3 Merged PDF
3 Merged PDF
3 Merged PDF
ii
Vision
To Become a Centre of Excellence Recognized Worldwide in Skill Development and
Research
Mission
To Be a Role Model of Academic Excellence in Science and Education
iii
Mr Balogun G. A. Sanni
Saag Chemical (Nig.) Ltd, 4 Sanni Way, Off Godwin Omonua, Off Banks Way, Isolo
Illasamaja, Lagos, Lagos State, Nigeria.
Prof. T. T. Adebolu
Department of Microbiology, Federal University of Technology, Ondo State, Akure,
Nigeria
Prof. V. A. Aletor
Elizade University, Ilara Mokin, Ondo State, Nigeria
Prof. E. A. Aderinola
Department of Agricultural Economics, Federal University of Technology, Akure,
Ondo State, Nigeria
iv
CHAPTER TWO 6 - 20
CHAPTER THREE 21 - 26
CHAPTER FOUR 27 – 38
CHAPTER FIVE 39 – 79
vi
vii
The book aims towards providing the basic and fundamental information to the
researchers and scientists worldwide on the vast herbal and natural medicinal treasure
available to us derived from plants, herbs and fruits obtained from traditional
agricultural practices. This book is dedicated to the professionals of Agriculture,
Horticulture and Forestry Sciences and has been composed exclusively for providing
first-hand knowledge on the related issues for the development of science and
education.
SUBHA GANGULY
Editor-in-Chief
viii
HERBAL IMMUNE ENHANCERS AND INDIGENOUS HERBS, PLANTS AND FRUITS AND ITS
TRADITIONAL IMPLICATIONS IN THERAPY INCLUDING ALTERNATIVE MEDICINE: AN
INTRODUCTION TO READERS
ABSTRACT
A herbal immunomodulator is a substance which stimulates or suppresses the
components of immune system including both innate and adaptive immune
responses (Agarwal and Singh 1969). The modulation of immune system by
various medicinal plant products has become a subject for scientific
investigations currently worldwide.
INTRODUCTION
Under Indian scenario, poultry industry has become a means for earning livelihood for
the economically distressed farmers in India due to its promising results in productivity
and National economy. Poultry rearing is currently the fastest growing industry in our
National livestock sector which is benefiting us from production and advantages in
prices along with provision of proteinacous food.
Also, Ocimum sanctum, commonly known as „tulsi‟ is also used in Ayurveda for various
ailments including treatment of allergies. The plant has been reported to evince
significant anti-stress properties. The beneficial effects of O. sanctum could therefore be
due to its direct or indirect effect on the immune system. O. sanctum has been reported
to modulate humoral immune response by releasing mediators for hypersensitivity
reactions (Kujur 2001; Krishnamohan et al. 1997; Kumar 2003).
Withania somnifera also fall in this category with many other useful plants. They exhibit
immunomodulatory activities. Withania somnifera (commonly called „Ashwagandha‟)
root extracts possess anti-estrogenic, adaptogenic, anti-cancer and anabolic activities
having beneficial effects in the treatment of arthritis, geriatric problems and stress. The
root of Asparagus racemosus (commonly called „Satavar‟) possess anti-diarrheal, anti-
ulcerative, anti-spasmodic, aphrodisiac, galactogogue and other properties and has
therefore gained its importance in Ayurveda, Siddha and Unani systems of medicine
(Nadkarni, 1954). It has been observed that feeding W. somnifera and A. racemosus dried
root powder significantly stimulates both humoral and cell mediated immune
responses in swiss albino mice by Kuttan and Kuttan (1992). W. somnifera and A.
racemosus extracts increase phagocytic activities of macrophages in vitro (Rege and
Dahanukar 1993). There have been studies on the immunomodulatory activities of W.
somnifera and A. racemosus in mice with myelo-suppression induced by
cyclophosphamide, azathioprim or prednisolone. Extracts of W. somnifera and A.
racemosus have also shown immunopotentiating effects in cyclophasphamide treated
mouse with ascitic sarcoma (Diwanay et al. 2004). Kalita and Dutta (1999) reported that
maternal antibody was persistently found in sera samples tested against ND virus
during the first week of age in broilers. This was attributed to transfer of natural passive
immunity in young chicks as demonstrated by Hellar (1975). Muruganandan et al.
(2001) reported the effects of ethanolic extracts of W. somnifera and A. racemosus on
humoral immune system which was assessed by humoral immune response and cell
mediated immune response in mice.
CONCLUSION
The use of various plant extracts and herbal fed additives in a specific dose during the
scheduled vaccination regimen may be helpful in obtaining higher protective antibody
against different infections including production and development of more effective cell
mediate immune response for protection against various bacterial, viral and other
diseases. Herbal formulation may be therefore recommended for use as positive
immunomodulator in normal and immunocompromized susceptible animals and birds.
Chopra R N, Chopra L C, Handa K D and Kapur L D. 1982. Indigenous Drugs of India. 2nd
edn. Dhur & Sons Pvt Ltd, Calcutta, India.
Hellar E.D. 1975. Res. Vet. Sci.18: 117 (Cited by Rao et al. 1987). Resistance of maternal
antibodies against Newcastle disease virus in chicks from immune parents and its effect
on vaccination. Indian J. Comp. Microbiol. Immunol. Inf. Dis. 8(3): 106-110.
Nadkarni A.K. 1954. Indian Materia Medica, Bombay, Popular book Depot, 3rd edn., 1:
153-155.
Panda S K and Rao A T. 1994. Effect of levamisole on chicken infected with infectious
bursal disease (IBD) virus. Indian Vet. J. 71: 427-439.
Soppi E, Lassila O, Vilijanen M K, Lehtonon O P and Eskole J. 1979. Clin. Exp. Immunol.
38: 609. (Cited by Chakraborty D and Chatterjee A. 1998. Studies on
immunomodulatory effect of Levamisole in Newcastle disease vaccinated chicks. Indian
J. Comp. Microbiol. Immunol. Infect. Dis. 19: 85-87).
Ganguly, S. and Prasad A. (2010) Role of plant extracts and cow urine distillate as
immunomodulator in comparison to levamisole – a Review. J. Immunol. Immunopathol.,
12(2): 91-94.
Ganguly, Subha (2013) A Handbook on Traditional Medicinal Plants, Herbs and Fruits
in Indian Agriculture and Forestry. 1st Edition. International E-Publication. ISBN 978-81-
927544-5-1. Official E-Book (Section: Agriculture & Forestry Sciences). Publication of the
International Science Congress Association, Indore, UP, India.
A. PLANT TISSUE
Types of plant tissue
Meristematic tissue
Apical meristems
Lateral meristems
Intercalary meristems
Permanent tissue
Simple permanent tissue
Parenchyma
Collenchyma
Sclerenchyma
Protective tissue
Epidermis
Cork (phellem)
Meristematic tissue
Apical meristems
These are situated at the growing tip of the stems & roots, i.e., at shoot apex & root
apex. Apical meristems are also found at apices of the leaves. It brings about the
elongation of the root & stem. It results in increase in the height of the plant, which is
called primary growth.
Lateral meristems
These are found beneath the bark (cork cambium) & in vascular bundles of dicot roots
& stems (cambium).They occurs in thin layers. Cambium is the region which is
responsible for growth in thickness. It causes the organ (stem or root) to increase in
diameter & girth. This is called secondary growth.
Meristematic Tissue
Permanent tissue
These tissues derived from the meristematic tissues but their cells have lost the power
of division & have attained their definite forms. Permanent tissues are classified into
two-simple & complex.
Occurrence
The parenchyma is widely distributed in plant body such as stem, roots. Leaves,
flowers & fruits. Thus, the parenchyma tissue is found in the soft parts of the plant such
as cortex of roots, ground tissues in stems & mesophyll of leaves. It is also distributed in
pith, medullary rays & packing tissue in xylem & phloem.
Functions
1. Parenchyma serves as a packing tissue to fill the spaces between other tissues &
maintain the shape & firmness of the plant due to its turgid cells.
2. Due to turgidity property, parenchyma forms the main means of support to the
stem of herbaceous plants.
3. The main function of parenchyma is to store & assimilate food. Parenchyma
serves as food storage tissue.
4. Transport of materials occurs through cells or cell walls of parenchyma cells.
5. Parenchyma cells are metabolically active their intercellular air spaces allow
gaseous exchange.
2. Collenchyma
Nature-collenchyma tissue consists of living cells. It shows many of the features of
parenchyma but is characterised by the deposition of extra cellulose at the corners of the
cells. In collenchyma, intercellular spaces are generally absent. Collenchymas cells are
elongated in shape. They often contain a few chloroplasts.
Occurrence
The cells of collenchyma are located below the epidermis of dicotyledons stem &
petiole. These cells also occur in midribs of dicot leaves. Collenchyma is absent in
monocot stems, roots & leaves.
Functions
Collenchyma is a mechanical tissue; it provides mechanical support & elasticity. Thus,
collenchyma provides tensile strength with flexibility to those organs in which it is
found. It allows easy bending in various parts of a plant without actually breaking it.
When cells of collenchyma contain some chloroplasts, they manufacture sugar & starch.
Collenchyma
Occurrence
The sclerenchyma occurs in abundance either in patches or definite layers. They are
found in stems, roots, veins of leaves, hard covering of seeds & nuts. Sclereids form the
gritty part of the most of the ripe fruits & contribute hardness to the seed coat &
nutshells.
Functions
The sclerenchyma is mainly mechanical & protective in function. It gives strength,
rigidity, exibility & elasticity to the plant body &, thus, enables it to withstand various
strains.
Sclerenchyma
Functions
Xylem
Phloem
Nature-like xylem, it contains tubes but has no mechanical function. Phloem is
composed of following four elements or cells like, sieve tubes, companion cells, and
phloem parenchyma& phloem fibres. Except for phloem fibres, phloem cells are living
cells.
Functions
Phloem transport photosynthetically prepared food materials from the leaves to the
storage organs & later from storage organs to the growing regions of the plant body.
Protective tissue
Epidermis
It is usually present in the outermost layer of the plant body such as leaves, flowers,
stem & roots. Epidermis is one cell thick & is covered with cuticle. Cuticle is a water
proof layer of a waxy substance called cutin which is secreted by epidermal cells.
Cuticles possess variable thickness in plants such as it is thicker in xerophytic plants.
The main function of epidermis is to protect the plant from desiccation & infection. In
fact, cuticle of epidermis helps to reduce water loss by evaporation from the plant
surface as well as helping in preventing the entry of pathogens
Epidermis
Cork
As plants grow older, the outer protective tissue undergoes certain changes. A strip of
secondary meristems, called phellogen or cork cambium replaces epidermis of stem.
Cork cambium is a simple tissue having only one type of cells. The cells of cork
cambium are rectangular & their protoplasts are vacuolated & contain tannins &
chloroplasts. Cork cambium gives off new cells on its both sides, thus, forming cork on
the outer side & the secondary cortex or Phelloderm on the inner side. The layer of cells
which is cut by cork cambium on the outer side ultimately becomes several layered
thick cork or the bark of trees. Cells of cork are dead & compactly arranged without
intercellular spaces. The walls of cork cells are heavily thickened by deposition of an
organic substance, called suberin. Suberin makes these cells impermeable to water &
gases. The cork cells do not contain protoplasm but are filled with resin or tannins. In
case of onion bulb too, in the skin of onion the cell walls become thick & water proof
due to addition of suberin. Cork is protective in function. Cork cells prevent desiccation,
infection & mechanical
Cork
Cell Wall
It is rigid wall made up of cellulose, proteins, and carbohydrates
Function: boundary around the plant cell outside of the cell membrane that provides
structure and support
Protoplasm
Centrospheres
Small spherical bodies are associated with the nucleus and appear to be concerned in
cell division. There are in fact quite a number of minute bodies in the cytoplasm which
may be always present or only under certain conditions, and which are grouped under
the general name of microsomes or microsomata.
Chemically protoplasm is an extremely complex substance, but does not appear to have
a definite molecular structure of its own, being composed in large measure of proteins,
a class of organic compounds which always contain nitrogen, and frequently
phosphorus and sulphur. The molecule of the proteins is large and more or less
unstable, and hence subject to rapid changes and a variety of combinations, and it is to
these interactions that the vital activities of the plant are attributed Nucleus. The
nucleus consists of a ground substance in which is embedded a network composed of
threads containing a granular material known as chromatin, and generally one or more
spherical bodies called nucleoles, the while being enclosed by a delicate membrane. The
chromatin threads are readily stained by some of the aniline dyes, and are mainly
composed of nucleins (proteins) rich in phosphorus, which by some writers are
supposed to be essential constituents of the nucleus and necessary to the life of the
protoplast. Chromatin is constant in the nucleus and prior to cell division the threads
become organized into bodies of a definite number and shape known as chromosomes.
Plastids
The plastids or chromatoid hores form a group of differentiated protoplasmic bodies
found in the cytoplasm (Frontispiece) and are associated with it in the building up of
complex organic compounds, as starch, oil and proteins. The term chromatophore
Chromo plastids.
Chloroplastid is found in all plants except Fungi and non-chlorophyllous flowering
plants, and chromoplastids in all plants except Fungi. Plastids vary in form from more
or less spherical to polygonal or irregular-shaped bodies, and they increase in number
by simple fission. They suffer decomposition much more readily than the nucleus, and
are found in dried material in a more or less altered condition.
Chromoplastids. In many cases, as in roots, like those of carrot, or flowers and fruits,
which are yellowish or orange colored, there is present a corresponding yellow
pigment, and to this class of pigments the name chlorophyll may be applied. Some of
these pigments, as the carotin in carrot, have lien isolated in a crystalline condition
Chromoplastids usually contain, as first pointed out by Schimper and Meyer, protein
substances in the form of crystal-like bodies; starch-grains may also be present. The
chromo plastids are variable in shape and in other ways are markedly different from the
chloroplastid. They are more unstable than the chloroplastid, and are formed in
underground parts of the plant, as in roots, as well as in parts exposed to the light, as in
the flower. Their formation frequently follows that of the chloroplastid, as in the
ripening of certain yellow fruits, such as apples, oranges, persimmons, etc.
Chromo Plastids
Plastid pigments
They are distinguished from all other colour substances in the plant by the fact that they
are insoluble in water and soluble in ether, chloroform and similar solvents. In fact they
are but little affected by the usual chemical reagents under ordinary conditions. Apart
from the difference in colour, the yellow pigment (chlorophyll) is distinguished from
the green (chlorophyll) by the fact that the latter is said to contain nitrogen, and also by
their difference in behaviour when examined spectroscopically, chlorophyll giving
several distinct bands in the yellow and orange portion of the spectrum, which arc
wanting in the spectrum of the yellow principle.
Non-protoplasmic cell-contents
The non-protoplasmic constituents of plants may be said to differ from the
protoplasmic cell-contents in two important particulars, namely, structure and function.
Crystalline substances.
The sugars constitute a group of crystalline principles of wide distribution. They occur
in the cell-sap, from which by evaporation or on treatment with alcohol they may be
crystallized out. Quite a large number of distinct principles belonging to this class have
been recognized, of which the following may be mentioned
Dextrose
(grape-sugar or dextro-glucose) is found in sweet fruits, the nectarines of the flowers,
and stems and leaves of various plants. It crystallizes in needles and varies in amount
from i to 2 per cent, (in peaches), to 30 per cent
Sucrose
(saccharine or cane-sugar) is found rather widely distributed, as in the stems of corn,
sorghum and the sugar-cane ; in roots, as the sugar-beet ; in the sap of certain trees, as
sugarmaple and some of the palms
Maltose
It is found in the germinating grains of cereals (see malt); it forms colourless, needle-
shaped crystals resembling those of dextrose, and forms compounds with calcium,
strontium, barium and acetic acid.
