Getting a facelift means that you must prepare your body before the big day. A certified surgeon such as Joel Aronowitz, MD, or another doctor, will provide you with preparation tips that you may need to begin at least a few weeks in advance. This guide will provide you with those preparation tips to ensure a successful procedure.

Preparation Tips for a Facelift

A facelift is a procedure that is done to help you achieve a younger-looking face. The skin is lifted and pulled back to make your skin appear smoother and tighter. However, before your big day, your surgeon will provide you with the following preparation tips that you must do to ensure a successful procedure free of complications.

Alter Medications

It is important that you share your medical history and meds with your doctor during your consultation. If necessary, your doctor will communicate with your prescribing physician about changes that may need to occur to your current medications. This ensures that you are safe during the procedure.

Financially Prepare

Facelifts are not cheap. Unfortunately, your health insurance will not cover it either. Before you schedule to have your surgery performed, it is important that you discuss your payment options so you are aware of how you will pay for your treatment.

Quit Smoking

You must also stop smoking if you use nicotine when preparing for a facelift. Nicotine restricts the flow of blood and can even create complications during your procedure and afterward. If you smoke, vape, or chew tobacco, now is the time to stop.

Stop Taking OTC Meds

Anti-inflammatory drugs such as ibuprofen and aspirin should also be avoided prior to having a facelift. Doing so will reduce your risk of experiencing excessive bleeding during and following the procedure. If you are ever unsure what medications you should stop taking, consult with your surgeon.

Plan to Have Help

Prepare to experience some downtime when you undergo a facelift. It is critical that you ask in advance for some help from either your friends or family. Additionally, you will need to have someone drive you to and from your appointment. You will also need to have someone help you with simple daily tasks such as cleaning until you recover.

Cook Meals in Advance

It is also a great idea to cook your meals in advance and freeze them prior to your surgery. This will reduce some of the stress and hassle of cooking and preparing during your recovery.

Fill Any Prescriptions

Your doctor will provide you with any prescriptions for pain meds during your last appointment. It is important that you have those meds filled before the day of your surgery. This ensures that you are able to maintain your regimen for your meds and also prevents you from experiencing severe pain.

Stay Hydrated

As odd as it may sound, it is important that you stay hydrated the day before your surgery. Water does wonders for your body and can aid in helping your body heal. Be sure to drink a lot of water in the days and weeks leading up to your big day.

Saeed Samarghandian, Tahereh Farkhondeh,¹ and Fariborz Samini²

Author information Copyright and License information Disclaimer

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Abstract

Honey is one of the most appreciated and valued natural products introduced to humankind since ancient times. Honey is used not only as a nutritional product but also in health described in traditional medicine and as an alternative treatment for clinical conditions ranging from wound healing to cancer treatment. The aim of this review is to emphasize the ability of honey and its multitude in medicinal aspects. Traditionally, honey is used in the treatment of eye diseases, bronchial asthma, throat infections, tuberculosis, thirst, hiccups, fatigue, dizziness, hepatitis, constipation, worm infestation, piles, eczema, healing of ulcers, and wounds and used as a nutritious supplement. The ingredients of honey have been reported to exert antioxidant, antimicrobial, anti-inflammatory, antiproliferative, anticancer, and antimetastatic effects. Many evidences suggest the use of honey in the control and treatment of wounds, diabetes mellitus, cancer, asthma, and also cardiovascular, neurological, and gastrointestinal diseases. Honey has a potential therapeutic role in the treatment of disease by phytochemical, anti-inflammatory, antimicrobial, and antioxidant properties. Flavonoids and polyphenols, which act as antioxidants, are two main bioactive molecules present in honey. According to modern scientific literature, honey may be useful and has protective effects for the treatment of various disease conditions such as diabetes mellitus, respiratory, gastrointestinal, cardiovascular, and nervous systems, even it is useful in cancer treatment because many types of antioxidant are present in honey. In conclusion, honey could be considered as a natural therapeutic agent for various medicinal purposes. Sufficient evidence exists recommending the use of honey in the management of disease conditions. Based on these facts, the use of honey in clinical wards is highly recommended.

SUMMARY

There are several evidence that suggesting the usage of honey in the management of disease. Therefore, honey in clinical wards is highly recommended.

Abbreviations Used: WA: Water activity, RDI: Recommended daily intake, Si: Silicon, RB: Rubidium, V: Vanadium, Zr: Zirconium, Li: Lithium, Sr: Strontium, Pb: Lead, Cd: Cadmium, As: Arsenic, MIC: Minimum inhibitory concentration, PARP: Poly (ADP-ribose) polymerase, ROS: Reactive oxygen species, iNOS: Inducible nitric oxide synthase, NKcells: Natural killer cells, SCFA: Short-chain fatty acid, CRP: C-reactive protein.

