Pharmacognostical, Pharmaceutical and Microbiological Analysis of Mrudwika Sharkara

Draksha (Mrudwika) is best among all fruits as per Ayurveda. It is also indicated in different diseases as a medication and used in diets in fresh and dry forms. Draksha is a fruit that is only available during certain times of the year. Sharkara dosage form of it can be prepared to make that is palatable. Draksha is used in dry form i.e., Munakka (Mrudwika, raisins). Commonly, Munakka, Kismis, and Currants are three varieties with slight differences in their characteristics and nutritional content. They own property in Mridu Rechana, Vatahara, Pittahara, Brimhana, Vrishya, and Rasayana. For health promotion, disease prevention, and a wide range of Vata, Pitta, and Raktaja Vyadhis and Apatarpana Vyadhis, Draksha should be regularly incorporated into diet in either dry or fresh form. In the present study, an attempt has been made to develop pharmacognostical and pharmaceutical standards for Mrudwika Sharkara for assurance of quality of herbal compounds pharmacognostical and pharmaceutical analysis should be done. Methods: Mrudwika Sharkara was subjected to microscopic evaluation for pharmacognostical study, analysis physic-chemical analysis includes specific gravity, pH value, reducing sugar, non-reducing sugar and total sugar and high Performance thin layer chromatography (HPTLC). Mrudwika Sharkara was assessed for microbiological which include smear examination and culture study. Results: Pharmacognostical study showed the presence of certain identifying characters of Mrudwika and Sharkara. In pharmaceutical study, preliminary physico-chemical analysis showed specific gravity is 1.160, pH value is 4, reducing sugar 21.1%, non reducing sugar 48%, total sugar content 69.1%. HPTLC analysis showed eight spots in 254nm and six spots in 366nm. From date of preparation 23/06/21 to 18/10/22 no fungal contamination was found in Mrudwika Sharkar Conclusion: Present work was carried out to standardize the formulation Mrudwika Sharkara in terms of its identity, quality and purity. All of the preparation's active ingredients were identified by pharmacognostic and physicochemical examination. Self life of Mrudwika Sharkara showed that the quality of syrup in standard condition.

Isolamento e identificação de bactérias presentes em estojos de lentes de contato / Isolation and indentification of bacteria presents of contact lens cases

Objetivo ­ Esta pesquisa teve o intuito de realizar um estudo microbiológico em estojos de lentes de contato, bem como correlacionar com os hábitos de higiene dos usuários. Métodos ­ Após aprovação do comitê de ética, 50 estojos de lente de contato foram cedidos por acadêmicos voluntários, os quais também responderam a um questionário contendo dados pessoais, assim como sobre a forma de manipulação das lentes. As amostras foram coletadas da superfície interna do estojo, isoladas em meios de cultura e identificadas através de provas bioquímicas específicas. Resultados ­ Dos 50 estojos, 49 (98%) apresentaram crescimento de microrganismos, tais como Staphylococcus sp (27), Staphylococcus aureus (9), Serratia liquefaciens (4), Citrobacter freundii (2), Escherichia coli (1) e Hafnia alvei (1), sendo que em um estojo foi identificado ambas as bactérias Staphylococcus aureus e Serratia liquefaciens. As lentes mais utilizadas (96% dos usuários) foram dos tipos gelatinosas descartáveis, seguida do tipo rígida (4%). O uso terapêutico esteve presente em 76% dos usuários, já o uso estético em 24%. O tempo de uso das mesmas lentes foi de 30 dias até quatro anos. Quando questionados sobre higienização, 34% afirmaram lavar as mãos sempre que manipulavam as lentes, 10% armazenavam os estojos em locais fechados, enquanto os outros 84% armazenavam em gabinetes de banheiros ou expostos sobre as pias. Em relação a incômodos na utilização, 32% relataram prurido, ardência ou vermelhidão. Conclusão ­ A falta de cuidado na higienização e no armazenamento do

