Chronic kidney disease (CKD) impacts approximately 15-20% of adults globally and is identified as an independent risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD is associated with cardiovascular disease (CVD) and poses a threatening condition as it is becoming a major public health concern in connection with metabolic syndrome (1). Due to the connection it has with several metabolic disorders, proteinuria - the detection of proteins excreted in the urine - is gaining prevalence with the increase of chronic diseases such as CKD, diabetes mellitus, hypertension, brain strokes, preeclampsia, cancer, and obesity. Normal urinary protein excretion is less than 150 mg/24 hours and consists mostly of secreted proteins. The normal mean albumin excretion rate (AER) is 5-10 mg/day, with an AER of more than 30 mg/day considered abnormal. Poor kidney and cardiovascular outcomes are caused by structural damage to the glomerular filtration barrier. Proteinuria often manifests clinically in the forms of cachexia, foamy urine, and edema (2). The term Cachexia (kak-ex-ee-a) comes from the Greek words “Kakos” (meaning bad) and “Hexis” (meaning condition). Characterized by a hypercatabolic state that alters the body’s utilization of proteins, carbohydrates, and fats in the context of a chronic inflammatory response, cachexia is defined as the accelerated loss of skeletal muscle and is distinct from ordinary weight loss. What exactly happens in cachexia is still a mystery to scientists due to its complex process that involves several organs and systems in the body. Cachexia manifests in individuals with chronic illnesses, such as cancer, heart failure, cirrhosis, and hepatic or renal failure. Foamy urine is an indicator of protein in the urine (2). Food, when digested by the liver, is converted into secondary metabolites, a collection of substances that are called Humor in PM. The process of food digestion is divided into four stages: gastric, hepatic, vascular, and tissue metabolism. Disturbance in any of these four stages can lead to the production of bad humors and eventually cause diseases, such as su-ol-qonyeh which corresponds to cachexia in terms of clinical symptoms and refers to widespread tissue damage throughout the body caused by chronic diseases, such as heart failure and chronic liver and kidney disease. Su-ol-qonyeh, when advanced, develops into a disease called Estesqua - equivalent to Ascites - which is categorized into different types. As stated in PM resources, these diseases share similar symptoms with proteinuria, such as foam in the urine and edema in various degrees appearing in different organs. In the past, a method of diagnosis used by PM physicians was to examine the patient’s urine in a glass container made in the shape of a human bladder, called a Qarooreh . Foamy urine was seen in the same way in some diseases. By comparing these two points of view, it can be concluded that chronic diseases caused by underlying factors trigger the release of pathogenic mediators and tissue damage. PM states that these predisposing factors are divided into two categories: cold and hot. Treatment and drug selection are based on this division, and the treatment protocols differ for each patient (3). Taking PM into consideration when treating patients, especially those with proteinuria accompanied by weight loss, edema, or ascites, not only helps the process but also provides a basis for further research and improvement in the prevention and control of these diseases.

Introduction:The treatment of male sexual disorders, considering the side effects of chemical drugs, it is more desirable to identify appropriate approaches such as herbal medicines with fewer side effects.The aim of this study was to explain the role of onion (Allium cepa) as a complementary treatment in improving male sexual disorders.Method: This review identified the existing studies from the beginning to 2023 related to the purpose of the article in PubMed, Web of Science, Scopus, Embase, and Google Scholar databases with keywords "Allium cepa, Onion, Male sexual dysfunction, Erectile disorder, Libido, Men's sexual health, and Testosterone".Results: Totally, 17 articles related to the research topic were included in the final review.Onion products (including juice, aqueous extract, skin, ethyl acetate fraction, and seed extract) were used, mostly orally consumed over a period of 10-60 days.Conclusion: Onion through increasing testosterone (with the mechanisms of increasing LH production, antioxidant properties, improving insulin resistance, increasing nitric oxide production, and changing the activity of AMP 5-activated protein kinase) as well as treating erectile dysfunction and on the other hand improving reproductive status with positive effects on sperm (number, survival and motility) and its effects against infectious agents may have positive effects on male reproductive system.Although, there is a lot of evidence that onions can improve male sexual disorders, clinical trials are necessary to confirm this effect of onion in humans.

