Oxymel: A systematic review of preclinical and clinical studies

Background

Oxymel is a functional beverage with a rich historical background of use in multiple societies. Various simple and compound oxymels are prescribed in certain complementary and traditional medical systems, including traditional Persian Medicine. In recent years, numerous clinical and preclinical studies have been conducted in the pharmacy and food industry to investigate the efficacy of various oxymel formulations. This article aims to systematically review and summarize interventional studies on oxymel in both clinical research and animal models.

Methods

Relevant articles were searched in Embase, MEDLINE, Web of Science Core Collection, Scopus, and Google Scholar from inception to July 2023 using the keyword "Oxymel" and its equivalents in other languages. Animal and human interventional studies were selected from the search results for review.

Results

This review includes twenty studies, comprising twelve clinical trials, two case studies, and six animal studies. The most commonly reported actions of oxymel include positive effects on the cardiovascular system, as well as antioxidant and anti-inflammatory properties. Furthermore, compound oxymel formulations have demonstrated additional benefits depending on the inclusion of specific medicinal herbs.

Conclusion

Based on our findings, oxymel appears to be a valuable functional food for healthy individuals and a potentially effective and safe treatment option for managing certain diseases such as asthma, obesity, and type 2 diabetes. However, further clinical trials with larger sample sizes and longer durations are needed to fully elucidate the potential side effects and benefits of both simple and compound oxymels in various disease states.

Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine

Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains-which are similar to moxibustion usages-have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended. Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; Epub ahead of print.

Immunomodulatory Effect of SINA 1.2 Therapy Protocol in Asthmatic Mice Model: A Combination of Oxymel and Sauna

Alternative medicine, has become popular in asthmatic patients. We evaluated the immunomodulatory effects of SINA 1.2 therapy protocol derived from Persian medicine in an asthmatic mice model. Forty-two male BALB/c mice divided into six groups: one control (sham) and five sensitized groups (by parenteral injection of 20 μg ovalbumin in 100 μL normal saline plus 50 μL alum on days 1 and 14). Sensitized groups were as: untreated, budesonide (1 mg nebulized budesonide: 200 μg/puff every 5 min for 25 min), dry sauna (30 min, 37°C), oral oxymel (gavaged: 0.2 mL of the syrup plus 0.8 mL of water), and SINA protocol No.1.2 (oxymel followed by sauna) groups. Treatments were given for 10 days from day 23 to 33 then sacrificed. Significant gene expression reduction of interleukin(IL)-4, IL-5, and MUC5AC and increase of interferon(IFN)-γ and IFN-γ/IL-4 ratio and decreased perivascular and peribronchial inflammation, goblet cell hyperplasia, and subsequent mucus hypersecretion in SINA group were seen compared to untreated group. SINA lowered IL-5 and MUC5AC gene expression levels similar to the budesonide and acted better than budesonide in increasing IFN-γ gene expression up to normal level. Compared with the asthma group, sauna alone only affected MUC5AC and IFN-γ gene expressions and oxymel alone, only reduced IL-4 gene expression, perivascular and peribronchial inflammation, and mucus hypersecretion. It seems that SINA therapy alleviates asthma via immune modulation of pro-inflammatory cytokines and improvement of pathological changes in ovalbumin-induced asthma in mice, supporting the notion of innate healing power mentioned in Persian medicine literature.

Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I)

BACKGROUND

Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era.

METHODS

This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City.

RESULTS

Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament.

CONCLUSION

Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

Biomedical applications of silkworm (Bombyx Mori) proteins in regenerative medicine (a narrative review)

Silk worm (Bombyx Mori) protein, have been considered as potential materials for a variety of advanced engineering and biomedical applications for decades. Recently, silkworm silk has gained significant importance in research attention mainly because of its remarkable and exceptional mechanical properties. Silk has already been shown to have unique interactions with cells in tissues through bio-recognition units. The natural silk contains fibroin and sericin and has been used in various tissues of the human body (skin, bone, nerve, and so on). Besides, silk also still has anti-cancer, anti-tyrosinase, anti-coagulant, anti-oxidant, anti-bacterial, and anti-diabetic properties. This article is supposed to describe the diverse biomedical capabilities of B. Mori silk as the appropriate biomaterial among the assorted natural and artificial polymers that are presently accessible, and ideal for usage in regenerative medicine fields.

