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.

Hepatitis B virus is a major public health impasse all over the world. Recently a new form of hepatitis B infection named Occult hepatitis B Infection (OBI) has appeared globally. The OBI is defined as the presence of HBV DNA in the liver and/or blood in the absence of detectable serum HBsAg with/without anti-HBc or anti-HBs. The prevalence of OBI has been reported in hemodialysis (HD) patients in different regions of the world. Thus, this study investigated the prevalence of OBI among HD patients. The cross-sectional study was carried out on 84 HD patients. These sera were checked for HBsAg, HBc-IgG assessment using Enzyme linked immunosorbent assay. The DNA was extracted from the sera samples and tested for HBVDNA detection using Nested Polymerase Chain Reaction (Nested PCR). The liver function tests including serum alanine aminotransferase and aspartate aminotransferase levels were carried out for all the HD individuals. 52/84(61.9%) of HD were males and 32/84 (38.1%) were females. The patient’s age ranged from 25 to 64 with a mean age of 52.4±15.2 years. HBsAg and HBc-IgG were detected in 1(1.1%) female. 2 (2.4%; a female and a male) patients were positive for HBsAg. 14/84 (16.7%; 6 female and 8 male) HD patients were positive for anti-HBc but negative for HBsAg, among them 4(28.6%; 2 female and 2 male) cases were positive for HBV DNA, indicating the presence of OBI in HD patients. Even distribution of OBI among the HD was found in 2(2.36%) male and 2(2.36%) female (P>.0.05). In the present study the moderate rate of 4.76% OBI has been observed in HD patients. The prevalence of seropositive OBI among the gender was 2(2.36%) male and 2(2.36%) female. The seronegative OBI have not been detected in the present study but requires further investigation. In this study the affliction of OBI in HD patients is not clear.

Cerebral ischemia commonly occurs when the blood flow to the entire brain or some part of the brain is disrupted. Global cerebral ischemia attenuates the nucleus tractus solitaries (NTS) EEG

Background: Cerebral ischemia/reperfusion (I/R) could increase the reactive oxidative stress in the cardiomyocytes. Also, some studies report cardiac arrhythmias following oxidative stressor such as I/R. Hence, this study was aimed to investigate the effects of ellagic acid (EA) against arrhythmias in a cerebral I/R model. Materials and Methods: Thirty-two male rats were randomly allocated into four groups: Sham (normal saline, 10 days), EA (100 mg/kg EA, 10 days), I/R (20 min ischemia followed by 30 min reperfusion, 10 days), and EA + I/R (100 mg/kg EA before I/R). In all animals, electrocardiogram (ECG) was recorded pre-ischemia and postischemia on the first and 11th days, respectively. Results: The I/R group showed an abnormally prolonged QTc interval after ischemia compared to the preischemia and control groups. EA administration in the EA+I/R group significantly reduced this prolonged QTc interval (P< 0.01). In the I/R group, ischemic/reperfusion resulted in a prolonged QRS complex and an elevated ST, which EA significantly prevented (P<0.01). In addition, EA significantly prevented the dramatically shortened RR interval induced by reperfusion (P<0.01). The incidence of ventricular fibrillation significantly increased in the I/R group; then it dramatically decreased following the administration of EA (P<0.0001). Conclusion: EA pretreatment repaired the adverse effects of I/R on the ECG parameters, which can be attributed to its negative chronotropic effects. EA pretreatment can prevent the cerebral I/R-induced heart arrhythmias. [GMJ.2019;8:e1235]

Background: Cerebral ischemia/reperfusion (I/R) could increase the reactive oxidative stress in the cardiomyocytes. Also, some studies report cardiac arrhythmias following oxidative stressor such as I/R. Hence, this study was aimed to investigate the effects of ellagic acid (EA) against arrhythmias in a cerebral I/R model. Materials and Methods: Thirty-two male rats were randomly allocated into four groups: Sham (normal saline, 10 days), EA (100 mg/kg EA, 10 days), I/R (20 min ischemia followed by 30 min reperfusion, 10 days), and EA + I/R (100 mg/kg EA before I/R). In all animals, electrocardiogram (ECG) was recorded pre-ischemia and postischemia on the first and 11th days, respectively. Result: The I/R group showed an abnormally prolonged QTc interval after ischemia compared to the preischemia and control groups. EA administration in the EA+I/R group significantly reduced this prolonged QTc interval (P< 0.01). In the I/R group, ischemic/reperfusion resulted in a prolonged QRS complex and an elevated ST, which EA significantly prevented (P<0.01). In addition, EA significantly prevented the dramatically shortened RR interval induced by reperfusion (P<0.01). The incidence of ventricular fibrillation significantly increased in the I/R group; then it dramatically decreased following the administration of EA (P<0.0001). Conclusion: EA pretreatment repaired the adverse effects of I/R on the ECG parameters, which can be attributed to its negative chronotropic effects. EA pretreatment can prevent the cerebral I/R-induced heart arrhythmias.[GMJ. 2019;inpress:e1235]