Embedded in the very heart of Persian culture, the ritualistic practice of burning Esfand serves as a sacred thread, weaving through the intricate fabric of tradition. This age-old act is a profound expression, a choreography of symbolism and significance that transcends the realms of the everyday. Esfand, also known as wild rue, is a plant whose seeds are believed to ward off evil spirits and bring good luck when burned. The ritual involves placing the seeds in a special container, lighting them on fire, and allowing the smoke to fill the space.
The Essence of Esfand
At its core, the ritual unfolds with meticulous care-the gathering of Esfand seeds, tiny vessels of history and cultural resonance. These Esfand seeds, carefully selected, are then bound together with a vibrant red thread-a crimson symphony that resonates with cultural meaning. This thread is not just a visual embellishment; it is a symbolic lifeline connecting the present to the depths of Persian heritage.
The resulting fragrant smoke, rising gracefully into the air, is an alchemical blend of botanical essence and cultural resonance. It transcends the boundaries of mere sensory perception. Instead, it carries with it the weight of tradition, a tangible manifestation of the collective consciousness of a people. The aroma, rich and evocative, serves as a spiritual incense, purifying the surroundings with a symbolism that stretches beyond the material plane.
The act of burning Esfand, therefore, becomes a poetic dance between the physical and the metaphysical-a cultural offering that goes beyond the boundaries of time and space. In its flames, the past is not forgotten; it is illuminated. In its fragrant smoke, the present is not mundane; it is elevated.
Occasions for Burning Esfand
Burning Esfand is practiced on various occasions, adding a spiritual dimension to significant life events and cultural practices.
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Persian Weddings
In Persian weddings, the burning of Esfand takes center stage as a customary practice steeped in symbolism. As two souls unite in matrimony, the ritual serves to purify the wedding space, creating an atmosphere untainted by negative energies. The fragrant smoke of Esfand becomes a ceremonial incense, swirling around the couple, symbolizing the protective embrace that surrounds them as they embark on the sacred journey of marriage.
Welcoming a Newborn
Welcoming a newborn into the world is a momentous occasion in Persian culture, and the burning of Esfand becomes a celebration of life and protection. As Esfand smoke wafts through the air, it is believed to form a gentle shield, ensuring the well-being of both the newborn and the mother. The act symbolizes a wish for a life unburdened by negativity and a hope for the child’s journey to be guided by positive energies.
Moving into a New Home
Moving into a new home marks a significant chapter in one’s life, and the burning of Esfand is a ritual designed to consecrate this transition. As the Esfand bundle ignites, it acts as a purifying agent, dispelling any lingering negative energies from previous occupants. The fragrant tendrils of smoke infuse the new residence with positive vibes, transforming the house into a sanctuary filled with the promise of a fresh start.
Times of Illness
During times of illness or health challenges, the burning of Esfand takes on a role as a catalyst for healing and well-being. The fragrant smoke is thought to possess purifying properties, creating an environment conducive to the restoration of health.
Funerals and Mourning
In moments of grief and loss, the burning of Esfand serves as a comforting ritual within Persian funerals and mourning periods. The fragrant smoke is believed to guide the departed soul, providing solace to the grieving family. The act becomes a poignant expression of reverence and a means of connecting with the spiritual realms during a time of emotional intensity.
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Spiritual and Religious Events
Esfand burning takes on heightened significance during spiritual or religious events, such as ceremonies at shrines, mosques, or other places of worship. The act becomes a spiritual enhancer, creating an atmosphere that is conducive to contemplation and connection with the divine. The fragrant smoke is seen as a means of inviting positive energies, fostering a sense of sacredness during these spiritual gatherings.
Daily Protection
Beyond specific occasions, the burning of Esfand is embraced as a continuous protective measure against the malevolent influence of the evil eye. Many individuals incorporate Esfand burning into their daily lives, particularly in their homes. The regular practice is seen as a proactive step to ward off negativity, ensuring a harmonious and protected living environment.
