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 two 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.

Efficacy and safety of aniseed powder for treating gastrointestinal symptoms of COVID-19: a randomized, placebo-controlled trial.

Background: Gastrointestinal symptoms are prevalent amongst patients with a confirmed diagnosis of COVID-19 and may be associated with an increased risk of disease severity. This trial aimed to evaluate the efficacy and safety of aniseed (Pimpinella anisum L.) powder as an add-on therapy to standard care for treating gastrointestinal symptoms experienced by adults with an acute SARS-CoV-2 infection. Methods: The study was a randomized parallel-group double-blinded placebo-controlled add-on therapy trial. Adults with an acute SARS-CoV-2 infection who did not require hospitalization and reported at least one gastrointestinal symptom in the preceding 48 h were assigned to either the aniseed or placebo group in a 1:4 ratio. All 225 participants (45 in the aniseed group and 180 in the placebo group) were instructed to use 25 g of powdered aniseed or placebo twice daily for 2 weeks. The primary outcomes were the proportion of patients who experienced an improvement of at least one point in the symptom score after adjusting for age group, gender, and time. Backwards stepwise logistic regression was applied to calculate the risk ratios. The clinical symptoms and adverse events were assessed at the beginning, 1 week later, and at the end of the trial (week two). Results: Participants in the aniseed group were significantly more likely to report symptom improvement for abdominal pain [adjusted risk ratio (RR):0.55; 95% confidence interval (CI): 0.46-0.72], anorexia (RR:0.62; 95% CI: 0.47-0.82), and diarrhea (RR:0.19; 95% CI: 0.12-0.30), but not nausea/vomiting (RR:0.87; 95% CI: 0.71-1.08) or bloating (RR:0.87; 95% CI: 0.72-1.05). Two participants in the aniseed group and three participants in the placebo group reported mild to moderate adverse events. Conclusion: This study showed that 2 weeks of aniseed powder containing trans-anethole (87%-94%) may help improve abdominal pain, anorexia, and diarrhea in COVID-19 patients. The findings align with the known biological, multitargeted activity of P. anisum and trans-anethole, which includes inhibiting SARS-CoV-2 along with other anti-infective, anti-inflammatory, antioxidant, hepatoprotective, and anti-dysbiosis properties. Multicenter trials with larger sample sizes and longer follow-up are warranted to confirm these findings. Clinical Trial Registration: Iranian Registry of Clinical Trials (IRCT20120506009651N3).

Complementary and alternative medicine use among people living with HIV in Shiraz, Southern Iran.

Background: Living with HIV requires lifelong care to support engagement with and adherence to antiretroviral therapy. The Middle East and North Africa region provides access to ART, but research is lacking on the lived-experiences of people living with HIV. Globally, complementary and alternative medicine (CAM) is increasingly used by patients who need support alongside receiving medical treatment for chronic conditions. This study aims to examine the frequency and reasons behind the use of CAM, as well as identify its associated factors among people living with HIV in Shiraz, Iran. Methods: In this cross-sectional study, a total of 320 patients (aged 18-70 years) with a confirmed diagnosis of HIV residing in Fars province and diagnosed between 1999 and 2019 were recruited randomly through their clinical record numbers from five HIV treatment centers. They were surveyed on their quality of life and CAM use via the Short-Form Health Survey questionnaire (SF-36) and a semi-structured survey of "CAM use." The data analysis for this study involved the use of Chi-squared test, independent t-test, and multiple logistic regression model. Results: Of 287 patients, 89.22% reported using CAM in the previous year. CAM use was more prevalent among those with a family history of CAM use (94.3% vs. 81.8%, p = 0.023). Frequent reasons for using CAM were reported to be sexual dysfunction (32.4%), depression (28.3%), thirstiness (23.3%), and nausea (17.5%). Quality of life, as measured via the SF-36 questionnaire in all its 8 sub-domains, did not differ among those who used CAM versus those who did not (61.5 ± 27.6 vs. 58.1 ± 30.9, p = 0.626). Conclusion: CAM was used among a majority of people living with HIV in Shiraz, Iran. People who used CAM appeared to experience a similar quality of life relative to those who did not use CAM. Future studies on the modalities of engagement with CAM can improve patient-physician shared decision-making and increase lifelong care options for people living with HIV.

