فصلنامه طب مکمل
سال نهم شماره 2 (پیاپی 31، تابستان 1398)

Disorders of consciousness are the most common complications after head injury. Patients with traumatic coma, due to their nature, are more likely to show impaired physiological indices. This study aimed to investigate the effect of listening to nature sounds on the level of consciousness and physiological indices in patients with traumatic coma. 60 patients with traumatic coma admitted to the Intensive Care Units (ICUs) of Shohaday-e-Haft-e-Tir Hospital in the city of Tehran, Iran, and Imam Hossein Hospital in the city of Shahroud, Iran, were randomly selected in 2017 to participate in this randomized clinical trial. They were randomly assigned to two groups of control and intervention through randomized block method. The patients in the intervention group listened to nature sounds twice a day (each time for 30 minutes) for two weeks. The level of consciousness of the patients was measured and evaluated using Glasgow Coma scale before and one and two weeks after the intervention. Also, the physiological indices of the patients were examined and recorded immediately, 30 minutes and 2 hours after the intervention on the first day of the intervention. The data were analyzed using SPSS 21 and through independent t-test, repeated measures analysis of variance, Fisher and Chi-squared tests. The number of the patients reaching complete consciousness in the intervention group was more than that in the control group (p=0.001). In the intervention group, immediately after the intervention, the mean pulse, systolic blood pressure and mean arterial pressure were lower than other times. According to these results, listening to nature sounds increased the level of consciousness of the patients, decreased the duration of coma and caused an immediate and short-term decrease in physiological indices.

This study aimed to investigate the effect of garlic supplementation on oxidative stress markers (AST, ALT, LDH, and CPK) following progressive resistance exercise. This research was a double-blind clinical trial with repeated measures. After obtaining informed consent, 20 sedentary females participated in this study (age: 23.15±2.65 years, BMI: 22.93±1.25 kg.m2). They were then randomly assigned to two groups of garlic supplementation (N=10) and placebo (N=10).
After 14 consecutive days of supplementation (500 mg garlic or lactose every 12 hours a day), all the participants performed a progressive resistance exercise protocol. The changes in oxidative stress markers were measured in four phases (before supplementation and before, immediately after and 24 hours after the resistance exercise protocol). The data were analyzed by repeated measures analysis of variance with Bonferroni post hoc test and independent t- test at significance level of P≤0.05. The results showed that the garlic supplementation after resistance exercise significantly decreased some of oxidative stress markers, that is, ALT (p=0.001) and AST (p=0.001). However, other markers (LDH, CPK) did not change significantly. The results of this study showed that the garlic supplementation leads to a decrease in some of oxidative stress markers. Therefore, garlic supplementation may be able to reduce the oxidative stress following the progressive resistance exercise.

Liver dystemperament is one of the main concepts of Iranian Traditional Medicine. However, the significance of its diagnostic criteria is not clear. The purpose of this study is to determine the major and minor diagnostic criteria of liver dystemperament in Iranian Traditional Medicine. This study is a qualitative study based on a hybrid model or a combination of theoretical and empirical studies. At the theoretical stage, 11 books of the main texts of Iranian Traditional Medicine were reviewed and scientific databases were searched by the keywords "liver" and "temperament" (mizaj) in Persian and English. Then, in order to examine the diagnostic method and the importance of each of the criteria, a semi-structured face-to-face interview was conducted with 16 traditional medicine specialists. The data were analyzed through conventional content analysis. Then, the significance and diagnostic priority of each of the symptoms were assessed through a discussion group featuring 10-12 professors. In this study, six major criteria and six minor criteria were identified for hot and cold dystemperament and eight major and ten minor criteria were identified for wet and dry liver dystemperament. This study is the first study to assess the importance of symptoms from the viewpoint of traditional medicine specialists and can be considered as an important step forward in integrating the methods of traditional Iranian medicine in terms of diagnosis and treatment. Further studies, as well as validation of the proposed diagnostic indicators and tools for liver dystemperament, are recommended.

Acupressure is one of the natural methods of labor induction but limited study has been done to evaluate its effectiveness. The aim of this study was to determine the effectiveness of acupressure for the initiation of labor. A randomized clinical trial was carried out at the Ganjavian hospital Dezful-Iran 2010. Eighty nulliparous women with uncomplicated pregnancy, singleton fetus at 40-42 weeks,bishop score  4, without uterine contraction were randomized to acupressure group versus usual medical care(control group). In acupressure group recieve acupressure with special technique at Large Intestine.4 (Hego), Gall Bladder.21(Jianjing) and Spleen.6(Sanynjiao)points. Acupressure to delivery interval, acupressure to active phase interval, Estimate Date of Confinement to delivery time interval and Mean duration of active phase, second and third stages of labor were evaluated in each group. The data were analyzed using the descriptive static, t-test, chi square, fisher test, Kaplan Mayer and Repeated Measure test. Compared to controls, women in the acupressure group tended to be more likely for labor initiation (70% vs. 35%, p=0.002). There was a significant difference among groups about acupressure to delivery interval (p=0.004) and acupressure to active phase interval (p=0.04). Estimate Date of Confinement to delivery time interval was not significant (p=0.06). Mean duration of active phase, second and third stages of labor and mode of delivery was not different in two groups (p0.05). Acupressure increase spontaneous labor and it can reduce delivery time interval.

