Lost Ethnic Borders in Ethnopharmacological Research

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Symptoms and underlying diseases associated with the hospitalization period of 3,480 Covid-19 patients in Hormozgan, Iran

OBJECTIVES: COVID-19 has a relationship with patients ‘demographic characteristics as well as their underlying diseases. This research has been conducted to evaluate factors' effect on Covid-19 patient's hospitalization rate and period in Hormozgan, Iran.METHODS: The inclusion criteria of this retrospective study included all patients diagnosed as COVID-19 patients after PCR who were referred to Covid-19 hospitals from February 2020 to June 2020 in Hormozgan province (3480 patients). The checklist was designed according to COVID-19 guidelines and approved by the World Health Organization and Iran Ministry of Health and Medical Education. These data were analyzed using descriptive (average-standard deviation-percentage) and analytical (including Chi-square, t-test, and regression tests) statistics with SPSS Ver.23 software.RESULTS: In this study, 1852 male patients (53.20%) with a median age of 43.11±21.72 and 1628 female patients (46/80%) with a median age of 44.86±22.40.The median age of men was significantly lower than the women's median age(P= 0.02). The hospital stay length of male and female patients was reported 2.64±4.14 and 2.76±4.297; the death rate of patients in our study was 6.6%.CONCLUSION: The results of this study showed that the hospital stay length of HIV-positive patients and patients with cardiovascular and pulmonary diseases is much longer than other people, which imposes many human and financial costs on the country's health care system. These results can improve health care system planning and improve medical services presented to covid-19 patients.peer-reviewe

Topical Licorice for Aphthous: A Systematic Review of Clinical Trials

Background: Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease that affects oral mucosa. The coating agents, topical analgesics, and topical steroids are usually used as treatment methods. Glycyrrhiza glabra has been used for RAS treatment based on its anti-inflammatory, antioxidant, and immunomodulatory properties. In this study, a systemic review on the therapeutic effect of topical licorice on RAS management was performed. Methods: Science Direct, Scopus, Cochrane databases, PubMed Google Scholar, and ResearchGate were searched up to September 2021 to find all English randomized clinical trials studying the effect of G. glabra, or its compositions on RAS. Meta-analysis was not conducted because of data heterogeneity. Articles were reviewed qualitatively, and only those with a Jadad score ≥3 were included. Animal studies, in vitro, review papers, non-English papers, and case reports were excluded.Results: Six studies with 314 subjects were included after screening. The result showed licorice has significant effects on RAS pain reduction, ulcer size, and healing time. Its effectiveness is related to its dose-dependent anti-inflammatory and antioxidant effects through several mechanisms. It also has antibacterial effects against Streptococci mutans and Porphyromonas gingivalis as another mechanism of action in RAS treatment. In addition, licorice can elevate the epidermal growth factor (EGF) level compared to the control group, which has an essential role in oral mucosal tissue integrity. Conclusion: Licorice extract has been used in different dosage forms, including paste, patch, and mouthwash with concentrations of 1% or 5%. The healing time after licorice therapy is expected to be within 4-8 days. Licorice did not show any adverse effect in the intervention groups, indicating its effectiveness and safety in RAS treatment

