Digesters in traditional Persian medicine

Background: Functional gastrointestinal diseases are common in general populations and comprise more than 40% visits to gastroenterologists. Treatment options of gastrointestinal diseases have been limited. There are a few medications for functional gastrointestinal diseases and some of medications are not available in the market or in the place where the patient lives. Traditional Persian medicine (TPM) is a branch of alternative and traditional medicine based on individual viewpoint and humoral theory, focuses on lifestyle modification and uses natural products to manage the patients. Methods: In this study, a set of compound drugs known as digesters (jawarishes) and other applications are described based on main TPM text books. Results: Jawarishes have different formulations containing various medicinal herbs used for better food digestion and improved gastric functions and also used for other disorders including reinforcing the brain, heart, liver and some therapeutic approaches. Conclusions: By reviewing medieval Persian pharmaceutical manuscripts, we can conclude that many herbs are effective in different systems of the body and improve gastric functions. Zingiber officinalis and Piper nigrum are mixed together to get various formulations. The variety of jawarishes formulations and their different clinical applications can indicate continuity of their use

Age-Specific Distribution of Intraocular Pressure in Elderly Iranian Population and Its Associated Factors

Background: The purpose of this study was to determine the distribution of intraocular pressure (IOP) and assess its association with age, sex, systemic blood pressure, diabetes mellitus, body mass index (BMI) and tobacco smoking in Iranian elderly population. Methods: This cohort-based, cross-sectional study assessed elderly individuals aged 60-90 years in Amirkola, northern Iran, in 2016-2017. Past medical history, blood pressure, diabetes mellitus, BMI and tobacco smoking were recorded through an interview and physical examination. IOP was assessed using non-contact tonometry. Results: Total of 1377 individuals participated in this study, out of which 1346 IOP measurements were included for the final analysis. The mean age of participants was 69.4 ± 7.1 years and mean IOP was determined to be 16.7 ± 3.2 mmHg. Majority of the participants were males (56.1 vs 43.1), 73.8 of participants were overweight or obese, 6.1 smoked tobacco, 28.9 had diabetes mellitus and 84.9 had higher than normal blood pressure. Through multiple regression analysis, it was determined that age (β=-0.132, p<0.001) was negatively associated with IOP, and the presence of diabetes mellitus (β=0.118, p<0.001), systolic blood pressure (β=0.101, p<0.001), and BMI (β=0.020, P=0.020) were positively associated with IOP. Conclusion: Mean IOP of individuals in this study was higher than average based on other studies. Age, was negatively and systemic blood pressure, BMI and presence of diabetes mellitus were positively associated with mean IOP of elderly Iranian population. Sex and tobacco smoking were not correlated with IOP. &#160

Bone Metastasis Prognostic Factors in Breast Cancer

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P   .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups

الگوی اولویت‌بندی داروها در منابع طب سنّتی ایران

  In the medical world today, the searching process to find a new drug (drug discovery) is very expensive and time consuming. Although the principles of Iranian Traditional Medicine (ITM) differs from conventional medicine, including the viewpoints to drugs and its mechanisms of effectiveness, but it seems that it is possible to find ideas to produce new drugs matching with basics of conventional medicine. In this paper, we have tried to introduce a logical and repeatable manner to find the most effective material medica in ITM references for a definite disease or sign and symptom. This manner is explained in 9 steps including: accommodation of subject, arrange keywords, determine resources, giving a score to each book, search in the references, find synonyms and classification, re-monitoring, scoring and setting priorities. After setting priority based on literature review, recommendation of each materia medica for clinical trials should be done regarding to factors such as: availability, cost, being native, fewer complications, better tasting, easy to prepare and availability to maintain long-time.در دنیای پزشکی امروز جست‏وجو و کشف داروی جدید، فرآیندی پرهزینه و زمان‌بر است. اگرچه مبانی و دیدگاه طب سنّتی ایران با مبانی طب رایج غربی در بسیاری از موارد مانند چگونگی نگاه به دارو و مکانیسم‌های اثربخشی آن تفاوت اساسی دارد، شاید بتوان از انبوه علوم متراکم در کتاب‏های طب سنّتی برای جست‏وجو و یافتن دارو، حتی بر اساس مبانی طب رایج استفاده کرد. در مقاله حاضر سعی شده است روش جست‏وجو و اولویت‌بندی دارو در منابع طب سنّتی ایران برای یک علامت یا بیماری تعریف‎شده از دیدگاه طب رایج، با سیر منطقی ارائه شود تا علاوه بر یافتن حداکثر مفردات توصیه‌شده، این کار قابلیت تکرارپذیری نیز داشته باشد. شیوه جست‎وجو در متون، در 9 مرحله شامل: تطبیق موضوع، تعیین کلیدواژه‌ها، تعیین منابع، نمره دادن به کتاب‏ها، جست‎وجو در منابع، یافتن مترادفات، دسته‌بندی، بازبینی، نمره‎دهی و اولویت‌بندی، تنظیم و توضیح داده شده است. پس از اولویت‌بندی مفردات بر مبنای جست‎وجو در متون، توجه به مواردی مانند در دسترس بودن، ارزان بودن، بومی بودن، عارضه کمتر، مزه بهتر، قابلیت تهیه آسان و نگهداری طولانی‌مدت در توصیه مفردات برای انجام کار بالینی، مهم است

Demographics, clinical characteristics, and outcomes in hospitalized patients during six waves of COVID‑19 in Northern Iran: a large cohort study

Abstract Since the first report of coronavirus disease 2019 (COVID-19) in Iran, our country has experienced several waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Northern Iran was one of the most affected regions of the country by COVID-19. In the current study, the demographic and clinical characteristics and outcomes of hospitalized patients were determined over a 2-year period (during six waves of SARS-CoV-2). This is a large cohort study investigating hospitalized patients with suspected and probable, and confirmed SARS-CoV-2 infection in Babol district, northern Iran, during the two years of COVID-19. The study population included patients admitted to four hospitals affiliated with Babol University of Medical Sciences between March 7, 2020 (start of the first wave) and March 20, 2022 (end of the sixth wave). Epidemiological and demographic characteristics, real-time PCR, cycle thresholds, clinical data and outcomes of COVID-19 were analyzed in 24,287 hospitalized patients. A total of 24,287 hospitalized patients were included in the study: 13,250 (46.6%) patients were suspected of having COVID-19, 11037(45.4%) were confirmed COVID-19 cases. The mean age of confirmed COVID-19 patients was 54.5 ± 18.9 years and 5961 (54%) were female. The median length of hospitalization for COVID-19 survivors and non-survivors was 5 (interquartile range [IQR] 4-8) and 7 (IQR 3-15) days, respectively. Of the patients with confirmed COVID-19, 714 (6.5%) died during hospitalization. In addition, the mortality rate from the first to the sixth wave was 22.9%, 8.1%, 9.9%, 6.8%, 2.7% and 3.5% in confirmed COVID-19 patients. The patients in the fifth wave were significantly younger than the others (mean age and SD of 51.1 ± 17.4 versus 59.2 ± 16.9, 54.7 ± 19.9, 58.4 ± 17.9, 53.5 ± 16.8 and 58.5 ± 25.1 years; p<0.001). The highest in-hospital mortality rate was 22.9% (126/551) in the first wave and the lowest in the fifth wave was 2.7% (96/3573) of cases. In conclusion, in the present study, the in-hospital mortality rate was 6.5% and more than half of the deceased patients were ≥65 years old. Male gender, advanced age and comorbidities significantly increased the mortality rate. The patients in the fifth wave were significantly younger than those in the other waves, and the lowest mortality rate and intensive care unit admission were also observed in the fifth wave

