Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101The effects of curcumin on the prevention of atrial and ventricular arrhythmias and heart failure in patients with unstable angina: A randomized clinical trial191129410.22038/ajp.2018.11294ENMostafa DastaniDepartment of cardiology, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-2788-2827Leila BigdeluCardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMahsa HoseinzadehDepartment of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranHamid Reza RahimiNeurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Modern Sciences & Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-2269-4109Asieh KarimaniDepartment of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranAmir Houshang MohammadpourDepartment of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
Pharmaceutical Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-6000-3276Masoumeh SalariDepartment of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-3443-6158Journal Article20171226<span style="font-size: medium;"><strong>Objective:</strong> Inflammation along with oxidative stress has an important role in the pathophysiology of unstable angina which leads to acute myocardial infarction, arrhythmias and eventually heart failure. Curcumin has anti-inflammatory and anti-oxidant effects and thereby, it may reduce cardiovascular complications. This randomized controlled trial aimed to investigate the effects of curcumin on the prevention of atrial and ventricular arrhythmias and heart failure in patients with unstable angina.</span><br /> <span style="font-size: medium;"><strong>Materials and Methods:</strong> Forty patients with unstable angina who met the trial inclusion and exclusion criteria, participated in this double-blind randomized clinical trial. The patients were randomized into two groups: curcumin (80 mg/day for 5days) and placebo (80 mg/day for 5days). Cardiac function was evaluated by two-dimensional echocardiography devices at baseline (immediately after hospitalization) and 5 days after the onset of the trial. Atrial and ventricular arrhythmias were recorded by Holter monitors in cardiology ward, Ghaem academic hospital, Mashhad, Iran. Progression to heart failure, myocardial infarction, and pulmonary and cardiopulmonary resuscitation events as well as mortality were recorded daily throughout the study.</span><br /> <span style="font-size: medium;"><strong>Results:</strong> There were no significant differences between the two groups in atrial and ventricular arrhythmias (p=0.2), and other echocardiographic parameters (Ejection fraction, E, A, E/A ratio, Em, and pulmonary artery pressure) at baseline and five days after the start of the trial.</span><br /> <strong><span style="font-size: medium;">Conclusion:</span></strong><span style="font-size: medium;"> </span><span style="font-size: medium;">Nanocurcumin administered at the dose of 80 mg/day for five days had no effect in the incidence of cardiovascular complications in patients with unstable angina.</span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Effects of L-citrulline supplementation on blood pressure: A systematic review and meta-analysis10201159010.22038/ajp.2018.11590ENBahareh BarkhidarianDepartment of Nutrition, Mashhad University of Medical Sciences, Mashhad, IranMasoud KhorshidiDepartment of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, IranSakineh Shab-bidarDepartment of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, IranBaran HashemiRajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.Journal Article20180416<span style="font-size: medium;"><strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Objective: </span></strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">We aimed to conduct a systematic review and meta-analysis of clinical trials that examined the effects of L-citrulline supplementation on blood pressure (BP). </span></span><br /> <span style="font-size: medium;"><strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Materials and Methods:</span></strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"> We searched MEDLINE, SCOPUS, PUBMED and Google scholar databases from inception to November 16, 2017 and 811 papers were identified, of which 8 trials with 10 data sets met the inclusion criteria. Inclusion criteria were: (1) application of randomized clinical trial with either crossover or parallel designs; (2) studies conducted in adults (≥18 y); (3) oral supplementation with L-citrulline compared to control group; (4) expression of sufficient data about systolic and diastolic BP at baseline and at the end of the study in each group. BP effects were pooled by random-effects models, with trials weighted by inverse variance.