Objective ­ This research aimed to carry out a microbiological study in contact lens cases, as well as to correlate with users' hygiene habits. Methods ­ After approval by the ethics committee, 50 contact lens cases were provided by volunteer academics, who also answered a questionnaire containing personal data, as well as how to manipulate the lens. Samples were collected from the inner surface of the kit, isolated in culture media and identified by specific biochemical tests. Results ­ Of the 50 kits, 49 (98%) showed growth of microorganisms such as Staphylococcus sp (27), Staphylococcus aureus (9), Serratia liquefaciens (4), Citrobacter freundii (2), Escherichia coli (1) and Hafnia alvei (1), and in one kit both Staphylococcus aureus and Serratia liquefaciens bacteria were identified. The most used lenses (96% of users) were of the disposable soft types, followed by the rigid type (4%). Therapeutic use was present in 76% of users, while aesthetic use in 24%. The wearing time of the same lenses was from 30 days to four years. When asked about sanitation, 34% said they washed their hands whenever they manipulated the lenses, 10% stored the cases indoors, while the other 84% stored in bathroom cabinets or exposed on the sinks. Regarding discomfort in use, 32% reported itching, burning or redness. Conclusions ­ The lack of care in the hygiene and storage of the cases were extremely important for its microbiological contamination, answering the hypothesis raised at the beginning of the study.

Análisis microbiológico del tracto genital materno y de la sangre del cordón umbilical en relación con el daño neonatal / Microbiological analysis of the maternal genital tract and umbilical cord blood and its association with neonatal damage

La etiología que conduce al daño neonatal es multifactorial, y los procesos infecciosos pueden estar implicados en él. El objetivo de este estudio fue identificar microorganismos del tracto genital materno asociados con el daño neonatal, a fin de prevenir futuras complicaciones perinatológicas. Se estudiaron 711 embarazadas que concurrieron entre enero de 2010 y julio 2013 al consultorio externo de Obstetricia del Hospital de Clínicas de la UBA para sus controles prenatales, y cuyos partos también tuvieron lugar en dicho nosocomio. En la sangre del cordón umbilical se investigó la presencia de Ureaplasma urealyticum y Mycoplasma hominis mediante el cultivo con sustratos metabólicos (Micofast-Biomerieux), y la de Trichomonas vaginalis por PCR, con primers específicos. El estudio microbiológico del contenido vaginal se efectuó en 288 de las embarazadas en la semana 35 a 37. Se empleó la metodología convencional, a la que se agregó el cultivo en tioglicolato modificado para T. vaginalis. Se investigó la presencia de estreptococos grupo B (EGB) en hisopado anorrectaly de introito vaginal, utilizando enriquecimiento en caldo selectivo y posterior siembra en medio cromogénico. Se utilizaron los test de χ² Yates y de Fisher para muestras independientes, considerándose significativo p < 0,05. La vaginosis bacteriana (VB) se relacionó significativamente con el daño neonatal (p = 0,02), al igual que la presencia de M. hominis (p = 0,03) y de T. vaginalis (p = 0,03) en la sangre del cordón umbilical. Las complicaciones predominantes fueron el parto pretérmino, la rotura prematura de membrana (RPM), el bajo peso y un valor de Apgar <7. No se asoció al daño neonatal la presencia de U. urealyticum (p = 0,35) en el cordón umbilical, ni la de Candidaspp. (p = 0,94) o EGB (p = 0,18) en el tracto genital de las madres. Dado que ciertas alteraciones en la microbiota del tracto genital materno se relacionaron con el dano neonatal, consideramos de fundamental importancia realizar el estudio microbiológico del contenido vaginal durante el embarazo, para prevenir posibles complicaciones maternas y perinatológicas.

