Article

Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: a randomized, double-blind, placebo-controlled, crossover study

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Abstract

Phytotherapy is a source of finding new remedies for migraine. Traditional chamomile oil (chamomile extraction in sesame oil) is a formulation in Persian medicine (PM) for pain relief in migraine. An oleogel preparation of reformulated traditional chamomile oil was prepared and then standardized based on chamazulene (as a marker in essential oil) and apigenin via gas chromatography (GC) and high-performance liquid chromatography (HPLC) methods, respectively. A crossover double-blind clinical trial was performed with 100 patients. Each patient took two tubes of drug and two tubes of placebo during the study. Visual analog scale (VAS) questionnaires were filled in by the patients and scores were given, ranging from 0 to 10 (based on the severity of pain) during 24 h. Other complications like nausea, vomiting, photophobia, and phonophobia were also monitored. There was 4.48 ± 0.01 μl/ml of chamazulene and 0.233 mg/g of apigenin in the preparation (by correcting the amount with extraction ratio). Thirty-eight patients in the drug-placebo and 34 patients in the placebo-drug groups (a total number of 72 patients as per protocol) completed the process in the randomized controlled trial (RCT). Adapted results from the questionnaires showed that pain, nausea, vomiting, photophobia, and phonophobia significantly (p < 0.001) decreased by using chamomile oleogel on the patients after 30 min. Results supported the efficacy of chamomile oleogel as a pain relief in migraine without aura.

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... Moreover, a total of 74% of chamomile-treated attacks and 10% of placebo-treated attacks were associated with sustained pain relief over the 24-hr monitoring period. Chamomile application was also associated with greater reductions in nausea and/or vomiting and photophobia (Zargaran et al., 2018). ...
... Polyphenols such as apigenin can also inhibit neuroinflammation of meningeal and dural trigeminal nociceptors (Drummond et al., 2013;Ranpariya, Parmar, Sheth, & Chandrashekhar, 2011). In terms of the safety and tolerability of chamomile topical application, four participants (4%) withdrew from the study by Zargaran et al. (2018) due to hypersensitivity to chamomile administration (details of this hypersensitivity were not provided). Allergic reactions to chamomile have also been reported (Srivastava, Shankar, & Gupta, 2010). ...
... The efficacy of blinding also posed a potential problem in studies comprising the application of topical preparations (Borhani Haghighi et al., 2010;Niazi et al., 2017;Rafieian-Kopaei et al., 2019;Zargaran et al., 2018), and variability in treatments offered including variances in the number of tablets ingested by groups (Abdolahi et al., 2017;Parohan et al., 2019), differences in treatment administrations (i.e., syrups versus tablets) (Jafarpour et al., 2016), and variability in the intensity of the intervention offered (Ferro et al., 2012;Oelkers-Ax et al., 2008). ...
Article
Herbal treatments are often used as a treatment for migraine. Therefore, an evaluation of their safety and efficacy is important. Based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, and Cochrane Collaboration's tool for assessing the risk of bias, a systematic literature review of randomised, controlled human trials assessing the effects of herbal treatments delivered as a single ingredient for the acute or prophylactic treatment of migraine were conducted. Studies were identified through electronic database searches on Medline (Pubmed), Cochrane Library, Scopus, and CINAHL. Nineteen studies were identified examining the effects on migraine of feverfew, butterbur, curcumin, menthol/peppermint oil, coriander, citron, Damask rose, chamomile, and lavender. Overall, findings on the efficacy of feverfew were mixed and there was positive, albeit limited evidence for butterbur. There were positive, preliminary findings on curcumin, citron, and coriander as a prophylactic treatment for migraine, and the use of menthol and chamomile as an acute treatment. However, the risk of bias was high for many studies. The results of this systematic review suggest that several herbal medicines, via their multifactorial physiological influences, present as potential options to enhance the treatment of migraine. However, further high‐quality research is essential to examine their efficacy and safety as a treatment for migraine.
... Photophobia and phonophobia occurring during migraine without aura were also effectively treated. Both of the aforementioned effects were confirmed in a randomized, double-blind, placebocontrolled clinical trial [26]. Guaiazulene, as an ingredient of local pomade, has provided rapid recovery in risky neonates with recalcitrant diaper dermatitis without any side effects [27]. ...
... Yanagisawa et al. studied the anti-peptic activity of compounds related to the metabolites of known APIsodium 3-ethyl-7-isopropyl-1-azulenesulfonate (22, KT1-32, egualen sodium) (Fig. 8) [48]. They synthesized six compounds (23)(24)(25)(26)(27)(28), of which five molecules 24-28 containing 3-alkyl-1-azulenesulfonate moiety are the metabolites of 22 and assessed their antiulcer activity. Compounds 22 and 23 were treated as reference compounds in the study. ...
Article
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Azulene is an aromatic hydrocarbon that possesses a unique chemical structure and interesting biological properties. Azulene derivatives, including guaiazulene or chamazulene, occur in nature as components of many plants and mushrooms, such as Matricaria chamomilla , Artemisia absinthium , Achillea millefolium , and Lactarius indigo . Due to physicochemical properties, azulene and its derivatives have found many potential applications in technology, especially in optoelectronic devices. In medicine, the ingredients of these plants have been widely used for hundreds of years in antiallergic, antibacterial, and anti-inflammatory therapies. Herein, the applications of azulene, its derivatives and their conjugates with biologically active compounds are presented. The potential use of these compounds concerns various areas of medicine, including anti-inflammatory with peptic ulcers, antineoplastic with leukemia, antidiabetes, antiretroviral with HIV-1, antimicrobial, including antimicrobial photodynamic therapy, and antifungal.
... Improvements in blood pressure, insulin resistance, inflammation and oxidative stress, and lipid profile in patients with obesity-related hypertension [199] Quercetin 50 500 mg, daily 8 weeks Improvements in clinical symptoms, disease activity, hs-TNFα, and health assessment questionnaire in women with RA [200] Apigenin 100 2 mL of an oleogel preparation of reformulated traditional chamomile oil Topical application, once Pain, nausea, vomiting, photophobia, and phonophobia significantly decreased in patients with migraine without aura [201] Silymarin Reduction in tumor burden on chronic lymphocytic leukemia patients [206] NHS: Nurses' Health Study; HPFS: Health Professionals Follow-Up Study; hs-TNFα: high-sensitivity tumor necrosis factor-α; RA: rheumatoid arthritis; OA: osteoarthritis. ...
... A crossover double-blind clinical trial, enrolling 100 patients diagnosed with migraine without aura, tested the efficacy of an oleogel with chamomile extracts. Results showed that pain, nausea, vomiting, photophobia, and phonophobia significantly decreased [201]. Topic application of apigenin-containing cream in 20 women reduces skin aging, besides increasing dermal density and elasticity [245]. ...
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Pathological pain can be initiated after inflammation and/or peripheral nerve injury. It is a consequence of the pathological functioning of the nervous system rather than only a symptom. In fact, pain is a significant social, health, and economic burden worldwide. Flavonoids are plant derivative compounds easily found in several fruits and vegetables and consumed in the daily food intake. Flavonoids vary in terms of classes, and while structurally unique, they share a basic structure formed by three rings, known as the flavan nucleus. Structural differences can be found in the pattern of substitution in one of these rings. The hydroxyl group (–OH) position in one of the rings determines the mechanisms of action of the flavonoids and reveals a complex multifunctional activity. Flavonoids have been widely used for their antioxidant, analgesic, and anti-inflammatory effects along with safe preclinical and clinical profiles. In this review, we discuss the preclinical and clinical evidence on the analgesic and anti-inflammatory proprieties of flavonoids. We also focus on how the development of formulations containing flavonoids, along with the understanding of their structure-activity relationship, can be harnessed to identify novel flavonoid-based therapies to treat pathological pain and inflammation.
... Apigenin and methoxy-coumarin have antispasmodic properties. 22,23 The anti-inflammatory effects of Chamomile are mostly due to compounds such as Matrisin and Bisabolol. There is also evidence of flavonoids with similar functions to benzodiazepines and phytoestrogens in Chamomile, which has positive sedative effects. ...
Article
Background: Primary dysmenorrhea is characterized by pain during menstruation without any pelvic pathology. It is a common problem among females in their reproductive age which is caused by increased production of prostaglandin in the endometrium as one of leading causes. Chamomile extract ceases the production of prostaglandins and leukotrienes. The aim of this study was to systematically review the clinical trials to determine the effect of Chamomile on pain and menstural bleeding in primary dysmenorrhea. Methods: Search process to find relevant articles was conducted on electronic Iranian (MagIran, SID) and international databases (Google Scholar, Science Direct, PubMed, ProQuest, Cochrane library, Scopus, Web of Science and EBSCO), using English keywords and Persian equivalents such a "Dysmenorrhea", "Pain", "Menstrual bleeding" and "Chamomil" without a time limit until March 2020. Irrelevant, duplicate, descriptive, or qualitative studies were excluded. To evaluate the quality of articles, we used the Cochran's Risk of Bias tool. Results: Among124 articles found in the initial search, finally 7 clinical trials (with a sample size of 1033) were systematically examined. Two out of 7 studies examined the effect of Chamomile on the pain of primary dysmenorrhea, 2 studies on the effect of Chamomile on menstrual bleeding volume, and 3 on the effect of Chamomileon pain and menstural bleeding in primary dysmenorrhea. Conclusion: Based on results of the most reviewed studies, Chamomile can be considered as an effective treatment for primary dysmenorrhea and reducing menstrual bleeding.
... Concerning these diseases, international clinical studies have been performed mainly in adults. They have consistently shown positive results in the treatment of wounds [156], atopic dermatitis [157,158], migraine [159], sleep disorders [160]. Regarding the indication in respiratory disorders, a recent study evaluated the effect of a herbal mixture including chamomille in asthmatic children during viral respiratory tract infection. ...
Article
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Background: Romanian ethnopediatrics has a long history of medicinal plant use. The main objective of the present review was to identify, collect, systematize, and prioritize the available bibliographical data related to medicinal plants traditionally used to treat various pediatric diseases in Romania during the 1860s-1970s. Methods: Information was mainly obtained by manual systematic search in various relevant historical works focused on the traditional use of medicinal plants in Romania (1860s-1970s), found in the Archives of Romanian Academy Library and National Romanian Library. Results: A total of 153 medicinal plants belonging to 52 families were identified as having ethnopediatric significance. The plant traditional indications, targeted body systems, parts used, and way of administration were provided. We have also proposed one index (expressed as percentage) in order to assess the ethnopediatric applicability area of species: ethnopediatric relative therapeutic versatility (ERTV), which was calculated on the basis of the number of distinct uses mentioned for a species. The species identified to have the highest ERTV scores were Dryopteris filix-mas (100%), Gratiola officinalis (85.71%), Allium sativum (71.42%), Eryngium planum (71.42%), Juglans regia (71.42%), Matricaria chamomilla (71.42%), Plantago major (71.42%). Conclusions: The present study exposed for the first time to the international scientific community important ethnopediatric information contained in several local Romanian bibliographical resources that could guide the local and international researchers towards new directions of plant valorization.
