Volume 17, Issue 1 -

Eclipta alba (L.) Hassk. or Eclipta prostrata (Linn.) or Eclipta erecta (Linn.) is an herbaceous plant well known in Asian as African traditional medicines. These extracts are used in traditional medicine for treatment of microbial diseases and certain metabolic disorders. This review aimed to investigate phytochemical profile and neuroprotective effects of E. alba (L.) Hassk. Several compounds belonging to the families of phenolics, alkaloids, terpenoids and polysaccharides have been isolated, identified or characterized from E. alba extracts. This plant has a diverse neuropharmacological profile. Thus, its extract improves cognitive deficits and also attenuated epileptic seizures. Phytomolecules implicated in these potentials are Eclalbasaponin II and luteolin, respectively. This document updates isolated and identified organic compounds from the extracts of E. alba and reviews their neuropharmacological activities.

Introduction Vitex agnus-castus , also called Vitex , is a plant with many medicinal properties. This systematic study examined the evidence of the effectiveness and safety of Vitex on menstrual bleeding (primary outcome) and its side effects (secondary outcomes). Materials and methods This systematic review study examined all papers that were a randomized controlled trial, quasi-experimental, and cross-over conducted on the effect of Vitex on menstrual bleeding, following the PICO (population, intervention, control, and outcomes) criteria without any time limits in December 2017. The participants were women of reproductive age with no gynecologic disorders. The intervention included the use of Vitex in form of tablets, capsule, or oral drops with different doses. The control group included the placebo or mefenamic acid group. The search strategy in this study was in accordance with MeSH terms. The keywords used separately or in combination with other words were Menstrual bleeding OR Menstruation OR Menorrhagia AND Vitexcastus OR Vitex OR Chasteberry AND randomized controlled trial OR randomized trial OR randomized clinical trial OR randomized controlled. All papers, including Persian or English, were searched for in the databases; Medline (through PubMed), Scopus, Embase (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, SID, Magiran, Irandoc, and Iranmedex, without any time limits. Two authors independently reviewed the quality of the papers and assessed the risk of bias based on Cochrane handbook, and the disputes were resolved through discussion and consensus with a third person. The meta-analysis was done on continuous data (mean of menstrual bleeding). In meta-analysis, subgroup analysis was performed based on the type of comparison group. Results Out of the 8,905 searched papers in the databases, 8,905 titles, 720 abstracts, 85 full texts, and 20 references of the papers were reviewed, of which 5 papers entered this study. Based on the subgroup analysis, the consumption of Vitex did not have a significant effect on the amount of menstrual bleeding compared to the placebo group in the first (mean difference [MD]: 3.08; 95% CI: −3.11–9.26; p=0.33; I 2 =0%) and second menstrual cycles (MD: 0.00; 95% CI: −5.75–5.75; p=1.00; I 2 =0%). Also, the Higham mean score was statistically more in the Vitex group compared to the mefenamic acid group in the first menstrual cycle (MD: 7.17; 95% CI: 0.33–14.01; p=0.04; I 2 =0%) but there was no statistical significant difference between Vitex and mefenamic acid groups in the second menstrual cycle (MD: 12.18; 95% CI: −5.57–29.94; p=0.18; I 2 =75%). Only nausea and abdominal pain were reported as side effects of Vitex in the included studies. Conclusions The results of this study showed that the consumption of Vitex in the intervention group did not have a significant effect on menstrual bleeding in comparison with the placebo group. However, due to the relatively low quality of the papers, it is essential to perform clinical trials with an appropriate design to determine the effect of Vitex on menstrual bleeding.

