale.

BACKGROUND: Oral mucositis is one of the serious complications of chemotherapy and/or radiotherapy that significantly affects the quality of patients' life. The Oropharyngeal Mucositis-Specific Quality-of-Life questionnaire (OMQoL) is an acceptable instrument for measuring the quality of life in these patients. The aim of this study was to evaluate the validity and reliability of the Persian version of OMQoL questionnaire. METHODS: This study was a cross-sectional and multi-centric research. After translation from English to Persian, back translation, and cultural adaptation, the Persian version of the questionnaire was prepared. One hundred forty-four patients suffering from oral mucositis referred to three different university affiliated hospitals related to Zahedan, Kerman and Tehran Universities of Medical Sciences, were participated in this study. Then the questionnaire was completed by trained interviewers. The reliability was assessed by Cronbach's alpha coefficient, and validity was measured through factor analysis, and construct validity (including discriminant validity, and convergent validity) methods. RESULTS: Cronbach's alpha in all dimensions was higher than 0.9 that indicated a perfect internal consistency. The results of factor analysis indicated that the dimensions specified in the Persian version were the same as the original version (Factor loading of all items > 0.4). The correlation coefficient for all items was more than 0.75, and the convergence validity was 100% in all dimensions. CONCLUSION: The results of this study showed that the reliability, and validity of Persian version of OMQoL were acceptable, which can be used to measure the quality of life in patients with oral mucositis.

Ethnopharmacological Knowledge for Management of Oral Mucositis in Zahedan, Southeast Iran

Objectives: Oral mucositis is among the complications of cancer therapy that affects quality of life and imposes remarkable financial costs for patients with cancer. This study aimed to explore, preserve, and scientifically investigate the ethnomedicinal knowledge of traditional healers for treatment of oral mucositis in Zahedan, Iran. Materials and Methods: Field surveys were performed from September 2018 to October 2018 in Zahedan. Data was collected using a structured questionnaire in Persian. All species recorded for the treatment of oral mucositis were sampled. Samples were identified by a botanist and a voucher specimen of them was deposited in the Herbarium Center of the Faculty of Pharmacy in Kerman, Iran. Information, such as scientific name, family, local name, parts used, and preparation method, were also provided. Literature review on available data on effect of the addressed plant species on mucositis and other relative pharmacological actions, such as wound healing and anti-inflammatory properties, was performed. Results: A total of 29 informants (attars) were interviewed and 18 medicaments were recommended, of which three samples were of synthesis or mineral origin and 15 samples were of herbal origin. Drugs were administered both topically and orally. According to recent studies, two herbs were evaluated for their direct effect on mucositis. Some pharmacological properties related to mucositis treatment by the other 11 samples have been confirmed. Conclusion: This study provides information on the characteristics of medicinal plants from Zahedan, Iran based on their ethnopharmacological knowledge and pharmacological properties for mucositis treatment.

An Evidence-Based Research on Botanical Sources for Oral Mucositis Treatment in Traditional Persian Medicine.

BACKGROUND: Cancer is one of the most prevalent diseases associated with heavy complications in treatment. Mucotoxic cancer therapies such as head and neck radiotherapy and some of the chemotherapy agents may lead to oral mucositis. In addition to its economic consequences, mucositis also affects patients' quality of life. In Traditional Persian Medicine (TPM) manuscripts, several medicaments have been suggested for the treatment of mucositis. OBJECTIVE: Considering the public welcome for herbal medicine, the current evidence-based review study is conducted to investigate the herbal remedies which have been proposed for oral mucositis in TPM. METHODS: At first, a comprehensive survey was done on Qanon fi al-Teb, which is the most important textbook of TPM; then the scientific name of the herbs was authenticated according to the botanical textbooks. At last, data banks including Scopus, Pubmed, Web of science and Science direct were investigated for possible relevant properties of each medicinal plant in the literature. RESULTS: In total, 30 herbs are introduced in this study. According to the registered documents, 18 herbs are reported to have antioxidant, anti-inflammatory, antimicrobial, anti-nociceptive and wound healing properties of which the therapeutic effect of only a few herbs including Glycyrrhiza glabra, Malva sylvestris, Morus nigra, Punica granatum, and Solanum nigrum were directly evaluated against oral mucositis on the literature. CONCLUSION: Despite the lack of human studies on mucositis for the other discussed herbs, their related pharmacological properties can be considered for new natural drug discovery supported by medieval and traditional experiments.

