فصلنامه طب مکمل
سال دوازدهم شماره 2 (پیاپی 43، تابستان 1401)

 Viola odorata has been used since ancient times. According to Traditional Iranian Medicine (TIM) sources, it has a cool and moist temperament and is used for treatment of different diseases. Due to the low side effects and numerous beneficial effects of this plant, this study aims to review its therapeutic effects from the perspective of TIM and modern medicine.

In this review study, a search was conducted for the materials in many TIM books such as Canon of Medicine, Tuhfat al-Momenin, al-Jami’ li-Mufradat al-Adwiya wa’l-Aghdhiya, Al-shamel fi al-Sanaat Al-Tabiat, Makhzan al-Adawiyah, Firdaws al-Hikmah fi al-Tibb, Al-Hawi fi al-Tibb, Khulasat al-Hikmah, as well as the book “PDR for Herbal Medicines”, and for the related studies in online databases such as PubMed and Scopus using the keywords sweet violet, common viola, garden violet, herbal medicine, traditional Iranian medicine.

The medicinal forms of Viola odorata in TIM are various and are used for skin, digestive, respiratory, and urinary system diseases. Numerous studies have confirmed the various therapeutic effects of the plant. According to studies in modern medicine, its constituents include volatile oils, glycosides, tannins, flavonoids, saponins, alkaloids, mucilage, gallates, phenols, vitamin C, coumarin, and Sitosterol.

Studies in modern medicine have proven the traditional uses of Viola odorata. However, due to the strong potential of this plant for making various medicinal products from it, more research is needed.

 Considering the high prevalence of diabetes mellitus and its effect on the quality of life (QoL) of patients which can lead to low self-care and increased risk of disease complications, this study aims to assess the effect of a self-care training program based on temperament modification on the QoL of patients with type 2 diabetes (T2D).

In this quasi-experimental study, 110 patients with T2D were selected by a convenience sampling method and were randomly divided into two groups of intervention and control using the random number table. After obtaining informed consent from them, they completed a demographic from and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, and their temperament was diagnosed by a doctor expert in Iranian traditional medicine. The intervention group received four sessions of self-care training based on temperament modification each for 45 minutes. The control group received routine treatment without any intervention. Then, they completed the WHOQOL-BREF questionnaire again three months after the intervention. Data were analyzed in SPSS software, version 22 using chi-square test, paired t-test, and independent t-test. The significant level was set at 0.05.

Before the intervention, there was no significant difference in the quality of life score between the intervention (83.2±11.9) and control (85±9.4) groups (P= 0.194). After the intervention, the difference was significant between the intervention (87.7±11.3) and control (85.1±9.5) groups (P=0.044). There was no significant difference in the quality of life score in control group before and after the intervention (P=0.244).

The self-care program training based on temperament modification can improve the quality of life of patients with T2D.

Doxorubicin (Dox) is a very effective drug for the treatment of a wide range of cancers. However, in healthy tissues, especially cardiac tissue, it can lead to cytotoxicity. This study aims to determine the effect of 8 weeks of high intensity interval training (HIIT) and crocin consumption on serum markers of Dox-induced cardiotoxicity in male rats

In this study, 32 male Wistar rats were randomly divided into four groups: healthy control, doxorubicin, doxorubicin + HIIT,  and doxorubicin + crocin + HIIT. The HIIT program was performed for 8 weeks, five days a week, with two 2-min intervals and 80% intensity in the first week and eight 2-minute intervals and 90% intensity of maximum speed in the final weeks. The last group received 10 mg/kg body weight of crocin by gavage for 8 weeks. Dox was injected subcutaneously seven times at a dose of 2 mg/kg. Forty-eight hours after the last training session and after anesthesia, blood samples were taken directly from the left ventricle; after separating serum from plasma, the levels of lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MB) were measured. Data were analyzed using independent t-test and one-way analysis of variance. The significance level was set at 0.05.