Shiraz Azodi hospital and its role in Advancing medical knowledge

زمینه و هدف: با قدرت‌گيري آل‌بويه و دستيابي این خاندان بر بخش‌هاي مرکزی و غربي جهان اسلام به خصوص بغداد و شيراز، كه اصلي‌ترين مراكز تحت حكومت آل‌بويه بودند، روند فعاليت‌های پزشكي و بهداشتي ازجمله ساخت و تجهيز بيمارستان شتاب بيشتري یافت. ازجمله این مراکز، بیمارستان عضدی شیراز بود که در سال 360 ق. و به دستور عضدالدوله دیلمی بنا شد و بنیان‌گذار حوزه طبی شیراز گردید. علیرغم اهمیت این بیمارستان، اطلاعات مدون محدودی پیرامون آن وجود دارد که ضرورت انجام پژوهشی گسترده را آشکار می‌سازد. بر همين اساس شناخت جايگاه پزشكي این بیمارستان به عنوان حلقه استمرار پيوند دانش پزشكي جندی‌شاپوری به دوران اسلامي از اهميت به سزايي برخوردار است. از اين رو هدف از اين مطالعه ترسيم وضعيت اين بیمارستان بر اساس منابع موجود تاریخی است. مواد و روش‌ها: در اين پژوهش با روش توصيفى تحليلى، بیمارستان عضدی شیراز از جنبه‌هاي ساختاری و تشکیلاتی چون كاركردهاى درمانى و آموزشى بررسی شد. یافته‌ها: نتايج اين بررسی نشان مى‌دهد كه بیمارستان عضدی شیراز به سبک بیمارستان جندی‌شاپور اداره می‌شد و در امور داخلي و تشكيلات سازماني خود داراي سلسله مراتب و بخش‌هاي مختلفي بود که به مرور زمان و با بهره‌مندي از دستاوردهاي پزشكي حاصل شده بود. این بیمارستان با برخوردارى از پشتوانه مالی دولتی و حمایت خیرین سال‌ها پابرجا بود و در طول دوران فعالیت خود به واسطه‌ کتابخانه‌ بزرگ آن مطرح می‌شد. نيز اين بیمارستان در انتقال دستاوردهاى علمى و پژوهشى و تربیت پزشکان برجسته‌ای چون ابوماهر شیرازی و علی بن عباس اهوازی مؤثر بود. نتیجه‌گیری: نتايج تحقيق بيانگر آن است كه حمايت‌هاي عضدالدوله دیلمی موجبات ارتقای سطح بهداشت و درمان طی دوران حکومت آل‌بویه در شیراز را به همراه داشت که پیامد آن جذب دانشمندان و پزشكان برجسته و انتقال اطلاعات طبي آنان از طريق کتب طبی و حفظ آن‌ها به صورت تأليف و ترجمه بود.Background and Aim: With the Buyid dynasty day to day powering and conquering central and western regions of the Islamic world, especially Baghdad and Shiraz, health-related activities including building and equipping the hospital accelerated. One of these centers was Shiraz Azodi hospital, which was built under the order of Azod od-Dowleh Panah (Fana) Khusraw in 971-973 AD. This interest in medical sciences resulted in founding Shiraz Medical Field. Despite the importance of this hospital, there is limited published information about it, which reveals the need for more extensive research. Accordingly, recognizing the role of this hospital in linking Jundishapuri’s medical knowledge and the Islamic era is of great importance. Therefore, the purpose of this study is to explain this hospital status in the Buyid dynasty based on historical sources that are available. Materials and Methods: In this study by descriptive-analytical method, Shiraz Azodi hospital was studied from structural and organizational aspects such as therapeutic and educational functions. Findings: The results of this study showed that Shiraz Azodi hospital was managed like Jundishapur Hospital. Azodi hospital had its specific organizational structure and departments, which were developed over time and as a result of medical achievements. This hospital was established and managed with the financial support of the government and the receiving charity for many years and was known mainly because of its great library. This hospital was also active in transferring research achievements and training physicians such as Abu Maher Shirazi and Ali Ebn Al-Abbas-al-Majusi (Haly Abbas). Conclusion: The results of the study indicate that the support of Azod od-Dowleh led to the improvement of the health system in Shiraz over four centuries, which resulted in attracting prominent scientists and physicians and transmitting their medical information through the preparation of books and educating other students. Amiri Ardakani E, Nikpour SH, Zare F. Shiraz Azodi hospital and in Advancing medical knowledge. Medical History Journal 2021; 13(46): e14

Evaluation of in vitro enzyme inhibitory, anti-inflammatory, antioxidant, and antibacterial activities of Oldenlandia corymbosa L. and Oldenlandia umbellata L. whole plant extracts

