Antibacterial Effects of Henna (Lawsonia inermis) Leaf Extracts (Chloroform) Against Two Food Borne and Nosocomial Infection Causing Pathogens: Staphylococcus aureus and Escherichia coli.

Evaluation of the in vitro antibacterial activity of Chloroform extracts isolated from Henna (Lawsonia inermis) leaf against two food born & nosocomial infection causing pathogens, gram-positive Staphylococcus aureus and gram-negative Escherichia coli. This interventional study was carried out during the period of January 2021 to December 2021 in the Department of Pharmacology and Therapeutics in collaboration with the Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. The antibacterial activity was tested at different concentrations of Chloroform Henna leaf extracts by using disc diffusion and broth dilution method. The extract was prepared by using solvents chloroform and 0.1% DMSO. The test microorganisms were also tested for their activity against a standard antibiotic Ciprofloxacin by broth dilution method and the result was compared with that of Chloroform extracts. Chloroform Henna Extracts (CHE) were used initially in nine different concentrations (2.5, 5, 10, 20, 50, 100, 200, 500 and 1000mg/ml) and later in selected concentrations as needed to confirm the more precise margin of antimicrobial sensitivity of the extracts. Among different concentrations of the CHE, 100mg/ml and above concentrations showed inhibitory effect against Staphylococcus aureus and 300mg/ml and above concentrations showed inhibitory effect against Escherichia coli. The MIC for Staphylococcus aureus and Escherichia coli were 100 and 350mg/ml in CHE respectively. The MIC of Ciprofloxacin was 1µg/ml against both Staphylococcus aureus and Escherichia coli. The MIC of Ciprofloxacin was the lowest in comparison to MICs of CHE for the test organisms. The present study showed that Chloroform Henna extracts demonstrated antibacterial effects against food borne pathogens. From this study, it is clearly observed that there is definite antibacterial effect of the chloroform extract of Henna leaves against Staphylococcus aureus and Escherichia coli.

Antibacterial Effect of Moringa (Moringa oleifera) Leaf Ethanolic Extract Against Staphylococcus aureus and Escherichia coli.

Increasing resistance of pathogenic microorganisms to synthetic antibiotics has lead to the search for alternative drug sources. In this regard, one of the reputed Medicinal plant, Moringa (Moringa oleifera) was investigated for potential antimicrobial effect against some commonly encountered bacteria such as Staphylococcus aureus, Escherichia coli. This experimental study was conducted from July 2019 to June 2020 in the Department of Pharmacology and Therapeutics in collaboration with the Department of Microbiology, Mymensingh Medical College, Bangladesh to determine the antibacterial effect of Ethanolic extract of Moringa oleifera leaf (EMLE) against aforementioned bacteria. The antibacterial activity was tested at different concentrations (100, 200, 400, 600, 800 and 1000µg/ml) of Ethanolic extract by using disc diffusion and broth dilution method. Dose dependent inhibitory effect was seen against the test organisms using disc diffusion method. The maximum zone of inhibition was 19 mm against S. aureus and 20mm against E. coli at 100.0% (1000µg/ml) concentration. The minimum inhibitory concentrations (MICs) of EMLE were 400µg/ml and 500µg/ml against Staphylococcus aureus and Escherichia coli respectively. The present study showed that Ethanolic extract of Moringa leaf demonstrated antibacterial effects against food borne pathogens. Further studies are required to detect and isolate the active ingredients present in the Moringa leaves extract responsible for its antibacterial effect.

Development of Lepidium sativum Extracts/PVA Electrospun Nanofibers as Wound Healing Dressing.