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).

Use of Complementary and Alternative Medicine and its Related Factors Among Pregnant Women in Shiraz, South of Iran: A Cross-Sectional Study.

Background: Women are known to use Complementary and Alternative Medicine (CAM) during pregnancy despite the subsequent potential unknown effects associated with its use. This study was performed to evaluate the use of CAM products and its related factors among pregnant women in Shiraz, Iran. Materials and Methods: This cross-sectional study of 365 pregnant women referred to obstetrics clinics affiliated to Shiraz University of Medical Sciences (Iran) was conducted in 2020. Sampling was performed in all three affiliated centers based on a probability, proportional to size protocol. Pregnant women were nominated using a systematic random sampling scheme using their health record numbers. A 20-item questionnaire was administered via in-person interviews and data on demographics, use of CAM products, reasons for use, and referral and information sources were collected. Binary logistic regression was applied and adjusted odds ratios were estimated. Results: CAM use was reported for recent pregnancies by 56.92% of participating women, with a significantly higher use in participants of low socioeconomic status (Chi21 = 5.12; p < 0.024). The main reason for CAM use was having faith in the efficacy of CAM (72.73%). Reported CAM use was restricted to herbal preparations. Most of the women who used CAM (73.0%) did not report their CAM use to their doctor. Conclusions: There is a high rate of CAM use among pregnant women. More maternal care services during current pregnancy, parity, and general and pregnancy-related history of CAM use were correlated with CAM use. Mother-healthcare provider relationship should be improved in the field of CAM.

The effects of chicory supplementation on liver enzymes and lipid profiles in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of clinical evidence.

BACKGROUND & AIMS: The beneficial effects of Cichorium intybus L., chicory, in patients with non-alcoholic fatty liver disease (NAFLD) are controversial. This review aimed to systematically summarize the evidence on the effects of chicory on liver function and lipid profile in patients with NAFLD. METHODS: Online databases of Scopus, Web of Science, PubMed, EMBASE, Cochrane Library, and grey literature were searched for relevant randomized clinical trials. Weighted mean differences (WMD) with 95% confidence intervals (CIs) were used as effect sizes and a random-effects model was used to pool the data. Besides, sensitivity analyses and publication bias analysis were performed. RESULTS: In total, five articles containing 197 patients with NAFLD were included. The study showed that chicory significantly decreased the levels of both aspartate transaminase (WMD: -7.07 U/L, 95%CI: -13.82 to -0.32) and alanine transaminase (WMD: -17.53 U/L, 95%CI: -32.64 to -2.42). However, no significant effects on alkaline phosphatase and gamma-glutamyl transferase levels and the components of the lipid profile were observed with the use of chicory. CONCLUSIONS: This meta-analysis showed that chicory supplementation may exert potential hepatoprotective effects in patients with NAFLD. However, for widespread recommendations, more studies with a higher number of patients and longer periods of intervention are mandatory.

Reporting of adverse effects of pomegranate in clinical studies: a systematic review.

OBJECTIVES: Numerous studies have shown the pharmacological effects of pomegranate, such as: anti-cancer, cholesterol-lowering, anti-diabetic, and antihypertensive features. Pomegranate consumption has also revealed some adverse effects. This systematic review aimed to explore the adverse effects of pomegranate reported in clinical studies. CONTENT: The keywords "pomegranate", "Punica granatum", "side effect", "clinical trial", and "case report or case series" were searched for in valid databases. Reports about adverse effects of pomegranate were also collected from several international registries. SUMMARY: This systematic review included a total of 66 clinical articles. Eleven articles have reported side effects of pomegranate. Twenty-one articles have recorded no side effects in the pomegranate group while 34 articles have not mentioned any side effects for this plant. The study also included 7 case report studies. The most common side effects included gastrointestinal problems, flu-like symptoms, and urinary problems. In case report studies, the most significant reported side effect was allergic reaction. OUTLOOK: In summary, pomegranate and its extract seem to be safe according to the reported adverse effects. Meanwhile, conducting more robust controlled trials with pomegranate products and documentation of any probable side effect is warranted.

