Effects of pomegranate peel extract and vitamin E on the inflammatory status and endothelial function in hemodialysis patients: a randomized controlled clinical trial

Inflammation and endothelial dysfunction are major problems in hemodialysis (HD) patients. This study assessed the effects of an 8 week administration of pomegranate peel extract (PPE) and vitamin E (Vit E) alone or in combination on the biomarkers of inflammation, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), and the biomarkers of endothelial function, including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and P-selectin, in HD patients. In a randomized, double-blind, parallel, placebo-controlled trial, 100 HD patients were randomly divided into 4 equal groups: (a) PPE + Vit E, received 2 pomegranate tablets (each tablet contained 225 mg PPE, equal to 90 mg ellagic acid) + 1 Vit E soft gel (400 IU) daily, (b) PPE, received 2 pomegranate tablets + 1 Vit E placebo soft gel daily, (c) Vit E, received 1 Vit E soft gel + 2 pomegranate placebo tablets daily, and (d) placebo, received 2 pomegranate placebo tablets + 1 Vit E placebo soft gel daily. For group allocation, a stratified block randomization procedure based on sex, age, and HD duration was used. Each intervention product and its placebo had identical shape, color, size, and packaging. Consumption of PPE + Vit E significantly reduced the serum CRP level (mean change: -7.12 ± 4.59 mg l-1, P < 0.001) compared to other groups, while reduced levels of IL-6 (mean change: -2.19 ± 2.33 pg ml-1, P < 0.001), TNF-α (mean change: -2.41 ± 3.21 pg ml-1, P = 0.008), ICAM-1 (mean change: -64.2 ± 111.0 ng ml-1, P = 0.017), and VCAM-1 (mean change: -117.7 ± 177.1 ng ml-1, P = 0.002) were observed compared to the control. There was no significant difference in the P-selectin level among the groups. Consumption of PPE or Vit E alone significantly reduced the CRP level (mean change for PPE: -3.58 ± 5.41 mg l-1, P < 0.001; mean change for Vit E: -3.25 ± 8.29 mg l-1, P = 0.002) compared to the control. As a result, consumption of PPE in combination with Vit E enhanced the inflammatory status and endothelial function in HD patients.

Chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care

INTRODUCTION

Chronic non-communicable diseases (NCDs), global health problem and it is a threat to health and the development of countries. Currently, the number of people with COVID-19 as well as the resulting death toll is rising sharply worldwide. People with underlying diseases may be at greater risk.

AIM

The purpose of the present study was to investigate the chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care.

METERIALS AND METHODS

To access the articles, including international databases Scopus, PubMed, Web of Science, Embase were searched using the keywords of chronic non-communicable diseases (NCDs), chronic, risk factors, prevention and control, self-efficacy and self-care and their various combinations using AND/OR operators. No language restrictions were applied to the search process.

RESULTS

Based on the evidence, NCDs, exacerbate the negative consequences of COVID-19. according to the results of this study, Among the patients admitted with COVID-19, The most common underlying diseases, were in these people, include, cardiovascular disease, hypertension, chronic obstructive pulmonary disease (COPD), smoking, malignancy, chronic kidney disease, and diabetes mellitus. Obesity may be considered as a potential COVID-19 risk factor.

CONCLUSIONS

Although lifestyle, nutrition, and medical interventions are important for the early prevention of NCDs, having the tools and resources to use information more effectively is more important One of the determining and effective factors in maintaining health and preventing the aggravation of signs and symptoms of the disease COVID-19, especially in chronic diseases, is to perform self-care behaviors.

Acute kidney injury in COVID-19; a review on current knowledge

Coronaviruses are a large family of viruses that can cause a variety of diseases in humans. Some coronaviruses cause only mild illnesses like the common cold. While, some coronaviruses such as SARS-CoV (SARS-associated coronavirus) and Middle East respiratory syndrome coronavirus (MERS-CoV) have, in recent years, been able to cause severe respiratory involvement (pneumonia), leading to death in several patients. By identifying the genomic sequence of the new human coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) it has been revealed that it belongs to the beta coronavirus genus. COVID-19 appears to be transmitted by a mechanism similar to the influenza virus via person to person, sneezing coughing, or contact with the secretions of infected patients. Early symptoms of these respiratory viruses include fever, cough, and shortness of breath, with an incubation period of 2-14 days. SARS-CoV-2 is an acute respiratory disease that initially causes lung damage. SARS-CoV-2 can affect other organs, including the kidneys. Kidney damage may be caused by alterations that occur during coronavirus infection. It seems that low-oxygen delivery to tissues like the kidney in the setting of this disease may lead to ischemic damage of the kidney. Considering the importance of the kidneys, as one, this review study aimed to investigate the effect of the new coronavirus on the kidneys and its role in the development of renal failure.