Cultural Festivals
Various cultural festivals and celebrations in Persian tradition incorporate the burning of Esfand as an integral part of traditional rituals. This inclusion adds a spiritual dimension to cultural events, connecting participants with their heritage and the rich tapestry of Persian traditions. The fragrant swirls of Esfand smoke become a ceremonial dance, infusing these festivals with a sense of sacredness and continuity.
Cultural and Spiritual Significance
Beyond the realm of protective rituals, the burning Esfand extends into the very soul of Persian culture, encapsulating a rich tapestry of spirituality and cultural identity. Passed down through the ages, this ancient practice serves as a bridge, connecting the past to the present. The act of burning Esfand is not an isolated event but a dynamic expression of a people’s collective consciousness, a cultural heartbeat pulsating through the veins of Persian society.
The burning of Esfand seeds in Persian culture is not only a tradition deeply rooted in history and symbolism but is also associated with perceived benefits, both cultural and believed to be spiritual. While the scientific evidence supporting some of these benefits may be limited, the cultural and spiritual significance of burning Esfand seeds continues to be an integral part of Persian practices.
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- The act of burning Esfand seeds is believed to purify the surrounding space.
- Burning Esfand seeds is often seen as a spiritual practice that connects individuals with ancient traditions and cultural heritage.
- The fragrant smoke from burning Esfand is thought to invite positive energies into a space.
- Participating in the burning Esfand seeds is a way for individuals to engage with and perpetuate their cultural identity.
- The use of a vibrant red thread to bind the Esfand seeds holds symbolic significance. The color red is often associated with protection and good fortune in Persian culture.
- In times of illness or health challenges, burning Esfand seeds is believed to have purifying properties that contribute to the restoration of health.
- The smoke produced by burning Esfand is believed to create a protective barrier, warding off negative energies and the malevolent influence of the evil eye.
Esfand and its potential benefits
There are clinical studies on the effect of Salvia mirzayanii on H. pylori eradication are lacking. Therefore, a study was designed to evaluate the effect of this plant as adjunctive therapy on the eradication of H. pylori.
Preparation, extraction and standardization of S.
The leaves of S. mirzayanii were gathered from Kerman province and authenticated by Pharmacognosy Department of Faculty of Pharmacy. The herbarium specimen of the plant was kept in the herbarium center (herbarium number KF1467). After cleaning the leaves, they were dried at room temperature. The dried leaves were ground and the resulting powder was used for capsule formulation. For standardization, the extraction of the plant leaves was performed using warm maceration method with 80% ethanol. To standardize the extract, the amount of the plant total phenolic content was determined by Folin-Ciocalteu method based on gallic acid calibration curve. According to the slope of the calibration curve of gallic acid (Y = 0.0016X + 0.0544, R2 = 0.993), the amount of the total phenolic content in the plant was determined as 5.86 ± 0.49 (w/w %).
Preparation of S. mirzayanii oral granules
S. mirzayanii oral granules were prepared by mixing 350 mg of the powdered plant per capsule with lactose monohydrate and starch powder. The resulting mixture was passed through a 12-mesh sieve to create the granules. Then appropriate amounts of talc and magnesium stearate were added to the dried granules. These amounts were determined based on Carr’s index and Hausner ratio. A manually operated capsule filling machine was used to fill hard gelatin capsules size 00 with the prepared granules. The final capsule weight was 650 mg. It should be mentioned the dose of S. mirzayanii in each capsule was determined according to its minimum inhibitory concentration (MIC) against H. pylori and Persian traditional medicine.
Hausner ratio and Carr’s index were determined based on the calculation of bulk density and tapped density to assess the flow property of the granules. Hausner ratio and Carr index were in the range of suitable granule flowability (Hausner ratio < 1.2) and Carr index ≤ 16).
Randomly ten capsules were selected and weighed by an analytical scale. The weight range of each capsule was in the acceptable range (90%-110% of the claimed capsule weight).