Key words: Antioxidant, flavonoids, honey, polyphenols, therapeutic agent, traditional

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INTRODUCTION

Honey is a natural product formed from nectar of flowers by honeybees (Apis mellifera; Family: Apidae).[1] Honey has been used by humans since ancient times, nearly 5500 years ago.[2] Most ancient population, including the Greeks, Chinese, Egyptians, Romans, Mayans, and Babylonians, consumed honey both for nutritional aims and for its medicinal properties.[2,3] Honey is the only insect-derived natural product, and it has nutritional, cosmetic, therapeutic, and industrial values.[4,5] Honey is reviewed as a balanced diet and equally popular for male and female in all ages.[6] Honey no needs to refrigerate, it never spoils, and it can also be stored unopened at room temperature in a dry place.[7,8] The water activity (WA) of honey is between 0.56 and 0.62 and its value of pH is almost 3.9.[7,8] Honey was utilized as a natural sweetener from ancient period since it has high level of fructose (honey is 25% sweeter than tablet sugar).] Moreover, the use of honey in beverages is also increasingly popular.[8] Nowadays, information on the usage of honey for the cure of many human diseases can be found in general magazines, journals, and natural products’ leaflets and suggesting a wide variety of unknown activities.[10] Evidence indicates that honey can exert several health-beneficial effects including antioxidant,[11] anti-inflammatory,[12] antibacterial,[13] antidiabetic,[14] respiratory, gastrointestinal,[15] cardiovascular, and nervous system[16] protective effects. Although many investigations were done on honey, only a few are published. This study, which is a comprehensive review of the current literature, highlights the therapeutic benefits of honey in the management of diseases.

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METHODS

A literature search was conducted to identify recent articles illustrating efficacy of honey in the cure of diseases. Several online databases were queried, including Web of Science, ScienceDirect, and PubMed. The following keywords were used individually and in combination as inclusion criteria for articles to be considered for this review: honey antioxidant, anti-inflammatory, antibacterial, antidiabetic, apoptotic, respiratory, gastrointestinal, and cardiovascular and nervous system. The present review covers a 42-year period which includes publications from 1970 to 2014. Initial searches yielded nearly 200 results. The abstracts of these papers were reviewed to confirm applicability. After considering additional exclusion criteria (non-English language, and manuscripts not available as full text), 108 papers remained.

Medicinal history of honey

Evidence from Stone Age paintings shows treatment of disease with bee product such as honey originated from 8000 years ago. Ancient scrolls, tablets and books-Sumerian clay tablets (6200 BC), Egyptian papyri (1900–1250 BC), Veda (Hindu scripture) 5000 years, Holy Koran, Bible, and Hippocrates (460–357 BC) illustrated that honey had been widely used as a drug.[17,18,19] Qur’an vividly indicated the activity of therapeutic value of honey.[20] The Lord has inspired the bees, to build their hives in hills, on trees, and in man’s habitations, from within their bodies comes a drink of varying colors, wherein is healing for humankind, verily in this is a sign, for those who give thought. Although a number of papers have been published about honey, most of them have focused on the biochemical analysis, food, and nonfood commercial utilization. Honey was used for variety of disease conditions including eye diseases, asthma, throat infections, tuberculosis, thirst, hiccups, fatigue, dizziness, hepatitis, constipation, worm infestation, piles, eczema, healing of ulcers, and wounds in traditional medicine.[20,21]

