Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial / 中西医结合学报

BACKGROUND@#Constipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly.@*OBJECTIVE@#This study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks.@*MAIN OUTCOME MEASURES@#Constipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire.@*RESULTS@#A total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group.@*CONCLUSION@#Although both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood.@*TRIAL REGISTRATION@#This trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).

Mesenchymal Stem Cell-Derived Exosomes: A Promising Therapeutic Ace Card to Address Autoimmune Diseases

With the development of novel treatments for autoimmune disorders, it has become a popular research focus which mesenchymal stem cells (MSCs) have the capacity to counteract with autoimmune diseases progression. One of the underlying mechanisms behind their activities is the release of extracellular vesicles especially exosomes. MSC-derived exosomes are hypoimmunogenic nanocarriers which contain numerous immunoregulatory factors and similar to other exosomes, are able to pass through boundaries like the blood-brain barrier (BBB). Accumulating evidence provided by animal studies has demonstrated that MSC-derived exosomes, as a novel therapy, can re-induce self-tolerance, without subsequent complications reported for other treatments. Therefore, therapeutic applications of MSC-derived exosomes are contributing to core advances in the field of autoimmune diseases. Here, we briefly describe the biological characteristics of MSC-derived exosomes and review the experimentally verified outcomes for autoimmune disease therapy purposes.

[Validation of short-form Nepean dyspepsia index in Iranian patients with functional dyspepsia]

Background: studying the validity and reliability of short-form ]SF[-Nepean Dyspepsia Index ]NDI[ in patients with functional dyspepsia ]FD

Materials and Methods: after translating to Persian, the NDI-10 was filled out by 210 patients with FD, whose disease had been diagnosed by a gastroenterologist based on Rome 3 criteria, who admitted to Gastroenterology Clinic of Afzalipour Hospital in 2015. The reliability of the questionnaire was studied by test-retest and Cronbach's alpha coefficient. The validity of the questionnaire was evaluated through content-validity and criterion-validity

Results: through analyzing the results of test-retest of the questionnaire, the Pearson coefficient was obtained as 83%, which proves the reliability of the questionnaire. Criterion-validity with the correlation coefficient of 0.56 and content validity both proves the adequacy of questionnaire for measuring the quality of life in patients with FD

Conclusion: generally, Persian translation of this questionnaire has acceptable validity and reliability for measuring the quality of life in patients with FD

[ survey on knowledge attitude and practice of interns regarding nutrition in Kerman Medical University]

Inappropriate nutrition has an important role in many pathological conditions, including such common diseases as diabetes, cancer and cardiovascular diseases. Despite the recognition that physicians are often called upon to provide counseling in nutritional aspects of diseases, nutrition does not hold the place it deserves in medical schools' curricula, especially in clinical and case-based teaching. The aim of study was to determine the knowledge, attitude and practice of interns in Kerman Medical University regarding the nutrition. Self-administered questionnaires, including 29 questions and in a cross-sectional study were completed by 105 interns. The mean knowledge, attitude and practice scores were 6.93 +/- 1.89 [out of 14], 15.50 +/- 3.54 [out of 40] and 1.48 +/- 1.58 [out of 7], respectively. There were no significant differences in knowledge and practice scores between males and females, but male interns had higher score in attitude [P<0.05]. We detected a statistically significant positive correlation between knowledge and attitude [r=0.22, P=0.023], so that higher knowledge level, the higher attitude score. A significant negative relationship was observed between interns' attitudes and their practices [r=-0.33, P=0.001]. Despite good attitude concerning nutrition principles, their practice scores were undesirable. The results of this study indicate there are serious defects in the knowledge of the interns concerning the principles of nutrition. Furthermore, their attitudes and practices about nutrition are undesirable. Considering the importance of proper nutrition for good health and treatment and prevention of diseases, there is a need for improvement of nutritional knowledge in future doctors. This requires careful planning and curricula changes to include the principles and practice of nutrition. In other words, nutrition needs to be re-evaluated and properly integrated into the medical school's curriculum