Traditional and Integrative Medicine

Enhancing Osteopathic Care through Understanding the Drucebo Effect

Roberto Tedeschi — Sun, 28 Sep 2025 08:02:25 +0000

The Article Abstract is not available.

Effects of the Pistacia atlantica subsp. kurdica Oleoresin on The Symptoms and Quality of Life in Functional Dyspepsia: A Randomized Controlled Trial

Sun, 28 Sep 2025 08:06:46 +0000

The Pistacia atlantica subsp. kurdica oleoresin (OPA) is utilized for the treatment of dyspepsia and other gastrointestinal diseases in the Persian Medicine. Therefore, the therapeutic efficacy and safety of standardized OPA in functional dyspepsia (FD) were evaluated. To standardize OPA, the constituents of the OPA essential oil were determined by gas chromatography-mass spectrometry. Fifty patients were allocated to each of the OPA and placebo groups. The OPA and placebo groups consumed two 200 mg OPA or placebo capsules, respectively, every 12 hours along with one 40 mg famotidine tablet per day for 8 weeks. Dyspepsia severity was the primary outcome measured by the Hong Kong dyspepsia index. The secondary outcomes included quality of life measured by the sf-36 questionnaire, complete blood count, and the blood levels of alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The outcomes were measured at the baseline and endpoint. OPA contained 10% w/w essential oil, and the constituents of the OPA essential oil were α-pinene (96%), β- pinene (2%) and terpinolene (2%). Thirty five patients in each group completed the trial. OPA decreased the Hong Kong score significantly (p = 0.013), but the placebo had no significant effect on the Hong Kong score (p = 0.651), at the endpoint compared to baseline. The sf-36 questionnaire score of the OPA group increased significantly (p = 0.027), but it increased insignificantly in the placebo group (p = 0.078), at the endpoint compared to baseline. There was no significant effect on the blood tests, and also no side effect. Thus, OPA may mitigate the symptoms, and increase the quality of life of the FD patients without side effects. The OPA essential oil and the monoterpenes α-pinene, β- pinene and terpinolene may be responsible for the effects of OPA in FD.

Prophylactic Effectiveness of Coenzyme Q10 for Migraine in Adults: A Systematic Review and Meta-Analysis of Double-Blinded Randomized Clinical Trials

Emna Ellouz, Imen Ketata — Sun, 28 Sep 2025 08:10:24 +0000

We aimed to evaluate the influence of coenzyme Q10 alone (CoQ10) or in association with other nutraceuticals (CoQ10+) on the frequency, severity, duration of migraine attacks, and quality of life. We conducted a meta-analysis and a network meta-analysis (NMA) according to PRISMA 2020. We searched PubMed, Web of Science, Google Scholar, and Europe PMC for eligible studies up to January 2024. We used R software for pooled outcomes. This meta-analysis was registered in PROSPERO (CRD42024499733). Five studies were included, with a total of 326 individuals with confirmed migraine. CoQ10/CoQ10+ was shown to be associated with significant improvement in migraine frequency per month, and migraine duration and severity. NMA indicated that CoQ10 combined with L-carnitine appeared to be more effective than CoQ10 on migraine frequency and severity (SMD= -0.99 [95% CI: -1,68 to -0,29]; SMD= -3.05 [95% CI: -4.05 to -2.04], respectively). CoQ10 associated with L-carnitine yielded the greatest significant decrease in migraine duration compared with placebo; NMA revealed no significant difference between CoQ10, CoQ10 with multivitamin, and CoQ10 with L-carnitine. Our findings suggest that for optimal effectiveness, the use of CoQ10/CoQ10+ should be prolonged for at least 3 months. Using CoQ10 had a significant effect on the improvement of the quality of life of patients with migraine. Our meta-analysis suggested a beneficial effect of CoQ10/CoQ10+ for reducing monthly migraine frequency, severity, and duration, notably when it was associated with L-carnitine. Additionally, CoQ10 significantly improved the quality of life.

Azadirachta indica A. Juss Ameliorates Memory Deficits and Reduces Anxiety-Like Behavior by Modulating Cholinergic Neurotransmission in An Animal Model of Depression: In Silico and In Vivo Studies

Bhagya Venkanna Rao, Sahid Raza, Priyanka Tiwari — Sun, 28 Sep 2025 08:15:20 +0000