Nutritional and nonnutritional components of honey

Today, approximately 300 types of honey have been recognized.[22] These varieties are related to the different types of nectar that are collected by the honeybees. The main composition of honey is carbohydrates that contribute 95–97% of its dry weight. Furthermore, honey includes main compounds, such as proteins, vitamins, amino acids, minerals, and organic acids [Figure 1].[23,24] Pure honey also consists of flavonoids, polyphenols, reducing compounds, alkaloids, glycosides, cardiac glycosides, anthraquinone, and volatile compounds.[25,26,27] Monosaccharides (fructose and glucose) are the most important sugars of honey and may be contributed to the most of the nutritional and physical effects of honey.[28] In addition to monosaccharides, smaller quantities of disaccharides (sucrose, galactose, alpha, beta-trehalose, gentiobiose, and laminaribiose), trisaccharides (melezitose, maltotriose, 1-ketose, panose, isomaltose glucose, erlose, isomaltotriose, theanderose, centose, isopanose, and maltopentaose), and oligosaccharides are present in honey [Figure 2].[29,30] Many of these sugars are formed during the honey ripening and maturation times. Gluconic acid, a product of glucose oxidation, is the main organic acid that is present in honey; in addition, small amounts of acetic, formic, and citric have been found.[31] These organic acids are responsible for the acidic (pH between 3.2 and 4.5) property of honey.[32] Honey also consists of some important amino acids, such as all nine essential amino acids and all nonessential amino acids except for asparagine and glutamine. Proline was reported as the primary amino acid in honey, followed by other types of amino acids.[33] Enzymes (diastase, invertases, glucose oxidase, catalase, and acid phosphatase) constitute the main protein ingredients of honey.[34] The vitamin level in honey is low and does not close to the recommended daily intake [Figure 3]. All of the water-soluble vitamins exist in honey, with Vitamin C being the most frequent. Approximately 31 variable minerals have been found in honey, including all of the major minerals, such as phosphorus, sodium, calcium, potassium, sulfur, magnesium, and chlorine [Figure 4]. Many essential trace components are detected in honey, such as silicon (Si), rubidium (RB), vanadium (V), zirconium (Zr), lithium (Li), and strontium (Sr). However, some heavy metals such as lead (Pb), cadmium (Cd), and arsenic (As) are present as pollutants.[35] Previous studies have detected the approximately 600 volatile compositions in honey that contribute to its potential biomedical effects.[36] The volatile compounds of honey are generally low but include aldehydes, alcohols, hydrocarbons, ketones, acid esters, benzene and its derivatives, pyran, terpene and its derivatives, norisoprenoids, as well as sulfur, furan, and cyclic compounds.[37,38] Flavonoids and polyphenols, which act as antioxidants, are two main bioactive molecules present in honey. Recent evidence has shown the presence of nearly thirty types of polyphenols in honey.[39,40] The existence and levels of these polyphenols in honey can vary depending on the floral source, the climatic and geographical conditions. Some bioactive compounds, including galangin, quercetin, kaempferol, luteolin, and isorhamnetin, are present in all types of honey whereas naringenin and hesperetin are found only in specific varieties.[41] In general, the most phenolic and flavonoid compounds in honey consist of gallic acid, syringic acid, ellagic acid, benzoic acid, cinnamic acid, chlorogenic acid, caffeic acid, isorhamnetin, ferulic acids, myricetin, chrysin, coumaric acid, apigenin, quercetin, kaempferol, hesperetin, galangin, catechin, luteolin, and naringenin.[39,40] The ingredients of honey have been reported to exert antioxidant, antimicrobial, anti-inflammatory, antiproliferative, anticancer, and antimetastatic effects.

Figure 1

An overview of composition of raw honey (average amount per 100 g)

Figure 2

Carbohydrate (average amount per 100 g)

Figure 3

A comparison of the minerals found in honey (major and essential trace minerals)

Figure 4

Vitamin (average amount mg per 100 g)

Structures of major flavonoids, organic acids, and phenolic acids in honey

Flavonoids refer to a group of active natural compounds with a 15-carbon structure, comprising two benzene rings joined by a heterocyclic pyrane ring.[42] They are generally classified as flavonols (quercetin, kaempferol, and pinobanksin), flavones (luteolin, apigenin, and chrysin), flavanones (naringenin, pinocembrin, and hesperetin), isoflavones (genistein), and anthocyanidins.[43] Some flavonoids including genistein, chrysin, luteolin, and naringenin have been reported to show estrogenic activity and are often referred to as phytoestrogens.[44] Figure 5 shows the chemical structures of the major flavonoids and phenolic acids present in honey.

Figure 5

Chemical structures of the flavonoids, organic acids, and phenolic ingredients in honey

Biological activities of honey

Antioxidant activity 

Oxidants agents such as oxygen involve in preventing damage play as an antioxidant which is detected in foods and human body.[45] Although, the natural antioxidants function in human body has not fully understood, however, the investigations illustrated a function in effects of natural honey in many of aging and process highly reactive ingredient drive from oxygen which named free radicals and reactive oxygen species (ROS) are generated during metabolism. These ingredients interact with lipids and protein components in the cell membranes, enzymes as well as DNA. These damaging reactions may lead to various diseases. Fortunately, antioxidants intercept free radicals before they can do damage. Both enzymatic and nonenzymatic substances apply in protective antioxidant.[46] The ability of honey for antioxidant properties is related to the brightness of honey; therefore, the darker honey has higher value of antioxidant. It has been showed that the phenolic compounds are the major responsible factor for antioxidant activity of honey, since the phenolic level is related to radical absorbance activity values of honey.[47] The other investigations illustrated that the antioxidant activity is related to the combination of wide range of active compounds present in honey. Thus, honey has the ability to act as a dietary antioxidant. According to the scientific literature, honey applied alone or in combination with conventional therapy might be a new antioxidant in the control of commonly associated with oxidative stress.[47] In fact from the majority of these data extracted from experimental research, there is an essential need to study this antioxidant effect of honey in the different human disorders.

