Mallow (Malva sylvestris) and Pain (general): evidence and sources

Background Episiotomy is one of the common procedures during childbirth in Iran, which causes pain, discomfort, and scar in the perineum. This study aimed to pursue the effect of Malva Sylvestris cream on episiotomy pain and healing. Methods This study was a double-blinded randomized-controlled clinical trial that was conducted from April to December 2021 at the Sina hospital in Ahvaz, Iran. Sixty women were selected and randomly assigned to control and intervention groups using block randomization. The main outcomes included pain assessment and episiotomy wound healing that are assessed by the Visual analog scale (VAS), and perineal healing scale included redness, edema, ecchymosis/bruising, discharge, approximation (REEDA). The cream was used twice a day for up to 14 days. The participants were followed on the first, seventh, and fourteenth days postpartum. Independent T-test, Mann-Whitney, and Chi-square, and Generalized Estimating Equations (GEE) model were used by SPSS software version 22 for data analysis. Statistically significant level was considered less than 0.05. Results There were no significant statistical differences between the two groups in demographic characteristics (P>0.05). No significant statistical differences were found in both groups in terms of perineal healing (B=-0.05; P=0.89) and pain scores (B=0.15; P=0.56). However, the chance of external dysuria in the intervention group decreased by 77% (P=0.01). Conclusion Despite showing the positive effect of Malva Sylvestris extract on wound healing in animal and in-vitro studies, this clinical study failed to show the positive effect of this extract on wound healing and pain relief of episiotomy. However, future clinical trials are needed to substantiate the above findings. Trial Registration Number: IRCT20190826044621N1.

Malva sylvestris L., is commonly referred to as Mallow and is found in Europe, Asia and Africa. This has been traditionally used for inflammation, gastrointestinal disturbances, skin disorders, menstrual pains, and urological disorders. This review covers phytoconstituents and Pharmacological activities of M. sylvestris . The plant contains a large number of phytochemical constituents having diverse pharmacological activities. The plant contains many phenolic compounds responsible for its strong antioxidant activity. Coumarins from Mallow have a potential anticancer activity. Malva sylvestris also contains essential as well as non-essential elements and minerals. Many researchers have provided evidence that Malva sylvestris is a good candidate for use as a medicinal herb and has good nutritional value. The leaves, in particular, offer properties like anticancer, skin whitening, and anti-aging. Furthermore, the aqueous extract was recently shown to have an anti-ulcerogenic effect. Malva sylvestris has a high potential for use in cosmetics such as skin whitening and anti-aging treatments. Methanolic extracts of Malva sylvestris leaves, and flowers showed strong antibacterial activity against a common plant pathogen bacterium. The plant also contains Malvone A, which is responsible for antibacterial action. The plant also possesses anti-inflammatory, analgesic, wound healing properties and various other activities.

Malva sylvestris is a plant commonly found in Europe, Asia, and Africa. The leaves and flowers of this plant have been used for centuries in traditional medicine to treat various ailments such as cough, cold, diarrhoea, and constipation. Google Scholar, PubMed, Scopus, and Web of Science were used to search for relevant material on the phytochemical profiling and pharmacologic activities of Malva sylvestris. The techniques used in phytochemical profiling and the pharmacologic activity of each compound were extracted from the included studies, including in vitro, in vivo, and clinical studies. The phytochemical analysis of Malva sylvestris revealed that the leaves and flowers are the most commonly used parts of the plant and contain various bioactive compounds such as flavonoids, mucilages, terpenoids, phenol derivatives, coumarins, sterols, tannins, saponins, and alkaloids. These phytochemicals are responsible for the many pharmacological activities of Malva sylvestris, such as anti-inflammatory, antimicrobial, hepatoprotective, laxative, antiproliferative and antioxidant properties. This review has presented an overview of the antinociceptive and anti-inflammatory activities and the cytotoxic effects of Malva sylvestris on different types of cancer cells. It has also summarised the work on developing copper oxide nanoparticles using Malva sylvestris leaf extract and its potential use in food and medicine. This review aims to highlight the traditional uses, phytochemistry, pharmacological activities, and safety of Malva sylvestris.