Background: Oldenlandia corymbosa and Oldenlandia umbellata are well-known medicinal plants in various traditional systems of medicine and used to treat bronchitis, asthma, tuberculosis, constipation, and leprosy. We evaluated the phytochemical content, antioxidant potential, enzyme inhibitory action, anti-inflammatory, and antibacterial activities of the whole plant extracts of O. corymbosa and O. umbellata due to their therapeutic importance. Methods: The phytochemical analysis includes qualitative analysis and quantification of total phenolics, flavonoids, tannins, flavonols, proanthocyanidins, and vitamin E. Enzyme inhibitory assays were studied using α-amylase and α-glucosidase enzymes and anti-inflammatory activity was determined by egg albumin denaturation assay. Antioxidant potential was estimated using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2′-azino-bis (3-ethyl benzothiozoline-6-sulfonic acid) diammonium salt (ABTS), ferric reducing antioxidant power (FRAP), hydroxyl radical, superoxide, nitric oxide, metal chelating, and phosphomolybdenum assays. Minimum inhibitory concentrations of extracts were studied against ten bacterial strains by the microdilution method. Results: The aqueous extract of O.umbellata showed a higher extract yield (5.0%). The highest amount of total phenolics and flavonoids were observed in the ethanolic extract of O.umbellata (77.23±0.46 mg GAE/g) and O.corymbosa (19.01±0.26 mg GAE/g). Ethanolic extract of O.umbellata (IC50 of 31.71±0.32 µg/mL) and aqueous extract of O.corymbosa (30.53±1.83 µg/mL) showed notable α-amylase inhibitory effect and petroleum ether extract of both plants observed good inhibition against α-glucosidase enzyme. Likewise, petroleum ether extract of O.umbellata (IC50 of 57.16±1.88 µg/mL) showed a moderate anti-inflammatory effect. In all extracts, considerable antioxidant potential was recorded specially with aqueous extract in the nitric oxide scavenging assay with an IC50 of 40.72±1.25 µg/mL. Ethanolic extract of O.umbellata and petroleum ether extract of O.corymbosa (MIC of 56.25 µg/mL) showed good antibiotic potency in lower concentrations which proves these two valuable herb's potential in herbal preparations. Conclusions: The results of the study provide a basis for further studies aiming to evaluate the possibilities of using the O. umbellata and O. corymbosa as natural sources of antioxidants, enzyme inhibitory, and antibacterial agents. Further studies could be directed to exploit these plants in experimental animal models as potential pharmaceutical agents

Startup-Based Learning as an Innovative Method for Pharmacy Education: Medicinal Plants Course Model

Background: Familiarizing students with knowledge-based businesses is one of the goals emphasized in the developed educational systems worldwide. This study aimed to design a startup-based learning model (SBL). Methods: As a qualitative research study, startup teams were formed by the pharmacy students of Shiraz University of Medical Sciences in 2020. This model was used to train 120 students as pharmaceutical entrepreneurs through related lectures, simulations, and field activities. We employed this model for students to become familiar with the various stages of examining market needs, knowledge-based company registration, intellectual property, logo design, and even pharmaceutical product development. Students' feedback was assessed with a questionnaire designed by the team of researchers, and its results were used to analyze the course and improve the quality of the proposed model. Results: Most of the studied indices revealed that the students rated this model as good or excellent. Satisfaction with more important indices includes student creativity and ideation in educational activity (60.7%), attractive presentation (60.4%), teamwork among learners (62.2%), appropriateness of evaluation method (65.4%), understanding how to make herbal remedies (49.1%), learner participation in the educational activity (74.8%), entrepreneurial motivation (60.7%), and applicability (64.4%). Conclusion: We found this model effective in boosting students' satisfaction, creativity, and entrepreneurial spirit. Lecturers also play a facilitator role in addition to specialized training. Therefore, in this model, both lecturers and students can grow more and make education more attractive. This study, for the first time, demonstrated that SBL could be applied in education systems and make the students more interested in educational content and help them to prepare for the job market

A Comprehensive Review of the Pharmacological Properties and Bioactive Components of <i>Retama monosperma</i>

Retama monosperma L. (Boiss.) or Genista monosperma L. (Lam.), known locally as “R’tam”, is a spontaneous and annual herb that belongs to the Fabaceae family. It is native to the Mediterranean regions, specifically in the desert areas and across the Middle Atlas in Morocco. This plant has been extensively used in folk medicine and it is rich in bioactive compounds, including polyphenols, flavonoids, and alkaloids. Current research efforts are focusing on the development of novel natural drugs as alternatives to various organic and non-organic chemical products from Retama monosperma. In addition, extract, and isolated compounds obtained from different parts of the chosen plant have been described to exhibit multiple biological and pharmacological properties such as antioxidant, anti-aging, anti-inflammatory, antihypertensive, anti-helminthic, disinfectant, diuretic, and hypoglycemic effects. The plant-derived extract also acts as an antimicrobial agent, which is highly efficient in the treatment of bacterial, viral, and fungal infections. Its antiproliferative effects are associated with some mechanisms, such as the inhibition of cell cycle arrest and apoptosis. In light of these assessments, we critically highlight the beneficial effects of the flowers, stems, seeds extracts, and isolated compounds from R. monosperma (L.) Boiss in human health care, industrial, and other applications, as well as the possible ways to be employed as a potential natural source for future drug discovery

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

BackgroundFuture trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050.MethodsUsing forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline.FindingsIn the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]).InterpretationGlobally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions.FundingBill & Melinda Gates Foundation.</p