Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial / 中西医结合学报

BACKGROUND@#Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.@*OBJECTIVE@#This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.@*MAIN OUTCOME MEASURES@#Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.@*RESULTS@#Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).@*CONCLUSION@#The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.@*TRIAL REGISTRATION NUMBER@#IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial / 中西医结合学报

BACKGROUND@#Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.@*OBJECTIVE@#This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.@*MAIN OUTCOME MEASURES@#Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.@*RESULTS@#Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).@*CONCLUSION@#The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.@*TRIAL REGISTRATION NUMBER@#IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

Periconceptional care and offspring health at birth and long term, from the perspective of Avicenna / 中西医结合学报

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna (980-1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE, Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre- and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some organs. On the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

The necessity for integrating traditional, complementary, and alternative medicine into medical education curricula in Iran / 中西医结合学报

BACKGROUND@#The use of traditional and complementary medicine (T&CM) is increasing in both developed and developing countries. The school of Persian medicine (PM) in Iran is a comprehensive medical school that is rich in history and has its own special principles, elements, philosophy, and diagnostic and treatment options. Many complementary therapy modalities are also popular and in demand among patients and physicians. The aim of this paper is to provide logic for the policymakers in Iranian medical education to make changes in medical education curricula, particularly on integrating T&CM.@*METHODS@#We reviewed the global experience in teaching T&CM to medical students, and highlighting the strengths of PM, described why it is necessary to integrate T&CM into general medicine curricula in Iran.@*RESULTS@#PM is a traditional system of medicine that dates back about 7000 years. Although there are few studies about the safety and effectiveness of PM, research into it has recently been accelerated. There is a suitable opportunity for integrating T&CM with conventional medicine. Physicians should be familiar with T&CM to avoid any contraindications, interactions, and unwanted effects.@*CONCLUSION@#Traditional medicine is part of Iran's heritage and, thus, needs special attention. Familiarization of physicians with T&CM can help them choose the best treatment options for their patients. To integrate T&CM into the medical education curricula of Iran, a two-credit course has been proposed for implementation across the country.

The medieval Persian manuscript of Afyunieh: the first individual treatise on the opium and addiction in history / 中西医结合学报

According to historical evidence, the abuse of opium has been reported all over the globe-specifically throughout Eastern nations-since the sixteenth century. Before that, opium had mostly been applied as medication. Reference has been made in traditional Persian medical literature to the method of cultivation, properties, side effects and toxicity. In sixteenth century Iran, during the reign of the Safavids, opium abuse began. It was from then that prominent Persian scholars started to think of solutions to this societal problem. One of the most famous scholars was Imad al-Din Mahmud ibn Mas'ud Shirazi, who composed a book concerning addiction-Afyunieh, a comprehensive book on the topic of opium and all issues of opium. Furthermore, he recommended methods for reducing opium dose as well as substitution with other medications that had a narrower range of side effects, in order to eradicate dependency upon opium and opium-derived materials. This is most likely the first book that comprehensively addressed opium and discussed drug rehabilitation methodology, in traditional Persian medical literature. In this historical review, the authors have introduced the book Afyunieh, which presents methods for treating addiction to and giving up opium; the text comprises a synthesis of the author's opinions, professional experience and references to the work of other famous physicians.

Renovation of a traditional Ergh-al-Nassa pill [Hab] to a standard Pharmaceutical molded tablet

The Ergh-al-Nassa pill [Hab] is a traditional combination suggested as one of the most effective preparations useful for treatment of sciatica. Although traditional preparations can be applied as new therapeutic drugs for investigations and clinical trials, they need to be reformulated to achieve pharmacopoeial standards for modern medicine. In this research, based on seven traditional Persian pharmacopeias for Ergh-al-NassaHab, nine different molded tablets were reformulated. Each formulation comprised the same amount of colchicum, ginger, aloe and yellow myrobalan fruit. Sweet almond oil had to be added in the maximum amount needed to be absorbed by the yellow myrobalan fruit according to its particle size [30-40 mesh sizes]. The studies were performed in order to optimize the formulation process according to the role of three levels in particle size of the herbal ingredients [60-70, 80-100, 100-150 mesh sizes] and three levels of initial water for granulation. The molded tablets were evaluated according to standard quality controls for tablets [mass uniformity, LOD, hardness, friability, and disintegration time at 20 and 30 min]. Myrobalan powdered to 30-40 mesh size absorbed the maximum amount of sweet almond oil [1:0.75 w/v]. The best formulations occurred when the particle size of colchicum, ginger, and aloe was 60-70 mesh size with an initial moisture content of 0.47 ml per 1g of dried powder. The outcome of this research is a pharmaceutical standardized formulation from the traditional Ergh-al- Nassa pill which can be suggested as a sample drug discovery based on traditional knowledge

