ETHNOBOTANICAL SURVEY AND SCIENTIFIC VALIDATION OF MEDICINAL PLANTS USED IN THE TREATMENT OF FUNGAL INFECTIONS IN AGUMBE REGION OF WESTERN GHATS, INDIA

Objective: Western Ghats is one of the plant biodiversity hot spot of India. Agumbe region of Western Ghats is known for rich plant diversity and traditional medicinal practices. The aim of the study was to document ethnomedicinal practices followed in this region to treat fungal infections and their scientific validation in vitro.Methods: An ethnobotanical survey was conducted to identify the plants used to treat fungal infections in Agumbe region of Western Ghats, India. Aqueous extracts of the plants selected based on the ethnobotanical survey were subjected to in vitro antifungal activity assay. Significantly active plant extract was subjected to activity guided separation methods. The active fraction was subjected to phytochemical, TLC bioautographic and IR spectral analysis to identify the active principle.Results: Ten plants were identified to be used to treat fungal infections. Scientific validation by in vitro antifungal activity assay revealed significant inhibitory activity by aqueous extract of Combretum latifolium. Phytochemical and Infra red spectral analysis of the active fraction revealed the presence of saponins, tannins and phenolic compounds.Conclusion: The study presents the first report of antifungal potential of Combretum latifolium and Humboldtia brunonis. High polar tannin is identified as the antifungal active principle in the aqueous extract of C. latifolium.Â

ANTIFUNGAL ACTIVITY OF PIMENTA DIOICA (L.) MERRIL AN AROMATIC MEDICINAL TREE

Objective: To assess the antifungal activities of the extracts of leaves of Pimenta dioica against human pathogenic fungi and identify the class of phytochemical responsible for the biological activity.Methods: The shade dried, and powdered leaves of Pimenta dioica were subjected to polarity based solvent extraction by soaking. The extracts were dried in a rotary flash evaporator and subjected to antifungal activity assay against Candida albicans, Microsporum canis and M. gypseum, by disc diffusion method. Antifungal active petroleum ether extract was subjected to phytochemical analysis to identify the active compound. The extract was then subjected to Thin Layer Chromatography (TLC) and Bioautography, by agar overlay method. The fractions were collected by Preparative TLC method and subjected to antifungal activity assay by disc diffusion method. Further, the Libermann-Burchard test was conducted to detect the broad group of compounds responsible for the bioactivity.Results: Among the five extracts viz. petroleum ether, chloroform, ethyl acetate, methanol and aqueous, the petroleum ether extract showed significant antifungal activity against Microsporum canis (50 mm), Microsporum gypseum (60 mm) and Candida albicans (23 mm). Terpenoids, tannins and flavonoids were found to be the chief constituents of the petroleum ether extract. The TLC of the extract revealed 7 spots with the Rf values 0.37, 0.42, 0.45, 0.52, 0.59, 0.76, 0.96 with the solvent system of hexane and acetone (1:0.5). The bioautography assay revealed inhibitory activity in the spots at Rf values 0.52 and 0.59. These fractions obtained by preparative TLC also confirmed the same. The phytochemical analysis of the fractions on the TLC plate suggests that the compound is triterpene or steroid.Conclusion: The antifungal activity of Pimenta dioica and the bioactive phytochemical has been reported in the present study. Preliminary phytochemical analysis has indicated that the compounds are triterpenes or steroids. The results indicate that the active compounds are potential lead molecules for new antifungal drugs in the management of infectious fungi

Clinical, etiological and laboratory profile of febrile thrombocytopenia and correlation of platelet count with outcome in a South Indian tertiary hospital

Background: Febrile thrombocytopenia is commonly encountered by doctors especially during monsoon and peri-monsoon period, many of these patients have a turbulent cthisse with multi organ dysfunction and might land up in ICU with significant morbidity and mortality. Infections are the commonest causes of thrombocytopenia and they vary with season and geographical location. A systematic approach, carried out with an awareness of causes, clinical presentation and laboratory profile of febrile thrombocytopenia can shorten the duration of investigations and bring out the diagnosis early, reducing morbidity and mortality of patients and reducing burden on hospital resthisces. The objective of the study is to study the underlying etiology, the various clinical presentations, laboratory profile and complications of fever with thrombocytopenia in this community during monsoon period and to correlate thrombocytopenia with outcome, co morbidities and its etiology.Methods: The prospective observational study was conducted in tertiary centre in Kolar between June-December 2017. Patients meeting inclusion and exclusion criteria were grouped into 4 groups based on platelet counts, and correlated with comorbidities, etiology and outcome. Detailed clinical and laboratory examination were done in all patients and p value of <0.05 was considered statistically significant.Results: Among 465 patients were included in the study. Dengue was the most common cause for febrile thrombocytopenia and mortality. Hepatic complications and petechiaes were the most common complications and bleeding manifestations. 135 patients received platelet transfusion but there was no relationship between platelet transfusion and outcome, there were 9 deaths in the study and there was no association between death and platelet count at admission.Conclusions: There was no relation between platelet count on admission and mortality and also there was no relationship between platelet transfusion and outcome. Knowing the clinical presentation, etiology, complications and its monitoring can significantly reduce the morbidity and mortality due to febrile thrombocytopenia

