Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Smooth muscle relaxant activity of Crocus sativus (saffron) and its constituents: possible mechanisms4754771148110.22038/ajp.2018.11481ENMansoureh GorginzadehEndometriosis and Gynecologic Disorders Research Center, Department of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences0000-0001-7323-2775Mansoureh VahdatEndometriosis Research Center, Hazrat-e-Rasool Hospital,Iran University of Medical Sciences, Tehran, IranJournal Article20180210We praise the article by Mokhtari-Zaer et al. (2015) published in the Avicenna Journal of Phytomedicine on the effects of saffron on smooth muscle activity (Mokhtari-Zaer et al., 2015). It was a well-designed and interesting study on the therapeutic properties of <em>Crocus sativus</em> which is a precious plant cultivated in our country. We do believe that along with all other medicinal effects, saffron or its active constituents, primarily crocin and crocetin, could also have some clinical implications in the gynecology field. Historically and particularly in traditional Persian medicine, saffron has been regarded as an abortifacient agent (Hosseinzadeh and Nassiri-Asl, 2013; Schmidt et al., 2007). Farmer women exposed to saffron had increased rates of miscarriage (Ajam et al., 2014). This could be due to the fact that saffron stimulates uterine contractions. However, in Table 1 of the article by Mokhtari-Zaer et al. (2015), a relaxant effect of saffron on uterine contraction was mentioned (Mokhtari-Zaer et al., 2015). Concerning various components of saffron including crocin, picrocrocin, crocetin, and safranal, each could have different actions on muscular tissue. As an antispasmodic, saffron is used for stomach pain by helping digestion and improving appetite. It also reduces tension and alleviates symptoms of premenstrual syndrome and renal colic (Agha-Hosseini et al., 2008; Moshiri et al., 2006; Kashani et al., 2018). In one study, the impact of saffron on cervical ripening in term pregnant women was evaluated for the first time in the form of a clinical trial (Sadi et al., 2016). They concluded that saffron could induce cervical priming which is a perquisite for vaginal delivery by improving the bishop score. Cervical ripening caused by prostaglandins such as misoprostol or prostaglandin E1 is associated with simultaneous increase in uterine muscle contractility which is apparently in contrast with the effects of saffron as a relaxing agent (Vahdat et al., 2015). In a study by Sadraei et al, the effects of <em>Crocus sativus</em> extracts on uterus contractions were assessed in vitro. Following removal of the uteri of rats, spontaneous rhythmic contractions were induced using potassium chloride (KCL). According to their results, <em>Crocus sativus</em> increased these contractions and showed spasmodic action on muscle fibers (Sadraei et al., 2003). Likewise, in other studies, saffron had stimulatory effects on uterus as a result of myogenic and neurogenic actions resulting in prolonged bleeding, premature birth and abortion (Tafazoli et al., 2004; Modaghegh et al., 2008). This stimulatory effect of saffron on uterine musculature, however, is sometimes desirable in obstetrics to enhance the process of labor and also in gynecology for facilitating the surgical procedures on the uterus (Sadi et al., 2016; Vahdat et al., 2015). Thus, the exact mechanism of action of saffron derivatives on uterus and cervix has not been fully elucidated yet. In all the studies mentioned, the effects of the plant extract were assessed without purifying or differentiating its different elements which could have different or even opposing actions. With the availability of saffron tablets in Iran which mainly consists of crocin, with the brand name of Krocina, we believe that it would be much easier to assess the impact of this particular component of saffron on uterine or cervical tissue to clarify the exact mechanisms underlying abortion or induction of labor.<br /> In the end, we congratulate Mokhtari-Zaer et al on their article and we appreciate the Avicenna Journal of Phytomedicine editorial board for their judicious concern on this topic. We hope to read well-controlled randomized clinical trials regarding the beneficiary effects of saffron in futureMashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Toxicological profile of the aqueous-fermented extract of Musa paradisiaca in rats4784871079110.22038/ajp.2018.27453.1982ENEziuche UgboguDepartment of Biochemistry Abia State University, PMB 2000, Uturu, Abia State, NigeriaVictor Chibueze UdeDepartment of Medical Biochemistry, College of Medicine Enugu State University of Science and Technology, PMB 01660, Enugu-Nigeriahttps://orcid.org/00Iheanyichukwu ElekwaDepartment of Biochemistry Abia State University, PMB 2000, Uturu, Abia State, NigeriaUche ArunsiDepartment of Biochemistry Abia State University, PMB 2000, Uturu, Abia State, NigeriaChikezie Uche-IkonneFederal Medical Centre Umuahia, Abia State, NigeriaChinedu NwakanmaDepartment of Biochemistry Abia State University, PMB 2000, Uturu, Abia State, NigeriaJournal Article20171110Objective: This study was conducted to assess the toxicity profile of the aqueous-fermented extract of Musa paradisiaca in rats.