The clinical study records the clinical presentations of forty cases with amoebias and / or giardiasis including the efficacy of Kutaja (Holarrhena antidysenterica) in intestinal amoebiasis. E. H. Cyst passers also have symptoms like loose motions, constipation, flatulence, abdominal cramping, diminished appetite and mucus in stools. Patients with giardiasis have more tendency to diarrhoea and flatulence with no mucus in stools. 70 per cent good response was observed in E. H. Cyst passers when treated with Kutaja bark. Therefore, it appears that well known anti – diarrhoeal traditional herbal drug Kutaja, may be helpful to an extent in treating the amoebiasis. It will prove to be a very economic drug
Amoebiasis is an important public health problem in developing countries. Entamoeba histolytica, the causative agent of amoebiasis, may develop resistance to nitroimidazoles, a group of drugs considered to be the most effective against this parasitic disease. Therefore, research on new drugs for the treatment of this common infection still constitutes an important therapeutic demand. In the present study we determined the effects of a carbamate derivative, ethyl 4-chlorophenylcarbamate (C4), on trophozoites of E. histolytica strain HM-1:IMSS. C4 was subject to various toxicity tests, including the determination of mutagenicity for bacterial DNA and changes in the enzymatic activities of eukaryotic cells. Genotoxicity studies were performed by the mutagenicity Ames test (plate incorporation and preincubation methods) with Salmonella enterica serovar Typhimurium, with or without metabolic activation produced by the S9 fraction of rat liver. C4 toxicity studies were performed by measuring enzymatic activity in eukaryotic cells by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide-formazan test with Fischer 344 rat hepatocytes. C4 did not induce either frame-shift mutations in S. enterica serovar Typhimurium TA97 or TA98 or base pair substitutions in strains TA100 and TA102. The compound was not toxic for cultured rat hepatic cells. Trophozoites treated with 100 μg of C4 per ml were inhibited 97.88% at 48 h of culture; moreover, damage to the amoebae was also confirmed by electron microscopy. The antiamoebic activity of C4 was evaluated by using an in vivo model of amoebic liver abscess in hamsters. Doses of 75 and 100 mg/100 g of body weight reduced the extent of the amoebic liver abscess by 84 and 94%, respectively. These results justify further studies to clearly validate whether C4 is a new suitable antiamoebic drug.
Forty children with symptomatic intestinal amoebiasis were treated with tinidazole in a single dose of 50 mg/kg for 3 consecutive days. A cure rate of 97% was obtained. Tinidazole was tolerated well in children and proved to be a valuable new amoebicidal drug.
Melatonin has immunomodulatory effects but very little is known about its influence in protozoan infections, such as Entamoeba histolytica, which causes amoebiasis, a disease with significant morbidity and mortality. In this study, we evaluated the effects of exogenous melatonin interference in experimental amoebiasis and on interactions between human blood cells and E. histolytica trophozoites.
The effect of melatonin was investigated in models of experimental amoebiasis in hamsters and rats by evaluating the area of necrosis induced by E. histolytica. The activity of melatonin on the interactions between leukocytes and amoebae was determined by examining leukophagocytosis. For in vitro tests, polymorphonuclear and mononuclear human blood leucocytes were incubated with E. histolytica trophozoites.
The areas of amoebic necrosis were significantly reduced in animals treated with melatonin. Melatonin treatment increased leukophagocytosis but was associated with a greater number of dead amoebae.
These results suggest that melatonin may play a beneficial role in the control of amoebic lesions, raising the possibility that this drug may be used as an adjuvant in anti-amoebic therapy.
The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of “traditional mental health promoting practices” was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a “mind control” as referred by Caraka, is achieved through “spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.
Achar rasayana; Ayurveda; psychotherapy; psychoveda; sattvavajaya
Asthma is one of the commonest respiratory diseases in Jimma area as well as a significant disease burden worldwide costing billions of dollars. Anti-asthmatic drugs that are available in the market are expensive and have adverse effects. Thus, it is wise to look for an adjunct therapy to alleviate these problems. Therefore, the main aim of this study is to see the effect of yoga on patterns of clinical features, peak expiratory flow rates and use of drugs in asthmatic patients.