Alfa-amylase inhibitors are used to reduce glucose absorption by suppressing carbohydrate digestion. The current study aimed to evaluate seven wild edible Palestinian plants’ hydrophilic and lipophilic fractions against porcine pancreatic α-amylase enzyme. The lipophilic fractions of Arum palaestinum , Malva sylvestris, Plantago major , Centaurea iberica, Cichorium endivia, Bituminaria bituminosa , Sisymbrium irio leaves were sequentially separated with a nonpolar solvent hexane, while the hydrophilic fractions of the studied plants were separated with polar solvents ethanol and water. The activity of α-amylase inhibition was carried out by using α-amylase porcine pancreatic enzyme and 3,5-dinitrosalicylic acid (DNSA) method as well as by using Acarbose as a positive control. Among the studied plant’s hydrophilic fractions, C. iberica and C. endivia have the highest porcine pancreatic α-amylase inhibitory effect with an IC 50 value of 12.33 µg/mL and 9.96 µg/mL, respectively. In addition, among the studied plant’s lipophilic fractions, S. irio and A. palaestinum have the highest porcine pancreatic α-amylase inhibitory effect with an IC 50 value of 7.72 µg/mL and 25.3 µg/mL, respectively. In fact, these revealed results were near the values of Acarbose. The hydrophilic fractions of M. sylvestris and the lipophilic fractions of P. major plants exhibit remarkable α-amylase inhibitory activity. Hence, these leaves have a potential for use as regular supplements also; further investigations are required to isolate pure pharmacological molecules and to design suitable pharmaceutical dosage forms with anti-diabetic activity.

Background Plant and medicinal herbs are important sources of bioactive compounds and minerals that can play a role in preventing various diseases and they are considered a factor indispensable for the proper functioning of the human body. Methods We investigated the content of carotenoids and chlorophylls of leaves from Pallenis spinosa ( P. spinosa ), as well as their antioxidant activity and mineral composition then, we optimized the solvent extraction for the recovery of total carotenoids and chlorophylls using spectrophotometric method. Finally, we tested the antioxidant activity of the optimized extract by three assays (DPPH, ABTS and FRAP) and we determined the mineral composition by Emission Spectrometer Induced Couple Plasma (ICP). Results Carotenoid (CART), chlorophylls (CHLa + b), chlorophyll a (CHLA), chlorophyll b (CHLB) contents were about 36.337 ± 0.312; 347.769 ± 6.326; 224.286 ± 5.601; 123.483 ± 1.339 mg/100 g dw, respectively. We revealed an interesting antioxidant capacity by the tested extract (DPPH: 127.522 ± 1.406 mmol ET/Kg dw , ABTS: 104.827 ± 1.222 mmol ET/Kg dw and FRAP 71.89 ± 0.495 ± 0.994 mmol ET/Kg dw ). Carotenoids and chlorophylls content correlate positively with the antioxidant activity of P. spinosa leaves extract (r=0.646–0.986). Eight minerals have been detected (Mg, Ca, P, Fe, Mn, Zn, Cu and Cr), Mg and Ca being the predominant ones (6479.32 ± 48.33 and 3851.88 ± 130.63 mg/Kg, respectively). Conclusions These results have shown that P. spinosa leaves are a good source of carotenoids and chlorophylls with a potent antioxidant potential with high amount of minerals.

Background Oxidative stress and inflammation are the underlying factors in many chronic debilitating diseases and commonly intertwined. Terminalia ferdinandiana is a traditional medicinal plant, endemic to Australia and is a rich source of many bioactive phytochemicals such as ellagic acid (EA) with known antioxidant capacity. Methods We investigated the in vitro antioxidant and anti-inflammatory activity of an aqueous food grade EA enriched (EAE) extract of T. ferdinandiana . Caco-2 and KERTr cell lines were treated with EAE or pure EA (used as reference control), followed by the exposure to hydrogen peroxide (H 2 O 2 ). Levels of reactive oxygen species (ROS) production and gene expression of molecular markers associated with oxidative stress and inflammation were monitored. Results Significant reduction in ROS production was observed in both cell types treated with 100 or 200 µg/mL EA or EAE. Treatment of cells with EAE or EA showed upregulation of mRNA expression of the antioxidative gene superoxide dismutase ( SOD ) -2 and downregulated the expression of inducible nitric oxide synthase ( iNOS ), soluble cell adhesion molecule ( sICAM ), and cyclooxygenase ( COX ) -2 . Neither EAE nor EA had any effect on the constitutively expressed COX1 . Conclusions The antioxidant and anti-inflammatory activity of T. ferdinandiana extract on mammalian cells exposed to H 2 O 2 suggests the potential of using this traditional medicinal plant in preventing oxidative damage and inflammation related diseases.

