Epidemic dropsy in India

Sharma, Bhawna; Malhotra, Sanjay V.; Bhatia, Vikram; Rathee, Mandeep

doi:10.1136/pgmj.75.889.657

Cited by 38 publications

(18 citation statements)

References 20 publications

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“…Various types of chemical constituents are present in this plant, although alkaloids are the most abundant [ 10 ]. In traditional medicine, different parts of this plant are used to treat chronic skin diseases, ulcers, asthma, and other intestinal conditions [ 11 – 13 ]. Studies have shown that the extracts of A. mexicana and some of its individual components are effective against bacteria, fungi, viruses, nematodes, and parasites [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Study of Antiamoebic Activity of Methanol Extracts ofArgemone mexicanaon Trophozoites ofEntamoeba histolyticaHM1-IMSS

Elizondo-Luévano

Castro‐Ríos

Sánchez

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Infections caused by parasites in humans represent one of the main public health concerns. Amoebiasis, a parasitic infection caused by Entamoeba histolytica (E. histolytica), is considered endemic in Mexico, where Argemone mexicana (A. mexicana) has been used in traditional medicine to treat intestinal parasitic diseases. The objective of this work was to evaluate the potential biological activity of A. mexicana on E. histolytica. For this purpose, a methanolic extract was prepared from A. mexicana leaves, and a differential fractionation was carried out with solvents of different polarities. The inhibitory capacities of the extract and its fractions were evaluated in vitro using HM1-IMSS, a strain of Entamoeba histolytica. A. mexicana extract was found to have a growth-inhibiting activity for E. histolytica, showing IC50 = 78.39 μg/mL. The extract was characterized phytochemically, and the methanolic extract fractions were analyzed by liquid chromatography (HPLC) and mass spectrometry (MS). Berberine and jatrorrhizine were present in the active fractions, and these compounds may be responsible for the antiparasitic activity. The identification of amoebicidal activity of A. mexicana on E. histolytica gives support to the traditional use. Further studies with berberine and jatrorrhizine will be carried out to understand the mechanism involved.

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Section: Introductionmentioning

confidence: 99%

In Vitro Study of Antiamoebic Activity of Methanol Extracts ofArgemone mexicanaon Trophozoites ofEntamoeba histolyticaHM1-IMSS

Elizondo-Luévano

Castro‐Ríos

Sánchez

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…A recent and large outbreak of epidemic dropsy appears in August 1998 in India involving 2900 hospitalized patients and more than 67 deaths reported [2][3][4][5][6]. Clinical manifestations in man are vomiting, diarrhea, nausea, swelling of limbs, erythema and cardiac arrest in extreme cases [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Quantitative liquid chromatographic determination of sanguinarine in cell culture medium and in rat urine and plasma

Hoellinger

Ré

Deroussent

et al. 2004

Journal of Chromatography B

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“…The seeds of Argemone mexicana contain the toxins sanguinarine and dihydrosanguinarine. In epidemic dropsy, the toxic alkaloid sanguinarine affects the oxidation of pyruvic acid, which accumulates in the blood and promotes capillary dilatation and increased permeability, the predominant clinical symptom of which is widespread edema [1,3,7].…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcomes of Epidemic Dropsy Patients Attending a Tertiary Care Centre in Assam, India

Sharma¹,

Brahma²,

Laskar³

et al. 2023

Cureus

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BackgroundThe clinical condition of epidemic dropsy is caused by the consumption of edible oils contaminated with Argemone mexicana oil. Two of the most toxic alkaloids found in argemone oil are sanguinarine and dehydrosanguinarine, which cause capillary dilation, proliferation, and increased permeability. Extreme cardiac decompensation leading to congestive heart failure and glaucoma resulting in blindness are the most serious consequences of epidemic dropsy. Materials and methodsAll patients attending the medicine department of Tezpur Medical College and Hospital with clinical features of epidemic dropsy were included in the study after obtaining informed consent. All patients, after a complete history, underwent a thorough clinical examination, and findings were recorded using a preformed proforma. Along with routine blood examination, patients were also evaluated with echocardiography, ECG, and chest X-ray. Cooking oil samples obtained from patients were investigated for the presence of sanguinarine in a standardized laboratory with the help of the district authority. The statistical analysis was done using MS Excel 2017. ResultsOut of 38 patients, 36 were male (94.7%), and only two were female (5.2%). Male to female ratio was 18:1. This difference in sex ratio may be due to the fact that only severely ill patients attended our tertiary care hospital. In contrast, moderate and mildly ill patients were treated in local hospitals. The mean age of patients was 28.1 years, and the mean length of hospital stay was eight days. Bilateral pitting type of ankle edema was the most common clinical manifestation, and all 38 patients (100%) exhibited edema. A total of 76% of patients had dermatological manifestations. Sixty-two percent of patients had gastrointestinal manifestations. In cardiovascular manifestation, persistent tachycardia was seen in 52% of patients, pansystolic murmur was best heard in the apical area in 42% of patients, and 21 percent had evidence of a raised jugular venous pressure (JVP). Five percent of patients had pleural effusion. Sixteen percent of patients had ophthalmological manifestations. Eight patients (21%) required ICU care. The in-hospital fatality rate was 10.53% (n=4). Of the expired patients, 100% were male. The most common cause of death was cardiogenic shock (75%), followed by septic shock (25%). ConclusionFrom our study, it was found that most of the patients were male, with an age group of 25-45 years. The most common clinical manifestation was dependent edema, along with signs of heart failure. Other common manifestations were dermatological and gastrointestinal. The severity and outcome were directly related to the delay in seeking medical consultation and diagnosis.

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Epidemic dropsy in India

Cited by 38 publications

References 20 publications

In Vitro Study of Antiamoebic Activity of Methanol Extracts ofArgemone mexicanaon Trophozoites ofEntamoeba histolyticaHM1-IMSS

In Vitro Study of Antiamoebic Activity of Methanol Extracts ofArgemone mexicanaon Trophozoites ofEntamoeba histolyticaHM1-IMSS

Quantitative liquid chromatographic determination of sanguinarine in cell culture medium and in rat urine and plasma

Clinical Profile and Outcomes of Epidemic Dropsy Patients Attending a Tertiary Care Centre in Assam, India

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