Antimicrobial activity 

The main factors for antimicrobial activity of honey are the enzymatic glucose oxidation reaction and some of its physical aspects,[48,49] but the other factors that can show antimicrobial activity of honey include high osmotic pressure/low WA, low pH/acidic environment, low protein content, high carbon to nitrogen ratio, low redox potential due to the high level of reducing sugars, a viscosity that limits dissolved oxygen and other chemical agents/phytochemicals. Due to the properties of honey such as low WA and water acidity, glucose oxidase, and hydrogen peroxide, honey does not help in the growth of yeast and bacteria.[50] The peroxidase is not all origin of antibacterial level of honey, but many products with low antibacterial level were discovered in honey including terpenes, pinocembrin, benzyl alcohol, 3,5-dimethoxy-4-hydroxybenzoic acid (syringic acid), methyl-3,5-dimethoxy-4-hydroxybenzoate (methyl syringate), 2-hydroxy-3-phenylpropionic acid, 2-hydroxybenzoic acid, 3,4,5-trimethoxybenzoic acid, and 1,4-dihydroxybenzene.[51]

Many investigations indicated that the antibacterial activity of honey is minimum inhibitory concentration; therefore, honey has the minimum concentration necessary for complete inhibitory growth.[52] Among the many types of honey, manuka honey has the highest level of nonperoxide activity.[49,53] Investigations indicated that Escherichia coli and Staphylococcus aureus can be significantly prevented by manuka honey.[54] It has been illustrated that antibacterial activity of honey is effective on many bacterial pathogens and fungi.[55,56]

Apoptotic activity 

Cancer cells are characterized by inadequate apoptotic turnover and uncontrolled cellular proliferation.[57] Chemicals which are applied for cancer treatment are apoptosis inducers.[58] Honey makes apoptosis in many types of cancer cells through depolarization of mitochondrial membrane.[58,59] Honey increases caspase 3 activation and poly (ADP-ribose) polymerase (PARP) cleavage in human colon cancer cell lines which is related to its high phenolic component.[60] Moreover, it makes apoptosis through modulating the expression of pro- and anti-apoptotic proteins in colon cancer.[60] Honey induces the expression of p53, caspase 3, and proapoptotic protein Bax and also downregulates the expression of anti-apoptotic protein Bcl2.[60] Honey produces ROS leading to the activation of p53 and p53 in turn modulates the expression of pro- and anti-apoptotic proteins such as Bcl-2 and Bax.[60] Oral administration of honey increases the expression of pro-apoptotic protein Bax and also reduces the anti-apoptotic protein Bcl-2 expression in tumor tissue of Wistar rats.[61] Intravenous injection of manuka honey acts its apoptotic effect on cancer cells lines through the involvement of the caspase 9 which in turn activates the caspase-3, the executor protein. Apoptosis was made by manuka honey which also involves in the activation of PARP, DNA fragmentation and loss of Bcl-2 expression.[62] The apoptotic properties of honey make it a possible natural substance as anti-cancer agent as many chemotherapeutics currently used are apoptosis inducer agents.

Anti-inflammatory and immunomodulatory activities 

Chronic inflammation can inhibit healing by damaging tissues. According to the present literature, honey reduces inflammatory response in animal models, cell cultures,[63,64,65] and clinical trials.[66] Phenolic content in honey is responsible for anti-inflammatory effect.[67] These phenolic and flavonoids compounds cause the suppression of the pro-inflammatory activities of cyclooxygenase-2 (COX-2) and/or inducible nitric oxide synthase (iNOS).[68] Honey and its ingredients have been indicated to be involved in regulation of proteins including of iNOS, ornithine decarboxylase, tyrosine kinase, and COX-2. Different types of honey are discovered to induce tumor necrosis factor alpha, interleukin-1 beta (IL-1β), and IL-6 production.[69,70,71] Honey increases T and B lymphocytes, antibodies, eosinophils, neutrophils, monocytes, and natural killer cells generation during primary and secondary immune responses in tissue culture.[72]

It was indicated that slow absorption leads to the production of short-chain fatty acid (SCFA) fermentation agents.[73] It is a likely mechanism that the ingestion of honey may result in SCFA production.[74] The immunomodulatory actions of SCFA have been confirmed.[75] Therefore, honey may induce the immune response through these fermentable sugars.[76] A sugar, nigerooligosaccharides, present in honey has been observed to have immunopotentiating effects.[77] Nonsugar ingredients of honey are also responsible for immunomodulation.[76]

Medicinal properties

Honey and wound 

Honey is the oldest wound-healing agent known to mankind when some modern chemicals have failed in this regard.[53] Experimental research illustrated more documents supporting its usage in wound healing because of its bioactivities including antibacterial, antiviral, anti-inflammatory, and antioxidant activities.[78] Honey induces leukocytes to release cytokines, which is what begins the tissue repair cascades. Furthermore, it actives immune response to infection.[79] The stimulation of other properties of the immune response by honey is also reported (Proliferation of B- and T-lymphocytes and the phagocytes activity). Honey induces the generation of antibodies. Many evidence suggest the use of honey in the control and treatment of acute wounds and for mild to moderate superficial and partial thickness burns.[80] Although some studies indicated the efficacy of honey in relation to wound treatment and leg ulcers, more studies are needed to strengthen the current evidence.