Background The study investigated the in vivo neuroprotective, antinociceptive, anti-inflammatory potential and in vitro antioxidant and clot lysis activities of crude methanol extract with its different solvent-soluble fractions like petroleum ether (PESF), carbon tetrachloride (CTSF), chloroform (CSF) and aqueous (AQSF) of Holigarna longifolia Roxb. Methods Phenobarbitone-induced sleeping time method was used for the neuroprotective activity, writhing response experimental model introduced by acetic acid was designed for antinociceptive efficacy, carrageenan-induced paw edema model was carried out for anti-inflammatory activity, DPPH free radical scavenging activity was assessed for antioxidant activity and clot lysis model was investigated for the thrombolytic potential of the plant. Results On investigation it was found that methanol extract and CS fraction revealed statistically meaningful (p<0.05) neuroprotective activity by increasing phenobarbitone-induced sleeping time of mice, produced substantial (p<0.05) inflammation inhibitory efficacy compared to standard diclofenac sodium and also exhibited statistically significant (p<0.01) oxidative stress inhibitory efficacy by inhibiting free radical formation compared to ascorbic acid as standard. Only methanol extract produced significant (p<0.05) antinociceptive activity by inhibiting abdominal writhes produced by acetic acid compared to standard analgesic drug diclofenac sodium. And only aqueous soluble fraction exhibited moderate clot lysis activity compared to streptokinase as standard. Conclusion The findings demonstrate that H. longifolia could be potential neuroprotective due to its justified antioxidative capacity as well as clot lysis properties.

Background Virgin coconut oil (VCO), a cold processed form of coconut oil, is traditionally consumed in Asian countries owing to its nutritional and medicinal properties. The aim of this study was to investigate whether the health benefits of VCO involve alterations in immune responses that are regulated by intracellular signaling molecules in the spleens of rats. Methods Young male Wistar rats were fed with three doses of VCO in diet for 30 days. At the end of the treatment period, spleens were isolated and in vitro effects on immune responses (Concanavalin A [Con A]-induced lymphoproliferation and cytokine production), and direct effects of VCO treatment on intracellular signaling molecules and antioxidant status were examined. Serum was collected to measure glucose, lipid levels, and leptin. Results VCO supplementation in diet enhanced Con A-induced splenocyte proliferation and Th1 cytokine production while it suppressed the proinflammatory cytokine production. VCO increased the expression of mechanistic target of rapamycin (p-mTOR), sirtuin1 (SIRT1), liver kinase B1 (p-LKB1) p-ERK, and p-CREB in spleen. Similarly, VCO increased the activities of antioxidant enzymes while it suppressed lipid peroxidation in the spleen. VCO diet had hypolipidemic effects on the rats: an increase in high density lipoprotein cholesterol (HDL-C) levels while lowering triacylglycerol (TAG) levels. Conclusion The health benefits of VCO may be mediated through enhanced Th1 immunity through the upregulation of survival signaling pathways and inhibition of free radical generation in the spleen besides its capacity to induce hypolipidemia.

Background Eucalyptus oil (EO), derived from Eucalyptus species, possesses vast remedial and healing properties, although its gut health-promoting properties have not been well investigated. In this study, we investigated the chemical composition of a commercial EO formulation and its potential role in protecting against aflatoxin B1 (AfB1)-induced gastrointestinal damage in rats. Methods Male Wistar rats were divided into six groups with eight rats each. Control rats were administered with the vehicle (1% Tween 80) for 14 days, while another group was exposed to two oral doses of AFB1 on days 12 and 14. Two other groups were pre-treated with oral doses of EO (50 and 100 mg/kg b.w.) for 14 consecutive days, along with two oral doses of AfB1 (5 mg/kg b.w.) on days 12 and 14. The remaining two groups were treated with EO alone at the two doses for 14 days. At the end of the experiment, blood samples, stomach and intestinal tissues were collected for measurement of oxidative stress and antioxidant parameters and light microscopic examination. Results Gas chromatography-mass spectrometry analysis revealed Eucalyptol (1, 8-cineole) as the main constituent (67.48%) of the oil. AfB1 administration induced oxidative and inflammatory disturbances, indicated by significantly (p<0.05) increased serum nitric oxide level and myeloperoxidase activity; increased tissue contents of hydrogen peroxide, malondialdehyde and protein carbonyls, accompanied with corresponding histological alterations. AfB1 also induced significant (p<0.05) reductions in glutathione peroxidase and superoxide dismutase (SOD) activities. Treatment with EO produced significant improvements in the biochemical parameters as well as the appearance of the gastric and intestinal mucosa. EO alone, at the two doses tested did not produce any significant changes in the parameters investigated. Conclusion The findings from this study showed that EO demonstrated protective activity against Aflatoxin-induced toxicity in stomach and intestinal tissues and may thus find application in treatment of gastrointestinal disorders.