Absorbance of different concentrations of it was measured at 230 nm. Its concentration-absorbance curve (C-A curve) was plotted (Abs = 0.0044*conc. + 0.148, R² = 0.9968). There was a good relationship between the concentration and absorbance. Ten capsules were randomly selected to measure their plant contents based on C-A curve. The plant content of each of the ten capsules was in the acceptable range (85%-115% of the claimed plant content weight).
Six capsules were placed in the basket-type dissolution apparatus containing distilled water as a dissolution medium, and the temperature was adjusted to (37.0 ± 0.5) ℃. The speed was set on 75 rpm for 30 min, and the sample was withdrawn at 0, 5, 10, 15 and 30 min. The absorbance of the samples was measured at 230 nm using a spectrophotometer, and the amount of the dissolved plant was determined. Finally, the percentage of the dissolved plant n 30 min was calculated. The results showed that 84% ± 6% of S. mirzayanii content of the capsules was dissolved in 30 min.
Stability of the capsules
The stability of the capsules was assessed by placing them in three different conditions including a refrigerator (2-8 ℃), environment (15-25 ℃), and oven (40 ℃). The organoleptic properties and the plant content of each capsule were evaluated at 0, 1, 2, 4, 8, 12, and 24 weeks based on C-A curve. More than 92% of S. mirzayanii content of every single capsule remained constant after six months in all the three conditions. Also, their organoleptic properties remained unchanged after six months in the above-mentioned conditions.
Clinical Trial
A randomized double-blind, placebo-controlled clinical trial was conducted in Besat Clinic affiliated to Kerman University of Medical Sciences, Kerman, Iran, from October 2019 to July 2020. The patients aged 15 to 70 years with symptoms of dyspepsia and positive fecal antigen test for H. pylori were included. The exclusion criteria were previous H. pylori eradication therapy, allergy to the prescribed medications or S. mirzayanii, consumption of bismuth or antibiotics within four weeks and PPI or H2-receptor antagonists within two weeks prior to the fecal antigen test, pregnancy or lactation, gastric cancer, and severe underlying diseases.
The participants were randomly allocated to S. mirzayanii or the placebo group in a 1∶1 ratio using block randomization with a block size of four. The participating patients received one S. mirzayanii or placebo capsule twice a day for two weeks. Also, all the patients in both groups received clarithromycin-based triple therapy (H. pylori eradication therapy) including omeprazole (20 mg twice daily) or pantoprazole (40 mg twice daily), amoxicillin (1 g twice daily), and clarithromycin (500 mg twice daily) for two weeks simultaneously. The placebo (containing starch) and S. mirzayanii capsules were identical in shape, color, and outer packaging.
The demographics of the patients including age, sex, drug and medical history, smoking, consumption of alcoholic drinks, drinking tea (leaves of Camellia sinensis), and other herbal teas were recorded. The side effects of the treatment such as nausea, vomiting, loss of appetite, taste alteration, weakness, abdominal pain, diarrhea, dizziness, headache, flushing, and skin rash were also recorded for the patients at the completion of the eradication therapy. Treatment compliance was assessed by counting the medications upon the completion of the treatment. The percentage of the medications intake for each patient was calculated. The medications intake less than 80% was considered as poor compliance.
To evaluate the eradication rate, post-treatment H. pylori status was determined by fecal antigen test at least four weeks after the completion of the treatment regimen. All the randomized patients were followed up until the end of the study.
