Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: a double-blind, randomized, placebo-controlled clinical trial / 中西医结合学报

<p><b>BACKGROUND</b>Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal complaints. GERD, caused by the reflux of stomach contents into the esophagus, leads to troublesome symptoms such as heartburn and regurgitation. It is classified into two types: erosive esophagitis, characterized by visible esophageal mucosa erosion in endoscopy, and non-erosive reflux disease (NERD). GERD is a chronic and recurrent disease that impairs the quality of life and imposes socioeconomic and therapeutic burdens to both patients and society.</p><p><b>OBJECTIVE</b>Due to the failure of the conventional treatments for GERD and to the traditional use of Amla (Phyllanthus emblica L.), in addition to beneficial effects shown in recent studies, we evaluated the safety and efficacy of Amla tablet for improvement of symptoms of patients with NERD.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>We designed a double-arm, randomized, double-blind, placebo-controlled clinical trial. Sixty-eight patients who had classic symptoms of GERD (heartburn, regurgitation and epigastralgia) for at least three months before the start of the trial were randomized in two parallel groups. Patients in the Amla group received two 500 mg Amla tablets twice a day, after meals, for 4 weeks. In the control group, patients received placebo tablets similar to the Amla prescription.</p><p><b>MAIN OUTCOME MEASURES</b>The patients were visited at baseline, and at the end of the 2nd and 4th weeks of intervention; their symptoms were measured on a frequency and severity scale for the symptoms of NERD, according to the quality of life in reflux-associated disease questionnaire.</p><p><b>RESULTS</b>Frequencies of heartburn and regurgitation in both groups of the study were significantly reduced after intervention (P < 0.001). Repeated measures logistic regression analysis showed that, in the Amla group, there was a more significant reduction in regurgitation frequency, heartburn frequency, regurgitation severity and heartburn severity during the study period, compared with the placebo group (P < 0.001).</p><p><b>CONCLUSION</b>This randomized double-blind, placebo-controlled clinical trial demonstrated that Amla could reduce frequencies of heartburn and regurgitation and improve heartburn and regurgitation severity in patients with NERD.</p><p><b>TRIAL REGISTRATION</b>Iranian Registry of Clinical Trials IRCT2016061428469N1.</p>

Anti-obesity and Anorectic Effects of Saffron and its Constituent Crocin in Obese Wistar Rat

Background: Obesity is p and emic worldwide and a strong risk factor for cardio-metabolic disorders. The few approved anti-obesity drugs have poor efficacy and safety profile. Thus, there is an urgent need for new anti-obesity agents. According to the traditional medicine and a clinical trial, saffron may have anorexigenic and anti-obesity effects which need further investigation. Objectives: Evaluation of the effects of saffron and crocin on body weight, food intake and blood leptin levels in obese Wistar rat. Methods: In the present study, saffron methanolic extract [25, 50, 100, 200 mg/kg] and its active constituent crocin [5, 15, 30, 50 mg/kg], sibutramine [5 mg/kg] and saline were gavaged daily to obese Wistar rats for 2 months and their effects on the body weight, food intake and blood leptin levels were evaluated. Results: The saffron extract and crocin at all doses as well as sibutramine reduced body weight, food intake and leptin levels significantly compared to saline and baseline [p < o.o5]. The extract and crocin effects were comparable to sibutramine. Conclusion: Saffron has anti-obesity and anorectic effects in the obese Wistar rat. The lowered leptin levels indicate that saffron reduces fat mass and increases insulin sensitivity. Crocin may be one of the active constituents involved in the effects of saffron. The effects of saffron and crocin may have important clinical implications in terms of treatment and prevention of obesity in humans.Keywords: Crocus sativus, Crocin, Obesity, Rat, Saffron

Effects of Rosa Canina L. fruit on glycemia and lipid profile in type 2 Diabetic Patients: a randomized, double-blind, placebo controlled clinical trial

Background: Rosa canina L. [rose hip] has been traditionally used to treat diabetes mellitus in Iran. However, no scientific human study has determined its efficacy in diabetic patients

Objective: This study was conducted to evaluate the efficacy and safety of R. canina fruit aqueous extract in type 2 diabetic patients

