In vitro and in vivo studies of Dragon's blood plant (D. cinnabari)-loaded electrospun chitosan/PCL nanofibers: Cytotoxicity, antibacterial, and wound healing activities

The D. cinnabari plant was loaded into the chitosan (Chn)/polycaprolactone (PCL) nanofibers in two forms: resin (D. cinnabari) and its ethyl acetate fraction. The Chn/PCL, Chn/PCL/D. cinnabari (CPD, 1, 3, and 5 %), and Chn/PCL/ethyl acetate extract D. cinnabari (CPED, 1, 3, and 5 %) showed no toxicity against human dermal fibroblast cells. The lactate dehydrogenase assay results indicated that the toxicity of pour, coated D. cinnabari, and CPED nanofibers were lower than 10 and 15 % after 1 and 3 days, respectively. The antibacterial results showed the inhibition zone for ethyl acetate extract D. cinnabari (ED-3 %), the Chn/PCL-2, and CPED3% nanofibers was 8.1, 7.4, 4.2, 5.1 mm, 12.8, 12.4, 21.7, 17.2 mm, and 24.7, 22.9, 37.1, 30.2 mm against S. aureus, B. subtilis, E. coli, and P. aeruginosa, respectively. The antibacterial activity results showed synergistic effect between the Chn/PCL and ethyl acetate extract D. cinnabari occurred. The diameter of wounds (1.50 × 1.50 cm diameter) made on the dorsal surface of rabbits reduced to 1.50 × 0.70, 0.50 × 0.30, 1.00 × 1.00, 0.60 × 0.50, 0.20 × 0.05, and 0.00 × 0.00 cm in the presence of ordinary gauze dressing, silver sulfadiazine, ED-3 %, Chn/PCL-2, CPD3%, and CPED3%nanofibers, respectively, after 14 days.

Efficacy and safety of add-on Viola odorata L. in the treatment of COVID-19: A randomized double-blind controlled trial

ETHNOPHARMACOLOGICAL RELEVANCE

Severe Acute Respiratory Syndrome (SARS) due to the novel coronavirus has become the highest priority that threatens human health. This situation demands widespread vaccination and the innovation of new therapeutic methods. Despite drug discoveries, the need for approving new medicaments is felt because of adverse effects and lack of efficacy. Several medicinal plants including Viola odorata L. are recommended in traditional Persian medicine for alleviating respiratory infection symptoms. Recent studies showed anti-inflammatory, antioxidant, anti-asthmatic, antitussive, analgesic, and antibacterial activities of sweet violet. These enhance respiratory functions, reduce pulmonary inflammation, and decline mucous membrane edema. This study aimed to evaluate the efficacy of sweet violet syrup in alleviating the manifestations of COVID-19 infection.

MATERIAL AND METHODS

A randomized parallel-group double-blind controlled trial was conducted at Al-Zahra general hospital, Isfahan, Iran. A total of 108 outpatients were enrolled in the study. The patients were randomly allocated to intervention and placebo groups, with 54 patients in each group. The allocation was concealed using sealed opaque envelopes. The intervention group received violet syrup and the control group received placebo syrup, an add-on to the conventional treatment. The outcomes were COVID-19 manifestations, such as dyspnea, cough, myalgia, headache, and diarrhea, considered as outcomes of the study and were evaluated twice using a visual analog scale before the intervention and after 7 days, at the end of the study. Patients were followed daily by phone calls to monitor proper drug consumption and possible side effects.

RESULTS

No significant difference was between groups regarding demographic characteristics and vital signs before and after the treatment. Although all symptoms have improved significantly in both groups, patients who received violet syrup recovered faster and the mean severity scores of cough (P = 0.025), myalgia (P = 0.036), headache (P = 0.037), and diarrhea (P = 0.044) decreased greater in comparison to control group.

CONCLUSION

This study, the first clinical trial on the effectiveness of Viola odorata on SARS-CoV-2 patients, showed that Viola odorata L. effectively controls prevalent manifestations of COVID-19 including cough, myalgia, headache, and diarrhea. Regarding this survey, the violet syrup can be mentioned as a complementary treatment for viral influenza-like infections in which cough, myalgia, headache, and diarrhea are prominent.