Introduction: Anxiety is one of the most important symptoms after orthopedic surgery which can have various side effects and negatively affect the process of recovery after surgery. The present study was conducted with the aim of evaluating the effect of Melissa Officinalis tea and Matricaria Chamomilla tea on anxiety of patients after lower limb orthopedic surgery. Methods: This was a randomized controlled trial which was conducted on 96 patients after lower-limb orthopedic surgery in Ayatollah Kashani hospital in Shahrekord, Iran. Patients were selected with convenience sampling method and after obtaining informed consent form, allocated to either Melissa Officinalis, Chamomile or control group. For Melissa Officinalis group, 1g of Melissa tea, for Chamomile group 1g chamomile tea and for control group black tea was prescribed 3 times a day. Participants' anxiety was evaluated using Spielberger's state anxiety inventory, once before interventions and nine times after intervention (after each prescription of tea). The mean score of anxiety before interventions and the mean changes of anxiety score after each step of interventions compared between groups. Data were analyzed with descriptive and analytical statistics using SPSS software. The results of Tukey's post-hoc test showed that after the second step of interventions till the last step, the mean change of anxiety score in Melissa Officinalis and Chamomile group was significantly greater than in the control group (P<0.05). The results of this study show that prescription of Melissa Officinalis and Chamomile tea is effective in reducing anxiety of patients after lower limb orthopedic surgery.

Introduction: Exercise interventions and the consumption of some supplements can lead to changes in some growth and stress factors in sports activities, based on this, the current research investigates and studies the effect of four weeks of Nigella sativa oil supplementation and exercise Aerobic effect on serum levels of cortisol and IGF-I in inactive young women.Methods: The current semi-experimental research was conducted in the form of pretest-post-test and in the field method.For this purpose, a number of 40 inactive young women who were eligible to study at Qom University with age range: 22 4 and BMI: 25 8 participated in the upcoming research by filling out a written consent form.The subjects were randomly divided into four groups: control (9 people), exercise + placebo (10 people), supplement (10 people) and exercise + supplement (11 people).Aerobic training groups performed four weeks of aerobic aerobic training with an intensity of 50 to 80% of the maximum heart rate three sessions a week, and the supplement groups received Nigella sativa oil supplement for four weeks, one capsule of 1000 mg per day after lunch.The control group was not subjected to any training or supplements during four weeks.Statistical analysis was performed by paired t-tests and analysis of covariance at a significance level of P<0.05.All statistical studies and graphs were done using SPSS version 25 and Excel (2007) software.Results: Correlated t results indicated a significant increase in serum IGF-I levels only in the supplement group (P = 0.022) and a significant decrease in serum cortisol levels in the training + supplement group (P = 0.002).The results of inter-group differences in cortisol and IGF-I values did not show significant changes.Conclusions: The combined consumption of Nigella sativa supplement along with aerobic exercise did not have a positive and significant effect on the amount of cortisol and IGF-I.

Letter to the Editor: In response to “The effect of Aromatherapy with Geranium and Lemon Essential Oil on Situational Anxiety and Physiological Indices of Patients after Coronary Angioplasty”

Introduction: Today, pressure ulcers have become one of the serious problems in the treatment and care of patients, which, in addition to delaying the recovery of the patient, imposes a lot of costs on the patient and his family. This research was conducted with the aim of comparing the effect of dressing with aloe vera gel and normal saline on the healing of pressure ulcers in patients hospitalized in the medical centers of Arak city. Methods: In this randomized clinical trial that was conducted in 1400 in Amir al-Mominin and Wali Asr (AS) hospitals in Arak. 60 patients with grade 2 pressure ulcers were selected and after obtaining informed written consent, divided into two experimental and control groups (normal saline) by a simple random method. The intervention group was dressed with aloe vera gel with a diameter of 5 mm, and the control group was dressed with normal saline. After obtaining written informed consent from the two groups, parameters related to the wound were examined on the first, seventh and fifteenth day using the Betts Jensen wound assessment tool. Data were analyzed with SPSS version 17 statistical software and REMANOVA and Chi-2 statistical test. The mean and standard deviation before and on the fifteenth day of aloe vera gel in the intervention group were 30.896 ± 0.518 and 13.658 ± 0.617 respectively and in the control group (normal saline) 31.329 ± 0.381 and ± 0.584 respectively, which had a significant difference on the 15th day, (F=487/512, P = 0.000). Conclusions: Dressing with aloe vera gel accelerated the healing process of pressure ulcer compared to dressing with normal saline; Therefore, due to the absence of side effects, ease of preparation and easy application of aloe vera gel, its use can be useful in healing pressure ulcers.