<br /> Materials and Methods: In acute toxicity test, the rats of different groups were orally administered with a single dose of 500, 1000, 2000 and 5000 mg/kg of fermented extract of M. paradisiaca. The rats were monitored for behavioral changes, toxicity signs and mortality. In sub-acute test, the rats were orally administered with fermented M. paradisiaca extract (200, 400 and 800 mg/kg/day) for 14 days. Haematological and serum biochemical parameters were evaluated and histopathological studies of the liver and kidney were done. The study was performed from June to July 2017.<br /> Results: Concerning the acute toxicity, no toxicity signs or death were recorded and an LD<sub>50 </sub>value of >5 g/kg for fermented extract of M. paradisiaca was observed. Regarding the sub-acute toxicity, ingestion of the fermented extract of M. paradisiacacaused no significant effects (p<0.05) in terms of relative organ weight, body weight percentage, haemoglobin, red blood cells count, electrolytes levels, lymphocytes count, basophils count, and aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels. However, significant differences (p<0.05) were observed in white blood cells, eosinophils, platelets, neutrophils and monocytes counts, and urea, creatinine, alanine aminotransferase (ALT) and high-density lipoprotein (HDL) levels. The histological assessments of the liver and kidney showed normal results.<br /> Conclusion: The findings of this study has suggested that daily administration of fermented extract of M. paradisiaca at doses up to 800 mg/kg for 14 days, is not toxic and may be considered safe for therapeutic uses.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Protective effect of Rheum turkestanicum root against mercuric chloride-induced hepatorenal toxicity in rats4884971098110.22038/ajp.2018.29651.2034ENAzar HosseiniPharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-3423-0539Arezoo RajabianDepartment of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSahar FanoudiDepartment of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMehdi FarzadniaCancer Molecular Pathology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad Taher BoroushakiPharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20180205Objective: The present study was designed to investigate the protective effects of hydroalcoholic extract of Rheum turkestanicum against HgCl<sub>2</sub> hepatorenal toxicity in rats.<br /> Materials and Methods: Animals were randomly divided into five groups (n= 6 in each group) and received HgCl<sub>2</sub> and plant’s extract, intraperitoneally. Group1 received saline (1 mL/kg/day), group 2 received extract (200 mg/kg/day), group 3 was treated with HgCl<sub>2</sub> (5 mg/kg/day,) and groups 4 and 5 received the extract (100 and 200 mg/kg/day, respectively), 1 hr before HgCl<sub>2</sub> administration. All injections last for 3 days. Blood samples and specimens of the liver and kidney were collected 24 hr after the last injection.<br /> Results: Data showed that HgCl<sub>2</sub> significantly increases liver malondialdehyde (MDA) level, reduces total sulfhydryl content and increases serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, compared to control group. The histopathological changes such as inflammatory cells infiltration was observed in HgCl<sub>2</sub>-treated group while plant’s extract partially improved histological changes. The extract (100 and 200 mg/kg/day) improved the liver functions as reflected by significant reductions in AST and ALT levels in serum, MDA decreased and the content of total sulfhydryl elevated. Also, the extract improved necrosis and atrophy of the kidney induced byHgCl<sub>2</sub>. Pretreatment with the extract reduced creatinine and urea in serum, and glucose and protein concentrations in urine, compared to HgCl<sub>2</sub>- treated group (group III). The extract significantly reversed HgCl<sub>2</sub>-induced depletion in thiol content and elevation in MDA content.<br /> Conclusion: Therefore, oxidative stress may play an important role in HgCl<sub>2</sub>-induced hepatorenal injury and R. turkestanicum extract may be regarded as a useful to protect the kidney and liver against HgCl<sub>2</sub>-induced oxidative damage.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Efficacy of Nigella sativa seeds oil in patients with Behcet’s disease: a double-blind randomized controlled trial4985031110110.22038/ajp.2018.11101ENHadiseh KavandiConnective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IranMehrzad HajialiloConnective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IranAlireza KhabbaziConnective Tissue Research Center, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-9482-6967Journal Article20170902Objective: Nigella sativa (NS) is a herbal medicine with anti-inflammatory and anti-oxidant functions. This study was designed to evaluate the effect of oral administration of NS seeds oil on the treatment of Behcet’s disease (BD).