Coronavirus has spread around the world with high prevalence rate and severe manifestations since 2019 (COVID-19) and imposed global economic, social, and health burden. Many studies were conducted to manage the complications of COVID-19 and to reduce the hospital stay but results were not satisfactory. Hence, according to the high potential of medicinal plants in management of diseases, we aimed to investigate the effects of barley aqueous extract (BAE) on clinical and laboratory features of COVID-19 in hospitalized patients. This study was an open-labeled, randomized, controlled clinical trial performed on 80 hospitalized COVID-19 patients in COVID-19 medical center, Isfahan, Iran, from July to August 2021. All patients received a same standard treatment according to the protocol of the Iranian Ministry of Health and BAE was added to the treatment of intervention group. Patients received BAE 200 mL every 4 hours for 5 days. Seventy-two patients completed the study and no significant differences were reported in the baseline data between groups. Results showed significant improvement of shortness of breath (p=0.012) and cough (p=0.09) after receiving BAE, compared to the control group. On the other hand, there was no significant difference between groups considering body temperature, respiratory rate, oxygen saturation, muscle pain, and laboratory factors. No serious adverse effect was reported. This study suggests that BAE may serve as a safe complementary treatment for alleviating symptoms of COVID-19; however, more clinical trials with higher sample size are needed.

Diabetic nephropathy affects more than 40 % of diabetic patients and is the major cause of death in this population. Current medications, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), statins, sodium-glucose cotransporter-2 inhibitors, calcitriol, etc., represent limitations both in terms of maximum efficacy and adverse effects. Animal studies exist regarding the nephroprotective effects of Punica granatum L. (Pomegranate) extract. The present study aims to assess the safety and efficacy of pomegranate juice in patients with diabetic nephropathy. Freeze-dried pomegranate juice powder was purchased from Shaanxi Tianxingjian Co. and filled in 500 ± 5 mg capsules. The intervention group (n= 23) received 4 capsules of pomegranate daily for 8 weeks; while the placebo group (n= 23) received identical-looking capsules similarly. All patients received maximum tolerated doses of ACEI /ARB, Statin, and fixed doses of Empagliflozin for the last 6 months. Fasting blood sugar, serum creatinine, blood urea nitrogen, aspartate transaminase, alanine transaminase, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, urine albumin, and urine albumin-creatinine ratio were measured at baseline and the end of the 4^th and 8^th weeks. Among all of the investigated parameters, urine albumin-creatinine ratio, and urine albumin were significantly reduced (p < 0.001) in the intervention group after 4 and 8 weeks as compared with the baseline and the placebo group. Other investigated parameters represent no differences in none of the groups. No adverse reaction was reported during the study. Previous studies suggest that pomegranate possesses anti-inflammatory properties by inhibiting interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor-α, and transforming growth factor-β. This is the first clinical trial study investigating the efficacy of pomegranate in diabetic nephropathy, suggesting a promising role for this formulation as a supplement for patients receiving standard treatment, since it remarkably reduced the indicators of diabetic nephropathy.

Inflammatory bowel disease (IBD) is a long-life disease with increasing global incidence, especially in children. In addition to the economic and social costs imposed by this disease, the progression of the disease over time can also increase the risk of developing colon cancer. Recent studies have shown the positive effects of natural products, especially herbal medicines, in controlling the signs and symptoms of IBD. This study explored the anticolitic effects of Qurs-e Gol, a traditional polyherbal formulation in Persian Medicine, in male Wistar rats suffering from colitis induced by acetic acid. Rosa damascena Mill. (Damask rose), Rumex conglomeratus Murray (clustered dock), starch, Senegalia senegal L., Britton gum (gum Arabic), and Astragalus L. subgenus. Tragacanth gum (gum Tragacanth) was separately ground, sifted, and then mixed with suitable excipients to formulate Qurs-e Gol tablets. To induce colitis, animals were administered 4% acetic acid intrarectally. The 14-day experiment involved six groups of rats, including a sham group that received normal saline; a second group that received normal saline postinduction; a third group that received dexamethasone postinduction; and three treatment groups that received Qurs-e Gol at doses of 200, 400 and 800 mg/kg for 14 days. Macroscopic evaluation revealed that, compared with the control, Qurs-e Gol at doses of 400 and 800 mg/kg significantly reduced inflammation and ulcers (p<0.001), with effects similar to those of dexamethasone. Microscopic examination of colon tissue confirmed these results, revealing a decrease in lesion depth with the 400 and 800 mg/kg doses (p<0.001). The most significant reduction in serum tumor necrosis factor (TNF-α) levels was noted at 800 mg/kg (p< 0.001), although the 200 and 400 mg/kg doses were also effective (p<0.01). This study highlights the effectiveness of Qurs-e Gol, a traditional Persian polyherbal remedy, in easing colitis symptoms in rats, resulting in impressive anti-inflammatory effects. When administered at doses of 400 mg/kg and 800 mg/kg, there was a notable decrease in inflammation, ulcers, and lesion depth, with results that rival those of dexamethasone. Moreover, the most significant decrease in the serum TNF-α concentration occurred at the highest dosage. These results indicate that Qurs-e Gol might be a promising natural option for treating ulcerative colitis, and further research in both animal and human trials is needed to fully explore its therapeutic potential.