Crystal Fibers.
In quite a number of drugs a single monoclinic prism occurs in each of the parenchyma
cells adjoining the sclerenchymatous fibers, and to this single longitudinal row of
superimposed cells the name crystal fiber has been applied
Amorphous substances
Cystoliths.
Occasionally cells are found among the parenchyma or in the inner row of the
epidermal cells on the upper side of the leaf, the walls of which form an inward
protrusion in cell and impregnated with and encrusted by calcium Carl ovate, giving
rise to more or less stalked bodies known as Cystoliths
REFERENCES
Botanic drugs Their materia medica, pharmacology And therapeuticspublished by The
therapeutic digest publishing co. Cincinnati, ohio 1917.
The Ayurvedic Pharmacopoeia of India Part- I, Volume – i, ii, iii, iv, government of
India Ministry of Health and Family Welfare Department of Ayush.
ABSTRACT
The textile materials were considered primarily for economic and functional
point of view some end users in particular demands on the safety of textiles for
the health. An insect-repellent helped to prevent and control the outbreak of
insect-home disease such as malaria, dengue fever. The most herbal plants
contain compounds that are preventing attack from phytophagous regulators.
Insect repellent textiles are also a part of protective textiles which help in
protection from the species that are prone to cause damage in some or the other
manner. These textile products find their application over a wide range. The
knitted fabrics were finished with mosquito repellent test by excite chamber.
The treated fabrics show 100% mosquito repellent efficiency. The finished
fabrics were tested for laundering process they retained their activity until 16
washes. So these types of plant based mosquito repellents has been used for
generations in practice as a personal protection against mosquito.
INTRODUCTION
Protective textiles are among one such smart application of smart technology in textiles.
Protective textiles refer to those textile products which have a functionality of giving
protection from something in some or the other sense. Mosquitoes have a complex
method of detecting hosts and different types of mosquitoes react to different stimuli.
At present, there are very few durable repellents that can be applied to clothing and
almost all the repellents are designed to be applied directly on the skin. This poses a
great risk to the individuals using them and hence, with a view to reducing this risk and
at the same time meeting the needs of industry. Basically mosquito repelling textiles are
the ones which have a character of repelling mosquitoes. This feature was developed as
a need in sense of protection from the mosquitoes in the areas which are habitats of the
mosquitoes and are prone to disease like malaria. Global warming has resulted in the
spread of mosquitoes from tropical regions to rest of the world resulting in spread of
viral infection to different parts of the world. Anti- mosquito finishing on textile
products can suppress mosquito-transmitted diseases such as West Nile fever; malaria.
Cotton is the natural vegetable fiber of great economic importance as a raw material for
cloth. Bamboo is grown using methods and materials that have low impact on the
environment.
Pretreatment
The material is treated with soap at 50 0C for 20 minutes to remove the dirt on the
untreated fabric with water. The soap solution is added into water in the proportion of
3: 1.Then the material is given hot wash and cold wash. The M: L is 1:30.
Rosemary has been around for a long time, and therefore has a long list of claims
regarding its medicinal uses, including use as a tonic, a digestive aid, to treat
depression, headache, and muscle spam, and as an expectorant, promoter of menstrual
flow, and stimulant for production of bile.
Mosquito
S.No. methods samples Repellency
in %
1 Untreated Controlled 0
2 herbal Rosemary 88
Mosquito Repellency in %
100
50
Mosquito Repellency in
0
%
Controlled Rosemary
Untreated herbal
1 2
Wash durability
The laundering durability of the treated fabrics were tested with excite
chamber after each and every washes it was calculated using formula. The
coated fabrics were with stand nearly up to 16 washes.
Herbal
1. Untreated 0
2. Before laundering 88
3. After launderings 4 88
4. After launderings 8 68
5. After launderings 12 60
6. After launderings 16 48
7. After launderings 20 20
After…
After…
After…
After…
After…
Untreated
1 2 3 4 5 6 7
CONCLUSION
From the study it was concluded that rosemary herbal extracts treated fabrics eco-
friendly, bio-degradable and non-toxic to the skin. Apart from the industrial use,
mosquito repellent finish on textiles has become essential in our day today life to live in
REFERENCE
Butter Worth, (1964), Review of Textile Process, Butter Worth And Co. Publishers
Ltd, Bangalore, P-330
Carey AF, Wang G, Su CY, Zwiebel LJ, Carlson JR. Odorant reception in the malaria
mosquito Anopheles gambiae Nature. 2010; 464:66–71.
Elementary idea of textile dyeing, printing and finishing, kanwar varinder pal singh,
Kalyani Publishers, 2004, pg.no-5, 29
Hallem EA, Dahanukar A, Carlson JR., (2006). “Insect odour and taste
receptors” Annu Rev Entomol. Vol.51. P.113–135
Taubes G. A mosquito bites back. New York Times Magazine. August 24, 997:40-6.
ABSTRACT
Ethnobotanical medicine has attracted great interest due to the belief that it is
safe, cheap and more dependable than aliphatic drugs, which have adverse side
effects. The current study was conducted to analyze the antibacterial activity of
Tetradenia riparia leaves hydroalcoholic extract. The plant sample was
extracted using methanol and water in the ratio of 9:1. From the study the
plant Tetradenia riparia was found to inhibit the growth of Escherichia coli
with a zone of inhibition of 11.67 ± 0.882, Serratia liquefaciens zone of
inhibition of 12.67 ± 0.667, Bacillus cereus 28.00 ± 1.154, Enterobacter
aerogenes 8.67±0.882 and Proteus vulgaris 11.00 ± 0.577. The data collected
and documented in this paper is a scientific justification that the plant
Tetradenia riparia can be used to treat against various diseases caused by
Escherichia coli, Serratia liquefaciens, Bacillus cereus, Enterobacter aerogenes
and Proteus vulgaris. However, further research is needed to isolate the active
compounds identify their structure, their mode of action to the microorganisms
and their effect in the in vivo environment.
INTRODUCTION
Nature is a paradise of medicinal solutions to all ailments affecting human beings
through medicinal plants. Medicinal plants are being used widely to treat against the
currently widespread strains of drug resistant bacteria. Scientists all over the world are
working hard to provide scientific justification on the traditional use of medicinal plants
to treat against the ailments affecting human beings
All chemicals found in plants are potential drugs. Certain tree barks produce chemicals
that discourage caterpillars from feeding on them, a good example being the Indian
neem tree, which keeps off desert locusts. The twigs are chewed by people in Serengeti
national park in east Africa to prevent tooth decay. Plants produce more than 10,000
different compounds to prevent themselves against animals who feed on them. Almost
half of all prescribed drugs contain chemicals produced by plants, fungi and bacteria.
Aliphatic drugs also contain synthesized compounds in the laboratory that have been
modeled after plants originating compounds (Moore et al., 1995).
The use of medicinal plants to treat diseases is as old as man. Medicinal plants have
been used since ancient times to treat many illnesses (Mir et al., 2013). Research has
shown that the concentration of these compounds in plants is directly related to their
capability to treat certain illness. Many of these non-nutritive secondary metabolites are
found in plants which are even used for food. Over 80% of the plants in Nigeria used
for treatment of malaria and other sicknesses are also used as food (Cousins and
Huffman, 2002); there seem to be not much distinction between medicinal benefits of
plants and their nutritive value.
Over the past few years much research has been done and is still going on to prove
scientifically the plants nutritional value and medicinal value. A good number of
chemical compounds have been discovered from plants and found to have
pharmacological value; this has led to the development of over 25% of all the artificial
medicines used today. Many of the traditional plants species used all over the world
have been found to have great pharmacological value. Studies carried out throughout
Africa confirm that indigenous plants are the main constituents of traditional
medicines. The published WHO traditional strategy addressed the issues and provided
a framework for countries to develop policies to govern medicinal plants use. The
strategy put forward by WHO advocates the formulation of a policy by states as the
first component of developing traditional medicine. India is one of the few countries
which have started to develop such policies (Prajapati and Purohit, 2003).
Over 80% of the people in developing countries use medicinal plants to treat the
illnesses which affect them from time to time (Ganga et al., 2012). This can be attributed
to poverty in these countries which has led to inefficient health care system in hospitals
and inadequate resources to access these facilities. People in these countries look for
cheap and available medicines which are known traditionally to cure the illnesses. The
use of herbal medicines in the western world is steadily growing with 40% of the
population using plants to treat illnesses; while in Kenya 90% of the population has one
Our environment is very rich with a great range of medicinal plants and this mainly
explains the reason why our grand‟s lived for quite some time. They could stay in the
bush during war and even could use plants to treat ailments and wounds affecting
soldiers in the battle ground. People all over the world should go back to these basics of
treatment. Many communities in Africa still consider the use of medicinal plants as an
important part of their culture, just to mention, the Maasai community in Kenya still
value their culture very much, the Kalenjn community and their medicinal fermented
milk which is prepared mainly from medicinal plants such as Senna didymobotrya stem
which previous studies have shown this plant to have a great potential in treatment of
diseases such as typhoid, diarrhea and food poisoning caused by Salmonella typhi, E.coli
and Bacillus cereus (Ngule et al., 2013). The reason why herbal medicine still remains
controversial is because of some greedy practitioners who want to become wealthy by
pretending to know much about the treatment of every disease that clients complain
about. This has led to administration of wrong drugs which do not cure a patient
leading to death of the individual. Proper scientific evidence needs to be provided in
order to create confidence in medicinal herbs. The increase of multi-resistant strains of
bacteria calls for new discoveries of new classes of antibiotics that can clearly inhibit
these resistant strains. This is the reason why much research should be turned to plants
which have been used since ancient times to treat many diseases (Cousins and
Huffman, 2002).
A big percentage of plants in the savanna and semi-arid areas of east Africa where
Kenya is located contains alkaloids which have been associated with increase in renal
secretion when ingested, hence used as a diuretics and in the treatment of dropsy
(Kokwaro, 2009). The use of alkaloids, saponins and tannins as antibiotics has been
scientifically justified (Mir et al., 2013). Majority of the pharmacologically active
chemical compounds were found mainly in ethanol extracts which is contrary to
previous researches which had affirmed the traditional way of extracting these
compounds using water (Iqbal, 2012).
According to Coopoosamy and Naidoo (2011), the plant Tetradenia riparia has great
effect in the treatment against skin infections. The plant has also shown great potency in
the treatment of chest diseases. According to Ndamane et al., (2013), the plant showed
antibacterial activity against all the gram positive and gram negative bacteria it was
tested against. In Kenya, the plant has a wide variety of uses depending on the region.
The plant is used traditionally in the rift valley and western region to treat against
stomach problems, wound infections, throat infections and also it is believed to treat
have anti-cancer activity. The plant is grown by the local Nandi community in Kenya
along farm edges and around their homes. The plant is greatly used by traditional
practioners to treat various diseases; however, some of the practioners find it difficult to
transfer this information to their clients even upon request for the information about the
plant. This calls for scientific documentation to enable the transfer of knowledge about
the plants use. The literature available is also contradicting and therefore the current
study was not only done to give a scientific justification of the plants traditional use but
also to compare the data obtained in this study with that in literature and provide a
scientific view on the same.
Extraction procedure
Using electric analytical beam balance fifty grams of the powdered leaves of the
Tetradenia riparia was placed in 1000 ml conical flask, methanol and water were then
added in the ratio of 9:1 respectively until the leaves were completely submerged in the
solvent. The mixture was then agitated for thorough mixing. The mixture was kept for
24 hours on a shaker for effective extraction of the plant components. The extract was
filtered using Butchner funnel; Whatman no.1 filter paper and a vacuum and pressure
pump. The filtrate was re-filtered again using the same apparatus. The solvent was
evaporated using rotary vacuum evaporator (R-11) with a water bath at 40oC. The
extract was brought to dryness using vacuum and pressure pump at room temperature.
The residue was then obtained and used for the experiment.
BIOASSAY STUDY
Preparation of the Bacterial Suspension:
The turbidity of each of the bacterial suspension was prepared to match to a 0.5
McFarland standard, a procedure similar to that used by Biruhalem et al., (2011) and
Donay et al., (2007). The McFarland standard was prepared by dissolving 0.5 g of BaCl2
in 50 ml of water to obtain a 1% solution of Barium chloride (w/v). This was mixed
with 99.5 ml of 1% sulphuric acid solution. Three – five identical colonies of each
bacterium was taken from a blood agar plate (Himedia) culture and dropped in Mueller
Hinton broth (Himedia). The broth culture was incubated at 370C for 2 - 6 hours until it
achieved turbidity similar to the 0.5 McFarland standards. The culture that exceeded
the 0.5 McFarland standard were each adjusted with the aid of a UV spectrophotometer
to 0.132A0 at a wavelength of 600 nm in order to obtain an approximate cell density of
1x108 CFU/ml.
Table 1: Zones of Inhibition (mean ± S.E.) of 500 mg/ml of Tetradenia riparia Extract
against Selected Microorganisms.
The average mean zone of inhibition (±S.E.) was calculated for each of the microbial
organism. The zones of inhibition of the microorganisms were also analyzed by
analysis of variance (ANOVA) and it was shown that there were significant differences
in the zones of inhibition among the microbial organisms (p<0.05). The biggest zone of
inhibition was against B. cereus (28.00±1.154) followed by S. liquefaciens (12.67±0.667),
Escherichia coli (11.67±0.882), Proteus vulgaris (11.00±0.577) and Enterobacter aerogenes
(8.67±0.882). Penicillin which was used as the positive control inhibited the growth of
all the organisms while DMSO did not have any inhibition against the organisms tested.
The study shows that the plant Tetradenia riparia can inhibit the growth of five
microorganisms out of the six it was tested against. The plant show clear zones of
inhibition against Escherichia coli with a zone of inhibition of 11.67 ± 0.882, S. liquefaciens
12.667 ± 0.667, Bacillus cereus, 28.00 ± 1.154, Enterobacter aerogenes, 8.67±0.882 and Proteus
vulgaris, 11.00 ± 0.577. Comparing for the mean zones of inhibition of 500 mg/ml of
Tetradenia riparia showed that there was significant difference in the zones of inhibition
among the organisms (p<0.001). Further comparison using the Tukey‟s pairwise
comparison showed that the zones of inhibition for E. coli were significantly higher than
those of Salmonella sp. and P. vulgaris (p<0.05). Zones of inhibition of Salmonella typhi
were significantly lower than all of the other organisms (p<0.05) except for E. aerogenes.
Significant difference were also observed between B. cereus and all the organisms
(p<0.05). The study is in conformity with previous studies in which the plants
methanol and water extracts were found to inhibit the growth of all the gram positive
and gram negative bacteria (Ndamane et al., 2013), The study is completely in
agreement with the same study in which the plant inhibited B. cereus most. The current
study use a system of solvent which constituted methanol and water in the ratio of 9:1
unlike in previous studies the two were used separately. The data obtained in this study
in conformity with previous studies which shows the two solvents to have great
antibacterial activity, however, contradicts with the results obtained by Erasto et al.,
The plant extract can be used to treat infections caused by Bacillus cereus viz
posttraumatic wounds, self-limited gastroenteritis, burns, surgical wounds infections,
and ocular infections such as endophthalmitis, corneal abscess and panophthalmitis
(Garcia-Arribas et al., 1988) & Sankararaman and Velayuthan, 2013). The plant extract
can also be used to treat immunologically compromised patients including AIDS and
malignant disease victims (Cotton et al., 1987 & Tuazon et al. 1979). The plant‟s ability
to inhibit the growth of E. coli is a scientific justification that the plant can be used to
treat against enteric infections caused by the bacteria. The plants extract can also be
used to treat against gastro-intestinal diseases, ear infections, urinary tract infections
and wounds infections caused by Proteus vulgaris (Goodwin et al., 1971 & Neter and
Farrar, 1943).