</span></span><br /> <span style="font-size: medium;"><strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Results:</span></strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"> The included studies’ sample size ranged between 12 and 34 subjects. The mean age of the participants in these trials ranged between 22 and 71 years. Dosage of L-citrulline supplementation varied from 3 to 9 g/day. Duration of the intervention ranged between 1 and 17 weeks. The pooled changes in systolic and diastolic BP were (MD, −4.10 mm Hg; 95% CI [−7.94, -0.26]; p=0.037) and (MD −2.08 mm Hg; 95% CI [−4.32, 0.16]; P=0.069), respectively. The subgroup analysis showed a significant diastolic BP reduction in studies that used doses of ≥6 g/day (MD −2.75 mm Hg; 95% CI [−5.37, -0.12]; p=0.04).</span></span><br /> <span style="font-size: medium;"><strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Conclusion: </span></strong><span style="font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Our results suggest that L-citrulline supplementation may reduce systolic BP. A significant reduction in diastolic BP was observed only in the studies that used doses ≥ 6 g/day.</span></span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Histomorphological effects of the oil extract of Sphenocentrum jollyanum seed on benign prostatic hyperplasia induced by exogenous testosterone and estradiol in adult Wistar rats21331110010.22038/ajp.2018.24039.1882ENGodwin MbakaDepartment of Anatomy, Faculty of Basic Medical Sciences, Lagos State University College of Medicine, Ikeja, Lagos, NigeriaSteve OgbonniaDepartment of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Idi-Araba, Lagos, NigeriaAdeola SulaimanDepartment of Anatomy, Olabisi Onabanjo University, Remo Campus, Ogun State, NigeriaDaniel OsiagwuDepartment of Anatomic and Molecular Pathology, College of Medicine of the University of Lagos, NigeriaJournal Article20170603<span style="font-size: medium;">benefits due to its very potent anti-inflammatory and antioxidant properties. Despite its widespread use, it has not been validated for use in the treatment of benign prostatic hyperplasia (BPH). This study was conducted to examine histomorphological effects of SJ seed on BPH that usually causes bladder outlet obstruction.</span>
<span style="font-size: medium;"><strong>Materials and Methods: </strong>There were a total of six groups of animals each comprising 5 adult male rats. Apart from group 1 (normal control), in the remaining five groups, BPH was induced. Group 2 (negative control) was sacrificed immediately after BPH induction; groups 3 and 4 received the extract at 300 and 600 mg/kg respectively by gavages for thirty days; group 5 received finasteride (0.1 mg/kg) for thirty days and group 6 received the extract (600 mg/kg) simultaneously with the steroid administration for thirty days. The animals’ were weighed before the experiment and subsequently every three days until the end of the study.</span>
<strong><span style="font-size: medium;">Results: </span></strong><span style="font-size: medium;">The extract caused marked decrease in prostate weight of rats with BPH with histo-morphology of the tissue showing degenerated stromal and epithelial cells with few epithelial involutions of glandular tissue. Prostate specific antigen (PSA) level as well as testosterone level significantly (p<0.05) decreased in the treated groups compared to negative control. BPH animals treated with extract</span><span style="font-size: medium;">/finasteride exhibited remarkable increases in anti-oxidant enzymes level with concurrent decreases in peroxidative activity.</span>
<strong>Conclusion: </strong>SJ effectively ameliorated prostatic hyperplasia in BPH animals causing marked degenerative changes in prostate stromal and epithelial cells and also exhibited marked anti-oxidant effect.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Modulation of in vitro proliferation and cytokine secretion of human lymphocytes by Mentha longifolia extracts34431154110.22038/ajp.2018.11541ENYahya AsemaniImmunology Department, Shiraz University of Medical Sciences, Shiraz, IranMaryam BayatDepartment of Immunology, Shiraz University of Medical Sciences, Shiraz, IranSaeed Malek-HosseiniImmunology Department, Shiraz University of Medical Sciences, Shiraz, IranZahra AmirghofranAutoimmune Diseases Research Center, and Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20180115<span style="font-size: medium;"><strong>Objective: </strong><em>Mentha longifolia</em></span><span style="font-size: medium;"> L. Hudson has been used in folk medicine for various purposes especially for its anti-inflammatory effects. Lymphocytes play a central role in development of inflammation. In the present study, we investigated the immunomodulatory effects of different extracts of <em>M. longifolia</em></span><span style="font-size: medium;"> on human peripheral blood lymphocytes (PBLs), as main players in development of inflammation.