Honey and diabetes 

There are strong evidences which indicate the beneficial effects of honey in the treatment of diabetes mellitus.[81] These results point out the therapeutic prospects of using honey or other potent antioxidants as an adjunct to standard antidiabetic drugs in the control of diabetes mellitus. Regarding the restrictions associated with using of antioxidants, other interventions targeted at decreasing ROS generation may also be used as an adjunct to conventional diabetes therapy. In one of the clinical trials of Type 1 and Type 2 diabetes mellitus, the application of honey was associated with dramatically lower glycemic index than with sucrose or glucose in type 1 diabetes and normal.[82] Type 2 diabetes has values similar for honey, glucose, and sucrose. In the diabetic patients, honey can induce significantly a reduction in plasma glucose level versus dextran.[83] In normal and hyperlipidemic patients, it also reduces blood lipids, homocysteine and C-reactive protein contents. However, several questions have been remained, especially as it relates to the prospect of controlling diabetes mellitus by interventions that target both oxidative stress and hyperglycemia. Furthermore, the therapeutic effects of honey in the management of diabe tes may not only be restricted to controlling glycemia but also may be extended to ameliorating the associated metabolic complication diseases.[81]

Honey and cancer 

Current studies show that honey may exert anticancer effects through several mechanisms.[84] Investigations have indicated that honey has anticancer property through its interference with multiple cell-signaling pathways, including inducing apoptosis, antimutagenic, antiproliferative, and anti-inflammatory pathways. Honey modifies the immune responses.[84] Honey has been indicated to prevent cell proliferation, induce apoptosis, modify cell cycle progression, and cause mitochondrial membrane depolarization in several types of cancer such as skin cancer cells (melanoma),[85] adenocarcinoma epithelial cells, cervical cancer cells,[86] endometrial cancer cells,[87,88] liver cancer cells, colorectal cancer cells, prostate cancer cells,[89,90,91] renal cell carcinoma,[92] bladder cancer cells, human nonsmall cell lung cancer,[93] bone cancer cells (osteosarcoma), and leukemia and mouth cancer cells (oral squamous cell carcinoma).[94] In addition, honey could be able to inhibit several forms of tumor in animal modeling including breast cancer, carcinoma, melanoma, colon carcinoma, hepatic cancer, and bladder cancer. However, more studies are needed to improve our understanding of the positive effect of honey and cancer.

Honey and asthma 

Honey is commonly used in folk medicine to treat inflammation, cough, and fever.[95] The ability of honey to act in reducing asthma-related symptoms or as a preventive agent to preclude the induction of asthma was showed. Chronic bronchitis and bronchial asthma were treated by oral honey consumption in animal modeling.[95] Furthermore, a study conducted by Kamaruzaman et al. showed that treatment with honey effectively inhibited ovalbumin-induced airway inflammation by reducing asthma-related histopathological changes in the airway and also inhibited the induction of asthma.[96] Inhalation of honey was also discovered to effectively remove mucus-secreting goblet cell hyperplasia. However, future studies are needed to investigate these effects of honey to better understand the mechanisms by which honey reduces asthma symptoms.

Honey and cardiovascular diseases 

Antioxidants present in honey such as flavonoids, polyphenolics, Vitamin C, and monophenolics may be associated with a reduced risk of cardiovascular failures. In the coronary heart disease, the protective effects of flavonoids such as antioxidant, antithrombotic, anti-ischemic, and vasorelaxant and flavonoids reduce the risk of coronary heart disorders through three mechanisms: (a) improving coronary vasodilatation, (b) reducing the ability of platelets in the blood to clot, and (c) inhibiting low-density lipoproteins from oxidizing. Although there is a wide spectrum of antioxidant types, caffeic acid, quercetin, phenethyl ester, kaempferol, galangin, and acacetin predominate in different types of honeys. Several investigations showed that certain honey polyphenols have a promising pharmacological function in reducing cardiovascular disorders. However, in vitro and in vivo research and clinical trials should be initiated to further validate these compounds in medical applications.[97]