... Chamomile flowers contain a volatile oil containing a-bisabolol, matricin, and other terpenoids that have anti-inflammatory properties [36]. Moreover, Chamomile oil has a neuroprotective effect because it reduces nitric oxide levels [37]. A recent RCT in 142 women who underwent cesarean section found that patients who applied topical chamomile oil to their abdominal region after the surgery experienced earlier spontaneous passage of gas and shorter times to first defecation and food tolerance [38]. ...
Article
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Postoperative ileus (POI) is characterized by impaired gastrointestinal motility after surgery. POI is a major concern for surgeons because it increases hospital stay, the cost of care, and postoperative morbidity in patients who have undergone extensive gynecological oncological surgery. Although several interventions have been proposed and investigated, no effective treatment for the prevention and management of POI has been established. The present review summarizes the current evidence on non-pharmacological interventions, including coffee consumption and chewing gum, used to prevent and treat POI. We obtained studies from MEDLINE, Cochrane Database of Systematic Reviews, ISI Web of Science, and SCOPUS databases.
... In addition, a randomized controlled trial by Khadem et al. (2018) involving 142 patients with postoperative ileus, a common gastrointestinal complication after surgery, showed that the application of chamomile oil (20 drops every 1 h until fecal defecation) on the abdominal region of patients reduced the duration of time to first flatus, bowel sounds, abdominal pain, return of appetite, and rate of nausea and vomiting compared to placebo. Finally, Zargaran et al. (2018) reported the relieving effect of 30-min application of chamomile essential oils on pain, nausea and vomiting that are associated with migraine in a crossover double-blind clinical trial involving 100 patients. Overall, evidence supports that chamomile is effective in treating nausea and vomiting, diarrhea, and postoperative ileus, and warrants further assessment and recommendation for its use in gastrointestinal disorders. ...
Article
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Throughout history, Matricaria chamomilla L. (M. chamomilla) has had countless applications in traditional medicine. Its extracts, oils and teas have been used for treating diverse ailments, including wounds, rheumatic pain, menstrual cramps, eye and ear infections, gastrointestinal disorders, and respiratory illnesses. These traditional applications guided modern research into its medicinal effects through increasingly detailed in vitro and in vivo studies and clinical trials. A plethora of preclinical studies have assessed the antimicrobial, antioxidant, anti-inflammatory, antiulcer, hypoglycemic, hypolipidemic, cardioprotective, hepatoprotective, neuroprotective, nephroprotective, anti-diarrheal, antispasmodic, wound healing, and anticancer properties of M. chamomilla. These pharmacological properties of M. chamomilla are attributed to its rich reservoir of phytochemical constituents, primarily its flavonoids, such as luteolin, apigenin, and quercetin, as well as its sesquiterpenes, mainly chamazulene and (−)-α-bisabolol. Remarkably, preclinical studies have paved the way for progress towards controlled human clinical trials. M. chamomilla has been clinically evaluated for its effects against anxiety, sleep-deficiency, depression, as well as oral, women-related, inflammatory, metabolic, dermatological, gastrointestinal disorders, and children-related conditions. In this sense, this review elucidates and discusses the recent findings for M. chamomilla development as a therapeutic agent that possesses health-promoting, disease-preventing and even treatment properties. The traditional medicinal uses and evidence-based research studies, which were performed in cell culture, animal models and human subjects to assess the pharmacological activities of M. chamomilla, are extensively highlighted. Particular emphasis is given to some phytochemical constituents of M. chamomilla, which demonstrate great potential in treating various conditions.
... Traditional chamomile oil was prepared based on the direct heat method, which was standardized in previous studies 21,22 . In this method, chamomile flower was powdered and boiled in water to achieve an aqueous extract. ...
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Background: Plaque psoriasis is a chronic inflammatory skin disease. Conventional treatments of psoriasis are not completely effective. In addition, unwanted side effects limit their long-term use. In this regard, developing new natural treatments with fewer side effects could be an alternative option. This study was designed to evaluate the efficacy and safety of topical chamomile-pumpkin oleogel (ChP) in treating plaque psoriasis. Methods: A total of 40 patients with mild-to-moderate plaque psoriasis were enrolled in this intra-patient, double-blind, block-randomized clinical trial. In each patient, bilateral symmetrical plaques were treated with ChP or placebo twice daily for four weeks. For clinical assessment, the Psoriasis Severity Index (PSI) and the Physician's Global Assessment (PGA) scale were evaluated at baseline and after the treatment. At the end of the study, patients' satisfaction with the treatment was evaluated using a visual analog scale (VAS) ranging from 0 to 10. For safety assessment, all treatment-related side effects were recorded. Results: Thirty-seven subjects (20 female, 17 male; age 20–60 years) completed the study. The mean decreases in the PSI score in the ChP group (4.09 +/- 2.24) were significantly (p = 0.000) greater than the placebo group (0.48 +/- 1.39). According to the PGA results, 13/37 (35%) of the ChP-treated plaques could achieve marked to complete improvement compared to 0% in the placebo group. Three patients dropped out from the study due to worsening of bilateral plaques during the first week of trial. Conclusion: Our results suggest that topically applied ChP could provide a safe and effective complementary option for psoriasis plaque management. IRCT registration code: IRCT2016092830030N1.
... The botanical name "Matricaria" comes, indeed, from the latin matrix (i.e., uterus), in reference to its relaxing ability for uterine muscles in menstrual and postpartum disorders. The anti-inflammatory and antioxidant activities of chamomile within the analgesic action are well known, so that this medicinal plant is usually used as liquid extracts, tablets, or capsules to decrease sleep and digestive tract disorders and to diminish anxiety and neuralgic pains (headache, sciatica, rheumatic pain) [1][2][3][4]. Topical application is useful in treatment of epidermis and mucous membrane inflammation (burns, sunburn, insect bites, psoriasis, eczema, and conjunctivitis) [5]. In addition to the aforementioned properties, recent studies have also shown a possible role of chamomile in the prevention of tumors, cardiovascular diseases, and diabetes [6,7]. ...
Article
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Several phytochemical-containing herbal extracts are increasingly marketed as health-promoting products. In particular, chamomile (Matricaria recutita L.) is well known for its anti-inflammatory, analgesic, and antitumor properties. Here, we evaluated differences in chemical composition among six commercially available products and their potential impact on biological activity in human immortalized colonocytes. Our investigation encompassed: (i) preparation of dry extracts and yield evaluation; (ii) qualitative and quantitative analysis of phenol content; (iii) modulation of redox state; and (iv) bioavailability of main bioactive compounds. We demonstrated that apparently identical products showed huge heterogeneity, in terms of yield extraction, chemical composition, and antioxidant effects. All samples contained high amounts of flavonoids and cinnamic acid derivatives, but differentially concentrated in the six extracts. Depending on polyphenol content, chamomile samples possessed variable antioxidant potential, in terms of decreased radical generation and increased reduced glutathione levels. The observed effects might be ascribed to flavones (apigenin, luteolin, and their glycones) highly represented in the six extracts. Nonetheless, chamomile extracts exerted cytotoxic effects at high concentrations, suggesting that a herbal medicine is not always safe. In conclusion, due to the complexity and variability of plant matrices, studies evaluating effectiveness of chamomile should always be accompanied by preliminary characterization of phytochemical composition.
... In addition, studies on wound healing, anxiolytic, antispasmodic, anticancer, analgesic, antiallergic, antihyperglycemic and antiparasitic effects are also included in the literature. Further, the effects on stomach, mucosa and memory are studied (11)(12)(13)(14)(15)(16)(17)(18)(19). Recent antimicrobial activity studies on M. chamomilla mainly performed with its' extracts which obtained by using various solvents and extraction techniques or essential oil of the plant. ...
... M. chamomilla tea was effective in reducing pain in patients after orthopedic surgery [45]. In addition, dermal application of flower EOs by patients with knee osteoarthritis decreased their need for analgesic acetaminophen and ameliorated physical function and stiffness [180]. In another clinical trial, Zargaran et al. found that M. chamomilla oleogel can be used to relieve pain in patients with migraine without aura [181]. ...
Article
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Matricaria chamomilla L. is a famous medicinal plant distributed worldwide. It is widely used in traditional medicine to treat all kinds of diseases, including infections, neuropsychiatric, respiratory, gastrointestinal, and liver disorders. It is also used as a sedative, antispasmodic, antiseptic , and antiemetic. In this review, reports on M. chamomilla taxonomy, botanical and ecology description, ethnomedicinal uses, phytochemistry, biological and pharmacological properties, possible application in different industries, and encapsulation were critically gathered and summarized. Scientific search engines such as Web of Science, PubMed, Wiley Online, SpringerLink, Sci-enceDirect, Scopus, and Google Scholar were used to gather data on M. chamomilla. The phytochem-istry composition of essential oils and extracts of M. chamomilla has been widely analyzed, showing that the plant contains over 120 constituents. Essential oils are generally composed of terpenoids, such as α-bisabolol and its oxides A and B, bisabolone oxide A, chamazulene, and β-farnesene, among other compounds. On the other hand, M. chamomilla extracts were dominated by phenolic compounds, including phenolic acids, flavonoids, and coumarins. In addition, M. chamomilla demonstrated several biological properties such as antioxidant, antibacterial, antifungal, anti-parasitic , insecticidal, anti-diabetic, anti-cancer, and anti-inflammatory effects. These activities allow the application of M. chamomilla in the medicinal and veterinary field, food preservation, phytosanitary control, and as a surfactant and anti-corrosive agent. Finally, the encapsulation of M. chamomilla essential oils or extracts allows the enhancement of its biological activities and improvement of its applications. According to the findings, the pharmacological activities of M. chamomilla confirm its traditional uses. Indeed, M. chamomilla essential oils and extracts showed interesting antioxidant, antibacterial, antifungal, anticancer, antidiabetic, antiparasitic, anti-inflammatory, anti-depressant, anti-pyretic, anti-allergic, and analgesic activities. Moreover, the most important application of M. chamomilla was in the medicinal field on animals and humans.