</span><br /> <span style="font-size: medium;"><strong>Materials and Methods:</strong> PBLs stimulated with phytohemagglutinin (PHA) were cultured in the presence of the plant extracts. The effects of the extracts on activation of cells were determined by BrdU assay. The viability of cells was examined by flow cytometry using propidium iodide staining. Also, IFN-γ (T helper 1, TH1) and IL-4 (TH2) secretion was measured by ELISA. </span><br /> <strong><span style="font-size: medium;">Results: </span></strong><span style="font-size: medium;">Except for the water extract which had a weak inhibitory effect, treatment of cells with more than 1μg/ml of butanol, hexane, ethyl acetate and dichloromethane extracts resulted in strong inhibition of cells proliferation (IC</span><sub><span style="font-size: small;">50</span></sub><span style="font-size: medium;"> 4.6-9.9 µg/ml). Flow cytometry analysis showed that these extracts at ≤10μg/ml were non-cytotoxic. Dichloromethane and ethyl acetate extracts at 10 μg/ml decreased IFN-γ production in a dose-dependent manner from 919±91.1 pg/ml in PHA-only-treated cells to 568±22.6 pg/ml (in dichloromethane-treated cells) and 329±12.3 pg/ml (in ethyl acetate-treated cells) (p<0.001). At 10 μg/ml, the ethyl acetate extract increased IL-4 secretion compared to PHA-only-treated cells (p<0.05). The hexane extract decreased IFN-γ level but did not affectIL-4 production. </span><br /> <strong><span style="font-size: medium;">Conclusion: </span></strong><span style="font-size: medium;">Reduction of IFN-γ and augmentation of IL-4 secretion induced by the extracts suggested the potential of <em>M. longifolia </em></span><span style="font-size: medium;">to inhibit TH1 inflammatory responses toward a TH2 dominant response.</span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Effects of standardized hydro-alcoholic extract of Vaccinium arctostaphylos leaf on hypertension and biochemical parameters in hypertensive hyperlipidemic type 2 diabetic patients: a randomized, double-blind and placebo-controlled clinical trial44531158810.22038/ajp.2018.11588ENReza MohtashamiMedicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, IranHasan Fallah HuseiniMedicinal Plants Research Center, Institute of Medicinal Plants,ACECR, Karaj, Iran.0000-0002-3192-6012Farzaneh NabatiMedicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.Reza HajiaghaeeMedicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.Saeed KianbakhtInstitute of Medicinal Plants (ACECR)0000-0002-2086-248XJournal Article20180416<span style="font-size: medium;"><strong>Objective:</strong> </span><span style="font-size: medium;">To study </span><span style="font-size: medium;">the blood pressure, lipid and glycemic effects and safety of</span><span style="font-size: medium;"> <em>Vaccinium arctostaphylos </em></span><span style="font-size: medium;">leaf in the h</span><span style="font-size: medium;">ypertensive hyperlipidemic type 2 diabetic patients.</span><br /> <span style="font-size: medium;"><strong>Materials and Methods:</strong> The patients took 350 mg standardized plant leaf hydro-alcoholic extract capsule (n=50) or placebo capsule (n=50) three times daily alongside conventional drugs for 2 months. At the baseline and endpoint, systolic and diastolic blood pressures and blood levels of fasting glucose (FG), 2-hr postprandial glucose (2hPPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), LDL-C, triglyceride, HDL-C, SGOT, SGPT and creatinine were determined in both groups. To evaluate the extract safety, serum SGOT, SGPT and creatinine levels were tested; also, the patients were requested to report any adverse effects. </span><br /> <span style="font-size: medium;"><strong>Results:</strong> FG, 2hPPG, HbA1c, TC, LDL-C, triglyceride and systolic and diastolic blood pressures were decreased, whereas HDL-C was increased significantly in the extract group compared to those of the placebo group at the endpoint (for all cases, p<0.05). The extract did not significantly influence other parameters and no adverse effects were reported.</span><br /> <strong><span style="font-size: medium;">Conclusion:</span></strong><span style="font-size: medium;"> <em>V. arctostaphylos</em></span><span style="font-size: medium;">leaf hydro-alcoholic extract as an adjunct to the conventional drugs has additional antihypertensive as well as anti-dyslipidemic and anti-hyperglycemic effects in hypertensive hyperlipidemic type 2 diabetic patients. Besides, the extract lacks hepatic, renal and patient-reported adverse effects.</span><span style="font-size: medium;"> </span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Skin inflammatory reactions to capsaicin in rheumatoid arthritis patients compared to healthy controls54611158910.22038/ajp.2018.11589ENMasoumeh SalariRheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-3443-6158Roshanak SalariDepartment of Traditional Persian Pharmacy, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-4690-7823Hoshang RafatPanahAllergy Research Center, Mashhad University of Medical Sciences, Mashhad, IranYalda RavanshadClinical Research Unit, Mashhad University of Medical Sciences, Mashhad, IranDanial ZirachiRheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, IranMaryam SahebariRheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-2476-2478Journal Article20171118<span style="font-size: medium;"><strong>Objective: </strong>Previous studies have examined the role of sensory nerves and neural mediators in symmetrical joint inflammation and autoimmunity in rheumatoid arthritis (RA). In this study, we sought to examine the association between capsaicin skin test and disease activity in RA patients.