Indigofera arrecta can be a good source of active compounds for a variety of diseases
affecting human beings in the world today. The plants ability to inhibit the growth of
Serratia liquefaciens shows how the plant can be important to treat against the bacteria
which according to Okunda et al., (1984) cause nosocomial urinary tract infections. The
inhibition of the plant against these bacteria is, therefore, note worthy since the
microorganisms have been found to have resistance against most of the currently used
antibiotics. Enterobacter aerogenes is a major cause of a wide variety of nosocomial
infections viz, pneumonia, urinary tract infections, meningitis, wound infections and
intravascular and prosthetic devices infections (Santos et al., 1990, Blot et al., 2003,
Donnenberg, 2005).
CONCLUSION
The data provided in this study is a scientific justification that the plant Tetradenia
riparia can be used to treat against diseases such as abdominal cramps and diarrhea
caused by Bacillus cereus due to its ability to cause food poisoning, treat against
Escherichia coli which causes serious and even life threatening effects such as hemolytic-
uremic syndrome (HUS), diarrhea and neonatal meningitis. It can also be used to treat
against throat problems caused by Serratia liquefaciens, opportunist pathogen Proteus
vulgaris which causes wound infections. From the study the plant Tetradenia riparia has
shown to have great medicinal value and therefore justifying its traditional use to treat
against various diseases. More research needs to be done to identify the mode of action
of the active compounds in the plant.
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Fig 1. Picture showing the zones of inhibition of the plant extract and positive and
negative action against Proteus vulgaris
ABSTRACT
The district Mayurbhanj is charecterised by a diverse tribal population of
people with different ethinic background. Similipal Biosphere Reserve is
present at the center of Mayurbhanj District; its rich biodiversity is
acknowledged internationally. The district as a whole and SBR in particular,
offers unique opportunities to study the indigenous knowledge and their uses
prevalent among the local tribes. The native tribals depend on wild as well as
cultivated plants for their various food and medicinal purposes. As a part of
the socio-cultural life, all tribes prepare rice beverage using their own unique
starter culture. In the preparation of starter they use some of the wild plants as
antimicrobials without knowing the actual role of these plants in fermentation.
They say that yeast is formed from these plants, responsible for yeast action
during the fermentation. This chapter deals with the available plants used for
starter preparation of Handia by the tribes of Mayubhanj, their ethnomedicinal
uses. All these plants were evaluated for the phytochemical constituents and
antibacterial activity against enteric pathogens. Results found that alcoholic
extracts of the plants contain abundant alkaloids, flavonoids, carbohydrate,
protein and amino acids, saponins, tannin and phenolic compounds. With the
exception of Aspargus racemosus (root), Cissampelos pareira (leaf), Dioscorea
sp. (tuber), Rauwolfia serpentina (leaf) extracts, all test plant parts exhibited
antibacterial activity by agar cup method. The zone of inhibition was found
maximum against Staphylococcus aureus followed by Shigella sonnei and S.
flexneri. The MIC result ranged from 125 to 1000 µg/ml (w/v) with the lowest
against S. aureus (125, 156, 250 µg/ml) followed by S. sonnei (156, 250, 312,
500, 625 µg/ml). MBC test validate that in between 1000-2500 µg/ml (w/v)
concentrations, most of test bacteria were killed due to broad spectrum activity.
This chapter also provides information on different types of starter used for
preparation of rice beverage through out India.
In Odisha, from time immemorial, both fermented and distilled beverages have been
prepared by fermenting different varieties of rice. These beverages are primarily
prepared and used by different tribal communities all over the state. About 62 ethnic
tribal communities are reported from the state (Naik, 1998) and they mostly inhabit
forest villages. They meet most of their requirements, including food and primary
healthcare, from the forest resources. Out of 62, 30 communities (48%), several
aboriginals, are found in the district of Mayurbhanj, (largest district of the state; area -
10, 418 sq km forest cover – 4, 392 sq km. population – 25, 13, 895/2011 census).
Similipal Biosphere Reserve (SBR, 5569 sq. km.) is located at the centre of the district
and its rich biodiversity is acknowledged internationally. The district as a whole and
SBR in particular, offers unique opportunities to study the indigenous knowledge and
their uses prevalent among the local tribes. Santal, Kolha, Bathudi, Bhumij, Munda and
Gond are major tribes whereas Mankidia, Lodha, Kisan and Baiga are minor tribal groups
that inhabit the area. Santals constitute the largest tribal group of the district and are
scattered throughout. The social, cultural and religious life of aboriginal people is
influenced by the nature and natural resources available in and around their habitat
that provide food, fodder, medicine, shelter and various other material and cultural
needs.
The fermented food, locally known as handia, is an inseparable food item in the life of
tribals of Mayurbhanj and most other districts of the state. The word handia finds its
origin from the word Handi in Odia (local language), means large earthen pot. Handia
occupies a key position in the social, cultural and economic life of Santals and accepted
as a traditional drink (Sahu, 1996). Handia is generally prepared throughout the year,
but most common during the summer months (March to June). Women and children
are also fond of these beverages but consume in small quantity and preferably during
festivals, ceremonies and on Sundays. Tribals get 5-10% of their daily nutrient
requirements that plays a supplementary role in the nutrition of the people (Roy, 1978).
LITERATURE REVIEW
Traditional rice-based alcoholic beverages
Traditional rice beverages have different compositions according to the formulation and
processes used. The principle of their manufacture can be characterized as a
biochemical modification of cereal starches brought about by microorganisms. Moulds
produce the amylases that degrade the starch into dextrins and sugars and yeasts
convert these sugars to alcohol (Lim, 1991; Motarjemi and Nout, 1996; Nout and Aidoo
2002).
The preparation and the use of fermentation starters as a source of inoculum are
important for preparation of rice beverage. The choice of starter tablets influences the
yield and quality of the rice beer. Even in certain region the local processors claim that
using a combination of two or three different starters yields better quality with a
stronger sweet alcoholic taste and more attractive flavor than is obtained with a single
starter. The dried starters normally include yeasts, moulds and bacteria and convert
starchy materials to fermentable sugars and subsequently to alcohol and organic acids
(Hesseltine et al., 1988; Nwosu and Ojimelukwe, 1993; Luong, 1998; Nout and Aidoo,
2002). A variety of starter cultures is available in the through out India especially in the
North East region (Table-1).
Throughout the world three different kinds of starters are used e.g. starters without
oriental medicinal herbs; starters supplemented with oriental medicinal herbs; and
starters supplemented with plant containing aromatic essential oils. In the most cases,
starters supplemented with medicinal plants are predominating. It was suggested by
some authors that a number of plants have a stimulatory effect on biomass and on yeast
count. Few authors believe that plants are used in starter because of their antibacterial
properties and their fragrant flavour.
Preparation of Apop Pitha by the Mising tribes of Upper Assam (Gogoi et al., 2013)
For preparing apop pitha a mixture of plants (table) collected, cleaned and dried by
placing on a bamboo mat. Soaked rice and the leaves are grinded separately in a
wooden grinder and they are mixed together in a vessel with a little of water. From the
dough, oval shaped balls of about (6 cm x3cm) are made and dried in the sun. Apop
pitha is used for preparation of Apong-rice beer. The earthen pot is use as a fermentor
and before starting the fermentation process, it is fumigated by placing it on a bamboo
frame constructed over the fire place until the pot turns blackish. There after the boiled
rice are spread over a large banana leaf and allowed to cool. To this powdered apop pitha
is added (1 apop pitha for 1 kg of rice) and the whole mixture is kept inside the fermentor
and the mouth of the pot is covered with banana leaves or leaves of bhilongoni
(Cyclosorus exlensa). The fermentor is left for a period of at least 5 days. A little water is
added to the fermented product and is filtered to get the apong (Das et al., 2012). Similar
type of starter is also prepared by the Khampti tribe of Arunachal Pradesh locally
known as Khamtip for preparation of Apong (Srivastava et al., 2012).
Preparation of Bakhor, Surachi/Phap by the Rabha tribes, Assam (Deka and Sharma,
2010)
Rice-beer cake is popularly known as bakhor, surachi or phap among the Rabhas of
Goalpara district while rice-beer is known as choko or jongamod. Paste of 2 kg wet
seeds of rice (Oryza sativa L.) is prepared after mixing several plants. A considerable
amount of old rice-beer cake is mixed along with these plant materials for the
preparation of fresh rice-beer cakes. Some round and flat globules (each of around 50
gm) are prepared from the grinded mixture. The globules are placed on straw. Different
parts of ten plant species are used in particular amount to prepare rice-beer cake.
Heteropogon contortus is kept scattered on a broad sieve made of bamboo (Bambusa
Preparation of epop (starter culture) by Mishing tribe of Assam (Kardong et al., 2012)
The epop is prepared from rice, preferably glutinous, soaked in water for about 2 hrs.,
ground together and mixed properly with semidried powder of leaves or the whole
plant/plant parts which is then kneaded to specific shape (usually oval) followed by the
transfer (inoculation) of microbial consortium with desired quality from the old stock of
previous batch culture. The preparation of epop and the poro apong is somewhat
similar with babud preparation reported from Phillipines and the Ipoh preparation by
Adi tribe of Arunachal Pradesh, India (Tiwari and Mohanta, 2007). Mishing tribe
generally uses at least 16 different herbs with different interpretations (Table-1). This
number may vary from place to place, persons to persons within the tribe itself.
Preparation of Hamei as a starter by Meitei tribes, Manipur (Singh and Singh, 2006)
Yu is a distilled product of the fermented local rice of Meitei communities of Manipur.
For quality and more alcohol production of Yu, Hamei (a fermented product) is added
generally, because of its action as a starter/catalyst. Moreover, the preparation of Hamei
is a popular domestic business for the people of scheduled caste and tribes, as it is also
used as an ingredient of cattle foods. The traditional practitioners believe that, the
quality of Hamei fermentation will be responsible for the quality and quantity of ethyl
alcohol.
Preparation of Humao as a starter by Dimasa tribes, Assam (Das and Deka, 2012)
Dimasa tribe of Assam prepared rice beer popularly known as Judima. The starter
culture needed for Judima preparation is humao. For preparing humao, brown rice is
soaked in water for 10-12 hours at room temperature. It is then crushed with the barks
of Glycyrrhiza glabra L. The mixture is then made into paste by adding water and flat
cakes are prepared from this mixture and sundried (Chakrabarty et al., 2009). For
preparing judima, rice is first cleaned and washed. This is then cooked and dewatered.
After cooling it is mixed properly with humao in appropriate quantity. This mixture is
then spread on a banana leaf for overnight and then transferred to an earthen pot and
made partially air tight. Fermentation is allowed to take place at ambient temperature
for 3-4 days during summer and 6-7 days during summer. The resultant juices are
known as judima (Chakrabarty et al., 2009). In similar manner the North East tribes used
Acacia pennata bark, are cut into small pieces and dried in the sun. Rice is soaked in
water until it is softened. It is then grinded in a wooden or metallic mortal pestle called
rimin along with the barks of Acacia pennata. A little water is added in order to make a
paste. They are then made into cakes of appropriate sizes and allowed to dry for a
period of one week. They can be stored for many months (Das et al., 2012).
Preparation of Mod pitha (natural starter) by Deori tribe of Assam (Deori et al., 2007)
Saol (rice grains), plant species (Table 1), Kula (a round bamboo utensil), Saloni (round
bamboo utensil or sieving), Dheki (wooden grinder), Dhua sang (a rectangular frame
made of bamboo), Soriya (aluminium utensil) and Kher (straw) are required for the
preparation of Mod pitha (Figs. 1-3). A handful each of cleaned leaves, fronds, barks,
roots and bulb of the plant parts are put in a Saloni and kept for a day for sun drying. 3-
5 kg of Saol is soaked in water for about 2 hrs, mixed with the dried plant materials and
grounded in a Dheki. The grounded powder is taken out, sieved in a Saloni and the
For marcha preparation, glutinous rice (Oryza sativa) is soaked in water for 8–10 h at
ambient temperature and unheated soaked rice is crushed in a foot-driven, heavy
wooden mortar and pestle. In 1 kg of ground rice, ingredients added include roots of
guliyo jara or chitu (Plumbago zeylanica), 2.5 g; leaves of bheemsen paate (Buddleja asiatica),
1.2 g; flowers of sengreknna (Vernonia cinerea), 1.2 g; ginger, 5.0 g; red dry chilli, 1.2 g;
and previously prepared marcha as mother culture, 10.0 g. The mixture is then made
into a paste by adding water and kneaded into flat cakes of varying sizes and shapes.
These are then placed individually on the ceiling–floor, above the kitchen, made up of
bamboo strips inlaid with fresh fronds of ferns (Glaphylopteriolopsis erubescens), covered
with dry ferns and jute bags and are left to ferment for 1–3 days, depending upon the
temperature. Completion of fermentation is indicated by a distinct alcoholic and ester
aroma and puffy/swollen appearance of the marcha (Tamang, 2010).
Preparation of Perok Kushi by the Deoris tribals of Assam (Das et al., 2012)
The indigenous rice beer of the Deoris is known as Sujen, prepared using starter material
perok kushi. The plant materials used for preparing perok kushi are leaves of Jasminum
sambac, Cinnamomum byolghata, Zanthoxylum hamiltonianum, Lygodium flexuosum,
Acanthus leucostychys, Cyclosorus exlensa, Alstonia scholaris and roots of Alpinia malaccensis
and the stem and rhizome of Costus speciosus. All these are washed and cut into small
pieces, dried and grinded using a specialized wooden grinder called as dheki. The
Preparation of starter (Ranu dabai) by the tribals of West Bengal (Ghosh and Das,
2004)
Ranu dabai is the starter used for preparation of Jhara/Harhia similar to Hnadia
preparation by the tribes of West Bengal. Ranu dabai are the mixture of roots, barks,
rhizomes, leaves of about 10-12 plant species (Table-1) and binded with the rice flour. 10
Kg of rice grains are taken on a flat traditional utensil generally made of sliced bamboo
(„Soop‟) washed properly. Clean water is poured in it, stirred and decanted. The
decanted wash-water is preserved in a bucket for future use. The most common plants
viz. tuberous roots of Coccinia grandis (500 gm); leaves of Clerodendrum viscosum (300
gm); whole plant of Vernonia cinerea (350 gm) and leaves of Plumbago zeylanica (250 gm)
are taken and chopped and ground properly on Soop. All rest plant (50-100 gm only)
depending on the availability are taken and added for preparation which will improve
the quality of the starter. In some cases 300 gm of Rauvolfia serpentina roots can replaces
Coccinia grandis roots. Rice grains are then put in the pit of wooden husking machine
(Dhiki) and where partially powdered a few (3–4 large tablets for 10 kg of rice) old Ranu
Dabai are added. After some time, the plant paste is also added to it and allowed to mix
properly. When the rice grains are properly powdered and mixed with plant paste, it is
then taken out on a sieve (Chakni) and the coarse part is returned to the wooden
husking machine. After completing sieving, woody and fibrous materials are rejected.
