الفهرس 
Literature ReviewOnly 14 pages are availabe for public view
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Abstract
Cancer chemotherapy has many side effects, including immunodeficiency, which results in bacterial infection. Therefore, collected 53 blood cultures from pediatric cancer patients suffering from bacterial infection in the bloodstream.
The present study using pomegranate peel ethanol extract as well as miswak extract showed a promising in vitro antibacterial activity versus isolated common bacterial isolates including MRSA, E. coli and Klebsiella pneumonia. Furthermore, it could be noticed that pomegranate peel and miwak enhanced in vitro antibiotic action versus Gram negative and Gram positive bacteria.
Moreover, miswak and pomegranate peel extracts were applied either alone or in combination with antibiotics to treat wound infected with most common Gram negative and Gram positive bacteria to assist in wound healing and prevent dissemination of microbes in vivo and it could be noticed that a combinational therapy have given the most successive results upon macroscopic examination of outer surface of skin reflecting the synergistic activity of miswak and pomegranate peel to eradicate bacterial infection and assisting in wound healing action.
One hundred and thirty adult male rats (150-180 g), used during the experimental period of 3 weeks were divided into 13 groups:
group (1) (cont.): Animals skin were processed for wound preparation and act as control.
group (2) (BN): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA (Gram positive bacteria) over the wound.
group (3) (BP): Animals skin were processed for wound preparation and administration of 105 CFU of Klebsiella pneumonia (Gram negative bacteria) over the wound.
group (4) (GR): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of Gentamicin ointment over the processed area twice daily for one week.
group (5) (CIPRO): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of Ciprofloxacin ointment over the processed area twice daily for one week.
group (6) (PM): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of 50mg of miswak extract over the processed area twice daily for one week.
group (7) (PR): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of 60mg of pomegranate peel extract over the processed area twice daily for one week.
group (8) (NM): Animals skin were processed for wound preparation and administration of 105 CFU of Klebsiella pneumonia over the wound, then administration of thin layer of 50mg of miswak extract over the processed area twice daily for one week.
group (9) (NR): Animals skin were processed for wound preparation and administration of 105 CFU of Klebsiella pneumonia over the wound, then administration of thin layer of 60mg of pomegranate peel extract over the processed area twice daily for one week.
group (10) (GR+M): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of 50mg of miswak extract and Gentamincin over the processed area twice daily for one week.
group (11) (GR+R): Animals skin were processed for wound preparation and administration of 105 CFU of MRSA over the wound, then administration of thin layer of 60mg of pomgrante peel extract and Gentamincin over the processed area twice daily for one week.
group (12) (CIPRO+M): Animals skin were processed for wound preparation and administration of 105 CFU of Klebsiella pneumonia over the wound, then administration of thin layer of 50mg of miswak extract and ciprofloxacin over the processed area twice daily for one week.
group (13) (CIPRO+R): Animals skin were processed for wound preparation and administration of 105 CFU of Klebsiella pneumonia over the wound, then administration of thin layer of 60mg of pomegranate peel extract and ciprofloxacin over the processed area twice daily for one week.
Histological investigation of treated rats with combinational therapy of pomegranate peel extract or miswak extract with antibiotics showed more improvement of wound healing.
These histological results on has been confirmed using masson’s trichrome staining for sections from different groups and also observed improvement. While, using TNF-alpha antibody in immunehistostaining protocol considers as an extra confirmatory step in elucidating the synergistic effect of using natural products including pomegranate peel as well as miswak with antibiotics showed rare reactivity as compared to in the wound infection model.
On the other hand, physiological studies recorded that, pro-inflammatory cytokines, including TNF-alpha and IL-1β detected a decreasing levels upon using a combinational therapy approach which confirming the results in the present model.
Testing of oxidative enzymes in the current study reflecting that using natural products of pomegranate peel extract or/and miswak extract increase the secretion of antioxidant enzyme ( SOD) and decreasing the oxidative strees by decreasing the level of MDA to improve the healing process.