Digesters in traditional Persian medicine

Background: Functional gastrointestinal diseases are common in general populations and comprise more than 40% visits to gastroenterologists. Treatment options of gastrointestinal diseases have been limited. There are a few medications for functional gastrointestinal diseases and some of medications are not available in the market or in the place where the patient lives. Traditional Persian medicine (TPM) is a branch of alternative and traditional medicine based on individual viewpoint and humoral theory, focuses on lifestyle modification and uses natural products to manage the patients. Methods: In this study, a set of compound drugs known as digesters (jawarishes) and other applications are described based on main TPM text books. Results: Jawarishes have different formulations containing various medicinal herbs used for better food digestion and improved gastric functions and also used for other disorders including reinforcing the brain, heart, liver and some therapeutic approaches. Conclusions: By reviewing medieval Persian pharmaceutical manuscripts, we can conclude that many herbs are effective in different systems of the body and improve gastric functions. Zingiber officinalis and Piper nigrum are mixed together to get various formulations. The variety of jawarishes formulations and their different clinical applications can indicate continuity of their use

بررسی سطح آگاهی بیماران بخش‌های داخلی و ارتوپدی از رضایت آگاهانه

زمینه و هدف: رضایت آگاهانه، موافقت آزادانه و ابطال‌پذیر بیمار مبنی بر مشاركت در تصمیم‌گیری می‌باشد که این رضایت باید کاملاً آگاهانه از بیماران اخذ گردد. این پژوهش با هدف تعیین میزان آگاهانه‌بودن رضایت كسب‌شده از بیماران بستری در بیمارستان شهید بهشتی بابل انجام شده است. روش: این پژوهش به صورت یک مطالعه مقطعی روی بیماران بستری در بخش‌های ارتوپدی و داخلی بیمارستان شهید بهشتی بابل در سال 1400 انجام شده است. تعداد 424 بیمار وارد مطالعه‌ شده و اطلاعات با استفاده از چک‌لیست ویژگی‌های جمعیت‌شناختی و پرسشنامه آگاهی بیمار از رضایت آگاهانه (در خصوص اقدام درمانی) جمع‌آوری و ثبت گردید. توصیف و تحلیل داده‌ها با استفاده از نرم‌افزارSPSS 18  و شاخص‌های توصیفی و آزمون‌های T-test و ANOVA در سطح معناداری 05/0 انجام پذیرفت. ملاحظات اخلاقی: در این مطالعه موازین اخلاقی شامل محرمانه‌نگه‌داشتن اطلاعات بیماران، کسب رضایت برای ورود به مطالعه، اجرای طرح پس از تصویب و گرفتن کد اخلاق رعایت شده است. یافته‌ها: میانگین نمره کل آگاهی بیماران از فرم رضایت آگاهانه 26/4±2/52 بود. میزان آگاهی در گروه‌های سنی (037/0=P) و سطوح مختلف تحصیلات (040/0=P) تفاوت معناداری داشته است، اما بر حسب جنسیت بیمار، بخش بستری و نوع درمان انجام‌شده، اختلاف معناداری نداشته است (05/0&lt;P). نتیجه‌گیری: میزان آگاهی بیماران بیشتر از 50 و نزدیک به حداکثر نمره آگاهی از رضایت آگاهانه (نمره 60) محاسبه شد و در حالی که میزان آگاهی بر اساس گروه سنی و سطح تصیلات بیمار، تفاوت مورد توجهی داشته، بیشترین نمره آگاهی مربوط به موافقت با شرکت در یک اقدام درمانی و اطمینان از انجام درمان توصیه‌شده به جهت بهبود بیماری بوده و کمترین آگاهی هم به ممکن‌بودن عدم سودمندی درمان انجام‌شده تعلق داشته است. جهت حصول نتایج دقیق‌تر، انجام مطالعه چند مرکزی، بررسی مشابه بر روی بیماران تحت یک مداخله خاص و همچنین انجام یک مطالعه مرور نظام‌مند پیشنهاد می‌شود

Hospital diet for COVID-19, an acute respiratory infectious disease: An evidence-based Protocol of a Clinical Trial

