Summary Eighteen cases of actinomycetoma caused by Nocardia asteroides are described. The cases presented with mycetoma of neck, chest, back, elbow, palm, inguinal region, vulva, thigh, popliteal fossa, leg, ankle, foot and toes, having swelling with nodules and discharging sinuses. In 2 cases, the infection had spread extensively on the chest wall, but the underlying viscera ware not affected. The disease followed previous injury in 8 cases. There was higher predilection of males to the disease, but age and occupation appeared to have no relation to susceptibility to this infection. Radiology showed involvement of bony tissues in 6 cases. The discharge from the nodules and sinuses contained macroscopic granules in 4 cases; small, delicate, microscopic granules composed of branched filaments of less than 1 |x diameter in 6 cases, and GRAM positive, branched filaments in all the cases. Direct microscopy of the discharge with KOH was found to be superior to examination of stained smears in finding microscopic granules. Histopathology revealed presence of granules in microabscesses in 3 cases. The cultural, physiological and biochemical properties of the organisms isolated from all these cases were in conformity with N. asteroides. The local soil was considered to be the source of infection. Zusammenfassung Durch Nocardia asteroides wurde bei 18 Patienten ein Aktinomyzetom verursacht. Bei diesen hier beschriebenen Fällen wurden die Myzetome im Nacken‐, Brust‐, Rücken‐, Ellbogen‐, Handflächen‐, Leisten‐, Vulva‐, Oberschenkel‐, Kniehöhlen‐, Bein‐, Fuß‐knöchel‐, Fuß‐ und Zehenbereich beobachtet, bei gleichzeitigen Lymphknotenschwellungen und eitrigen Fisteln. 2 Fälle zeigten eine ausgedehnte Infektion im Brustbereich, aber die darunter liegenden Organe wurden nicht befallen. Die Erkrankung folgte oft voraus‐gehenden Verletzungen. Dies war bei 8 Patienten der Fall. Männer erkrankten in einem höheren Maße an der Nocardiose, hingegen schienen das Alter und die Beschäftigung in keiner Beziehung zu dieser Infektion zu stehen. Durch die röntgenologischen Untersuchun‐gen konnte in 6 Fällen eine Beteiligung des Knochengewebes nachgewiesen werden. Der Eiter aus den Lymphknoten und den Fisteln enthiek in 4 Fällen makroskopisch nachweis‐bare Granula. Die kleinen, zarten, mikroskopisch nachweisbaren Granula bestanden aus Filamenten von weniger als 1 μ, Durchmesser (6 Fälle) und GRAM‐positive verzweigte Fäden wurden im Eiter bei alien Patienten nachgewiesen. Es fand sich, daß die direkte mikroskopische Durchsicht von Eiter mit KOH gefärbten Präparaten (z. B. GRAM‐Präpa‐raten) zum Nachweis relativ kleiner Granula überlegen war. In 3 Fällen wurde mit Hilfe der Histologie der Nachweis von Granula in Mikroabszessen geführt. Die kulturellen physiologischen und biochemischen Eigenschaften dieser isolierten Stämme stimmten mit den Eigenschaften von Nocardia asteroides gut überein. Als Infektionsquelle für den Menschen wurde der Erdboden angesehen.
Cite as: Basu N. Usefulness of the homeopathic repertory in the management of chronic suppurative otitis media (CSOM).
Background Breast cancer is the most common cancer in women worldwide. Use of homeopathic medicines for the treatment of cancers has increased in the last several years. Arnica montana is an anti-inflammatory homeopathic medicine used in traumatic conditions and because of this property we performed investigations for its potential as a chemotherapeutic agent against breast cancer. Methods An ethanolic extract of Arnica montana (mother tincture, MT), prepared according to the Homoeopathic Pharmacopoeia of India, was characterized by gas chromatography–mass spectroscopy (GC–MS), followed by computational (in silico) analysis using molecular docking, to identify specific compounds that can bind and modulate the activity of key proteins involved in breast cancer survival and progression. To validate the in silico findings, in a controlled experiment breast cancer cells (MCF7) were treated in vitro with Arnica montana and the cytotoxic effects assessed by flowcytometry, fluorescence microscopy, scratch assay, clonogenic potential and gene expression analysis. Results Phytochemical characterization of ethanolic extract of Arn MT by GC–MS allowed identification of several compounds. Caryophyllene oxide and 7-hydroxycadalene were selected for molecular docking studies, based on their potential drug-like properties. These compounds displayed selective binding affinity to some of the recognized target proteins of breast cancer, which included estrogen receptor alpha (ERα), progesterone receptor (PR), epidermal growth factor receptor (EGFR), mTOR (mechanistic target of rapamycin) and E-cadherin. In vitro studies revealed induction of apoptosis in MCF7 cells following treatment with Arn MT. Furthermore, treatment with Arn MT revealed its ability to inhibit migration and colony forming abilities of the cancer cells. Conclusion Considering the apoptotic and anti-migratory effects of Arnica montana in breast cancer cells in vitro, there is a need for this medicine to be further validated in an in vivo model.
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