A manual therapy rooted in Persian Medicine known as "ghamz therapy" involves applying pressure to specific soft tissues within the musculoskeletal system to alleviate myofascial spasms. This study aimed to evaluate its effectiveness in reducing pain and disability in patients with lower back pain radiating to their lower limbs. This study is a quasi-experimental pilot investigation that explores the effects of ghamz therapy on patients with chronic radicular low back pain. Participants underwent treatment across three sessions on days 0 (Visit 1), 7 (Visit 2), and 30 (Visit 3). Pain intensity was assessed using the Visual Analog Scale (VAS), along with the Roland-Morris Disability Questionnaire and the fingertip-to-floor test, at each session. Additionally, follow-up assessments of VAS and disability scores were conducted over two months post-intervention. The study involved 12 participants with low back pain, who reported an average pain level of 5.83 on the VAS initially, which decreased to 1.24 by the third visit. Lower limb pain also significantly diminished from 6.08 to 1.58. The average disability score improved from 10.42 to 3.33, and all outcomes remained stable during follow-up, with no significant increases in pain or disability. The fingertip-to-floor test showed significant improvement, with measurements going from 5.63 cm to 0.08 cm. In conclusion, Ghamz therapy has the potential to alleviate pain and disability in patients with low back pain radiating to the lower limbs. However, controlled clinical trials with larger sample sizes are necessary to evaluate the efficacy of this manual technique.

The process of neuroplasticity in stroke recovery remains poorly understood. SRY-related HMG-box 2 (SOX2), a protein that plays a role in controlling neural stem cell (NSC) proliferation and differentiation, is of particular interest. This research seeks to investigate how exercise and wet cupping therapy affect SOX2 expression in animal models of stroke, which are created using unilateral common carotid artery occlusion (UCCAO). The study utilized a control group design with a post-test evaluation. Thirty-six Wistar rats, aged 3 months, were randomly divided into six groups of equal size:  control (n=6), stroke (n=6), cupping (n=6), exercise (n=6), stroke plus cupping (n=6), and stroke plus exercise (n=6). Wet cupping therapy was performed twice a week for three weeks. The exercise included a 20-minute swimming activity scheduled daily. This swimming exercise was performed three times a week for three weeks. Analysis of multiple comparisons among groups employing the ANOVA test proved that SOX2 expression in both the stroke plus exercise group and the stroke plus cupping group was significantly elevated. The stroke group was significantly lower than the control group. This study highlights the potential of physical exercise and wet cupping therapy to upregulate SOX2 expression in a UCCAO-induced brain injury model, supporting their role as promising alternative neuroregenerative interventions.

Joint pain is a prevalent symptom affecting millions worldwide, often resulting from inflammatory or non-inflammatory conditions such as arthritis and arthralgia. Conventional treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, often lead to adverse effects, increasing the demand for alternative therapies. Ethnobotanical studies provide valuable insights into traditional medicinal practices, helping to bridge the gap between folk medicine and modern pharmacology. This study aimed to document medicinal plants used by the indigenous population of Ilam Province, Iran, for joint pain management. A cross-sectional ethnobotanical survey was conducted in Ilam City between April and November 2024. Data were collected through face-to-face interviews and structured questionnaires administered to 25 traditional healers, selected based on their expertise and long-standing practice in herbal medicine. Herbarium specimens of the cited plants were collected and authenticated at the Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences. Quantitative analyses, including the Usage Report Index (UR) and Relative Frequency of Citation (RFC), were employed to evaluate the cultural significance and therapeutic relevance of the identified species. The results revealed 20 medicinal plant species across 15 botanical families used in joint pain management. The Asteraceae family emerged as the most frequently utilized, with aerial plant parts being predominantly employed (29%) and decoction (35%) as the primary method of preparation. Notable species include Syzygium aromaticum (L.) Merr. & L.M.Perry, Olea europaea L., Nigella sativa L., and Salvia Rosmarinus Spenn., each recognized for their anti-inflammatory, analgesic, and antioxidant properties. This study documented the rich ethnobotanical heritage of Ilam Province, highlighting its potential as a source of effective, natural treatments for joint pain. The findings underscore the urgent need for conservation of traditional knowledge and further phytochemical and pharmacological investigations to validate and potentially commercialize these herbal remedies, bridging traditional practices with modern evidence-based medicine.