Lepidium sativum L. (Garden cress/Hab El Rashad) (Ls), family Brassicaceae, has considerable importance in traditional medicine worldwide because of its antioxidant and anti-inflammatory activities. Ls fruits were used in Ayurvedic medicines as a useful drug for injuries, skin, and eye diseases. The aim of this study was to examine the effectiveness of the total ethanol extract (TEE) and polysaccharide (Poly) of Ls seeds loaded on poly(vinyl alcohol) (PVA) nanofibers (NFs) as a wound healing dressing and to correlate the activity with the constituents of each. TEE and Poly were phytochemically analyzed qualitatively and quantitatively. Qualitative analysis proved the presence of phenolic acids, flavonoids, tannins, sterols, triterpenes, and mucilage. Meanwhile, quantitative determinations were carried out spectrophotometrically for total phenolic and total flavonoid contents. High-performance liquid chromatography (HPLC) for TEE identified 15 phenolic acids and flavonoid compounds, with gallic acid and catechin as the majors. Separation, purification, and identification of the major compounds were achieved through a Puriflash system, column Sephadex LH20, and spectroscopic data (1H, 13C NMR, and UV). Eight compounds (gallic acid, catechin, rutin, kaempferol-3-O-rutinoside, quercetin-3-O-rhamnoside, kaempferol-3-O-rhamnoside, quercetin, and kaempferol) were obtained. Gas-liquid chromatography (GLC) analysis for Poly identified 11 compounds, with galactose being the main. The antioxidant activity for both extracts was measured by three different methods based on different mechanisms: 1,1-diphenyl-2-picrylhydrazyl (DPPH), ferric reducing ability of plasma (FRAP), and 3-ethylbenzothiazoline-6-sulfonic acid (ABTS). TEE has the highest effectiveness as an antioxidant agent with IC50 82.6 ± 8.35 µg/mL for DPPH and 772.47 and 758.92 µM Trolox equivalent/mg extract for FRAP and ABTS, respectively. The PVA nanofibers (NFs) for each sample were fabricated by electrospinning. The fabricated NFs were characterized by SEM and Fourier transform infrared spectroscopy (FTIR); the results revealed successful encapsulation of TEE and Poly in the prepared NFs. Moreover, the swelling index of TEE in the prepared NFs shows that it is the most appropriate for use as a wound dressing. Cytotoxicity studies indicated a high cell viability with IC50 216 µg/mL and 1750 µg/mL for TEE and Poly, respectively. Moreover, the results revealed that nanofibers possess higher cell viability compared to solutions with the same sample quantities: 9-folds for TEE and 4-folds for Poly of amount 400 µg. The in vitro wound healing test showed that the TEE nanofibers performed better than Poly nanofibers in accelerating wound healing, with 90% for TEE, more than that for the Poly extract (82%), after 48 h. These findings implied that the incorporation of TEE in PVA nanofibers was more efficient than incorporation of Poly in improving the biological activity in wound healing. In conclusion, the TEE and polysaccharides of L. sativum L seed are ideal candidates for nanofibrous wound dressings. Furthermore, the contents of phenolic acids and flavonoids in TEE, which have potential antioxidant activity, make the TEE of L. sativum more favorable for wound healing dressing.

Evaluation of the Effect of Elite Jojoba Lines on the Chemical Properties of their Seed Oil.

Jojoba oil (JO) extracted from seeds has outstanding properties, including anti-inflammatory, antioxidant, and antibacterial activities, and can be stored forlong periodsof time. The unique properties of jojoba oil depend on its chemical composition; therefore, the effect of the jojoba genotype on the chemical properties and active components of the seed oil was evaluated in this study. Oil samples were collected from 15 elite Egyptian jojoba lines. The chemical composition, such as moisture, crude fiber, crude oil, ash, and crude protein of elite lines' seeds was determined to investigate the variation among them based on the jojoba genotype. In addition, the iodine value was obtained to measure the degree of jojoba oil unsaturation, whereas the peroxide number was determined as an indicator of the damage level in jojoba oil. Fatty acid composition was studied to compare elite jojoba lines. Fatty acid profiles varied significantly depending on the jojoba genotype. Gadoleic acid exhibited the highest percentage value (67.85-75.50%) in the extracted jojoba oil, followed by erucic acid (12.60-14.81%) and oleic acid (7.86-10.99%). The iodine value, peroxide number, and fatty acid composition of the tested elite jojoba lines were compared withthose reported by the International Jojoba Export Council (IJEC). The results showed that the chemical properties of jojoba oils varied significantly, depending on the jojoba genotype.

Effects of Amlaki (Emblica officinalis) on Serum Lipid Profile in Rats.