Efficacy and Safety of a Persian Medicine Formula on Functional Dyspepsia Symptoms: A Randomized Double-Blind Active-Control Clinical Trial.

INTRODUCTION: Functional dyspepsia (FD) is one of the most frequent gastrointestinal disorders with a high burden. Although FD is a heterogeneous disorder without any standard therapy (treatment/treatment - repetition), there is a wide history of using herbal remedies for its treatment. Two of these herbal remedies quoted in various Persian medicine resources are celery and ajwain. Their effects have been investigated in recent clinical trials in FD patients. We aimed to compare the effect of celery and ajwain to that of domperidone in patients with postprandial distress syndrome. METHODS: This is a randomized double-blind active-control clinical trial, conducted at Kerman, Iran in 2020. Participants of this study were 100 patients suffering from FD (postprandial distress syndrome subtype). The intervention group received 1 g of the combination of celery and ajwain (Apium graveolens L. and Trachyspermum copticum [L.] Link), while the control group received 30 mg of domperidone per day for 4 consecutive weeks. Primary outcomes were symptom severity and frequency, and secondary outcomes were quality of life (QoL) and safety. All outcomes were assessed at the end of the trial and also 4 weeks after the trial was finished. RESULTS: No significant differences in symptom frequency were found between groups. However, differences in symptom severity were found at the end of the follow-up (week 8) (p = 0.001). The intragroup analysis showed a significant decrease in the symptoms severity and frequency at the end of week 4 in both groups (p < 0.001). QoL in the intervention group was higher compared to the control group at the end of the study (p < 0.001) and at the point of the follow-up (week 8; p < 0.001). No serious adverse events occurred in either group. CONCLUSION: The herbal mixture of celery and ajwain could be considered a safe and effective remedy, decreasing the severity of symptoms and increasing QoL in patients with postprandial distress syndrome. It is further suggested to confirm these findings in high-quality multi-center clinical trials.

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.

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.

Prevalence and the Determinants of Traditional, Complementary, and Integrative Medicine Use Among Breastfeeding Mothers: A Cross-Sectional Study.

Objectives: Breastfeeding is highly important for a child's health, and the widespread use of herbal medicines as galactagogues has been reported. The present study was conducted to evaluate the use of traditional, complementary, and integrative medicine (TCIM) and its determinants among breastfeeding mothers in Shiraz, Iran. Design: Cross-sectional study. Setting/Location: Neonatal clinics affiliated to Shiraz University of Medical Sciences. Subjects: Mothers elder than 18 years old. Interventions: Nothing. Outcome Measures: Prevalence and of the use of TCIM products and its associated factors. Methods: In this cross-sectional study, mothers older than 18 years who referred to neonatal clinics affiliated to Shiraz University of Medical Sciences were enrolled. Using a structured interview, the authors explored the prevalence and of the use of TCIM products and its associated factors. Results: Of 625 mothers who were approached, 483 agreed to participate (response rate: 77.3%). The average age was 27.3 ± 5.9 years. The prevalence of using TCIM products during current breastfeeding was 97.1%. There were 168 working mothers (44.9%); 163 mothers (34.1%) complaining of postpartum breastfeeding problems, and 327 mothers (68%) had no history of breastfeeding. Recommendations of medical staff or relatives were the most frequent reasons for the consumption of TCIM products (64.9%). Only 27% of mothers disclosed the use of TCIM products to their doctor or health care provider, although 62% of mothers were asked about the use of such products. Notably, 438 mothers (95.8%) considered TCIM to increase their milk. Based on multivariable logistic regression, literacy and past use of TCIM galactagogues were independently associated with TCIM products use. Conclusions: The use of TCIM galactagogues is highly common among breastfeeding mothers in south of Iran, showing a diverse range of determinants. It is necessary to evaluate the safety and efficacy of common herbal galactagogues, and evidence-based studies must be designed to achieve standardized complementary medicine approaches in this regard.

Effect of a Persian metabolic diet on the functional dyspepsia symptoms in patients with postprandial distress syndrome: a randomized, double-blind clinical trial.