Ethnobotanical study of medicinal plants used in the management of diabetes mellitus in the Urmia, Northwest Iran

OBJECTIVE@#To collect and document information on anti-diabetic plants traditionally used in the treating of diabetes in Urmia at Northwest Iran because ethnomedicines are considered as valuable sources to find new potential drugs.@*METHODS@#We used the method of direct observation and interview (35 traditional healers) along with gathering herbarium specimens mentioned plants in site.@*RESULTS@#There were 30 medicinal plants from 17 families for the treatment of diabetes. The family with most plants was Lamiaceae (20%). Leaves (20%) are often used and its form is decoction (70%). It was also found that Citrullus colocynthis has the most frequency of use among traditional healers.@*CONCLUSIONS@#Furthermore, base on current findings many of the mentioned plants have potential active ingredients to influence diabetes.

short introduction to a 19th century Persian book on Pulsology: Naiier Azam

Islamic Golden Age, 9-12 century AD, was the period through which Persian scientists and physicians were most influential in improving medical sciences including cardiovascular knowledge. Although post-Islamic Golden Age witnessed a number of great Persian scholars moving cardiovascular concepts forward, they failed to become as well known as their predecessors. One of these scholars was Hakim Mohammad Azam Khan belonging to the 19th century. He authored many books on medical sciences. He wrote all the books in Persian. Some of his most famous works are Eksir Azam [The Greatest Elixir; a comprehensive medical encyclopedia]; Romouz Azam [The Greatest Secrets; a general book on medicine] and Qarabadin Azam [Pharmacopeia]. In addition, he had a valuable treatise on pulsology, named Naiier Azam. Naiier Azam, one of the important works on cardiology in Persian medicine, which includes three parts: one introduction and two teaching chapters [Taelim]

Ethnobotanical study of medicinal plants used in the management of diabetes mellitus in the Urmia, Northwest Iran

Objective: To collect and document information on anti-diabetic plants traditionally used in the treating of diabetes in Urmia at Northwest Iran because ethnomedicines are considered as valuable sources to find new potential drugs. Methods: We used the method of direct observation and interview (35 traditional healers) along with gathering herbarium specimens mentioned plants in site. Results: There were 30 medicinal plants from 17 families for the treatment of diabetes. The family with most plants was Lamiaceae (20%). Leaves (20%) are often used and its form is decoction (70%). It was also found that Citrullus colocynthis has the most frequency of use among traditional healers. Conclusions: Furthermore, base on current findings many of the mentioned plants have potential active ingredients to influence diabetes.

Avicenna's concept of cardiovascular drug targeting in medicamenta cordialia

Avicenna [980 - 1037 AD] known as the prince of physicians in the west was one of the most prominent Persian thinkers, philosophers, and physicians. Owing to his interests in cardiology, he authored considerable works on different aspects of cardiology. "Resaley-e-Ragshenasi" [Book on Pulsology] and "Kitab al-Adviyt- ol-Qalbiye" [the book on drugs for cardiovascular diseases] are Avicenna's great dedication to the field of cardiology. In the field of drug therapy, an important concept which Avicenna touched on was the approach of drug achievement to the site of action in an easier and more efficient way. The mentioned concept is now recognized as "drug targeting" in current medicinal sciences and is an important challenge and field of research in pharmacy. Drug targeting has its starting point just a few decades ago. Whereas Avicenna considered the strategy 1000 year ago

[Design and performance evaluation of dry cupping tools described in the book Al-Tasreef]

Dry cupping is one of the main procedures in many traditional medicine systems all around the world with its root in antiquity. Traditional method of dry cupping is depended on practitioner proficiency and can lead to skin burn if the practitioner is a beginner. On the other hand, Zahrawi [11th century AD], the Muslim physician from Andulus [current Spain] presented two novel forms of cup for cupping to improve and correct cupping problems. In this regards, based on the model described in Al-Tasreef, we tried to redesign and manufacture the tools. These tools were made from galvanized iron owing to its nonconductivity of heat. Zahrawi models were compared with traditional model [with the same material and size] by negative pressure of mercury as well as qualitative test performed by a traditional practitioner. The results showed the superiority of Zahrawi's models [9792Pa and 10200Pa] over the traditional model, displaying a better and more stable vacuum pressure [mean: 8704 Pa with variation in repeat the test]. Furthermore, the introduced models are user friendly; i.e., every practitioner, even the beginner without specialized skill, may work with them easily. Therefore, the new model is suggested for dry cupping