The effect of Amlaki (Emblica officinalis) on lipid profile (Serum cholesterol, triglyceride, HDL-cholesterol & LDL-cholesterol) in normal and fat fed rats were studied. The experimental study was carried out in the department of Pharmacology, Sir Salimullah Medical College (SSMC), Mitford, Dhaka and in the animal house of Institute of Science & Technology (IFST) of Bangladesh Council of Scientific & Industrial Research (BCSIR) Laboratory, Dhaka, Bangladesh from January 2005 to December 2005. Twenty four adult rats of both sexes weighing between 200-300gms were used. The experiment was divided into two parts: Part-1 and Part-II. In Part-I: to demonstrate the effect of Amlaki on serum lipid profile in normal rats, a total number of twelve rats were taken and divided into two groups. Group A1: Consisted of 6 rats, received normal laboratory diet and water to 1.5-2.0ml daily for 21 days and served as normolipidemic control group. Group A2: Consisted of 6 rats which received normal laboratory diet and Amlaki in a dose of 1.5gm/kg body wt. daily orally for 21 days and served as normolipidemic experimental group. On 22nd day, rats of both groups were sacrificed and estimation of serum lipid profile was done. In the first part of this study, administration of Amlaki for 21 days to normal rats, significantly reduced the serum cholesterol level (p<0.01), triglycerides (p<0.01) and LDL-cholesterol level (p<0.01). But there was no significant change in serum HDL-cholesterol level (p>0.1). In Part-II: to demonstrate the effect of Amlaki on lipid profile in fat fed rats, a total number of twelve rats were taken and divided into two groups. Group B1: Consisted of 6 rats, received normal lab. diet and fat (1% cholesterol plus 0.25% cholic acid dissolved in 100ml vegetable oil) in a dose of 1.5ml daily orally for 28 days serve as a hyper-lipidemic control group (fat fed). Group B2: Consisted of 6 rats and received normal lab. diet and cholesterol rich diet and Amlaki in a dose of 1.5gm/kg body wt. daily orally for 28 days and served as a hyper-lipidemic experimental group. On 29th day, rats of both groups were sacrificed and estimation of serum lipid profile was done. In the second part of this study, fat feeding produced a significant increase in serum cholesterol (p<0.001), triglyceride (p<0.001) and LDL-cholesterol level (p<0.001) and a significant reduction of serum HDL-cholesterol level (p<0.001) i.e. a state of hyper-lipidemia was produced. In the 2nd part of this study, concomitant administration of Amlaki and fat rich diet daily orally in rats for 28 days, produced a significant reduction in serum total cholesterol (p<0.001), triglyceride (p<0.001) and LDL-cholesterol level (p<0.001). The serum HDL cholesterol level was increased but not significantly (p>0.1). In the light of these results, it may be concluded that Emblica officinalis (Amlaki) has significant hypo-lipidemic effect in both normal and fat fed rats.

Factors Associated with Domestic Violence in Rural Bangladesh.

Women's experience of domestic violence has adverse consequences on women's health globally and is itself affected by several factors. This study aims to determine the factors that are associated with experience of any form of domestic violence in rural Bangladesh. Data were derived from the baseline survey database of Suchana, a large-scale nutrition program in Bangladesh. Data of 5,440 women from poor households in rural areas were analyzed. Descriptive statistics were used to summarize the data. Multilevel logistic regression analysis was conducted to determine the factors that were significantly associated with experiencing any form of domestic violence. The prevalence of women experiencing domestic violence was found to be 35% and household food insecurity was 86%. Of the women's characteristic domain, age at marriage, lack of any support from household members, visit from non-governmental organizations (NGO) health professionals, number of children, and decision-making power of women at the household level were significantly associated with reporting of domestic violence. Of the household characteristic domain, the associated factors were having a male household head, increased household size, low socio-economic status, having a loan, experience of at least one crisis event, and household food insecurity. The strength of association between household food insecurity and domestic violence was higher among poor families. Experience of domestic violence is inevitably associated with women's decision-making power and household food insecurity. Behavioral change communication interventions may help to positively affect decision-making power but a holistic approach needs to be undertaken to reduce food insecurity, for which the underlying mechanism of food insecurity in Bangladesh needs to be explored further.

Open Label Randomized Controlled Comparison of Three Alternative Regimes of Ciprofloxacin, Azithromycin and Cefixime for Treatment of Uncomplicated Typhoid Fever in Bangladesh.