Saffron offers hepatoprotection via up-regulation of hepatic farnesoid-X-activated receptors in a rat model of acetaminophen-induced hepatotoxicity

OBJECTIVES

The most important toxicity of acetaminophen is hepatotoxicity. Farnesoid X-activated receptors (FXR) are one of the nuclear receptor superfamily members which have a pivotal role in the bile acid regulation. The objective of the present study was to examine the role of FXR in mediating the hepatoprotective effects of saffron.

METHODS

Male Wister rats were randomly allocated into five groups including a control, vehicle, acetaminophen and two saffron extract groups of 150 and 300 mg/kg/day. The liver function and hepatic FXR expression were evaluated using biochemical assay and real time RT-PCR, respectively. Data analysis was performed using the one-way ANOVA followed by Duncan's multiple range test.

RESULTS

Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) of the acetaminophen group were significantly higher than the control group whereas those of the extract-treated groups were significantly lower than those of the acetaminophen group. The real time RT-PCR findings showed a non-significant down-regulation of FXR mRNA expression, however, a dose-dependent FXR up-regulation was seen in the groups treated with 150 and 300 mg/kg of the extract for 2.67 (p=0.002) and 10.22 (p=0.0001) fold, respectively.

CONCLUSION

The main finding of the present study was that the hepatic FXR up-regulation had an important role in saffron hepatoprotective activity.

Formulation, Standardization, and a Preliminary Before-After Clinical Trial on Effect of a Traditional Herbal Formula (Maqliasa) on Manifestations of Ulcerative Colitis

BACKGROUND

Ulcerative Colitis (UC) is a chronic condition that represents a group of intestinal disorders causing prolonged inflammation of the digestive tract. Nowadays, efforts to investigate new remedies have led to a committed movement toward the integration of traditional and complementary medicine into mainstream medicine. In Traditional Persian Medicine (TPM), Maqliasa is one of the most frequent gastrointestinal prescriptions which is claimed to be effective in both remission and recurrent phases of UC.

OBJECTIVE

The aim of this pilot study was to examine the effect of Maqliasa on UC symptoms.

METHODS

Through a non-randomized before-after uncontrolled clinical trial, 13 outpatients with active UC were enrolled in the study. They continued their conventional drug regimens plus Maqliasa capsules (2 capsules t.i.d.) for 28 days. Three visits were arranged for each patient- the first admission, day 14th admission and day 28th admission. The patients were evaluated by Lichtiger Colitis Activity Index. Wilcoxon signed-rank test was used for statistical analysis.

RESULTS

The Lichtiger colitis activity index improved in the study group was compared to the corresponding baseline values: baseline score: 7.8 ± 0.5; after two weeks: 5.9 ± 0.6 (P=0.002); after four weeks: 3.6 ± 0.5 (P=0.001).

CONCLUSIONS

This study showed the promising effect of Maqliasa in the treatment of active UC. However, due to some of the limitations of the study, conducting future high-quality randomized clinical trials would be crucial.

Effect of Bastibaj, a Traditional Persian Formula, on Premature Ejaculation: Observation of a Traditional Treatment

Premature ejaculation (PE) is one of the main sexual problems among the male population. There is a folk treatment for this ailment in a small town near Kashan, Iran. The treatment contains hydro-alcoholic extracts of Tribulus terrestris L., Rosa × damascena Herrm, Zingiber officinale Roscoe, and Crocus sativus L. in honey. The aim of this preliminary study was to evaluate the effect of the syrup on premature ejaculation. The study population was 17 outpatients visited by a traditional healer. Each patient was diagnosed clinically based on the Premature Ejaculation Diagnostic Tool (PEDT). Inclusion criteria included male participants between 20 to 60 years old, PE more than 6 months, PEDT score more than 11, IELT more than 1 minute, no severe organic disease. Exclusion criteria included taking any chemical drug during the intervention, and sexual contacts less than twice in 3 weeks. 17 male patients aged between 26-65 years old were eligible for the study according to the inclusion criteria. The patients enrolled in the study, filled out the written consent form and conditions of the research were explained. The medication (Bastibaj syrup) was administered for the patients 5 milliliters 3 times daily for 3 sequential weeks. The intravaginal ejaculatory latency time was recorded in all coitus. After the course of the intervention, the mean of IELTs before and after the intervention was compared via paired T-test. Results show that the mean IELT before the intervention (33.2 seconds) in comparison to after it (129.3 seconds) has been improved significantly (P < 0.01). According to the results, the study revealed that the traditional remedy prescribed in this study, i.e. Bastibaj, can be effective in patients with premature ejaculation, and can prolong the IELT significantly.

