Water Intake from the Points of View of Rhazes and Avicenna

Owing to the effect of acute and chronic hypohydration on health and the lethal effects of hyperhydration, an appropriate amount of water intake is important for each individual. Traditional Iranian medicine (TIM) is a holistic system one of whose important parts deals with lifestyles and how to maintain health, including the amount of water intake for every person and the appropriate principles of drinking water. In this study, Avicenna's Canon of Medicine, Rhazes' Benefits of Food and Its Harmfulness, and conventional medical articles were reviewed to evaluate the amount of water intake for each person and the principles of drinking water. TIM has expressed an individualized difference in the amount of water intake in the form of temperament and the relationship between the appropriate time of drinking water with other daily activities. In this view, drinking water at the inappropriate time causes liver and gastrointestinal diseases; it can create the foundation for conducting new studies in the field of appropriate water intake and lifestyle changes to reduce malnutrition complications.

Science and Pseudoscience in Traditional Iranian Medicine

The recent efforts for revitalizing traditional Iranian medicine (TIM) have shaped two main streams: The quackery traditional iranian medicine (QTIM) and the academic traditional iranian medicine (ATIM). The QTIM encompasses a wide range of practitioners with various backgrounds who work outside the academic arena and mostly address the public. These practitioners have no solid bases or limited boundaries for their claims. Instead, they rely on making misleading references to the Holy Islamic Scriptures, inducing false hope, claiming miraculous results, appealing to the conspiracy theories, and taking advantage of the public resentment toward some groups of unprofessional healthcare providers. The theories and practices of ATIM, however, can be categorized into two major categories: First, valid and scientific TIM that is aimed to conduct well-designed clinical trials and thereby, supply the evidence-based medicine with new treatments originated in or inspired by TIM. Second, a pseudoscientific part of the current TIM that is based on some obsolete medical theories, especially the medieval humoral medicine, and erroneous accounts of human anatomy, physiology, and physiopathology, mostly adopted from the ancient and medieval medical scripts. TIM has recently established some clinical centers for practicing humoral medicine that is partly pseudoscientific and involves significant risks. This paper suggests that the public health sector has a duty to act against the promulgation of medical superstitions by QTIM and the pseudoscientific medical practices of ATIM, and at the same time, support and promote the valid and potentially beneficial research pursued by ATIM aimed to explore the rich recourses of TIM and thereby enrich the evidence-based medicine.

Efficacy of Violet oil, a traditional Iranian formula, in patients with chronic insomnia: A randomized, double-blind, placebo-controlled study

ETHNOPHARMACOLOGICAL RELEVANCE

Violet oil is an ancient herbal drug which has been extensively used to treat insomnia in traditional Iranian Medicine clinics. Violet oil is an almond or sesame oil-based extract of Viola odorata, which is administered as nasal drops. This study aimed to evaluate the efficacy of Violet oil in the treatment of insomnia.

METHODS AND MATERIALS

This study was conducted as a 3-arm double-blind randomized trial. A total of 75 patients with chronic insomnia were enrolled and randomly assigned to three groups in Traditional Iranian Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. The treatment consisted of intranasal dropping of Violet oil, Almond oil or placebo (1% solution of Carboxymethyl cellulose) in each nostril every night before sleep for 30 days, i.e. three drops of the drug (including either Violet oil or Almond oil) or the placebo was used every night before the sleep. All the patients were asked to complete Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires before and after the intervention.

RESULTS

There were no significant differences between patients in the three groups before the intervention (P > 0.05). However, there were significant differences between the three groups after the intervention in ISI scores (P<0.002) and PSQI scores (p<0.001). When comparing the pre- and post-treatment data, the ISI and PSQI scores improved significantly in all the three groups as follows: Violet oil (P<0.001), Almond oil (P<0.001) and placebo (P<0.001). The results also showed that the Violet oil had the most effect among the three groups. In addition, it was more effective on sleep quality than sleep quantity.