... In traditional medicine, MC is used in sedation, pain management, and as an antioxidant agent. Notably, the analgesic and anti-inflammatory effects of MC extract have been confirmed in human research (Mao et al., 2016;Zargaran et al., 2018;Franco et al., 2020). In a mouse model of cisplatin-induced neuropathy, MC hydroalcoholic extract was found to decrease cisplatin-induced pain and inflammation and was superior to morphine in terms of anti-inflammatory effects in the second phase (Abad et al., 2011). ...
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As observed with other chemotherapeutic agents, the clinical application of platinum agents is a double-edged sword. Platinum-induced peripheral neuropathy (PIPN) is a common adverse event that negatively affects clinical outcomes and patients’ quality of life. Considering the unavailability of effective established agents for preventing or treating PIPN and the increasing population of cancer survivors, the identification and development of novel, effective interventions are the need of the hour. Plant-derived medicines, recognized as ideal agents, can not only help improve PIPN without affecting chemotherapy efficacy, but may also produce synergy. In this review, we present a brief summary of the mechanisms of platinum agents and PIPN and then focus on exploring the preventive or curative effects and underlying mechanisms of plant-derived medicines, which have been evaluated under platinum-induced neurotoxicity conditions. We identified 11 plant extracts as well as 17 plant secondary metabolites, and four polyherbal preparations. Their effects against PIPN are focused on oxidative stress and mitochondrial dysfunction, glial activation and inflammation response, and ion channel dysfunction. Also, ten clinical trials have assessed the effect of herbal products in patients with PIPN. The understanding of the molecular mechanism is still limited, the quality of clinical trials need to be further improved, and in terms of their efficacy, safety, and cost effectiveness studies have not provided sufficient evidence to establish a standard practice. But plant-derived medicines have been found to be invaluable sources for the development of natural agents with beneficial effects in the prevention and treatment of PIPN.
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Objectives: Oral mucositis is among the complications of cancer therapy that affects quality of life and imposes remarkable financial costs for patients with cancer. This study aimed to explore, preserve, and scientifically investigate the ethnomedicinal knowledge of traditional healers for treatment of oral mucositis in Zahedan, Iran. Materials and methods: Field surveys were performed from September 2018 to October 2018 in Zahedan. Data was collected using a structured questionnaire in Persian. All species recorded for the treatment of oral mucositis were sampled. Samples were identified by a botanist and a voucher specimen of them was deposited in the Herbarium Center of the Faculty of Pharmacy in Kerman, Iran. Information, such as scientific name, family, local name, parts used, and preparation method, were also provided. Literature review on available data on effect of the addressed plant species on mucositis and other relative pharmacological actions, such as wound healing and anti-inflammatory properties, was performed. Results: A total of 29 informants (attars) were interviewed and 18 medicaments were recommended, of which three samples were of synthesis or mineral origin and 15 samples were of herbal origin. Drugs were administered both topically and orally. According to recent studies, two herbs were evaluated for their direct effect on mucositis. Some pharmacological properties related to mucositis treatment by the other 11 samples have been confirmed. Conclusion: This study provides information on the characteristics of medicinal plants from Zahedan, Iran based on their ethnopharmacological knowledge and pharmacological properties for mucositis treatment.
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Migraine is a disabling neurovascular disorder with few targeted, tolerable and effective treatments. Phytomedicines, or plant-based medicinal formulations, hold great promise in the identification of novel therapeutic targets in migraine. Many patients also turn toward herbal and plant-based therapies for the treatment of their migraines as clinical and preclinical evidence of efficacy increases. Patients seek effective and tolerable treatments instead of or in addition to current conventional pharmacologic therapies. We review some phytomedicines potentially useful for migraine treatment—feverfew (Tanacetum parthenium), butterbur (Petasites hybridus), marijuana (Cannabis spp.), Saint John’s Wort (Hypericum perforatum) and the Damask rose (Rosa × damascena)—with respect to their mechanisms of action and evidence for treatment of migraine. The evidence for feverfew is mixed; butterbur is effective with potential risks of hepatotoxicity related to preparation; marijuana has not been shown to be effective in migraine treatment, and data are scant; Saint John’s Wort shows relevant physiological activity but is a hepatic enzyme inducer and lacks clinical studies for this purpose; the Damask rose when used in topical preparations did not show efficacy in one clinical trial. Other plant preparations have been considered for migraine treatment but most without blinded randomized, placebo-controlled trial evidence.
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Phytomedicines may provide new options for migraine prophylaxis and treatment based on their historical use and pharmacological properties. However, as clinical data are limited, no phytomedicine can currently be strongly recommended to manage migraine. Feverfew and butterbur may be effective in preventing migraine, but the efficacy of butterbur has been overshadowed by reports of severe petasites hepatotoxicity. Although further research is needed, chamomile, coriander, peppermint and ginkgo have shown encouraging results in explorative clinical studies, and the active components of cannabis and St John’s wort have shown promise in preclinical studies.
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Since the edifice of conventional medicine is built on the pillars of past achievements, review or re-investigate the old medical manuscripts may lead to significant achievements. Avicenna was a famous Persian medieval physician and one of the pioneers of neuroscience. The aim of this study is to evaluate Avicenna's approach to traumatic brain injury (TBI), based on his main book on medicine, “Canon of Medicine”. Avicenna divided the TBI treatments into three categories: topical therapies, oral therapies, such as diets and medications, and manipulation therapies including phlebotomy, enema, foot bath, cupping, and massage. Although some of these recommendations are supported by current knowledge, many of them are still unknown and need scientific investigation to expand our knowledge of TBI treatments in the medieval period.
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Objective: To determine what dose of melatonin is most effective for treating migraine acutely in children and adolescents. Background: Acute migraine medications may not work for all patients and may cause side effects. Melatonin is effective for migraine prevention in adults and has been used acutely for procedural pain in children. Our goal was to determine whether a "high" or "low" dose of melatonin is more effective for treating migraine acutely in youth. Methods: In this pilot, randomized, open-label, single-center, dose-finding trial, children and adolescents aged 4-17 years with episodic migraine were randomized to "high-dose" or "low-dose" dose melatonin (<40 kg: 4 mg vs. 1 mg; ≥40 kg: 8 mg vs. 2 mg). The primary outcome measure was change in mean pain score between time 0 and 2 hours. Secondary outcomes included 2-hour pain-relief and pain-freedom rates. Results: Eighty-four participants (n = 42 per group) were enrolled in this study. Mean (SD) participant age was 11.8 (3.5) years and 55% (46/84) were female. Mean (SD) headache days/month was 5.6 (3.8). Sixty-six (79%) participants provided outcome data and were included in the analyses, n = 24 in the high-dose group and n = 22 in the low-dose group. The drop-out rate was 43% (18/42) in the high-dose group vs. 48% (20/42) in the low-dose group. Mean (SD) change in pain intensity at 2 hours was -2.7 (2.1) cm in the high-dose group vs. -2.3 (2.1) cm in the low-dose group (p = .581), a difference of 0.4 cm (95% CI: -1.17 to 1.92). Two-hour pain-freedom rate was 41% (7/17) vs. 27% (4/15) in the high-dose vs. low-dose groups (p = .415), and 2-hour pain-relief rate was 94% (16/17) vs. 80% (12/15), (p = .482). There were no serious adverse events. Napping occurred in the majority (67% (14/21) high dose vs. 47% (9/19) low dose). Higher mg/kg dose of melatonin and napping were each independently associated with greater headache benefit. Conclusions: As an acute treatment for pediatric migraine, both low and high doses of melatonin were associated with pain reduction; however, study drop-out was high. Higher dose and napping after treatment predicted greater benefit.
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Ethnopharmacological relevance Migraines have become a major threat to human health, as they significantly affect human health and quality of life due to a high prevalence rate, attack rate and pain intensity. Aromatherapy, with its comfortable and pleasant natural characteristics and rapid and efficient characteristics, is widely favored by patients in the folk. Chinese folk also have the application history and related records of aromatic plants in the treatment of migraine. Aim of the study This study was conducted to review the pathogenesis of migraine, the application of plant essential oils in the treatment of migraine, and further explore the material basis and mechanism of action of plant essential oils against migraine. Materials and methods Search the electronic literature of essential oils with anti-migraine effect in Google Scholar, PubMed and China National Knowledge Infrastructure, and further search the research situation of the monomer components of essential oils in migraine, inflammation, pain and other aspects. Results studies show that there are 10 types of plant essential oils that could relieve migraine symptoms, and that 16 monomers may play a role in migraine treatment by effectively inhibiting neurogenic inflammation, hyperalgesia and balancing vasorelaxation. Conclusion Aromatic plant essential oils can relieve migraine effectively, these findings can be used as an important part of the development of anti-migraine drugs.
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Neuroinflammation is a molecular and cellular process and tends to be one of the main hallmarks of neurodegenerative disorders. In this situation, astrocytes and microglia activate, and immune cells infiltrate to the brain. Any damage to the brain leads to the inflammatory response, leading to neurological dysfunction. Although inflammation has crucial roles in neurodegenerative disorders, few drug delivery systems have been studied on targeting the immune system compared to other pathogenesis mechanisms, and yet there is no effective treatment to stop most brain diseases. So, the management of neuroinflammation can be a good strategy for controlling brain diseases associated with neuroinflammation. Many targeted drug delivery systems are designed and developed to target immune cells of the central nervous system, especially microglia, and treat neuroinflammation associated with neurodegeneration disorders or brain tumors. This review article aims to discuss different targeted therapeutic and immunotherapeutic approaches to treat central nervous system disorders related to neuroinflammation.
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This systematic review shows the effectiveness of Matricaria chamomilla for improving health. Original papers and case reports published during 2014–2018 in PubMed, Science Direct and Scopus were included. Most studies were in vitro, performed with extracts, in 2018, and originated from Iran. In vitro assays focused mainly on antimicrobial, antiparasitic and antioxidant activities. In vivo studies specially investigated organ and tissue protective activity of chamomile. Clinical trials have validated some of these in vitro and in vivo pharmacological activities (diabetes mellitus, hypertension and pain). Future preclinical and clinical investigations should be aimed at deeping into pure compounds responsible for activities.