Background Moringa oleifera seed has anti-diabetic and anti-obesogenic properties. This study interrogated the effect of crude hydroethanolic M. oleifera seed extract on the blood markers of metabolic syndrome (MetS) in high-fructose diet fed growing Sprague-Dawley rats. Methods Sixty 21-day old female and male Sprague-Dawley rat pups were randomly allocated to and administered one of the following treatment regimens daily for twelve weeks: group I – plain drinking water (PW)+plain gelatine cube (PC), group II – 20% (w/v) fructose solution (FS)+PC, group III – FS+100 mg/kg body mass fenofibrate in gelatine cube (FN), group IV – FS+low dose (50 mg/kg body mass) of M. oleifera in gelatine cube (LMol) and group V – FS+high dose (500 mg/kg body mass) of M. oleifera in gelatine cube (HMol). The rats in each treatment regimen had ad libitum access to a standard rat chow. After the 12-week trial, the rats were subjected to an oral glucose tolerance test and then euthanised 48 h later. Blood was collected. Plasma triglyceride, cholesterol and insulin concentration were determined. HOMA-IR was then computed. Results The high-fructose diet increased (p<0.05) plasma insulin concentration and HOMA-IR in female rats only. It increased plasma triglyceride concentration in both female and male rats and plasma cholesterol concentration in male rats only. The crude hydroethanolic M. oleifera seed extract prevented the high-fructose diet-induced metabolic derangements in male and female rats. Conclusion Crude hydroethanolic M. oleifera seed extract can potentially be used as a prophylactic intervention for diet-induced MetS in children.

Background Warionia saharae Bentham & Cosson. is used in traditional medicine to treat many diseases including hypertension. Method The present study was designed to investigate the antihypertensive activity of aqueous extract of Warionia saharae (WSLAE) in anesthetized L-NAME (Nω-L-arginine methyl ester)-induced rats. The acute and sub-chronic effects of WSLAE on systolic, diastolic, mean arterial blood pressure and heart rate (HR) were investigated after oral administration of the extract (100 mg/kg body weight of WSLAE) during 6 h for the acute experiment and during 7 days for the sub-chronic test. In addition the effect of WSLAE on the contractile response of isolated rat aortic rings was tested and the role of the vascular receptors was evaluated using several drugs. Results The results showed that WSLAE induced a significant decrease in the systolic, diastolic, mean arterial blood pressure and HR in both normotensive and hypertensive rats. Furthermore, this extract induced relaxation in rings pre-contracted with Epinephrine (10 µM) or with KCl (100 mM). This vasorelaxant capacity seems to be mediated through inhibition of KATP channels and nitric oxide (NO) synthase pathways. Conclusion This study supports the use of Warionia saharae in the management of hypertension in Moroccan traditional medicine.