Lavender essential oil aromatherapy has been explored for its potential to alleviate anxiety and pain during medical procedures. This randomized controlled trial investigated its efficacy in reducing anxiety and pain levels during single-rod contraceptive implantation. Conducted at the Gynecology Clinic, Thammasat University Hospital, Thailand, between June and December 2024, the study enrolled volunteers seeking contraceptive implant services. Participants were randomly assigned to inhale either lavender essential oil or normal saline 15 minutes before the procedure, using a cotton swab with four drops of the assigned scent held 10 cm from the nose. Anxiety levels were measured using the Visual Facial Anxiety Scale (VFAS) before, during, and 15 minutes after the procedure; while pain was assessed with the Visual Analog Scale (VAS) during local anesthesia administration and implant insertion. A total of 200 participants were evenly divided into the lavender and control groups, with no significant differences in baseline characteristics. Lavender aromatherapy demonstrated a significant reduction in both anxiety and pain severity. Before the procedure, a greater number of participants in the lavender group reported mild anxiety compared to the control group (45 vs. 26, p < 0.001), and severe anxiety during implantation was markedly lower (1 vs. 27, p < 0.001). Similarly, during local anesthesia, a significantly higher proportion of participants in the lavender group reported mild pain (50 vs. 34, p = 0.004); while fewer experienced severe pain (5 vs. 19). Comparable trends were observed during implantation, with fewer participants reporting moderate (12 vs. 21, p = 0.027) and severe pain (1 vs. 6). These findings highlight the sedative and calming effects of lavender aromatherapy, demonstrating its potential as a simple and non-invasive intervention for managing anxiety and pain during contraceptive implantation.

Foot pathologies such as plantar fasciitis and hallux valgus significantly impact patients' quality of life causing pain and mobility limitations. This review explores the clinical application of trigger point treatment techniques, including manual therapy and dry needling, in addressing these conditions. A scoping review following the Joanna Briggs Institute (JBI) methodology was chosen to map the existing literature on trigger point treatments for foot pathologies and identify research gaps. Seven studies were included, evaluating dry needling, dry cupping, and local heating of trigger points. Some improvements in pain reduction and functionality were observed. For example, one study reported an effect size for pain reduction of 0.75 (95% CI: 0.50 to 1.00) with dry needling. Another study found a quality-of-life improvement effect size for percutaneous needle electrolysis at 52 weeks of 0.68 (95% CI: 0.34 to 1.02). Combining extracorporeal shock wave therapy with dry needling significantly improved Visual Analogue Scale (VAS) scores and maximum painless walking distance in another study. While trigger point treatment techniques may offer potential benefits for managing foot pathologies, current evidence is insufficient to draw definitive conclusions. Larger sample sizes and longer-term follow-up studies are needed to strengthen the evidence base and explore safety aspects.

Anxiety is a common condition often treated with pharmacological agents that have side effects. Aromatherapy, a non-pharmacological method using plant-derived essential oils, offers a safer alternative. Citrus × aurantium L. (bitter orange), traditionally used in Persian medicine to treat anxiety, is of particular interest. This systematic review and meta-analysis evaluate the efficacy of C. aurantium aroma in reducing anxiety. A systematic review and meta-analysis were conducted following PRISMA guidelines to evaluate the effect of C. aurantium aroma on anxiety. Databases including PubMed, Cochrane Library, Scopus, ProQuest, Science Direct, and Web of Science were searched for relevant clinical trials. Studies were included if they were randomized controlled trials involving human participants, used inhalation aromatherapy with C. aurantium, and measured anxiety with the State-Trait Anxiety Inventory (STAI). Data extraction and bias assessment were performed by two independent reviewers. Statistical analyses were conducted using Meta in R software version 4.2.2. An initial search identified 445 potential studies. After removing duplicates (n=46), 399 unique studies were screened. We excluded 35 review articles and 348 unrelated articles, resulting in 16 articles for detailed examination. Seven studies met the inclusion criteria and were analyzed, involving 666 participants (333 in intervention groups and 333 in control groups). The analysis revealed a significant reduction in anxiety in treatment groups using C. aurantium essential oil or neroli oil compared to control groups, with a mean difference of -12.45 (95% CI: -20.90 to -3.99, p = 0.004). Subgroup analysis indicated that both oils significantly reduced anxiety compared to control groups, with no significant difference between them (Q=0.64, p=0.42). Inhalation aromatherapy using C. aurantium essential oil and neroli oil effectively reduces anxiety. Further research is needed to explore underlying mechanisms and long-term benefits.