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Oleogelation based on emulsion using food-approved biopolymers is a feasible strategy to substitute solid fat with harmful trans and saturated fatty acids, providing food products with a better nutritional profile. However, oil with high content of unsaturated fatty acids is prone to oxidation, resulting in quality loss of food products. In the present study, proanthocyanidins from Chinese bayberry leaves (BLPs) were incorporated into emulsion-based oleogel to remedy the defect through the formation of colloidal complexes with gelatin. Oleogel stabilized with the colloidal complexes showed higher stability with lower oil loss and higher gel strength, compared to that with gelatin only. Then different polysaccharides were applied to further promote oleogel stability. However, polysaccharides abrogated the promotive effect of BLPs and resulted in comparable stability of oleogels with BLPs or not, which was confirmed with cryo-SEM observation. Then the application of oleogel with BLPs as margarine alternative was verified with batter properties, quality loss of cakes and oil stability in cakes. Batter properties of oleogel with BLPs were comparable to that without BLPs, and more close to margarine than oil. For quality loss, textural properties of oleogel cakes with BLPs or not resembled each other and were significantly better than oil cakes in hardness and chewiness and margarine cakes in cohesiveness. Particularly, BLPs were verified to retard oil oxidation in both oleogel and cakes prepared with oleogel. Overall, incorporation of BLPs into oleogel was feasible to improve its oil stability and keep its application in cake products.
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Introduction Currently, the demand for the use of constituents of natural origin in cosmetic formulations in detriment of synthetic compounds is noticeable. Several studies assess the potential of essential oils when incorporated into various cosmetic formulations and study their biological activities. This work intends to prepare a literature review on essential oils tested in dermocosmetic formulations and whose biological activities were evaluated through in vitro and/or in vivo tests. The main objectives for this study were as follows: to identify the essential oils that have been used in cosmetic formulations; and compile information on the main biological activities tested in cosmetic formulations. Methods A search was carried out until 2021 in the scientific databases PubMed and Web of Science, using different search terms, and several scientific articles from in vitro and in vivo studies in animals and clinical trials were selected and analyzed of involving development dermocosmetic formulations containing essential oils and the analysis of their biological activities. Results These studies demonstrate that the antimicrobial activity (antibacterial and antifungal) is the one most studied, mainly through in vitro tests. In vivo studies were also carried out either in animals or in clinical studies showing different effects, such as repellent action, inhibition of hair growth, and action against migraine. Regarding formulations, it was evident that creams are the most used. Conclusions There is enormous potential for the use of essential oils in future formulations in the cosmetic and pharmaceutical industry, in particular as preservatives, exploring their other biological activities.
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Importance Migraine is common and can be associated with significant morbidity, and several treatment options exist for acute therapy. Objective To evaluate the benefits and harms associated with acute treatments for episodic migraine in adults. Data Sources Multiple databases from database inception to February 24, 2021. Study Selection Randomized clinical trials and systematic reviews that assessed effectiveness or harms of acute therapy for migraine attacks. Data Extraction and Synthesis Independent reviewers selected studies and extracted data. Meta-analysis was performed with the DerSimonian-Laird random-effects model with Hartung-Knapp-Sidik-Jonkman variance correction or by using a fixed-effect model based on the Mantel-Haenszel method if the number of studies was small. Main Outcomes and Measures The main outcomes included pain freedom, pain relief, sustained pain freedom, sustained pain relief, and adverse events. The strength of evidence (SOE) was graded with the Agency for Healthcare Research and Quality Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Findings Evidence on triptans and nonsteroidal anti-inflammatory drugs was summarized from 15 systematic reviews. For other interventions, 115 randomized clinical trials with 28 803 patients were included. Compared with placebo, triptans and nonsteroidal anti-inflammatory drugs used individually were significantly associated with reduced pain at 2 hours and 1 day (moderate to high SOE) and increased risk of mild and transient adverse events. Compared with placebo, calcitonin gene-related peptide receptor antagonists (low to high SOE), lasmiditan (5-HT1F receptor agonist; high SOE), dihydroergotamine (moderate to high SOE), ergotamine plus caffeine (moderate SOE), acetaminophen (moderate SOE), antiemetics (low SOE), butorphanol (low SOE), and tramadol in combination with acetaminophen (low SOE) were significantly associated with pain reduction and increase in mild adverse events. The findings for opioids were based on low or insufficient SOE. Several nonpharmacologic treatments were significantly associated with improved pain, including remote electrical neuromodulation (moderate SOE), transcranial magnetic stimulation (low SOE), external trigeminal nerve stimulation (low SOE), and noninvasive vagus nerve stimulation (moderate SOE). No significant difference in adverse events was found between nonpharmacologic treatments and sham. Conclusions and Relevance There are several acute treatments for migraine, with varying strength of supporting evidence. Use of triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, dihydroergotamine, calcitonin gene-related peptide antagonists, lasmiditan, and some nonpharmacologic treatments was associated with improved pain and function. The evidence for many other interventions, including opioids, was limited.
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Internal organs fibrosis (IOF) is the leading cause of morbidity and mortality in most chronic inflammatory diseases, which is responsible for 45% of deaths due to disease. However, there is a paucity of drugs used to treat IOF, making it urgent to find medicine with good efficacy, low toxic side effects and good prognosis. Essential oils (EOs) extracted from natural herbs with a wide range of pharmacological components, multiple therapeutic targets, low toxicity, and broad sources have unique advantages and great potential in the treatment of IOF. In this review, we summarized EOs and their monomeric components with anti-IOF, and found that they work mainly through inhibiting TGF-β-related signaling pathways, modulating inflammatory cytokines, suppressing NF-κB, and anti-oxidative stress. The prognostic improvement of natural EOs on IOF was further discussed, as well as the quality and safety issues in the current development of natural EOs. This review hopes to provide scientific basis and new ideas for the development and application of natural medicine EOs in anti-IOF.
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Herbal oils have been widely used in Iran as medicinal compounds dating back to thousands of years in Iran. Chamomile oil is widely used as an example of traditional oil. We remade chamomile oils and tried to modify it with current knowledge and facilities. Six types of oil (traditional and modified) were prepared. Microbial limit tests and physicochemical tests were performed on them. Also, principal component analysis, hierarchical cluster analysis, and partial least squares discriminant analysis were done on the spectral data of attenuated total reflectance–infrared in order to obtain insight based on classification pattern of the samples. The results show that we can use modified versions of the chamomile oils (modified Clevenger-type apparatus method and microwave method) with the same content of traditional ones and with less microbial contaminations and better physicochemical properties.
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Medicinal oils were of the pharmaceutical dosage forms used since ancient Persian times to now in Iran. Chamomile oil is one of the medicinal oils prepared by the extraction of the chamomile flowers to sesame oil as an oily vehicle. It was widely used in the history of Persian medicine and is currently used by traditional practitioners of Persian Medicine in various disorders mainly in topical form. In this study, traditional chamomile oil was prepared based on the Qarabadin books. In advanced, 600 g of chamomile flower powder was boiled in 3.6 liter of water for 3 hours. Then, powder was removed and remained water (aqueous extract of chamomile) was boiled with 0.5 liter of sesame oil for 2 hours (until all the water was vaporized and oil remained). For standardization, the essential oil of chamomile oil was obtained via Clevenger apparatus method and then analyzed with the help of gas chromatography (GC)-mass method. In addition, total phenolic and flavonoid contents of the chamomile oil were calculated based on galic acid and quercetin, respectively. The results show that the main component of the essential oil were Caryophyllene (7.45%), Bisabolol Oxide B (2.05%), Bisabolone Oxide A (62.35%), Chamazulene (2.05%), Bisabolol Oxide A (15.54%) and Methyl ester 5,8,11-Heptadecatriynoic acid (5.52%). Besides, total phenolic and flavonoid contents were 11.0043 ± 0.4514 and 2.7640 ± 0.1776 mg/l, respectively. Our results show that the historical dosage form of chamomile oil in Persian medicine can be reproduced and is an stable and homogeneous oil and be standardized in our investigation.
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This invention relates to a pernasally administrable preparation for the controlled release of sexual hormones to the systemic circulation, in particular to a formulation which enables its active ingredient to be absorbed in a sustained manner providing a better bioavailability at very low doses and longer duration of action.
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Osteoarthritis affects about 50% of people aged older than 65 years. Pain is the most important symptom in this disease. Today public interest in the use of complementary medicine, especially traditional herbal medicines has increased. The present study was designed to investigate the efficacy of traditional preparation of Peganum harmala L oil on patients with knee osteoarthritis. The product has been analyzed and standardized by high-performance liquid chromatography. A double blind controlled randomized clinical trial consisting of 54 patients were performed. Patients rubbed the drug or control (olive oil) on the knee 4 drops 3 times a day for 4 weeks. The patients were asked to fill out the Western Ontario and McMaster Universities Arthritis Index and Visual Analogue Scale questionnaires at week 0 and 4. The adapted results from the questionnaires showed that pain and difficulty in function were significantly decreased in Peganum oil group after 4 weeks. There was no significant difference in stiffness change between 2 groups. © The Author(s) 2015.
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Background: Triptans are a family of selective serotonin (5-HT1B/1D) receptor agonists that are widely used to treat acute migraine attacks. Their efficacy is limited by side effects and the gastrointestinal manifestations of migraine. Aim: To compare the efficacy of a single intravenous administration of propacetamol, a prodrug of paracetamol (acetaminophen) with a single dose of oral rizatriptan in treating acute migraine attacks. Methods: Patients were selected from those who presented to the emergency room with a diagnosed migraine attack and who had not previously taken any analgesics. They were randomized into 2 groups: treatment with a single 1g IV dose of propacetamol or with a single oral dose of 5mg rizatriptan. Their Visual Analogue Scale (VAS) pain scores were assessed before and at 30, 60, and 120min after treatment. Results: The patients who received the propacetamol had significantly improved VAS scores at 60min compared to the rizatriptan group. There were no significant differences in VAS scores at 30 or 120min post-treatment. Conclusion: Propacetamol is either equivalent or superior in efficacy to rizatriptan for treating acute migraine attacks, while having the advantage of parenteral administration in patients whose migraines are accompanied by nausea and vomiting.
