فهرست مطالب فتانه هاشم دباغیان

Clinical education is one of the most important parts of training courses in the field of medicine and studies show many challenges in this field. This study was conducted to find the experiences of Persian medicine students in the field of ambulatory education in Iran University of Medical Sciences.

This qualitative study was conducted in 1400 using a content analysis approach. The Ph.D. students of Persian medicine were selected using a purposeful sampling with maximum diversity, and their experiences from ambulatory training were collected using a semi-structured interview method. Finally, the text of the conducted interviews was read several times and subjected to content analysis.

After interview with 15 students and saturating the data, three main categories including "educational program", "teaching methods" and "educational facilities" were identified. The main issues were related to educational planning and the characteristics and ability of teachers in teaching.

The experiences of the students showed that the educational program and objectives of the ambulatory education need to be improved, so that in order to manage common diseases, in addition to enriching the theoretical period, more patients should be introduced and discussed in the practical period in the presence of teachers. Also, more variety of patients, unification of diagnosis and treatment methods of teachers and optimization of the clinic environment are necessary.

The Amygdalus communis L. var. Amara (bitter almond) kernel oil (ACKO) is used topically for palliation of musculoskeletal and joint pains in the Traditional Persian Medicine. Also, it had anti-inflammatory effects in experimental studies.

Evaluation of the efficacy and safety of ACKO in the symptomatic treatment of knee osteoarthritis.

One hundred and fifty six patients were equally randomized to apply ACKO, diclofenac, or placebo to their knees every 8 hours for 1 month. Fifty two, 50, and 51 patients in the ACKO, diclofenac, and placebo groups, respectively, finished the trial. At the trial’s start and end, the symptoms were assessed using the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) questionnaire. Also, hematological, and liver and kidney function tests were performed.

Both ACKO and diclofenac reduced the symptoms significantly more than the placebo (P ˂ 0.001). The percent changes of the WOMAC pain and stiffness scores in the ACKO group were similar to the diclofenac group while the percent changes of the WOMAC function and total scores in the ACKO group were less than the diclofenac group (P ˂ 0.001). ACKO and diclofenac had no significant effect on the blood tests. Moreover, no adverse effect was identified.

Topical ACKO and diclofenac are safe, and superior to placebo in reducing the symptoms of OA. While ACKO is similar to diclofenac in alleviating pain and stiffness, ACKO is less effective than diclofenac in improving the WOMAC total and function scores.

Customer satisfaction with service delivery is one of the evaluation methods that needs to be assessed periodically in every organization. The present study was conducted to investigate patient satisfaction with the services provided in the Persian medicine clinic of Iran University of Medical Sciences.

A total of 280 patients referred to the Persian medicine clinic of Iran University of Medical Sciences (Dec 2021-March 2022) were selected by convenient method and completed the Persian version of the PSQ-18 questionnaire. Data were described and analyzed by SPSS software.

The mean± standard deviation age of the sample was 39.66 (±12.51) years and 176 (62.6%) were female. The most common causes of patient dissatisfaction were the high cost of medications, and the long waiting time. Proper behavior of physicians and the staffs of the clinic, complete examination and spending time for patients were some of the positive points that a large percentage of patients mentioned. In addition, an increase in the score of satisfaction was observed in all domains compared with the previous study in 2013.

The results of the present study showed an appropriate level of client satisfaction in all domains of service delivery in this clinic, and its promotion compared with the previous study.

Although many treatments reduce cough and its complications, cough is still one of the most common and annoying problems of patients who refer to medical centers. Therefore, finding simple and effective treatments is of great interest to the medical community. This study aimed to determine the types of cough and find simple and effective therapies based on Persian medicine (PM).

This research is a kind of narrative review study. Firstly the keyword “soaal” (cough) in authentic Persian medical manuscripts was investigated using Jame Teb software version 1/5 of the Computer Research Center of Islamic Sciences [Noor]. After data gathering, types of coughs and their diagnostic signs and symptoms and appropriate treatments were identified and categorized. Data analysis was done by directed content analysis. Furthermore, some of the common recommendations were discussed from the point of view of conventional medicine.