Honey and neurological diseases 

There is important scientific literature for the illustration of nutraceutical agents as novel neuroprotective therapies, and honey is one such promising nutraceutical antioxidant.[16] Honey exerts anxiolytic, antidepressant, anticonvulsant, and antinociceptive effects and ameliorates the oxidative content of the central nervous system. Several studies on honey propose that honey polyphenols have nootropic and neuroprotective properties.[98] Polyphenol ingredients of honey quench biological ROS that lead to neurotoxicity, aging, and the pathological deposition of misfolded proteins, including amyloid beta.[99] Polyphenol ingredients of honey counter oxidative stress through excitotoxins, including quinolinic acid and kainic acid, and neurotoxins, including 5-S-cysteinyl-dopamine and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine.[99] Furthermore, honey polyphenols constituents counter direct apoptotic challenges through amyloid beta, methyl mercury induced and retinoid.[100] Raw honey and honey polyphenol reduce the microglia-induced neuroinflammation that is induced through immunogenic neurotoxins or ischemia damage.[101] Most significantly, honey polyphenols counter neuroinflammation in the hippocampus, a brain structure that is involved in memory.[102] Honey polyphenols prevent memory disorders and induce memory production at the molecular level.[102] Several researches propose that the modifications of specific neural circuitry underlies the memory improving and neuropharmacological effects of honey.[16] However, more studies are needed to determine the ultimate biochemical impact of honey on mitochondrial dysfunction, apoptosis, necrosis, excitotoxicity, and neuroinflammation and anxiolytic, antinociceptive, anticonvulsant, and antidepressant activities should be examined in further detail.

Honey and gastrointestinal diseases 

Honey has been suggested as potentially useful for various conditions of the gastrointestinal tract, such as periodontal and other oral disorders,[51] dyspepsia, and as part of oral rehydration therapy. In vitro studies propose that honey exerts bactericidal activity against Helicobacter pylori[103] although a clinical trial of manuka honey therapy to induce Helicobacter eradication failed to indicate a beneficial treatment.[104] In addition, honey may be effective as a part of oral rehydration therapy, and as a clinical trial, honey shows therapeutic effects in the treatment of infants and children admitted into hospital with gastroenteritis indicated remarkable reduced duration of diarrhea in the honey-treated patients.[105,106]

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CONCLUSION

Sufficient evidence exists recommending the use of honey in the management of disease conditions. Evidence confirming the use of honey in all areas of clinical practice is needed. Studies revealed that the medicinal effect of honey may be due to of its antibacterial, anti-inflammatory, apoptotic, and antioxidant properties. This review should provide practitioner with remarkable evidence supporting the use of honey in the medical field. Although some studies exist having tested the efficacy of honey in relation to medical purposes, more studies are needed to cover all medicinal aspects of honey.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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Acknowledgement

The authors would like to thank Research Affairs of Neyshabur University of Medical Sciences for financially supporting this work.

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Premier League team news

Premier League team news: A classic is on the cards between Arsenal and Manchester United while Everton face West Ham in a relegation six-pointer

Liverpool v Chelsea

Saturday 12.30pm BT Sport 1 Venue Anfield Last season Liverpool 1 Chelsea 1

Referee Michael Oliver This season G15 Y48 R1 3.26 cards/game

Odds H 10-11 A 33-10 D 3-1

Liverpool

Subs from Kelleher, Adrián, Matip, Ramsey, Tsimikas, Phillips, Henderson, Milner, Oxlade-Chamberlain, Jones, Elliott, Bajcetic, Carvalho, Doak

Doubtful Núñez (knock)

Injured Van Dijk (hamstring, Feb), Díaz (knee, March), Arthur (thigh, Feb), Jota (calf, Mar), Firmino (calf, unknown)

Suspended None

Discipline Y18 R1

Form WWWWLL

Leading scorers Firmino, Salah 7

Chelsea

Subs from Bettinelli, Soonsup-Bell, Hall, Chukwuemeka, Aubameyang, Giraud-Hutchinson, Humphreys, Badiashile, D Fofana, Cucurella, Gallagher, Loftus-Cheek, Mudryk

Doubtful None

Injured Sterlling (hamstring, Feb), W Fofana (knee, Feb), Zakaria (quadricep, Feb), James (knee, Feb), Chilwell (thigh, Feb), Kanté (thigh, Mar), Broja (knee, unknown), Pulisic (knee, unknown), Mendy (finger, unknown)

Suspended João Felix (second of three)

Discipline Y37 R3

Form LWDLLW

Leading scorer Havertz 5

Bournemouth v Nottingham Forest

Saturday 3pm Venue Vitality Stadium Last season Bournemouth 1 Nottingham Forest 0 (Championship)

Referee Andy Madley This season G12 Y41 R2 3.58 cards/game

Odds H 8-5 A 17-10 D 11-5

Bournemouth

Subs from Dennis, Neto, Plain, Rothwell, Dembélé, Stacey, Cook, Kelly, Ouattara, Brooks, Fredericks, Stanislas, Tavernier, Dacosta, Adu Adjei, Sadi, Stephens

Doubtful Brooks (thigh), Fredericks (illness), Stanislas (knock), Tavernier (hamstring), Cook (knee)

Injured Solanke (knee, unknown)

