Traditional and Integrative Medicine
Volume:8 Issue: 2, Spring 2023

Osteoarthritis (OA) of the knee is a major health problem in the society. Iranian Traditional Medicine (ITM) or Persian Medicine (PM) as a branch of complementary medicine has been practiced in Iran for many centuries. An herbal medication known as squill oxymel has been used by PM physicians for OA. Our aim is to investigate the effect of squill oxymel on OA of the knee joint. Eighty eight patients were assigned to receive a placebo or squill oxymel syrup (10 ml each morning on empty stomach) for 8 consecutive weeks. Acetaminophen tablets were considered as the rescue medicine. Ultimately, 43 patients in the placebo group and 40 patients in the treatment group completed the trial and were included in the statistical analysis. Patients were followed for 4 weeks after cessation of treatment. The Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire and Visual Analog Scale (VAS) were considered as the main outcome measures. Laboratory tests including AST, ALT, BUN, Cr plus inflammatory tests including WBC, ESR, and CRP with specific tests i.e. IL6 and SOD at the beginning and the end of intervention were measured. The results showed the positive effect of treatment on the outcome of knee pain (p=0.04) and daily activity (p=0.01) of KOOS after Cessation of treatment. On the other hand, VAS decreased in both treatment and placebo groups while it showed significance intra-group and showed no significance between the two groups. After 4 weeks of cessation of treatment, the positive effect of the squill oxymel on the treatment group continued in some of the subscales of KOOS, including symptoms, knee pain and daily activities, but stopped in the placebo group. In general, both clinically and statistically significant improvement was observed after cessation of treatment. Squill oxymel syrup showed promising results in management of knee OA but future researches with larger sample size and longer duration are necessary.

Trachyspermum ammi (L.) Sprague (commonly known as ajwain) contains ingredients that attenuate menstrual problems, especially cramping. In this study, we evaluated the impact of ajwain on the pain intensity in a sample of Iranian female college students with primary dysmenorrhea (PD) in comparison to mefenamic acid (MFA). This study was an open-label, randomized, parallel-group clinical trial conducted in the university dormitories in Tehran, Iran, from September 2018 to May 2019. Seventy patients were randomly assigned to two groups of ajwain and MFA. The participants in the ajwain group were treated with a 500 mg ajwain capsule three times a day for seven days, from the 26th cycle day to the 3rd day of the menstrual cycle, for three consecutive cycle periods. The other group received MFA capsules with the first dose of 500 mg and then 250 mg every eight hours, if necessary, from the first day of the menstrual cycle. The two groups were compared in terms of the pain intensity by the visual analog scale (VAS) in pre-intervention cycle and three consecutive cycles during the study. Maximum pain intensity, mean pain, and duration of pain after the intervention were significantly reduced in both groups. The mean VAS score significantly decreased in the ajwain group compared to the MFA group post-intervention (p < 0.02). Moreover, passing blood clots was significantly reduced in the ajwain group (p < 0.03). The findings of this study suggest that ajwain may be effective in pain relief in PD without adverse effects.

Anxiety disorders are the most common mental disorders in communities. This cross-sectional study assessed the relationship between temperament and other demographic characteristics of participants with anxiety. It also determined the predictors of anxiety disorder among this cohort. This cross-sectional study was conducted in Kerman, Iran from 11 Mars, 2018 to 22 May, 2019. The participants were 1532 people who were selected through convenience sampling from those who attended the second round of KERCARDS in 2017. Physical activity, anxiety, depression, and temperament were assessed through related questionnaires. The collected data were described and analyzed by mean (Standard Deviation (SD)) and logistic regression models in SPSS v.23. The mean (SD) age of the participants was 30.02 (6.83) years (age range: 11 to 40). More than two-thirds of them were married (n=1084, 70.7%) and held a diploma and other university degrees (n=1112, 72.6%). The anxiety symptoms were prevalent among more than one-third of the participants (n=574, 37.5%, 95%CI: 35.2, 40.1). According to multivariate logistic regression model, female sex (OR:1.80, 95%CI:1.41, 2.30; P-value:0.001), illiteracy, lower education (OR:1.40, 95%CI:1.09, 1.81; P-value:0.009), a history of depression (OR:14.51, 95%CI:9.65, 21.80; P-value:0.001), and having warm Mizaj (OR:1.31, 95%CI:1, 1.71; P-value:0.04) were determined as predictors of anxiety. In the present study, female sex, lower educational status, the experience of depression, and warm temperament increased the risk of anxiety and were determined as predictors of anxiety disorder. Diagnosis of temperament seems to be necessary for recognizing anxiety symptoms and also finding an effective treatment.