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In a multicenter, double-blind, randomized, parallel-group, placebo-controlled, single-dose study ( N = 1555), a fixed combination of acetaminophen 500 mg, acetylsalicylic acid 500 mg, and caffeine 130 mg (AAC) was compared with ibuprofen 400 mg (IB) and placebo (PLA) for acute treatment of migraine. An exploratory post-hoc analysis compared AAC with IB and PLA in the subset of patients with severe pain at baseline ( N = 660). At most time points, AAC and IB relieved the pain and associated symptoms of severe migraine significantly better than PLA ( P ≤ 0.05). AAC was significantly superior to IB for pain relief at 45 minutes and at one, two, three, and four hours postdose ( P < 0.04); pain intensity difference from one hour through three hours ( P < 0.05); headache response at two hours ( P = 0.04); functional disability reduced to little or none at three hours ( P = 0.013); freedom from phonophobia at three hours ( P = 0.04) and photophobia at 15 minutes postdose ( P = 0.03); and use of rescue medication ( P = 0.018). AAC patients also reported meaningful pain relief 16 minutes faster than IB patients (132 minutes vs 148 minutes, P = 0.026). In patients with severe baseline migraine pain, AAC and IB are significantly more effective than PLA, and AAC provides significantly faster and more effective pain relief than IB.
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Intravenous chemotherapy is an important mean for the treatment of cancers. Infusion phlebitis (Ph) is a common and acute complication of chemotherapy. The frequency of Ph is about 70% in patients undergoing chemotherapeutic management. It can induce the pain, increase the risk of thrombophlebitis, lead to incomplete follow-up, and thereby, affect the patient’s health status. Respecting the great importance of these issues, it is essential to prevent Ph. This study conducted to determine the effect of external use of Sesame Oil (SO) in the prevention of Ph. Sixty patients with colon or rectum cancer, who admitted for chemotherapeutic management, enrolled in clinical trial and were randomly divided into two equal groups: Control and Intervention. Ten drops of SO was applied twice a day for 14 days externally in intervention group, whereas the control group received nothing. Incidence and grade of Ph was measured in both groups. Data was analyzed through independent t-test, Χ2, Fisher’s exact test, Mann-Whitney, and Lagrange survival using SPSS 16. The incidence of Ph was 10% and 80% in intervention group and control group, respectively.There was a significant difference between two groups (p < 0.05). Ph was 8 times more frequent in control group (R R = 8; AR R = 70%). In addition, there was statistically significant difference between the grade and incidence of Ph with SO and control group (p < 0.05). According to these results, it seems that external use of SO is effective, safe and well-tolerated for prophylaxis from Ph. Therefore, it can be suggested as a selected prevention method for reducing the complication.
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Migraine is a common and potentially disabling disorder for patients, with wide-reaching implications for health care services, society, and the economy. Nausea and vomiting during migraine attacks are common symptoms that affect at least 60% of patients suffering from migraines. These symptoms are often more disabling than the headache itself, causing a great burden on the patient's life. Nausea and vomiting may delay the use of oral abortive medication or interfere with oral drug absorption. Therefore, they can hinder significantly the management and treatment of migraine (which is usually given orally). The main treatment of pain-associated symptoms of migraine (such as nausea and vomiting) is to stop the migraine attack itself as soon as possible, with the effective drugs at the effective doses, seeking if necessary alternative routes of administration. In some cases, intravenous antiemetic drugs are able to relieve a migraine attack and associated symptoms like nausea and vomiting. We performed an exhaustive PubMed search of the English literature to find studies about management of migraine and its associated symptoms. Search terms were migraine, nausea, and vomiting. We did not limit our search to a specific time period. We focused on clinical efficacy and tolerance of the various drugs and procedures based on data from human studies. We included the best available studies for each discussed drug or procedure. These ranged from randomized controlled trials for some treatments to small case series for others. Recently updated books and manuals on neurology and headache were also consulted. We herein review the efficacy of the different approaches in order to manage nausea and vomiting for migraine patents.
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Sesame lignans have multiple functions and were recently reported to have potential as sources of phytoestrogens. Sesame oils used in Taiwan are expelled from roasted sesame seeds with dark colour and strong flavour. This study analyzed lignan contents of 14 brands of sesame oils, and found their mean of total lignans to be 11.5mg/g; 82% and 15% of the lignans were sesamin, and sesamolin, respectively. Sesamol contents were relatively higher in those with darker colour. In use as a cooking oil, heating at 180°C for 4min did not change the content of lignans, but the level of sesamol increased after heating at 180°C for 20min. Heating at 200°C for 20min caused a significant loss of sesamolin and sesamol. From our calculation, ingestion of 10g of sesame oil is adequate to provide the level of lignans that might benefit cardiovascular health, as found by other studies. Cooking at temperatures above 200°C will cause loss of some lignans, but sesamin, a source of phytoestrogen, is relatively heat-stable.
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Context: In Iran, conventional production methods of herbal oils are widely used by local practitioners. Administration of oils is rooted in traditional knowledge with a history of more than 3000 years. Scientific evaluation of these historical documents can be valuable for finding new potential use in current medicine. Objective: The current study (i) compiled an inventory of herbal oils used in ancient and medieval Persia and (ii) compared the preparation methods and therapeutic applications of ancient times to current findings of medicinal properties in the same plant species. Materials and methods: Information on oils, preparation methods and related clinical administration was obtained from ancient Persian documents and selected manuscripts describing traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plant species used for herbal oils through a search of the PubMed, Scopus and Google Scholar databases. Results: In Iran, the application of medicinal oils date back to ancient times. In medieval Persian documents, 51 medicinal oils produced from 31 plant species, along with specific preparation methods, were identified. Flowers, fruits and leaves were most often used. Herbal oils have been traditionally administered via oral, topical and nasal routes for gastrointestinal, musculoskeletal, and neural diseases, respectively. According to current investigations, most of the cited medicinal plant species were used for their anti-inflammatory and analgesic properties. Conclusions: Medicinal oils are currently available in Iranian medicinal plant markets and are prepared using traditional procedures for desirable clinical outcomes. Other than historical clarification, the present study provides data on clinical applications of the oils that should lead to future opportunities to investigate their potential medicinal use.
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Tremor has been described in traditional systems of medicine throughout history. Persian medicine was one of those systems in medieval times and in it neurology and neurosurgery were also widely practiced and accepted. Based on the main Persian medical manuscripts, the current study focuses on the medieval concept of tremor as an important neurological disorder in order to clarify the development of neurology. Accordingly, three main approaches to the control and treatment of tremor in traditional Persian medicine are considered. First is lifestyle modification. The administration of simple medicines is the second, and the last is the application of compound medicines. Our study shows how much was known about tremor in traditional Persian medicine.
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Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH), its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS) diagnosis criteria. A random sam-ple of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were col-lected by screening questionnaire followed by clinical interviews, general physical and neurological examina-tion, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were es-timated as 11.2% (115 cases), 19.5% (199 subjects) and 3.2% (33 subjects) respectively. In this study , clini-cal characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001). Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026). The average of prevalence of mi-graine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache-related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treat-ment.
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Pathophysiology of the neurovascular unit (NVU) is commonly seen in neurological diseases. The typical features of NVU pathophysiology include tissue hypoxia, inflammatory and angiogenic activation, as well as initiation of complex molecular interactions between cellular (brain endothelial cells, astroctyes, pericytes, inflammatory cells, and neurons) and acellular (basal lamina) components of the NVU, jointly resulting in increased blood-brain barrier permeability, brain edema, neurovascular uncoupling, and neuronal dysfunction and damage. The evidence of important role of the brain vascular compartment in disease pathogenesis has elicited the debate whether the primary vascular events may be a cause of the neurological disease, as opposed to a mere participant recruited by a primary neuronal origin of pathology? Whereas some hereditary and acquired cerebral angiopathies could be considered a primary cause of neurological symptoms of the disease, the epidemiological studies showing a high degree of comorbidity among vascular disease and dementias, including Alzheimer's disease, as well as migraine and epilepsy, suggested that primary vascular pathology may be etiological factor causing neuronal dysfunction or degeneration in these diseases. This review focuses on recent hypotheses and evidence, suggesting that pathophysiology of the NVU may be initiating trigger for neuronal pathology and subsequent neurological manifestations of the disease.
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Chamomile has long been used in traditional medicine for the treatment of inflammation-related disorders. In this study we investigated the inhibitory effects of chamomile on nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression, and explored its potential anti-inflammatory mechanisms using RAW 264.7 macrophages. Chamomile treatment inhibited LPS-induced NO production and significantly blocked IL-1β, IL-6 and TNFα-induced NO levels in RAW 264.7 macrophages. Chamomile caused reduction in LPS-induced iNOS mRNA and protein expression. In RAW 264.7 macrophages, LPS-induced DNA binding activity of RelA/p65 was significantly inhibited by chamomile, an effect that was mediated through the inhibition of IKKβ, the upstream kinase regulating NF-κB/Rel activity, and degradation of inhibitory factor-κB. These results demonstrate that chamomile inhibits NO production and iNOS gene expression by inhibiting RelA/p65 activation and supports the utilization of chamomile as an effective anti-inflammatory agent.
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To investigate the efficacy and safety of the cutaneous application of menthol 10% solution for the abortive treatment of migraine. Peppermint and its active ingredient menthol have long been used for the treatment of various pain conditions including headache. This is a randomised, triple-blind, placebo-controlled, crossed-over study conducted in the neurology Clinic of Nemazee Hospital, affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran, from March 2007 to March 2008. The patients were recruited via local newspaper advertisements. Eligible patients were categorised into two groups and a 10% ethanol solution of menthol (as drug) and 0.5% ethanol solution of menthol (as placebo) were applied to the forehead and temporal area in a crossover design. Pain free, pain relief, sustained pain free and sustained pain relief end-points were measured by questionnaires using a visual analogue scale. The intent-to-treat population consisted of 35 patients (80% women, 20% men, mean age: 29.6 +/- 6.2) with 118 migraine attacks. In the intent-to-treat population, the menthol solution was statistically superior to the placebo on 2-h pain free (p = 0.001), 2-h pain relief (p = 0.000), sustained pain free and sustained pain relief end-points (p = 0.008). The menthol solution was also more efficacious in the alleviation of nausea and/or vomiting and phonophobia and/or photophobia (p = 0.02). In the per-protocol population, there was significantly higher number of patients who experienced at least one pain free/pain relief after the application of menthol rather than the placebo (p = 0.002). No significant difference was seen between the adverse effects of the drug and the placebo groups (p = 0.13). Menthol solution can be an efficacious, safe and tolerable therapeutic option for the abortive treatment of migraine.