The powdered material (Gunda) is now taken in a large vessel (Dikchi) and made into
paste using the previously stored rice wash water. The paste becomes slightly greenish-
white and emits the smell of mixed herbage. Clean gunny bags are then spread on the
floor under shade or inside the rooms. Different size such as small, medium and large
(standard size is 4.5-7 cm in diameter), are prepared by pressing with hand and
arranged in rows on the gunny bags, where these are kept for 40-60 minutes. Tablets
loose some amount of water and become little tough. All the materials are taken in a
large basket (Dhakiya) made of sliced bamboo. Clean and dry straw is spread on the
bottom of the basket and some tablets are kept on it. These are then covered with straw
and another layer of tablets is kept on it. The entire set is covered with polythene sheet
and/or gunny bags and stored in a dark and warm place. The incubation period varies
from 2-3 days in warm season and 4–6 days in winter. The inside temperature rises
considerably (fever) and the set starts emitting pungent Harhia-like smell. During this, a
layer of cottony mycelia develops on the tablets. The fungal mycelia produce a mat of
Preparation of fermentation cake (Ranu goti/ Ranu tablets) by the tribals of Central
India (Kumar and Rao, 2007)
In the preparation of Handia and Mahua, Ranu tablets play an important role, act as
yeast starter or fermentor, and help in fermentation of both beverages. Ranu tablets or
Ranu goti are the mixture of roots, barks, rhizomes, leaves of about 20-25 plant species
(Table-1) and binded with the rice flour. The preparation is almost same with the
preparation of Ranu dabai with only difference in plant species used and their ratio. For
preparation of tablets, rice is soaked in water, pounded, and kept in shady place for
drying. The plant species used in preparation of Ranu goti are collected mostly from
forests in wild condition. The roots, leaves, bark, seeds of the plants are sun dried and
pounded, powdered and dried in sun. The powder is mixed with flour thoroughly in
the ratio of 1:2, and rolled in small pieces in the form of small cakes. These tablets are
kept in closed room for drying. After drying, these Ranu tablets or Ranu goti are used for
preparing local beverages Handia.
Preparation of Vekur pitha by the Ahoms tribes of Assam (Saikia et al., 2007)
Vekur Pitha is the starter prepared by the Ahoms tribes of Assam for preparation of rice
beer xaj-pani (Saikia et al., 2007). For preparing vekur pitha, a mixture of plant leaves viz.
Lygodium flaxuosum Linn., Leucas aspera Spreng, Cissampelos pereira, Scoparia dulsis Linn.,
Cinamommum glanduliferum Meissn. and Piper betle Linn. are dried in the sunlight for 1-2
Phytochemical Analysis:
Qualitative phytochemical analysis was carried out using methods described by Trease
and Evans (1989). Each extract was screened for presence of alkaloids (using Mayer‟s,
Wagner‟s, Hager‟s and Dragend dorff‟s reagents); flavonoids (NaCl and HCl);
carbohydrates (using Molisch‟s reagent); glycosides (using Keller Killiani and
Borntrager‟s reagents); protein and amino acids (using Biuret, Xanthoproteic,
Ninhydrin and Millon‟s reagent); tannin and phenolic compounds (FeCl3 and Gelatin);
triterpenoids (thionyl chloride solution); steroid and sterols (using Liebermann
Burchard and Salkowski‟s reagents), fat and fixed oils with alcoholic KOH reagents.
Antimicrobial activity
Enteric pathogens viz. enteropathogenic and enterotoxigenic Escherichia coli,
Pseudomonas aeruginosa, Salmonella typhimurium, Shigella flexneri, S. sonnei, Staphylococcus
aureus and Vibrio cholerae were used in the present study as discussed earlier by Panda
et al., (2010). The antibiogram was carried out by adopting disc diffusion method using
several antibiotics. The result of the antibiogram was published in our earlier report
(Panda et al., 2010). The agar cup method and MIC were used to study the antibacterial
activity. Broth microdilution technique adopted using 96-well microtiter plate and
tetrazolium salt, 2,3,5-triphenyltetrazolium chloride (TTC), was carried out to determine
the MIC following the method as described by Eloff, (1998). Selected extracts were
serially diluted in the 96-well plate with an overnight culture of microorganisms (0.5
McFarland) grown at 37°C to obtain the final concentration of extracts ranging from 78
to 2500 µg/ml. The microplate was sealed and incubated at 37°C and observed for the
growth of the microorganism. 10µl of the broth from each well of 96 microtiter plate
(≤MIC) and control wells were taken aseptically and plated on one day old MH agar
RESULTS
Handia preparation includes two distinct phases: preparation of ranu or bakhar tablets
and making of handia.
Preparation of Handia
Mechanically de-husked rice is soaked and boiled in water. The cooked rice is dried on
a bamboo mat under sun (Fig. 1d). After drying, the rice is mixed with required amount
of powdered ranu tablets (approximately 10 tablet per kg rice), kept in a large earthen
pot or handi (hence the name of the product) followed by addition of required amount
of water.
The mixture is kept untouched for 3-4 days for fermentation. After proper fermentation
a white supernatant was present at the upper layer containing 8-10% alcohol called
rashi, which fetches higher price. After 2-3 days the fermented liquid is allowed to
trickle down through a bamboo sieve, collected in earthen pots and is ready for
consumption (Fig. 1e &f). The taste of handia depends on the plants used for ranu/bakhar
preparation. About 8-10 bakhar tablets are used for 1 kg of rice, which together produce
about 10 L of handia. The quality gets lowered on dilution. On an average, some 30% of
families prepare handia for their own consumption. Per capita consumption amounts to
be about 1 L/day. Consumption is much higher during summer and hence, it is
essentially a summer drink (Figs. 1g & h). It keeps the stomach cool, protects from
extreme heat and is also intoxicating. Handia preparation and selling is a secondary
source of livelihood for tribals and some accept it as a primary occupation. It is used in
all social, cultural and religious purposes and no social occasion is considered complete
without it. The Santals believe it to possess medicinal value, i.e. use it in the cure of
jaundice, colic disorders and dysentery.
DISCUSSION
Preparation and consumption of cereal based beverages is a common practice in many
Mid-Asian, Middle East and African countries (Hesseltine, 1979). These are known by
different names at different places: sake in Japan, Shaosingiju and lao-chao in China,
Chongju and Takju in Korea, Brem bali, Tapuy and Tape ketan in Indonesia, khao-mak in
Thailand, Tapai pulal in Malaysia and jhara, daru, kali, pachwai, apong, bunkchung, chi,
laopani, jumai, suze, morpo, jou, zu, mod, harhia and handia in India (Lee, 2009).
These products have many advantages like superior digestibility and nutritive value
compared to their unfermented counterparts. The consumption of rice beer prepared
from rice is a common practice among many tribal communities residing among the
tribals of Odisha and many of them have been preparing it since time immemorial.
Among the Santal tribes of Mayurbahnj, it is prepared in almost every third house.
More or less all tribals are fond of drinks and consume during every ceremony,
festivals, marriages, funeral feasts, and offer it to their, guests, gods and deities 7. In
marriages, the amount of handia to be given to the girl side and is decided well in
advance.
Sa- Staphylococcus aureus; Sf- Shigella flexneri; Ss- S. sonnei; St- Salmonella typhimurium;
Cpr- Cissampelos pareira root; Csr- Clerodendrum serratum root; CgRh- Coccinia grandis
rhizome; Esr- Elephantopus scaber root; Hab- Holarrhena antidysenterica bark; MlF-
Madhuca longifolia flower; RsR- Rauwolfia serpentina root; SmR- Smilax macrophylla root;
WfL- Woodfordia fruticosa flower; WfR- Woodfordia fruticosa root
The consumption of rice beverage emerged mainly due to the climatic conditions and
discovering the use of surrounding natural resources (Roy et al., 2004). There are also
reports of rice beer being used as a drug from North east region of India (Singh and
Singh, 2006). It works effective against insomnia, headache, body ache, inflammation of
body parts, diarrhoea and urinary problems, expelling worms and as a treatment of
cholera (Samati and Begum, 2007; Deka and Sarma, 2010). It cures jaundice, colic, and
dysentery. It protects from sun stroke and maintains the motility and tone of the gastro-
Plant ingredients are used in preparation of starter culture (ranu or bakhar) universally
that are essential for fermentation of rice to prepare beverages. After surveying 12
districts of Odisha including Mayurbhanj (Dhal et al., 2010) recorded the use of bark and
root of six plant species in the preparation of bakhar by the tribals.
Singh, 1996 has reported the use of several plant species viz. mature leaves of Allophylus
cobbe (L.) Blume, Antidesma roxburghii Wall. ex Tul. and tender leaves of Artocarpus
heterophyllus (Lam.), in equal proportions together with little chilli, are used in the
preparation of Choarak, a local wine of Tripura state, India. Tribal inhabitants of tea
gardens in Terai region of West Bengal use 12 plants, specific parts for particular
purpose, for preparation of rice beer jhara or haria (Ghosh and Das, 2004). According to
Ghosh and Das, 2004, Sweetness of the liquor is developed by the use of tuberous roots
of Coccinia grandis L. (Voigt), whole plant including fleshy roots of Veronia cinerea L.
(Lessing) and leafy twigs of Scoparia dulcis L.. Likewise, young and soft leaves of
Clerodendrum viscosum Ventinat, bark of Oroxylum indicum (L.) Benth. Ex. Kurz, root
bark of Rauvolfia serpentina (L.) Benth. Ex. Kurz, and bark of Wattakaka volubilis (L.f.)
Staph. Produce a bitter taste. Leafy branches of Plumbago zeylanica (L.) act as a process
enhancer. Roots of Stephania japonica (Thumb.) Miers and Stephania glabra (Roxb.) Miers,
are used for long storing. Roots of Mussaenda roxburghii (Hook.f.) and leaves of
Artocarpus heterophyllus (Lam.), impart sweetness and yellowish tint to the liquor. The
tribals of Central India use a number of roots, bark, rhizomes, leaves and seeds of some
21 plants for making ranu (Kumar and Rao, 2007). The tribals get the phytotherapeutic
value of these plants through the drink. The use of specific plants and parts thereof is a
tradition and passed through generations. However, due to the loss of biodiversity and
fragmentation of habitat, all the plants are not available in the vicinity of a particular
village.
Poli et al., 1992 evaluated pharmacological properties of Elephantus scaber and observed
the presence of alkaloid, anthocyanin, chalcones, flavonoid, lactone and triterpenoids.
In another study conducted by Kamalkannan et al., 2012 showed presence of alkaloid,
carbohydrate, proteins and saponin while absence of volatile oil, gum, mucilage and
steroid. The same authors studied the antibacterial property and conclude that the
methanol extract of Elephantus scaber has potential antimicrobial activity against
Streptococcus pyogene while no activity against E. coil, P. aeruginosa, S. aureus and S. typhi.
In contrary to this work the study conducted by Kumar et al., 2004 and Avani and
Neeta, 2005 reported promising antibacterial activity against pathogens such as B.
subtillis, E. coil, P. aeruginosa and S. aureus. At this juncture, antibacterial activity was
confirmed against S. aureus, S. typhimurium and S. flexneri whereas absence of activity
against E. coli, P. aeruginosa, S. sonnei and V. cholerae. Tambekar and Khante[23]
Parekh and Chanda, 2007 studied antibacterial activity of W. fructicosa flowers and
result found that methanol extract exhibited potential activity against B. cereus, S.
aureus, S. epidermidis, P. vulgaris, P. seudoalcaligens and S. typhimurium. Later, similar
experiment carried out by Kumarswamy et al., 2008 showed promising antibacterial
activity against E. coli, K. pneumoniae, P. aeruginosa, P. mirabilis, S. typhi, S. boydii, S.
flexneri, S. sonnei and S. aureus. Chougale et al., 2009 also studied antibacterial activity of
fraction of leaf extracts of W. fructicosa with promising antibacterial activity against B.
subtillis, E. coli, S. aureus and P. aeruginosa. Further, Bhattarai and Bhuju, 2011 tested both
leaf and flower extracts of W. fructicosa and concluded that methanol extracts have
antibacterial activity against B. cereus, E. coli, P. aeruginosa, P. mirabilis, S. dysentriae, S.
typhimurium and S. aureus. Finose and Devaki, 2011 investigated presence of
phytochemicals viz. carbohydtate, aminoacid, glycoside, saponin, flavonoid, alkaloid
and tannin in W. fructicosa. Later, Gyawali et al., 2012 establish presence of same
phytoconstituents in addition with terpenoids.
The detail study and uses of these plants clearly indicate that the presence of these plant
materials and their bactericidal activity are mainly responsible for protecting and
preserving starter cultures since traditional system of fermentation normally operates in
unhygienic condition which sometimes contaminates the system and cause toxication of
drinks. But due to the presence of antimicrobial chemical principles of these plants or
plant parts, they are able to continue such practice for generations without much
decline in the characteristics of microorganisms involved in fermentation.
CONCLUSIONS
The study establishes the deep knowledge of tribal people in terms of selection of plants
for preparation of handia and the processing technique. The native skill of rice beer
preparation using unique starter culture technique is well recognized. Both the Bakhar
tablets and handia are used in the treatment of several ailments. Probably, this is central
theme in the preparation of rice beverages by the tribals across the world.
RECOMMENDATION
It is possible that the traditional knowledge of beverage preparation along with various
parts of different plant species used will be a useful lead for phytochemists and
pharmacologists for further study. Once the efficacy of these indigenous drinks is
scientifically established, the popularization of these remedies can be recommended in
ACKNOWLEDGEMENTS
The present research has been funded by the Department of Science and Technology,
Government of Odisha (Grant No. ST-BIO-70/2010/ST). We wish to express our
profound gratitude to Dr. A. K. Biswal (Department of Botany, North Orissa University)
for identification of the plant samples. We are also grateful to the authorities of North
Orissa University for providing necessary facilities to carry out this research. Finally,
we wish to thank to all the informants and sellers; they allowed us to take photographs
of plant materials. We also thank to Dr. Abhijeet Das for photographic documentation.
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ABSTRACT
Several sources reported the advantages of synthetic fungicides in boosting
food production. However, there are serious concerns and negative
consequences associated with their use on ecological and human health in
recent years. Besides, pathogens’ resistances to some of the most effective
fungicides have been reported. These amongst others prompted search for
alternatives. Plants offer an expanse of exploitable chemical space in this
regard which is unparalleled in nature and not beaten by combinatorial
chemistry as yet.Extracts of higher plants have demonstrated a wide range of
activity against plant pathogenic organisms. These plants extracts have been
found to contain broad spectra of phytochemicals (secondary metabolites) such
as alkaloids, flavonoids, tannins, saponins, phenols, glycosides, terpenoids,
phlobatannins, polyphenols and steroids. Secondary metabolites constitute
plants’ weaponry against pest and pathogen invasion. These groups of
phytochemicals possess wide ranging chemical functional groups; by which
they establish and bind to sites on target pathogens to ineffectuate them.
Complexes of these chemical compounds occur and incrude extracts. Need
therefore arises in the present to identify, isolate and purify the active
principle(s) in the extracts and to determine theone(s) effecting the reported
kills and fungitoxity of the extracts. With the exception of neem assertive
reports on their modes of action are unavailable. We have to understand the
functional groups of the isolates, their position on the carbon skeleton of the
principles, binding sites on target pathogenic species; and the metabolic
process(es) which they affect and ineffectuate. This will aid in either
synergizing or synthesizing them so as to combat the enormous and obvious
challenges of fungicide resistance threating agricultural production and food
security. This work reviews available literature in these regards.
Fungi represent the greatest number of pathogens responsible for these plant diseases
and deteriorations (Ajibade and Amusa, 2001). Many species of fungi decimate
agricultural crops or products in field, transit or store. It has been reported that up to
8000 – 750,000 crop diseases are caused by fungi with between 50 – 200 species, races
and/or biotypes attacking a single crop (Ragsdale, 1994; Madden et al., 2008). Infection
by fungi interferes with normal physiological function(s) of the host plant such as
photosynthesis, biosynthesis, nutrient and water uptake among others, leading to great
reductions in crop yield and product quality. Some pathogenic fungi such as Aspergillus
spp. and Fusarium moniliformeproduce toxins – mycotoxins – which cause cancer or may
be nerve or organ poisons, making affected produce dangerous for human and
livestock consumption (Ragsdale, 1994). The incidence of these plant diseases upon a
susceptible host is dependent on the presence of specific conducive conditions of
moistures in the atmosphere, in soil and/or on plant surfaces; in addition to optimum
temperatures for infection and disease development (Ragsdale, 1994; Amadioha, 2012).