Multi-drug resistant Typhoid fever (resistant to previously used chloramphenicol, ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole) has been commonly described in the South East Asia region and a recent report suggests that the salmonella typhi have reduced response to fluoroquinolones (nalidixic acid-resistant). The optimum treatment protocol for this type of serovar has not been established. This study compared different antimicrobial regimens for the treatment of uncomplicated typhoid fever which was conducted in the medicine ward of Dhaka Medical College Hospital (DMCH) and outdoor setting in private practice in Dhaka metropolitan city, Mymensingh and Sylhet town from January 2017 to December 2017. Bangladeshi adults with uncomplicated typhoid fever were included in this an open-label randomized controlled trial. Ciprofloxacin (20mg/kg of body weight/day for 14 days), azithromycin (20mg/kg/day for 14 days), and Cefixime (16mg/kg/day for 14 days) were compared. Of the 81 enrolled patients, 62 were eligible for analysis (61 S. enterica serovar Typhi, 1 Salmonella enterica serovar paratyphi A). Of the S enterica serovar Typhi isolates, 88.7% (55/62) were MDR and 93.5% (58/62) were nalidixic acid resistant (NAR). The clinical cure rate was 62% (13/21) with ciprofloxacin, 71% (15/21) with Cefixime, and 85% (17/20) with azithromycin (p=0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with cefixime (7.1 days [6.2 to 8.1 days]) and ciprofloxacin (8.2 days [7.2 to 9.2 days]) (p<0.001). All three antibiotics were well tolerated. A 7-day course of azithromycin can be successfully used in uncomplicated typhoid fever due to isolates of MDR S enterica serovar Typhi.

The molecular structure, morphology, and physicochemical property and digestibility of potato starch after repeated and continuous heat-moisture treatment.

The multiscale structural, physicochemical, and digestible properties of potato starch before and after heat-moisture treatment were investigated, and further compared between repeated heat-moisture treatment (RHMT) and continuous heat-moisture treatment (CHMT). After heat-moisture treatment, there appeared partial disruption and pits on the starch granules, and the birefringence edges of HMT starch particles became blurred. Besides, the molecular weight of samples conspicuously decreased after two kinds of treatments. The crystal type of HMT starches transformed from B-type to C-type according to X-ray analysis. A decrease in the solubility and swelling power in high temperatures were identified. The pasting temperature, the gelatinization transition temperature (To , Tp , Tc ), and the slowly digestible starch (SDS) content of HMT starches were significantly higher than native potato starch, while the peak viscosity, the trough viscosity, the final viscosity, the breakdown, and the gelatinization enthalpy (ΔH) of RHMT and CHMT potato starches decreased compared to the native. RHMT potato starches displayed significantly higher relative crystallinity degree and gelatinization transition temperatures. The cooling process of RHMT in which the linkage between the recombinant amylose/amylopectin was enhanced compared with CHMT, which contributed to that RHMT potato starches exhibited greater advantages in practical applications. PRACTICAL APPLICATION: The described RHMT and CHMT starches provide new ideas for the study of modified starch. Furthermore, this study revealed the mechanism of heat-moisture processing provided some instructions to the application of RHMT potato starch.

In Vitro Antibacterial Activity of Ethanol Extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa.

Cinnamomum zeylanicum as medicinal plants are measured as new resources for preparing elements in the treatment of antibiotic-resistant microbes as alternatives to antibiotics. This study was aimed to evaluate the antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against a Gram-negative bacteria Pseudomonas aeruginosa. This experimental study was carried out in the department of Pharmacology & Therapeutics and department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to July 2018. Evaluation of the in vitro antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa was performed by disc diffusion method. And also in this study we used broth dilution method to determine the minimum inhibitory concentration (MIC). Ethanol cinnamon extract (ECE) was found active against P. aeruginosa. Zone of inhibition (ZOI) ranged between 6-25mm at different concentration of extracts. The MIC was 0.3g/ml. Cinnamomum zeylanicum showed strong antibacterial activity against a Gram-negative bacteria Pseudomonas aeruginosa. The results may contribute to the development of potential antimicrobial agents for inclusion in antipseudomonal regimens.

The Antibacterial Activity of Ethanolic Extract of Cinnamon (Cinnamomum zeylanicum) against two Food Borne Pathogens: Staphylococcus aureus And Escherichia coli.

Evaluation of the in vitro antibacterial activity of the ethanolic extract isolated from Cinnamomum zeylanicum bark against two food borne pathogens, Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. This experimental study was carried out in the department of Pharmacology & Therapeutics in collaboration with the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to July 2018. The antibacterial activity was tested at different concentrations of extracts of spice by using disc diffusion method. The extracts were prepared by using a solvent ethanol. The test microorganisms were also tested for their activity against a standard antibiotic Amikacin (500mg) by disc diffusion method and the result was compared with that of ethanolic extracts. Cinnamon had inhibitory activity against both Staphylococcus aureus and Escherichia coli. The ethanolic extracts were more effective against Staphylococcus aureus than E. coli. Staphylococcus aureus showed activity from 60% conc. (zone of inhibition 17mm) where E. coli from 80% conc. (ZOI 18mm). Maximum zone of inhibition was 26mm for both the test organisms. This result was also compared to those obtained against a standard antibiotic Amikacin where extract produced wider zone of inhibition of 26mm as compared to Amikacin for both test organisms. The present study showed that ethanolic extract of cinnamon demonstrated stronger antimicrobial effect against food borne pathogens.