Background Interferon-α (IFNα) therapy causes psychiatric side effects, including depression that may result in poor compliance of therapy. It is important to find alternative therapies for the prevention of IFNα induced depression. Non-steroidal anti-inflammatory drugs (NSAIDs) have been useful in depressive disorder. Therefore the effects of celecoxib, ibuprofen, and indomethacin were evaluated following IFNα-induced depression in mice. Methods Male albino mice weighing 26 ± 2 g were used. Depression was induced by IFNα (16 × 10 5 IU/kg, SC) for six consecutive days. Animals were first subject to the locomotor test, then the splash test and finally the forced swimming test (FST) on the 7th day. The NSAIDs were administered (IP) either one single dose before the test, or simultaneously with IFNα. Results locomotor activity was only impaired by ibuprofen high dose (75 mg/kg), thus it was not further evaluated. Following IFNα therapy depression-like behaviors were observed; significant changes during the splash test (grooming time 24 ± 7 sec vs. control 63 ± 7 sec), the FST (immobility time 166  ± 15 sec vs. control 128  ± 6 sec), and sucrose preference reduced to 64 ± 0.8%. The NSAIDs noticeably reduced the immobility time in FST, while grooming time was increased. Celecoxib and indomethacin single doses were effective while ibuprofen showed better antidepressant effects when it was administered along with IFNα. Conclusions The NSAIDs were able to prevent IFNα induced depression in mice. NSAIDs administration with IFNα does not interfere with clinical benefit effects of IFNα and they could also be useful to prevent IFNα psychiatric side effects, thus further clinical trials are suggested.

Background Though hot arm and foot bath (HAFB) is widely used, a precise physiological response is not reported. Hence, the present study was conducted to evaluate the effect of HAFB on heart rate variability (HRV) and blood pressure (BP) in healthy volunteers. Materials and Methods Sixteen healthy male volunteers’ aged 23.81 ± 5.27 (mean ± standard deviation) years were recruited. All the subjects underwent only one session of HAFB (104-degree Fahrenheit) for the duration of 20 min. Assessments such as Electrocardiography and BP were taken before and after the intervention. Results Results of this study showed a significant reduction in systolic-BP (SBP), diastolic-BP (DBP), mean arterial pressure (MAP), the mean of the intervals between adjacent QRS complexes or the instantaneous heart rate (RR interval), the number of interval differences of successive NN intervals greater than 50 ms (NN50), the proportion derived by dividing NN50 by the total number of NN intervals (pNN50), and high frequency (HF) band of HRV along with a significant increase in heart rate (HR), low-frequency (LF) band of HRV and LF/HF ratio compared to its baseline. Conclusions Results of this study suggest that 20 min of HAFB produce a significant increase in HR and a significant reduction in SBP, DBP, and MAP while producing parasympathetic withdrawal.

Background This study was designed to examine the effectiveness of program combining chakrayoga and meditation on the physical health and disease-related factors and psychological factors of people. Methods Ninety-seven subjects (32–83 years old) who had free from prior experiences in meditation programs or Chakrayoga training courses were assigned to either the experimental group (EXP) (45 subjects; 13 male subjects and 32 female subjects; average age of 60.67 years, SD=11.09 years) or the control group (CONT) of remaining subjects (52 subjects; 14 male subjects and 38 female subjects; average age of 61.58 years, SD=9.70 years). Subjects in the EXP participated in the Chakrayoga Meditation Program for twice a week for 2 h during 6 weeks in each session consisted of 1 h of Chakrayoga and 1 h of meditation. The measurements in this study included the mindfulness, stress response, subjective quality of life, medical symptom checklist, difficulty in emotional regulation and objective of life and sense of control. Results Results revealed that participants in the EXP reported significantly more relief of mindfulness, stress response, subjective quality of life and medical symptom checklist than those in the CONT. Conclusions These findings provide evidence that the Chakrayoga Meditation Program can help relieve the physical health and disease-related factors and psychological factors.

Background There is growing evidence that exercise modalities have considerable effects on Parkinson’s disease (PD). This trial aimed to provide a more detailed viewpoint of short-term and long-term treadmill training (TT) effects on some motor and non-motor features of PD. Methods In this prospective, randomized, single-blind clinical trial, 20 mild to moderate PD patients, admitted in Rasoul-e-Akram hospital in Tehran, Iran, were randomly allocated in case (11) and control (9) groups. Treadmill intervention was performed at moderate intensity with 60% of heart rate reserved (HRR) in two 30-min sessions/week for a duration of 10 weeks. Both the groups were evaluated for three times; at the baseline, 2 months later and then 2 months after the second evaluation. We assigned the Timed Up and Go test (TUG), 6-min walk test (6MW), and the SF-8 healthy questionnaire, for assessment of balance, functional capacity, and Quality of life (QoL), respectively. Results Balance and functional capacity were significantly improved in the case group after the intervention (TUG p-value: 0.003, 6MW p-value: 0.003). Moreover, the long-term analysis revealed significant results as well (TUG p-value: 0.001, 6MW p-value: 0.004). Mental condition’s scores of SF-8 in cases were not statistically different in short-term follow-up (F/U). However, analysis illustrated p-value: 0.016 for long-term assessment. The intervention induced significant changes in physical condition’s scores in both of the F/Us (PC p-value: 0.013). Conclusions This study provides evidence that a TT of mild to moderate intensity has significant and persistent benefits for the balance, functional capacity, and QoL in PD.