Methods: Sixty patients with type 2 diabetes, aged 35 - 60 years with fasting blood glucose levels between 130 to 200 mg/dL and HbA1c between 7 - 9% despite using conventional oral hypoglycemic drugs were divided randomly to two groups. Two groups of 25 and 23 patients completing the trial received 750 mg R. canina fruit extract and 750 mg toast powder as placebo two times a day respectively for three months. Fasting blood glucose [FBG] and glycosylated hemoglobin [HbA1c] as primary outcomes and postprandial blood glucose [PBG], lipid profile and hepatic and renal function tests as secondary outcomes were determined at baseline and at endpoint of treatment. The patients were asked to note down any gastrointestinal or other side effects during the study

Results: The FBG level decreased significantly [P = 0.002] in R. canina group after 3 months compared to the baseline. In addition total cholesterol/HDL-C was significantly [P = 0.02] decreased in the R. canina group compared to the baseline. Other blood parameters were not significantly changed during the study compared with placebo and baseline. No serious side effects were reported in both groups during the study

Conclusion: Rosa canina 3-month administration to type 2 diabetic patients may reduce fasting blood glucose and total cholesterol/HDL-C without any side effect

Application of low-level laser therapy following coronary artery bypass grafting [CABG] surgery

An attack of acute myocardial infarction [MI] poses the threat of great damage to cardiac tissue. Operative therapeutic modalities such as coronary artery bypass grafting [CABG] may enhance myocardial perfusion in high-grade coronary vasculature occlusions. It has been shown previously that Low-Level Laser Therapy [LLLT] significantly reduces infarct size following induction of myocardial infarction in rats and dogs. The aim of this study was to investigate the effects of LLLT on cardiac tissue healing markers following grafting operations for coronary vessel occlusion. Thirty-two cases having each two or three coronary vessel occlusions [2VD/3VD] underwent low-level laser therapy post-CABG, and 28 patients who did not undergo laser therapy were studied as a control group. Diode laser [810 nm, 500 mW] was used as LLLT protocol for 3 successive days post-CABG. Repeated measurements of blood cell count [CBC] and cardiac damage markers [CPK, CPK-MB, LDH] attained before CABG and during the 5 days of LLLT post-operatively, taken at one and 12 hours after daily laser irradiation. In a comparison of the mean levels of the control and laser group, the variables were statistically different on 5[th] day after intervention for WBC, Neutrophil and Lymphocyte counts and WBC and lymphocyte changes. A statistically significant difference was seen in changes of CPK, CPK-mb and LDH over time P<0.001. It is concluded that low-level laser irradiation after CABG surgery could decrease cardiac cellular damage and help accelerate the repair of cardiac tissue post-operatively. This may lower post-operative disability as well as bed rest period in these patients

review of pioneer physicians' work on maternal health in pregnancy in ancient Iran; narrative systematic review

Maternal lifestyle and behaviors during pregnancy have been associated with future health outcomes for mothers and babies. Iranian Traditional medicine, which is a holistically-oriented medical discipline, has special attitudes towards pregnancy. The purpose of the study is the investigation of maternal health in medical books of ancient Iran. This study is a systematic review scrutinizing issues concerning lifestyle during pregnancy based on "Avicenna's Canon medicine" and "Rhazes Al-Havi" and for complete discussion, other reliable sources in traditional medicine which was conducted following the categorization and analysis of the gleaned data. Based on approaches by Iranian Traditional Medicine, the most important topics in lifestyle habits during pregnancy are divided into four main groups: Nutrition, physical exercise, sexual activity and psychological stress. Then special recommendations are suggested which include a regimen to facilitate labor. Eating behaviors and other lifestyle habits have a major role in optimizing the health of women in pregnancy. Regarding to traditional medicine viewpoints paying special attention to correcting diet, life style and preventive attitude with effective and simple therapeutic procedures, it seems that traditional medicine can offer efficient managements to alleviate some pregnancy complications

[Review of antidiabetic plants in Iranian traditional medicine and their efficacy]

High prevalence of diabetes mellitus and its complications and increasing use of complementary therapies, especially herbal therapies, and the need of developing countries to use their indigenous medical methods, motivated us to introduce some plants used in Iranian traditional medicine for the treatment of this disease. The topic of "ziabetes" [the synonym of diabetes] in some of Iranian traditional medical texts were studied and herbal therapies of this disease were collected. Some edible plant compounds introduced and scientific names of plants in these compounds were identified. Pubmed and Scopus databases were searched for studies regarding hypoglycemic effects of these medicinal herbs on animal or human subjects. Many medicinal herbs and; minerals in single or compound form have been used in Iranian traditional medicine. Plants such as Punica granatum, Rosa damascene, Plantago psyllium, Glycyrrhiza glabra, Coriandrum sativum, Portulaca oleracea and Rumex patientia are the most popular ones. Recent studies on animal or human subjects have shown the hypoglycemic effects of some of these plants. Reassessment of the effects of some antidiabetic plants used in Iranian traditional medicine, proved their efficacy mainly in animals. However, we need more clinical trials to prove safety and; efficacy of these herbs and compounds

