ABSTRACT
Diarrhoea is amongst the first ten causes of death and its treatment faces an increased threat of drug resistance. Previous studies on the guava leaf decoction (GLD) revealed its suitability for use in infectious diarrhoea of unknown etiology.ObjectiveThe objective of this trial was to establish efficacy, dose and safety of GLD prepared from the Indian Sardar variety in adults with acute infectious diarrhoea.MethodsThe current trial was an open efficacy randomized 5-day, parallel group multi-arm interventional study. Amongst 137 adults (18–60 years) suffering with acute diarrhoea, 109 were included (57% females, 43% males). Three doses of GLD (6-leaf, 10-leaf and 14-leaf) were compared with controls receiving oral rehydration solution. Decrease in stool frequency and improvement in consistency were the outcomes measured. The data was analyzed using ANOVA, Tukey's post-hoc test, Kruscal-Wallis test and Chi-Square test where applicable.ResultsThe trial showed that the 14-leaf (7.4 g) decoction was the most effective. Administration of the decoction, thrice daily helped the patients regain normalcy in 72 h as opposed to 120 h in controls. Safety of the intervention was reflected by normal levels of haemoglobin, liver and kidney parameters. No adverse events were reported.ConclusionThe 14 leaves decoction was a safe treatment for adult acute uncomplicated diarrhoea of unknown etiology. Moreover due to component synergy and divergent mechanisms of action, it could possibly combat the generation of drug resistance and destruction of gut microbiota. Hence GLD has the potential for development as a first line treatment for diarrhoea.
ABSTRACT
Aim: Identification of anti-Mycobacterium tuberculosis agents of plant origin, against sensitive and multidrug resistant (MDR) strains. Study Design: Assessing anti-M. tuberculosis activity of five Indian medicinal plants, which have been reported in traditional literature for various uses including respiratory ailments. Place and Duration of Study: Mumbai, India; May 2009 – December 2011. Methodology of Study: The reference strain (H37Rv), three susceptible and three MDR clinical isolates of M. tuberculosis were used. Acetone, ethanol and aqueous extracts (prepared sequentially) of Acorus calamus L. (rhizome), Andrographis paniculata Nees. (leaf), Ocimum sanctum L. (leaf), Piper nigrum L. (seed) and Pueraria tuberosa DC. (tuber) were tested at 1, 10 and 100 μg/ml using the Microplate Alamar Blue Assay. The active extracts were assessed for cytotoxicity on the human lung epithelial cell line (A549) using the neutral red assay and a phytochemical analysis was made using High Performance Thin Layer Chromatography (HPTLC). Results: Among the plants tested, the acetone extract of P. nigrum appears promising. It was effective against H37Rv, all susceptible isolates and one MDR isolate at 100 μg/ml. The ethanol extract caused some inhibition of growth, though less than the cut-off of 99%. A combination of acetone and ethanol extracts at 50 μg/ml each was effective against all isolates tested. The known active phytoconstituent of P. nigrum, piperine (also an efflux pump inhibitor), was effective against H37Rv in the presence of suboptimal concentration of Rifampicin, but not against the clinical isolates tested. Presence of piperine in the acetone and ethanol extracts was confirmed by HPTLC. Extracts of P. nigrum and piperine were not cytotoxic to the A549 cell line. Conclusion: Amongst the five plants tested, P. nigrum was active. The acetone extract may have active components in addition to piperine. It is possible that the class and expression of efflux pumps in H37Rv is different from that in the clinical isolates, and hence piperine did not inhibit these isolates. Thus, it is necessary to screen clinical isolates in addition to reference strains. The observation of the increased efficacy of the combination of acetone and ethanol extracts is interesting.
ABSTRACT
A longitudinal study of the bacteriological quality of rural water supplies was undertaken for a movement towards self-help against diseases, such as diarrhoea, and improved water management through increased community participation. Three hundred and thirteen water samples from different sources, such as well, tank, community standpost, handpumps, percolation lakes, and streams, and from households were collected from six villages in Maharashtra, India, over a one-year period. Overall, 49.8% of the 313 samples were polluted, whereas 45.9% of the samples from piped water supply were polluted. The quality of groundwater was generally good compared to open wells. Irregular and/or inadequate treatment of water, lack of drainage systems, and domestic washing near the wells led to deterioration in the quality of water. No major diarrhoeal epidemics were recorded during the study, although a few sporadic cases were noted during the rainy season. As a result of a continuous feedback of bacteriological findings to the community, perceptions of the people changed with time. An increased awareness was observed through active participation of the people cutting across age-groups and different socioeconomic strata of the society in village activities.