Exposure to prolonged and severe stress can lead to negative effects on learning and memory, increased anxiety, reduced motivation, disturbed cholinergic activity, and hippocampal and prefrontal cortical neuronal damage. On the other hand, drugs from natural origin have a beneficial effect on neuronal structure and functions. Azadirachta indica (neem), belonging to the Meliaceae family, has been reported to exhibit beneficial effects in wound healing, diabetes management, and antibacterial properties. This study aimed to assess the impact of Azadirachta indica on chronic immobilization stress-induced memory impairment in rats. Chronic immobilization stress was induced in rats for 2 hours/day over 10 days. Following this, Azadirachta indica was administered at doses of 200, 400, and 600 mg/kg for 14 days. Twenty-four hours after the treatment, behavioral tests, including the novel object recognition test (NORT), T-maze, and elevated plus maze (EPM), were conducted to evaluate memory and anxiety-like behaviors. Acetylcholinesterase (AChE) activity was measured in the frontal cortex, hippocampus, and septum. Additionally, molecular docking studies were performed using Molegro Virtual Docker (MVD-2013, 6.0) to analyze the interaction of 19 active chemical constituents from aqueous neem extracts with various targets, including AChE, brain-derived neurotrophic factor (BDNF), N-methyl-D-aspartate(NMDA) receptors, and anti-cortisol Fab in complex with corticosterone. Azadirachta indica treatment significantly enhanced learning and memory in chronically stressed rats, as evidenced by improved performance in NORT and T-maze tests, along with reduced anxiety-like behavior in the EPM test. Treatment also restored AChE activity in the stressed animals. Molecular docking studies indicated that the active constituents of neem extract showed high docking scores to AChE, BDNF, NMDA receptors, and anti-cortisol Fab, correlating with the experimental findings. Azadirachta indica exhibited neuroprotective and cholinergic transmission modulation properties, which may underlie its memory-enhancing effects in chronically stressed rats. Treatment enhanced memory in NORT and T-maze test (p<0.001). Also, anxiety behavior was reduced in the EPM (p<0.001). The correlation between the in vitro experimental data and the in silico molecular docking results suggests that neem’s active compounds could be potential candidates for improving memory and managing stress-induced cognitive impairments.

Formulation of Viola odorata L. Tablet and Evaluation of The Product Effect on Breast Cancer-Related Fatigue: A Randomized, Controlled Pilot Trial

Sun, 28 Sep 2025 08:29:24 +0000

This study was designed to formulate a Viola odorata L. tablet (VOT) and evaluate its efficacy in managing cancer-related fatigue (CRF) in breast cancer patients undergoing radiotherapy. The tablet was formulated and subjected to quality control tests. The pilot study was conducted as a randomized, double-blind trial. A total of 18 breast cancer patients were enrolled and randomly assigned to two groups. The intervention and control groups received VOT/bis in die (Bid) and placebo, respectively, for 4 weeks. All the patients completed the visual analog fatigue scale (VAFS), fatigue severity scale (FSS), and cancer fatigue scale (CFS) questionnaires before and after the intervention. The best tablet formulation contained V. odorata extract 486 mg, PVPK30 50 mg, lactose 450 mg, Avicel PH102 100 mg, SiO₂ 14 mg, and magnesium stearate 20 mg. Dimensions, disintegration time, hardness, friability, weight, and total phenolics as pyrogallol were 7.1×9.9×30.3 mm, 28 min, 9.5 kp, 0.37%, 1120mg, 22.8 mg/tab, respectively. More than 80% of the phenolics in the tablets were dissolved during the dissolution test in 30 min. In the pilot study, only VOT treatment significantly decreased the VAFS (p = 0.02), FSS (p = 0.08), and CFS (p=0.03) scores. The results indicated desirable VOT physicochemical characteristics and suggested it as an herbal product for managing CRF in breast cancer patients.

Suggested Foods Based on the Temperament (Mizaj) of Infertile Women: A Qualitative Content Analysis Based on Persian Medicine Texts

Sun, 28 Sep 2025 08:37:11 +0000

Infertility, affecting approximately 17.5% of the global adult population, is a multifaceted issue influenced by lifestyle and dietary factors. Persian Medicine (PM), as a complementary approach, emphasizes the role of individualized dietary and lifestyle modifications based on temperament (mizaj) in addressing infertility. This study aimed to identify and categorize dietary recommendations for infertile women according to their temperaments, as outlined in authoritative PM texts. A qualitative summative content analysis was conducted using eight key PM texts—including Qanun Fi Teb and Exir-e-Azam from the 9^th to 18^th centuries—alongside electronic databases such as Scopus, PubMed, Web of Science, and Google Scholar were searched. Foods were categorized based on four compound temperaments—cold and dry, cold and wet, warm and dry, and warm and wet—and subcategories such as fruits, vegetables, nuts, meats, and medicinal plants. The analysis highlighted the central role of warming, nutrient-dense foods in improving reproductive health, particularly for cold temperaments. Foods such as lamb, eggs, chickpeas, milk with cinnamon or ginger, and onions were frequently recommended. Conversely, cooling foods like cucumber and lettuce were advised for warm temperaments to achieve balance. The findings underscore PMʼs tailored dietary strategies for enhancing fertility by aligning food recommendations with individual temperaments. This approach offers a complementary pathway to modern infertility treatments by addressing underlying imbalances through personalized nutrition.