Field phyto-fungal diseases may be nematode-assisted. Nematodes of the order
Xiphenima, Trichoderma, Longidorus and Para-longidorus have been implicated in this
regard. These stylet-possessing organisms puncture and burrow into tender, succulent
Emechebe and Shoyinka (1985) reported that pathogenic fungi are capable of causing
up to 100% yield loss in crops. Worldwide, it is projected that 20 – 40% of potential yield
of crops are lost annually to plant diseases (Sygenta, 2012). This may aggravate to 50%,
particularly in Africa due to climate change impacts, noted Sadiku and Sadiku (2011).It
is estimated that globally these yield losses amounts tobetween 60 – 525 billion US
dollars annually (Agrois, 2004; Sygenta, 2012). According to Amadioha (2012), in
Nigeria alone, Nkama et al. (1994) estimated that 1.5 – 20 million tonnes of cereals,
tubers and legumes amounting to 0.3 – 0.4 billion Naira are lost annually in storage due
to fungal attacks. In a bid to control these devastating attacks, synthetic fungicides are
employed.Without controversy, fungicides contribute to yield increases in crop
production. Adipala and Edema (1994) reported that the application of Mancozeb and
Dithane M-45 significantly improved the yield of cowpeas in Uganda.In the USA noted
Bernnett (2005), 1.5 billion pounds of onion was harvested from onion plants cared for
with 0.8 million pounds of fungicides. Economic use of fungicides in agriculture
translates to improved returns on farm investment. According to this source, in
California apple growers invested 70 million dollars on various fungicides, and reaped
an attractive 1.2 billion dollars while grape growers got 2.6 billion dollars as return on
investment (ROI) of 128 million dollars in the same period. A total of 880 million dollar-
investment in fungicides by growers in the USA all together reaped the sum of 12.8
billion dollars ROI translating to US$1 fungicides investment to US$14.6financial
returns for them. Fungicides play a very active role in production of high value crops
with uniform appearances and quality (Biobank, 2009). Highly intensive and developed
crop farming as practiced in the USA and Europe, involves use of highly-bred crop
varieties to maintain uniform crop height, canopy, fruit size and shape as well as overall
appearance and quality of produce in mechanized farms. Without fungicides and other
pesticides it will be difficult to grow such crops ofhigh horticultural characteristics in
large monocultures given serious potential pathogenic challenges in the environment.
In the USA, concluded Croplife (2012) many crops would not be produced
commercially without fungicidal agents.
This review focuses on use of botanical pesticides in plant health management. Many
higher plants of the rain forest are being screened for fungicidal properties (Amadioha.
2001; 2002; 2003). Several workers have conclusively asserted the fungitoxic properties
of these plant-based extracts for management of phyto-fungal diseases (Olufolaji, 1999;
Awurum et al., 2005; Opara and Obana, 2010). These extracts have been reported to
have the merits of being readily available in faming localities of the tropics, cheap, eco-
compatible, less harmful to non-target organisms and useable in Integrated Disease
Management (IDM) programmes for smallholder resurce-poor farmers. They are also
reported to provide sustainable disease management solutions especially in organic
farming where synthetic pesticides are non-tolerable. Above all, they are systemic and
contain multiple bioactive metabolites which make pathogens‟ resistance to them less
likely (Adjaye-Gbewonyo et al., 2010; Opara and Obana, 2010; Gurjar et al., 2012).
Awurum and
Ocimum sanctum.
Cephalosporiu
Musk bean, m sp.
Sarpeleh et al.,
Cucumber 2009.
Perganum hamala
Phytophtora
(shoot, flower, seed)
drechsleri
Verticillium
diahlae
Scleretina
scleroiorium
Aternaria sp.
Botrytis
cinerea
Macrophomina
phaseolus
Azadirachta indica,
Zzingiber officinale
Suleiman and
Emua, 2009.
Cowpea Garcinia kola
Afromonium meleguata.
Okigbo and
Aspergillus
Nmeka, 2005.
niger Xylopia aethiopica
Fusarium
Ugwuoke et al.,
Azadirachta indica
Geotrichum
candida
Cortichum
rolfsii
Sclerotium
rolfsii
Aspergillus
niger
B. theobromae
F, oxysporium
Curvularia
Maize Phyllanthus amarus
leaf spot
Curvularia Akinbode, 2010
Tithonia diversifolia
lunata
Morinda lucida
Gliricidia sepium
Sclerotium
rolfsii
Penicillium
italicum
Sorghum Cymbopogon citratus
Aspergillus
Eucalyptus Somda and
niger
camaldulensis Serene, 2009.
Colletotrichum
gramminis
Phoma
sorghumi
Aspergillus
flavus
Aspergillus
niger
Callistemon citrinus
Nguefack et al.,
Ocimum gratissimum.
2007
Fusarium
White rot Onion solani Pimenta dioica Montes-
Penicillin sp. Belmont and
Syzygium aromaticum
Prados-Ligero,
Sclrerotium Piper nigrum 2006
ceporium
Rheum emodi
Alcorous calamus
Ageratum conyzoides
Allium sativum
Abutilon indicus
Bipolaris
maydis
Curvularia
Rhizoctonia
stolonifer
Phoma sp.
Sclerotium
rolfsii
Curvularia
lunata
Fusarium
oxysporium
Penicillin
chrysogenum
Mucor mucedo
Alternaria
alternate
Aspergillus
flavus
Aspergillus
fumigatus
Aspergillus
Plants extracts as seen from Table 1, are hence suitable for exploitation as potent sources
of pesticides to reduce losses arising from pathogenic attacks on crops and stored
products (Amadioha, 2012). The use of these natural products for pathogenic disease
management is particularly important and necessary in the developing economies of
the world like Nigeria where synthetic fungicides are not only unavailable but farmers
who produce about 98% of food in the country are poorly equipped to handle them
making their use uneconomic for resource-poor farmers.
Phytochemicals of the group alkaloids have complex structure. They are bitter tasting,
colourless, basic, and toxic,and contain nitrogen in a heterocyclic ring.At room
temperature alkaloids may be liquids or crystalline solids (Okigbo etal., 2009). They are
the most physiologically active compounds of medical importance found in plants.
Alkaloids and their derivatives are used as basic starting points for drugs. They possess
antifungal and bactericidal properties (Okwu and Uchendu, 2009). Karlovsky (2008)
reported that alkaloids can inactivate enzymes, block ionchannels, interfere
withneurotransmission and cause loss of electrical coordination (ataxia) in organisms.
Plant Materials Alka Flav Tan Sap Phe Ter Gly Ste Source/References
Tinospora cordifolia + + + + + + + + “ “ “
Clutiaabyssinica - + - + + + - -
Eruca sativum 11.27 24.43 4.15 6.20 26.90 - 2.76 - Mohammed et al., 2011.
Alchornea cordifolia leaf 5.90 4.20 6.80 3.20 Adeshina et al., 2012
Cleome rutidosperma 0.34 0.34 15.25 2.00 0.20 - + - Edeoga et al., 2005
Carica papaya seed 0.62 0.34 0.22 0.68 0.08 - + - Enyiukwu and Awurm, 2013
Monodora myristica leaf 4.28 8.29 0.34 0.02 0.03 Okwu and Njoku, 2009
Bryophyllum pinnatum 1.48 1.72 0.51 1.74 0.06 Okwu and Uchenna, 2009
Cissis populnea root 2.79 4.13 1.18 1.11 - 0.36 0.53 0.13 Soladoye and Chukwuma,
2012
C. populnea stem 4.70 1.46 1.10 1.21 - 0.27 0.41 0.15 Okwu and Uchenna, 2009
Azadirachta indica leaf 0.52 0.62 9.10 2.10 0.02 Khrishnaiah et al., 2009
Cleredendon sp. Leaf 5.41 0.70 3.60 2.10 0.08 Okwu and Uchenna, 2009.
Spondias mombin leaf 6.00 3.00 3.80 7.60 1.00 Njoku and Amaefula, 2007.
Afromonum meleguata leaf 0.29 2.15 0.16 0.14 0.10 Okwu and Njoku, 2009
Citrus limonum 0.54 0.64 1.31 0.34 0.25 Okwu et al., 2007.
Detarium Senegalese 0.72 5.68 0.79 4.60 0.25 Uchegbu and Okwu, 2012.
Uvaria chamae 0.81 5.70 0.40 0.38 0.10 Okwu and Iroabuchi, 2009.
Saponins are glycosides of both triterpenes and steroids known for the soap-like
foaming they produce in aqueous solutions. Saponins have a characteristic property of
being bitter or astringent (Okigbo et al., 2009). Their soap-like nature makes them
useable as surfactants and adjuvants for vaccines to enhance macromolecule
penetration (Wikipedia, 2008). Saponins can ward off microbes and this makes them
good candidates for treating yeast, viral and fungal infections. They are known to play a
role in cytolysisby complexing with cell membrane bilayers (Okwu and Njoku, 2009)
sometimes creating pores on them (Rongai et al., 2012).
In recent years noted a study from Italy, plants of the family Brassicacaea have attracted
scientific attention due to their high contents of glucosinolates. These glycosidic
compounds have no biocidal activity in their native forms but are converted through
enzymatic hydrolysis within living systems to their active forms (isothiocyanates)
which have strong cytotoxic activity (Rongai et al., 2012). Methyl isothiocyanate (MITC)
and benzyl isothiocyanate (BITC) were reported present in Carica papaya (Morton, 987;
Cornell University, 2012). BITC occurs in the range of 1.37-1.96% in the Family Caricaceae
(Tang et al., 2001). According to Reulas et al. (2003) BITC isolated from Papaya seeds is
known to be a strong antifungal compound. At 0.5mg/ml the compoundinhibited the
fungus Alternaria alternata causing post-harvest rot of tomato. Later evaluations
indicated that aqueous seed extract from C. papaya was superior to metalaxyl (ridomil)
in inhibition effects against Phytophtora palmivora inciting black pod disease of cocoain
vitro. Investigators believed BITC was responsible for this reported activity(Wokocha
and Nwaogu, 2008; Enyiukwu and Awurum, 2013).Furthemore, for instance, the
According to Okwu and Uchenna (2009), many other functional groups exist in these
phytochemicals besides the ones shown above in Table 3, such as pyrones,double and
triple bonds etc. These chemically reactive groups have been postulated to be isolates‟
Limonene,
3-(4-dihydroxyphenyl)-oxo-
2H-chromene-6-carbaldehyde
Methyl chavicol
Eugenol
Bergamotene
Methyl cinnamate
Heptacosane-3enyl-5-
hydroxyhexanoate
Butelin
Butelinic acid
Stigmasterol
Neridienone A
Neridienone B
Sabenene
Chondrillasterol
n-Hexadecanoic acid
Limonene
Alpha-bisabolol
Alpha-humulene
Anthocyanidines
Furanocoumarines
Bergapten
Alpha-pinene
Hexadeconoic acid
Naphthaleno
Octadecanoic acidl
Rutin,
Kaemoforol-3-glycoside,
Beta-Sitosterol
Hispudilin
Luteoline
Piperidine.
Pseudo-carpaine,
Ricininoleic acid
Plants contain a marvelous array of potent and bioactive chemical compounds which
play roles in warding off microbial, pest and herbivoral attacks. A source noted that 12,
000 of such chemical compounds have been isolated from the plant kingdom. In the
thoughts of Pallat (2010), these are still infinitesimal compared to the enormous
chemical space provided by the 250,000 species constituting the world‟s flora.
Identification, isolation, characterization and purification of novel potent compounds of
plant origin will pave way to sustainable food production; reduceeco-contamination
while delaying or reversing pathogen resistance to plant health management chemicals.
CONCLUSION
Reports show that majority of the evidences of plant-based chemical activity against
plant pathogenic fungi and other micro-organisms of agricultural importance were
provided from in vitro evaluations. Crude extract evaluations have become very
rudimentary. Numerous phyto-chemicals which have demonstrated in vitro effects
should be evaluated on-farm under natural or induced infections, to further determine
and establish their efficacy in controlling the incidences of pathogen-borne diseases in
crops in a multi-factor environment. Information on the active ingredients of plant
extracts is sparingly available while that ofthe mechanism of action of isolates is almost
non-existent.These are high profile, high-tech areas of scientific endeavours, and multi-
disciplinary in nature.Therefore further focused and articulated researches to improve
the effectiveness, target specificity and shelf storageability of botanicals are pressingly
imperative. To achieve this, we must liaise and collaborate effectively with scientists in
biochemistry, plant physiology, biotechnology, pharmacology and natural products
chemistry. It is in the light of this kind of collaboration and purpose-guided assays that
the much anticipated outcome of identifying, isolating, characterizing and
understanding isolate-pathogen interaction which will lead us to the knowledge of the
mechanisms of action (MOA) of the active principles of plant-based natural products
will be achieved in the near future.
2. Given proven phyto-fungal toxicity of the plant materials and assertions on their
effectiveness especially from actual field trials in the management of plant health
challenges;many concerted and directed efforts and thrusts should hence be geared
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ABSTRACT
This chapter presents a comprehension on ethnomedicinal uses of medicinal plants by the
indigenous tribals of District Mayurbhanj, Odisha, India. In addition to this the chapters also
scientifically validated how many of these plants are active to kill bacteria responsible to cause
infectious diarrhea. Aqueous and methanol extracts of 150 plants were recorded as medicinal
value, of which 136 plants were tested for antibacterial activity using agar well diffusion against
eight pathogenic bacteria involved in diarrhea and dysentery. The results indicated that out of
136 plants species, 100 species exhibited antibacterial activity against one or more test
organisms. In total 288 (144 methanolic+144 aqueous) extracts, 107 methanolic and 74 aqueous
extracts expressed antibacterial properties. From the screening results plant family’s viz.
Fabaceae (08), Rutaceae (07), Combretaceae (06), Caesalpinaceae (06), Anacardiaceae (05) and
Apocynaceae (04) showed highest antibacterial activity in terms of test plant numbers. However,
families viz. Burseraceae, Crassulaceae, Hypoxidaceae, Liliaceae, Lygodiaceae, Musaceae,
oxalideceae, Pedaliaceae, Strychnaceae, Trapaceae, Ulmaceae did not showed activity against any
test organism. Moreover, Euphorbiaceae, Rubiaceae are the two largest families from which
plants did not show result significant activity against diarrheal causing bacteria. Among the
plants viz. Acacia leucophloea, Adhatoda vasica, Andrographis paniculata, Annona reticulate,
Anogeissus latifolia, Anthocephalus chinensis, Bombax ceiba, Buchanania lanzan, Butea
monosperma, Careya arborea, Cassia fistula, Centella asiatica, Cissampelos pareira , Coccinia
grandis, Croton roxburghii, Curculigo orchioides, Diospyros melanoxylon, Eleutherine bulbosa,
Erycibe paniculata, Ficus racemosa, Flemingia nana, Helicteres isora, Holarrhena pubescens,
Helicteres isora, Lannea coromandelica, Litsea glutinosa, Mesua ferrea, Mimusops elengi,
Moringa oleifera, Nyctanthes arbortristis, Phyllanthus emblica, Piper longum, Pterocarpus
marsupium, Pterospermum acerifolium, Punica granatum, Quisqualis indica, Semecarpus
anacardium, Smilax zeylanica, Terminalia arjun, Terminalia bellirica, Tinospora cordifolia and
Vitex negundo experimentally proved to inhibit most of the diarrheal causing bacteria.
INTRODUCTION
Diarrhea, particularly infectious diarrhea is the second leading cause of mortality and
morbidity throughout the world in children less than 5 yrs of age. This is especially true
in developing countries like India where there is poor sanitation and overcrowding.
