The Effect of Aromatherapy with Citrus aurantium Aroma on Pain after Orthopedic Surgery: A Randomized Clinical Trial

Introduction: Postoperative pain is one of the most common physiological and psychological stress in patients that disrupts body function and can endanger patients’ health. This study aims to determine the effect of aromatherapy with Citrus aurantium essential on pain after orthopedic surgery. Methods: This randomized clinical trial was performed on 60 candidates for orthopedic surgery. Patients were selected through convenience sampling and divided into intervention and control groups through randomized block allocation. If the visual analogue scale (VAS) score was above 3, patients in the intervention group received aromatherapy with C. aurantium essential and the patients in the control group received a placebo (almond oil). VAS was used to measure pain. Data analysis was performed using independent t test, paired t test, and analysis of variance with repeated measures using SPSS software version 13. Results: Mean (SD) of pain intensity after intervention in experimental and control groups within 4, 8, and 12 hours after surgery was 7.30 (1.23) vs. 7.90 (0.99), 5.30 (0.98) versus 5.53 (0.68) and 2.53 (0.9) vs. 3.60 (0.77) respectively. The findings indicated that there was a significant difference in mean pain intensity between the experimental and control groups at 4 and 12 hours after surgery. Use of analysis of variance with repeated measures test with taking into account the interaction of time and group also showed a significant difference in mean pain intensity between the two experimental and control groups. Conclusion: Aromatherapy with Citrus aurantium essential can be effective in reducing mild to moderate pain after orthopedic surgery. Further studies are recommended to confirm this finding

PRIMARY QUALITIES IN PHYTOTHERAPY AND TRADITIONAL MEDICINES

Objectives: The significance of principles of traditional medicines in research protocols are emphasized by World Health Organization. Primary qualities, traditionally referred to as “hotâ€, “coldâ€, “dry†and “wetâ€, are fundamental concepts of many medical traditions of antiquity such as Persian, Chinese, Greek, and Indian. In Humoral-based traditional medicines, these qualities are regulating factors and act in dynamic balance to maintain health. Therefore, understanding of the primary qualities of body humors and drugs is decisive for treatment, self-care and prevention of diseases in many traditional medicines. The main goals of this study are to consider the relationships among primary qualities and botanical or phytochemical profiles of the traditional Iranian Medicinal herbs.Method: A number of 489 medicinal plants were accommodated with proposed scientific names and the corresponding primary qualities were extracted from Old Persian pharmacopeias. Based on literatures, two data sets screened for statistical study. To ensure consistency and similarity of screened samples, they were examined by Chi-square (χ2) test. Influences of botanical families on primary qualities were studied by screening of 339 plants in 29 botanical families tested with χ2 test. In the second stage, major phytochemicals of 192 herbs were categorized based on existence of 23 groups of phytochemicals and a model based on traditional medicine concepts was made using logistic regression.Results: Statistical outcomes revealed that although a few botanical families tend to correlate in specific primary qualities, most others displayed no significant relationship. The proposed phytochemical model was able to estimate the relationship between primary qualities and phytochemical classes in more than 77% of the cases. The findings were in accordance with literatures.Conclusion: The botanical family classification is not an empirically acceptable indicator of primary qualities in medicinal plants. On the other hand, phytochemical profile of a plant is an authentic indicator of primary qualities

The Mediating Role of Perceived Stress in the Relationship between Personality Traits and Negative Automatic Thoughts in Adolescents with Migraine

Background: Literature suggests that chronic headaches, particularly migraines, in adolescents are crucially affected by psychological problems. In addition, groundbreaking studies have shown that preexisting personality traits are important to accelerate the likelihood of migraine onset, maintenance, and outcome. This study aims, therefore, to investigate the mediating role of perceived stress in personality traits and negative automatic thoughts, in adolescents with migraine.Methods: In this cross-sectional, descriptive study, the participants consisted of patients with chronic migraine referring to two neurology clinics in Ahvaz City, Iran, from 2019 to 2020. The diverse sample of patients (n =200) completed Cohen's Perceived Stress Scale, NEO Five-Factor Inventory (NEO-FFI), and Automatic Thoughts Questionnaire (ATQ-N).  To analyze the obtained data, SPSS V. 21 and Amos 18 were used.Results: Based on the standard path coefficients and the P-values, the relationship between personality traits and the negative dimension of perceived stress (β = -46, P≥ 0.001), personality traits and the positive dimension of perceived stress (β = 0.44, P≥ 0.001), the negative dimension of perceived stress and negative spontaneous thoughts (β = 0.45, P≥ 0.008), and the positive dimension of perceived stress and negative automatic thoughts (β = -0.28, P≥ 0.004) were significant.Conclusion: According to the results, the indirect relationship between personality traits and n negative automatic thoughts was established and significant through the negative dimension of perceived stress. Moreover, the indirect relationship between personality traits and negative automatic thoughts was established and significant through the positive dimension of perceived stress

Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial

ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1

Natural terpenoids as a promising source for modulation of GABAergic system and treatment of neurological diseases

γ-Aminobutyric acid (GABA) is the main inhibitory neurotransmitter reducing neural excitability in the mammalian central nervous system (CNS) with three subclasses of receptors. Several conventional drugs and compounds modulate the GABAergic system, demonstrating different pharmacological effects. In this review, interactions of natural terpenoids with the GABAergic system are highlighted with relation to disorders like anxiety, insomnia, convulsion, pain, and cognitive deficits. Terpenoids with various structures affect the function of the GABAergic system via dissimilar mechanisms. Most of the discussed compounds interact with GABA receptors, but especially with the GABAA subtype. This may be due to the fact that researchers tend to assess the interaction of compounds using GABAA receptors. However, bilobalide, a sesquiterpene, showed anticonvulsant properties through the activation of glutamic acid decarboxylase (GAD) enzyme, which is a key enzyme in biosynthesis of GABA. Therefore, further studies evaluating and comparing terpenoids of different classes and their interaction with the GABA system, along with their pharmacokinetic properties, could be worthwhile in future studies

The effect of aromatherapy with Rosa damascena essence on postoperative pain in inguinal hernia repair: A randomized clinical trial

Background: Despite therapeutic interventions, patients are still dissatisfied with the treatment of postoperative pain. Objectives: The aim of this study was to examine the effect of Rosa damascena essential oil on postoperative pain in patients undergoing inguinal hernia repair surgery. Methods: In a double-blind, randomized trial, 60 patients undergoing inguinal hernia repair surgery were selected consecutively and equally assigned to two groups of experimental and placebo. In both groups, the pain intensity was measured by a visual analog scale in 4, 8, and 12 h after the surgery. Patients in the experimental group received aromatherapy with R. damascena essential oil and those in the placebo group treated with almond oil. In both groups, pain intensity was measured before and 20 min after aromatherapy. Data analysis was performed using the repeated-measures analysis, analysis of covariance, independent-samples t- test, Chi-square, and Fisher's exact tests. Results: The mean pain intensity in the experimental and the placebo groups was 7.10 ± 1.24 versus 7.20 ± 1.10, 4.56± 1.04 versus 4.90 ± 0.84, and 1.30 ± 0.79 versus 2.46 ± 0.68 after the 4th, 8th, and 12th postsurgical hours, respectively. The repeated-measures analysis showed that the intervention was effective on pain reduction, especially in the 8th and 12th postoperative hours when the pain was at moderate-to-mild levels (P < 0.001). Conclusion: Aromatherapy with R. damascena essential oil was effective in relieving mild to moderated postoperative pain. Yet, further studies are needed to confirm this finding

Allergic rhinitis and dental caries in preschool children

Background: Allergic rhinitis (AR) may be overdocumented in cases of dental caries because of controversies in the literature This study was conducted to investigate the potential relationship between AR and dental caries in children. Materials and Methods: A total of 296 children were included in this cross-sectional study. Participants were evaluated using the decay-missing-filled (DMF) index, and their AR status was evaluated by physical examination and through a standard questionnaire. Baseline demographics and clinical characteristics were compared among groups using Student's t-test or the Mann–Whitney U-test, the Chi-square test, and/or Fisher's exact test as appropriate. A level of P < 0.05 was regarded as statistically significant. Results: Evidence of AR was found in 77 (35.1%) participants. There was no significant difference in the rate of tooth decay or DMF between participants with or without AR (P = 0.07), but a significant difference was observed in the number of missing and filled teeth between those with and without AR (P 0.05 in all cases) between AR-positive and AR-negative patients. Fluoride therapy and oral breathing were identified as confounding factors and controlled using log-linear analysis. The mean rate of DMF in patients who also had AR was 20% greater than in the AR-negative group (odds ratio [OR] = 1.21, confidence interval [CI]: 1.05–1.35) and 15% greater in among children who breathed orally than those who did not (OR = 1.15 CI: 1.02–1.31). Conclusion: AR and oral breathing may have an effect on oral health and dental condition, leading to an increased rate of tooth loss, oral fillings, and development of dental caries

Table_5_Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial.docx

ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)</p

Table_2_Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial.docx

ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)</p

Table_6_Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial.docx

ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)</p