Investigating Research Method in Persian Medicine: Insights from a Qualitative Study

Mojtaba Norouzi, Ali Akbar Haghdoost, Saba Barkhori — Sun, 28 Sep 2025 00:00:00 +0000

Research is one of the most important cornerstones of success and always held a specific place in Persian medicine (PM). This study aims to investigate the basics of PM research method. In a qualitative study conducted between July and September 2024, we interviewed 19 experts in PM nationwide. During semi-structured interviews, they shared their perspectives on evidence-based medicine (EBM), research protocol standards, ethical codes, and using observational studies in PM. All participants agreed unanimously on four features of the research methodology: the potential for PM to evolve into EBM, the application of observational studies, adherence to strict product standards, and the similarity of research ethics in PM and contemporary medicine (CM). Over 89% agreed on the efficacy of blinding, the usefulness of current outcome assessment instruments, and the significance of assessing the patient-therapist relationship in clinical trial studies. Respondents (84%) believed the present randomization method was ineffective. Furthermore, 64% acknowledged the animal model's limitations. PM experts believed that the fundamental principles of medical practice should be implemented based on EBM. It is also vital to highlight that the philosophy of PM and CM differ, and this issue should serve as the foundation for creating PM's research methodology. Furthermore, the research methodology criteria for PM should be derived from the principles used in conventional medical sciences.

Treatment of Diabetic Foot Osteomyelitis with Persian Medicine: A Case Report

Sun, 28 Sep 2025 08:58:53 +0000

Osteomyelitis of the lower extremity is a commonly encountered problem in patients with diabetes and is an important cause of amputation and admission to the hospital. The patient presented in this article was a 52-year-old diabetic man with a diabetic foot osteomyelitis who was referred to Vali-e-Asr Persian medicine clinic. He was treated with Persian medicine methods. The treatment methods of Persian medicine were: modification of lifestyle such as sleep and nutrition, oral herbal therapy, wound washing with herbal decoctions, dry cupping, wet cupping, venesection and leech therapy. During the period of 52 days, the foot ulcer and the osteomyelitis were improved. This case report demonstrates that using the capacities of Persian medicine in addition to conventional treatments, helped to markedly improve the patient’s condition.

Exploring Herbal Alternatives for Conjunctivitis Management: Opportunities and Challenges

Samsi D. Salaman, Omveer Singh, Smita Jain, R Velmurugan, Saraswati Patel — Sun, 28 Sep 2025 09:21:35 +0000

The eyes, vital sensory organs, are particularly vulnerable to various ophthalmic conditions. Conjunctivitis, or “pink eye”, is one such condition characterized by inflammation and redness of the conjunctival mucosa, caused by both infectious and non-infectious agents. Affecting approximately 6 million people annually in the United States alone, its highly contagious nature presents a public health concern. Current treatments, predominantly synthetic drugs, often result in undesirable side effects. In response, there is growing interest in exploring herbal remedies as safer alternatives. Medicinal plants, rich in bioactive compounds such as alkaloids, glycosides, and terpenoids, show potential in managing conjunctivitis. Specific herbs, including Euphrasia officinalis L. (eyebright), Matricaria chamomilla L. (chamomile), and Aloe vera (L.) Burm.f., have demonstrated promising results in in vitro and animal studies by mitigating mast cell degranulation and modulating key inflammatory pathways. This review aims to delve into the efficacy, safety, and mechanisms of action of these and other herbal treatments for conjunctivitis, offering a focused evaluation of their therapeutic potential.

A Complete Review of Ethnopharmacology, Pharmacology and Phytochemistry of Anacyclus pyrethrum DC

Fahim Fuard, . Zarnigar, Fathima Nairoza Jamaldeen — Sun, 28 Sep 2025 09:26:22 +0000

