Exploring the Effectiveness of Ajwain Cream in Treating Taxane-induced Peripheral Neuropathy in Cancer Patients: A Pilot, Randomised and Double-blind Clinical Trial.

Objectives: Chemotherapy-induced peripheral neuropathy is a common disorder among cancer patients receiving various chemotherapeutic protocols. The present study aimed to explore the feasibility of ajwain (Trachyspermum ammi [L.] Sprague) cream in treating peripheral neuropathy symptoms triggered by taxane chemotherapeutic agents. Materials and Methods: This was a pilot, double-blind, and randomised clinical trial on patients with peripheral neuropathy attributable to chemotherapy with taxane drugs during 2021-2022 in Tehran. Patients received ajwain or placebo cream for four weeks and filled out the chemotherapy-induced peripheral neuropathy assessment tool (CIPNAT) at the start and end finale of the trial. Side effects were also noted. Results: Thirty patients suffering from breast, lung, gastro-intestinal, or prostate cancer were allocated to each of the drug and placebo groups. The mean difference in CIPNAT score between the groups was 0.83, demonstrating the statistical ineffectiveness of the drug compared with the placebo (P = 0.372). The safety profile showed promising outcomes at the end of the trial. Conclusion: Although the effectiveness of ajwain cream was unacceptable in treating chemotherapy-induced peripheral neuropathy symptoms, multicentre controlled trials with ample sample size are mandatory for an all-inclusive inference.

Effect of Honey-Lime Spray as Add-On Therapy on Chemotherapy-Induced Xerostomia in Breast Cancer Patients: A Pilot Randomized Double-Blinded Controlled Trial.

INTRODUCTION: Xerostomia (dry mouth) is a common side effect among patients with cancer undergoing chemotherapy. There is no standard treatment for this symptom yet, although Persian medicine textbooks suggested some products to relieve xerostomia. We aimed to assess the efficacy of honey-lime spray in treating chemotherapy-induced xerostomia in breast cancer patients through a controlled study. METHODS: In this pilot, randomized, double-blinded clinical trial conducted in Shohadaye Tajrish Hospital, Iran, the intervention group received honey-lime spray and nystatin, while the control group used distilled water plus nystatin for 2 weeks. The six-item dry mouth form and visual analog score (VAS) were used to evaluate xerostomia extent and pain, respectively. RESULTS: The standardized value of the difference between the mean scores before and after the study was -10.21 (p < 0.001), and the effect size was estimated at 55%. Also, VAS showed a significant decrease in pain for the intervention group compared with the control group (p < 0.001). There were no serious side effects. CONCLUSION: Honey-lime spray may be a good treatment choice for xerostomia in chemotherapy-induced breast cancer patients, but robust trials with larger samples and prolonged follow-ups are highly recommended.Mundtrockenheit (Xerostomie) ist eine häufige Nebenwirkung bei Krebspatienten, die sich einer Chemotherapie unterziehen. Es gibt bisher keine Standardtherapie für dieses Symptom, doch Lehrbücher der persischen Medizin schlagen einige Mittel zur Linderung von Mundtrockenheit vor. Unser Ziel war es, die Wirksamkeit von Honig-Limetten-Spray zur Behandlung von chemotherapiebedingter Mundtrockenheit bei Patientinnen mit Brustkrebs im Rahmen einer kontrollierten Studie zu untersuchen.In dieser randomisierten, doppelt verblindeten klinischen Pilotstudie, die im Shohadaye Tajrish Hospital im Iran durchgeführt wurde, erhielt die Interventionsgruppe zwei Wochen lang Honig-Limetten-Spray und Nystatin und die Kontrollgruppe destilliertes Wasser plus Nystatin. Ein Mundtrockenheits-Fragebogen mit sechs Items wurde zur Beurteilung der Schwere der Mundtrockenheit verwendet und eine visuelle Analogskala zur Beurteilung der Schmerzen.Der standardisierte Wert der Differenz zwischen den mittleren Scores vor und nach der Studie betrug −10,21 (p < 0,01), und die geschätzte Effektstärke betrug 55%. Zudem zeigte die VAS eine signifikante Abnahme der Schmerzen in der Interventionsgruppe im Vergleich zur Kontrollgruppe (p < 0,01). Es traten keine schwerwiegenden Nebenwirkungen auf.Honig-Limetten-Spray könnte eine gute Wahl für die Behandlung von Mundtrockenheit bei Brustkrebspatientinnen unter Chemotherapie sein, doch hierzu werden belastbare Studien mit größerem Probenumfang und längerer Nachbeobachtung nachdrücklich empfohlen.