</span><br /> <strong><span style="font-size: medium;">Materials and Methods: </span></strong><span style="font-size: medium;">Eighty RA patients (case group) and 20 healthy volunteers were enrolled in this experiment. The subjects in case group were calcified to newly diagnosed patients and those previously diagnosed with RA. A topical solution of capsaicin (0.075%) was applied on the volar forearm during the skin test, and evaluations were done after 5, 10, and 20 min. The parameters recorded in capsaicin skin test were time to tingling, area of induration (cm</span><sup><span style="font-size: small;">2</span></sup><span style="font-size: medium;">), and area of redness (cm</span><sup><span style="font-size: small;">2</span></sup><span style="font-size: medium;">). </span><br /> <span style="font-size: medium;"><strong>Results: </strong>A faster capsaicin skin reaction was observed in healthy controls compared to the case group (p=0.02). Newly diagnosed and previously diagnosed RA patients were not significantly different in terms of reaction latency (p=0.06). The redness area after 15 (p=0.04) and 20 (p=0.001) min was significantly larger in previously diagnosed RA patients than in newly diagnosed ones. The area of redness and time to tingling did not show any difference between active and inactive RA patients, but after 15 and 20 min, the area of redness was significantly greater in inactive RA patients compared to active RA patients (p=0.01 and p=0.03, respectively).</span><br /> <span style="font-size: medium;"><strong>Conclusion: </strong>This study suggested that capsaicin skin test is not an efficient tool for the examination of synovial inflammation and disease activity in RA. </span>Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Antimutagenic, antitumor and estrogen receptor binding activity of the rare plant Shortia galacifolia: An ethnobotanical and chemosystematic approach62711159310.22038/ajp.2018.11593ENSandra GrayEndocrine Physiology Lab, AVS Department, Clemson University, Clemson, SC 29634Seneca Creek Organics, Seneca, SCBrett RLackeyEndocrine Physiology Lab, AVS Department, Clemson University, Clemson, SC, 29634, USAPatricia LTateSchool of Nursing, Clemson University, Clemson, SC, 29634, USAJournal Article20180207<strong>Objective:</strong> <em>Shortia </em>and other members of the Diapensiaceae family have ethnomedicinal history in both Eastern and Western hemispheres. Based on ethnopharmacological and chemosystematic evidence, pharmacological and toxicological bioassays were conducted on the rare plant Oconee Bell,<em> Shortia galacifolia</em>.<br /> <strong>Materials and Methods:</strong> Extracts were examined in assays for antimutagenicity, antitumor and estrogen receptor (ER)-binding activity. Antitumor activity was assessed by the tumor induction assay (TiA), using <em>Agrobacterium tumefaciens</em> based on its ability to transform plant tissue. Antimutagenicity was examined using the Ames bacterial reverse mutation test. Recombinant human ERα and ERβ proteins were utilized to screen extracts for receptor selectivity.<br /> <strong>Results:</strong> All concentrations of extracts inhibited <em>A. tumefaciens</em>-induced tumor formation on potato discs, with the mature rhizome extracts having the most marked inhibition. All three plant extracts significantly inhibited the formation of histidine-independent revertant colonies after exposure to the mutagen 2-aminoanthracene (2-AA) in the Ames <em>Salmonella </em>mutagenicity assay. In the ER binding assays, ERβ, but not ERα, displayed affinity for <em>Shortia</em> extracts.<br /> <strong>Conclusion:</strong> Antitumor, ER binding and antimutagenic activities of <em>S. galacifolia</em> extracts were identified using rapid bench-top assays and warrant further investigations. Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101The protective effect of Zataria multiflora Boiss. hydroalcoholic extract on TNF-α production, oxidative stress, and insulin level in streptozotocin-induced diabetic rats72831161410.22038/ajp.2018.11614ENMarzieh MahmoodiStudent Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran0000000279405937Farhad KoohpeymaDepartment of Endocrinology, Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000000167297732Forough SakiShiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Amir MaleksabetDepartment of Medical Biotechnology, Faculty of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, IranMohammad Ali ZareDepartment of Endocrinology, Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20180528<strong><span style="font-size: medium;">Objective:</span></strong><span style="font-size: medium;"> Oxidative stress leads to reactive oxygen species (ROS) overproduction, which causes tissue injury in diabetic patients. The aim of this study was to evaluate the effects of <em>Zataria multiflora</em></span><span style="font-size: medium;"> extract on TNF-α, oxidative stress products, and insulin levels as well as lipid profile in diabetic rats.