A preliminary controlled clinical trial study was conducted on 24 volunteer asthmatic patients who were getting support at the missionary of charity. They were grouped in yoga and control groups. An Indian yoga expert through a translator conducted the training on yogic practice, yogic posture, breath slowing technique and discussion at the end. Then, the yoga groups were supervised for four weeks taking yoga exercise daily for 50 minutes. Peak expiratory flow rate was taken using the mini Wright peak flow meter and vital signs were measured in both groups. Data were analyzed using web based Graph pad quick calcs statistical software.
The male to female ratio was 1:1 in both cases and control groups, 8(66.7%) were Christian and 9 (75.0%) were farmers. The yoga group showed 66.7% reduction in the use of salbutamole puff and 58.3% salbutamole tablets. There was a 10% increment in the PEFR in the yoga group while only 2% in the control group. There was statistically significant reduction in day and night asthma attacks in the yoga group.
Yoga exercise among asthmatic patients resulted in a decreased number of day and night attacks and use of drugs. It also shows significant improvement in the peak expiratory flow rate. Further large scale study is recommended.
Asthma; Yoga; Expiratory flow rate; Salbutamol; Ethiopia
Nonpharmacological treatment of epilepsy includes surgery, vagal nerve stimulation, ketogenic diet, and other alternative/complementary therapies, e.g., yoga, Ayurveda, electroencephalography (EEG) biofeedback technique, aerobic exercise, music therapy, transcranial magnetic stimulation, acupuncture, and herbal remedies (traditional Chinese medicine). Alternative therapies, despite the term, should not be considered as an alternative to antiepileptic medication; they complement accepted drug treatment. Alternative therapies like yoga, through techniques that relax the body and mind, reduce stress, improve seizure control, and also improve quality of life. Ketogenic diet is a safe and effective treatment for intractable epilepsies; it has been recommended since 1921. The diet induces ketosis, which may control seizures. The most successful treatment of epilepsy is with modern antiepileptic drugs, which can achieve control of seizures in 70–80% cases. Patients opt for alternative therapies because they may be dissatisfied with antiepileptic drugs due to their unpleasant side effects, the long duration of treatment, failure to achieve control of seizures, cultural beliefs and, in the case of women, because they wish to get pregnant Surgical treatment may lead to physical and psychological sequelae and is an option only for a minority of patients. This article presents supportive evidence from randomized controlled trials done to assess the benefit of non-pharmacological treatment.
Ayurveda; epilepsy; non-pharmacological treatment; ketogenic diet; yoga
A small series of patients with amoebiasis presenting to the surgical service in Seychelles is described. The varied nature of the symptomatology indicates that this may be a local pattern of the disease process. The value of specific clinical features and the use of a therapeutic trial for diagnosis is emphasised. The features of common 'Third-World' diseases should be well known to all surgeons wherever they practise in view of the rapidity with which people can now travel from country to country.
Thoracic symptoms were noted in 38 (86%) out of 44 patients with hepatic amoebiasis and dominated the clinical picture in 4 (9%), causing dangerous delay in initiating appropriate treatment. Thoracic amoebiasis characteristically presents as a febrile illness with cough, chest pain, and point tenderness in an intercostal space or the right upper quadrant of the abdomen. Haemoptysis, diarrhoea, and dysentery are uncommon, occurring in approximately equal proportions (9%). The most important factor in clinical recognition is awareness of the possibility of the lesion. Chest radiography, serological tests, and therapeutic trials give corroborative evidence. In endemic areas thoracic amoebiasis should always be considered in the evaluation of obscure, especially right-sided, respiratory symptoms.
Acute Fulminant Necrotizing Amoebic Colitis is a rare complication of amoebiasis that is associated with high mortality. Only one to four such cases are seen per year in large hospitals of India, and only few such cases have been reported in the literature. The condition requires early diagnosis and surgical intervention. We recently cared for a patient who presented with acute abdomen with history of intermittent abdominal pain and diarrhea. Before presenting to our institution he was misdiagnosed as a case of inflammatory bowel disease and had been treated with steroids. On emergency exploration, extensive necrosis and multiple perforations in retroperitoneum involving entire colon were seen. Total colectomy with ileostomy was performed. Postoperative course was marked by septicaemia and multi-organ failure followed by death. This case report emphasizes the importance of early diagnosis and treatment of acute FAC, and associated high mortality.
