The effects of add-on therapy of Phyllanthus Emblica (Amla) on laboratory confirmed COVID-19 Cases: A randomized, double-blind, controlled trial.

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.

Evaluation of the frequency of resistance to 2 drugs (Isoniazid and Rifampin) by molecular investigation and it's risk factors in new cases of smear positive pulmonary tuberculosis in health centers under the cover of Jundishapur University of Medical Sciences in 2017.

INTRODUCTION: Despite the great efforts to control tuberculosis (TB), the disease is still one of the major health challenges throughout the world. The basic treatment for TB is drug therapy. Currently, the main anti-tuberculosis drugs with major use in the treatment and control of the disease are isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin. One of the serious crises in controlling TB epidemic is diagnosis and treatment of patients with Multidrug Resistant Tuberculosis (MDR-TB MDR). The purpose of the study was to examine and evaluate the resistance of mycobacterium TB strains isolated from specimens of newly diagnosed smear positive pulmonary TB to isoniazid and rifampin using molecular methods and their risk factors. METHODS: Sputum samples of newly diagnosed smear positive pulmonary TB patients were prepared, collected, and sent to Reference Laboratory in Ahvaz. DNA of mycobacterium tuberculosis was prepared from the samples using Qiagen kit according to the instructions of the manufacturing company. Isoniazid resistance was evaluated using specific primers for inhA and KatG genes. Rifampin resistance was evaluated using MAS-PCR method with three specific alleles of rpobB codons and codons 516, 526 and 531. RESULTS: Mycobacterium tuberculosis resistance to Isoniazid was 7.3%, to Rifampin 5.5% and to both drugs 1.8%. In our study, there were no association between drug resistance and gender, age, prison history, smoking, drug use, underlying disease, occupation, and HIV. CONCLUSION: According our findings that include prevalence of 7.3% Isoniazide resistance, 5.5% Rifampin resistance and 1.8% to both drugs, evaluating all newly diagnosed patients for resistance to standard anti-tuberculosis treatment seems rational.