LITERATURE REVIEW
Diarrhea poses a significant economic and societal burden throughout the world both in
developing and developed countries. Annually, more than five million people, 80% of
whom are less than one year of age, die from acute infectious diarrhea (Sood and
Pacheco, 2002). Additional agents of infectious diarrhea for which clinical diagnostic
testing is not routinely available include enterotoxigenic, enteropathogenic,
enteroaggregative, and enteroinvasive strains of E. coli, toxin-producing Clostridium
perfringens, Staphylococcus aureus, Bacillus cereus and rotaviruses (Guerrant, 1998).The
emergence of multiple drug resistant strains of diarrheagenic pathogens has made the
treatment of dysentery more difficult. In developing countries, the majority of people
living in rural areas almost exclusively use traditional medicines in treating all sorts of
diseases, including diarrhea. A range of medicinal plants with anti-diarrheal properties
have been widely used by the tribes of Mayurbhanj. The effectiveness of many of these
plants has not been scientifically evaluated.
Antimicrobial: Many plant metabolites are known to exhibit some level of toxicity
toward microorganisms. Numerous mechanisms of actions have been hypothesized to
explain their antimicrobial activity such as microbial enzymes inhibition, deprivation of
essential growth substrates, cell membrane disruption (Cowan, 1999) or direct
interference with metabolic pathways.
Antiadhesion: Adhesion of some enteric pathogen to the mucosa epithelium of the host
cells is the first important step in intestinal infections that may lead to the development
of diseases (Ofek and Sharon, 1990). Application of antiadhesives chemotherapy can be
effective only against microorganisms that depend on the surface contact with host cells
as prerequisite for survival, multiplication and virulence (Lengsfeld et al., 2007).
Antitoxin: Since enteric pathogens may induce diarrhea through the production of toxin
(endotoxin or cytotoxin) the neutralization with plant antidiarrheal compounds may
beneficial in the management of diarrhea. Activated charcoals processed from plants
are also used as toxin binders.
Bacteria, viruses and parasites are the major causes of infectious diarrhea, with bacteria
leading highest (2-4 billion cases of infection with 3-5 million deaths per year (Sanchez
and Holmgren, 2005). Phytochemicals inhibit the growth and virulence of diarrhea-
causing bacteria in numerous ways. When bacteria invade the intestines, they follow
similar etiologies. The sequence, known as the five stages of pathogenicity (Mitchell,
1998), includes: 1) adherence to host tissue, 2) invasion or control of host tissues, 3)
multiplication in host tissues or with nutrients from host tissues, 4) evasion of host
defenses, and 5) damage and spread.
Phytochemicals can inhibit bacterial growth or virulence at any of these five stages of
pathogenicity. For example, mucilaginous, astringent and fibrous properties of some
plants can mechanically prevent bacterial adhesion to host intestinal cells by direct
competition between plant-derived lectins and bacterial membrane glycosides (Coutião
Rodriguez et al., 2001; Rabbani et al., 2004).
Staphylococcus aureus
S. aureus is a gram-positive coccus present in normal intestinal and skin flora of human
and homoeothermic animal. Under define conditions, the pathogenic strains produces
heat stable staphylococcal enterotoxins (SETs) and toxic shock syndrome toxins (TSST-
1) (de Oliveira, 2010) both of which are known to induce diarrhea. Upon ingestion of
the contaminated food with the SETs, results diarrhea associated with fever, nausea and
vomiting (Rosengren et al, 2010; Perez-Bosque and Moreto, 2009). In contrast, TSST-1 is
characterized by sudden onset of fever, vomiting, diarrhea, erythematous rash with
skin peels, hypotensive shock, impairment of renal and hepatic functions. Toxicity
results by way of the production of pro-inflammatory cytokines and chemokines.
Toxicity is usually aggravated by further interaction between the activated immune
system and inflammatory mediators (Krakauer et al., 2001).
Campylobacter jejuni
C. jejuni is an invasive Gram-negative, spiral-shaped rod bacterium present in the GIT
of mammals, birds and primates (Lengsfeld et al., 2007). The clinical signs of
campylobacter infections include pyrexia, abdominal pains, watery diarrhea and
dysentery (Podewils et al, 2004). The characteristic mechanisms Campylobacter
infection involves invasion and translocation of the epithelium with a concomitant
induction of inflammation (Hu et al., 2008).
Shigella species
Four species of Shigella (S. flexneri, S. dysenteriae, S. sonnei and S. boydii) invades the
colon with resulting inflammation and diarrhea (Podewils et al., 2004). S. flexneri is
responsible for dysenteric symptoms and persistent illness while S. dysenteriae type-1
produces Shiga-toxin causes bloody diarrhea (Podewils et al, 2004), S. sonnei causes
bacterial gastroenteritis and bacillary dysentery and S. boydii causes fever, chills,
abdominal pain and diarrhea.
Vibrio cholerae
V. cholerae is a motile, facultative anaerobic Gram-negative rod associated with
potentially fatal diarrhea (Granum, 2006) that results from the ingestion of the cholera
enterotoxins (CT) (Podewils et al, 2004). Watery, colour less mucous-flecked stool and
vomiting are the main clinical signs associated with cholera which in severe cases can
Bacillus species
B. cereus is a sporulating bacterium that causes diarrhea due to food poisoning resulted
by enterotoxins such as haemolysin BL (HBL), non-haemolytic enterotoxin (NHE) and
cytotoxin K (CytK) (Lund et al., 2000). Other species of Bacillus such as B. subtilis, B.
licheniformis, B. pumilus and B. megaterium can also produce enterotoxins and emetic
toxins involved in food borne illness but are usually considered relatively safe (From et
al, 2007).
Yersinia species
Yersinia species are Gram-negative facultative anaerobic nonsporing rods bacteria
belonging to Enterobacteriaceae family. Two pathogenic species Y. enterocolitica and Y.
pseudotuberculosis are responsible for yersiniosis with clinical signs such as diarrhea,
vomiting, fever and abdominal pain (Linscott, 2011).
Listeria monocytogenes
L. monocytogenes is the only single species which causes life-threatening invasive
diseases referred to listeriosis in human and animals (Chaturongakul et al., 2008; Todd
and Notermans, 2011). Upon ingestion of the bacteria through contaminated foods,
causes diarrhea by colonizing the intestinal tract (Chaturongakul et al., 2008).
Clostridium species
Three species of Clostridium viz. C. difficile, C. botulinum, C. perfringens are responsible
for diarrheal diseases. C. difficile causes a spectrum of diseases ranging from benign
diarrhea to fatal colitis and most often as a consequent of antibiotics treatment. Most
antibiotics predispose C. difficile overgrowth leading to the production and
accumulation of and diarrhea are Toxins A (enterotoxin) and B (cytotoxin) in the
intestine. Both toxins A and B inactivate intracellular Rhoproteins by glycosylation,
leading to desorption of the cytoskeleton, production of inflammatory cytokines and
damage to tight junctions. In contrast, C. perfringens is an important food poisoning
bacterium with clinical sign as diarrhea, abdominal cramping and nausea. C. botulinum
play a role in diarrheal diseases due to botulinum toxin resulting abdominal cramping,
nausea, vomiting, diarrhea, double vision, long term nerve damage and possible even
death from paralysis (Linscott, 2011).
Salmonella typhimurium
Viral agents
Several viruses belonging to Rotavirus, Norwalk viruses, Adeno viruses, Calciviruses,
Coronaviruses, Astroviruses and Enteroviruses are responsible for causing diarrhea
throughout the world.
Norovirus
Norovirus is considered as major global causes of gastroenteritis resulting diarrhea
(Mattison, 2010). The disease is opportunistic with clinical signs viz. nausea, vomiting,
diarrhea and abdominal pains (Koopmans, 2008).
Hepatitis A virus
Hepatitis A is a small, non-enveloped spherical with cubic symmetry, thermostable and
acid resistant entero virus. It multiply in the intestinal epithelium and reaches the liver.
The clinical signs are dark urine, jaundice, malaise, weakness, fever, anorexia, nausea
and vomiting, abdominal pains, and diarrhea (Koff, 1992).
Giardia intestinalis
G. intestinalis (syn. G. doudenalis, G. lamblia) is a flagellate protozoa parasite colonizes
the small intestinal lumen and induces non-inflammatory and malabsorptive diarrhea
(Schulzke et al., 2009). The pathophysiology of Giardiasis involves Na+ dependent D-
glucose absorption impairment, active electrogenic anion secretion activation, mucosal
inflammation and leak flux (Buret, 2007; Troeger et al., 2007). Clinical signs of Giardia
infection include bloating, steatorrhea and nausea.
Entamoeba histolytica
Cryptosporidium parvum
C. parvum is an intracellular protozoa parasite that infects epithelia causing
cryptosporidiosis which manifest clinically as profuse watery diarrhea containing
mucus and some times blood or leukocytes (Kenny and Kelly, 2009; O‟Hara and Chen,
2011).
Cyclospora cayetanensis
C. cayetanensis is a protozoan parasite which invades the epithelial cells of the small
intestine (Chacin-Bonilla, 2010; Manfield and Gajadhar, 2004). The clinical signs of the
infection include watery diarrhea, loss of appetite, weight loss, abdominal bloating and
cramping, increased flatulence, nausea, fatigue, and low-grade fever (Linscott, 2011).
Trichinella spiralis
T. spiralis is a food-borne zoonotic parasite induced changes in intestinal function by
hypersensitivity mechanism resulting in an increased intestinal chloride and fluid
secretion (Cui et al., 2011). The clinical intestinal symptoms are nausea, abdominal
pain, vomiting and diarrhea (Linscott, 2011).
Ethnomedicinal documentation
In Mayurbhanj district, phytotherapy (treatment with medicines from plant and their
derived products) forms an integral part of the local culture, and the information about
plants and their uses are passed from generation to generation through oral folk-lore,
primarily amongst the elderly; the natural retainers of traditional knowledge in their
respective communities. The field study was carried out from September 2006 to
November 2008, and the information on the use of medicinal plants for treatment of
diarrhea was obtained through structured questionnaires, complemented by free
interviews and informal conversations (Huntington, 2000). The interviews were
individually carried out during the first contacts with the local population, native
specialists were identified, i.e. people considered by the community as having
exceptional knowledge about the use of plants.
Processing
Stems, leaves, bulb, barks, roots, rhizomes, seeds etc. of plants have separately been
collected during field trips to different parts of Similipal Biosphere Reserve. The roots
are dug out from the soil and the adhering soils were removed by shaking and washing.
The leaves were plucked from the trees, washed properly and infected leaves were
discarded. After collection, the healthy leaves were dried at low temperature to
maintain their green color and volatile oils, if present. The materials were completely
shed dried so long it does not allow for the growth of any type of fungi, molds, bacteria
and other microorganisms. The dried leaves, roots and stems were powdered separately
using mortar and pestle and then were passed through sieve to get the uniform
powdered sample.
Test bacteria
Pathogenic bacteria under study were Escherchia coli, Escherichia coli O157:H7, Salmonella
typhimurium, Salmonella typhi, Shigella dysentriae, Vibrio alginolyticus, Vibrio cholerae and
Vibrio cholerae O139.
Maintenance of bacteria
The bacterial cultures were maintained on nutrient agar (NA) slants and stored at 4 оC.
Activation of the bacterial was carried out by streaking culture from the slants on to a
Muller Hinton agar (MHA) plate and incubating overnight at 37 оC. Single colony was
picked up from each plate and transferred to nutrient broth, incubated for 1 day at 37 оC
prior to the test.
Antibiotics
The following antibiotics sensitivity test disc (Hi media Pvt. Ltd., Mumbai, India) at the
given concentration were used to determine antibiotic sensitivity profile of reference
bacteria: Amikacin-Ak (30μg); Amoxicillin-Aug (10μg); Amphotericin-Ap (100unit);
Ampicillin-A (10μg); Bacitracin-B (10units); Cefoxitin-Ctn (10μg); Ceftriaxone-Cez
(10μg); Cephotaxime-Ce (30μg); Chloroamphinecol-Ch (10μg); Ciprofloxacin-C (10μg);
Erythromycin-E (15μg); Gatifloxacin-Gf (30μg); Gentamycin-G (10μg); Levofloxacin-Lvx
(5μg) ; Naladixic acid-Nal (30μg); Ofloxacin-Ofl (5μg); Polymyxin-B-Pb (300 unit);
Streptomycin-St (10μg); Tetracycline-Te (10μg) and Vancomycin-Vn (30 μg).
Sensitivity test
Antibiogram was done by disc diffusion method (Bauer et al., 1966) with commonly
used antibiotics. Antibiotic sensitivity was tested in MHA plates. The test microbes
were removed from the slant aseptically with inoculating loops and transferred to
separate test tubes containing 5.0ml of sterile distilled water. Inoculums added until the
turbidity equaled 0.5 McFarland (108 CFU/ml). For each of the bacteria, one milliliter of
the test tube suspension was added to 15-20ml of nutrient agar and transferred to the
agar plate (90 mm diameter). After cooling the inoculated agars at room temperature for
25 min, antibiotic sensitivity test discs were placed on the surface of solid agar. The
plates were incubated at 37°C. The plates were examined thereafter, clear zones of
inhibition formed around the discs were measured and antibiotic sensitivity was
assayed from the diameter of the clear inhibition zones (in mm) (Figure-2).
RESULTS
The antidiarrheal screening of 134 plants collected from Similipal Biosphere Reserve,
Orissa, India was carried out by agar cup method. The selection of plants was based on
ethnomedicinal uses reported earlier as well as freshly recorded data (Table-3). Two
different solvents viz. methanolic (80%) and aqueous used for the preparation of crude
extracts (Table-2). A total of 288 plants extract (Table-4) belonging to 66 families were
tested for anti-diarrheal activity. Among the selected 136 plants, 100 species showed
anti-bacterial activity against at least two or more test organisms. Two families with
higher number of plants didn‟t show any activity belonged to Rubiaceae and
Euphorbiaceae. Acanthaceae, Anacardiaceae, Apocynaceae, Ceasalpiniaceae,
Clusiaceae, Combretaceae, Fabaceae, Moringaceae, Oleaceae, Rutaceae, Punicaceae and
Verbenaceae were some of important families which showed anti-diarrheal activity
against pathogens. Screening results showed antibacterial activity with 107 methanol
and 74 aqueous extracts against one or more test strains.
Some of the active species have already been reported earlier to have antibacterial
activity. The effects of few medicinal plants viz. Justicia adhatoda, Achyranthes aspera,
Andrographis paniculata, Holarrhena antidysenterica, Cassia fistula, Carica papaya, Punica
granatum, Moringa oleafera, Vitex negundo, Hemidesmus Spondias pinnata were previously
described (Valsaraj et al. 1997) and was confirmed in this work. Similar results were
DISCUSSION
Diarrhea is known to be caused by several factors including the non infectious type of
diarrhea such as metabolic diseases, food allergy and other organic causes. On the
contrary, infectious diarrhea is a type of diarrhea which is caused by an infectious agent
(bacteria, fungus, parasites and viruses) due to the invasion and colonization of the host
tissue. Infectious diarrhea is characterized by an alteration in a normal bowel
movement, an increase in the volume of water content, or frequency of stools, nausea,
vomiting, cramps and/or abdominal discomfort (Sood and Pacheco 2002). Studies on
pathogens responsible for acute diarrhea in developing countries, revealed that the
contribution of Rotavirus (15-25%), entrerotoxigenic E. coli (10-20%), Shigella species (5-
15%) Salmonella species (1-5%), C. jejuni (10-15%) and entropathogenic E. coli (1-5%)
(EHNRI 2002). E. coli (EIEC) entroinvassive and enterohemorragic (EHEC), Salmonella,
Shigella, V. cholerae are the major bacterial pathogens most often responsible for causing
pandemic and epidemic infectious diarrheal disease in developing countries (Black et
al. 1984).