Effects of Some Lamiaceae Species on NO Production and Cell Injury in Hydrogen Peroxide-induced Stress

Nitric oxide (NO) is a key mediator that plays an important role in pathogenesis of various chronic diseases like Alzheimer’s disease and Parkinson’s disease. Additionally, there is a great attitude for finding natural compounds, which could control and inhibit NO production in pathological conditions. Therefore, we were encouraged to investigate the effects of some Lamiaceae species on NO production and cell injury during oxidative stress in PC12 cells. In this study, cell death determined by MTT assay and NO levels were evaluated using Griess assay. PC12 cells were exposed to total metanolic extracts of three Scutellaria and one Nepeta species. The results revealed that Nepeta laxiflora (N. laxiflora) could protect PC12 cells from hydrogen proxide-induced oxidative stress and all of the plants inhibited NO production in that condition except Scutellaria tournefortii (Sc. tournefortii). In addition, Scutellaria multicaulis (Sc. multicaulis) was meanwhile subjected to fractionation using different organic solvents. The dichloromethan and ethyl acetate fractions of Sc. multicaulis could protect PC12 cells from oxidative stress injury. However, NO production was restrained by the hexane and dichloromethane fractions. Considering the results, N. laxiflora, Scutellaria nepetifolia (Sc. nepetifolia), and Sc. multicaulis are good candidates for further investigations in neuroprotection and anti-inflammation studies.

Antimicrobial and Antioxidant Activities of Some Medicinal Smokes Prescribed in Iranian Traditional Medicine for Catarrh

Background: Microbial resistance has recently become one of the major healthcare problems worldwide. Finding new sources of chemical active antimicrobial compounds, along with what has been produced by fungi is now a common approach to solve this problem. On the other hand, inflammation has recently been considered as an underlying factor of many diseases, and working on anti-inflammatory drugs is interesting as well. Information provided by Iranian traditional medicine (ITM) can be used as a source of inspiration in order to find the herbs with antimicrobial and antioxidant activity. Objective: The present study aimed to examine antimicrobial and antioxidant activities of 6 medicinal smokes prescribed in ITM for catarrh. Materials and Methods: Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 9027, Bacillus subtilis ATCC 6051, Candida albicans ATCC 10231, and Aspergillus niger ATCC 16404 were used in this study. In addition, the preliminary antimicrobial activity of Commiphora myrrha, Cinnamomum cassia, Costus arabicus, Nigella sativa, Pimpinella anisum, and Tetraclinis articulate was performed by the disc diffusion method. Further, the minimum inhibitory concentration and minimum lethal concentration were determined using the microdilution method. Finally, antioxidant activity was evaluated by measuring the reduction of the 1,1-diphenyl-2-picrylhydrazyl solution. Results: The results showed that C. arabicus, C. cassia, and P. anisum had considerable antimicrobial activities. Furthermore, antioxidant evaluation of the herbal smokes demonstrated the lowest IC50 for C. cassia (10.44 µg/mL), C. myrrha (13 µg/mL), and C. arabicus (15.16 µg/mL). Conclusion: In general, herbal medicinal smokes were found to have interesting antimicrobial and antioxidant activities. Therefore, more investigation on these smokes would be fruitful.

