Jyoti Tomar

Abstract

Mycetoma is a chronic granulomatous infection of cutaneous and subcutaneous tissues caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). The most common site of infection is the foot, followed by the hand, but sometimes other body parts may also be infected. The patients present with a painless hard and swelling subcutaneous mass, multiple sinuses, and the pathognomonic discharge of grains. A 42-year-old male patient, presented pain and swelling in his right hand and also complained of swelling in his right forearm. The swelling later involved his whole right hand and wrist joint. Physical examination revealed multiple discharging sinuses with serosanguineous exudates and black grains. Swelling and local erythema were present, lymph nodes were not palpable. The patient complained of constant mild pain which is relieved by pain medications. The serohematic discharge was witnessed with conglomerates of small and firm blackish pellets, evoking eumycetomaSaline dressing was applied overnight and next morning grains were directly collected from sinuses. Tissue and black grain samples were analyzed for bacterial and mycological evaluation. Direct microscopy was performed using Gram stain showed thicker hyphae of eumycetoma. Modified ZN stain showed no acid fast bacilli. LPCB was helpful in confirming thicker hyphae of eumycetoma. Here, on clinical diagnosis (classical triad that is, painless soft tissue swelling, draining sinuses and extrusion of grains) with microbiological investigation, we concluded it a case of “Eumycetoma”.   Keywords : Eumycetoma, Itraconconazole, serosanguineous, Black grains

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Abstract

Introduction: Tuberculosis (TB) is a national health priority and with failing current treatment regimens, uses of ethnobotanical therapies are being more vigorously explored. Treatment of TB using oral and inhalational administration (hawan) of a mixture of herbs (hawan samagri, HS) has been practiced in India since ages. In vitro antitubercular effect of extract of HS against H37Ra strain of Mycobacterium tuberculosis (MTB) was recently reported in an ICMR funded research project.1 Hence this study aims to document scientific data on antitubercular effect of this HS extract against clinical MTB strains. Materials and Methods: Minimum inhibitory concentration (MIC) against clinical MTB strains of two different ethnobotanical mixtures (HS1 and HS2) used traditionally in India for the indigenous treatment of TB was compared. Extraction of essential oil (EO) from the mixture was done by hydro distillation and chemical characterization was done by Gas Chromatography and mass Spectroscopy (GCMS). Resazurin Microtiter Assay (REMA) was done to study antitubercular MIC. Result and Discussion: Crude essential oil (EO) extract of HS showed significant antitubercular effect in MIC range 50 - 400 µg/ml. HS1 showed lower MIC values compared to HS2. GCMS analysis of EO showed an array of bioactive compounds known to have antitubercular and other beneficial effects. Conclusion: Scientific validation of ethnobotanical use of HS extract for antitubercular activity was obtained in this work. HS crude EO seems to be a promising natural product with potential for new drug development in the treatment of TB. Keywords: Ethnobotanical, Antitubercular activity, Essential oil, Multi drug resistant (MDR), Resazurin microtiter assay (REMA), Gas Chromatography and mass spectroscopy (GCMS), Phytochemical, Terpenoids, Phenolics, Hawan samagri (HS).

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Abstract

Introduction: Microbiota of respiratory tract may be responsible for acute exacerbation of bronchial asthma and chronic bronchitis. So the present study was carried out to find out specific bacterial etiological agents’ involvement in acute exacerbation of these diseases. Materials and Methods: Sputum samples from patients of bronchial asthma, chronic bronchitis during acute exacerbation and endotracheal aspirates from control cases were processed to isolate the microbiota of respiratory tract using quantitative methods after liquefying and diluting the samples. Significant and insignificant bacterial counts from the samples were determined. Grading of pus cells and bacterial morphology was seen by Gram's staining. Results: Pus cell grading of 1+ to 3+ were seen in the both cases of bronchial asthma and chronic bronchitis whereas pus cells were not found in control cases. Percentage of microorganisms by Gram's staining in asthmatics, chronic bronchitis, and controls cases were 93.33%, 86.67%, 76.67% respectively. Among the pathogenic bacteria, percentage of significant count of Staphylococcus aureus and Klebsiella pneumonia were found to be high in chronic bronchitis cases when compared these pathogens in asthmatics. In bronchial asthma cases, the percentage of significant count of Streptococcus pyogenes, Proteus mirablis and Pseudomonas aeruginosa were high as compared to chronic bronchitis cases. In chronic bronchitis patients and asthmatics, significant count of non-pathogens were 16.67% and 13.33% respectively. Conclusion: The quantitative cultures showing significant numbers as 104/ml and 107 /ml of pathogenic and nonpathogenic bacteria respectively are found to be associated with acute exacerbation of bronchial asthma and chronic bronchitis. Keywords: Bronchial asthma, Chronic bronchitis, Microbiota, Quantitative culture.

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