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In present study, we carried out a systematic record of the relative antioxidant activity in selected Iranian medicinal plant species' extracts. The total phenol varied from 24.1 ± 1 to 289.5 ± 5 mg g -1 in the extracts. Flavonoid contents were between 25.15 ± 0.8 and 78.3 ± 4.5 mg g -1 . 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging effect of the extracts was determined spectrophotometrically. The highest radical scavenging effect was observed in Mellilotus officinalis with IC50 = 0.018 mg ml –1. The potency of radical scavenging effect of M. officinalis extract was about 4 times greater than synthetic antioxidant butylated hydroxy toluene (BHT). The greater amount of phenolic compounds leads to more potent radical scavenging effect as shown by M. officinalis extract.
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Migraine is a common type of headache which has a deep history dating back thousands of years. Avicenna (980–1032), a Persian scholar, made a great contribution to neurology including headache and migraine. The aim of this study is to consider Avicenna’s description about migraine (Shaghighe in Persian language) including definition, etiology and intervention. Also, his definition and treatment approaches were considered based on current concepts and findings. Although Avicenna believed in humoral theory and divided migraine into two categories, hot and cold, and suggested special treatments for them as well as general considerations, most of his definitions and explained pathologies are supported by current concepts of medicine. He believed that the migraine can result from bone of skull and also intra-parenchymal; or from skull underneath membrane (dura-mater); or reaching substances from the painful side or from outer vein and arteries (extra cranial); or from brain and meninges (pia-mater). Furthermore, current findings show most medicinal plants mentioned by Avicenna for the treatment of migraine can have potentially significant effects such as remedies which stop central and peripheral sensitization [anti-neuroinflammatory agents, decreasing nitric oxide level, cyclooxygenase (COX)-2 inhibitors], as well as serotonergics, neuroprotective agents and analgesics.
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To assess the efficacy and safety of topical Matricaria chamomilla (Chamomile) oil in patients with knee osteoarthritis. Patients were randomized and treated with topical chamomile oil, diclofenac or placebo, 3 times/day for 3 weeks. They were allowed to use acetaminophen as analgesic. The patients were asked about their total acetaminophen use. Moreover, they were assessed in the terms of pain, physical function and stiffness by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire at the enrolling and weekly. Chamomile oil significantly reduced the patients' need for acetaminophen (P = 0.001) compared with diclofenac and placebo. However, there were no significant differences in WOMAC questionnaire domains. The patients did not report any adverse events by using chamomile oil. Chamomile oil decreased the analgesic demand of patients with knee osteoarthritis. In addition, it may show some beneficial effects on physical function, and stiffness of the patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Objectives In this paper, we focused on essential oils and their constituents as skin penetration enhancers for transdermal drug delivery, mechanism of their action as well as their possible toxicity.Key findingsEssential oils and their volatile constituents can penetrate through the skin as well as enhance penetration of different drug from topical formulation into the lower skin layers using different mechanisms of action based on (1) disintegration of the highly ordered intercellular lipid structure between corneocytes in stratum corneum, (2) interaction with intercellular domain of protein, which induces their conformational modification, (3) increase the partitioning of a drug. After application to the skin, essential oils and their components are rapidly metabolized, not accumulated in the organism and fast excreted what strongly suggest that they can be successfully use as safe penetration enhancers.SummaryEssential oils and their constituents may be preferred over the traditionally used synthetics materials as safe and suitable permeation enhancers to promote the percutaneous absorption of hydrophilic and lipophilic drugs from topical formulation into the lower skin layers.
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Dexamethasone is a glucocorticoid that is widely used in the ophthalmic arena. The recent FDA approved dexamethasone implant can provide a three month efficacy but with high rate of drug related cataract and high intraocular pressure (IOP). It seems that higher steroid in aqueous humor and around lens may be associated with these complications based on clinical fact that higher IOP was observed with intravitreal triamcinolone acetonide (TA) than with subtenon TA. We hypothesize that placing a sustained dexamethasone release system near back of the eye through a fine needle can maximize efficacy while mitigate higher rate of IOP rise and cataract.
Conference Paper
Antioxidants protect the body from various disease conditions through their ability to neutralize the effects of free radicals. Synthetic antioxidants are extensively used in processed foods for prevention of oxidation and retention of sensory quality. Consumer awareness and preference has led to a vigorous interest in the search for natural antioxidants. Sesamin and sesamolin, the major lignans present in sesame oil, are known for their antioxidative properties. Roasted sesame oil has a higher concentration of sesamol, the thermally degraded product of sesamolin, which is considered a more potent antioxidant compared to its parent molecule. The isolated lignans and sesamol were tested for their antioxidant, free radical scavenging and antibacterial properties. Sesamol is the best antioxidant and free radical scavenger amongst the molecules studied with IC50 value of 5.44 μg / mL (DPPH radical scavenging activity). Antibacterial assays against food borne pathogens revealed sesamol to be an antimicrobial agent with minimal inhibitory concentration (MIC) of 2 mg /mL in the culture. Its activity was synergistic with γ-tocopherol, also present in sesame seeds. Inhibition of browning (60-65 %) in fruit pulps (apple, banana and potato) was observed in presence of 20 μM sesamol.
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Migraine is a chronic recurring headache for which no complete treatment has been found yet. Therefore, finding new treatment approaches and medicines is important. In this review, we consider the probable mechanism of action of a traditional and ethnic formulary of chamomile extract in sesame oil as a new topical medication for migraine pain relief. Chamomile oil is prepared in traditional Persian medicine by boiling aqueous extract of chamomile in sesame oil. To optimize the procedure, we can use a Clevenger-type apparatus to extract the essential oil and add it to the end product. The preparation includes both essential oils (chamazulene and bisabolol oxide) and polyphenols (a flavonoid such as apigenin and its derivatives). It probably possesses pain relief effects for migraines because of the following properties: 1) chamazulene and apigenin, which inhibit iNOS expression in activated macrophages and can lead to the prohibition of NO release and synthesis; 2) chamomile flavonoids, which have a strong inhibitory effect on endogenous prostaglandin E2 (PGE2) levels in RAW 264.7 macrophages and can play the role of selective COX-2 inhibitor; 3) chamomile polyphenols, which possess anti-inflammatory effects due to the inhibition of pro-inflammatory biomarkers in THP1 macrophages and which can reduce inflammation in neurovascular units (NVU) at the site of migraine pain; 4) chamomile, which has neuroprotective effects because of reduced NO levels; 5) sesamine in sesame oil, which possesses an anti-inflammatory effect. These effects are supported by main pathophysiology theories of migraine such as neural and sensitization theories. Chamomile oil is a traditional formulation still used in Iran as an ethno-medicine. Because of the mentioned mechanisms of action, it can be hypothesized that chamomile oil is a novel medicine for the relief of migraine pain.
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Editorial Reviews Product Description Now complete in 17 volumes, the Encyclopedia of Pharmaceutical Technology presents authoritative and contemporary articles on all aspects of drug development, dosage forms, manufacturing, and regulation;enabling the specialist and novice alike to keep abreast of developments in this rapidly evolving and highly competitive field. A dependable reference tool and a solid investment for years to come--maintaining currency through its supplements (Volume 18/Supplement 1 due to be published in the Fall, 1998)! The Encyclopedia contains interdisciplinary contributions in a wide array of subjects, including Drugs decomposition metabolism pharmaceutical incompatibilities pharmacokinetics physicochemical properties preformulation stability Drug Delivery Systems and Devices;Development and Manufacture analysis and controls bioavailability use of computerization formulation and processing alternatives national and international registration packaging patents process validation scale-up safety and efficacy stability standards Post-Production and Practical Considerations governmental/industrial/professional organizations legal aspects national and international agencies patent life of drugs patient compliance …and much, much more! Special Discount Offer New Subscribers ... save $415.00 off the subscription price of $3315.00! Purchase the entire 17-volume set for $2900.00 (only $171.00 per volume) offer expires 3/31/98 Missing volumes? For a limited time, complete your set at the special price of $171.00 per volume. offer expires 3/31/98 --This text refers to an alternate Hardcover edition.
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Introduction: Ample evidence that nitric oxide (NO) is a causative molecule in migraine has encouraged research to develop drugs that target the NO-cGMP cascade for migraine treatment. NO synthase (NOS) inhibition is an innovative therapeutic principle. Areas covered: This paper reviews the rationale underlying NOS inhibition in migraine treatment. It also provides a review on the efficacy and safety data for NOS inhibitors (nonselective NOS inhibitor L-N(G)-methyl-arginine hydrochloride [L-NMMA], selective inducible NOS [iNOS] inhibitors GW273629 and GW274150, combined neuronal NOS [nNOS] inhibitor and 5-HT1B/1D receptor agonist NXN-188) in acute or preventive migraine treatment. Expert opinion: The data highlighted herein, from four placebo-controlled trials and 1 open-labeled clinical trial using 4 different NOS inhibitors on a total of 705 patients, provide convincing efficacy data only for the nonselective NOS inhibitor L-NMMA. Unfortunately, this NOS inhibitor raises cardiovascular safety concerns and has an unfavorable pharmacokinetic profile. As experimental studies predicted, iNOS inhibitors are ineffective in migraine. Still, upcoming selective nNOS inhibitors are a hope for migraine treatment, with the nNOS isoform being most clearly involved in trigeminovascular transmission and central sensitization. Future studies should help to clarify whether NOS inhibition is equally fruitful in acute and preventive treatment. It should also clarify if nNOS inhibition holds promise as a therapeutic tool for the treatment of chronic migraine and other forms of headache.
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The Sassanid Empire in Persia (224-637 AD) ruled one of the most influential eras in world history. They with the Romans and later the Byzantines were two global powers in ancient times. Medicine was well organized in the official Sassanid system. Hospitals, medical centers, and universities were developed throughout Persia during their reign. This study brings to light for the first time the era's medical views on the heart and blood, based on extant Sassanid Pahlavi manuscripts and documents. Although these documents are non-medical texts (because Sassanid medical texts were destroyed in attacks on Iran by neighboring powers, such as Alexander the Macedonian and leaders of the Arab Empire throughout history), some novel theories on the history of cardiology can be found among them. Physicians of that time made a preliminary description of pulmonary circulation. They knew about the role of blood circulation in feeding bodily organs. They believed that blood is a factor for spreading infection because of its invisible monsters (divan). Their beliefs can be considered as the first theories on infection due to an external living factor, today known as the microbe. Other Sassanid beliefs and findings about the heart and blood in medicine are described in this review.