Suspended None

Discipline Y32 R0

Form LWLLLL

Leading scorers Billing, Moore 4

Nottingham Forest

Subs from Smith, Soh, Colback, Surridge, Cafú, Badé, Taylor, Cook, O’Brien, Dennis, Toffolo, Williams, Yates

Doubtful None

Injured Lingard (hamstring, Feb), Henderson (hamstring, Feb), Boly (ankle, Feb), Niakhaté (thigh, Feb), Richards (calf, Feb), Awoniyi (groin, Mar), Biancone (knee, unknown), Kouyaté (hamstring, unknown)

Suspended None

Discipline Y42 R0

Form WDLDWW

Leading scorers Awoniyi, Johnson 4

Leicester v Brighton

Saturday 3pm Venue King Power Stadium Last season Leicester 1 Brighton 1

Referee Thomas Bramall This season G4 Y14 R0 3.5 cards/game

Odds H 12-5 A 11-10 D 5-2

Leicester

Subs from Iversen, Smithies, Vardy, Iheanacho, Pérez, Vestergaard, Mendy, McAteer, Soyuncu, Brunt, Braybrooke, Albrighton, Maddison

Doubtful Maddison (knee), Pérez (knock)

Injured Pereira (calf, Feb), Soumaré (hamstring, Feb), Evans (calf, Feb), Justin (achilles, Jun), Bertrand (knee, unknown)

Suspended None

Discipline Y24 R0

Form WWLLLL

Leading scorer Maddison 7

Brighton

Subs from McGill, Steele, Lamptey, Welbeck, Sarmiento, Enciso, Undav, Van Hecke, Moran, Gilmour, Veltman

Doubtful None

Injured Moder (knee, Feb), Colwill (knock, unknown)

Suspended None

Discipline Y26 R0

Form WLWLWW

Leading scorer Trossard 7

Southampton v Aston Villa

Saturday 3pm Venue St Mary’s Stadium Last season Southampton 1 Aston Villa 0

Referee Michael Salisbury This season G8 Y36 R1 4.62 cards/game

Odds H 2-1 A 8-5 D 5-2

Southampton

Subs from Caballero, McCarthy, Mara, Edozie, Walcott, Aribo, S Armstrong, Maitland-Niles, Morgan, Alcaraz, Orsic, A Armstrong, Djenepo, Bella-Kotchap, Perraud

Doubtful Walcott (match fitness), McCarthy (ankle), Bella-Kotchap (knee)

Injured Livramento (knee, Feb), Larios (groin, unknown)

Suspended None

Discipline Y31 R0

Form LLLLLW

Leading scorer Ward-Prowse 5

Aston Villa

Subs from Olsen, Steer, Sanson, Chambers, Augustinsson, Nakamba, Bednarek, Dendoncker, Coutinho

Doubtful Cash (groin), Steer (calf)

Injured McGinn (hamstring, Feb), Diego Carlos (calf, Feb), Digne (shoulder, unknown)

Suspended None

Discipline Y43 R1

Form WWLWDW

Leading scorer Bailey 4

West Ham v Everton

Saturday 3pm Venue London Stadium Last season West Ham 2 Everton 1

Referee Stuart Attwell This season G12 Y42 R2 3.66 cards/game

Odds H 4-5 A 21-5 D 14-5

West Ham

Subs from Areola, Randolph, Johnson, Fornals, Antonio, Lanzini, Downes, Ogbonna, Coventry, Ashby, Luizão, Kehrer, Scamacca

Doubtful Areola (groin), Cornet (calf), Scamacca (knee), Ings (registration)

Injured None

Suspended None

Discipline Y25 R0

Form LLLLDL

Leading scorers Benrahma, Scamacca 3

Everton

Subs from Begovic, Lonergan, Mina, Holgate, Vinagre, Doucoure, Davies, McNeil, Gordon, Maupay, Mills, Price, Simms, Onyango

Doubtful Garner (back)

Injured Townsend (knee, Feb), Keane (knee, Feb), Patterson (knee, Mar)

Suspended None

Discipline Y40 R0

Form LLLDLL

Leading scorers Gordon, Gray 3

Crystal Palace v Newcastle

Saturday 5.30pm Sky Sports Premier League Venue Selhurst Park Last season Crystal Palace 1 Newcastle 1

Referee Craig Pawson This season G11 Y47 R0 4.27 cards/game

Odds H 18-5 A 11-12 D 12-5

Crystal Palace

Subs from Johnstone, Whitworth, Milivojevic, Tomkins, Mateta, Édouard, Ferguson, Balmer, Riedewald, Gordon, Wells-Morrison, Goodman, Rodney, Ward, Schlupp, Ozoh

Doubtful Ferguson (match fitness)

Injured McArthur (groin, unknown), Richards (thigh, unknown)