Plant description PU E S S S S S S S S
1 2 3 4 5 6 7 8
Acanthaceae
Adhatoda vasica Nees Lf A 12 - 11 - - 12 12 12
M 11 12 10 12 - 11 10 10
Andrographis paniculata Lf A 11 - - 11 12 12 12 10
(Burm. f.) Wall. ex Nees M 14 - - - - - - 13
St A 12 12 - - - - - 12
M 13 12 10 12 12 12 10 -
Alangiaceae
Alangium salviifolium (L.f) Lf A - - - - - - 11 12
Wang. M 12 - - - - - 10 13
Amaranthaceae
Achyranthes aspera L. Wp A - - 9 - - - - 11
M - 10 8 - - - - 12
Anacardiaceae
Buchanania lanzan Lf A - - - - - - - -
Spreng. M 10 - - 12 12 14 - 13
Lannea coromandelica Lf A 12 - - 10 - - 10 9
Tridax procumbens L. Lf A 10 - 13 - - - - -
M 12 - 12 - - - - -
Barringtoniaceae
Barringtonia acutangula ND
(L.) Gaertn.
Bombacaceae
Bombax ceiba L. Gu A - - - - - - - -
m
M 10 - - - - - 12 -
Bignoniaceae
Oroxylum indicum (L.) Bk A 10 - - - - - - -
Vent.
M 10 12 - - - - - 13
Burseraceae
Boswella serrata Roxb. Lf A - - - - - - - -
M - - - - - - - -
Caesalpiniaceae
Bauhinia purpuria L. Lf A - - - - - - - -
M - - 11 - - - - -
Bauhinia racemosa Lam. Lf A - - - - - - - -
M - - - - - - - -
Bauhinia variegata L. Lf A - 10 - - - - - -
M - 12 12 - - - - -
Bauhinia vahlii W. & A. Lf A - - - - - - - -
M - 12 10 - - - - -
Cassia fistula L. Lf A 9 12 12 11 12 12 11 9
M 13 12 13 12 12 12 10 12
Saraca asoca (Roxb.) de Lf A - - - - - - - -
Wilde M - - 13 - - - - -
Tamarindus indica L. Lf A - - 12 - - - - 10
Cucurbitaceae
Coccinia grandis Lf A 12 11 - - - - - 11
(L.) Voigt M - 14 - - - - - 12
Momordica charantia L. Lf A - 12 - - - - 12 -
M - 14 - - - - - -
Cyperaceae
Cyperus rotundus L. Lf A - 10 - - - - - -
M - 12 - - - - - 10
Dipterocarpaceae
Iridaceae
Eleutherine bulbosa Bl A - 14 - - - - - 17
(Miller) Urban M 12 15 - - - - 11 15
Lamiaceae
Hyptis suaveolens (L.) Poit. Lf A - - - - - - - -
M - - 10 - - - - -
Ocimum canum Sims Lf A - - - - - - - 10
M 12 - - - - - - 12
Ocimum sactum L. Lf A - 10 - - - - - 10
M 10 10 - - - - - 10
Pogostemon benghalensis ND
(Burm.f.) Kuntze
Lauraceae
Litsea glutinosa (Lour.) Lf A - - 10 - - - - -
Robin M 10 11 12 - - - - -
Lecythidaceae
Careya arborea Roxb. Lf A - - - 10 - - - -
M 12 - 12 12 - 15 - 14
Liliaceae
Allium cepa L. Bl A - - - - - - - -
M - - - - - - - -
Asparagus racemosus Rt A - - - - - - - -
Willd. M - - - - - - - -
Lygodiaceae
Lygodium flexuosum L. Wp A - - - - - - - -
M - - - - - - - -
Lygodium microphyllum Lf A - - - - - - - -
Lythraceae
Lawsonia inermis L. Lf A - - - - - - - -
M - - 12 - - - - -
Woodfordia fruticosa Lf A - - - - - - - 12
(L.) Kurz M - - 11 - - - - 14
Malvaceae
Hibiscus rosasinensis L. Lf A - - - - - - - -
M - - - - - - - -
Sida acuta Burm.f. Lf A - - 10 - - - - -
M - - 13 - - - - -
Melastomataceae
Melastoma malabathricum L Bk A - - 10 - - - - -
M - - 20 - - 12 - 16
Soymida febrifuga Lf A - - - - - - - -
(Roxb.) A. Juss. M - - - - - - - -
Meliaceae
Azadirachta indica A. Juss. Bk A 11 - 13 - - - - 12
M 10 - - - - - - 12
Menispermaceae
Cissampelos pareira L. Rt A - - - - - - - 12
M 12 - - 14 - 10 10 14
Tinospora cordifolia (Willd.) Wp A - - - - - - - 12
Hook.f.& Thoms. M 10 - 13 11 - 10 10 14
Mimosaceae
Acacia catechu (L.f.) Willd ND
Acacia leucophloea Lf A - 10 - - - - - 9
(Roxb.)Willd. M 10 12 10 - - - 12 14
Acacia nilotica (L.) Delile ND
Moringaceae
Moringa oleifera Lam. Lf A 12 10 8 - - - - -
M 14 11 12 - - - 10 12
Musaceae
Musa paradisiaca L. Fl A - - - - - - - -
M - - - - - - - -
Myrsinaceae
Ardisia solanacea Roxb. Lf A - - - - - - - -
M 10 10 - - - - - -
Myrtaceae
Psidium guajava L. Lf A - - - - 10 - - 12
M - - - - 13 - - 14
Syzygium cumunis L. Bk A - - - - - - - -
M - - - - - - - -
Nyctaginaceae
Boerhavia diffusa L. Lf A - - - - - - - -
M - - 9 - - - - -
Oleaceae
Nyctanthes arbortristis L. Lf A 12 - 10 - - 10 - 12
M 20 - 13 10 - 12 - 10
Bk A 12 10 10 12 - 12 - 14
M 23 10 18 12 12 11
Oxalidaceae
Oxalis corniculata L. Wp A - - - - - - - -
M - - - - - - - -
Pedaliaceae
Sesamum orientali L. Wp A - - - - - - - -
M - - - - - - - -
Piperaceae
Piper longum L. Sd A 10 10 - 12 - 10 10 10
M 13 13 10 12 - 12 13 14
Piper nigrum L. Lf A - - - - - - - -
M - - - - - - - -
Plumbaginaceae
Plumbago zeylanica L. Lf A - - - - - - - -
Punicaceae
Punica granatum L. Lf A 10 10 14 - 10 - - 12
M - - 12 - 12 - - 10
Ranunculaceae
Thalictrum foliolosum DC. ND
Rutaceae
Aegle marmelos L. Lf A - - - - - - - -
M - - - - - - - -
Sapendaceae
Allophylus serratus (Roxb.) ND
Kurz
Schleichera oleosa (Lour.) Wp A - - - - - - - -
Oken M - - - - - - - 10
Sapotaceae
Mimusops elengi L Bk A - - 10 12 - - - -
M - - 14 12 12 - 12 -
Smilacaceae
Smilax zeylanica L. Lf A - - - - - - - -
M - 12 - - 11 - 10 12
Solanaceae
Nicotiana tabacum L. Lf A - - - - - - - -
M - - - - - - - -
Sterculiaceae
Helicteres isora L. Lf A 11 - - 10 - - - 12
M - - - 8 - - - 10
Fr A - - - - - - - -
M 11 - - - - - - 12
Rt A 12 12 - 12 - - - 14
M 14 10 - 10 - 10 - 12
Pterospermum acerifolium Lf A 10 10 - - - 10 - 12
Strychnaceae
Strychnos nux-vomica L. Sd A - - - - - - - -
M - - - - - - - -
Tiliaceae
Grewia hirsute Vahl. Lf A - - - - - - - -
M 10 - - - - - - -
Grewia helicterifolia Lf A - - - - - - - -
Wall. ex. G. Don M - - - - - - - -
Trapaceae
Trapa natans L. Lf A - - - - - - - -
M - - - - - - - -
Ulmaceae
Trema orientalis (L.) Bl. Lf A - - - - - - - -
M - - - - - - - -
Verbenaceae
Vitex negundo L. Lf A 10 10 - - - - - -
M 12 10 14 10 - - - 10
Bk A 10 - 10 - - - - 12
M 18 - 16 - - - - 17
Zingiberaceae
Curcuma angustifolia Lf A - - - - - - - -
Roxb. M - - 8 - - - - 10
Curcuma aromatica Salisb. Rh A - - - - - - - -
M - - 12 - - - - 12
Zingiber officinale Rosc. Rh A - - - - - - - -
M 10 - 12 - 12 - - 14
Among the test strains the most sensitive strains were recorded in decreasing order
were S. typhi followed by E. coli, Vibrio cholerae, S. typhimurium, V. alginolyticus, E. coli
Nigella satavia (Ranunculaceae), used to treat numerous ailments including diarrhea and
its essential oil has been shown to exhibit activity against Staphylococcus aureus,
Salmonella, Shigella, V. cholerae, and E. coli (Ali et al. 2003). Swertia corymbose shows
antibacterial activity against a wide range of microorganisms, including (E. coli,
Salmonella sp., V. cholerae and Staphylococcus aureus) that cause diarrhea. Vijaya et al.
1997 reported 10 Indian traditional plants (Allium sativum, Bauhinia racemosa, Camellia
sinensis, Euphorbia hirta, Cissampelos pareira, Acorus calamus, Psidium guajava and
Sphaeranthus indicus) used to treat dysentery and diarrhea showed high antibacterial
activity. Methanol and water extracts of a number of medicinal plants used to treat
dysentery and diarrhea in the Democratic Republic of Congo showed activity against
one or more enteropathogens, including Shigella, Salmonella, E. coli, Vibrio and
Campylobacter (Longanga-Otshudi et al. 1999). Diehl et al. 2004 evaluated 60
traditionally used plants in human or veterinary medicine to treat worm infections
(worms in general, round worms, Guinea worms, or flatworms), diarrhea, dysentery
and abdominal pain.
Modern scientific evaluation of medicinal plants and herbs is concerned with validating
the traditional use of plants as well as identifying the active components of extracts and
preparations. With respect to traditional medicines used to treat diarrheal diseases, such
medicines will continue to be used as long as there are communities with limited access
to modern therapies. In future, it may be possible to supplement conventional ORS
treatment with plant extracts resulting in complementary treatments that may lead to a
reduction in the length of disease symptoms.
CONCLUSIONS
This study proves that use of plants for treatment of diarrhea and dysentery among the
tribes of Similipal is still a major part of life and culture. The data collected show that
majority of remedies are taken orally in fresh form. The study concludes that the tribes
are depending on traditional medicinal uses and modern health system is far away
from them. It is necessary to acquire and proper documentation of the knowledge of the
tribes of Similipal, Mayurbahnj. The result obtained in the present study point out that
in their crude form bout 75 % have scientifically proved as medicinal uses with respect
to the antibacterial properties against diarrhea causing bacteria.
RECOMMENDATION
Surely, the evidence provided by this study will encourages further investigation in the
expectation that alternative treatments for diarrheal diseases will be developed. Further
ACKNOWLEDGEMENT
The authors wish to thank Prof. S. K. Dutta and Dr. A. K. Bastia (North Orissa
University) for their guidance during my Ph. D. and providing facilities for this work.
We wish to express our profound gratitude to Dr. A. K. Biswal (North Orissa
University) for identification of the plant samples. Thanks are also to S. K. Jena, B.
Behera, D. Dubey, N. Patra and Y. K. Mohanta (North Orissa University), Dr. Sanat
(Ayurvedic doctor, Badasahi, Mayurbahnj) for collection of plant samples and expert
technical help during experiment. SKP is also grateful for financial support provided by
DST, Govt. of Odisha. Finally, we wish to thank to all the tribal informants as they
travelled with me and help in collection, identification and provided traditional uses of
plants. We also thankful to all other informants those provide me information on
medicinal uses and helps in communicating in vernacular languages. Hope that the
information produced from these studies will be of use to them in future.
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Background Papers· Burden of Disease in India; Estimation of the burden of diarrheal
diseases in India.
Eric Boahen
Department of Statistics, Faculty of Mathematical Sciences, University For Development
Studies –Tamale.Box 24 uds Navrongo- Ghana.
ABSTRACT
Typhoid fever is one of the top ten outpatient diseases that is recorded by the
Akuse Government Hospital. Akuse is a big town located in the eastern region
of Ghana. The Government Hospital located in the area recorded a continuous
substantial increase in the number of typhoid fever cases. This substantial
increase was partly attributed to the fact that the probability of an individual
to be healed of the disease was relatively low. As a result of this, a five staged
clinical trial was conducted by the hospital to assess the probability of being
cured after receiving treatments. This five staged clinical trial was used in the
research to assess the survivability growth and reliability of the typhoid fever
drugs administered. The research was carried out by first, obtaining the
observed survival probabilities at each stage and then the maximum likelihood
estimates and least squares estimates were found. The Newton-Raphson
procedure was used in the calculation of the maximum likelihood estimates. An
appropriate (1-α) 100 percent lower confidence limit was then constructed for
each stage of the clinical trial. In clinical trials, patients response to treatment
is classified as success or failure, therefore, the overall probability of success in
the clinical trial was then assessed with the aid of smoothen constants. The
study identified that the drugs administered had huge effect on the survival of
an individual and it was therefore recommended that the Hospital creates an
awareness program for the people of Akuse to know that treating typhoid the
drugs used in the clinical trial helps in curing typhoid. Also, the Akuse
Government Hospital in their endeavor to the increase the curing rate of
typhoid fever in the township should encourage patients to take drugs
prescribed to the patients well.
INTRODUCTION
Introduction
The purpose of the study was to find out the reliability and growth in the healing
process of typhoid fever at Akuse in the Lower Manya District. This chapter consists of
Typhoid Fever also known as Enteric Fever can be a life – threatening febrile disease,
caused by the bacterium Salmonella Typhi. According to the Centre for Disease and
Control (CDC) an estimated 22 million cases of typhoid fever and 200 000 related deaths
occur worldwide every year. Typhoid is common in most parts of the developing
world. In Ghana, a study conducted in 2010 has shown that typhoid fever ranks among
the leading causes of outpatient illness accounting for 0.92% of hospital admissions.
Typhoid fever belongs to the family Enterobacteriaceae and has been associated with
gastroenteritis and food borne diseases. The salmonella species is the etiological agents
of most food borne disease and gastroenteritis.
In the year 2011, three hundred and twenty two cases (322) of typhoid fever were
recorded in the Akuse Government Hospital with seven hundred and seventy two (772)
cases and one thousand (1000) cases in 2012 and 2013 respectively.Domestically
acquired typhoid fever, however, is often transmitted by chronic carrier of salmonella
typhi. After recovering from typoid fever, some individuals carry the bacterium
asymptomatically for long periods; others are asymptomatic carriers without ever
having the disease. The silent carriers contribute to continued episodes of infection.
Most of the disease is acquired by people travelling overseas (Prescott, 1999).
According to CDC, one can get typhoid fever if food or drink beverages that have been
handled by a person who is shedding Salmonella Typhi are ingested or if sewage
contaminated with Salmonella Typhi bacteria gets into the water used for drinking or
washing food. Therefore, typhoid fever is more common in areas of the world
where hand washing is less frequent and water is likely to be contaminated with
sewage. World Health Organization (WHO) also mentioned the mode of transmission
of the disease as through the ingestion of food or drink contaminated by the faeces or
urine of infected persons.
Typhoid fever in Akuse is mostly attributed to the works of witchcraft and other
demonic powers. The people of Akuse believe that the disease can be transmitted onto a
person by spiritual means. In a blog posted on March 10th, 2012 by one researcher
named BiorKwerBiorJr (Borglobe), he mentions that the people of South Sudan and
other neighboring countries have a myth that typhoid fever is attributed to the sun.