</span><br /> <strong><span style="font-size: medium;">Materials and Methods:</span></strong><span style="font-size: medium;"> Rats were randomly divided into 6 groups of 10 animals. Diabetes was induced by a single injection of streptozotocin (STZ). Control and diabetic control rats orally received 1 mL/day of normal saline, whereas the other three groups received 250, 500 and 1000 mg/kg/day of <em>Z. multiflora</em></span><span style="font-size: medium;"> extract, and one non-diabetic group orally received 1000 mg/kg/day </span><em><span style="font-size: medium;">Z. multiflora</span></em><span style="font-size: medium;"> extract, for 28 days. At the end of the treatment course, rats were anesthetized and their serum samples were analyzed for TNF-α, malondialdehyde (MDA), super oxide dismutase (SOD), total antioxidant capacity (TAC), lipid profile, total plasma protein, blood glucose, insulin, and liver enzymes levels. </span><br /> <strong><span style="font-size: medium;">Results:</span></strong><span style="font-size: medium;"> Our results showed that cholesterol, LDL, TG, MDA and TNF-α levels decreased, but HDL, SOD, TAC, and total protein increased significantly in the diabetic group receiving 1000 mg/kg<em> Z. multiflora</em></span><span style="font-size: medium;"> compared to the diabetic control group (P<0.05). Moreover, blood glucose level was significantly reduced following administration of different concentrations of Z.</span><em><span style="font-size: medium;"> multiflora</span></em><span style="font-size: medium;">. Liver sections of diabetic rats treated with Z. </span><em><span style="font-size: medium;">multiflora</span></em><span style="font-size: medium;"> 1000 mg/kg showed normal hepatocytes and restoration of liver architecture.</span><br /> <strong>Conclusion:</strong> <em>Z. multiflora</em> extract ameliorated oxidative stress, TNF-α serum level, lipid abnormality, blood glucose, and liver damage in rats with diabetes mellitus.Mashhad University of Medical SciencesAvicenna Journal of Phytomedicine2228-79309120190101Effect of acupressure on constipation in patients undergoing hemodialysis: A randomized double-blind controlled clinical trial84911162610.22038/ajp.2018.11626ENParivash AbbasiStudent Research Committee, Gonabad University of Medical Sciences, Gonabad, IranMohammad MojalliSocial Development and Health Promotion Research Center & Department of Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, IranMojtaba KianmehrDepartment of Medical Physics, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran.Somayeh ZamaniDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR IranJournal Article20170826<span style="font-size: medium;"><strong>Objective:</strong> Constipation is one of the most common digestive problems in patients undergoing hemodialysis. It has a negative effect on quality of life in these patients. As routine treatments are not effective in this regard, complementary therapies may help to overcome this condition. This study aimed to investigate the effect of acupressure on constipation in patients undergoing hemodialysis.</span><br /> <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 conducted in 2014.</span><span style="font-size: medium;">A convenience sample of 70 patients undergoing hemodialysis was selected from hemodialysis units of three hospitals affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. Patients were randomly assigned to intervention or control group. Intervention group received acupressure in acupressure points three times a week for four weeks during hemodialysis. In control group, acupressure was delivered in false points. We assessed the frequency of defecation in the two groups before and after the study. The study instruments consisted of a demographic questionnaire, and a data sheet for documenting constipation frequency.</span><br /> <span style="font-size: medium;"><strong>Results:</strong> The results indicated a significant difference between intervention group (13.73±3.63) and control group (10.06±3.77) in frequency of defecation during the fourth week of intervention (p<0.001). Regarding quality of stool, there was a meaningful difference between the groups in the fourth week in a way that the stool in the intervention group was more natural and in the control group, it was thicker and more adhesive.</span><br /> <span style="font-size: medium;"><strong>Conclusion:</strong> Acupressure seems to be an effective complementary treatment for constipation in patients undergoing hemodialysis.</span>