Suspended None

Discipline Y39 R2

Form LLWLLD

Leading scorer Zaha 6

Newcastle

Subs from Dubravka, Lascelles, Dummett, Manquillo, Lewis, Ritchie, Anderson, Isak, Murphy

Doubtful None

Injured Shelvey (calf, Feb), Krafth (knee, Aug), Guimarães (ankle, unknown), Targett (ankle, unknown)

Suspended None

Discipline Y33 R0

Form WWWDDW

Leading scorer Almirón 9

Leeds v Brentford

Sunday 2pm Sky Sports Premier League Venue Elland Road Last season Leeds 2 Brentford 2

Referee Peter Bankes This season G9 Y42 R0 4.66 cards/game

Odds H 7-5 A 2-1 D 27-10

Leeds

Subs from Robles, Ayling, Aaronson, Cooper, Firpo, Llorente, Perkins, Georginio, Gyabi, Sinisterra, Gelhardt

Doubtful Cooper (knee), Wober (groin)

Injured Forshaw (groin, Feb), Summerville (ankle, Feb), Dallas (leg, unknown)

Suspended None

Discipline Y36 R2

Form WLLDDL

Leading scorer Rodrigo 10

Brentford

Subs from Strakosha, Cox, Roerslev, Hickey, Goode, Sørensen, Canós, Damsgaard, Dasilva, Ghoddos, Lewis-Potter, Crama, Trevitt, Jørgensen, Schade

Doubtful Hickey (knock), Henry (calf)

Injured Baptiste (groin, Feb), Onyeka (thigh, Feb), Jansson (thigh, Feb)

Suspended None

Discipline Y26 R0

Form DWDWWW

Leading scorer Toney 13

Manchester City v Wolves

Sunday 2pm Venue Etihad Stadium Last season Manchester City 1 Wolves 0

Referee David Coote This season G10 Y33 R1 3.4 cards/game

Odds H 1-5 A 16-1 D 7-1

Manchester City

Subs from Carson, Palmer, Wilson-Esbrand, Walker, Ortega, Gomez, Silva, Phillips, Dias, Foden, Álvarez, Stones, Laporte

Doubtful None

Injured None

Suspended None

Discipline Y18 R1

Form LWDWLW

Leading scorer Haaland 22

Wolves

Subs from Sarkic, Aït-Nouri, Mosquera, Jonny, Toti, Ronan, Smith, Campbell, Guedes, Costa, A Traoré, Jiménez

Doubtful None

Injured Neto (ankle, Feb), Chiquinho (knee, Apr), Kalajdzic (knee, unknown), B Traoré (groin, unknown)

Suspended None

Discipline Y39 R3

Form LLWLDW

Leading scorer Podence 5

Arsenal v Manchester United

Sunday 4.30pm Sky Sports Premier League Venue Emirates Stadium Last season Arsenal 3 Manchester United 1

Referee Anthony Taylor This season G14 Y54 R5 4.21 cards/game

Odds H 13-14 A 16-5 D 41-14

Arsenal

Subs from Hein, Turner, Soares, Tierney, Tomiyasu, Holding, Sambi Lokonga, Elneny, Vieira, Marquinhos, Smith Rowe, Trossard

Doubtful Elneny (knock)

Injured Jesus (knee, Mar), Nelson (hamstring, unknown)

Suspended None

Discipline Y32 R0

Form WWWWDW

Leading scorer Ødegaard 8

Manchester United

Subs from Heaton, Butland, Hannibal, Fred, Pellestri, Malacia, Maguire, Elanga, Williams, Lindelöf, Martial, Weghorst

Doubtful Martial (match fitness)

Injured Dalot (hamstring, 28 Jan), Van de Beek (knee, Aug), Sancho (match fitness, unknown), Tuanzebe (match fitness, unknown)

Suspended Casemiro (one match)

Discipline Y48 R0

Form WWWWWD

Leading scorer Rashford 8

Fulham v Tottenham

Monday 8pm Sky Sports Premier League Venue Craven Cottage Last season n/a

Referee Paul Tierney This season G15 Y50 R2 3.46 cards/game

Odds H 23-10 A 6-5 D 14-5

Fulham

Subs from Rodak, Adarabioyo, Duffy, Chalobah, James, Mbabu, Harris, Vinícius, Cairney, Wilson, Kurzawa, Solomon

Doubtful None

Injured Kebano (achilles, unknown)

Suspended None

Discipline Y49 R1

Form LWWWWL

Leading scorer Mitrovic 11

Tottenham

Subs from Forster, Austin, Spence, Davies, Sánchez, Tanganga, Skipp, Sarr, Gil, Doherty, Perisic, Bissouma, Son

Doubtful None

Injured Lucas Moura (calf, unknown)

Suspended None

Discipline Y39 R1

Form WDLWLL

Leading scorer Kane 15