Background Excess exposure to pesticides induces oxidative stress and causes alteration in the lipid profile Objectives The study aimed to evaluate the effects of Zinc (Zn) supplementation on the oxidant/antioxidant and lipid status in pesticide sprayers. Methods Forty pesticide sprayers were included in the study. Blood lipids, malondialdehyde (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD), and Zn were estimated; before and after Zn supplementation. Results Statistical analysis revealed that after Zn supplementation, total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and MDA were significantly decreased. However, there was a significant increase in the high density lipoprotein (HDL), SOD, GPx, and Zn levels. After Zn supplementation, significant inverse correlations were detected between the Zn and the levels of MDA, TG, and VLDL, while positive correlation between Zn and the levels of HDL and TC. Conclusions Zn supplementation improves the oxidative/antioxidants and lipid status in pesticide sprayers.

Background Low-dose immunotherapy affects baseline levels of intracellular calcium. However, the effect of background electric fields is yet to be ascertained. The aim of this study was to test the following hypotheses: desensitization by low-dose immunotherapy is associated with reduced calcium ion influx during electric field exposure; the effect of low-dose immunotherapy on intracellular calcium ion concentration does not depend on electric field exposure; and the intracellular calcium ion concentration is amplified by electric field exposure. Methods The experimental design was balanced and orthogonal. Intracellular lymphocytic calcium ion concentrations were assayed in 47 patients, following incubation with picogram amounts of 12 test allergens, using a cell-permeable calcium-sensing ratiometric fluorescent dye and fluorescence spectroscopy, both at baseline and following successful provocation neutralization treatment with low-dose immunotherapy. Duplicates were also exposed to an electric field which replicated the frequency spectrum measured in a non-Faraday shielded room. Results A significant or trend-level main effect was found for low-dose immunotherapy for: benzoate; formaldehyde; metabisulfite; natural gas; nitrosamines; organophosphates; salicylate; azo-dyes and precursors; nickel; and petrol (gasoline) exhaust. Significant or trend-level main effects for electric field exposure were observed for: formaldehyde; mercury (inorganic); natural gas; nickel; nitrosamines; petrol exhaust; salicylate; benzoate; and metabisulfite. There was no evidence of a statistical interaction between these two factors. Electric field exposure was associated with a higher intracellular calcium ion concentration. Conclusion There was support for all three hypotheses. The results suggest that patients may experience increased sensitivity to allergens as a result of exposure to everyday electric fields.

Background The purpose of the study was to assess the effect of emotional regulation training on depression, anxiety, and stress among patients with alcohol dependence. Depression, anxiety, and stress are very common negative emotions seen in the patients with alcohol dependence which leads to relapse of the condition. The emotional regulation could help the individuals to overcome the negative emotions. Methods The present study adopted a one-group pretest and posttest in a preexperimental design. A total of 30 patients with alcohol dependence in two de-addiction centers were recruited using a convenience sampling technique. In this study, the participant received the intervention of emotional regulation training for 13 days to overcome negative emotions. On the 14th-day posttest was conducted. Results There was a statistically significant difference found in the mean scores of depression, anxiety, and stress at p<0.001 level between the pre and posttest. There was no significant association found between the scores of depression, anxiety, stress, and any of the background variables of the patients with alcohol dependence throughout the pretest and posttest. Conclusions The study proved that emotional regulation training is an effective intervention in reducing negative emotions like depression, anxiety, and stress among patients with alcohol dependence.