Efficacy and safety of purslane (Portulaca oleracea) for mild to moderate chronic hand eczema; A randomized, double-blind, placebo-controlled clinical trial.

INTRODUCTION: Chronic hand eczema (CHE) is a common skin inflammation with a complex pathophysiology. Due to its anti-inflammatory properties, Portulaca oleracea L. (purslane) is traditionally used in Persian medicine for skin ailments. This study aimed to evaluate the safety and efficacy of a standardized purslane extract (based on traditional Persian medicine) for adults with mild or moderately severe CHE. METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted at Razi Hospital in Iran from January to June 2022. Participants were randomly allocated to receive an oral purslane or placebo syrup plus topical Vaseline for four weeks. Seventy participants were randomly allocated into the intervention (n = 35) and placebo (n = 35) groups. The primary outcomes were the extent and severity of CHE symptoms over the four weeks after adjusting for age, gender and baseline score. Secondary outcomes were quality of life, symptom recurrence, treatment satisfaction, and adverse events. RESULTS: After 4 weeks of treatment, compared to the placebo group (n = 31), the purslane group (n = 31) had significantly lower physician-reported fissure scores (adjusted mean difference (adjMD): -0.50, 95 %CI -3.93 to -0.34, p = 0.043), participant-reported itching (adjMD -0.51, 95 %CI -2.32 to -0.31, p = 0.041), dryness (adjMD -1.46, 95 %CI -2.89 to -0.03, p = 0.045), and total itching, dryness and thickness (adjMD -2.36, 95 %CI -6.23 to -1.51, p = 0.023) scores. Fourteen participants (purslane n = 10; placebo n = 4, p = 0.068) experienced adverse events of mild to moderate severity. CONCLUSION: Purslane has some promising effects for reducing the extent and severity of CHE symptoms, and no direct comparisons have been made with commonly used treatments. Future multicenter trials and mechanistic studies are warranted to establish the safety and effectiveness of purslane as a potential therapeutic agent for CHE. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT20200707048040N1).

Sumac-rose water mouthwash versus benzydamine to prevent radiation-induced oral mucositis in head and neck cancers: a phase II randomized trial.

BACKGROUND: Radiation-induced oral mucositis (OM) largely impairs the quality of life (QoL) of patients with head and neck cancer (HNC). Few choices with limited efficacy are available to prevent this adverse effect. This randomized trial was conducted to compare the efficacy of benzydamine (standard) and a new combination (sumac and rose water) in preventing radiation-induced OM. METHODS: This was a phase II, triple-blind, active-controlled, randomized trial. The primary endpoint was OM, and the secondary endpoints were oral pain and QoL. Besides, the possible variables defining the outcomes were analyzed using the chi-squared test (univariate analysis) and binomial regression model (multivariate analysis). RESULTS: Sumac-rose group had fewer high-grade OM (33% vs. 63%, odds ratio [OR] 0.28, 95% confidence interval [CI 95%] 0.08-0.93, P = 0.03) and better QoL (P < 0.05). Multivariate analysis confirmed these findings. Sumac-rose rinsing could also postpone the start of oral pain (hazard ratio [HR] 0.02, CI 95% 0.001-0.32, P = 0.001) and high-grade OM (HR 0.28, P = 0.03) compared with benzydamine. CONCLUSIONS: The sumac-rose group had a lower OM rate and grade and higher QoL than the benzydamine group. In addition, the experimental group developed high-grade OM and oral pain later during the radiotherapy course. Further studies need to be conducted to assess the role of sumac and rose water in reducing grade 3-4 mucositis in patients who undergo chemoradiation for head and neck cancer.

Psychometric properties of a Persian version of the Vulvovaginal Symptoms Questionnaire for measuring vulvovaginal symptoms in postmenopausal women.