The Dox injection led to a significant increase in LDH and CK-MB levels in rats compared to the healthy control group (P=0.001). However, 8 weeks of HIIT significantly reduced the serum levels of LDH (P=0.001) and CK-MB (P=0.017) compared to the Dox group. In addition, 8 weeks of HIIT plus crocin consumption significantly reduced the LDH (P=0.001) and CK-MB (P=0.001) levels compared to the Dox group. There was no significant difference between the effects of HIIT alone and HIIT plus crocin consumption on the serum levels of LDH (P=0.087) and CK-MB (P=0.877) in rats received doxorubicin.

It seems that HIIT alone and in combination with crocin consumption can reduce the changes in serum levels of LDH and CK-MB induced by doxorubicin.

 Anxiety and stress are among the most common mental problems in patients before surgery. This study aims to determine the effect of aromatherapy with rosemary essential oil on preoperative anxiety, stress, depression and physiological parameters in candidates for general surgery. 

 In this clinical trial, 60 candidates for general surgery at Ayatollah Kashani Hospital in Shahrekord, Iran in 2019 were randomly divided into two groups of aromatherapy (n=30) and control (n=30). In the aromatherapy group, on the day of surgery, one hour before going to the operating room, three drops of 10% rose essential oil were poured on a tissue and pinned to the patients’ pillows, and they were asked to smell it for 20 minutes. There was no intervention in the control group. Data collection tools were a demographic form, the 21-item depression anxiety stress scale, and vital signs checklist. Data were analyzed in SPSS software, version 21 using chi-square test and paired t-test. 

Before the intervention, the mean scores of anxiety, stress, and depression in the aromatherapy group were 16.80, 17.77, and 16.27, respectively, where the difference in these three variables was not significant (P>0.05). After the intervention, their mean scores were 15.03, 15.57, and 15.83, respectively, where the difference in these variables was significant (P<0.05). There was a significant difference in these variables between the two groups (P<0.05). 

Aromatherapy with rosemary essential oil can reduce anxiety, stress, depression and improve some physiological indicators of patients before general surgery. Therefore, it is recommended to use it along with modern medicine.

Objective:

 The use of amino acid supplements among athletes for reducing muscle injuries has become more popular. This study aims to examine the effect of branched-chain amino acids (BCAA) consumption before exhaustive exercise along with one month vitamin E supplementation on lactate dehydrogenase (LDH) and creatine kinase (CK) levels of active females.  

Methods :

In this study, 32 active female students of Razi University in Kermanshah, Iran aged 18-23 years were selected and, after obtaining the informed consent form them, were randomly divided into four groups of placebo (n=8), Vitamin E (n=8), BCAA (n=8), and Vitamin E+BCAA (n=). Vitamin E was consumed as 400 IU daily for a month and BCAA with lemon juice was consumed 2.5 hours before exercise four times with a 30-min interval. The exercise program included 30 minutes of cycling on an ergometer with 50% of the aerobic capacity, and immediately followed by cycling with 75% of the aerobic capacity until the exhaustion. Sampling was done immediately and 48 hours after the exercise, and data were analyzed using Shapiro-Wilk test, repeated measures ANOVA, Bonferroni test, and Pearson correlation test in SPSS software, version 22.

Results:

 None of the supplements had a significant effect on levels of LDH and CK immediately after the exercise (P>0.05), but 48 hours after the exercise, the mean levels of LDH and CK decreased in BCAA group  (CK: 199.4±11.00, LDH: 213.2±23.44) and Vitamin E+BCAA (CK: 188.3±3.20, LDH: 208.3±40.12) compared to Vitamin E and placebo groups (P = 0.001). Their lowest levels was observed in the Vitamin E+BCAA group which was negatively correlated to plasma leucine and isoleucine levels (P = 0.001). 

Conclusion :

Although BCAA consumption alone before exhaustive exercise can reduce muscular damage indicators in active females, it seems that leucine and isoleucine along with Vitamin E supplementation is more effective in reducing muscular damage.

Pancreatic cancer is one of the deadliest cancers related to the digestive system in the world. Due to the increasing resistance of cancer cells to chemotherapy and its side effects, there is a need for drugs with fewer side effects and natural origin. In this study, the effect of harmine combined with fluorouracil on apoptosis induction in pancreatic cancer cells (AsPC-1) and the expression of apoptotic genes was investigated.