Inactivity in the people with intellectual disability leads to their impaired motor function. Therefore, the purpose of this study was to investigate the effect of eight weeks of selected corrective-balanced training on motor function of the intellectually disabled students with developmental coordination disorder. This study was a randomized clinical trial with pretest-posttest design. The statistical population of this study included 23 educable intellectually disabled boy student with developmental coordination disorder. They were randomly assigned to two groups of experimental (N=12, average age: 15.75 ± 1. 21 years) and control (N=12, average age: 16.73 ± 1.34 years). Written informed consent forms were obtained from the parents of the students. The experimental group performed the training for eight weeks. In order to assess the flexibility, gait speed, muscular endurance, muscle strength and coordination of the participants, sit and reach, 50-foot walking, sit ups, and timed chair rising tests were used. To analyze the results of this study, dependent-t test and covariance analysis were used at significance level of p≤0.05. The results of this study showed a significant difference the two groups in terms of flexibility (p = 0.01), gait speed (p = 0.006), muscular endurance (p = 0.01), muscle strength and coordination (p = 0.01). The results of this study showed that eight weeks of corrective-balanced training can improve motor function in intellectually disabled students with developmental coordination disorder. Therefore, sports trainers and teachers are advised to use these exercises to improve the motor function of intellectually disabled students.

Pruritus is one of the most common problems in patients with kidney failure. 60-80% of dialysis patients complain of itchy skin for which different therapies have been recommended. Medicinal plants compose a group of these therapies. This study aimed to evaluate the effect of aloe Vera gel on pruritus in hemodialysis patients. This clinical trial was conducted on 60 hemodialysis patients with moderate and severe uremic pruritus in the hospitals affiliated to Arak University of Medical Sciences. The written consent forms were obtained from the patients. The participants were then randomly divided into two groups of 30. The intervention group was treated with Aloe Vera gel twice a day for one month. The control group did not receive any treatment. The patients in both groups recorded their itching twice a day through a visual analog scale. The data before and after the treatment were compared. The data were analyzed by paired t-test and independent t-test through SPSS 17. The mean pruritus before and after the intervention in the group treated by Aloe Vera gel was 5.53 ± 1.73 and 2.03 ± 1.12, respectively (p = 0.001). In the control group, it was 5.96 ± 1.03 and 5.9 ± 0.75 (p = 0.423). Since many drugs used to treat pruritus in dialysis patients are expensive and cause problems such as allergies and drug resistance, it is recommended that these patients use Aloe Vera gel to control their itchy skin condition.

State anxiety is one of the common psychological problems among cancer patients. The aim of this study was to determine the effect of guided imagery on the state anxiety of cancer patients. This randomized, clinical trial study was conducted on 70 cancer patients who were randomly selected from the patients in the cancer ward of Shahid Beheshti Hospital in Kashan in 2019. The participants were assigned to two 35-member groups of intervention and control, filling demographic questionnaires and The State-Trait Anxiety Inventory (STAI). Then, the intervention group received 8 sessions of guided imagery, twice a week for four weeks and again filled out the anxiety inventory. The data were analyzed through SPSS 16 using Chi-square, t-test and ANOVA. and ANCOVA. The results of ANCOVA test showed that there is a significant difference between the groups in the post-test compared to the pre-test. The mean scores of the imagery group in the state anxiety variables significantly decreased in the post-test (54.17±6.82) compared to those in the control group (41.67±6.45). (p<0.001). The results of this study showed that guided imagery can significantly reduce the anxiety symptoms in cancer patients, which can be useful in caring cancer patients while decreasing treatment cost.

Traumatic nipple is among the most common problems of the breastfeeding women which leads to early cessation of breastfeeding. This study aimed to investigate the effect of the peppermint cream on traumatic nipples of breastfeeding women.
Methodes: This double-blind randomized clinical trial was carried out on 84 breastfeeding mothers who had referred to the health centers and Children’s Hospital of the city of Sanandaj, Iran in 2014. The selected participants were randomly assigned to two groups of peppermint cream and placebo (liquid-based moisturizing cream). After obtaining the written informed consents, both groups were trained for proper method of breastfeeding and drug use. Nipple pain was measured using the Store scale while nipple trauma through the Champion scale. The data were analyzed through the Chi-square, Fisher's exact test, independent t- test, Mann-Whitney and Wilcoxon tests. The results showed that the mean scores of nipple pain and nipple trauma were significantly lower in the peppermint cream group compared to those in control group. This safe cream can be used to solve this big problem with breastfeeding. In the peppermint cream group, the mean scores of nipple pain and nipple trauma at third (p<0.001), seventh (p<0.001), and fourteenth (p<0.001) days of the intervention were significantly lower than those in the control group. The mean scores of nipple pain and nipple trauma were significantly lower after the four time periods of intervention in peppermint cream group compared to before the intervention (p<0.05). The result of Mann-Whitney test showed that the mean scores of nipple pain and nipple trauma were not significantly different between the two groups prior to the intervention.