Sweating as a Preventive Care and Treatment Strategy in Traditional Persian Medicine

Proper and regular sweating plays a significant thermoregulatory role. It is a common perception that, sweating has other important homeostatic functions such as clearance of excessive micronutrients, waste products of metabolic processes, and toxins from the body, which helps to maintain human good health. In addition, sweating, thermotherapy, and sauna are commonly used to treat various diseases such as cardiovascular, respiratory and joint diseases. In traditional Persian medicine (PM) textbooks, sweating is considered a preventive care and treatment strategy as well. In this study, we aim to explain the beneficial effects of sweating in human health and its role in the management of various diseases, as well as introducing the therapeutic applications of some diaphoretic plants from the viewpoint of PM. We reviewed the most famous PM textbooks such as Kamil al-Sinaa al-Tibbiya, Al-Qānūn fī al-Tibb, Zakhireye Kharazmshahi, Kholasat al-Hikmat, Exir-e-Azam, and Hifzos-sihhat-e Naseri. Also, current evidence was searched in PubMed, Web of Science, Scopus, and other relevant databases related to the topic. The results of this study revealed that PM scientists believed proper sweating removes waste products and maintains the body’s health, thus, any disturbances in the excretion of these waste products can cause diseases. They recommended the induction of sweating through hot and dry baths, sun bath, sand bath and also the use of diaphoretic herbs for the management of various diseases. Therefore, further researches are recommended to evaluate the effectiveness of these diaphoretic plants.

Hakim Mohammad Azam Khan Chishti (1814-1902) and His Book about "Crisis in Diseases"

The term “crisis” in medical context is an important turning point or stage which occurs in some diseases and if not managed correctly, can become life threatening. Despite the use of the term in modern medicine, it was a much wider and sophisticated traditional medical concept. The first usage has been seen in the Greek writings of Hippocrates. In the Islamic Golden Age, this concept entered Persian Medicine by translation of Greek medical treatises. Great Persian Medicine scholars have paid particular attention to the concept and have written exclusive chapters about it. One of such scholars, Hakim Mohammad Azam Khan Chishti (1814-1902), an Indo-Persian physician and medical writer, wrote several comprehensive encyclopedic books - in Persian language - about various aspects of PM including crises. In this historical review we discuss his biography and his books, especially his important book Rokn-e-Azam, which is a comprehensive work on the concept of crisis in which he collected and discussed opinions of great medical scholars from ancient times to the 19th century. Despite his fidelity, unfortunately he rarely criticized the previous literature and thus did not add an additional value to the subject else than his comprehensive review. In the recent worldwide accepted roadmap towards Integrative Medicine, studying such inclusive traditional manuscripts may give better insight and understanding of the behavior of acute and chronic diseases and their appearance, exacerbations and remissions.

Effect of Persian acupressure (Ghamz) on Patients with Knee Osteoarthritis: A Single-Blinded Parallel Clinical Trial

BACKGROUND

Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain.

AIMS

To examine the potential efficacy of Ghamz on osteoarthritis outcomes.

DESIGN

Clinical Trial.

SETTINGS

Randomized, single-blind, sham-controlled clinical trial. Participants/Subjects: Eighty patients with diagnosed knee osteoarthritis, age over 35 years old.

METHODS

Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS).

RESULTS

Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment.

CONCLUSIONS

This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.