OBJECTIVE: Vulvovaginal symptoms are common in postmenopausal women and can affect their quality of life and sexual function. Using a sample of postmenopausal Iranian women, we evaluated a Persian translation of the Vulvovaginal Symptoms Questionnaire (VSQ). METHODS: This study included 201 postmenopausal Iranian women referred to dermatology and gynecology clinics affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. We translated the VSQ to the Persian language using the forward-backward method. We examined the questionnaire's internal consistency using Cronbach α coefficient and evaluated its construct validity using exploratory and confirmatory factor analyses. RESULTS: A Cronbach α coefficient of 0.763 confirmed the overall internal consistency of the Persian VSQ. Exploratory factor analysis indicated that except for three items in the symptoms subscale, others had sufficient α coefficients, although some did not load on the expected subscales. Confirmatory factor analysis confirmed the appropriate allocation of all but two items to the expected subscales. An intraclass correlation coefficient of 0.89 confirmed the reliability of the questionnaire. CONCLUSIONS: Although some parts of the Persian VSQ were unsatisfactory, most were appropriate for assessing vulvovaginal symptoms in postmenopausal Iranian women. We recommend further cultural adaptations.

Effects of Chicory and Fumitory on Hot Flashes Among Breast Cancer Survivors: A Randomized, Double-Blind Placebo-Controlled Trial.

Objectives: Hot flashes are unpleasant long-term complications of breast cancer. This study aimed to evaluate the effects of a traditional Persian medicine containing extracts of Cichorium intybus L. (chicory) and Fumaria parviflora L. (Fumitory) extract syrup (CFS) compared with placebo when used as intended. Design: Randomized, double-blind, placebo-controlled clinical trial. Setting/Location: The Oncology Ward of Shahid Modarres Hospital (Tehran, Iran). Subjects: Breast cancer survivors undergoing hormone deprivation therapy. Interventions: Patients were randomly allocated to receive 5 mL CFS or placebo syrup three times a day, for 4 weeks. Outcome measures: The co-primary outcomes were self-reported daily hot flashes frequency and severity scores assessed using self-reported daily dairies, including 1 week of baseline data. Results: Of the 148 patients screened, 137 were eligible, and 96 were randomly allocated to receive either CFS (n = 48) or placebo (n = 48). All participants who returned their dairies were compliant and analyzed as randomized in the a priori per-protocol analysis. After 4 weeks of treatment, both the mean daily hot flashes frequency and severity score had reduced by 57% in the CFS group and 10% in the placebo group. The overall weekly mean daily hot flashes frequency (effect size ηp2 0.221, p < 0.001, n = 66) and severity scores (effect size ηp2 0.160, p = 0.001, n = 66) were significantly lower in the CFS group compared with the placebo group (one-within one-between repeated-measures analysis of variance adjusted for baseline). CFS was well tolerated, with similar proportions of serious and nonserious adverse events occurring in both groups. Conclusions: This is the first study to report the effects of chicory or fumitory for the treatment of hot flashes. The findings provide preliminary evidence that CFS can improve hot flashes in breast cancer survivors undergoing hormone deprivation therapy. More research is warranted to confirm its effectiveness, safety, and mechanisms of action. Clinical Trial Registration: IRCT20210226050506N1.

Effects of honey-lemon spray on recurrent aphthous stomatitis comparing to Triamcinolone ointment: a randomized controlled clinical trial

Recurrent aphthous stomatitis (RAS) is recurrent and painful diseases of the oral mucosa that can be very painful and annoying despite their small size. There is no definitive cure for this disease and the usual treatments are mainly based on pain control. The aim of this study was to investigate the effect of honey-lemon spray (mucotin) in the treatment of recurrent aphthous stomatitis. Methods: This study is a randomized controlled clinical trial conducted in 2020 at Zahedan University of Medical Sciences on 46 RAS patients. The participants were randomly assigned to the intervention (mucotin) or control groups (Triamcinolone ointment) equally (23 patients in each group). Patients were evaluated for the severity of pain and ulcer size. Evaluations were performed on days 0, 2, 7 of the treatment using VAS. Data were analyzed using ANOVA statistical test. Results: The inner aspect of the lower lip was the most common site of RAS in the participants (48.8%) and the lowest site went for hard palate (2.4%). Four items including pain, burning sensation, necrosis area, and erythematous area were evaluated in both groups. There was no significant difference in all parameters before the treatment period (day 0). The mean pain score, burning sensation, necrosis, erythematous areas were not different in days 0, 2 and 7 between groups respectively (p=0.849, p=0.105, p=0.917, p=0.442). Conclusion: Honey-lemon spray (Mucotin) and topical corticosteroid have similar effects in RAS treating, So Mucotin can be used as the first line of treatment for RAS lesions. This herbal medicine has no side effects