Chemical Constituents of Donkey Dung (Anbarnasara): Questioning the Recent Claims Concerning Therapeutic Effects

Background: Various animal excrements have been used as a medicine for the treatment of different diseases in the past. Today, people still use some of these excrements, especially female donkey dung (Anbarnasara,) by smelling the smoke of burnt dung for some ailments like sinusitis and bronchitis. Recently, some studies have focused on the therapeutic activities of Anbarnasara but no one has studied the active ingredients of it. Objective: The aim of this study was to identify the chemical constituents and antibacterial activities of Anbarnasara and its smoke. Materials and Methods: Female donkey dungs were collected from Shahreza in May 2017. The substance was burnt and the smoke was led to a beaker of methanol by a distillation apparatus. Then, the methanolic extract was dried via a rotary evaporator. Antibacterial activity of the smoke and also the total methanolic extract of Anbarnasara were tested on Staphylococcus aureus and Escherichia coli via well diffusion method. Chemical constituents were analyzed through gas chromatography-mass spectrometry (GC–MS) . Results: The results showed that Anbarnasara and its smoke have a very weak antibacterial activity. Regarding chemical constituents, both total methanolic extract and smoke extract predominantly contained toluene, xylene, and dibutyl phthalate. Conclusion: Previous studies showed xylene as one of the major components of the smoke of Anbarnasara. These articles also reported the presence of some plant-based compounds such as glyoxal, syringol, and limonene in the smoke. The presence of these compounds is probably due to the donkeys’ diet. In our study, the presence of dibutyl phthalate, an industrial plasticizer, among the components is probably due to environmental factors. These evidences suggested that Anbarnasara is under the influence of environmental factors like vegetation and pollutions and therefore, should be used as a medicine with caution. Recent claims regarding the antibacterial, cytotoxic, and wound healing activities of Anbarnasara should be considered independent of these environmental factors.

Omega-3 Fatty Acids and Cholesterol Have a Main Role in Antidepression Diet of Iranian Traditional Medicine

Depression is one of the major health problems of our world. Recent studies have revealed the relationship between diet and depression. In Iranian traditional medicine, there is a therapeutic diet that is recommended in melancholic diseases like depression. One of the main components of this diet is meat. Meats are divided into 2 groups: recommended and abstinent. The aim of this study was to clarify the logic of this diet through comparing nutritional elements of the 2 groups with each other. For this purpose, prominent books on Iranian traditional medicine were searched for abstinent and recommended meats traditionally prescribed for depressed patients. The results of each group were compared with the other by using Mann-Whitney Test (SPSS version 16). The results showed that recommended meats contain higher amounts of polyunsaturated fatty acids ( P = .01) especially omega-3 ( P = .03). Both groups contain high amounts of cholesterol. Iranian traditional medicine recommends consumption of meats that contains cholesterol with omega-3 fatty acids in depression.

Health-Related Quality of Life and Health Utility Values in Beta Thalassemia Major Patients Receiving Different Types of Iron Chelators in Iran

Background: Thalassemia is a chronic, inherited blood disorder, which in its most severe form, causes life-threatening anemia. Thalassemia patients not only engage with difficulties of blood transfusion and iron chelating therapy but also have some social challenges and health threatening factors. There are some reports on quality of life in thalassemia patients around the world from southeast of Asia to Italy in Europe and United States. In this study, we tried to evaluate and compare Health Related Quality of life (HRQoL) and the health utility in beta thalassemia major patients receiving different types of iron chelators and living in different socio-economical situations. Subjects and Methods: EQ-5D-3L accompanied by a Visual Analogue Scale (VAS) questionnaire was used. The respondents were patients with beta thalassemia major that were at least 12 years old selected from 3 provinces of Sistan-Blouchestan, Fars and Mazandaran. Comorbidities including heart complication, Diabetes Mellitus and Hepatitis and also types of iron chelators (oral, injection, combination of both) were also asked. Cross tab and ANOVA analysis conducted to evaluate each dimension score and health utility differences between provinces, iron chelation methods, comorbidities, age group and gender. Results: 528 patients answered the questionnaires. The health utility of patients that received oral iron chelator were 0.87 ± .01 for oral iron chelators versus 0.81 ± .01 for injection dosage form (p<0.05). Increase in age was accompanied by decrease in health utility. Females faced more usual activity problems, anxiety and depression. Heart problems were more prevalent in males. Conclusion: This study suggests that the quality of life of beta thalassemia major patients is dependent on type of iron chelation treatment which they received, the gender they have, the comorbidities they suffer and socio-economical situations they live in.