Background: COVID-19 caused a global pandemic problem. No confident management is introduced for it yet. This study aimed to propose a dietary protocol for hospitalized patients with the diagnosis of acute respiratory infectious disease caused by COVID-19 based on Persian Medicine. Methods: This study was conducted in three phases. In the first phase, any diseases that could be matched with the clinical features of infection with COVID-19 were searched in selected PM references. In the second phase, medicinal herbs and foods that were available and could be used in the hospital diet were extracted and summarized. In the third phase, the new documentation of these pharmaceutical and food items was conducted. Results: The signs and symptoms of infectious respiratory disease caused by COVID-19 can be categorized in the field of Zato al-rieh that can mainly be matched with pneumonia. Based on the described criteria, some nutrients and medicinal materia medica have been introduced for acute respiratory infection including Cydonia oblonga, Honey, Citrus sinensis, Malus domestica, Citrus medica, Crocus sativus, Raisin, Rosa Damas Cena, D.Carota, Camellia Sinensis, Anethum graveolens dhi, Punica granatum, Petroselinum Crispum, Coriandrum sativum, Urtica dioica, Allium sativum, Sesamum indicum Conclusion: Most materia medica has documents in current articles including anti-cough suppressants, antiviral properties, anti-bacterial, anti-inflammatory, antioxidant, immunomodulatory etc. A protocol of hospital diet for patients with infectious respiratory syndrome caused by COVID-19 has been introduced in this manuscript

Prevalence of Ocular Toxoplasmosis in the General Population and Uveitis Patients: A Systematic Review and Meta-Analysis

The present study aimed to estimate the global prevalence of ocular toxoplasmosis in the general population and patients with uveitis. Four electronic databases were searched and 130 studies for evaluating the prevalence of OT among the general population and uveitis patients were included. The pooled prevalence of OT among the general population was estimated at 2% (95% CI, 2–3%; 762/486 051). The highest prevalence rate was observed in America 6% (95% CI, 1–11%). In uveitis patients, a prevalence rate of 9% (95% CI, 8–10%; 5668/88 006) was reported. The countries with a lower middle income had higher prevalence rates. The prevalence of OT in posterior uveitis 33% (95%CI, 24–42%) was substantially higher than in panuveitis 7% (95% CI, 5–8%). Our results provide a new perspective on the prevalence of OT. Knowledge of international and regional patterns of disease is essential for the establishment of precise diagnostic protocols and control programs.</p

Effect of eryngo (Eryngium caucasicum Trautv) on primary dysmenorrhea: A randomized, double-blind, placebo-controlled study

Objective: This study strove to investigate the safety and effectiveness of Eryngo in the treatment of primary dysmenorrhea. Materials and methods: The researchers conducted a blinded, randomized, trial design on 169 women, 15–30 years of age, who had been diagnosed with primary dysmenorrhea at Babol University of Medical Sciences. Subjects were randomly assigned to receive 5 ml syrup of Eryngo, placebo, or Ibuprofen (200 mg) three times a day (15 ml/day), from one day prior to the onset of bleeding for five days. The degree of dysmenorrhea was reported by two measures; Visual analogue scale (VAS), as a primary outcome, and the assessment of dysmenorrhea severity (VMS), as a secondary outcome at 4 menstrual cycles: at pretreatment phase, at the first menstrual cycle, at the second menstrual cycle, and the third menstrual cycle without drug. Results: The reduced peak-pain differed by the treatment length in women treated for two menstrual cycles: 4.2 (1.0) cm in the Eryngo group, 4.3 (0.0) cm in the Ibuprofen group, and 0.9 (0.1) cm in the placebo group (P < 0.0001). No serious side effects were reported in all groups under study. According to the results, minor side effects did not increase in the Eryngo group when compared with the placebo group. Conclusion: Eryngo relieved dysmenorrhea as effectively as Ibuprofen did. Thus, Eryngo could be regarded as a new herbal remedy for the treatment of dysmenorrhea. However, in order to prescribe Eryngo as herbal remedy, rigorous research studies are required to establish its efficacy by investigating its chemical, pharmacologic, and therapeutic properties. Keywords: Dysmenorrhea, Herbal medicine, Wome