Based on the results of this study, from the point of view of PM, there are different types of cough, including hot and cold post nasal discharge, hot, cold, humid, dry, cough caused by loud noise or dust, and smoke, cough caused by lung ulcer, swellings, participatory cough, and children's cough. The type is determined based on the patient's clinical symptoms and detailed history. The appropriate treatment is selected based on the type of cough, such as gargling, fumigation, anointment, warm compress with drug, bathtubs, poultice, decoction, cupping, leech, and phlebotomy.

Considering the wide range of treatments mentioned for different types of cough, it seems that using the opinions of PM and paying attention to the type of cough can open a new window for researchers to find new treatments.

Coronaviruses, with single-stranded RNA, are widespread and cause respiratory, gastrointestinal, liver, and neurological diseases. This study aimed to evaluate the effect of Padzahr capsules to control clinical symptoms in patients with COVID-19 in a pilot clinical study.

This is a randomized controlled clinical trial study that was conducted in the summer and autumn of 1400 AD (2021) in Mazandaran province. The statistical population comprised COVID-19 patients based on the Iranian protocol and based on the set criteria. In this study, 68 definitive patients were randomly divided into intervention (Padzahr) and control groups. All patients admitted with COVID-19 in the infectious ward received routine corona treatment drugs, and the intervention group were additionally administered six Padzahr capsules per day (manufactured by NIAK with license number 0385-94). Data were analyzed by SPSS software (version: 17) using the ITT method. The criterion for statistical significance was a value of P less than 0.05.

At the time of admission, there was no significant difference between the two groups in terms of severity of signs and symptoms (p> 0.05); The severity of signs and symptoms during hospitalization did not show a statistically significant difference. At 14-day follow-up, 28 patients in the drug group and 24 patients in the control group responded. Twenty-two patients (78.6%) in the drug group and 11 patients (45.8%) in the control group reported complete improvement of symptoms. No side effects were observed or reported in Padzahr users.

Padzahr caused a decrease in the severity of signs and symptoms of COVID-19 disease, but did not show a statistically significant difference compared to the control group during hospitalization. At follow-up two weeks later, the intervention group had better conditions and fewer symptoms.

Primary dysmenorrhea is painful menstrual cramps without a pathological cause which is more common in reproductive age. According to Persian medicine, the cause of primary dysmenorrhea can be changes in Mizaj (Temperament). This study was performed aimed to evaluate the general temperament and uterine temperament of patients with primary dysmenorrhea.

This descriptive-analytical case series study was performed on 104 female students with primary dysmenorrhea living in the dormitories of Shahid Beheshti University of Medical Sciences of Tehran in 2015-2016. The questionnaire of personal information, general temperament and uterine temperament was completed by the researcher and the frequency of general temperament and uterine temperament was evaluated. Data were analyzed by SPSS software (version 17). Quantitative variables were expressed with mean and standard deviation and frequency of qualitative variables with number and percentage.

The total age range of the samples was 19 to 43 years with a mean of 23.03 ± 3.91 and the mean body mass index of the participants was 22.22 ± 3.06 kg/m2.The results showed that the highest frequency of general temperament in all patients with primary dysmenorrhea was moderate (47.1%) and dry (39.4%). The highest frequency of uterine temperament in all patients with primary dysmenorrhea was cold (91.3%) and wet (73.1%).

According to the results of this study, the highest frequency of general temperament in patients with primary dysmenorrhea was moderate and dry and considering the higher prevalence of cold and wet temperament in the uterus of women with primary dysmenorrhea, it can be said that the presence of this type of distemperament in women can be a predictor of primary dysmenorrhea. Also, by using preventive and therapeutic measures of this distemperament based on traditional medicine texts, it is possible to treat primary dysmenorrhea with a new approach.