Evaluating the efficacy and safety of the myrtle (Myrtus communis) in treatment and prognosis of patients suspected to novel coronavirus disease (COVID-19): study protocol for a randomized controlled trial.

BACKGROUND: Since December 2019, the outbreak of coronavirus pneumonia was observed in China and quickly propagate in all of the world. Nowadays, many trials are underway on this disease in which the efficacy of various therapeutic remedies including chemical or natural agents as well as different non-pharmacological methods such as acupuncture are evaluated. This study aims at investigating the effect of M. communis fruit for treatment of COVID-19 disease. METHODS: We are performing an open-label randomized controlled trial on outpatients clinically suspected to COVID-19 disease in the age range of 18-65 years old with mild to moderate symptoms and without respiratory distress. Patients in both groups (M. communis and control) receive conventional therapy, but those in M. communis group get M. communis preparation in addition to conventional therapy. Intervention will continue for 5 days and the study outcomes including clinical status as well as mortality rate and adverse effects will be measured up to 14 days. DISCUSSION: The protocol describes the design of an ongoing randomized controlled trial to establish the evidence for the usage of water extract of M. communis fruit in clinically suspected COVID-19 disease and identify any safety concerns. TRIAL REGISTRATION: The trial has been registered at the Iranian Registry of Clinical Trials website under the code IRCT20180923041093N3 on March 28th, 2020 ( https://www.irct.ir/trial/46721 ). The results will be disseminated through manuscript publications and presentations to scientific meetings.

Effects of a Plantago ovata-based herbal compound in prevention and treatment of oral mucositis in patients with breast cancer receiving chemotherapy: A double-blind, randomized, controlled crossover trial.

BACKGROUND: Oral mucositis (OM) is one of the most common complications of mucotoxic cancer therapy. Mucositis induces clinically significant pain, increases the risk of infections and affects the patients' quality of life. OBJECTIVE: This study investigated the effects of an herbal preparation from Plantago ovata hydrocolloid in the prevention and treatment of OM, in breast cancer patients undergoing chemotherapy with a regimen including adriamycin. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: This research was a double-blind, randomized, controlled crossover trial. The herbal compound consisted of a mixture of 500 mg of P. ovate husk in 30 mL water plus three drops of vinegar per dose, which was used as a mouthwash. Phytochemical and physicochemical tests of the compound were also performed. Twenty-eight patients who developed mucositis during the chemotherapy screening cycle were randomized to the herbal compound (n = 14) and placebo (n = 14) groups. They received herbal compound or placebo three times per day during their next chemotherapy cycle (cycle 1 of treatment). Patients were crossed over during cycle 2 of treatment and received the alternative therapy. An oral care protocol was prescribed to all patients in cycles 1 and 2 of the treatment. MAIN OUTCOME MEASURES: The patients were visited at baseline, the end of the first and second weeks of the screening cycle, and the end of the first and second weeks of each of two treatment cycles. The degree of mucositis was used as the main treatment outcome. Other indexes, such as the severity of pain, xerostomia grade and the quality of life were also measured. RESULTS: Compared with the placebo, the herbal compound significantly reduced the degree of mucositis, the severity of pain and the xerostomia grade; it also improved the patients' quality of life (P < 0.05). Comparison between the screening cycle and placebo treatment group showed that the oral care protocol had a significant effect in the reduction of OM (P < 0.05). CONCLUSION: The oral care protocol and the herbal compound based on P. ovata are effective ways for preventing and treating OM in patients undergoing mucotoxic cancer therapy. TRIAL REGISTRATION: Iranian registry of clinical trials IRCT20180923041093N1.