Aloe vera leaf gel in treatment of advanced type 2 diabetes mellitus needing insulin therapy: a randomized double-blind placebo-controlled clinical trial

Advanced type 2 diabetes mellitus [T2DM] needing insulin therapy is a common disease. Previous studies indicate that aloe [Aloe vera L.] leaf gel may positively affect the blood glucose and lipid levels in patients with advanced T2DM needing insulin. Evaluation of the efficacy and safety of aloe leaf gel in the treatment of type 2 diabetic patients resistant to oral synthetic anti-hyperglycemic drugs needing insulin. In this randomized double - blind placebo-controlled clinical trial with the patients aged 40-60 years, the efficacy and safety of taking aloe leaf gel [one 300 mg capsule every 12 hours for 2 months] combined with oral synthetic anti-hyperglycemic drugs in treatment of 35 patients were evaluated and compared with the placebo group [n = 35]. The aloe leaf gel lowered the blood levels of fasting glucose and glycosylated hemoglobin significantly [p = 0.041 and p = 0.023 respectively] without any significant effects on the lipid profile and liver/kidney function tests [p > 0.05] compared with placebo at the endpoint. No adverse effects were reported. The results suggest that aloe leaf gel may safely improve glycemic control in patients with advanced T2DM needing insulin

Use and attitude on herbal medicine in a group of pregnant women in Tehran

While the use of herbal medicines is common in Tehran, there is scant data regarding various aspects of the use of such medicines during pregnancy. The frequency of the use of herbal medicines in a group of pregnant women in Tehran and their attitude to the use of such medicines were evaluated. In this cross-sectional study, 600 pregnant women were studied. A researcher-made questionnaire was used to explore the demographic and pregnancy related data, the extent of use of the herbal medicines, the subjects' sources of information and their attitude regarding such medicines. The data were analyzed using student t- and chi-square tests. Logistic regression was used to determine the predicting factors. 402 [67%] participants had used at least one type of herbal medicine during their current or previous pregnancies, with a mean of 2.71 +/- 1.94 herbs per individual. Two commonly used herbs were peppermint [32.8%] and olibanum [26.3%]. Maternal and Gestational age, family size, children number, frequency of having medical insurance and positive attitude in users were significantly higher than non-users [P values were 0.02, 0.02, 0.001, <0.001, 0.04 and <0.001 respectively]. The score of attitude was the only predictor for taking herbal medicine with the odds ratio 0.89 [95% confidence interval: 0.86-0.92] of logistic regression model for negative attitude. Considering the high frequency of herbal medicine use during pregnancy, pregnant women need appropriate sources of information about these medicines. Further, health care providers should ask pregnant women about taking herbal medicines

Antidiabetic plants of Iran

To identify the antidiabetic plants of Iran, a systematic review of the published literature on the efficacy of Iranian medicinal plant for glucose control in patients with type 2 diabetes mellitus was conducted. We performed an electronic literature search of MEDLINE, Science Direct, Scopus, Proquest, Ebsco, Googlescholar, SID, Cochrane Library Database, from 1966 up to June 2010. The search terms were complementary and alternative medicine [CAM], diabetes mellitus, plant [herb], Iran, patient, glycemic control, clinical trial, RCT, natural or herbal medicine, hypoglycemic plants, and individual herb names from popular sources, or combination of these key words. Available Randomized Controlled Trials [RCT] published in English or Persian language examined effects of an herb [limited to Iran] on glycemic indexes in type 2 diabetic patients were included. Among all of the articles identified in the initial database search, 23 trials were RCT, examining herbs as potential therapy for type 2 diabetes mellitus. The key outcome for antidiabetic effect was changes in blood glucose or HbA1 c, as well as improves in insulin sensitivity or resistance. Available data suggest that several antidiabetic plants of Iran need further study. Among the RCT studies, the best evidence in glycemic control was found in Citrullus colocynthus, Ipomoea betatas, Silybum marianum and Trigonella foenum graecum