Technologies for enhancement of bioactive components and potential health benefits of cereal and cereal-based foods: Research advances and application challenges.

Cereal grains are a major source of human food and their production has steadily been increased during the last several decades to meet the demand of our increasing world population. The modernized society and the expansion of the cereal food industry created a need for highly efficient processing technologies, especially flour production. Earlier scientific research efforts have led to the invention of the modern steel roller mill, and the refined flour of wheat has become a basic component in most of cereal-based foods such as breads and pastries because of the unique functionality of wheat protein. On the other hand, epidemiological studies have found that consumption of whole cereal grains was health beneficial. The health benefit of whole cereal grain is attributed to the combined effects of micronutrients, phytochemicals, and dietary fibre, which are mainly located in the outer bran layer and the germ. However, the removal of bran and germ from cereal grains during polishing and milling results in refined flour and food products with lower bioactive compounds and dietary fibre contents than those from whole grain. Also, the level of bioactive compounds in cereal food is influenced by other food preparation procedures such as baking, cooking, extrusion, and puffing. Therefore, food scientists and nutritionists are searching for strategies and processing technologies to enhance the content and bioavailability of nutrients, bioactive compounds, and dietary fibre of cereal foods. The objective of this article was to review the research advances on technologies for the enhancement of bioactive compounds and dietary fibre contents of cereal and cereal-based foods. Bioactivities or biological effects of enhanced cereal and cereal-based foods are presented. Challenges facing the application of the proposed technologies in the food industry are also discussed.

The effect of repeated versus continuous annealing on structural, physicochemical, and digestive properties of potato starch.

Native potato starch was suspended in distilled water at starch: water ratio of 1:3 (w/v). The starch-water suspensions were then subjected to repeated annealing treatments (RANN) at 55 °C for 12 h, repeated for 8 cycles or continuous annealing treatments (CANN) at 55 °C for 24, 48, 72 and 96 h. The structural, physiochemical and digestive properties of the annealed starch samples were studied and compared with those of the native starch. The scanning electron microscopy and light microscopy analysis showed that the repeated and continuous annealing treatments could keep the integrity and surface perfection of the starch granules. The growth rings of the annealed starch granules were more distinct than those of the native starch granules as revealed by confocal laser scanning microscopy. The crystallinity degree increased and the crystalline retained the B-type pattern after the annealing treatments. There were no chemical bonds and functional groups produced or disappeared during the applied annealing treatments. Infrared absorption peak intensity of starch decreased and short-range ordered structures increased after treatments. The swelling power and solubility decreased at low temperature (50 to 60 °C) and increased at relatively high temperature (70 to 90 °C). The rapid visco-analyzer and differential scanning calorimeter analysis revealed an increase in the setback, final viscosity, pasting temperature and gelatinization transition temperature, and a decrease in breakdown value of the starch after the annealing treatments. On the other hand, the repeated and continuous annealing treatments resulted in starch with low in vitro digestibility degree, indicating formation of resistant starch. Generally, the repeated annealing treatment resulted in starch with high improved properties compared with the starch resulted from the continuous annealing treatments. Therefore, the repeated annealing treatments can be suggested as an effective method for producing of modified starch for food industrial applications.

Vitamin D supplementation in obese type 2 diabetes subjects in Ajman, UAE: a randomized controlled double-blinded clinical trial.

