ObjectivesIn this systematic review, the effectiveness of herbal medicines in improving depression and anxiety in menopausal women was assessed.MethodsThree following databases were individually searched: MEDLINE (1966-March 2017), SCOPUS (1990-March 2017), and the Cochrane Library (Cochrane Central Register of Controlled Trials; 2017).ResultsA total of 9 trials were included in this systematic review. Overall, soy was found to have a beneficial effect. Also, fennel had a significant positive effect on menopausal women with depression and anxiety disorder, but not on healthy women. Red clover showed varying effects ranging from significant to non-significant on depression and anxiety. Moreover, kava was found to have a significant beneficial effect on depression and anxiety at dose of 200 mg/days.ConclusionsOur study demonstrated that herbal medicines could improve anxiety and depression in among menopausal women. However, the beneficial effect still remains indefinite due to the poor methodology.

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Background: Piperine is a natural compound obtained from the Piper nigrum that exhibits anti-proliferative and anti-cancer activity in cancer cell lines. We analyzed the cytotoxic effect of piperine combined with cisplatin compound in the human MCF-7 breast cancer cell line and the underlying mechanism. Methods: The present in vitro study was performed on MCF-7 cell line in Jahrom University of Medical Sciences between, Jahrom, Iran from 2016 to 2017. Cultured MCF-7 cells were seeded into four groups: a control group (untreated group), a group treated with cisplatin, a group treated with piperine and a group treated with cisplatin and piperine. Cell viability was analyzed using the MTT assay method. Flow c-ytometric analysis was investigated for apoptosis. The mRNA and protein expression of the apoptotic regulators p53, Bcl-2, Bax, caspase 3 and caspase 9 were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting analysis. Results: Piperine (20 and 30 µM) in combination with cisplatin (5, 10 and 15 µM) for 24 h synergistically inhibited cell viability of MCF-7 breast cancer cells more than piperine and cisplatin used alone. Synergistic antibreast cancer activities cisplatin (5 µM) and piperine (20 µM) were via inducing apoptosis. Piperine (20 µM) and cisplatin (5 µM) for 24 h induce apoptosis strongly through reduction of Bcl-2 and increase of caspase 3, p53, caspase 9, and Bax. Conclusion: Piperine in combination with cisplatin could trigger p53-mediated apoptosis more effective than cisplatin alone in MCF-7 breast cancer cells, reducing the toxic dose of cisplatin used in cancer chemotherapy.

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Background: During the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, anxiety has always been with patients. Objectives: It is necessary to obtain a valid instrument for the evaluation and screening of patients with anxiety. The current study attempted to evaluate the sensitivity and specificity and provide the clinical cut-off scores for the Death Anxiety Scale (DAS) and Generalized Anxiety Disorder 7-Item (GAD-7) Scale in hospitalized patients diagnosed with COVID-19 in Iran. Methods: This diagnostic accuracy study was carried out for 4 months on 150 hospitalized patients diagnosed with COVID-19 to evaluate generalized anxiety disorder and death anxiety. Cronbach’s alpha was used to evaluate reliability. For the determination of the presence of anxiety disorders, the Structured Clinical Interview with hospitalized subjects was conducted by a psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria. Results: The Cronbach’s alpha coefficients for the GAD-7 Scale and DAS questionnaires were observed to be 0.88 and 0.74, respectively, confirming their reliability. Based on cut-off scores with the best balance, the sensitivity and specificity of the GAD-7 Scale questionnaire were 61.9% and 86.9%, respectively. Moreover, the sensitivity and specificity values related to the DAS questionnaire were 47.8% and 73.8%, respectively. The values for the area under the curve were 0.75 and 0.63 for the GAD-7 Scale and DAS, respectively. With this scoring method, those who scored higher than 8 and 7 in the GAD-7 Scale and DAS questionnaires were considered patients, respectively. Moreover, in these two tests, higher levels of generalized anxiety and death anxiety were reported in female patients. Conclusions: The GAD-7 Scale and DAS both showed adequate psychometric properties and diagnostic accuracy; therefore, they are applicable for anxiety screening in patients with COVID-19. It will likely take a few years to bring the virus under control worldwide. Iran’s Ministry of Health should implement exact psychological interventions during hospitalization and after discharge to prevent the adverse mental health consequences of COVID-19.