OBJECTIVES: Postprandial distress syndrome (PDS) is associated with food indigestion. Efficacy of drugs used against PDS is limited whereas dietary modifications were shown to have important beneficial effects. Traditional Persian Medicine (TPM) sages suggested a dietary regimen known as Persian metabolic diet (PMD) for the management of PDS patients. In this study, the efficacy of PMD in alleviating the symptoms of PDS was explored. METHODS: This single-center, parallel-group, randomized clinical trial included 56 patients whom were randomly allocated to PMD group (29 participants) and Optional diet (OD) group (27 participants). They were instructed to follow the protocol for two weeks. Using a standard validated questionnaire, all outcomes were evaluated at baseline, end of the intervention period, and end of follow-up time. RESULTS: At the end of the intervention period, comparing the changes of severity scores between the groups showed a statistically significant difference in week 2 (p-value<0.001) and week 8 (p-value<0.001) follow-up comparing to the baseline. Similarly, at the end of the follow-up period, epigastric fullness, epigastric discomfort, and bloating were significantly improved in the PMD group (p<0.001). CONCLUSIONS: This diet prepared based on Persian medicine seems to be effective in relieving the symptoms of patients with PDS.

Efficacy of herbal treatments for functional dyspepsia: A systematic review and meta-analysis of randomized clinical trials.

Functional dyspepsia (FD) is a very common condition globally. Relevant keywords were searched for in title and abstract of selected databases, that is, Medline/PubMed, Scopus, Embase, Web of knowledge, and Google Scholar. Placebo and active-control trials on herbal remedies amongst adults who were diagnosed with FD were included. Dichotomous outcomes were presented as relative risk (RR) with 95% confidence interval (CI) and continuous outcomes were presented as pooled standardized mean difference (SMD) with 95% CI. Forty-nine randomized controlled trials (RCTs) were entered into meta-analysis (6,987 subjects). Herbal remedies resulted in a higher improvement in FD symptoms in comparison with the placebo (SMD = -0.58 [-0.66- -0.51], p < .00001 and RR = 1.73 [1.62-1.85], p < .00001). No significant difference between herbal remedies and placebo in the incidence of adverse events was observed (12.27 vs. 8.41%, RR = 1.06 [0.91-1.23], p = .45). Also, herbal remedies resulted in a higher improvement in quality of life in comparison with placebo (SMD = -0.64 [-0.73- -0.55], p < .00001). When comparing herbal remedies with conventional medicine through sensitivity analysis, no outcomes were significantly different (p > .05). Herbal remedies might be efficacious and safe in treating FD, and demonstrate comparable effect sizes for efficacy to conventional treatments. Further high-quality studies are warranted to firmly establish the clinical efficacy of the herbal remedies.

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.

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.

Psychometric Properties of a Persian Version of the SpREUK-P Questionnaire: An Instrument for Measuring the Importance and Frequency of Spiritual/Religious Practices in Iranian Patients with Chronic Gastrointestinal Diseases.

Attention to spiritual and religious issues is considered an important therapeutic method for patients with chronic disorders. This study aimed to assess the psychometric properties of a Persian version of the SpREUK-P questionnaire for evaluating spiritual and religious opinions among Iranian patients with chronic gastrointestinal diseases. This cross-sectional study was performed on 233 adult patients referring to the gastrointestinal clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, in 2017. The Persian version of the SpREUK-P questionnaire was prepared through the forward-backward translation method. The internal consistency of the questionnaire was evaluated by Cronbach's alpha coefficient. Furthermore, the construct validity of the instrument was assessed via exploratory factor analysis, while convergent and discriminant validity were investigated using Spearman correlation. Cultural adaptation, linguistic equivalency, and content validity of the Persian version of the SpREUK-P questionnaire were approved by a ten-member team of Shiraz University of Medical Sciences. Content validity indices were more than 0.8% across all items. Cronbach's alpha coefficients in terms of importance and practices were 0.81 and 0.71, respectively. Furthermore, the Persian version of the SpREUK-P showed excellent convergent validity and moderate to excellent discriminant validity. The results of exploratory factor analysis showed that all items were loaded properly on their own subscales, except for two items in the practice aspect and one item in the importance aspect. In conclusion, this study showed that the developed Persian SpREUK-P questionnaire is appropriate for assessing spiritual/religious opinions in Iranian patients with chronic diseases.

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.