A five-year retrospective descriptive study on the clinical characteristics and outcomes of candidaemia at a tertiary hospital in South Africa.

Objectives: To describe the clinical features, microbiological profiles and outcome of patients with candidaemia at a tertiary hospital in South Africa. Methods: A retrospective study of blood cultures isolating Candida species at Tygerberg Hospital from 2014 to 2019. Results: We identified 108 patients with candidaemia. The most frequent species cultured were Candida albicans (51; 47.2%) followed by C glabrata (32; 29.6%), C parapsilosis (11; 10.2%), then C tropicalis (5; 4.6%). No treatment was given in 31 patients (28.7%), of whom 22 (71%) demised. Few patients were screened for complications. Of 14 screened by ophthalmoscopy, none had complications of ophthalmitis, 1 of 23 who underwent echocardiography had infective endocarditis, and 1 of 3 screened had hepatosplenic abscess. Case fatality rate was 59 of 108 (55%). Multivariable logistic regression for predictors of mortality showed that patients with diabetes mellitus were twice as likely to die from candidaemia (odds ratio (OR) 2.43; P=0.079). Failure to consult with Infectious Diseases increased the likelihood of mortality 3 times (OR 2.99; P=0.041). Conclusions: The all-cause mortality of patients with candidaemia was high. Many patients did not have follow up on blood cultures performed, were not screened for complications, nor had antifungal treatment. The study highlighted the role of Infectious Diseases consultation for candidaemia.

Ethnobotanical, phytochemical and toxicological studies of Xanthium strumarium L.

The present study describes the ethnobotanical, phytochemical, and toxicological evaluations of Xanthium strumarium L. growing in Bangladesh. In toxicity evaluation on rats, the methanol extract of seedlings showed mortality, while both seedling and mature plant extracts raised the serum alanine transaminase and aspartate transaminase values and produced significant abnormalities in the histopathology of liver and kidney of rats. On the other hand, the aqueous soluble fraction of methanol extract of mature plant (LC50 = 0.352 microg/mL) and methanol crude extract of seedlings (LC50 = 0.656 microg/mL) demonstrated significant toxicity in the brine shrimp lethality bioassay. A total of four compounds were purified and characterized as stigmasterol (1), 11-hydroxy-11-carboxy-4-oxo-1(5),2(Z)-xanthadien-12,8-olide (2), daucosterol (3) and lasidiol-10-anisate (4). The present study suggests that X. strumarium is toxic to animal.

Evaluation of the safety and adverse effects of goreisan/wulingsan, a traditional Japanese-chinese herbal formulation (kampo), in a rat model: a toxicological evaluation.

Diarrhea is the second leading cause of death among children less than 5 years of age. Most of these deaths occur in developing countries in the tropical areas of Africa and South Asia. Goreisan/Wulingsan, a formula of Japanese-Chinese medicinal herbs (Kampo), has been used for the treatment of diarrhea and vomiting from ancient times in East Asia. Therefore, we planned a randomized controlled clinical trial of Goreisan/Wulingsan in Bangladeshi children. Although it is believed to be safe in East Asia, information regarding its toxicity on animals is scarce. Since Goreisan/Wulingsan has never been used in Bangladesh, it was necessary to ensure the safety of the formula in an animal experiment. Rats were assigned to a control group (normal saline, n = 4) or various Goreisan/Wulingsan groups (n = 26) receiving doses of 1 to 8 mg/g/day (7.7 to 61.5 times the recommended pediatric dose) over a period of 25 days. Their activities and health conditions were observed until they were sacrificed, after which blood samples were collected for biochemical liver function tests. The kidneys, liver and heart tissue were collected for histopathological study. No lethality was observed during the experiment. All of the rats consumed the doses completely and no constipation was observed, suggesting the absence of any inhibitory effect on intestinal motion. Also, no abnormal neurological activity was detected, nor any significant elevation of AST, ALT or ALP levels, except for AST and ALT at the highest dose of 8 mg/g/day. Histopathological studies of the kidneys, liver and heart tissues revealed no abnormalities. In conclusion, our results showed that Goreisan/Wulingsan is safe for rats, thereby justifying the use of the drug in a human trial.