Article
Migraine is a common form of headache that is a major burden for patients who often seek emergency care. The goal of this study was to compare the effectiveness of intravenous non-steroidal anti-inflammatory medication (dexketoprofen) with paracetamol (acetaminophen) in the treatment of an acute migraine attack. This prospective, randomised, double blind, controlled study was conducted in a tertiary care emergency unit. Study patients were randomised into two groups to receive either 50 mg of dexketoprofen trometamol or 1000 mg of paracetamol intravenously by rapid infusion in 150 mL of normal saline. Pain reduction was measured at baseline, and after 15 and 30 min, using a Visual Analogue Scale (VAS)) as the primary outcome. VAS is a measurement tool ranging from 0 (no pain) to 100 mm (worst pain). 200 patients were included in the final analysis. Mean (SD) age of the study subjects was 30.1±11 years and 81% (n=162) were women. Median reduction in VAS score at 30 min was 56 (IQR 30-78.5) for the paracetamol group and 55 (IQR 34-75) for the dexketoprofen group, with a difference of 1 mm (95% CI -7 to 10) between the two groups. Intravenous paracetamol and dexketoprofen appear to produce equivalent pain relief for migraine in the emergency department. NCT01730326.
Article
Migraine is a common and highly disabling neurological disorder. Despite the complexity of its pathophysiology, substantial advances have been achieved over the past 20 years in its understanding, as well as the development of pharmacological treatment options. The development of serotonin 5-HT1B/1D receptor agonists ("triptans") substantially improved the acute treatment of migraine attacks. However, many migraineurs do not respond satisfactorily to triptans and cardiovascular co-morbidities limit their use in a significant number of patients. As migraine is increasingly considered to be a disorder of the brain, and preclinical and clinical data indicate that the observed vasodilation is merely an epiphenomenon, research has recently focused on the development of neurally acting compounds that lack vasoconstrictor properties. This review highlights the most important pharmacological targets for which compounds have been developed that are highly likely to enter or have already advanced into clinical trials for the acute and preventive treatment of migraine. In this context, preclinical and clinical data on compounds acting on calcitonin gene-related peptide or its receptor, the 5-HT1F receptor, nitric oxide synthase, and acid-sensing ion channel blockers are discussed.
Article
To assess the influence of triptan or nonsteroidal anti-inflammatory drug (NSAID) use on the likelihood of developing chronic migraine (CM) among persons with episodic migraine (EM). CM is common in tertiary headache care, and relative to EM, CM is associated with a number of deleterious outcomes, including higher headache-related disability, reduced health-related quality of life, and increased direct and indirect costs. Symptomatic medication use has emerged as an important risk factor for the development of CM. Limited evidence based on a single year of follow up suggests that the association between NSAID and triptan use with the onset of CM varies in a dose-dependent manner that interacts with headache frequency. However, this interaction has never been explicitly studied. Herein, we evaluate results from a large-scale, 5-year, population-based observational study to characterize these relationships and test the hypothesis that NSAID use may modify the effect of triptan use on CM onset. In the American Migraine Prevalence and Prevention (AMPP) study, 11,249 participants had EM in 2005 and provided up to 5 years of annual follow-up data. We analyzed the characteristics of persons with EM 1 year that predicted new onset CM in the subsequent year, focusing on treatment with NSAIDs and triptans as exposures. These adjacent years of data provide the basis for analysis and are termed "couplets." Repeated measures logistic regression with a subject-specific random intercept was used to model the likelihood of transition from EM to CM as a function of NSAID or triptan dose while controlling for a number of covariates including headache features, use of other medications, and the number of couplets per individual. The analysis included 9031 individuals with EM contributing up to 5 years of data and up to 4 couplets each. Results indicated that on average, 55% of the participants used NSAIDs in any given year and 2% transitioned to CM over subsequent years. Among the 20% using triptans, 3% per year transitioned to CM. Among persons with less than 10 headache days per month, frequency of NSAID use was associated with dose-dependent reductions in risk of CM onset. Among those with 10-14 headache days per month, increasing days per month of NSAID use was associated with increasing risk of CM onset. Increasing days per month of triptan use was associated with increased risk of transitioning to CM. Combination use of NSAIDs and triptans was not protective against transition to CM, but was also not statistically significantly associated with increased risk of CM onset. Triptan use in EM is associated with an increased risk of CM onset that increases with days of medication use. For NSAIDs, effects depend on headache days per month. NSAIDs are protective in individuals with less than 10 headache days per month but associated with increased risk with 10 or more headache days per month. Combining a triptan and NSAID was not associated with a statistically significant increased risk of CM onset, whereas increased risk of CM onset was significantly associated with triptan monotherapy.
Article
"Ergot alkaloids (ergotamine, dihydroergotamine) are used in patients with frequent, moderate migraine, but are less effective than triptans" [1] .
Article
(−)-α-bisabolol was found to form an inclusion complex with β-cyclodextrin (β-CD) in solution as well as in the solid state. To investigate molecular associations of β-CD with pure (−)-α-bisabolol or (−)-α-bisabolol as a component of camomile essential oil, phase solubility studies were undertaken. A Bs type solubility with an apparent complex constant of 273 M−1 for the pure (−)-α-bisabolol and 304 M−1 for (−)-α-bisabolol as a constituent of the essential oil were obtained. The two curves in the phase solubility diagram reach their plateau at different concentrations of (−)-α-bisabolol, 7.04×10−4 M for the pure substance and 2.88×10−4 M for the substance as a component of the essential oil. Although the shapes of the curves are almost similar, the intrinsic solubility's of pure (−)-α-bisabolol (4.85×10−4 M) and (−)-α-bisabolol as a component of the essential oil (1.82×10−4 M) differ significantly. An inclusion complex having a stoichiometric composition of 2:1 (β-CD: drug) was obtained. A mechanism of complexation has been proposed on the basis of the stability constant calculated from phase solubility data and the stoichiometric ratio of the solid state complexation.
Article
Background: Risk factors for suicide are at least partially heritable and functional polymorphisms of targeted genes have been suggested to be implicated in the pathogenesis of this phenomenon. However, other studies examining the association between specific gene variants and suicide revealed inconsistent findings. We aims to evaluate the possible association between MAO-A3, CYP1A2*1F and GNB3 gene variants, hopelessness and suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation. Methods: 56 women were genotyped for MAO-A3, CYP1A2*1F and GNB3 gene variants. Participants were also assessed using Beck Hopelessness Scale (BHS), the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A), and the Suicidal History Self-Rating Screening Scale (SHSS). Results: Patients with higher total scores on affective dysregulated temperaments are more likely to have higher BHS (11.27+/=5.54 vs. 5.73+/=3.81; t19.20 = -3.57; p < 0.01) and higher SHSS total scores (4.79+/=3.31 vs. 1.05±2.31; t17.74 = -3.90; p < 0.001) than those with lower total scores. 67% of patients in the dysregulated group has BHS total scores >= 9 indicating high levels of hopelessness. No association was found between MAO-A3, CYP1A2*1F and GNB3 gene variants and suicidal risk as assessed by BHS and SHSS. Conclusions: This study did not sustain the association between MAO-A3, CYP1A2*1F and GNB3 gene variants and increased suicidal risk in patients with chronic migraine and affective temperamental dysregulation. Further studies investigating the gene-environment interaction or focusing on other genetic risk factors involved in suicidal behaviour are needed.
Article
With a better and more diverse armamentarium than ever before, physicians can now select migraine therapy to satisfy the preferences of migraine sufferers, provided physicians understand what migraineurs want from therapy. To determine patient preferences and priorities, individuals with migraine were identified by a random-digit telephone survey during 1998. These individuals were polled regarding their consultation practices, treatment preferences and priorities, and factors affecting their satisfaction with migraine care. At a subsequent satellite symposium at a meeting of the American Association for the Study of Headache (AASH), attendees were asked to predict the responses of migraine sufferers; responses of migraine sufferers and health care professionals attending the meeting were then compared. Of the 688 migraine sufferers identified in the telephone survey, 46.7% currently consulted physicians regarding migraine, while 20.6% had consulted at some time but not during the past year, and 32.3% had never consulted a physician regarding migraine. While most (77%) patients were satisfied or very satisfied with current medications, those who were not completely satisfied complained that pain relief took too long (87%), was inconsistent (84%), or that the pain recurred (71%). Only 35% complained of side effects. The three most important attributes of a migraine medication (according to migraine sufferers) were complete relief of pain (87%), lack of recurrence (86%), and rapid onset of pain relief (83%). The majority of migraine sufferers preferred an oral tablet or capsule as a first-choice route of administration (73%) and an oral, rapidly dissolving tablet as a second-choice route (51%). Attendees of the AASH meeting closely anticipated these patient responses about medications. The physician attribute most highly valued by patients was willingness to answer questions (86%), which was not anticipated by AASH attendees.
Article
Antiinflammatory compounds in the diet can alleviate excessive inflammation, a factor in the pathogenesis of common diseases such as rheumatoid arthritis, atherosclerosis and diabetes. This study examined three European herbs, chamomile (Matricaria chamomilla), meadowsweet (Filipendula ulmaria L.) and willow bark (Salix alba L.), which have been traditionally used to treat inflammation and their potential for use as antiinflammatory agents. Aqueous herbal extracts and isolated polyphenolic compounds (apigenin, quercetin and salicylic acid, 0-100 μM) were incubated with THP1 macrophages, and interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α) were measured. At concentrations of 10 μM, both apigenin and quercetin reduced IL-6 significantly ( p < 0.05). Apigenin at 10 μM and quercetin at 25 μM reduced TNF-α significantly ( p < 0.05). Amongst the herbal extracts, willow bark had the greatest antiinflammatory activity at reducing IL-6 and TNF-α production. This was followed by meadowsweet and then chamomile. The lowest effective antiinflammatory concentrations were noncytotoxic (MTT mitochondrial activity assay). The Comet assay, which was used to study the protective effect of the isolated phenols against oxidative damage, showed positive results for all three polyphenols. These are the first findings that demonstrate the antiinflammatory capacity of these herbal extracts. Copyright © 2012 John Wiley & Sons, Ltd.
