Introduction: Candida albicans and Enterococcus faecalis are the most predominant microorganisms found in the canals of failed root canal treated teeth. Thorough debridement of an infected root canal and complete elimination of microorganisms are objectives of effective endodontic therapy. For thousands of years, humans have used herbs as the primary means to sort out health issues and illnesses. Not all herbs have shown to provide scientific evidence as medicine to illness. Neem is a Botanical herb that is truly remarkable with its scientific value, a tropical evergreen native to India. Although different agents have been suggested as root canal irrigants, sodium hypochlorite and EDTA are the most popularly used. Aim: To compare the antimicrobial efficacy of commercially available irrigants, 17% EDTA and a herbal product, neem leaf extract compared with 3% sodium hypochlorite as a control against Enterococcus faecalis and Candida albicans. Materials and Methods: The antimicrobial activity was determined using the agar well diffusion method. Freshly prepared neem leaf extracts, 17% EDTA, 3% Sodium hypochloriteStandard strain of E. Faecalis and C. Albicans were used in this study. These isolates were subcultured on to Brain heart infusion agar (BHI agar) and HI-chrome candidal differential media respectively. The agar well diffusion test was performed in brain heart infusion media and broth. The plates were incubated at 37°C for 24 hours and the zone of inhibition was recorded and analyzed statistically. Results: Zones of inhibition were present with Neem leaf extract suggestive of antimicrobial properties. Zones of inhibition were greater with Neem extract than 17% EDTA. Hence, further research should be directed towards the use of this herbal extract as an irrigant clinically with endodontic therapy. Conclusion: Within the limitation of this study, it was found that neem leaf extract had a significant antimicrobial effect against E. Faecalis and C. Albicans compared to EDTA and Sodium Hypochlorite. Since the study is a qualitative analysis, further testing needs to be done to final quantitative analysis of the antimicrobial activity of neem leaf extract.
Introduction: Scrub typhus, a dreaded disease in the pre-antibiotic era, was a serious military disease that killed thousands of people in the Far East during WWII. It is a zoonosis that is common throughout Asia and the Pacific Islands. Scrub typhus is a febrile illness characterized by a wide range of symptoms and indications. This disease has a wide spectrum of clinical symptoms, from subclinical through organ failure to death. The objective of this study was to assess the clinical profile of scrub typhus infection among children in a tertiary care hospital in south India. Methodology: This is a retrospective study of the clinical profile of 50 paedriatric children, who were admitted in the Paediatric ward of a tertiary care hospital, during the study period of JAN 2020 to DEC 2020. Results: All children presented with fever. Other common symptoms were vomiting (56%), facial swelling (52%), cough (35%), abdominal pain (33%), breathlessness (29%) and decreased urine output (29%). High grade fever (>101 oF) was recorded in 91% of children. Other common signs were hepatomegaly, splenomegaly, edema, tender lymphadenopathy and hypotension, observed in 82%, 59%, 39%, 38% and 36% of cases, respectively. An eschar and a maculopapular rash each were observed in 20% of patients. Within 48 hours of starting an appropriate antibiotic, 90% of the children became afebrile. Overall, there was a 7.5 percent mortality rate. Refractory shock, meningoencephalitis, acute respiratory distress syndrome, bronchopneumonia, acute renal damage, and myocarditis were among the causes of mortality. Conclusion: In any febrile child with a maculopapular rash, hepatosplenomegaly, tender lymphadenopathy, thrombocytopenia, or symptoms indicative of capillary leak, paediatricians should have a high index of suspicion for scrub typhus. Pending serological confirmation, empirical therapy with doxycycline or azithromycin should be initiated immediately, since any delay in treatment could lead to life-threatening consequences.
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