Monthly menstrual cycle in Bun-Dahisn, an ancient Persian Manuscript

The history of Persia [Iran] dates back 10,000 years. Iranian history prior to the introduction of Islam in 637 AD is classified as ancient Persia but unfortunately, very little written evidence remains from that period. Furthermore, there is little current investigative research on this period of Iranian history, so it remains largely unclear, particularly in the case of medical scientific thought. The last period of this era was the Sassanid dynasty [224-637 AD]. Some of the manuscripts remained from this period are written in the Pahlavic language, illuminating this dark period in the history of medical science. One of these ancient Pahlavic manuscripts is entitled "Bun-Dahisn". It is analyzed in this paper to uncover ancient Persian wisdom on the female monthly menstrual cycle. The book is fundamentally about genesis and creation rather than medicine, but it holds valuable information about attitudes of the time to the female menstrual cycle. The manuscript describes the female menstrual cycle in terms of three phases. The first of which is the Pes-abest, phase of the female reproductive cycle; Abast, refers to the second phase; and the third phase is termed Dastan and refers to the menstrual period itself. This is the principle concept conveyed in this manuscript, which can be related to current concepts of gynecology. However, in comparison with other ancient civilizations, it can be considered as a novel and advanced theory. Regarding this ancient text from a current perspective and in relation to modern knowledge in the field is an insightful way to track the progression of thought in gynecology

[Women's medical rights in ancient Persia]

Nowadays and throughout the history, medical rights and ethics were among the most important subjects in relation with the field of medicine. Women's medical rights including issues about sickness, sex, abortion and so on are among main branches of medical ethics. It should be stated that this matter was not investigated sufficiently about ancient Persia [since the beginning of historical period to 638 AD] up to this time. Therefore women's medical rights were studied in this research using remained ancient Iranian and non-Iranian manuscripts and also recent works conducted on this topic. Finally, the results of our survey on women's medical rights were presented, as follows: 1- Women's situation in ancient Persian society and their beliefs about this. 2- Medical laws about pregnancy and pregnant women. 3- Sexual issues. 4- Women's sickness and their rights and laws related to this issue. Although, some laws were strict and unacceptable as good ones, ancient Persian society had notable laws about women and their rights compared with contemporaries

Jamasp, an ancient Persian pharmacist

Although Iran has a deep history about 10000 years, its role in development of science in general and medicine in particular is yet to be known. There are several factors responsible for this, namely the destruction of a good number of ancient Persian manuscripts and books. Furthermore, lack of interest found among contemporary researchers seems to add to this anonymity. One way to compensate for this is to introduce scientific figures of the time. In this regard, Jamasp, as the great Persian scientist who lived about 500 BC, is introduced in this article. He was the minister of king Vishtasb and contemporary with Zoroaster. Though Jamasp is known as a great astronomer, physician, pharmacist, chemist and botanist by historians, he is a good candidate for the title "the father of Persian pharmacy"

Azodi hospital and university in Shiraz [10th - 14th century AD]

Hospitals have a long history throughout the history of medicine. First hospitals are originated from Persia in ancient times in the Sassanid Dynasty [2nd to 6th century AD]. After the advent of Islam in Persia [Iran] in 637 AD, medical knowledge and also hospitals were flourished and advanced by Persian scholars. Shiraz Azodi hospital and University was one of the important hospitals in Persia. This hospital was built under the order of Azod od-Dowleh Panah [Fana] Khusraw in 971-973 AD in Shiraz. It had a great library, belonging to the university. A number of important physicians of the time Such as Haly Abbas were in practice at this hospital. The last report about this hospital dates back to 14th century. Azodi hospital and University were valuable scientific centers in Shiraz. The status of this medical center shows the close connection between medical education and therapy

Medicine and economy in ancient Persia

The relation between economy and medicine had a long history since ancient times. Supplying [providing] health care and the required drugs and medical equipments were the main concerns of the human communities even when they were at rather primitive stages of civilization. Later, in developed civilizations, trade was added to the concepts of medical economy. In this study, various economic activities, ranging from the physicians' income to the export and import of medicines in one of the old civilizations, ancient Persia [from the beginning of the history to 637AD], are discussed. In these eras, it is found that patients, based on their social and economic levels, had to pay the physician fees for the office visit. The governments, in turn, tried to prepare free medical facilities such as free-of-charge hospitals for patients. On the other hand, physicians had high earning and important statues in the society. The trade of medicine was another important economic in ancient Persia. Ancient Persia was actively involved in importing and exporting different articles, including medicines. The findings of the study showed a close relationship between medicine and economy in the ancient Persia as witnessed by the social and governmental policies