The etiology leading to neonatal damage is multifactorial, being genital infections one of the causes. The objective of the study was to identify microorganisms of the maternal genital tract that are associated with neonatal damage, in order to prevent future perinatal complications. Seven hundred and eleven pregnant patients attended their prenatal control during the period January 2010-July 2013. Ureaplasma urealyticum and Mycoplasma hominis presence was investigated in umbilical cord blood by metabolic substrates (Micofast-Biomerieux) and that of T. vaginalis, by PCR using specific primers. The microbiological study of the vaginal contents of 288 pregnant patients at weeks 35 to 37 was performed by conventional methods, adding the modified thioglycolate culture for T. vaginalis. Group B streptococcus (GBS) was investigated in anorectal and vaginal introitus swabs, using selective broth enrichment and subsequent isolation in chromogenic medium. The χ² Yates test and Fisher's test were used for independent samples. A p value <0.05 was considered statistically significant. The pathogens significantly related to neonatal damage were M. hominis (p = 0.03), T. vaginalis (p = 0.03), and BV (p = 0.02). Main complications were preterm birth, premature rupture of membranes (PRM), low weight and Apgar score <7. U. urealyticum (p = 0.35), Candidaspp. (p = 0.94) and GBS (p = 0.18) were not related to neonatal damage. Since different microorganisms of the maternal genital tract were related to neonatal damage, it is very important to perform the microbiological study of vaginal contents during pregnancy to prevent possible maternal and perinatal complications.

Estancia hospitalaria de pacientes con antibioticoterapia por infecciones posoperatorias / Hospitalization of patients with antibiotic therapy due to postoperative infections

Se realizó un estudio descriptivo, de serie de casos, de 258 pacientes intervenidos de forma urgente o electiva durante el trienio 2012-2014 en el Servicio de Cirugía General del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, quienes presentaron infecciones posoperatorias, con el propósito de identificar diferentes factores relacionados con el empleo de antibióticos ante esta complicación. Entre los resultados sobresalientes se obtuvo que la estancia hospitalaria se prolongara por más de 14 días en más de la mitad de los pacientes cuyas operaciones quirúrgicas fueron clasificadas como contaminadas o sucias, y que en el período preoperatorio se aplicaron antibióticos en 77,1 % de la serie, mientras en la fase posoperatoria se administraron en todos los infectados. Asimismo, los estudios microbiológicos mostraron positividad en 86,5 % y los microorganismos más comúnmente aislados fueron gramnegativos: Klebsiella, estafilococo patógeno, Escherichia coli y Acinetobacter. Pudo concluirse que la política del uso racional de antibióticos con fines profilácticos y terapéuticos, debe relacionarse con la circulación intrahospitalaria de gérmenes, de acuerdo con el mapa microbiológico y la resistencia de estos, para así implementar un protocolo estandarizado al respecto.

A descriptive, serial cases study, of 258 patients undergoing surgery in an emergent or elective way who presented postoperative infections was carried out during the triennium 2012-2014 in the General Surgery Service of "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, with the purpose of identifying different factors related to the use of antibiotics in these cases. Among the outstanding results it was obtained that the hospitalization lasted more than 14 days in more than half of the patients whose surgical operations were classified as polluted or dirty, and that in the preoperatory period antibiotics were applied in 77.1 % of the series, while in the postoperative phase antibiotics were administered in all those infected. Also, the microbiological studies showed positivity in 86.5 % and the most common isolated microorganisms were gramnegative: Klebsiella, pathogen Staphylococcus, Escherichia coli and Acinetobacter. It was concluded that the politics of the rational use of antibiotics with preservatives and therapeutic ends, should be related to the intrahospital circulation of germs, according to the microbiological map and the resistance of these, so as to implement a standardized protocol in this respect.

Evaluación de la disfunción vaginal en mujeres embarazadas sintomáticas y asintomáticas mediante la utilización de los estados vaginales básicos (EVB) y su comparación con el estudio microbiológico convencional / Evaluation of vaginal dysfunction in symptomatic and asymptomatic pregnant women by using the analysis of basic vaginal states (BVS) and its comparison with the conventional microbiological study