Anacyclus pyrethrum DC is an important medicinal plant belonging to the family Asteraceae, indigenous to North Africa and found in the Arabian peninsula, the Mediterranean, and north India. It is a perennial herb known as Aqarqarha, Pellitory, Akarkara, or Spanish Chamomile. This herb is widely used in traditional medical systems such as Unani, Siddha, and Ayurveda systems of medicine. Its root has been traditionally employed to address ailments like toothache, gingivitis, dental caries, periodontitis, Ludwig's angina, migraine, epilepsy, hemiplegia, facial palsy, headache, hysteria, atony/flaccidity, tremor, nasal congestion, anaphrodisia, premature ejaculation, amenorrhea, coccydynia, sciatica, backache, polyarthritis, general weakness, rheumatism, cholera and edema. This review summarises studies gathered up to January 2022 from databases including PubMed, Scopus, ScienceDirect, Google Scholar, Wiley Online Library, ResearchGate, and Web of Science, using keywords such as Anacyclus pyrethrum DC, Aqarqarha, and Akarkara. A. pyrethrum is rich in bioactive compounds including saturated fatty acids (isovaleric acid, decanoic acid, lauric acid, myristic acid, octadecanoic acid, palmitic acid), unsaturated carboxylic acid (cinnamic acid), fructans (inulin), phenols, polyphenols, tannins, flavonoids, pellitorine, pyrethrin, anacycline, herculin, sesamin, polysaccharides, volatile oils, essential oils, propanedioic acid, levulinic acid, squalene, steroids, terpenes, saponins, and stigmasterol. Medicinal studies show that the plant exhibits a wide range of pharmacological properties, including antioxidant, antimicrobial, anti-inflammatory, antinociceptive, immunomodulatory, analgesic, antiprotozoal, neuroprotective, anti-hyperglycemic, wound healing, anticancer (cytotoxicity), anabolic, aphrodisiac, and reproductive activities, as evidenced by in vivo, in vitro, and clinical studies. This manuscript provides a comprehensive overview of the traditional uses, phytochemistry, and pharmacological activities of A. pyrethrum, identifying significant gaps and research objectives, especially regarding the active compounds and their mechanisms of action.

Licorice (Glycyrrhiza sp.) in Health and Disease: A Minireview of Traditional Uses and Therapeutic Activities

Sun, 28 Sep 2025 09:39:24 +0000

Throughout history, human beings have utilized animals, minerals and plants for various purposes including use of them as foods and remedies. The distribution of plants, animals and minerals varies across different regions of the world; however, we can find same species or closely related varieties in different geographical areas. Based on distinct different historical and cultural circumstances, there plants exhibit diverse therapeutic applications. Licorice (Glycyrrhiza spp.) as an ancient plant with long history of therapeutic uses is noticeable among traditional medicine of various cultures. Respectively, licorice is found in traditional medicines of Iran, India, Thailand and Korea and is recommended to respiratory, gastrointestinal, cardiovascular, and musculoskeletal problems. In modern medicine diverse beneficial effects of licorice has been shown by researches. Licorice effects on oral complications, dyspepsia, dental and gingival problems, non-alcoholic fatty liver disease, and polycystic ovarian syndrome are examples of its positive role on human health. Considering the inhibitory effect of licorice on 11-β-hydroxysteroid dehydrogenase enzyme type 2, pseudohyperaldosteronism may occur in case of long-term use of high doses and therefore, should be used with cautioun in susceptible patients. In spite of all the researches on licorice, it seems more clinical trials are needed to further confirm the therapeutic effects on this medicinal plant based on the traditional applications.

Boswellia: A Systematic Review of the Adverse Events

Sun, 28 Sep 2025 09:44:55 +0000

Boswellia is one of the oldest alternative medicinal plants in the world. Boswellia is thought to have anti-inflammatory effects, antioxidant properties, and immunity stimulating. This herbal medicine relieves several diseases such as osteoarthritis, asthma, and inflammatory bowel diseases. Little is known about the adverse drug reactions of Boswellia; this systematic review attempted to identify the potential side effects of this supplement and its severity in different diseases. Relevant studies conducted up to May 2024 were identified from Scopus, Science Direct, Web of Science, PubMed, Cochrane Library, and Embase databases. Spontaneous reports about the side effects of Boswellia were gathered from three international spontaneous reporting schemes, as well. Age, sex, type of disease, dosage, and duration of the drug as well as self-reported side effects were considered. Subgroup analysis was performed to determine the prevalence of each adverse effect of Boswellia. The quality of the included trials was assessed using version 2 of the Cochrane risk-of-bias tool (RoB 2). Sixty-two clinical trials were included in this review. Twenty-five of them reported side effects. Twenty-seven studies reported that Boswellia had no adverse effects, and 10 articles had not mentioned the side effects. Low-to-high risk of bias was found in clinical trials. Ten case reports were included in this study, but no case series was included. Spontaneous reporting schemes included 26 reports. The most common adverse effects were gastrointestinal disorders and cutaneous allergic reactions. Although most detected adverse effects were mild to moderate, two patients developed hypersensitivity pneumonitis and bezoar formation, respectively. This systematic study reported that Boswellia, as an herbal medicine, is often considered safe to use; however, it is possible to experience severe side effects. We suggest that Boswellia should be administered only under the supervision of a specialist doctor in usual medical treatment.