Treatment of cutaneous leishmaniasis: cassia fistula fruit gel- intralesional glucantime Vs. placebo gel- intralesional glucantime combination

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Cutaneous leishmaniasis is a major health problem in Iran and especially Isfahan province is considered as an endemic area for this disease. Regarding the previous report of positive effects of Cassia fistula boiled extract in the treatment of cutaneous leishmaniasis, this study was designed to evaluate the effect of combination therapy with intralesional meglumine antimoniate and Cassia fistula fruit gel compared to placebo in this disease."n"nMethods: 140 patients with cutaneous leishmaniasis referring to Skin Disease and Leishmaniasis Research Center of Isfahan (SDLRC) were randomly allocated in two groups. One group received intralesional meglumine antimoniate injection and Cassia fistula fruit gel and the second group were treated with intralesional meglumine antimoniate and placebo gel. Improvement was defined as complete cure, partial cure and treatment failure. "n"nResults: At 12 week, 47 patients treated with intralesional meglumine antimoniate and topical Cassia fistula fruit gel achieved complete cure (67.1%) compared to 29(41.4%) patients in placebo treated group. There was significant difference in cure rate between two treatment groups of this study (p<0.001). Nine patients (19%) in each group suffered from adverse effects of the treatment such as itching and erythema. There was no significant difference in this regard between two groups (p=0.82). "n"nConclusions: The results of this study shows the efficacy of Cassia fistula fruit gel in increasing the cure rate of cutaneous leishmaniasis lesions achieved by intralesional meglumine antimoniate. Combination therapy of intralesional meglumine antimoniate and Cassia fistula fruit gel could be suggested as a choice for the treatment of acute cutaneous leishmaniasis lesions

A comparative study between the efficacy of systemic meglumine antimoniate therapy with standard or low dose plus oral omiprazole in the treatment of cutaneous leishmaniasis

Background & objectives: Pentavalent antimony compounds are the first line of drugs in the treatment of cutaneous leishmaniasis. However, because of their potential toxic effects, many investigations are performed to find an effective and safe treatment for cutaneous leishmaniasis patients. Our objective in this investigation was to compare the effect of oral omeprazole and low dose systemic meglumine antimoniate (MA) and standard dose of systemic MA in the treatment of cutaneous leishmaniasis. Methods: This was a randomized double-blinded clinical trial. In 150 patients with cutaneous leishmaniasis who were randomly divided into three groups and were treated with: (i) MA 60 mg/kg/day/IM and oral placebo for three weeks; (ii) MA 30 mg/kg/day/IM and oral omeprazole 40 mg/day for three weeks; and (iii) MA 30 mg/kg/day/IM and oral placebo for three weeks. All the patients were visited every two weeks from the beginning of the trial up to six weeks and then at 8 and 12 weeks. The effectiveness of the treatment was classified in three levels as complete response, partial response and no response. Data were analyzed by SPSS 10 using KI square, Mann-Whitney, Kaplan-Mayer and ANOVA tests.Results: Rate of complete response for three months (12 weeks) after starting the treatments was 93% for the group treated with standard dose of glucantime and placebo, 89% for the group treated with omeprazole and low dose glucantime and 80% for the group treated with low dose glucantime and placebo and these differences were significant (p<0.05). The highest response rate was for the group treated with standard dose of glucantime and placebo.Interpretation & conclusion: Although oral omeprazole and low dose of systemic MA showed less efficacy in comparison to standard dose of systemic MA in the treatment of cutaneous leishmaniasis, it still can be considered as a replacement therapy in high risk patients (such as patients with heart, kidney and/or liver disease) under close supervision of physician

Karyosystematic and morphometric characterization of the rodents as reservoir hosts of zoonotic cutaneous leishmaniasis in an endemic focus of Isfahan Province, Iran

Background & objectives: Rodents belonging to Gerbillinae subfamily are the main reservoir hosts of zoonotic cutaneous leishmaniasis (ZCL) in Iran. Regarding the important role of these rodents in the maintenance of Leishmania major in the nature, their identification with morphometric, cytogenetic and molecular methods seems to be essential. The karyotype study of these species, captured from a new focus of zoonotic cutaneous leishmaniasis located in the south of Isfahan Province was carried out in 2007.Methods: Twenty specimens containing seventeen Meriones persicus and three Nesokia indica were captured from Mobarakeh rural district south of Isfahan. Giemsa-stained karyotypes of these two species were prepared from bone marrow chromosome preparations. Systematic important characters of the body and cranium (incisors, molars, occipitonasal, condylobasal, zygomatic, tympanic bullae, etc.) of these rodents were studied. Cranium size was measured using a Vernier calipers.Results: Specimens of M. persicus and N. indica had 2n = 42. The karyotype study of these species included metacentric, sub-metacentric and acrocentric chromosomes. Morphological studies were completely matched with the reported characters of these species and further confirmed the diagnoses. Interpretation & conclusion: Based on the results of this study, M. persicus and N. indica are two completely differentiated rodents species that were collected from a new focus and they can also be differentiated morphologically

Chemical and Biological Analyses of the Essential Oils and Main Constituents of Piper Species

The essential oils obtained from leaves of Piper duckei and Piper demeraranum by hydrodistillation were analyzed by gas chromatography-mass spectrometry. The main constituents found in P. demeraranum oil were limonene (19.3%) and β-elemene (33.1%) and in P. duckei oil the major components found were germacrene D (14.7%) and trans-caryophyllene (27.1%). P. demeraranum and P. duckei oils exhibited biological activity, with IC50 values between 15 to 76 μg mL−1 against two Leishmania species, P. duckei oil being the most active. The cytotoxicity of the essential oils on mice peritoneal macrophage cells was insignificant, compared with the toxicity of pentamidine. The main mono- and sesquiterpene, limonene (IC50 = 278 μM) and caryophyllene (IC50 = 96 μM), were tested against the strains of Leishmania amazonensis, and the IC50 values of these compounds were lower than those found for the essential oils of the Piper species. The HET-CAM test was used to evaluate the irritation potential of these oils as topical products, showing that these oils can be used as auxiliary medication in cases of cutaneous leishmaniasis, with less side effects and lower costs