CONCLUSION

Considering the effects of natural nasal drug on the improvement of sleep quality in insomniac patients, this study has proposed the use of Violet oil as a natural and herbal drug in a non-oral method without serious side effects for treatment of insomnia.

Randomized and double-blinded clinical trial of the safety and calcium kidney stone dissolving efficacy of Lapis judaicus

ETHNOPHARMACOLOGICAL RELEVANCE

Kidney stones are one of the most common disorders of the urinary tract and cause a great deal of morbidity and economic loss. Because of the side effects and costs of current interventional procedures, researchers are interested in finding medicinal therapies. In this regard, some reports have focused on traditional medicines as a drug discovery resource. Iranian scholars in the medieval era recommended Lapis judaicus for the prevention and treatment of kidney stones. The present study assessed the efficacy and safety of Lapis judaicus on the size of calcium kidney stones and some related biochemical factors in blood and urine.

MATERIALS AND METHODS

Sixty patients with kidney stone disease were included in this double-blind randomized clinical study. Thirty patients received 2g of Lapis judaicus powder in hard capsules per day for 10 weeks, and another 30 patients received a placebo for the same period. Ultrasonography was performed on patients, and blood and urine samples were collected before and after the study to evaluate the efficacy and safety of Lapis judaicus in calcium kidney stone patients.

RESULTS

The size of the kidney stones was reduced significantly (p<0.001) in the drug group. In 9 patients from the drug group, the stone was completely dissolved. Moreover, urine calcium concentration and specific gravity were reduced and urine magnesium was increased (p<0.05). Lapis judaicus did not affect BUN, creatinine, ALT, or AST.

CONCLUSION

Contrary to the placebo group, the size of kidney stones was reduced significantly in the treatment group after oral administration of Lapis judaicus. This preliminary study confirms traditional knowledge of the efficacy and safety of Lapis judaicus in kidney stone diseases and suggests a new method to treat calcium kidney stones. Further detailed in vitro and in vivo studies aimed at discovering the mechanism of action of Lapis judaicus and clinical studies involving a larger population of patients will be necessary to fully explain and confirm the results obtained in the present study.

Synergistic activity between Echinophora platyloba DC ethanolic extract and azole drugs against clinical isolates of Candida albicans from women suffering chronic recurrent vaginitis

OBJECTIVE

Candida albicans is one of the main causes of vaginitis, especially in women with recurrent episodes. The appearance of drug resistant C. albicans and adverse effects of chemical agents have raised interest in Echinophora platyloba as one of four native species in Traditional Persian-Iranian medicine.

MATERIALS AND METHODS

This study evaluates the antifungal activity of ethanolic extract from dried aerial parts of E. platyloba against 27 clinical isolates of C. albicans from women suffering chronic recurrent vaginitis by micro-broth dilution assay. The synergistic effect of azole drugs and E. platyloba ethanolic extract were also determined by disc diffusion method after determining the MIC90.

RESULTS

The results of this study showed a potent synergistic effect of E. platyloba ethanolic extract and itraconazole (P<0.01) and fluconazole (P<0.001) but an antagonistic effect between E. platyloba ethanolic extract and clotrimazole and miconazole against clinical isolates of C. albicans.

CONCLUSION

These results must be confirmed by clinical application and by further clinical studies.

Promising effect of Magliasa, a traditional Iranian formula, on experimental colitis on the basis of biochemical and cellular findings

AIM: To investigate the efficacy of Magliasa, a traditional Iranian formula, on experimental colitis.

METHODS: After botanical authentication of herbal ingredients, formulation of Magliasa, quantitative determination of total glucosinolates and total phenolic content, and analysis of the thin layer chromatography profile were performed. Colitis was then induced in male rats by instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS) in all groups, aside from the Sham group. The experimental groups consisted of: the Sham group that received only normal saline; the Mag-50, Mag-100 and Mag-200 groups, which received 50, 100 and 200 mg/kg per day of Magliasa, respectively; the control group, which received vehicle water orally; the infliximab group, which received infliximab (5 mg/kg per day, subcutaneously); and the Dexa group, which received dexamethasone (1 mg/kg per day, orally). After completing the treatment period (2 wk), the rats were sacrificed, the colon was removed, its macroscopic and microscopic changes were recorded, and tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), total antioxidant capacity, myeloperoxidase (MPO), and lipid peroxidation (LPO) were assessed in colon homogenate.