Effects of Herbal Medicines on the Prevention and Treatment of Contact Dermatitis: A Systematic Review.

Background: Contact dermatitis (CD) is a common inflammatory disease of the skin. CD has a complex and multifaceted treatment, and one of the main components of CD treatment is inflammation management. We summarized the clinical trials exploring the effects of herbal medicine on patients with CD. Methods: A systematic review was performed by searching four databases. Clinical trials in English investigating the effect of herbal medicines on CD prevention and treatment published from 2010 to 2020 were reviewed. This study was conducted based on the PRISMA guidelines. Results: Nine clinical trials examining the effects of herbs on CD were identified. A total of 450 patients participated in these studies. Herbal medicines used in the reviewed studies were in various forms. Almost all the studies showed that these herbs were useful in preventing and treating CD. Regarding the side effects of the herbal medicines, few complications such as erythema and papules as well as positive chronotropic effects were reported. Conclusion: Evidence showed that herbal medicines were effective in preventing and treating CD by reducing the inflammation level and increasing antioxidant defense. However, the number of clinical trials was low to draw definitive conclusions. Moreover, the studies were not homogeneous and differed regarding methodology, evaluation tools, and quality. Also, in these studies, the interactions and safety of the herbal medicines were not considered adequately. Therefore, well-designed evidence is required to draw definitive conclusions in this regard.

Comparing Dermolina-Henna Cream with Mometasone Cream in Improving Radiodermatitis Among Patients with Breast Cancer: A Randomized Active-Control Double-Blind Clinical Trial.

Objectives: Radiotherapy is one of the treatments used for different types of cancer. Acute radiodermatitis is one of its most common complications. Despite the high prevalence of radiodermatitis, few studies investigated how to prevent or treat this complication. Hence, a standard treatment has not been introduced so far. We sought to evaluate the efficacy of Dermolina-Henna cream, a new polyherbal formulation, compared to Mometasone cream for alleviating acute radiodermatitis among breast cancer patients. Design: Randomized active-control double-blind clinical trial. Setting/Location: The oncology clinic of Shohaday-e Tajrish Hospital (Tehran, Iran). Subjects: Women older than 18 years with breast cancer undergoing radiotherapy. Interventions: Patients were instructed to apply a thin layer of Dermolina-Henna or Mometasone cream once daily on their lesions at least 3 h after radiotherapy for 4 weeks, and if grade I or II radiodermatitis developed, also afterward. Patients were visited weekly until end of study at after 4 weeks. Radiation Therapy Oncology Group standard questionnaires were evaluated and recorded every week as the primary outcome. Outcome measures: Primary outcome was defined as evaluating the efficacy of Dermolina-Henna cream to change the radiodermatitis grade, while the level of patients' satisfaction and the rate of adverse events recorded by patients were secondary outcomes. Results: The trends on decrease in number of lesions, erythema, radiodermatitis grade, burning sensation, pain, and itchiness were statistically significant for each treatment, separately (p < 0.001), except for radiodermatitis grade in Mometasone group (p = 0.4). Dermolina-Henna was significantly better than Mometasone in alleviating burning sensation (p < 0.001) and itchiness (p = 0.041). Approximately 3.7% of patients showed adverse events and 3.7% declared dissatisfaction in both groups. Conclusions: In summary, we showed that Dermolina-Henna cream and Mometasone cream were significantly effective in decreasing severity of radiodermatitis symptoms among patients with breast cancer. Dermolina-Henna cream was significantly superior to Mometasone cream in alleviating burning and itchiness. Clinical Trial Registration Number: IRCT20200115046144N1.

