Clinical Applications of Pomegranate

Pomegranate, Punica granatum L., is an ancient, unique fruit borne on a small, long-living tree in the Mediterranean region, Southeast Asia, and tropical Africa. Pomegranate was mentioned in ancient times in the Old Bible, the Jewish Torah, and mentioned three times in the holy Quran where it was described as one of the paradise fruits. In ayurvedic medicine, pomegranate is used in the treatment of parasitic infection, diarrhea, and ulcers. Recently, pomegranate has been studied in several systems of medicine for its pharmacological actions: anti-inflammatory, antioxidant, and anticarcinogenic. The aim of the chapter is to summarize pomegranate efficacy in many preclinical and clinical studies

Boswellia Carries Hope for Patients with Inflammatory Bowel Disease (IBD)

Boswellia serrata is an ancient and valuable herb that was widely used throughout the centuries. Boswellia trees grow in India, Northern Africa, and the Middle East from which Frankincense or olibanum resin is taken. The beneficial effects of Boswellia and its active ingredients (Boswellic acids) were thoroughly investigated in many diseases. Where the non-redox and 5-lipoxygenase inhibitory actions were reported. Inflammatory bowel disease (IBD) mainly ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory disorders of the gastrointestinal system. Although the cause is still unclear, the immune system is claimed to have the upper hand in the pathogenesis of IBD. Several studies have demonstrated the ameliorating effect of Boswellic acids on the severity of IBD and the potential role of Boswellia in the induction or maintenance of remission. The aim of this chapter is to explore the the possible effect of Boswellia in IBD management as a complementary and alternative strategy

Could Pomegranate Fight Against SARS-CoV-2?

Pomegranate, Punica granatum L., is an authentic, generous fruit which is cultivated in many parts of the world for thousand years. The divine fruit was born from nature to provide humanity with its effluent benefits for life and health. Through the ages, Pomegranate occupied an eminent place in ayurvedic medicine. It was prescribed for treatment of parasitic infection, diarrhea, and ulcers. Pomegranate wealth of prolific pharmacological activities makes it a rich culture for multiple studies in recent years. It will not be surprising if Pomegranate provides humans with a possible help in SARS-CoV-2 pandemic. The enemy that has raided the world since the end of 2019

Complementary and Alternative Medicine in COVID-19 Infection, an Old Weapon against a New Enemy

COVID-19 is a running story with an unexpected end. Despite the large effort to provide effective treatment and prophylaxis, many people are still getting infected. This may be explained by the continuous virus mutations, and hence, the attenuation of the vaccine’s efficacy. Therefore, long-life boosting of the body’s immunity is a hopeful way against SARS-CoV-2 infection. Medicinal plants and other complementary and alternative remedies were used effectively in treating numerous mankind’s health problems. Recently, a lot of studies have confirmed the effect of natural products, cupping therapy, and acupuncture against SARS-CoV-2. The aim of this chapter is to remind ourselves of the natural pharmacy that God gave us, by shedding the light on the importance of some herbs and traditional remedies in the management of SARS-CoV-2 infection

Quadruple Therapy Offers High SVR Rates in Patients with HCV Genotype 4 with Previous Treatment Failure

Background and Aims. Direct-acting antivirals (DAAs) have made a revolution in hepatitis C virus (HCV) treatment with promising reduction of HCV infection and disease morbidities. However, unfortunately, treatment failure still occurs in about 5–15% of patients treated with DAA‐based combination regimens. The primary aim of the study was to assess the efficacy and safety of a quadruple regimen of (sofosbuvir, daclatasvir, and simeprevir with a weight-based ribavirin) in chronic HCV DAAs-experienced patients. Methods. This observational, open-label prospective study was carried out on 103 genotype 4 hepatitis C virus-infected patients who failed to achieve SVR12 after sofosbuvir-daclatasvir with or without ribavirin. Patients were treated for three months with sofosbuvir (400 mg), daclatasvir (60 mg), and simeprevir (150 mg) with a weight-based ribavirin dosage (1000–1200 mg/d). Response to treatment was determined by quantitative PCR for HCV at 3 months after the end of treatment (SVR12), and adverse events during the treatment were recorded. Results. SVR was achieved in 100 patients (97.1%) at week 12 after treatment. No dangerous or life-threatening adverse events were recorded. Conclusions. Retreatment of HCV genotype 4 patients with quadruple therapy is a good therapeutic option and achieves high response rates with minimal side effects

Randomized Controlled Study Comparing Use of Propofol Plus Fentanyl versus Midazolam Plus Fentanyl as Sedation in Diagnostic Endoscopy in Patients with Advanced Liver Disease

Objectives. We aimed to investigate the safety and efficacy of propofol plus fentanyl versus midazolam plus fentanyl as sedative for patients with advanced liver disease presented for gastrointestinal endoscopy. Methods. A total of 100 patients with liver cirrhosis referred for upper endoscopy were enrolled and divided equally in two groups, midazolam plus fentanyl group and propofol plus fentanyl group. All patients were subjected to history taking, estimation of level of sedation, endoscopist rating, and hemodynamic parameters including oxygen saturation, heart rate, mean arterial pressure, incidence of side effect as (bradycardia, hypotension, hypoxia, nausea and vomiting, cough, shivering, or diplopia), time needed for complete recovery, and time needed for discharge. Results. There was no statistical significant difference between the studied groups regarding age, sex, weight, Child–Pugh classification score, type and duration of endoscopic intervention, time needed for complete recovery, or time needed for discharge. Complication rates were similar in both groups except for mean arterial blood pressure which was significantly lower in group of patients receiving propofol and fentanyl (P=0.001). Conclusion. The use of either propofol or midazolam in combination to fentanyl is effective in sedation of patients with advanced liver diseases presented for upper GIT endoscope. The trial is registered with ClinicalTrials.gov Identifier: NCT03063866