A CASE OF LEPTOSPIROSIS WITH ERYTHEMA NODOSUM AND REACTIVE ARTHRITIS DURING THE FIRST TRIMESTER OF PREGNANCY

Leptospirosis is a zoonosis and occurs in endemic as well as epidemic forms in many parts of India. Manifestations may range from asymptomatic infection to fulminant fatal disease with myositis, conjunctivitis, hepatic, renal, cardiac and neurological involvement and hemorrhagic manifestations. A 30 years old lady in her first trimester of gestation presented with fever, multiple painful erythematous swellings over the front of both legs and swelling associated with pain of left ankle joint for 1 week . On evaluation she had erythema nodosum over the anterior aspect of both lower extremities and reactive arthritis of left ankle joint. Leptospira serology for Immunoglobulin M was positive. She was started on intravenous ceftriaxone 1 gm twice daily. After 7 days of treatment, erythema nodosum and reactive arthritis subsided. Erythema nodsum and reactive arthritis which are rare manifestations of leptospirosis have occurred together in a patient during the first trimester of pregnancy makes this case worth presenting

Relation between monocyte/high density lipoprotein ratio in acute ischemic stroke severity

Introduction: Stroke is a common neurological condition, with a high incidence of mortality and morbidity, especially in the elderly population. Inflammation and lipid abnormalities have been proposed for the pathophysiology development and progression of atherosclerosis. Monocyte count to High density lipoprotein (HDL) ratio (MHR) is proposed as a novel predictor of prognosis in cardiovascular diseases. In this study, we aim to investigate the relationship of MHR with stroke severity in acute ischemic stroke patients.Methods: A total of 64 patients with acute ischemic stroke were inpatients of RLJH were included in the study. Patients were divided into 2 groups according to the National institute of health stroke (NIHS) score (group 1; national institute of health stroke scale (NIHSS) <16, group 2; NIHSS ≥16). MHR is the ratio obtained by dividing the monocyte count with HDL from a peripheral blood sample. Then the association between MHR and NIHSS score at the time of admission is evaluated.Results: Accordingly, the results obtained revealed MHR was significantly lower in group 1 patients who have lower NIHSS score than group 2 patients who have higher NIHSS.Conclusion: This study suggests that MHR is associated with stroke severity on admission in patients with acute ischemic stroke

PHYTOCHEMICAL, ANTIBACTERIAL AND ANTIOXIDANT STUDIES ON LEAF EXTRACTS OF PIPER BETLE L.

Objective: In the present research, a clear systematic investigation of antibacterial and antioxidant potential of ambadi variety of P. betle of Mysore region has been carried out.Methods: Antibacterial activity of aqueous and solvent extracts of Piper betle L. was evaluated by agar cup diffusion and disc diffusion methods against some common pathogenic bacteria. The antioxidant property of all the solvent extracts were evaluated by diphenyl picryl hydrazyl (DPPH), nitric oxide (NO) and hydrogen peroxide scavenging assay. The IC50 values were calculated and compared with standard BHT and AA.Results: The results indicated that methanol and chloroform extracts of this variety recorded significant antibacterial activity and all the extracts recorded good radical scavenging capacity. Phytochemical analysis revealed that phenols, tannins, flavanoids, glycosides and proteins are present in aqueous, methanol and petroleum ether extracts.Conclusion: The results obtained in this study clearly indicate that P. betle extracts has a significant potential to use as antibacterial agent. The free radical scavenging capability by DPPH was better and IC50 value found was lesser than the standard used for all the extracts, which suggest that P. betle extracts have potent antioxidant activity. The solvent extracts are effective against free radical mediated diseasesÂ

HbA1c as a prognostic indicator in prediabetics with acute coronary syndrome

Background: The role of HbA1C in predicting the outcomes of acute coronary syndrome remains controversial. Lesser is known about it in non-diabetic patients. Therefore authors conducted a study to seek association between the HbA1C levels and the clinical outcome in non-diabetic patients who presented with acute coronary syndrome. Objective of the study was to estimate HbA1C levels in population of prediabetics and non-diabetics and to document and correlate major adverse cardiac events in prediabetic and non-diabetics.Method: This case control study included consecutive patients (n=68) without known diabetes mellitus admitted with acute coronary syndrome (STEMI, NSTEMI, UA) at our hospital. HbA1c was measured on admission. The patients were divided into 2 groups according to their HbA1c level (group 1 HbA1c5.7%). The main outcome was MACE (major adverse cardiac events including cardiogenic shock, arrhythmia, heart failure).Results: There was no significant difference between baseline characteristics of both groups but complications were seen in higher number cases with HbA1c >5.7%. No significant difference in mortality was found. On analysis HbA1c >5.7% was found to be an independent predictor of MACE.Conclusion: HbA1C is a predictor of major adverse cardiac events. Measurement of HbA1C levels may improve risk assessment in such patients presenting with ACS