IrGO: Iranian traditional medicine General Ontology and knowledge base

Background

Iranian traditional medicine, also known as Persian Medicine, is a holistic school of medicine with a long prolific history. It describes numerous concepts and the relationships between them. However, no unified language system has been proposed for the concepts of this medicine up to the present time. Considering the extensive terminology in the numerous textbooks written by the scholars over centuries, comprehending the totality of concepts is obviously a very challenging task. To resolve this issue, overcome the obstacles, and code the concepts in a reusable manner, constructing an ontology of the concepts of Iranian traditional medicine seems a necessity.

Construction and content

Makhzan al-Advieh, an encyclopedia of materia medica compiled by Mohammad Hossein Aghili Khorasani, was selected as the resource to create an ontology of the concepts used to describe medicinal substances. The steps followed to accomplish this task included (1) compiling the list of classes via examination of textbooks, and text mining the resource followed by manual review to ensure comprehensiveness of extracted terms; (2) arranging the classes in a taxonomy; (3) determining object and data properties; (4) specifying annotation properties including ID, labels (English and Persian), alternative terms, and definitions (English and Persian); (5) ontology evaluation. The ontology was created using Protégé with adherence to the principles of ontology development provided by the Open Biological and Biomedical Ontology (OBO) foundry.

Utility and discussion

The ontology was finalized with inclusion of 3521 classes, 15 properties, and 20,903 axioms in the Iranian traditional medicine General Ontology (IrGO) database, freely available at http://ir-go.net/. An indented list and an interactive graph view using WebVOWL were used to visualize the ontology. All classes were linked to their instances in UNaProd database to create a knowledge base of ITM materia medica.

Conclusion

We constructed an ontology-based knowledge base of ITM concepts in the domain of materia medica to help offer a shared and common understanding of this concept, enable reuse of the knowledge, and make the assumptions explicit. This ontology will aid Persian medicine practitioners in clinical decision-making to select drugs. Extending IrGO will bridge the gap between traditional and conventional schools of medicine, helping guide future research in the process of drug discovery.

Nutritional Viscosity Management for Renal Stones (Nephrolithiasis) Prevention According to Avicenna’s Canon of Medicine

The prevalence of renal stones in industrialized countries is about 10 to 12%, and its incidence has increased in recent years. Renal stone is strongly dependent on dietary habits, so dietary changes are the most promising intervention to reduce renal stone production. Nutrition from the perspective of traditional Persian medicine is one of the important pillars of prevention and treatment of diseases such as renal stones. In this article, we intend to outline the nutritional managements indicated in Avicenna’s book of canon of medicine on renal stones. According to Avicenna, renal stone producing foods are concentrated and viscous foods, including some dairy products, meats, cereals, fruits, pastries, breads and some foods. Many such foods discriminated by Avicenna to be viscous and thus stone forming are also shown by modern science to increase the risk of renal stone production although based on diverse mechanisms. This issue may be an example that traditional medicine may suggest experienced-founded phenotype-based shortcuts for better research hypothesis designs. 

Introduction to The Concept of Crisis in Diseases

Crisis is one of the sophisticated yet important and practical concepts of Persian medicine which have been discussed and pointed out throughout traditional medical literature starting from Hippocrates, Galen, Avicenna and others or discussed independently in their related treatises. Being so important, it was used to classify the days of illnesses according to days devoted to it (critical days) or the days forecasting it (warning days) and the days in between. Crisis was known to be an important change in the process of disease which afterwards the destiny of the patient was predicted. It was categorized by its completeness/incompleteness and its good/bad prognosis, timing and direction of the pathogenic substance displacement or excretion. Many factors have been known to affect the onset and type of crisis including type of illness, the temperament of the patient, the season of disease occurrence, and even the effect of heavenly bodies especially the tidal force of the moon and the sun. Therefore many branches of science like chronobiology, physics, nanomechanics, astrophysics and rheology are needed to understand and demystify the narrated information derived from centuries of clinical observation. This understanding may lead to the decoding of unknown causes of exacerbation and remission of chronic diseases like multiple sclerosis and so on. As mentioned in previous articles, we have also designed a set of treatments named SINA therapy to simulate good crisis artificially in order to hasten the coction period and facilitate the curing of the daily increasing material diseases.

