فراز مجاب

One of the medical interventions in childbirth is episiotomy which is used to widen the pelvic outlet. The pain resulting from episiotomy affects mother's quality of life. Malva sylvestris L is one of the oldest medicinal plants that have pain relief properties due to its flavonoids and phenolic compounds. The present study was performed with aim to determine the effect of Malva sylvestris L ointment on intensity of pain episiotomy wound in primiparous women.

This triple-blind randomized clinical trial study with a control group was conducted on 92 primiparous women (43 in Malva sylvestris L group and 49 in placebo group) referred to Mahdieh Hospital in Tehran in 2022-2023. After delivery, a fingertip-sized amount of ointment was prescribed for local application to the episiotomy incision twice daily for 10 nights for both study groups. Data collection tools included the demographic questionnaire, midwifery characteristics checklist, and visual pain assessment scale (VAS). Data analysis was performed using SPSS statistical software (version 27) and chi-square, independent t and Fisher's exact tests. P<0.05 was considered statistically significant.

No statistically significant differences were found between the Malva sylvestris L and placebo groups regarding demographic characteristics, obstetric and health status prior to the intervention (P>0.005). There was no statistically significant difference between the two groups regarding the intensity of pain scores before the intervention (P=0.809). The mean pain score in the Malva sylvestris L group on the fifth day and the tenth day had a statistically significant difference with the placebo group (P<0.001).

Malva sylvestris L extract ointment reduces the pain of episiotomy wound in primiparous women.

Breast fissure is a disorder during breastfeeding that causes the lack of successful breastfeeding. Considering its high prevalence and due to the anti-inflammatory properties of ostrich oil, this study was conducted with aim to compare the effect of ostrich oil and breast milk on the improvement of breast fissures in lactating primiparous women.

This clinical trial study was conducted on 106 lactating primiparous women in 2022-2023. Mothers were divided into two groups of ostrich oil and breast milk (n=53 in each group). After teaching the correct method of breastfeeding, they continued the treatment 3 times a day for one week. In the intervention group, lactating women covered the nipple and the surrounding area with ostrich oil, and in the control group with their breast milk, for one consecutive week. The intensity of pain and nipple fissure score were recorded by the researcher based on the quality of visual analogue and the result of Store. Data analysis was done using SPSS statistical software (version 25) and independent t-test, paired t-test, chi-square, analysis of variance with repeated data and Fisher's exact tests. P<0.05 was considered statistically significant.

The mean nipple pain before the intervention was not significant in the two groups (p=0.659), but there was a statistically significant difference between the two groups on the 7th and 10th days after delivery (p<0.001). There was a significant difference in the severity of nipple damage before and after the intervention in the two groups (p<0.001); So that the severity of damage in the ostrich oil group was higher before the intervention and less during the 7 days of treatment.

Ostrich oil improves breast fissures and reduces nipple pain.

According to the high prevalence of primary dysmenorrhea and its consequences on the quality of life and the effects of nonsteroidal anti- inflammatory drugs consumption, the present study was performed with aim to investigate the effect of the capsella bursa-pastoris on the severity of primary dysmenorrhea.

This triple-blind clinical trial study was conducted in 2022 on 80 girls referred to the comprehensive health service centers of Kermanshah University of Medical Sciences with a history of primary dysmenorrhea. The participants were divided into two groups of 40 people, intervention and control. The intervention group received capsules containing 400 mg of hydroalcoholic extract of the "Capsella bursa pastoris" plant and the control group received 250 mg capsules of mefenamic acid every 8 hours for 3 days for 2 consecutive periods. The research tools were demographic profile questionnaire, menstrual status and physical activity questionnaire, and visual analog scale. Data were analyzed by SPSS software (version 19) and independent t-tests, chi-square, Bonferroni and analysis of variance with repeated measures. P<0.05 was considered statistically significant.

Before the intervention, the two groups were similar in terms of pain intensity (p=0.689). The two-factor variance test showed that the two groups had a significant difference in terms of pain intensity after the intervention (p=0.001), but the reduction of pain was more in the capsella bursa-pastoris group.

The Capsella bursa-pastoris plant can reduce the severity of primary dysmenorrhoea; Therefore, it is recommended to conduct more researches to confirm the effectiveness and safety of the Capsella bursa pastoris plant.

The efficacy of common antibiotics has been hindered by the emergence of drug resistance, including multidrug resistance (MDR). As a result, there is a growing interest in exploring alternative treatments for drug-resistant infections. One promising avenue is the use of herbal medicine, which possesses antimicrobial properties and may serve as a viable supplement or alternative to conventional antibiotics.