<br /> Materials and methods:In this double-blind randomized controlled study, 130 patients with BD were screened and 71 patients with BD were randomly allocated to the treatment (n=37) and control (n=34) groups. Finally, 32 and 30 patients in the treatment and control groups, respectively, completed the study.The study protocol was registered in the Iranian Registry of Clinical Trials (IRCT) with registration No. IRCT201511086975N5. Treatment and control groups received soft gels containing 1000 mg NS oil or 1000 mg placebo per day for 12 months, respectively. Disease activity using the Iranian Behcet’s disease dynamic activity measure (IBDDAM), total inflammatory activity index (TIAI) and Behcet’s disease current activity form (BDCAF) were evaluated in all patients before initiation of the trial and every 2 months, for 12 months.<br /> Results: Disease activity decreased in the study groups; difference between the two groups was not significant. No serious adverse events were seen in the treatment and control groups.<br /> Conclusion: NS oil at the dose of 1000 mg/day is not effective in controlling BD activity.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Evolvulus alsinoides methanolic extract triggers apoptosis in HepG2 cells5045121128510.22038/ajp.2018.11285ENInduja MPDepartment of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, IndiaEzhilarasan DevarajSaveetha Institute of Medical and Technical SciencesAshok Vardhan NandigamBiomedical Research Unit and Laboratory Animal Centre, Saveetha Dental College, Chennai, Tamil Nadu, India – 600 077Journal Article20180412<strong>Objective:</strong> The objective of the present study was to evaluate the cytotoxic potentials of <em>Evolvulus alsinoides </em>in human hepatoma HepG2 cells.<br /> <strong>Materials and Methods:</strong> HepG2 cells were treated with methanolic extract of <em>E. alsinoides</em> at 20, 40 and 80 µg/ml for 24 hr and cytotoxic effect was analyzed by MTT assay. The apoptosis rate was investigated by Hoechst 33342 and annexin V/propidium iodide staining. Mitochondrial membrane potential was evaluated by rhodamine staining. Also, the expression of catenin – β 1 protein was analyzed by western blotting.<br /> <strong>Results:</strong> <em>E. alsinoides </em>methanolic extract treatment caused significant cytotoxicity in HepG2 cells in a concentration-dependent manner.Dual staining assayconfirmed the presence of early and late apoptotic cells only in extract-treated groups. Plant extract treatment also caused nuclear fragmentation and chromatin condensation in HepG2 cells. Mitochondrial membrane potential also reduced upon <em>E.</em> <em>alsinoides </em>treatments.This treatment also modulated the catenin – β 1 protein expression.<br /> <strong>Conclusion:</strong>In this study, we demonstrated theproapoptotic potential <em>E.</em> <em>alsinoides </em>in HepG2 cells; thus, this plant may be beneficial in the treatment of liver cancer.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Saffron (Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trial5135231128710.22038/ajp.2018.28835.2020ENMansoor ShakibaPsychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranEhsan MoazenzadehPsychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IranAhmad Ali NoorbalaPsychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranMorteza JafariniaPsychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranParisa DivsalarPsychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranLadan KashaniInfertility Ward, Arash Hospital, Tehran University of Medical Sciences, Tehran, IranNazila ShahmansouriPsychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranAbbas TafakhoriNeurology Ward, Imam Hospital, Tehran University of Medical Sciences, Tehran, IranHannaneh BayatPsychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IranShahin AkhondzadehPsychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0002-2277-5101Journal Article20180103<strong>Objective:</strong> Saffron was found efficient and safe in treatment of neuropsychiatric disorders, in particular depression. We compared the efficacy of saffron with duloxetine in treatment of patients with fibromyalgia.<br /> <strong>Materials and Methods:</strong> In this double-blind parallel-group clinical trial, outpatients with fibromyalgia were randomized to receive either saffron 15 mg or duloxetine 30 mg starting with 1 capsule per day in the first week followed by 2 capsules per day from week 2 until the end of week 8. Participants were men and women aged 18-60 years diagnosed with fibromyalgia based on the American College of Rheumatology 2010 criteria who also had a pain score ≥40 based on visual analogue scale. Participants were excluded in case they had rheumatologic diseases, inflammatory/infectious/autoimmune arthritis, comorbid neuropsychiatric disorders except depressive disorders, pain due to traumatic injuries, drug history of duloxetine or saffron use, current use of psychoactive medications, recent use of muscle relaxants, steroids, opioid analgesics, benzodiazepines, anti-epileptics, or injective analgesics. Primary outcomes included differences in mean score changes from baseline to endpoint between the treatment arms for Hamilton Rating Scale for Depression, Fibromyalgia Impact Questionnaire, and Brief Pain Inventory.