Wide range of acute and chronic inflammatory ailments, side effects of their available therapies and incomplete treatment of such patients push the researches to find new and more effective drugs. To reach this aim, in the current study, we evaluate Urtica pilulifera L. (family Urticaceae) as an introduced traditional herb for treatment of inflammation in Persian Medicine (PM). In an animal study, Anti – inflammatory effects of U. pilulifera were surveyed in rats on the basis hind paw edema model which it’s inflammation induced with formalin. Sodium Salicylate (300mg/kg, ip, S.S) injection was used as a positive control group and compared with methanolic extract of U. pilulifera (20 mg/kg; i.p.) (MUP), three different doses of aqueous extract of U. pilulifera (20, 40 and 80 mg/kg; i.p.) (AUP) and a group of distilled water (6 mL/kg ; i.p.). As acute anti-inflammatory effect, AUP in doses 40 and 80mg/kg (i.p.) decreased edema significantly (p<0.05). In chronic anti- inflammatory response, results indicate that all AUP groups had anti- inflammatory effects (p <0.05) with no significant difference by the S.S group. In conclusion, AUP had anti-inflammatory effects on both acute and chronic edema while MUP was just effective in chronic anti-inflammatory studies.

Type 2 diabetes (T2DM) and its complications can cause severe morbidity and mortality. The researchers and clinicians’ attention has been toward finding the efficient treatment for T2DM to decrease its heavy burden on the people and countries. Whey protein (WP) is a known glucose-lowering treatment of traditional Persian medicine. This randomized controlled clinical trial aimed to evaluate the efficacy of the WP on the improvement of the glycemic index of the patients with T2DM in Fars, Fasa, Iran. A total of 58 people with T2DM met the inclusion criteria and were randomly assigned to one of two groups: intervention or placebo. For 12 weeks, they were given 1 sachet of WP or 1 sachet of placebo. Before and after the trial, fasting blood sugar, lipid profile, and liver enzymes were tested. Finally, 35 patients completed the study (18 in the whey group and 17 in the placebo group). The mean ± standard deviation of age, BMI, and the disease duration in placebo group were: 52.1±9.2 years, 26.8±3.9 kg/m2 and 102.9±67.7 months and in WP group were 51.2±8.2 years, 25.7±3.7 kg/m2 and 74.2±51.1 months. There were no significant differences among the study groups at the beginning (P>0.05). Meanwhile, the WP and placebo groups were the same by means of the amount of anti-diabetic drugs that participants consumed (P=0.242). After 12 weeks: the fasting blood sugar (FBS) and hemoglobin A1C amounts showed important decreases in the WP group compared to its starting point (P=0.011 and P=0.001 respectively), while in the placebo group, there was no significant difference in this matter (P>0.05).  No severe complications were reported in both groups. In conclusion, we found that whey protein would be a promising complementary therapy to control hyperglycemia in the patients with T2DM.

The Stachys genus is a medicinal plant, with 34 different species, from Lamiaceae family that grows in Irano-Anatolian plateau. There are 12 species of Stachys native to Iran. Some species of Stachys have been used in traditional medicine of Iran, Turkey, Italy, Greece, China, and Japan for the treatment of various diseases like inflammation, common cold, and etc. Some researchers have noted many biological effects, such as cytotoxic, antioxidant, immunomodulator, anti-inflammatory and anti-bacterial effects for the members of this genus. There are a few evidences on phytochemical constituents of S. byzanthinaThe aim of this study was phytochemical investigation of various extracts of this plant to obtain the most efficient fractions and compound(s) to study the antimicrobial effects of this plant. Separation and isolation of compounds was performed by various methods of chromatography. The structure of each compound was identified by spectroscopic methods.Antimicrobial studies were performed on different fractions of S. byzantina by microdilution method and to determine the Minimum Inhibitory Concentration (MIC), agar well diffusion was done.Ethyl acetate fraction has the highest total phenol contents (1082.05 mg GAE/g fraction) and antioxidant capacity (IC50= 1.23 mg/ml). Also, ethyl acetate fraction, the most potential fraction of S. byzanthina, was demonstrated the largest inhibition zone (17.5 ± 0.7 mm) with 5 mg/ml in MIC against Staphylococcus auresus.Apigenin and its derivatives were isolated from this fraction and according to literature; they can be responsible for antibacterial activity of this fraction of S. byzanthina.