Efficacy and Safety of Jollab (a Saffron-Based Beverage) on Cancer-Related Fatigue in Breast Cancer Patients: A Double-Blind Randomized Clinical Trial.

INTRODUCTION: Fatigue is a common complaint in cancer patients and profoundly affects the quality of life of the patients. Therefore, we designed a clinical trial to evaluate the safety and efficacy of Jollab (containing saffron, honey, and rose water) as a tonic beverage in the management of cancer-related fatigue in breast cancer patients. METHODS: Seventy-five patients were randomly assigned into two groups, patients received either 4 weeks Jollab or the placebo (20 mL three times daily). Fatigue was assessed with scores of Visual Analogue Fatigue Scale (VAFS), Fatigue Severity Scale (FSS), and Cancer Fatigue Scale (CFS) at weeks 0 and 4 (before and after the intervention). RESULTS: In the Jollab group, VAFS showed a significant decrease (p = 0.000), but in the placebo group, there was no significant difference (p = 0.258). In the Jollab group, FSS decreased significantly (p = 0.000), while in the placebo group, it slightly decreased (p = 0.096). CFS physical and cognitive subscales also showed improvement of fatigue in the Jollab group compared to the placebo group (p < 0.05), but affective subscale score did not show a significant change after the intervention in both groups (p > 0.05). CONCLUSIONS: Jollab beverage has significant positive effects on reducing fatigue in women with breast cancer. However, larger-scale trials with further sample size and longer period of the intervention are needed to confirm and develop our preliminary findings.

Efficacy of lettuce seed syrup on insomnia in patients with breast cancer: a pilot double blind randomized placebo controlled clinical trial.

OBJECTIVES: Insomnia and sleep disorders are common and can be severe amongst patients with cancer, especially during chemotherapy. The aim of this study was to evaluate the efficacy of lettuce seed syrup in breast cancer patients who suffer from insomnia or disordered sleep. METHODS: This pilot study was a double-blinded randomized controlled clinical trial conducted in Shoha-e-Tajrish Hospital (Tehran, Iran) from September 2018 to June 2019. 50 adult patients with breast cancer with insomnia or sleep disorders were enrolled. Participants were randomly allocated to lettuce seed syrup (5 mL twice daily), or placebo syrup at the same dose for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality before and after the intervention. RESULTS: Compared to placebo, the mean of the total PSQI score decreased significantly in participants who received lettuce seed syrup (p=0.014). In addition, there were statistically significant reductions in the mean scores of subject quality sleep (p=0.002), sleep duration (p=0.038), habitual sleep efficacy (p=0.029) and sleep disturbance (p=0.032) in patients who received lettuce seed syrup. CONCLUSIONS: Lettuce seed syrup may improve self-reported sleep quality in participants with breast cancer. Larger trials are indicated in diverse samples of participants with caner to learn if these finds are generalizable.

Herbal Medicines for Treatment of Radiodermatitis: A Systematic Review and Meta-Analysis.

Background: There is some evidence in favor of the efficacy of herbal medicine in the treatment of radiodermatitis as a frequent complication among cancer patients. Purpose: The present study aimed to evaluate the effect of herbal medicines on the treatment of radiodermatitis in cancer patients. Study design: Systematic review performed in accordance with the PRISMA guideline. Methods: We searched the electronic databases, Scopus, PubMed, Cochrane Library, Embase, Google Scholar, and ISI Web of Science, through July 2020 for randomized controlled trials (RCTs) that compared herbal compounds against a standard medication or placebo for treatment or prevention of radiodermatitis. Results: A total of 16 RCTs involving 1886 patients with breast, head and neck, or unspecified cancer were included. Risk of bias generally was high. Of those, three RCTs with 562 cancer patients (mainly breast cancer) who used Aloe vera to treat radiodermatitis were included in the meta-analysis. There was a significant level of heterogeneity between the studies (I2 = 95.8). One RCT found positive effects of Aloe vera in reducing the severity of radiodermatitis (standardized mean difference [SMD] = 3.37), whereas another revealed an inverse effect (SMD = -4). Conclusion: At present, there are no herbal compositions that are effective in treating radiodermatitis, with Aloe vera failing to show sufficient efficacy in the meta-analysis.