The sample size calculation was based on comparing two proportions. The eradication rate of clarithromycin-based triple therapy was assumed to be about 70%, and it was expected that the rate would increase to 95% by consumption of S. mirzayanii capsules. All the data were analyzed by SPSS 26 software (IBM Corp., Armonk, NY, USA). The data were shown as mean ± standard deviation or number (%). 2 or Fisher’s exact test and independent samples t-test were applied to compare qualitative and quantitative variables between the two groups, respectively. Both intention to treat (ITT) and per protocol (PP) analyses were performed to avoid potential bias. The ITT population included all the randomized participants who received at least one dose of the study medications. The side effects of the treatment and compliance of the patients were assessed based on ITT analysis. The patients whose post-treatment H. pylori status was unknown were classified as treatment failure for ITT analysis. The patients with unknown post-treatment H. pylori status and also those with poor compliance were excluded from PP analysis. A P-value less than 0.05 was considered to be statistically significant.
The mean age of the 99 participants was (35 ± 10) years of whom 59 (59.60%) and 40 (40.40%) ones were women and men, respectively. No significant difference was found regarding the demographics between the two groups. Among the 99 randomized patients, 79 patients completed the trial. There were no significant differences between the two groups concerning the frequencies of the side effects of the medications. The percentage of the medications intake was not significantly different (P value = 0.387) between S. mirzayanii (92 ± 15) and the placebo groups (89 ± 17). Six patients in S. mirzayanii group and seven in the placebo group were categorized as poor compliance [totally 13 (13.13%) per 99 patients]. H. pylori eradication rate of all the randomized participants was 59.59% (59 per 99 patients). The eradication rate was statistically significantly higher in S. mirzayanii group [84.62% (33 per 39 patients)] compared with that in the placebo group (62.50% (25 per 40 patients)) using PP analysis (P value = 0.026). The eradication rate was also higher in S. mirzayanii group (65.31% (32 per 49 patients)) compared with that in the placebo group [54.00% (27 per 50 patients)] for ITT analysis, but it did not reached statistical significance (P value = 0.252).
The results showed that the use of S. mirzayanii as adjunctive therapy could improve H. pylori eradication rate. 10 reported that S. mirzayanii had a considerable antibacterial activity against 12 clinical isolates of H. pylori with an MIC of 32-64 µg/mL. Also, both the extract and essential oil of the plant exhibited strong antibacterial effects against H. pylori. Moreover, it was reported that S. mirzayanii essential oil and phenolic compounds had strong antioxidant activities, and it was suggested that the plant could be used as a food additive. Furthermore, teuclatriol, a sesquiterpene from this plant, has shown anti-inflammatory effects by its inhibitory effect on nuclear factor-κB activation and tumor necrosis factor α release. In addition, the immunomodulatory compounds of S. As S. mirzayanii is endemic to Hormozgan and Kerman provinces in Iran, the clinical trials using this plant are rare, and so far no clinical study has evaluated its side effects. In the current study, more than 86% of the randomized patients had good compliance. The compliance to the treatment regimen was somewhat lower than the other studies. The profile of the adverse effects due to the eradication therapy in the present study is similar to that of other studies evaluating clarithromycin-based triple therapy in Iran. However, the frequency of these adverse effects in this study was lower than that of the previously reported ones. But the adverse effects of S. In the current study, the significancy of comparing the eradication rates of the two study groups was different between ITT and PP analyses. This may be related to the patients who were lost to follow up due to poor compliance or unknown post-treatment H. pylori status (they were considered as treatment failure). It should be noted that both analyses are valid but interpreted differently. PP analysis assessed the effect of S. mirzayanii on H. pylori eradication only in the participants who strictly adhered to the study protocol, but the benefits of randomization were not maintained. However, it is not clear whether the mentioned effect was related merely to the adherence to the protocol or to the characteristics of the participants who were compliant. Although ITT analysis prevents selection bias, it may have underestimated the true effect of S. Based on the study results, the overall H. pylori eradication rate was 59.59%, and it was below the acceptable range (85%-90%). It was reported that the eradication rates of clarithromycin-based triple therapy (for 14 d) were 70.0% to 90.9% in some parts of Iran from 2007 to 2015. Increasing antibiotic resistance and also patient nonadherence could be two major reasons for this low rate in this study. Antibiotic resistance decreases the efficacy of eradication regimens.