Durante el embarazo se producen frecuentemente infecciones del tracto genital inferior asociadas a complicaciones maternas y perinatológicas. El objetivo del trabajo fue evaluar la disfunción vaginal mediante el análisis de los estados vaginales básicos (EVB) por la metodología del balance del contenido vaginal (BACOVA) y compararlo con el estudio microbiológico convencional en el diagnóstico de candidiasis, tricomonosis y vaginosis bacteriana (VB). Entre 2010 y 2012 se estudiaron 1238 pacientes embarazadas; 1046 eran asintomáticas (A) y 192 sintomáticas (S). La prevalencia del EVB I fue del 59,5 % y 26 %, respectivamente. El EVB II se observó en 19,7 % de las mujeres A y en 17,2 % de las S. El EVB III se detectó solamente en las A, en 0,4 %. El EVB IV se observó en 14,4 % de las A y en 38 % de las S. El EVB V se detectó en 6 % de las A y en 18,8 % de las S. En las mujeres A, las levaduras se asociaron a los EVB I y II en el 55,5 % y 23,2 % de los casos, respectivamente; entre las S, alcanzaron el 32,4 % y 31 % de los casos, en igual orden. Las tricomonas se asociaron al EVB I en el 50 % de las A, al EVB IV en el 44,4 % de las S y al EVB V en el 33,3 % de las S. La sensibilidad del BACOVA para detectar levaduras fue 80,4 % en las A y 85,5 % en las S; para detectar tricomonas, del 40 % y 75 %, y para detectar VB, del 100 % en los dos grupos. La especificidad del BACOVA fue 100 % para todos los patógenos en las A y en las S. El estudio de los EVB resultó útil para orientar el diagnóstico a la disfunción vaginal, independientemente de la sintomatología, por lo que se sugiere este estudio como parte del control prenatal. Durante el embarazo se producen frecuentemente infecciones del tracto genital inferior asociadas a complicaciones maternas y perinatológicas. El objetivo del trabajo fue evaluar la disfunción vaginal mediante el análisis de los estados vaginales básicos (EVB) por la metodología del balance del contenido vaginal (BACOVA) y compararlo con el estudio microbiológico convencional en el diagnóstico de candidiasis, tricomonosis y vaginosis bacteriana (VB). Entre 2010 y 2012 se estudiaron 1238 pacientes embarazadas; 1046 eran asintomáticas (A) y 192 sintomáticas (S). La prevalencia del EVB I fue del 59,5 % y 26 %, respectivamente. El EVB II se observó en 19,7 % de las mujeres A y en 17,2 % de las S. El EVB III se detectó solamente en las A, en 0,4 %. El EVB IV se observó en 14,4 % de las A y en 38 % de las S. El EVB V se detectó en 6 % de las A y en 18,8 % de las S. En las mujeres A, las levaduras se asociaron a los EVB I y II en el 55,5 % y 23,2 % de los casos, respectivamente; entre las S, alcanzaron el 32,4 % y 31 % de los casos, en igual orden. Las tricomonas se asociaron al EVB I en el 50 % de las A, al EVB IV en el 44,4 % de las S y al EVB V en el 33,3 % de las S. La sensibilidad del BACOVA para detectar levaduras fue 80,4 % en las A y 85,5 % en las S; para detectar tricomonas, del 40 % y 75 %, y para detectar VB, del 100 % en los dos grupos. La especificidad del BACOVA fue 100 % para todos los patógenos en las A y en las S. El estudio de los EVB resultó útil para orientar el diagnóstico a la disfunción vaginal, independientemente de la sintomatología, por lo que se sugiere este estudio como parte del control prenatal.

Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control. Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control.

Manifestaciones clínicas bucales y análisis microbiológico en paciente con ateroesclerosis: presentación de caso / Buccal clinical manifestations and microbiological analysis in atherosclerosis patients: case presentation

La Organización Mundial de la Salud ha reconocido que la ateroesclerosis constituye la epidemia más grande en el mundo, ya que sus manifestaciones relacionadas con la cardiopatía isquémica y las enfermedades cardiovasculares y cerebrovasculares, constituyen la primera causa de muerte e incapacidad. En los factores de riesgo asociados a esta patología se encuentran la diabetes mellitus tipo II, la hipertensión arterial, la obesidad, la hipercolesterinemia, el tabaquismo y otros. La literatura sobre la asociación a enfermedades bucales es escasa, solo se refiere la higiene bucal deficiente. Se presenta un paciente de 52 años que refiere haber sufrido eventos de ateroesclerosis, con manifestaciones clínicas bucales compatibles con presencia de recesión periodontal e inflamación gingival sobreañadida, gingivorragia al sondeo y molestias masticatorias. Encías hipercoloreadas, con aumento de volumen, contorno, consistencia y textura alterados, movilidad dentaria grado II en incisivos inferiores, bolsas periodontales de 4 y 5 mm. El análisis microbiológico mostró presencia de patógenos periodontales en un nivel alto. Se aprecia asociación entre los elementos fisiopatológicos de la ateroesclerosis, factores de riesgo comunes con la enfermedad periodontal y su expresión en la cavidad bucal tanto en la flora microbiana del surco gingival como en los tejidos periodontales.