This study aimed to determine the effectiveness of plant essential oils in Iran against drug-resistant bacteria.

In this systematic review, we searched for keywords including herbal medicine, essential oil, Acinetobacter spp, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus species in Scopus, PubMed, Web of Science, and internal databases. Articles published up to October 4, 2023, were considered without any time limit.

The results showed that the majority of studies conducted were related to thyme, and the most tested bacterial species were methicillin-resistant Staphylococcus aureus (MRSA) strains. Thyme exhibited the highest antibacterial activity, with the lowest minimum inhibitory concentration (MIC) equal to 0.31 µg/ml, followed by Oliveria decumbens with a MIC of 0.625 µg/ml.

Herbal medicines may offer an efficient treatment option for antibiotic-resistant bacteria. However, further studies are needed to investigate potential adverse effects, antibacterial properties, and possible synergistic effects with other medicinal plants.

Episiotomy is one of the common methods used to widen the pelvic outlet, and it is associated with complications such as pain and bleeding. Green tea and Myrtus communis are two medicinal plants with anti-inflammatory and pain-relieving properties. The present study was conducted with aim to investigate the effect of Myrtus communis extract and green tea on pain reduction and episiotomy wound healing.

This three-blind randomized clinical trial study was conducted in 2020-2021 on 90 primiparous women referred to the maternity ward of Shushtar Al-Hadi and Ganjovian Dezful hospitals. The samples were randomly treated in groups receiving green tea, Myrtus communis extract ointment and placebo for 14 days. Evaluation of the wound healing status was done with Rida index and pain intensity by VAS. Data analysis was done with SPSS software (version 23) and Mann-Whitney and Friedman tests. P<0.05 was considered statistically significant.

There was a significant difference among the three investigated groups in the Rida index on the 14th day, and this index was lower in the Myrtus communis group than in the green tea group and the placebo group (P=0.001). VAS index on the 14th day had a significant difference among the three investigated groups, and this index was lower in the Myrtus communis group than in the green tea group and the placebo group (P=0.001).

The use of Myrtus communis ointment and green tea extract can reduce pain intensity and improve heal episiotomy wound, and it seems that the effect of Myrtus communis ointment is more than green tea ointment and placebo.

Herbal teas can be used for various therapeutic or nutritional purposes, depending on the chemical constituents. Quality control of products containing medicinal plants is important. Today, consumers' desire for herbal teas that have good aroma, taste and sensory properties is increasing. Herbal tea ingredients include one or more herbal species that are combined to improve taste and increase health. Quality control of herbal teas, like other nutritional supplements, is important to ensure safety and efficacy. Current methods are chromatography-based and require sample preparation. In some countries, researchers have used the ultra spectral imaging method as a fast and non-destructive method for quality control of medicinal plants and herbal teas. In this research, the quantitative and qualitative control of five herbal tea bags including Chamomile, Fennel, Lavender, Spearmint and Thyme were conducted. In terms of the kind of the plant, the ash content, the essential oil and their active substance were determined. Microscopic tests were carried out to ensure the type of plant, total ash and acid-insoluble ash were done with the method introduced in the references. Extraction of essential oils was done by water distillation and analysis of essential oil and determination of the major compounds was done by gas chromatography (GC). The essential oil of each sample was diluted with normal hexane solvent at a ratio of 1 to 10 and injected into the gas chromatography with the following information: Agilent 7890A GC device, injection temperature 250°C, thermal programming 60-220°C, column type HP-5MS, nitrogen as carrier gas, flow intensity 2 ml/min, temperature increase speed 6°C per minute, column length 30 meters, internal diameter 250 microns and FID detector. The ionization voltage was 70 electron volts, the ionization method was EI, and the temperature of the ionization source was 250 degrees Celsius. The temperature program of the column was set as follows: the initial temperature of the oven was 50 °C and stopped at this temperature for 5 minutes, the thermal gradient was 3 °C per minute, the temperature increased to 250 °C and stopped at this temperature for 10 minutes, the temperature of the injection chamber was 290 degree Celsius and the carrier gas was used with a flow rate of 1.1 mm/min.: By micrographic study, compatibility of the herbal contents were confirmed in tea bags with Iranian Herbal Pharmacopoeia (IHP). According to the TLC tests results, Rf values of anethol in Fennel essential oil, linalool and linalyl acetate in Lavender essential oil, thymol and carvacrol in Thyme essential oil and carvone in Mint were 0.88, 0.3, 0.75, 0.55 and 0.5 respectively. Chamomile sample had not essential oil. The total ash and acid-insoluble ash were respectively 1% and 8% for fennel, 5% and 13% for lavender, Were2.03 % and 7.5%, respectively for chamomile, 2.5% and 8% for Spearmint and 1% and 11% for Thyme. Based on GC analysis, amount of anethole in the essential oil of fennel, carvone in Spearmint essential oil, thymol in Thyme essential oil and linalool in Lavender essential oil were 0.098, 0.621, 0.019, 0.164 gr/ ml respectively.Discussion and In recent years, people's approach to medicinal plants and their products has increased. Every year, 50% are added to people who turn to the use of medicinal plants. Participating in such a large market and creating and developing the herbal medicine industry requires special attention to the production, processing, quality enhancement, standardization and safety of these products. It should be noted that factors such as the age of the plant, place and time of harvesting, drying method, storage conditions, production process, packaging method, etc. are effective on the quality of the plant and of course its effects, and therefore quality control and standardization are important. Post-harvest processes of the medicinal plants are very important in the production cycle of herbal products. Preservation of color, smell, taste, chemical nature and quality of active substances of medicinal plants has always been important for researchers and many studies have been done in this regard in recent years. Choosing the right method for drying medicinal plants depends on the type of organ, its moisture content and the purpose of drying. Finally, in the newer technologies, the minimization of changes is focused on plant raw materials.According to the results, Rf values were corresponded with standard indicators mentioned in the references. The total ash and acid-insoluble ash of Fennel, Spearmint and Chamomile were also correspond with the values available in Iranian Herbal Pharmacopoeia (IHP) but the mentioned values for Lavender and Thyme were not in compliance with reference. It is recommended to carry out periodic tests on herbal products after entering the market (PMS) to ensure the proper quality of the products. The outcome of this study can help to establish quality parameters for the standardization of herbal teas at the supply level.Keywords: Thyme, Lavender, Chamomile, Fennel, Spearmint, Quality control, Herbal tea