In this experimental study, MTT assay was used to study the cytotoxic effects. Annexin V/propidium iodide test and DAPI staining method were used to determine the type of cell death. The expression of apoptotic genes (P53, Bax, Caspase-3, and Caspase-9) was measured by real-time PCR. The data were analyzed using one-way ANOVA in SPSS software, version 16. The significance level was set at 0.05.

The results of MTT assay showed that the use of harmine at 20 μg/mL concentration combined with 10 μg/mL fluorouracil significantly reduced the growth (IC50) of AsPC-1 cells. The results of DAPI staining and annexin V/propidium iodide test showed the induction of apoptosis in treated samples. In addition, the results of real-time PCR showed that the expression of BAX, P53, Caspase-3 and Caspase-9 genes increased in the treated groups compared to the control group.

The combined use of harmine and fluorouracil can induce apoptosis in pancreatic cancer cells due to high cytotoxicity and reduce the concentration of chemotherapy drugs. Therefore, this method can be used along with other treatment methods for pancreatic cancer.

 Nurses experienced many psychological problems during the COVID-19 outbreak. Considering that spirituality can be a strong factor in controlling stressful situations, this study aims to investigate the effect of spiritual self-care education on the resilience of nurses working in intensive care units (ICUs) dedicated to patients with COVID-19 in Iran.

This experimental study was conducted on 64 nurses working in ICUs dedicated to patients with COVID-19 in Ziaeian Hospital in Tehran, Iran in 2021 who were selected by a census method and then randomly (by coin toss) assigned to the intervention (n=32) and control (n=32) groups. The intervention group received the spiritual self-care education at 6 sessions of 45 minutes every other day. Data were collected using a demographic form and the Connor-Davidson resilience scale and entered in SPSS software, version 25 and analyzed using independent t-test, paired t-test, and chi-square test. The significant level was set at 0.05.

 The Mean±SD score of resilience before the education in the intervention and control groups were 48.0±5.28 and 46.44±6.05, respectively. The difference was not statistically significant (P=0.275). After the education, the mean of resilience in the intervention and control groups were 74.65±3.35, 49.38±6.49 respectively. The difference was statistically significant (P<0.0001).

 It is suggested that spiritual self-care education should be provided to nurses in ICUs dedicated to patients with COVID-19 to improve their resilience and thus help them provide better services to patients.

Objective:

 Restless legs syndrome is a neurological condition associated with an irresistible urge to move the legs and eventually leads to discomfort, sleep disorders, and reduced quality of life. Restless legs syndrome is common in the elderly, whose health improvement is an important healthcare issue. This study aimed to determine the effect of hot water bags on the severity of restless legs syndrome and sleep quality in the elderly.

Methods:

 The study has a quasi-experimental design. In this research, 88 elderly people were selected based on purposive sampling. Then they were randomly assigned to the experimental (n=44) and control (n=44) groups. The intervention group received a hot water bag on the leg, and the control group received routine care. Data collection tools were the demographic questionnaire, the restless legs syndrome rating scale, and the Pittsburgh sleeps quality index. The questionnaires were completed as a self-report. Data were analyzed with the independent t test and paired t test using SPSS.

Results:

 The Mean±SD scores of restless legs syndrome were 16.7±0.46 in the experimental group and 16.50±1.17 in the control group before the intervention, which was not significantly different (P=0.32). The Mean±SD scores of restless legs syndrome were 10.68±1.52 in the experimental group and 15.55±1.79 in the control group after the intervention, which was significantly different (P=0.0001). In addition, the mean ± SD scores of sleep quality were 8.3±1.5 and 10.42±1.89 in the control group and the experimental group after the intervention, which showed a significant difference (P=0.0001).

Conclusion:

 Findings showed that the hot water bag application reduces the severity of restless legs syndrome and improves sleep quality. Therefore, a hot water bag is especially recommended for the elderly, as it is cheap, accessible, and acceptable.