The Effect of 8 Weeks High-Intensity Interval Training and Portulaca Oleracea Supplement on Serum Level of TAC, MDA, CRP, TNF-α in Rats with Non-Alcoholic Fatty Liver Disease

Objective Royal jelly is a honey bee secretion with beneficial effects on the nervous system. The present study aims to investigate the effects of royal jelly in reducing seizure and anxiety-like behaviors in Syrian rats. Methods This is an experimental study. In the seizure model, 25 male white Syrian rats were randomly divided into five groups: Control, royal jelly 100 mg/kg, royal jelly 200 mg/kg, royal jelly 400 mg/kg, and phenobarbital. After 30 minutes, strychnine was injected to induce seizure in animals. The time of seizure onset, seizure duration, and mortality rate in animals were recorded. In the anxiety model, 35 male white Syrian rats were randomly divided into five groups: Control, royal jelly 50 mg/kg, royal jelly 100 mg/kg, royal jelly 200 mg/kg, and diazepam. Anxiety-like behaviors were examined by using the elevated plus maze (EPM) test. Data analysis was performed using one-way ANOVA, and P&lt;0.05 was statistically significant. Results Royal jelly at doses of 200 and 400 mg/kg delayed the time of seizure onset and reduced the seizure duration compared to the control group (P&lt;0.05). The mortality rate was also reduced after using different doses of royal jelly compared to the control group (P&lt;0.05). Moreover, royal jelly at doses of 50 and 100 mg/kg increased the time spent in the open arms of the EPM platform and the number of entries to the open arms compared to the control group (P&lt;0.05). Conclusion Administration of royal jelly can reduce strychnine-induced seizure and modulate anxiety-like behaviors in rats.

Objective Pain is one of the most common problems after surgery. Various strategies have been used to alleviate it. To achieve the optimal pain management, various analgesics and narcotics are used, despite of having side effects. Numerous sources of Iranian Traditional Medicine have indicated the analgesic effects of lettuce. This study aims to evaluate the effects of lettuce syrup as an adjunctive therapy on pain relief after inguinal hernia surgery. Methods This is a triple-blind clinical trial. Seventy patients candidates for inguinal hernia surgery referred to Valiasr Hospital in Arak, Iran were randomly divided into two groups of intervention and placebo. From 3 days before surgery to after surgery, lettuce and placebo syrup were prescribed separately as well as morphine, if needed. Pain was measured using visual analogue scale (VAS) during recovery and 1, 2, 4, 6, 12 and 24 hours after surgery. The data were analyzed by independent t-test, chi-square test, and repeated measure ANOVA. Results The acute pain level during recovery after surgery significantly decreased in the intervention group compared to the control group. The mean VAS score 24 hours after surgery was 0.68±1.94 in the intervention group and 2.75±8.13 in the control group (P&lt;0.05). Conclusion The use of lettuce syrup as an adjunctive treatment is effective in reducing pain after inguinal hernia surgery.

Objective Traumatic Brain Injury (TBI) is one of the leading causes of death in younger people. It activates neuroinflammatory responses that play an important role in breaking the blood-brain barrier and resulting in brain edema. Various studies have indicated the anti-inflammatory effect and the ability of lettuce extract to reduce oxygen free radicals. Therefore, it is expected to improve the consequences of TBI. Therefore, this study aims to investigate the anti-inflammatory effect of lettuce extract on the outcomes of patients with TBI admitted to the Intensive Care Units (ICUs). Methods This is a randomized clinical trial. Patients were divided into two groups of intervention (n=15) and control (n= 15). In the intervention group, patients received 250 g of lettuce aqueous extract twice a day for 7 days. In the control group, a placebo was administered. For all patients, the levels of inflammatory markers and variables related to the patient outcome were recorded. The data were analyzed in SPSS v.18 software using t-test, Mann-Whitney U test, repeated measures ANOVA, and chi-square test. Results There was no significant difference between the study groups in any study variables (P&gt;0.05). Conclusion Lettuce aqueous extract is not effective in improving the outcomes of patients with TBI in ICUs, which can be due to the small sample size, short study duration, the illness of patients, the influence of confounding factors such as acidosis, and use of different lettuce cultivation method.