OBJECTIVES: To study the effect of Vitamin D3 supplementation on metabolic control in an obese type 2 diabetes Emirati population. METHODS: This randomized double-blind clinical trial was conducted with 87 vitamin D-deficient obese, type 2 diabetic participants. The vitamin D-group (n=45) and the placebo group (n=42) were matched for gender, age, HbA1c and 25-hydroxy vitamin D (25(OH) D) at the baseline. The study was divided into two phases of 3 months each; in phase 1, the vitamin D-group received 6000 IU vitamin D3/day followed by 3000 IU vitamin D3/day in phase 2, whereas the placebo group (n=42) received matching placebo. RESULTS: After supplementation, serum 25(OH) D peaked in the vitamin D-group in phase 1 (77.2±30.1 nmol/l, P=0.003) followed by a decrease in the phase 2 (61.4±18.8 nmol/l, P=0.006), although this was higher compared with baseline. In the placebo group, no difference was observed in the serum 25(OH) D levels throughout the intervention. Relative to baseline serum, parathyroid hormone decreased 24% (P=0.003) in the vitamin D-group in phase 2, but remained unchanged in the placebo group. No significant changes were observed in blood pressure, fasting blood glucose, HbA1c, C-peptide, creatinine, phosphorous, alkaline phosphatase, lipids, C-reactive protein or thyroid stimulating hormone concentrations compared with baseline in either group. CONCLUSIONS: Six months of vitamin D3 supplementation to vitamin D-deficient obese type 2 diabetes patients in the UAE normalized the vitamin D status and reduced the incidence of eucalcemic parathyroid hormone elevation but showed no effect on the metabolic control.

Gender, socioeconomic development and health-seeking behaviour in Bangladesh.

In efforts to reduce gender and socioeconomic disparities in the health of populations, the provision of medical services alone is clearly inadequate. While socioeconomic development is assumed important in rectifying gender and socioeconomic inequities in health care access, service use and ultimately, outcomes, empirical evidence of its impact is limited. Using cross-sectional data from the BRAC-ICDDR,B Joint Research Project in Matlab, Bangladesh, this paper examines the impact of membership in BRAC's integrated Rural Development Programme (RDP) on gender equity and health-seeking behaviour. Differences in health care seeking are explored by comparing a sample of households who are BRAC members with a sample of BRAC-eligible non-members. Individuals from the BRAC member group report significantly less morbidity (15-day recall) than those from the non-member group, although no gender differences in the prevalence of self-reported morbidity are apparent in either group. Sick individuals from BRAC member households tend to seek care less frequently than non-members. When treatment is sought, BRAC members rely to a greater extent on home remedies, traditional care, and unqualified allopaths than non-member households. While reported treatment seeking from qualified allopaths is more prevalent in the BRAC group, non-members use the para-professional services of community health care workers almost twice as frequently. In both BRAC member and non-member groups, women suffering illness report seeking care significantly less often than men. The policy and programmatic implications of between group and gender differences in care seeking are discussed with reference to the literature.

Intra-operative suggestions reduce incidence of post hysterectomy emesis.

The influence of therapeutic intraoperative auditory suggestions on the incidence and severity of emetic episodes was investigated in 50 adults ASA I and II patients undergoing elective abdominal hysterectomy. The patients were randomly divided into two groups, each consisting of 25 patients. In group I, a blank tape was played and in group II, positive suggestion was played via headphones throughout the anaesthetic period. It was observed that there was statistically significant difference (P < 0.05) between the incidence of vomiting in group I (60%) and group II (36%). The number of vomiting episodes per patient in group I was 3.1 +/- 1.2 as compared to 1.7 +/- 0.6 in group II. This difference was statistically significant. The patients requiring rescue antiemetic was significantly higher (P < 0.05) in group I (66.6%) as compared to group II (22.2%). It is concluded that positive therapeutic suggestion may be considered as an alternative to antiemetic therapy.

Comparative efficacies of pivmecillinam and ampicillin in acute shigellosis.

The clinical efficacies of pivmecillinam and ampicillin were compared in a randomized double-blind trial in the treatment of acute shigellosis. Of 44 adult male patients, all culture positive for Shigella strains, 22 patients received 400 mg of pivmecillinam and 22 patients received 500 mg of ampicillin every 6 h. Both drugs were administered orally for 5 days. Four patients receiving ampicillin were infected with Shigella strains that were resistant to ampicillin but susceptible to pivmecillinam, and two patients receiving pivmecillinam were infected with Shigella strains resistant to both ampicillin and pivmecillinam. The mean duration of diarrhea in all patients receiving pivmecillinam was 3.3 days compared with 4.5 days in patients receiving ampicillin (P less than 0.05). When patients infected with the resistant strains were excluded, the mean duration of diarrhea in patients receiving pivmecillinam was 3.2 days compared with 4.1 days in patients receiving ampicillin. The patients infected with strains susceptible to both antibiotics had mean durations of fecal excretion of Shigella strains of 1.2 days for those treated with pivmecillinam and 1.4 days for those treated with ampicillin. The patients infected with organisms resistant to both drugs had longer durations of diarrhea and fecal excretion of Shigella strains. The results suggest that pivmecillinam is as effective as ampicillin and can be a useful drug for the treatment of shigellosis.