Traditional Persian Medicine (TPM), a holistic system with a history of several thousand years, uses single and compound herbal remedies to treat a wide range of diseases based on their temperaments and actions. One notable remedy is oxymel (Sekanjabin), which has been used for centuries across various cultures. Rhubarb oxymel (Sekanjabin Rivandi), a form of medicinal oxymel, has shown effectiveness in treating liver diseases like non-alcoholic fatty liver disease (NAFLD). In this paper, pharmacy books on TPM (Qarabadin medical texts) were reviewed for Rhubarb oxymel. The medicinal effects of the herbs included in these formulations were thoroughly analyzed using R Studio, with the aim of identifying potential correlations between the therapeutic actions of the herbs and the underlying causes of liver diseases. This analysis was conducted across multiple formulations to determine how specific herbal components may target various aspects of liver diseases. The study provides insights into the role of herbal medicine in addressing the root causes of liver disorders, Rhubarb oxymel is made from a combination of 24 herbs, such as Rheum palmatum L. (rhubarb), Cichorium intybus L. (chicory), and Fumaria parviflora Lam. (fumitory), each with specific therapeutic properties like deoppilant (opening or unblocking), tonic (strengthening), and purgative (expellant) effects. TPM texts detail the preparation, benefits, and actions of these herbs, which support liver and digestive health. The most common effect among the herbs in Rhubarb oxymel is their liver obstruction deoppilant property. Other more frequently mentioned effects include tonic, rarefactive (softening), and abstergent (cleansing or purifying) actions. Future preclinical and clinical studies are recommended to further clarify the biological activities and underlying mechanisms of Rhubarb oxymel in different diseases.

Boswellia, has been utilized for centuries in various cultures for its potential health benefits. It is known for its anti-inflammatory, antioxidant and immune-stimulating properties. Despite its historical use, scientific evidence regarding its efficacy and safety remains limited. This systematic review aims to evaluate the effectiveness of Boswellia in treating various diseases by analyzing randomized controlled trials (RCTs) from the MEDLINE database from 2001 to the first half of 2025. Data from RCTs involving human subjects were collected, focusing on the effects of Boswellia versus placebo.  Key factors included age, type of disease, dosage, and duration of treatment. Outcomes assessed included efficacy and any adverse effects associated with Boswellia use. These studies included a total of 3274 individuals, comprising 1651 cases and 1623 controls, with ages ranging from 15 to 85 years. Of the 49 selected research studies: 12 studies focused on patients with osteoarthritis, 8 studies investigated gastrointestinal diseases, 8 studies examined neurological diseases, 5 studies addressed cutaneous reactions, 5 studies looked at cancer, 3 studies on diabetes mellitus, 2 studies on oral lesions and 2 on joint pain. Labor pain, asthma, ankle sprain, and obesity each had one study dedicated to them. The majority of studies (91.8%) reported better treatment outcomes of various diseases.  However, four studies specifically focused on Crohn’s disease, burn wounds, cancer-related fatigue and diabetes mellitus, showing no better outcomes. Ten studies did not consider any adverse effects, 19 studies observed no adverse reactions and the remaining studies noted minor gastrointestinal or skin manifestations with Boswellia. The review highlighted that Boswellia could serve as a complementary treatment for patients suffering from the various diseases studied. Current evidence suggests that Boswellia is generally well-tolerated.  There is a need for additional investigations into its efficacy in various diseases through studies with a large number of participants.

Human papillomavirus (HPV) is one of the most common sexually transmitted viral infections and plays a significant role in the development of precancerous lesions and cervical cancer. The immune system plays a crucial role in controlling and clearing this virus. Since complementary therapies, such as auriculotherapy, can modulate immune system function, it is important to investigate the effects of these therapies in individuals infected with HPV. This study was conducted as a review using keywords such as "auriculotherapy," "shenmen," "yin tang," "HPV," and "immune system" in scientific databases including PubMed, Scopus, Web of Science, and Google Scholar. Relevant articles published between 2000 and 2024 were reviewed and analyzed. The findings showed that stimulation of the Shenmen and Yin Tang points in acupuncture and auriculotherapy can contribute to improving immune system function by reducing anxiety, regulating the hypothalamic-pituitary-adrenal (HPA) axis, and increasing the activity of immune cells such as lymphocytes and macrophages. Additionally, other observed effects in the reviewed studies included the reduction of chronic inflammation, improvement in sleep, and an increase in parasympathetic tone. Although initial evidence suggests positive effects of auriculotherapy on immune regulation and improvement of psychological conditions in HPV patients, the lack of extensive and homogeneous clinical trials limits the ability to draw definitive conclusions. Given the safety of these interventions, auriculotherapy can be considered as a complementary approach in the management of HPV patients. Future studies with more precise designs and valid immune indicators are recommended.