<br /> <strong>Results:</strong> Socio-demographic characteristics and baseline scores were similarly distributed between the two treatment arms (2n=46). No significant difference was detected for any of the scales neither in terms of score changes from baseline to endpoint between the two treatment arms (Mean score changes: -4.26 to 2.37; p-values: 0.182-0.900) nor in terms of time´treatment interactions (p-values: 0.209-0.964).<br /> <strong>Conclusions:</strong> Saffron and duloxetine demonstrated comparable efficacy in treatment of fibromyalgia symptoms.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Evaluation of leishmanicidal effect of Euphorbia petiolata extract by in vivo anti-leishmanial assay using promastigotes of Leishmania major5245321135010.22038/ajp.2018.11350ENReza Kazemi OskueeNeurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMahmoud Reza JafariNanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-3908-6828Mahdi MoghaddasiSchool of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranMahdi RivandiDepartment of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFahimeh Afzal JavanDepartment of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad MohajeriDepartment of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad RamezaniPharmaceutical Research Centers, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20180115<strong><span style="font-size: medium;">Objective:</span></strong><span style="font-size: medium;"> The extract of different species of <em>Euphorbia</em></span><span style="font-size: medium;"> has been successfully used as a remedy for treatment of cutaneous leishmaniasis. The aim of this study was to assess the </span><em><span style="font-size: medium;">in vitro</span></em><span style="font-size: medium;"> leishmanicidal effect of </span><em><span style="font-size: medium;">Euphorbia petiolata</span></em><span style="font-size: medium;"> (</span><em><span style="font-size: medium;">E. petiolata</span></em><span style="font-size: medium;">) extract.</span><br /> <strong><span style="font-size: medium;">Materials and Methods:</span></strong><span style="font-size: medium;"> Ethanolic percolated</span><span style="font-size: medium;"> and methanolic Soxhlet extract of </span><em><span style="font-size: medium;">E. petiolata</span></em><span style="font-size: medium;"> on promastigotes of </span><em><span style="font-size: medium;">L. major</span></em><span style="font-size: medium;"> at different concentrations of extracts, one positive control group and one negative control group as well as 1 solvent control were prepared and placed in 24-well plates that contained 40,000 parasites/well. Afterwards, plates were incubated at 25 ˚C for six days and number of parasites in each well were determined on days 2, 4 and 6 of the experiment.</span><br /> <strong><span style="font-size: medium;">Results:</span></strong><span style="font-size: medium;"> Both percolated</span><span style="font-size: medium;"> and Soxhlet extracts in methanol and DMSO solvents had significant effects (equal to that of amphotericin B) on promastigote form of parasite at the concentration of 1 mg/ml. At lower concentrations, the extracts of </span><em><span style="font-size: medium;">E. petiolata</span></em><span style="font-size: medium;"> had favorable leishmanicidal activity and killed </span><em><span style="font-size: medium;">L. major</span></em><span style="font-size: medium;"> promastigotes dose-dependently.</span><br /> <strong><span style="font-size: medium;">Conclusion:</span></strong><span style="font-size: medium;"> Our results support the possibility of <em>E. petiolata</em></span><span style="font-size: medium;"> extracts application as an anti-leishmanial agent with similar effects to amphotericin B.</span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Arbutin attenuates behavioral impairment and oxidative stress in an animal model of Parkinson's disease5335421151010.22038/ajp.2018.11510ENMasoumeh DadgarStudent Research Committee, Babol University of Medical Sciences, Babol, IranDepartment of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranMahdi PouramirDepartment of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranCellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0002-5873-2373Zohreh DastanStudent Research Committee, Babol University of Medical Sciences, Babol, IranDepartment of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranMaryam Ghasemi-KasmanCellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IranManouchehr AshrafpourNeuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Physiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranAli Akbar MoghadamniaCellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranSoraya KhafriDepartment of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, IranMohsen PourghasemCellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Department of Anatomy, Embryology and Histology, Faculty of