Article
Osteoarthritis (OA) is a major disability of elderly people. Sesamin is the main compound in Sesamun indicum Linn., and it has an anti-inflammatory effect by specifically inhibiting Δ5-desaturase in polyunsaturated fatty acid biosynthesis. The chondroprotective effects of sesamin were thus studied in a porcine cartilage explant induced with interleukin-1beta (IL-1β) and in a papain-induced osteoarthritis rat model. With the porcine cartilage explant, IL-1β induced release of sulfated-glycosaminoglycan (s-GAG) and hydroxyproline release, and this induction was significantly inhibited by sesamin. This ability to inhibit these processes might be due to its ability to decrease expression of MMP-1, -3 and -13, which can degrade both PGs and type II collagen, both at the mRNA and protein levels. Interestingly, activation of MMP-3 might also be inhibited by sesamin. Moreover, in human articular chondrocytes (HACs), some pathways of IL-1β signal transduction were inhibited by sesamin: p38 and JNK. In the papain-induced OA rat model, sesamin treatment reversed the following pathological changes in OA cartilage: reduced disorganization of chondrocytes in cartilage, increased cartilage thickness, and decreased type II collagen and PGs loss. Sesamin alone might increase formation of type II collagen and PGs in the cartilage tissue of control rats. These results demonstrate that sesamin efficiently suppressed the pathological processes in an OA model. Thus, sesamin could be a potential therapeutic strategy for treatment of OA.
Article
The phenolic component of freeze-dried olive fruit was fractionated by high-performance liquid chromatography using ultraviolet, atmospheric pressure chemical ionisation (APCI) and electrospray ionisation (ESI) detection. The fractions together with several standards were tested for antioxidant activity in an aqueous and a lipid system. The negative ion mode of APCI and ESI showed less fragmentation than positive ion mode. The latter was generally more useful in obtaining fragmentation data and hence structural information. Some olive phenolics notably tyrosol exhibited a low ionisation efficiency in both APCI and ESI. There was no simple relationship between antioxidant activity and chemical structure. The ranking of antioxidant activity was strongly dependent on both the test system and on the substrate demonstrating the need to examine activity in both aqueous and lipid systems. Significant antioxidant activity was seen in most olive fractions and this was related to phenolic content. The kinetics of the oxidation process are complex and suggest that multiple pathways may be involved at different antioxidant concentrations.
Article
Knee osteoarthritis is the most common cause of disability among people and it is a common disease of joints that can lead to cartilage damage. In this study the analgesic effects of a herbal ointment containing cinnamon, ginger, mastic (Saghez) and sesame oil is compared with Salicylate ointment in patients suffering from knee osteoarthritis. It was a double-blind randomized controlled trail study. Patients with diagnosed arthritis were involved in the study and they were divided in two groups via block randomization method. For six weeks, twice a day, intervention group applied herbal ointment and control group used Salicylate ointment. The severity of pain, morning stiffness and limited motion were measured using Visual Analog Pain Scale. In order to analyze the trends of these three indexes, repeated measurement test was used. Ninety two participates with the mean age of 52.2 (+/- 12.4) years and with the mean disease period of 30.45 (+/- 30.3) months were involved in the study. There was no significant difference between two groups regarding the distribution of sex, weight, height, BMI and the duration of illness. No statistical difference was observed between two groups regarding pain relief, morning stiffness and limited motion; nevertheless in repeated measurements during second, forth and sixth weeks in both groups the decreasing trend of these three indexes had been statistically significant (p < 0.0001). It seems that using this herbal combination is clinically effective for patients suffering from knee osteoarthritis in order to decrease their pain, morning stiffness and limited motion; its effect is comparable with Salicylate ointment.
Article
To evaluate the efficacy and safety of transdermal sumatriptan in migraine patients who have baseline nausea. Migraine-associated nausea and vomiting can limit the effectiveness of acute treatment with oral agents by causing delays, avoidance, or incomplete absorption of medication due to post-dose vomiting. In a multicenter, randomized, double-blind, placebo-controlled study in adult (aged 18-66 years) migraineurs, 530 patients were randomized to receive transdermal sumatriptan or a placebo patch and remained in the study until they had treated a single moderate to severe migraine attack or had gone 2 months without treatment. At baseline (before applying the study patch), patients recorded headache pain intensity and the presence or absence of migraine-associated symptoms, including nausea. The use of analgesic or anti-emetic rescue medications within 2 hours of patch activation was prohibited. Post-hoc analyses were conducted to assess the proportion of patients with nausea at baseline who experienced headache relief and who were free from nausea, photophobia, and phonophobia at 1 and 2 hours post-activation. A total of 454 patients were included in the intent-to-treat population for efficacy analyses. Baseline demographic and migraine headache characteristics were generally similar between the treatment groups. In the overall study population, transdermal sumatriptan was significantly superior to placebo at 1 hour post-activation for pain relief (29% vs 19%, respectively; P < .0135) and freedom from nausea (71% vs 58%, respectively; P < .05) and at 2 hours post-activation for freedom from pain (18% vs 9%, respectively; P < .009), pain relief (53% vs 29%, respectively; P < .0001), freedom from nausea (84% vs 63% respectively; P < .001), freedom from photophobia (51% vs 36%, respectively; P < .0028), freedom from phonophobia (55% vs 39%, respectively; P < .0002); and freedom from migraine (16% vs 8%, respectively; P < .0135). In the post-hoc analysis, transdermal sumatriptan was markedly superior to placebo for pain relief and freedom from pain, nausea, photo-, and phonophobia at 1 and 2 hours post-activation. Transdermal sumatriptan is superior to oral triptans for migraine patients whose baseline nausea causes them to delay or avoid acute treatment.
Article
SUMMARY: Migraine is a common, multisymptom disorder that can severely impact the daily activities of migraineurs. Triptans (primarily sumatriptan) are the most commonly prescribed treatment for migraine and are considered a relatively safe and effective initial therapy. Unfortunately, current sumatriptan formulations (i.e., oral, nasal, subcutaneous) may be associated with limitations that can result in patients' delaying or avoiding treatment. For oral formulations, these limitations include difficulty in taking an oral medication due to the nausea and vomiting that often accompany migraine, and inconsistent absorption, whereas nasal and subcutaneous formulations may be associated with low bioavailability and an undesirable rate of adverse events, respectively. An alternative to current formulations is transdermal drug delivery, particularly iontophoresis. Transdermal delivery has several advantages over current formulations, including avoidance of the gastrointestinal tract, controlled and sustained delivery, and convenient administration. This article reviews the in vitro, in vivo, and preclinical data supporting the use of iontophoresis for the delivery of sumatriptan, as well as the recent clinical data for Zelrix (NuPathe Inc., Conshohocken, PA), an iontophoretic sumatriptan patch currently in phase III development for the treatment of migraine.
Article
Inducible cyclooxygenase (COX-2) has been implicated in the process of inflammation and carcinogenesis. Chamomile has long been used in traditional medicine for the treatment of inflammatory diseases. In this study we aimed to investigate whether chamomile interferes with the COX-2 pathway. We used lipopolysaccharide (LPS)-activated RAW 264.7 macrophages as an in vitro model for our studies. Chamomile treatment inhibited the release of LPS-induced prostaglandin E(2) in RAW 264.7 macrophages. This effect was found to be due to inhibition of COX-2 enzyme activity by chamomile. In addition, chamomile caused reduction in LPS-induced COX-2 mRNA and protein expression, without affecting COX-1 expression. The non-steroidal anti-inflammatory drug, sulindac and a specific COX-2 inhibitor, NS398, were shown to act similarly in LPS-activated RAW 264.7 cells. Our data suggest that chamomile works by a mechanism of action similar to that attributed to non-steroidal anti-inflammatory drugs. These findings add a novel aspect to the biological profile of chamomile which might be important for understanding the usefulness of aqueous chamomile extract in the form of tea in preventing inflammation and cancer.
Article
The most important primary headaches (i.e. independent disorders that are not caused by another disease) are migraine, tension-type headache and cluster headache. All primary headaches are in need of better treatments. Migraine has a prevalence of 10% in the general population and its societal costs are high. Although the precise mechanisms underlying the pathophysiology of migraine are still elusive, the last decades have witnessed some progress (e.g. involvement of serotonin, calcitonin gene-related peptide, nitric oxide, etc). Nitric oxide (NO) is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also involved in nociceptive processing. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so called delayed headache that fulfils criteria for migraine without aura in migraine sufferers. Blockade of nitric oxide synthases (NOS) by L-NMMA effectively treats attacks of migraine without aura. Similar results have been obtained for chronic tension-type headache and cluster headache. Inhibition of the breakdown of cGMP also provokes migraine in sufferers, indicating that cGMP is the effector of NO-induced migraine. Several relationships exist between NO, calcitonin gene-related peptide and other molecules important in migraine. Also ion channels, particularly the K(ATP) channels, are important for the action of NO. In conclusion, inhibition of NO production or blockade of steps in the NO-cGMP pathway or scavenging of NO may be targets for new drugs for treating migraine and other headaches. Indeed, selective n-NOS and i-NOS inhibitors are already in early clinical development.
Article
Aroxyl radicals of fifteen structurally distinct flavonoids were generated by attack of azide radicals (N3.) on the parent compounds dissolved in aqueous solution at pH 11.5. Generation rate constants were all found to be very high (2.4-8.8 x 10(9) dm3mol-1 s-1), whereas the decay rates differed considerably, ranging from 10(5) to 10(8) dm3mol-1 s-1. In most cases the spectral characteristics of the transient aroxyl radicals relate to structural features of the parent compounds and according to spectral similarities they can be classed in three distinct groups (with only two exceptions). Although the data do not conclusively prove that the biological function of flavonoids might be the scavenging of radicals, the very high rate constants of formation and the relative stability of some of the aroxyl radicals, are in support of such a hypothesis.
Article
Health risks posed by dermal contact with PCB-contaminated porous surfaces have not been directly demonstrated and are difficult to estimate indirectly. Surface contamination by organic compounds is commonly assessed by collecting wipe samples with hexane as the solvent. However, for porous surfaces, hexane wipe characterization is of limited direct use when estimating potential human exposure. Particularly for porous surfaces, the relationship between the amount of organic material collected by hexane and the amount actually picked up by, for example, a person's hand touch is unknown. To better mimic PCB pickup by casual hand contact with contaminated concrete surfaces, we used alternate solvents and wipe application methods that more closely mimic casual dermal contact. Our sampling results were compared to PCB pickup using hexane-wetted wipes and the standard rubbing protocol. Dry and oil-wetted samples, applied without rubbing, picked up less than 1% of the PCBs picked up by the standard hexane procedure; with rubbing, they picked up about 2%. Without rubbing, saline-wetted wipes picked up 2.5%; with rubbing, they picked up about 12%. While the nature of dermal contact with a contaminated surface cannot be perfectly reproduced with a wipe sample, our results with alternate wiping solvents and rubbing methods more closely mimic hand contact than the standard hexane wipe protocol. The relative pickup estimates presented in this paper can be used in conjunction with site-specific PCB hexane wipe results to estimate dermal pickup rates at sites with PCB-contaminated concrete.