Background This randomized, blinded, placebo-controlled clinical trial identifies the effect of an aromatherapy blend of essential oils on fatigue, which is one of the most commonly unaddressed symptoms of hypothyroidism, by evaluating the effects of daily aromatherapy inhalation. Methods Participants included women aged 18–55 with a diagnosis of hypothyroidism. Women who had a history of thyroid cancer were excluded, due to the confounding effects of cancer on fatigue as the outcome of interest. Participants were randomized into two groups: the aromatherapy group, treated with inhalation of the essential oil blend, and the control group, treated with an odorless vegetable oil blend. The primary outcome was change from baseline in fatigue scores as measured by the Multidimensional Fatigue Symptom Inventory (MFSI), a validated instrument which measures multiple patterns of fatigue. Results After adjusting for baseline scores, no significant difference was found between the aromatherapy group and the control group at midpoint. Both groups experienced a reduction in symptoms during the first week of the intervention. At the endpoint, participants in the aromatherapy group had improved fatigue scores across all ten subscales, as compared to the control group. Not all improvements achieved statistical significance, indicating that the aromatherapy treatment has a greater effect on the subscales of global, affective, and general fatigue. Conclusions This is the first study to evaluate the effects of aromatherapy on fatigue among women with hypothyroidism. These findings provide evidence that regular inhalation of an aromatherapy blend may reduce fatigue among women with hypothyroidism, particularly in the areas of global, affective, and general fatigue.

Background This randomized controlled pilot study evaluated the efficacy of osteopathic treatment in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) assessed using spirometry, COPD Assessment Test (CAT) and six minutes walking test (6MWT). The main goals were to improve the quality of life of patients with stable moderate-to-severe COPD, and to revise the parameters of the assessment tests, such as spirometry and 6MWT. Methods The study comprised several phases and patients were divided into two groups: group A (controls) received conventional pharmacological treatment with Indacaterol–Glycopyrronium and, while group B (OMT group) received both traditional therapy and osteopathic manipulative treatment (OMT) at different stages of the study. The osteopathic approach focused on maxillary sinus, vertebral-pleural ligaments, phrenic nerves, ribs, pleura, lungs, bronchi, subclavian muscles, and trapezoid and conoid ligaments. Results Overall, 32 patients were randomized and treated. Patients of the OMT group got better improvements in all tests compared to the control group: spirometry: FVC (p<0.5411), total FEV1 (p<0.5061); CAT: OMT (p<0.0005) - controls (p<0.188) 6MWT OMT (p<0.0038) - controls (p<0.5326). The clinical results collected in phase (T3) confirm those obtained in the first sessions; the results of CAT questionnaire (p<0.0005) and 6MWT (p<O, OO38) highlighted score improvements of patients treated with osteopathy compared to patients in the other group. Conclusions The results showed that the patients with COPD who received the conventional pharmacological treatment in association with the OMT therapy demonstrated a good response to the osteopathic treatment, thus leading to significant improvements in their health and wellbeing, and a better daily functioning.

Background The purpose of this study was to compare the effect of the two training methods: educational workshop and electronic package on the knowledge, attitude and practice of nurses in intensive care units (ICUs). Materials and Methods In this experimental study, 64 nurses working in ICU at Imam Hossein and Bahar Hospitals in 2017 in Shahroud were randomly selected into two groups of training: workshops and educational package. At first, knowledge, attitude and performance of the two groups were measured and then 2 weeks after the post-test training. Data were analyzed by Fisher exact, Wilcoxon, independent t -test, Mann–Whitney test with a significance level ≤0.05. Results A significant difference was found between knowledge score in the workshop (10.40 ± 1.41) and educational package (11.25 ± 0.95) (p=0.007). However, No significant difference was found between the nurses attitude in the workshop group (28.59 ± 2.74) and the trained by educational package (28.25 ± 2.85) (p=0.617). Also, no significant difference was found between the mean practice scores in two groups (p=0/143). Conclusion The results of this study indicated that the educational package was more effective than the workshop on improving the level of knowledge of nurses about physical restriction, but both methods increased the attitude and practice of nurses.