RESULTS: The mean value of total glucosinolates in one gram of Magliasa was 19 ± 1 μmol. The mean value of the total phenolic content was 293.8 ± 17.6 mg gallic acid equivalents per 100 gram of Magliasa. Macroscopic scores were significantly decreased in Mag-100 (1.80 ± 0.58, P = 0.019) and Mag-200 (1.20 ± 0.20, P = 0.001) compared to the control group (3.40 ± 0.24), although some inflammation and hyperemia were evident. Treatment of rats by dexamethasone (0.33 ± 0.21, P < 0.001) and infliximab (0.83 ± 0.31, P < 0.001) remarkably attenuated scores where mild hyperemia was observed macroscopically. In comparison to the control group (4.00 ± 0.32), only Mag-200 (1.60 ± 0.40) showed a significant decrease in colonic histopathological scores (P = 0.005). Minimal mucosal inflammation was observed in the Dexa group (0.67 ± 0.21, P < 0.001). The levels of TNF-α, IL-1β and MPO were significantly lower in all groups compared to the controls (P < 0.05). A significant decrease in LPO was seen in the Mag-200 (3.27 ± 0.77, P = 0.01) and Dexa (3.44 ± 0.22, P = 0.011) groups in comparison to the control group (6.43 ± 0.61). Only dexamethasone caused a significant increase in antioxidant power in comparison to the control group (346.73 ± 9.9 vs 228.33 ± 2.75, P < 0.001). Infliximab and different doses of Magliasa did not show any remarkable increase in antioxidant capacity (P > 0.05). The effect of Magliasa in all of mentioned parameters, except antioxidant capacity, was dose dependent.

CONCLUSION: The effects of Magliasa in TNBS-induced colitis are encouraging and warrant clinical trials for further confirmation.

A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease

The etiology of inflammatory bowel disease (IBD) is not yet known, but many factors such as defects in the immune system, oxidative stress, microbial content in the gastrointestinal tract, nuclear factor (NF)-κB, nitric oxide (NO), cyclooxygenase-2 (Cox-2), and leukotriene B4 (LB4) are thought to play a role in its pathogenesis. In traditional Iranian medicine (TIM), several medicinal plants are thought to be effective for the treatment of IBD. In this study, information on all of these remedies were derived from all available old sources such as documents or notes and books and were added to the information derived from modern medical databases covering all in vitro, in vivo and clinical trials. For some of these plants, only one or two mechanisms of action have been found such as in Cassia fistula, Lepidium sativum, and Bunium persicum. However, for some plants various mechanisms of action are known. For example, Commiphora mukul is effective in IBD due to its immunomodulatory, antioxidant, and antibacterial properties and it decreases NF-κB, NO and Cox-2. Another herb, Plantago ovata, has immunomodulatory, antioxidant, anti-inflammatory and wound healing activities and decreases NO and LB4. Considering the mechanisms of action of these plants, the combination of some of them may be useful because of their many mechanisms of action such as Pistacia lentiscus, Bunium persicum, Solanum nigrum, Plantago ovata, Boswellia, Solanum nigrum, Plantago ovata and Commiphora mukul. For some of the herbal products used in TIM such as oleogum resin from Commiphora myrrha, seeds of Ocimum basilicum, seeds of Linum usitatissimum, gum resin of Dracaena cinnabari, seeds of Plantago major, seeds of Lallementia royleana, and seeds of Allium porrum, there is no or not enough studies to confirm their benefits in IBD. It is suggested that an evaluation of the effects of these plants on different aspects of IBD should be performed.