World Health Organization recognizes that atherosclerosis is the biggest epidemics in the world, because its clinical manifestations related with ischemic cardiopathy and cardiovascular and cerebrovascular diseases are the first cause of death and disability. Among the risk factors associated to this pathology are Diabetes Mellitus type II, arterial hypertension, obesity, hypercholesterinemia, tobacco use and others. Literature on the association to buccal diseases is scarcely, and refers only to deficient buccal hygiene. We present the case of a 52 years old patient referring he had suffered atherosclerosis events, with oral clinical manifestations consistent with periodontal recession and added gingival inflammation, gingival bleeding when exploring, and masticatory discomforts. Hypercolored gums, with increased volume, altered shape, consistence and texture, grade II dental mobility in lower teeth, 4-5 mm periodontal cavities. The microbiological analysis showed the existence of high levels of periodontal pathogens. It is appreciated the association between atherosclerosis physiopathologic elements, common risk factors with the periodontal disease and its expression in the buccal cavity as much in the gingival sulcus microbial flora as in the periodontal tissues.

Antibioticoterapia en pacientes con infecciones posoperatorias / Antibiotic therapy in patients with postoperative infections

Introducción: la contaminación bacteriana es el requisito indispensable para la aparición de las infecciones posoperatorias, con repercusiones socioeconómicas desfavorables, las cuales aumentan el consumo de antimicrobianos. Objetivo: identificar diferentes factores relacionados con la utilización de antibióticos en pacientes con infecciones posquirúrgicas. Métodos: se realizó un estudio descriptivo, observacional y transversal acerca de la utilización de antibióticos en 207 pacientes expuestos a cirugías mayores, que presentaron infecciones posoperatorias, atendidos en el Servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba durante el trienio 2008-2010. Resultados: predominaron las infecciones incisionales superficiales, seguidas de las localizadas en órgano y espacio. En el período preoperatorio se utilizaron antibióticos en las dos terceras partes de la serie y en el posoperatorio, en todos los que sufrieron esta complicación. Los estudios microbiológicos alcanzaron una positividad de 96,3 % y los gérmenes más comúnmente aislados fueron gramnegativos: Klebsiella, Escherichia coli y Acinetobacter baumannii. Conclusiones: la política del uso racional de antibióticos con fines profilácticos y terapéuticos, debe relacionarse con la circulación de gérmenes intrahospitalarios acorde con el mapa bacteriológico y el patrón de resistencia a fin de implementar un protocolo estandarizado para su aplicación.

Introduction: bacterial contamination is the essential requirement for the occurrence of postoperative infections, with adverse social and economic implications, thus increasing the use of antibiotics. Objective: to identify different factors related to the use of antibiotics in patients with postoperative infections. Methods: a descriptive, observational and cross-sectional study on the use of antibiotics was carried out in 207 patients, who underwent major surgery and presented with postoperative infections, attended in the Department of General Surgery of "Saturnino Lora" Provincial Teaching Hospital of Santiago de Cuba during the triennium 2008-2010. Results: superficial incisional infections predominated, followed by those located in organ and space. In the preoperative period antibiotics were used in two-thirds of the series and in the postoperative period in all who had this complication. Microbiological studies had 96.3% of positivity and the most commonly isolated germs were: Klebsiella, Escherichia coli and Acinetobacter baumannii. Conclusions: the occurrence of postoperative infections is related to the proliferation of Gram-negative organisms. The policy of rational use of antibiotics with prophylactic and therapeutic purposes, related to the circulation of hospital germs and resistance pattern, is considered adequate, but a standardized protocol should be implemented for its application.