Effect of Honey-Lemon Spray Versus Benzydamine Hydrochloride Spray on Radiation-Induced Acute Oral Mucositis in Head and Neck Cancer Patients: A Pilot, Randomized, Double-Blind, Active-Controlled Clinical Trial.

Introduction: Oral mucositis (OM) is the most prevalent side effect in patients with head and neck cancer (HNC). It causes an obvious decrease in quality of life (QoL) in these patients, so different medications have been recommended for OM, however, without optimal response. This randomized trial aimed to assess the effects of a honey-lemon spray compared with benzydamine hydrochloride in prevention of radiation-induced OM in patients with HNC. Materials and Methods: Forty-six patients with HNC received external beam radiotherapy for 5 days per week. Patients were randomized to treatment with either benzydamine hydrochloride spray or honey-lemon spray for 5 weeks and continued for 1 week after the end of treatment. The oral cavity was examined weekly, with a score given to each site based on the degree of mucositis using a 4-point scale, and a mean mucositis score was calculated as the primary outcome. Occurrence of OM, pain, QoL, and adverse effects were defined as secondary outcomes. Patients, therapists, and outcome assessors were blinded to group allocation. Results: No significant group differences occurred in the mucositis score, pain, or QoL. Mucositis occurrence rates were higher in the benzydamine hydrochloride group compared with the honey-lemon group (hazard ratio = 2.1, 95% confidence interval: 1.1 to 4.2). Two patients in the honey-lemon group had mild nausea and burning throat; no adverse effects occurred in the benzydamine hydrochloride group. Conclusions: There were no significant group differences in mucositis severity between patients treated with honey-lemon spray and benzydamine hydrochloride. The potential preventive effects of honey-lemon spray need to be confirmed in further trials. The trial registration number is IRCT20161024030467N1.

Herbs as old potential treatments for lymphedema management: A systematic review.

INTRODUCTION: Herbs have been reported to be effective in reducing lymphedema burden. This paper aimed to review literature reporting on herbs for lymphedema treatment. METHODS: A systematic review was performed using the PRISMA guideline. Clinical studies on herbal intervention and lymphedema were included. Evidence on the effectiveness of herbal interventions for desired outcomes including reduction of edema volume, other symptoms, quality of life and inflammation were collected and assessed in detail. RESULTS: In all twenty studies were included in this review. Of these 14 studies were randomized clinical trials and the rest were prospective pilot studies. Herbal treatment was reported for breast cancer-related lymphedema in most studies and coumarin was the most reported herb that used for lymphedema management. Edema volume reduction (17 out of 20) and symptoms improvement (15 out of 20) were the outcomes reported in most studies. CONCLUSION: Phytochemicals can be a promising pharmacotherapy for lymphedema management. However, further evidence is needed to establish definite effectiveness for the use of herbal remedies for lymphedema management.

Topical Costus sp. Preparation as Palliative Care for Chemotherapy-Induced Peripheral Neuropathy of Patients: A Randomized Placebo-Controlled Pilot Trial.

Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of various anticancer regimens with different sensory-motor abnormalities in patients. The aim of this study was to examine the feasibility of using Costus sp. oil as a palliative treatment in such patients. Design: This was a pilot randomized placebo-controlled double-blind clinical study. Settings/Location: Imam Hossein Hospital, Tehran, Iran. Subjects: Patients 18-80 years of age undergoing chemotherapy treatment recently or during the last 6 months were enrolled after meeting the inclusion criteria. Interventions: The intervention group used Costus sp. as a topical ointment and the placebo group used topical paraffin for 4 weeks. Outcome measures: Feasibility of recruitment, including treatment acceptability (evaluated as number of patients leaving the study early), and compliance (defined as consumption of a minimum 80% of the ointment) with the intervention were assessed. Neuropathic pain change was defined as the secondary outcome, too. Results: Totally, 50 out of 73 participants were identified eligible and were randomly divided into intervention or placebo groups. There was no significant difference between groups in terms of sociodemographic data. At the end of the study, 24% (confidence interval [95% CI]: 9-45) (intervention group) and 12% (95% CI: 2-31) (placebo group) of patients revealed treatment unacceptability. Meanwhile, 12% (95% CI: 2-31) in the intervention group and 28% (95% CI: 12-49) in the placebo group did not show the compliance. Moreover, according to patients' records, pain reduction was higher in the intervention group compared to the placebo group (p = 0.001). Conclusions: This preliminary study showed that topical use of Costus sp. was feasible and acceptable in patients suffering from CIPN.