Medicine, Babol University of Medical Sciences, Babol, IranJournal Article20180615<strong><span style="font-size: medium;">Objective:</span></strong><span style="font-size: medium;"> Arbutin has been shown to have antioxidant and free-radical scavenging properties. The aim of this study was to investigate the effects of arbutin administration on behavioral impairment, and oxidative and nitrosative stress in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine</span><span style="font-size: medium;">(MPTP)-induced animal model of Parkinson’s disease (PD). </span><br /> <span style="font-size: medium;"><strong>Materials and Methods:</strong> PD model was developed by 4 intraperitoneal (i.p.) injections of MPTP (20 mg/kg) with 2 h intervals in mice. Experimental groups received once daily injection of saline as vehicle (control group) or arbutin (50 mg/kg, i.p.) one week before MPTP injections and this protocol was continued seven days post lesion. Behavioral deficits were evaluated using locomotion test, hanging wire test and forepaw stride length. Parameters indicating the oxidation levels including lipid peroxidation marker (TBARS), nitrite, protein carbonyl levels and antioxidant activity including ferric reducing antioxidant power (FRAP) were assessed in serum and midbrain samples. </span><br /> <span style="font-size: medium;"><strong>Results:</strong> Treatment with arbutin improved motor functions in an MPTP-induced PD model compared to control group (p<0.001). Mice treated with MPTP showed reduced levels of FRAP (p<0.001) and increased levels of TBARS (p<0.001), nitrite (p<0.001) and protein carbonyl (p<0.01), compared to the control group. In contrast to the MPTP group, arbutin treatment decreased the levels of TBARS (p<0.05), nitrite (p<0.05), protein carbonyl (p<0.05), and increased FRAP levels (p<0.05) in mice with PD. </span><br /> <span style="font-size: medium;"><strong>Conclusion:</strong> These findings suggest that arbutin attenuates the behavioral impairment and oxidative stress in a PD animal model.</span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79308620181101Topical application of Cassia fistula L. fruit gel in management of cutaneous lesions of pemphigus vulgaris: A double-blind, placebo-controlled clinical trial5435511151510.22038/ajp.2018.11515ENFatemh AtarzadehDepartment of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Traditional Iranian Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IranMohammad KamalinejadSchool of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran0009-0006-6373-1320Gholam RezaAminDepartment of Pharmacognosy and Department of Traditional Pharmacy, Tehran University of Medical Sciences, Tehran, IranAli RezaSalehiResearch Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, IranLadan DastgheibShiraz Molecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran0000000221179375Amir MohammadJaladatDepartment of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Mojtaba HeydariDepartment of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Zahra GouyandehShiraz Molecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20171205<strong><span style="font-size: medium;">Objective:</span></strong><span style="font-size: medium;"> <em>Cassia fistula</em></span><span style="font-size: medium;"> L. fruit extract has been traditionally used in the treatment of pemphigus vulgaris (PV) lesions in Iran. The aim of this study was to determine the efficacy of </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel on healing time of PV lesions in a clinical setting.<br /></span><strong><span style="font-size: medium;">Materials and Methods:</span></strong><span style="font-size: medium;"> This was a randomized, double-blind placebo-controlled clinical trial that was performed in dermatology ward at Saadi hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Right- or left- sided lesions of PV patients on standard systemic treatment were randomized for treatment with either </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel or placebo prescribed twice daily. The largest diameter of each lesion was measured at the baseline (day 0) and on days 10 and 20. Epithelialization Index (EI), as outcome measure was calculated and compared between the two groups.<br /></span><strong><span style="font-size: medium;">Results:</span></strong><span style="font-size: medium;"> The present study comprised 20 patients, with overall 82 cutaneous lesions including 41 lesions in the </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel group and 41 lesions in the placebo group. The EI in the </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel group was significantly higher than that of the placebo group both on day 10 (65±28vs 30±34; p=0.001) and at the end of the study (91±22 vs 69±49; p=0.003). <br /></span><strong><span style="font-size: medium;">Conclusion:</span></strong><span style="font-size: medium;"> Topical application of </span><em><span style="font-size: medium;">C. fistula</span></em><span style="font-size: medium;"> fruit gel can be considered as an effective adjuvant therapy in treatment of PV.</span>