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Objective This randomized, double-blind, controlled trial (RCT) aimed to evaluate the effect of Phyllanthus Emblica (Amla) as an add-on therapy on COVID-19_ related biomarkers and clinical outcomes in COVID-19 patients. Methods In this RCT, sixty-one patients were randomly assigned into two arms [the intervention (n=31) and control arms (n=30)]. The effect of Amla on diagnostic Reverse-transcription Polymerase Chain Reaction (RT-PCR) test results between the first and the last days of the study, the length of stay (LOS) in hospital, the percentage of lung involvement on CT scans, changes in the clinical symptoms, and the laboratory markers were assessed. Results The two study groups had similar baseline demographics and characteristics in terms of medical history. The mean of LOS in the intervention arm (4.44 days) was significantly shorter than in the control arm (7.18 days, P<0.001); RT-PCR results were not significantly different between the two arms (P=0.07). All clinical variables decreased over time in the two groups (P<0.001). However, the difference between the two groups in terms of fever (P=0.004), severity of cough (P=0.001), shortness of breath (P=0.004), and myalgia (P=0.005) were significant, but this intergroup comparison was not significant with regard to respiratory rate (P=0.29), severity of chills (P=0.06), sore throat (P=0.22), and weakness (P=0.12). Out of the eight evaluated para-clinical variables, three variables showed significant improvement in the intervention arm, including the mean increase in oxygen saturation (SpO2) level (P<0.001), the reduction in the mean percentage of lung involvement on CT (P<0.001), and the improvement in C-reactive protein test results (P<0.001). Conclusion Organic herbal Amla tea cannot significantly affect the RT-PCR results and or degree of lung involvement. Nevertheless, it showed an ameliorative effect on the severity of clinical signs and CRP levels. Also, Amla tea may shorten the recovery times of symptoms and LOS in COVID-19 patients.

Background and purpose: Stomatitis or oral inflammation is one of the common complications in patients undergoing chemotherapy, which causes pain, discomfort, infection and long-term hospitalization. The only way to prevent this condition is to use a suitable mouthwash and maintain oral hygiene. The purpose of this study is to investigate the effect of Cordia myxa mouthwash on preventing stomatitis in patients undergoing chemotherapy. Method: This study will be a double-blind, single-center randomized controlled clinical trial focusing on 60 patients undergoing chemotherapy. The samples will be randomly divided into intervention and control groups. In addition to receiving the routine betadine mouthwash, participants in the intervention group will receive a solution of 30 drops of 5% Cordia myxa formulation in 20 cc of water, and they will be asked to put the solution in their mouth, swirl it in their mouth for a minute and then spit it out. In the control group, in addition to betadine mouthwash, sterile water placebo (having the same taste and smell) will be used. Patients will brush their mouths with a soft toothbrush and the same toothpaste 3 times a day after breakfast, lunch, and dinner followed by mouthwash use for 14 days. Data will be collected using a demographic information questionnaire and the oral stomatitis severity checklist. The data will be analyzed based on statistical tests using SPSS version 22. Discussion: This study is expected to shed light on the effectiveness of Cordia myxa mouthwash in improving the severity of stomatitis among leukemia patients. To the best of our knowledge, no valid scientific research has so far been conducted on this very topic. If this intervention proves effective in improving access and adherence to treatment, it would be a step forward in addressing a chronic health problem that is common among leukemia patients undergoing chemotherapy. Given its natural essence and the fact that it is not associated with any complications, the Cordia myxa mouthwash can be used safely alongside the main treatment to prevent and reduce the severity of mouth ulcers caused by chemotherapy.