Galen's place in Avicenna's The Canon of Medicine: Respect, confirmation and criticism.

Galen (129-199 A.D.), an ancient Greek scholar, is one of the most influential and recognized physicians and surgeons in the history of medicine. He is one of the most influential Greek scholar in Persian medicine, who has been repeatedly cited by Iranian scholars. The purpose of this article is to describe the exact position of Galen in Avicenna's The Canon of Medicine, the most important work of Persian medicine. In The Canon of Medicine, Galen is cited about 300 times, and Avicenna always admired and praised Galen repeatedly. Galen's ideas were important to Avicenna, but there are also many elements of Galen's views that Avicenna challenged or criticized. For example, Avicenna diverged from Galen's philosophical view in medicine and rejected some of Galen's pharmaceutical opinions and Galen's views on the physiology of pain, the physiology of pulse, the same nature of the tendons and nerves and separation of the mind and body. Although the views of Greek scholars, especially Galen, in The Canon of Medicine have been quoted abundantly, Avicenna revised the knowledge of the ancient scholars through critical thinking and relying on observation and testing, systematized the science of medicine and introduced many ideas and innovations. As such, Europeans considered Avicenna as the most prominent physician of the Islamic Golden Age.

Efficacy of topical Citrullus colocynthis (bitter apple) extract oil in chemotherapy-induced peripheral neuropathy: A pilot double-blind randomized placebo-controlled clinical trial.

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common complications in patients with cancer. Citrullus colocynthis (bitter apple) has been used in traditional Persian medicine as an effective pain relief, especially for neuralgia. We designed a pilot clinical trial to evaluate the safety and efficacy of topical C. colocynthis oil in management of CIPN in breast cancer patients. Thirty-four cancer patients with CIPN were randomly enrolled in two arms of a randomized, double-blind, placebo-controlled clinical trial. The patients were treated by topical C. colocynthis oil or placebo, two times per day for 2 months. Functional Assessment of Cancer Therapy/Gynecologic Oncology Group (FACT/GOG)-Neurotoxicity (Ntx) score was set as the primary outcome measure. No significant improvement was observed in the total score of FACT/GOG-Ntx scale (2.40 ± 1.90 vs. 1.05 ± 1.36, p = .879) in drug and placebo groups, respectively. There was also no significant improvement in the mean scores of FACT/GOG-Ntx in the sensory, motor, hearing, and functional domains in the two study groups. According to the results of this preliminary study, topical C. colocynthis oil failed to improve the symptoms of CIPN compared with placebo.

The Effect of a Chickpea-Based Persian Diet on Cancer-Related Fatigue in Breast Cancer Patients: A Semi-Experimental Study.

BACKGROUND: Cancer-related fatigue (CRF) is one of the most common symptoms associated with cancer or its treatment. OBJECTIVES: The aim of the current study was to evaluate the effect of chickpea-based diet (Nokhodab) on CRF in female breast cancer patients undertaking routine treatment. METHOD: Forty female patients with diagnosis of breast cancer were enrolled. The patients were asked to use a chickpea-based Persian diet daily for the period of 3 weeks. Symptom assessment was made for all women by the Cancer Fatigue Scale (CFS) and the Fatigue Severity Scale (FSS) questionnaires and Visual Analogue Scale (VAS). RESULTS: CRF decreased significantly at the end of the study, compared to the beginning (p < 0.05). Mean of CFS was 40.72 before the intervention, while showing a significant decrease to 33.38 at the end of our study (p = 0.001). A comparison of FSS and VAS before and after intervention shows that FSS and fatigue VAS mean scores have a significant decline at the end (p < 0.001). CONCLUSIONS: Nokhodab, as an available diet, could be a good choice for relieving CRF in breast cancer women. Traditional/complementary medicine may present some effective therapeutic suggestions for cancer complications.