Symptoms of Uterine Dystemperament in Abnormal Uterine Bleeding from Perspective of Persian Medicine

Abnormal Uterine Bleeding (AUB) is the most common reason for women’s medical referral in the reproductive age. In Persian Medicine, one of the major causes of this disorder is known as uterine dystemperament (Su-e-Mizaj). AUB is known as “Kesrat-e Tams” in this medical school. We aimed to investigate the frequency of positive symptoms of uterine dystemperament in patients with AUB from the perspective of Persian Medicine. This cross-sectional study was conducted from October 2009 to September 2010 in Tehran, Iran. It comprised 70 patients with abnormal uterine bleeding who were 15-45 years old. Data were collected by a questionnaire prepared based on the textbooks of Persian Medicine. The frequency of each symptom of uterine dystemperament was obtained. Among the four uterine dystemperaments, the “dry” and “warm” uterine types had the highest rankings. In patients with excess uterine hemorrhage, the symptoms of warm uterine is more frequent than cold uterine. Meanwhile, the warm uterine dystemperament interference was also observed in excess uterine hemorrhage.

Novel Thermal-Therapy Protocol (SINA1.2) from Traditional Persian Medicine (TPM): a Pilot on Diabetic Rats

One of guilty pathologies in insulin resistance and type 2 diabetes mellitus (T2DM) is ectopic fat accumulation in organs like pancreas, liver and skeletal muscles due to fatty acid’s bad digestion. This situation corresponds much with a spectrum of illnesses named the Soo ul Qinya & Estesgha in Traditional Persian Medicine (TPM). We renamed and redefined the concept as “The Bad-Anbaasht Syndrome” meaning bad-deposition. One of its basic treatments mentioned is thermal-therapy which interestingly also shown to benefit T2DM in recent studies. We designed a novel protocol named SINA therapy to treat T2DM including sauna’s benefits but reducing its side effects and then performed an animal pilot study. Five Wistar rats made diabetic by high fat diet and low dose streptozotocin, were treated daily by month long SINA 1.2 treatment protocol (1 cc Oxymel gavage and then 30 min thermal therapy in 37 ̊C dry sauna incubator). Weight and blood glucose were measured at beginning and at the end. Although Mean weights increased significantly from 296 to 321 (paired T test, p = 0.022) but surprisingly the mean blood glucose lowered significantly from 200mg/dl to 127mg/dl (p = 0.049). According to results of this pilot study, SINA therapy 1.2 is probable to have benefits in treatment of T2DM, but yet needs further experimental and clinical evidence.

The Effect of Tastes in Treating Atherosclerosis

This article is a Letter to the Editor and does not include an Abstract.

Relapsing Sudden Hearing Loss Treated and Prevented with Principles of Persian Medicine: a Case Report

WHO has declared sudden hearing loss (SHL) as the third cause of disability. The mechanism of SHL remains unknown. Considering numerous complications of related medication, we decided to use non-medical therapeutic modalities derived from Persian Medicine (PM). A middle-aged female patient had a history of multiple attacks of SHL, she disliked to get injection again and preferred a traditional treatment. Therefore, she was advised to take a simple protocol in order to make rheological changes in and evacuation of the probable stagnant phlegmatic matter as it was diagnosed from the given oral history. The hearing loss recovered 60% after the first attempt and up to 100% after the second round and has not yet relapsed in the recent two and a half years of follow up despite its recurrences in the year before the trial. In this patient, by using safe user-friendly methods without any medications, we tried to increase the blood circulation to the affected organ, in order to change the consistency of the stagnated waste material so that it could be disposed from the auditory nerves and also out from the body.