Clinical Efficacy of Concurrent Therapy with Oral FDC Tablet of Euphorbia Prostrata plus Calcium Dobesilate and Topical FDC Cream of Euphorbia Prostrata plus Lidocaine in the Management of Haemorrhoids: A Prospective, Open-Labeled Multicentric Study

Objective: Haemorrhoids are associated with bleeding, pain, itching, exudation and swelling. So there is an unmet need foreffective treatment by both oral and topical drugs. Hence this study was designed to evaluate the efficacy of oral EuphorbiaProstrata fortified with Calcium Dobesilate and topical cream of Euphorbia Prostrata with Lidocaine. Methods: The study was aprospective, open label, single arm, multicentric study, in 30 patients with hemorrhoids treated with oral FDC EuphorbiaProstrata extract 100 mg plus Calcium Dobesilate 500 mg and topical FDC cream of Euphorbia Prostrata extract 1% w/w plusLidocaine 3% w/w for 14 days.Symptoms like bleeding, pain, itching, exudation and swelling were assessed and scored duringand at the end of the study. Results: There was decline from the baseline value scores right from day 4 i.e. bleeding (0.97±0.15),pain (0.60±0.13), itching (0.47±0.13), exudation (0.13±0.06) and swelling (0.43±0.09); after 7 days bleeding (0.15±0.07), pain(0.12±0.06), itching (0.15±0.07), exudation (0.15±0.07) and swelling (0.19±0.08) and after day 14 the symptoms of bleeding(0.09±0.06), pain (0.08±0.06) and swelling (0.08±0.06) were almost cured while symptoms like itching (0.00±0.00), exudation(0.00±0.00) disappeared completely. There was reduction in the number of patient’s population with symptoms towards the end ofthe study. Conclusion: Oral Euphorbia Prostrata extract 100 mg fortified with Calcium Dobesilate 500 mg and topical cream ofEuphorbia Prostrataextract 1% w/w with Lidocaine 3% w/w showed maximum improvement during first 4 days of therapy andachieved total improvement till the end of therapy thus providing multimodal targeted approach to treat a multimodalhaemorrhoidal disease.

Antimicrobial Activity of Aloe Vera Leaf Extract.

The antimicrobial activity of aloe vera extract was tested against pathogenic bacteria like Staphylococcus aureus, Klebisella pneumonia and E.coli and fungi like Aspergillus niger and Candida at a dose of 1:20 mg/ml and 2:40 mg/ml by using cup plate diffusion method. Various solvents such as petroleum ether, chloroform and methanol were used for extracts. The results reveal that, methanol and petroleum ether at a dose of 20 mg/ml has showed significant activity against Klebisella pneumonia and E.coli whereas in fungi, methanol extract showed significant activity against Aspergillus niger and Candida. Methanol extract has showed maximum inhibitory activity against E.coli and Candida. Petroleum ether has showed moderate inhibitory activity against Klebisella pneumonia and Candida. The zone of inhibition was measured and compared with standard Gentamycin (1 mg/ml). However, in none of the above mentioned extracts the inhibition zone was not more than that found in standard i.e., Gentamycin.

Detection of extra-cellular enzymes of anaerobic gram-negative bacteria from clinically diseased and healthy sites.

Anaerobic gram-negative bacteria (AGNB) produce enzymes that play a significant role in the development of disease. We tested 50 AGNB isolates, 25 each from clinically diseased and healthy human sites for in vitro production of caseinase, collagenase, etc. Majority of the isolates were Bacteroides fragilis and Porphyromonas gingivalis, which more commonly produced collagenase and haemolysin. Comparatively larger number of clinical AGNB produced collagenase (P = 0.004). No such difference was observed with other enzymes. Hence, collagenase is probably one of the key virulence markers of pathogenic AGNB, and the inhibitors targeting collagenases might help in the therapy of anaerobic infections.

Haemagglutination and siderophore production as the urovirulence markers of uropathogenic Escherichia coli.

A total of 160 strains of Escherichia coli isolated from urine of patients with clinically diagnosed urinary tract infection were included in the study and 50 faecal isolates of E. coli were studied. They were studied for virulence factors, namely mannose-resistant and mannose-sensitive haemagglutination (MRHA, MSHA) and siderophore production.Among 160 urinary isolates of E. coli , 40 (25%) showed MRHA, siderophore production was seen in 156 (97.5%). In 50 faecal isolates, two (4%) were MRHA, four (8%) MSHA and siderophore production in two (4%). The results suggest that MRHA and siderophore production positive strains can be considered as UPEC.

Evaluation of laboratory techniques for diagnosis of amoebiasis.

Evaluation of 82 cases of amoebiasis including 4 of liver abscess was done. Microscopy of 62 stool samples revealed trophozoites in 19 (30.6%) and cysts in 8 (12.9%). PVA preserved samples were stained by iron-hamatoxylin and trichrome. Twenty-nine samples (46.7%) were positive by culture on Endamoeba, NIH and Charcoal agar. Additional two culture positive cases were negative by direct microscopy. Three (75%) samples of liver abscess pus were culture positive. Of the sera screened for amoebic antibodies by ELISA, 13 (17.3%) were positive. Stool and blood of healthy controls and 25 gastroenteritis cases were similarly analysed. Of healthy controls one had a high ELISA titre.

Antimicrobial susceptibility of Salmonella typhi to quinolones & cephalosporins.

Antimicrobial sensitivity testing was carried out for 85 isolates of S. typhi by disc diffusion and microbroth dilution for estimation of minimum inhibitory concentration (MIC). The drugs used included amoxycillin, chloramphenicol, ciprofloxacin, ofloxacin, gentamicin, netilmicin, cefuroxime, ceftizoxime, cefoperazone and ceftazidime. Ninety three per cent of our isolates were resistant to amoxycillin and chloramphenicol but total susceptibility was seen to quinolones and aminoglycosides. We also found that 3 per cent of our isolates were resistant to cephalosporins and 23 per cent were in the intermediate range with an MIC of 12.5 or 25 micrograms/ml to these drugs. In spite of decreased efficacy, the strains continued to be fully susceptible to ciprofloxacin as could be seen from the extended dilutions in microbroth dilution tests. The study also revealed that there was lack of correlation between the two methods of sensitivity testing for cephalosporins. We feel that the development of resistance of S. typhi to third generation cephalosporins is a finding worth consideration for further studies.