Physiopathology of Dementia in Iranian Traditional Medicine

Recently, an article published in this journal by Dr Seifaddini and colleagues. In that article, the authors tried to connect dementia, including Alzheimer's disease, with a condition mentioned in Iranian traditional medical condition, Raoonat and Homgh In this condition, intellectual functions of the brain are disturbed and therefore, learning and decision-making abilities are damaged. This condition is not age limited and affects thinking ability but not memory. On the other hand, there is a condition described in Iranian traditional medicine, which completely matches with Alzheimer's disease. This condition is explained under the title of Nesyan (forgetfulness). Nesyan has 5 subdivisions, one of which is caused by the inclination of the brain normal temperament to more coldness and dryness. By performing animal studies, we have recently shown that this kind of Nesyan is related with Alzheimer's disease. Studies on the traditional recommendations on treatment of this kind of Nesyan can be useful in treatment of Alzheimer's disease.

Treatment of Alzheimer's disease in Iranian traditional medicine

BACKGROUND

Alzheimer's disease (AD) is a progressive neurodegenerative disease with a high prevalence in recent years. Dramatic growth in AD prevalence has increased the importance of more researches on AD treatment. History has shown that traditional medicine can be a source of inspiration to find new therapies.

OBJECTIVES

This study tried to codify the recommendations of Iranian traditional medicine (ITM) by studying the main medical manuscripts. The second purpose was to compare these findings with new medical information.

MATERIALS AND METHODS

Cardinal traditional medical and pharmacological texts from 10th to 18th century were searched for traditional terms of dementia (Nesyan, Fisad-uz-Zekr, Faramooshkari) focused on treatment methods. The findings were classified into three groups: lifestyle recommendations, dietary approaches, and drug therapies. These findings were compared with new medical findings.

RESULTS

ITM has dietary recommendations for dementia such as increasing consumption of nuts, poultry and eggs, milk, and grape products (like raisin and currant). These compounds are full of unsaturated fatty acids, cholesterol, and polyphenolic compounds. New findings suggest that these substances can help in prevention and treatment of AD. ITM has some lifestyle considerations like increasing physical and mental activities, listening to music, attending musical feasts, and smelling specific perfumes. New medical findings confirm nearly all of these recommendations. Along with the aforementioned items, treatment with natural medicines is in the first line of traditional treatment of dementia. New investigations show that many of these herbs have antioxidant, anti-inflammatory factors and acetylcholine esterase inhibitory effects. A few of them also have N-methyl-D-aspartate (NMDA) blocking activity. When these herbs are put together in traditional formulations, they can comprehensively fight against the disease.

CONCLUSIONS

More ethnopharmacological and ethnomedical studies on ITM antidementia therapy can be followed by fruitful results.

Effectiveness of compassionate mind training on depression, anxiety, and self-criticism in a group of Iranian depressed patients

OBJECTIVE

The purpose of this study was to examine the effectiveness of compassionate mind training (CMT) on symptoms of depression and anxiety in Iranian depressed sufferers.

METHOD

Nineteen depressed patients aged 20 to 40 (Beck Depression Inventory value ≥ 20) were randomly assigned into two groups. The experimental group participated in 12 sessions of group therapy based on Paul Gilbert's manual of CMT. The control group was given no intervention. The participants were assessed by Beck Depression Inventory-II (BDI-II), Anxiety Scale (AS), and Levels of Self-Criticism (LSCS) questionnaires at the beginning and immediately after the intervention. To follow-up the therapeutic effect of CMT, the three questionnaires were answered again by participants two months after the end of the intervention. Data were analyzed by independent samples t-test.

RESULTS

The results revealed that CMT significantly decreases depression (P < 0.05) and anxiety score (P < 0.05) in the follow-up study, but not immediately after the intervention. Although CMT decreased self-criticism, this effect was marginally insignificant.

CONCLUSION

The findings indicated that CMT could alleviatedepression and anxiety in a group of Iranian depressed patients.