Case-fatality rates of 10% can be reduced to less than 1% with appropriate antibiotic
therapy. However, strains resistant to chloramphenicol and other recommended
antibiotics (ampicillin, cotrimoxazole and even ciprofloxacin) have become prevalent in
several areas of the world. It usually takes two weeks for patients treating typhoid fever
to be fully cured.
Typhoid fever can also be treated herbally using the roots, bark and leaves of plants.
The use of mauringa is highly recognized in Akuse for the treatment of typhoid fever
and other fever related diseases.
CDC described measures of preventing the disease in four ways; boil it, cook it, peel it
or forget it. The Centre for Disease Control listed these measures of preventing or
avoiding typhoid;
The following problems are faced in the treatment process of typhoid fever;
Patients do not take medications as prescribed by the doctor or health
practitioner.
Patients do not heed to the doctor‟s advice by not returning for a checkup after
two weeks when the bacteria and the symptoms are expected to have gone.
Some patients feel reluctant to report signs and symptoms early but rather wait
till the symptoms become severe before seeking medical attention
Problem Statement
Typhoid fever is one of the leading causes of death among children and adults in
Ghana.
Study has shown that, EasternRegion has high cases of typhoid. Our study has also
shown that, Eastern Region is one of the regions with high typhoid cases due to the
open defecation practice, dirty surroundings and unhygienic practices.Typhoid fever is
one of the top 10 out-patient diseases in Ghana according to the Ghana health service. It
is rated among the top killer diseases in Ghana.
Typhoid fever cases in Akuse are on the rise. The typhoid fever cases at Akuse in the
eastern region for the year 2011, 2012 and 2013 are three hundred and twenty two (322),
seven hundred and seventy two (772) and one thousand (1000) respectively and the
recovery rate for the patients have been low. There is a situation at Akuse where
infected persons who report to the hospital, diagnosed with the disease, given
medication to follow and are asked to come back for review end up, taking the
medication until when the infected person feels his situation is better but not when the
dosage of the medication has been fully completed.
The infected persons also ignore the review instruction set by the doctor or health
practitioner. Therefore, the fact that, an infected person is fully cured of the disease and
There is a low level of sanitation at Akuse and hygienic conditions are also poor.
Infected persons, who do not wash their hands before handling food and water,
contaminate the food. When another person consumes tainted food or water, he picks
up the typhoid bacteria and become infected.
Some people, known as chronic carriers, still harbor typhoid bacteria (and can still
contaminate food and water supplies) even after receiving antibiotic treatment and
proving to be free of symptoms.
All these conditions add up to the increasing rate of typhoid cases at Akuse. In this
regard, the research was interested in studying the survivability growth and the
reliability of typhoid fever drugs at Akuse in the Eastern Region of Ghana.
Research Questions
These research questions have been outlined for the project.
How reliable is the drug?
Is the healing process improving?
Is the overall survival probability at each stage of the clinical trial good?
METHODOLOGY
Introduction
This chapter introduces the methodology adopted in the study. It discusses the study
area, the design of the research, sample size selection, population of study, technique
used in the data collection, sampling techniques, statistical analysis, and procedures
and describes the theory of the model used, formulations and methods of analyzing the
available data to satisfy the objectives of the study.
Study area
The study was conducted among typhoid fever patients in the Akuse Government
Hospital. The hospital is one of the biggest in the ManyaKrobo District and also one of
the oldest in the country. The Akuse Government hospital is located at the entrance of
the Akuse town, opposite the Ghana Commercial Bank. It serves people from
neighboring towns and villages. The people of Akuse are mainly farmers and petty
traders. Some of the indigenes are employed with the anana farm plantation located
close to the town. The Kpong Generation Station, with four power turbines, which
produces power for the national grid is also located at Akuse. Therefore, Akuse also
inhabits the Volta River Authority (VRA) workers, who work in the generation station.
* + . / ( ) …(1)
The proportion of survivors from the data, increases from stage to stage. is a function
of two parameters as well as the stage number i. The exponential model is given by
( ) …(2)
Least Squares
Let us define ( ) as
( ) ∑ 0 ( )1 …(3)
The least squares estimator and are the values of the parameters and ,
respectively, that simultaneously minimize ( ). Assuming that ( ) is
differentiable in and , , and that the minimum is obtained by
differentiation, we find and as the solution of
( )
∑ 0 ( )1 …(4)
and
( )
∑ 0 ( )1 …(5)
where
That is, and are the least squares estimators of and , respectively.
Maximum Likelihood
Given the probability that patients of on trial at stage survive, Thus
the stages being statistically independent, the likelihood function for all k stages is
given by
( ) ∏ . /, ( )- , ( )- (7)
Assuming that the parameter vector ( ) can be maximized with respect to the
observations by maximum likelihood procedures, the maximum likelihood estimator ̂
and ̂ are the values of the parameters and , respectively, that simultaneously
maximize ( ) or equivalently ( ) The vector ( ̂ ̂ ) is then the
simultaneous solution of
(̂ ̂ ) (̂ ̂ )
∑ ∑ (8)
(̂ ̂ ) ̂ (̂ ̂ ) ̂
and
(̂ ̂ ) (̂ ̂ )
∑ ∑ (9)
(̂ ̂ ) ̂ (̂ ̂ ) ̂
that maximizes ( ̂ ̂ ), where
(̂ ̂ ) ( )
̂
| ̂
. (10)
̂
7
theoritical growyh in survival
4
Y-Values
3
0
0 1 2 3 4 5 6
stages
This model depicts a slower growth in the early stages which sustains itself in the later
stages.
Let ( ) be defined by the exponential growth model. That is
( ) ( ) (11)
the least squares estimator and are obtained in the following ways. First
. / ( ) (13)
Where
As a result of this a least squares fit on the logarithm is used to obtain and . The
least squares equation is then
( ) ∑ 0 1 (14)
These are used as the least squares estimators of the exponential growth model. The
maximum likelihood function for the exponential growth model. Let ( ) be the
likelihood function for all k stages of the trials.
Then we have
( ) ∏ . /( ( )) ( ( ))
(19)
Taking logarithms and then differentiating with respect to and , the maximum
likelihood estimators ̂ and ̂ are obtained as the unique solution to
∑ ( )
∑ (20)
, (̂ ) ̂ - ̂
And
̂ ∑ , ( ) ̂ -
∑ ( ) (21)
Therefore taking the logarithm and differentiating with respect to and , we have
0∑ ∑ 1 (22)
, ( ) -
( )
∑ (23)
, ( ) -
and
( )
∑ (24)
, ( ) -
and
∑ (29)
( )
Assessment model for the overall probability of success in the clinical trial
Patients‟ response to treatment in clinical trials is classified as “success” or “failure”.
Models developed have been concerned in estimating the probability of success (failure)
at each stage for clinical trials conducted in stages. We are to assess the overall
probability of success at the end of each stage of the clinical trial conducted in stages.
At the first stage of the trial, ̃ the estimate for patient response is given by
̃ (33)
Where, = patients under stage ὶ, = patients are those who respond for stage ὶ,
The overall assessed probability of patient response after each stage the model is
Using the empirical approach or method discussed by Gross [1971b] in determining the
smoothing constant, we make the following assumptions,
̂ is an unbiased estimator of , where is the theoretical assessment of the
overall probability of success after the trial,
( ), thus is the probability that a patient on study during the stage
responds.
All patients within a stage have the same independent probability of response.
Furthermore, the stages are independent.
The criterion for the choice of each smoothing constant ̂ is to minimise the variance
̂ of its associated value ̂ by assumption 1 through 3.
̂
̂ (35)
∑
( )
̂ (36)
Hence
̂ ( )
(37)
̂ = inverse estimated variance for each stage
̂ = smoothing constant for each stage
The five staged clinical trial, has in each stage a total of ten patients who underwent the
trials. In each stage of the clinical trial some of patients were unable to be cured of the
disease, others did. The patients, who after two weeks, are supposed to be cured of the
disease, were grouped into healed and not healed. That is, those patients that were
cured of the disease were grouped under healed and those that were not cured, placed
under not healed. Stage one of the clinical trial had six patients healed and four patients
not healed. Stage two and stage three had seven patients healed and three patients not
healed each. Stage four had eight patients being healed and two patients not healed.
Stage five had nine patients out of ten healed.
The proportion of patients being cured at each stage of the clinical trial is derived. This
is done by dividing the total number of patients that were healed in the stage by the
total number of patients in that stage of the clinical trial. This proportion of patients also
depicts the survival probabilities of each stage. The table below shows the details of the
data collected.
Table 1: Stage by stage clinical trial with survival probability of each stage
Stages Total Number of Number of Number of Number of Survival
number of males females patients patients not probability
patients healed healed
1 10 4 6 6 4 0.6
2 10 3 7 7 3 0.7
3 10 5 5 7 3 0.7
4 10 6 4 8 2 0.8
10 4 6 9 1 0.9
Table 1 shows an improvement in the number of patients that are healed from stage-to-
stage. Plotting the survival probabilities of each stage aids in determining the
exponential model used in the analysis of the data. The graph in Fig 2 shows the
graphical display of the survival probabilities.
1
Survival Probabilities
0.8
0.6
0.4
0.2
0
0 1 2 3 4 5 6
Stage Number
Fig 2: Graph of Survival probabilities as a function of the stages (i) for typhoid fever
remission
X-axis = stages, Y-axis = survival probabilities
Fig 2 shows the survival probabilities having a slower growth in the early stages which
sustains itself in the later stages. This determines the use of the exponential model in the
analysis of the data. The exponential model is used when at the early stages of the
clinical trial the survival probabilities show a slow growth and later sustains itself.
Numerical analysis
Two methods are commonly used in the estimation of and . These are the
maximum likelihood and least squares. Maximum likelihood estimators are generally
preferred to least squares estimators because of the desirability of the large sample
properties of maximum likelihood estimators. On the other hand, least square
estimators are often obtainable in closed form and are good first approximation.
To this end, we obtained the initial estimates ̂ and ̂ by least square equations (17)
and (18). The estimates ̂ and ̂ were obtained from the layout in Table 2.
From Table 2 and equations (17) and (18), it follows that our initial estimates ̂ was
0.55480 and ̂ was 0.317805. These initial estimates are our least square estimates.
∑ ( )
, (̂ ) ̂ - ̂
̂
( )
, (̂ ) ̂ -
( )
, (̂ ) ̂ - ̂
(̂ )
, (̂ ) ̂ -
and
For the first iteration we used the initial estimates in the computation.
The values ̂ and ̂ were then found by solving the matrix equation
̂
( ) ( ) 0 1 ( )
̂
The values ̂ and ̂ were then found by solving the matrix equation
. ̂̂ / ( ) 0 1 ( )
Solving the matrix, ̂ and ̂ and were then used in the fourth
iteration to verify the convergence of the maximum likelihood estimates.
̂
( ) ( ) 0 1 ( )
̂
Solving the matrix, ̂ and ̂ . The iteration was stopped since the
Newton-Raphson procedure converged to the maximum likelihood estimates. Table 7
shows the results at each step of the iteration. The third iteration was chosen since
further iterations gave the requisite maximum likelihood estimates and does not change
the result.
Table 7 shows clearly that after the second iteration, the estimates begin to become the
same, that is, they converge.
It is intrusive to compare the observed and expected relief probabilities at each stage
using both least squares and maximum likelihood estimates. These comparisons appear
in Table 4.10.
Table 8: Expected and observed relief probabilities for typhoid fever patients at each
stage when the clinical trial is conducted
Stages Observed Expected Maximum Expected Least Squares
Likelihood Estimate likelihood Estimate
Probability probability probability
Table 8 indicates the growth in survivability at each stage of the clinical trial. The table
also indicates that the least square estimates tend to overestimate and the maximum
̂ ̂ ̂
* + 0 1 0 1
̂ ̂ ̂
(̂ ̂ ) ( ( ))
( )√ ( ), -
Table 9: Ninty-five (95) percent lower confidence limits for the probability of relief
from typhoid at each of the five clinical trial, plus predicted sixth stage lower limit
Stages (̂ ̂ )
1 0.3340049
2 0.5299582
3 0.6604890
4 0.7432562
5 0.7957258
6 0.8324348
Table 10: Assessed overall survival probabilities at each stage of the clinical trial
Stage ̂ ̂ ̂
Table 10 contains the overall assessed probability of patients‟ response after each stage
as well as the inverse estimated variance and smoothing constant for each stage. The
estimated variances were found to be 37.5, 42.86, 42.86, 56.25 and 100.00. Our smoothing
constants were found to minimize the variances of its associated value ̂ . The
smoothing constant were 0.533, 0.348, 0.313 and 0.358. ̂ was our overall remission
probabilities from typhoid fever at each stage.
The main objectives of the research was to assess the survivability growth and
reliability of typhoid fever drugs and also the overall probability of survival in each
stage of the clinical trial conducted by the hospital. The methodology employed to
assess the survivability growth was to find least squares and maximum likelihood
estimates of the exponential model chosen to analyze the data collected from the
hospital. The exponential model was chosen after the data collected from the hospital
was plotted on a graph. The graph showed a slow survivability growth in the early
stages which sustained itself in the later stages of the clinical trial.
The maximum likelihood estimates and the least squares estimates was used to find
expected maximum likelihood estimate probabilities and expected maximum likelihood
probability estimates, respectively, which was compared with the observed probability
estimates. The confidence interval and region for the probability of relief at each stage
was also calculated. The overall probability of success at each stage of the clinical trial
was calculated for by finding the inverse estimated variance and smoothing constants
for each stage. These in turn aid in assessing the overall probability of success in each
stage of the clinical trial.
The Least squares estimates were found to be the initial estimates of the maximum
likelihood estimates. These initialestimates ̂ was 0.55480 and ̂ was 0.317805. The
initial estimates was used in the computation for the Newton-Raphson procedure for
the calculation of the maximum likelihood estimates. By the Newton-Raphson
procedure, the maximum likelihood estimates was obtained by going through series of
iterations for the Newton-Raphson procedure to converge at an estimate. After the
second iteration, the Newton-Raphson procedure converged at ̂ and
̂ . The third iteration was chosen since further iterations gave the requisite
maximum likelihood estimates and does not change the result. The observed and
expected relief probabilities at each stage using both least squares and maximum
likelihood estimates was compared.
stage with its lower limit was found to be 1=0.3340049, 2=0.5299582, 3=0.6604890,
4=0.7432562, 5=0.7957258 and 6=0.8324348. A predicted value ( ̂ ̂ ) with
confidence 0.95 was also calculated for.
CONCLUSION
From the analysis made and estimates derived in the Newton-Raphson procedure, we
conclude that since ̂ , the drug is reliable and very useful in the healing process of
typhoid fever.
On whether the healing process is improving, conclusion was made on the observed
survival probabilities derived from the data collected from the hospital. The observed
probabilities showed an increase in the number of survivors at each stage of the clinical
trial. This depicts improvement in the healing process. This is further confirmed by the
expected least squares estimates probabilities and maximum likelihood estimates
probabilities derived for each stage which show increasing probabilities from stage to
stage. Noting that is a function of and , and also since is increasing that is, the
drug reliability increase from stage to stage, this in turn affects the survivability growth
and hence we conclude that there is improvement in the healing process.
RECOMMENDATION
From the conclusions theseare the recommendations we came out with.
It is obvious that typhoid fever has very high chances of being cured and hence
people affected with the disease are advised to visit the hospital to seek
treatment.
The Akuse Government Hospital in their endeavor to increase the curing rate of
typhoid fever in the township should encourage patients to take drugs
prescribed to them.
The Ghana Health Service should engage in more clinical trials to improve upon
the overall survival probabilities of patients
Future assessments and or researchers are encouraged to collect primary data
for their research.
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