A 41-year-old male was admitted to the hospital with symptoms of diarrhea, fever and rapidly progressive respiratory distress. A chest radiograph and computed tomography (CT) of the chest and the abdomen showed a large amount of right pleural effusion and a large liver abscess. The patient was thus diagnosed to have amoebic colitis, amoebic liver abscess and amoebic empyema complicated with an HIV infection. The patient demonstrated agranulocytosis caused by the administration of trimethoprim-sulfamethoxazole. However, the administration of granulocyte colony-stimulating factor made it possible for the patient to successfully recover from agranulocytosis, and he thereafter demonstrated a good clinical course.
amebiasis; amoebic empyema; HIV; agranulocytosis; trimethoprim-sulfamethoxazole
In accordance with the 1997 documents of the World Health Organization (WHO), amoebiasis is defined as the infection by the protozoan parasite Entamoeba histolytica with or without clinical manifestations. The only known natural host of E. histolytica is the human with the large intestine as major target organ. This parasite has a very simple life cycle in which the infective form is the cyst, considered a resistant form of parasite: The asymptomatic cyst passers and the intestinal amoebiasis patients are the transmitters; they excrete cysts in their feces, which can contaminate food and water sources. E. histolytica sensu stricto is the potentially pathogenic species and E. dispar is a commensal non-pathogenic Entamoeba. Both species are biochemical, immunological and genetically distinct. The knowledge of both species with different pathogenic phenotypes comes from a large scientific debate during the second half of the 20th century, which gave place to the rapid development of diagnostics technology based on molecular and immunological strategies. During the last ten years, knowledge of the new epidemiology of amoebiasis in different geographic endemic and non-endemic areas has been obtained by applying mostly molecular techniques. In the present work we highlight novelties on human infection and the disease that can help the general physician from both endemic and non-endemic countries in their medical practice, particularly, now that emigration is undoubtedly a global phenomenon that is modifying the previous geography of infectious diseases worldwide.
Amoebiasis; Diagnosis; Treatment
Here we present an interesting and extremely rare case of a 66 year old male who developed a colocutaneous fistula secondary to amoebiasis. The patient presented with an acute history of right lower abdominal pain, weight loss and a palpable mass. A CT scan demonstrated a fluid filled cavity in the right iliac fossa consistent with an appendiceal abscess which was drained under radiological guidance. However, following drainage his symptoms remained requiring open surgical drainage, and a controlled caecostomy was performed due to a small caecal perforation. Despite appropriate conservative therapy he failed to progress, and developed localised sepsis in the right iliac fossa with a colocutaneous fistula, requiring a formal right hemicolectomy. The histological examination confirmed the presence of abundant trophozoites of Entamoeba histolytica.
We highlight the fact that in the modern age of immigration and long distance travel, it will become increasingly likely that the so-called ‘tropical’ diseases will present throughout the world. This case also highlights the need to keep an open mind in cases that do not progress as expected, and to react accordingly to any unusual developments.
Colocutaneous fistula; Appendicular abscess; Amoebic dysentery; Amoebiasis
A study on Kutajarista’ was carried out and it was tested for anti-amoebic action which is presented in this paper.
Amoebiasis continues to be a major cause of morbidity and mortality in children in developing countries. Entamoeba histolytica infections are commonly observed in tropical and subtropical regions of the world including Iran. In developed countries Entamoeba histolytica infections are commonly seen in travelers, recent immigrants, homosexual men, and inmates of institutions. The disease is more severe in the two extremes of life. This paper paper describes a four-month-old male infant with Entamoeba histolytica presenting initially with refusal of feeds, hyperactive bowel sound, vomiting, and diarrhea. A fecal sample was positive for Entamoeba histolytica by Lugol's iodine solution and the concentration technique. He was successfully treated with metronidazole for 5 days. This case illustrates that Entamoeba species could be pathogenic in young infant; therefore, awareness of the infection, aggressive approach to diagnosis, and early initiation of treatment continue to be critical component of infection control.