Fatigue is a complex phenomenon that is explained as difficulty starting or keeping voluntary physical or mental activity leading to negative impacts on life and work performance. This study aimed to investigate the anti-fatigue effects of Viola odorata L. in an animal model. Aqueous and ethanol extracts of V. odorata were prepared and total phenolics content was determined. Then, the anti-fatigue activity of the extracts was evaluated via a weight-loaded forced swimming test in the rat. To this end, 48 male Wistar rats were randomly classified into 6 groups. The control group using distilled water and other groups with ethanol (EVO; 50, 100, 200 mg/kg) and aqueous extracts of V. odorata (WVO; 50, 100mg/kg) were gavaged once daily for four weeks. Then, the forced swimming was conducted and swimming time, as a fatigue factor was measured. In addition, to validate the effect of V. odorata on the endurance capacity of the rats, biochemical factors including glucose (Glc), lactate dehydrogenase (LDH), and tumor necrosis factor (TNF-α) were examined in the serum. Hepatotoxicity was also assessed using hematoxylin-eosin staining. Our Data indicated that the forced swimming time of the EVO-100, EVO-200, and WVO-100 groups was significantly increased. The serum Glucose in the group which received EVO-200 was increased significantly, while serum LDH levels in all treated groups were significantly decreased. Also, the serum level of TNF-α in the groups which received EVO-100 or 200 was increased significantly. However, there was no considerable difference in serum TNF-α level and no hepatotoxicity within aqueous extract groups. Pathology results showed fewer effects of the aqueous extract rather than ethanol extract on the liver. The results provide evidence for the development and use of V. odorata aqueous extract as an anti-fatigue supplement.

Gender selection has emerged as a controversial issue in different countries and in this respect, a wide range of studies and international symposiums have been dedicated to this subject. A comprehensive literature review was performed without restriction on publication date as well as credible Persian Medicine (PM) resources such as "Exir-e-Azam" (The Great Elixir), "Qarabadin-e-Kabir" (Great Pharmacopoeia), and "al-Qānūn fīl-tibb” (The Canon of Medicine) were completely studied. It was found that both nutritional factors such as glucose and electrolytes and non-nutritional factors including female tract, sperm, age, the timing of sexual intercourse, maternal body mass, stress, pH, estrogen, temperature, and testosterone can be used as important indicators in the gender selection. Most recommendations provided by PM for gender selection were found to be in good agreement with those reported by modern medicine.

In humans, the immune system serves as a protective barrier against infection; however, when the immune system is out of balance, it can harm the host. Immunomodulators are chemicals or medications that have been employed in the clinic to treat an unbalanced immune response. The majority of immunological medicines in clinical use are cytotoxic. They harm the patient's quality of life by causing various side effects and being associated with higher production costs, longer lead times, and a high failure rate. Furthermore, obtaining single-compound chemicals with low toxicity, high efficacy, and selectivity for specified disorders is difficult for researchers. As a result, techniques based on alternative medicine are gaining traction in drug development, focusing on innovative natural compounds utilized to treat various disorders. Many plant molecules founded to have biologically beneficial properties. This review aimed to look at the immunomodulatory activity of plant-derived chemicals from widely used plants that treat a range of diseases worldwide.

As a phytochemical, berberine can modulate metabolic parameters via altering gut flora. However, findings are conflicting. In the present systematic review, we aimed to summarize the effects of berberine on gut microbiota in the models of metabolic disorders in both animal studies and clinical trials. Publications in five electronic databases including PubMed, SCOPUS, EMBASE, Web of Science, and Cochrane Library were searched systematically up to 31 May 2021 to find relevant articles with English language. Out of 4102 studies (including 2125 duplicates), 35 studies were included. In animal studies, various effects of berberine on beneficial and harmful microbiota were reported. However, findings also indicated that berberine can decrease the Firmicutes to Bacteroidetes (F/B) ratio. Three out of five studies showed positive effects of berberine on the production of short-chain fatty acids (SCFA), particularly butyrate. In three animal studies, Lipopolysacaride (LPS) concentrations decreased with berberine administration. In clinical trials (n=3) positive effects on microbiota and metabolic status were also reported. However, the quality of clinical trials was mainly low.The present systematic review showed that berberine can modulate key metabolic parameters through improving the balance of intestinal microbiome, decreasing the abundance of harmful microbiota and LPS concentrations, and increasing the production of SCFAs, particularly butyrate in animal models. However, there are limited high-quality evidence regarding the effects of berberine on gut flora in clinical trials. Although berberine can be an effective prebiotic supplement to modulate metabolic parameters, further high-quality clinical trials are needed to confirm this potential.

Foeniculum vulgare Mill. (F. vulgare) belongs to the family Apiaceae with numerous medicinal and traditional applications. It has been widely used in South Asia as an important medicine for the treatment of many ailments. Different parts of F. vulgare, including seeds, leaves, aerial part and fruits, has been found to contain diverse phytochemicals such as anethole, fenchone, limonene, estragole, and p-coumaric acid. In particular, anethole and fenchone as the chief bioactives isolated from F. vulgare, have been proven to possess notable antioxidant, antitumor, carminative, diuretic, and galactagogue effects and is useful in amenorrhoea, dental decay and irritable bowel syndrome. This review summarizes the botanical activities, traditional uses, phytochemistry, and pharmacology of F. vulgare, along with the clinical studies to serve as the basis for further research and development on this medicinal plant.