Effects of Nigella sativa on outcome of hepatitis C in Egypt

AIM: To evaluate the safety, efficacy and tolerability of Nigella sativa (N. sativa ) in patients with hepatitis C not eligible for interferon (IFN)-α. METHODS: Thirty patients with hepatitis C virus (HCV) infection, who were not eligible for IFN/ribavirin therapy, were included in the present study. Inclusion criteria included: patients with HCV with or without cirrhosis, who had a contraindication to IFN-α therapy, or had refused or had a financial constraint to IFN-α therapy. Exclusion criteria included: patients on IFN-α therapy, infection with hepatitis B or hepatitis Ⅰ virus, hepatocellular carcinoma, other malignancies, major severe illness, or treatment non-compliance. Various parameters, including clinical parameters, complete blood count, liver function, renal function, plasma glucose, total antioxidant capacity (TAC), and polymerase chain reaction, were all assessed at baseline and at the end of the study. Clinical assessment included: hepato and/ or splenomegaly, jaundice, palmar erythema, flapping tremors, spider naevi, lower-limb edema, and ascites. N. sativa was administered for three successive months at a dose of (450 mg three times daily). Clinical response and incidence of adverse drug reactions were assessed initially, periodically, and at the end of the study. RESULTS: N. sativa administration significantly improved HCV viral load (380808.7 ± 610937 vs 147028.2 ± 475225.6, P = 0.001) and TAC (1.35 ± 0.5 vs 1.612 ± 0.56, P = 0.001). After N. sativa administration, the following laboratory parameters improved: total protein (7.1 ± 0.7 vs 7.5 ± 0.8, P = 0.001), albumin (3.5 ± 0.87 vs 3.69 ± 0.91, P = 0.008), red blood cell count (4.13 ± 0.9 vs 4.3 ± 0.9, P = 0.001), and platelet count (167.7 ± 91.2 vs 198.5 ± 103, P = 0.004). Fasting blood glucose (104.03 ± 43.42 vs 92.1 ± 31.34, P = 0.001) and postprandial blood glucose (143.67 ± 72.56 vs 112.1 ± 42.9, P = 0.001) were significantly decreased in both diabetic and non-diabetic HCV patients. Patients with lower-limb edema decreased significantly from baseline compared with after treatment [16 (53.30%) vs 7 (23.30%), P = 0.004]. Adverse drug reactions were unremarkable except for a few cases of epigastric pain and hypoglycemia that did not affect patient compliance. CONCLUSION: N. sativa administration in patients with HCV was tolerable, safe, decreased viral load, and improved oxidative stress, clinical condition and glycemic control in diabetic patients.

Combined radiofrequency and chemoembolization vs.chemoembolization in management of hepatocellular carcinoma

Aim:Hepatocellular carcinoma(HCC)is one of the most common cancers in the world.If left untreated,liver cancer has a poor prognosis with more than 90%of patients dying of the disease within 5 years of diagnosis.The aim of this study is to assess the value of combined radiofrequency ablation(RFA),followed by trans-arterial chemoembolization(TACE)in the management of HCC.Methods:Fifty HCC patients with chronic liver disease were categorized into two groups according to the modality of locoregional treatment:25 HCC patients treated with RFA followed by TACE within 5 days and 25 HCC patients treated with TACE only.Results:Complete response was achieved in 100%and 84%of the HCC patients after 1 month from combined RFA-TACE therapy and TACE only respectively.The rate of objective response after 7 months was 84%and 44%in the RFA-TACE and TACE groups respectively.One year disease free survival rate was 56%and 24%in RFA-TACE and TACE groups respectively,and overall survival rate was 88%in the RFA-TACE group and 80%in the TACE only group.Conclusion:Combined RFA-TACE appears to be an effective modality and superior to TACE only for the treatment of HCC.