Postpartum hemorrhage is the most leading cause of maternal mortality worldwide; prevention of it can be effective in reducing mortality and complications. Studies have shown the contractile and anti-inflammatory properties of Urtica dioica and its effect on reducing menstrual bleeding, so the present study was performed aimed to determine the effect of Urtica dioica drops on postpartum hemorrhage.

This triple-blind randomized clinical trial study was conducted in 2019 on 100 women referred to Kamali Hospital in Karaj (Iran) for vaginal delivery in two groups of intervention and control. The intervention group received 10 drops of Urtica dioica and the control group received 10 placebo drops after delivery. Bleeding was measured using PBLAC chart up to 24 hours after delivery. Hemoglobin and hematocrit levels were measured at arrival and 6 hours postpartum. Data were analyzed using SPSS software (version 20) and independent t-test, Mann-Whitney, Fisher, Chi-square and repeated measures ANOVA. P<0.05 was considered statistically significant.

There was no statistically significant difference between the two groups in terms of demographic and obstetric variables (p>0.05). The mean of bleeding in the first 24 hours after delivery was 55.94±11.55 ml for the intervention group and 71.48±12.45 ml for the control group, which was significantly different (p=0.001). Also, the mean decrease of hemoglobin (p = 0.006) and hematocrit (p = 0.001) level was significantly lower in the Urtica dioica group than the control group.

Urtica dioica drop have a significant effect on reducing bleeding and reducing hemoglobin and hematocrit after childbirth and is helpful in reducing postpartum hemorrhage.

Sexual function is a part of human life and behavior and is a multidimensional phenomenon that is influenced by a variety of biological, psychological, and social factors. Estradiol is the hormone which is directly related to the level of sexual function. Prevalence of Covid 19 virus causes severe mental and physical stress which may result in reduced sexual function. This study was performed aimed to determine the association between serum estradiol levels and stress score with sexual function in women referred to Shohadaye Yaftabad Hospital (simultaneously with the outbreak of coronavirus).

This correlational study was performed in 2021 on 223 pregnant women aged 18-35 years referred to the gynecology clinic of Shohadaye Yaftabad Hospital (simultaneously with the outbreak of coronavirus). The women underwent venous blood sampling in the follicular phase and then completed the demographic characteristics (including personal information), the Sexual Function Index (FSFI), and the DOS Stress Questionnaire. Data were analyzed using SPSS software (version 21) and Pearson correlation test and one-way analysis of variance. P<0.05 was considered statistically significant.

According to the Pearson correlation test, the mean of the total score of sexual function had a significant inverse correlation with stress (p <0.001, r =0.983). In other words, the more stress reduced the score of sexual function. Also, based on this test, estradiol levels have a positive correlation with sexual function (p =0.001, r = -0.223).

According to this research, the stressful conditions including the coronavirus pandemic resulted in reduction of sexual function and estradiol levels.