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      The Effect of Comfrey on Enoxaparin-Induced Bruise in Patients with Acute Coronary Syndrome: A Randomised Clinical Trial

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          Abstract

          Objectives

          Bruising is an important side effect of enoxaparin injection. Comfrey ( Symphytum officinale) is used to treat different types of wounds, bone fractures, and bruising in traditional medicine in many countries for centuries. This study aimed to determine the effects of the Comfrey ointment on the bruise size and color following enoxaparin injection.

          Methods

          This double-blind randomized clinical trial was conducted on 80 patients with acute coronary syndrome (ACS). The participants were randomly divided into two groups of 40, namely Comfrey and Placebo. Changes in bruise size and color in both groups were assessed daily before and after the intervention.

          Results

          The Comfrey and Placebo groups were homogeneous in demographic and clinical variables. A downward trend was observed in the bruise size in both groups throughout the study. However, the bruise size was smaller in the Comfrey group than the Placebo group on day 2-5 of the intervention. Moreover, there was a significant difference in bruise color between the groups, with a shorter healing course in the Comfrey group.

          Conclusion

          The Comfrey ointment accelerated the healing process of enoxaparin injection-induced bruising in patients with ACS. It is recommended as a safe and simple approach for these patients.

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          Most cited references40

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          Potential of herbs in skin protection from ultraviolet radiation

          Herbs have been used in medicines and cosmetics from centuries. Their potential to treat different skin diseases, to adorn and improve the skin appearance is well-known. As ultraviolet (UV) radiation can cause sunburns, wrinkles, lower immunity against infections, premature aging, and cancer, there is permanent need for protection from UV radiation and prevention from their side effects. Herbs and herbal preparations have a high potential due to their antioxidant activity, primarily. Antioxidants such as vitamins (vitamin C, vitamin E), flavonoids, and phenolic acids play the main role in fighting against free radical species that are the main cause of numerous negative skin changes. Although isolated plant compounds have a high potential in protection of the skin, whole herbs extracts showed better potential due to their complex composition. Many studies showed that green and black tea (polyphenols) ameliorate adverse skin reactions following UV exposure. The gel from aloe is believed to stimulate skin and assist in new cell growth. Spectrophotometer testing indicates that as a concentrated extract of Krameria triandra it absorbs 25 to 30% of the amount of UV radiation typically absorbed by octyl methoxycinnamate. Sesame oil resists 30% of UV rays, while coconut, peanut, olive, and cottonseed oils block out about 20%. A “sclerojuglonic” compound which is forming from naphthoquinone and keratin is the reaction product that provides UV protection. Traditional use of plant in medication or beautification is the basis for researches and making new trends in cosmetics. This review covers all essential aspects of potential of herbs as radioprotective agents and its future prospects.
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            Traditional wound-healing plants used in the Balkan region (Southeast Europe).

            The geographical and ecological specificity of the Balkan Peninsula has resulted in the development of a distinct diversity of medicinal plants. In the traditional culture of the Balkan peoples, plants have medicinal, economic and anthropological/cultural importance, which is reflected in the sound knowledge of their diversity and use. This study analyses the traditional use of medicinal plants in the treatment of wounds and the pharmacological characteristics of the most frequently used species.
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              Comfrey: A Clinical Overview

              Comfrey has a centuries-old tradition as a medicinal plant. Today, multiple randomized controlled trials have demonstrated the efficacy and safety of comfrey preparations for the topical treatment of pain, inflammation and swelling of muscles and joints in degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents, also in children aged 3 or 4 and over. This paper provides information on clinical trials and non-interventional studies published on comfrey to date and further literature, substantiating the fact that topical comfrey preparations are a valuable therapy option for the treatment of painful muscle and joint complaints. Copyright © 2012 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                J Pharmacopuncture
                J Pharmacopuncture
                Journal of Pharmacopuncture
                The Korean Pharmacopuncture Institute (KPI)
                2093-6966
                2234-6856
                31 December 2021
                31 December 2021
                31 December 2021
                : 24
                : 4
                : 196-205
                Affiliations
                [1 ]Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
                [2 ]Chronic Diseases (Home Care) Research Center, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
                [3 ]Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
                [4 ]Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
                [5 ]Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
                Author notes
                [* ]Corresponding Author Amir Larki-Harchegani, Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran, Tel: +98-81-3838-1591, E-mail: dr.amir.larki@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-8664-4477
                https://orcid.org/0000-0003-1379-0024
                https://orcid.org/0000-0002-2224-8870
                https://orcid.org/0000-0001-7521-4909
                https://orcid.org/0000-0001-9014-6772
                Article
                jop-24-4-196
                10.3831/KPI.2021.24.4.196
                8716702
                35028171
                5af33872-42d8-4694-a603-573cb188d384
                © 2021 Korean Pharmacopuncture Institute

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 July 2021
                : 24 October 2021
                : 26 November 2021
                Categories
                Original Article

                bruise,enoxaparin,comfrey,acute coronary syndrome,patient,ointment

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