Black myrobalan drug, known as “Imam Kazem drug” in Iran, is used by most of Iranian people to prevent and treat the coronavirus disease 2019 (COVID-19). This study aims to investigate the consumption pattern of black myrobalan by people in Qom, Iran and their attitudes towards it.

In this cross-sectional study, 1077 patients referred to health centers in Qom, Iran in 2021 participated. They completed a demographic form and a researcher-made questionnaire assessing the consumption pattern of black myrobalan and people’s attitudes towards this drug. Data were analyzed in SPSS v. 20 software using chi-square test, Fisher test, Spearman correlation test, and logistic regression analysis.

Out of 1018 patients who responded to the questionnaire, 660 (64.8%) were familiar with the drug and 491 (48.2%) had used the drug during the COVID-19 pandemic. Among them, 409 (83.2%) had used the drug for prevention and 166 (33.9%) for treatment of COVID-19. The attitude of participants towards this drug was positive in 515 patients (50.6%). The consumption pattern of black myrobalan was significantly correlated with occupation and attitude of people.  It was found out that 83 patients (16.9%) reported mild side effects following drug use.

A significant percentage of people in Qom city use black myrobalan, and have positive attitude towards it. This requires that its efficacy and side effects be investigated in clinical studies.

Due to the lack of evidence-based medicine (EBM) program in the Persian medicine curriculum, the EBM journal clubs were implemented as a method for teaching EBM and to evaluate its efficacy and satisfaction of participants.   

EBM journal clubs which was designed and implemented in 1398 and 1399 in the school of Persian Medicine of Iran University of Medical Sciences was a combination of an EBM workshop with EBM Journal Clubs, which included designing clinical questions and searching and critically appraising the evidence, and using EBM checklists. The evaluation was performed with a structured researcher-made questionnaire to assess the efficacy of the program, and a non-structured questionnaire to assess the strengths and weaknesses of the program, the expectations, and suggestions of the participants. 

Ten students who participated in more than 70% of sessions believed that the program was effective in conveying EBM concepts (90-100% of participants), but was not effective enough in gaining the ability to use statistical concepts (30% of participants). All of them stated that they need more practice and learning. A qualitative review of the opinions of 16 persons (some of them participated in less than 70% of the sessions) identified the strengths and weaknesses of the program, expectations, and suggestions for future programs. 

EBM journal club is an appropriate method to transfer EBM knowledge; however, to improve the efficacy of the program, other interventions such as mandatory participation of the students, improving the knowledge of masters of Persian medicine about EBM and continuing the program are suggested.

Menstrual bleeding is a reflection of periodic secretion endometrial loss due to decreased estradiol and progesterone production. In traditional medicine, ginger is described as a menstrual blood enhancer. This study was performed with aim to compare the oral and topical effect of ginger on the rate of menstrual bleeding in girls with regular menstruation.

This single-blind randomized clinical trial study was performed on 70 female students living in the dormitory of Shahid Beheshti University in 2016-2017. Subjects were divided into two groups: capsules and ginger oil (n=35 in each group). Both groups consumed the drug for three consecutive menstrual cycles from two days before menstruation until the first three days of menstruation. The Higham chart (PBAC) was used to determine the amount of menstrual bleeding. Data were analyzed by SPSS software (version 17) using Mann-Whitney U and Friedman tests. P< 0.05 was considered statistically significant.

The two groups were similar in terms of bleeding volume at the beginning of the study (P=0.38). The mean volume of bleeding in the first cycle in the ginger capsule group was 104.91 ± 64.01, and reached to 102.26 ± 57.2 in the fourth cycle of intervention, which was not significant (p= 0.8). In the ginger oil group, the mean volume of bleeding in the first cycle was 92.8 ± 46.44 and in the fourth cycle 101.88 ± 71.14, which was not significant (p= 0.4).

Ginger oil was not different from ginger capsules in the amount of menstrual bleeding in girls with regular menstruation; ginger oil and ginger capsule alone did not affect menstrual bleeding.