Clinical and microbiological profile of type 2 diabetic patients with urinary tract infections

Background: Diabetes Mellitus is reported to increase the risk of Urinary Tract Infection (UTI) with higher probability of drug resistant organisms. Understanding the burden, microbiological profile and antibiotic sensitivity pattern is vital for effective prevention and management. To assess the microbiological profile and antibiotic sensitivity pattern of Urinary Tract infections among type 2 diabetes mellitus patients.Methods: The study was A prospective observational study done on 117 type 2 diabetic subjects aged above 18 years presenting with symptoms of UTI in a tertiary care hospital Urine was analyzed for urine routine examination, culture and antibiotic sensitivity using standard testing methods on a midstream urine sample. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results: The mean age of the study population was 57 years. Females constituted 62.39% of participants. Burning micturition (52.99%) was the most common presenting symptom. The prevalence of culture positive UTI was 51.28%. Among gram-negative bacilli, Escherichia coli (20.51%), Klebsiella (6.85%) dominated the culture reports. Enterococcus (4.27%) and Staphylococcus aureus (2.6%) were the common gram-positive organisms isolated.  Meropenem was the most effective antibiotic against E. coli (87.5%) and Klebsiella (95%) Vancomycin had 100% sensitivity against Enterococci and S. aureus.Conclusions: More than half of diabetic patients presenting with symptoms of UTI had culture positive UTI, predominantly caused by gram negative organisms. There is a need for comparative studies of Diabetes and controls to explore the key differences in the pattern of UTI

Significance of APTT as early predictor of bleeding in comparison to thrombocytopenia in dengue virus infection

Background: Dengue is a systemic viral infection transmitted by mosquitoes such as Aedes aegypti or Aedes albopictus. Dengue Fever (DF) is characterized by fever, headache, muscle or joint pain, and rash. The spectrum of dengue virus infection spreads from an undifferentiated fever and dengue fever (DF) to dengue haemorrhagic fever (DHF) with shock. Factors responsible for bleeding manifestations in dengue are vasculopathy, thrombocytopenia, coagulopathy, and disseminated intravascular coagulation (DIC). Coagulopathy results in derangement of activated partial thromboplastin time (APTT) which is an indicator of impending bleeding risk.Methods: A prospective study was conducted from June to December in 2017 in R L Jalappa Hospital. Patients aged above 18 years with febrile thrombocytopenia who are positive for dengue virus serology (NS1Ag and/ or IgM) were included in the study. Serial daily monitoring of platelet count and analysis of APTT levels were done. APTT was considered abnormal if it was more than 33.8s. Patients were followed up for evidence of leaking and bleeding manifestations.Results: Out of 170 patients 28.1% patients had bleeding manifestations. Bleeding signs were seen on clinical examination in 52.37% of patients. capillary leak was found in the form of Pleural effusion in 35.3%, Ascites in 41.2% and Periorbital edema in 31.2% of patients. Elevated APTT levels were seen in 110(64.7%) patients. Among patients with abnormal APTT platelet transfusion was done in 78.9% of patients, and among those with normal APTT levels platelet transfusion was done in 21.1% of patients.Conclusions: Our study showed significant correlation between bleeding manifestations and prolonged APTT levels as well as thrombocytopenia with abnormal APTT levels. Study concluded that 21.1% of platelet transfusions could have been prevented considering prolonged APTT as a predictor of bleeding manifestation, thus saving the resources and reactions due to platelet concentrate transfusion

INVESTIGATION OF ANTIFUNGAL ACTIVITY OF CICER ARIETINUM L. LEAVES AGAINST IMPORTANT SEED BORNE FUNGI

In vitro evaluation of  aqueous leaf extract of Cicer arietinum L. when tested against Aspergillus flavus was recorded 93.0%  inhibition at 50% concentration followed by Penicillium sp and recorded 91.3% inhibition. Fusarium oxysporum recorded moderate activity of 88.0% inhibition and Curvularia lunata showed 80.0% inhibition  and least inhibition was observed in Cladosporium cladosporioides and recorded 74.5% inhibition. Significant inhibition was also observed in 10, 20, 30 and 40% inhibition. Compared to synthetic fungicide, Dithane M 45 and Bavisin tested at 2% concentration recorded 100% inhibition in all the test fungi