Antimicrobial Efficacy of Chemical and Herbal Agents against Streptococcus mutans: An in vitro study

Objective: To compare and evaluate antimicrobial efficacy of chlorhexidine gluconate and fennel seeds against Streptococcus mutans. Material and Methods: Three agar petri dishes for Streptococcus mutans were prepared. The methanolic extract of fennel seed and 0.2% chlorhexidine were inoculated on the each petri dish and incubated at 37ºC for 24 hours. Zone of growth inhibition for each extract was measured in millimeters using antibiotic inhibiting zone measuring scale. Data was analyzed using SPSS statistical software. The comparison of inhibition zone against S. mutans using CHX and fennel seed extract was done using Mann-Whitney and Wilcoxon tests. All statistical analyses were set at a significance level of p<0.05. Results: The mean of zone of inhibition of S. mutans after inoculation with 0.2% chlorhexidine and fennel seed extract are 21.44 ±1.46, 15.34 ±0.74 respectively. There was statistically significant difference in the mean of inhibition zone between 0.2% chlorhexidine and fennel seed against S. mutans (p=0.047). Conclusion: Chlorhexidine and fennel seed are effective in inhibiting the growth of cariogenic bacteria. Therefore, both herbal and chemical agents can be effectively used to reduce pathogenic oral microflora.

Spectrum of AIDS defining & non-AIDS defining malignancies in north India.

Background & objectives: There is scarcity of data on the frequency of malignancies in HIV infected individuals from India. The objective of this study was to determine the type and frequency of malignancies in HIV infected individuals attending a tertiary care hospital in north India. Methods: The study design included retrospective analysis of data of all HIV infected individuals registered in the Immunodeficiency clinic from December 2009 to December 2011 and a prospective analysis of HIV infected individuals registered from January 2012 to April 2013. The clinical details and treatment outcomes of all individuals diagnosed to have AIDS defining and non-AIDS defining malignancies were recorded. Results: Records of 2880 HIV infected individuals were reviewed. Thirty one (19 males, 12 females) individuals were diagnosed to have malignancy. AIDS defining malignancy was found in the form of non-Hodgkin’s lymphoma in 12 individuals and cervical cancer in six women. Non-AIDS defining malignancies included Hodgkin’s lymphoma (n=2); and chronic myelogenous leukaemia, carcinoma base of tongue, carcinoma larynx, carcinoma bronchus, sinonasal carcinoma, ovarian carcinoma, anal carcinoma, carcinoma urinary bladder, pleomorphic sarcoma, parathyroid adenoma, and renal cell carcinoma in one individual each. Mean CD4+cell count prior to ART initiation was 250 ± 195.6 (median: 187; range, 22-805) cells/μl and at the time of diagnosis of malignancy was 272 ± 202 (median: 202; range, 15-959) cells/μl. The mean CD4+ count of individuals with AIDS defining malignancy was significantly lower when compared with non-AIDS defining malignancy (P<0.001). Fourteen individuals were alive and on regular follow up, 15 had died and two cases were lost to follow up. Interpretation & conclusions: The frequency of malignancies in HIV infected patients at our centre was 1 per cent, with non-Hodgkin’s lymphoma being the commonest. Further studies need to be done to document similar data from different parts of the country.

Emergence of non-albicans Candida species and antifungal resistance in intensive care unit patients

Objective: To evaluate the epidemiology of candidiasis and the antifungal susceptibility profile of Candida species isolated from the intensive care unit (ICU) patients. Methods: The study used a qualitative descriptive design. Relevant samples depending on organ system involvement from 100 ICU patients were collected and processed. Identification and speciation of the isolates was conducted by the biochemical tests. Antifungal susceptibility testing was carried out as per CLSI-M27-A3 document. Results: Ninety Candida isolates were isolated from the different clinical samples: urine (43.3%), tracheal aspirate (31.1%), urinary catheter (12.2%), endotracheal tube (7.8%), abdominal drains (3.3%), sputum (2.2%). The incidence of candidiasis caused by non-albicans Candida (NAC) species (63.3%) was higher than Candida albicans (36.7%). The various NAC species were isolated as: Candida tropicalis (41.1%), Candida glabrata (10%), Candida parapsilosis (6.7%), Candida krusei (3.3%) and Candida kefyr (2.2%). The overall isolation rate of Candida species from samples was 53.3%. Antifungal susceptibility indicated that 37.8% and 7.8% of the Candida isolates were resistant to fluconazole and amphotericin B, respectively. Conclusions: Predominance of NAC species in ICU patients along with the increasing resistance being recorded to fluconazole which has a major bearing on the morbidity and management of these patients and needs to be further worked upon.

Dietary adequacy of HIV infected individuals in north India - A cross-sectional analysis.

Background & objectives: Dietary inadequacy is common in developing countries and so is in immunedeficient HIV infected individuals. Hence, an assessment of dietary patterns was done among a group of HIV infected individuals and compared with recommended dietary allowances. Methods: One hundred consecutive HIV infected individuals were interviewed from the Immunodeficiency Clinic of a tertiary care center at Chandigarh. Dietary intake was assessed by 24 h recall method. Mean carbohydrate, protein and fat intakes were evaluated. Mean difference in the calorie intake from recommended dietary intake was then calculated. Mean absolute CD4 cell count was calculated and correlated with BMI and mean calorie intake. Results: Mean weight and BMI of the individuals participated in the study was 58.6 ± 11.7 (range, 34 - 94) kg and 21.5 ± 3.7 (range, 13.6 - 36.7) kg/m2, respectively. Mean total calories intake was 1713 ± 292.8 (860 - 2525) calories/day and mean difference in the calories taken from the standard values was 249.5 ± 190.7 (10.6 - 967.5) calories/day. There was no significant correlation between CD4 cell count and total calories taken. Interpretation & conclusions: In HIV-infected individuals the energy intake was significantly lower than the recommended average intake. Hence, efforts should be taken to ensure that HIV-infected individuals have access to high-quality, nutritious food choices that promote optimal dietary patterns.