Nigerian doctors identify local herb, which clears oral thrush faster and better than conventional drug. CHUKWUMA MUANYA writes.IT is becoming one of the commonest infant diseases in the country, not sparing adults with compromised immunity due to certain diseases. It comes with white patches on the tongue and general skin diseases in infants (called nla in Yoruba and obu in Ibo); and in adults with white patches in genital areas.Thrush or candidiasis, caused by Candida albicans, is on the prowl. But a local herb has been demonstrated by medical doctors to be more efficacious than a conventional antifungal drug, Nystatin, in the treatment of thrush.Nigerian researchers have confirmed the efficacy of the juice extracts of a local plant, Jatropha multifada, in the management of oral candidiasis.The paediatricians in a preliminary study published in The Internet Journal of Alternative Medicine concluded: Compared to oral Nystatin suspension, it has the advantages of acting faster and being efficacious as a single dose. Its use in the management of oral candidiasis is recommended in third world countries where it is easily cultivated and accessible.The researchers include: Dr. Aladekomo Theophilus Adesola, lecturer/ consultant paediatrician at the Department of Paediatrics and Child Health , Obafemi Awolowo University (OAU), Ile-Ife, Osun State; and Dr. Oyedeji Olusola Adetunji, lecturer/ consultant paediatrician at theDepartment of Paediatrics and Child Health , Ladoke Akintola University of Technology Teaching Hospital (LAUTTH), Osun State.The study is titled The Efficacy of Jatropha multifida in the Management of Oral Candidiasis: A Preliminary Study.Commonly called French physic nut; Spanish physic nut; coral plant, Jatropha multifida belongs to the family Euphorbiaceae. It is called ebosa in Edo; olulu idu in Ibo; botuje, botuje-pupa, lapalapa, or lobotuje in YorubaH. M. Burkill in The Useful Plants of West Tropical Africa described Jatropha multifida as, bush or tree to 6m tall, native of tropical America, and now dispersed pan-tropically. It is a village ornamental tree in the Region and is often planted in hedges, and as an object of superstition. It is said, like Jatropha gossypiifolia, to keep off snakes.The Nigerian researchers described Jatropha multifida as, a small trees or shrubs with smooth gray barks, which exudes whitish colour watery latex when cut. Other common names are coral plant and adenoropium multifidum. It normally grows to attain a height between three and seven feet. In addition, it grows well in the tropics and can thrive in almost every kind of soil.Previous studies conducted in Tanzania have shown that Jatropha multifida has significant antifugal activity, against many species of Candida, but very little against Candida albicans.However, the Nigerian study showed that the specie of Jatropha multifida cultivated in Nigeria, possess antibiotic activity against Candida albicans (thrush), and faster and more efficacious than Nysatin (a conventional drug) in the management of thrush.Oral candidiasis (thrush) is a fungal infection caused by Candida albicans. This organism is a normal flora and inhabitant of the skin, mouth, vagina and intestinal mucosa. It can be spread to a newborn infant from the mothers birth canal during vaginal delivery. Prolonged use of antibiotics, leading to alteration in the oral flora may also cause thrush. The oral lesions are usually white flaky plaques and they may cover all or part of the tongue, lips, gingival and buccal mucous membranes. Oral candidiasis can be acute in the newborn or chronic in children with nutritional deficiencies or debilitating conditions.The differential diagnoses of thrush include geographical tongue, which is an asymptomatic, benign condition that requires no treatment. It is a normal variant of tongue appearance. The tongue being covered with milk can also mimic thrush, however this milk curds can be easily scrapped off from epithelial surfaces. Diagnosis of oral candidiasis can be confirmed by direct microscopic examination and culture of the scrapings from the mucous membranes.Nystatin is the most popular choice of antifungal agent used for the treatment of oral fungal infections among general dental practitioners. Conventionally thrush is treated by the oral administration of 100,000 I.U of Nystatin suspension four times a day for seven consecutive days. One per cent aqueous solution of gential violet is also effective orally and topically, but it is messy.According to the Nigerian study, all the clinically detected cases of children with oral candidiasis at the childrens outpatient department of the Osun State Hospital, Osogbo and childrens welfare clinic of the Wesley Guild Hospital, Ilesa were randomized into either Jatropha multifadum Juice extract therapy or the Nystatin group. The juice extracts from the Jatropha multifada leaves were applied to the tongue and the oral mucosal areas affected by candida lesions as a single application in the patients randomized to this group. Oral Nystatin was administered four times a day, for seven consecutive days to the children randomized to the Nystatin group.The researchers studied a total of five patients (three boys and two girls) were studied with their ages ranging from two to 10 months. Clearance of the white lesions on the tongue was defined as cure and this was recorded within 24 hours in the patients on Jatropha multifada juice extracts, while those on oral Nystatin showed features of cure at 48 hours.The researchers wrote: The present study has shown that Jatropha multifada leaf juice extract is effective in the management of thrush and works faster compared to Nystatin. Its mechanism of action is however unknown, as well as the active ingredient responsible for the antifungal action. The drug however appears relatively safe because of the absence of complications in the present study. No side effects were also reported to Nystatin therapy in the present study. However, vomiting and diarrhea are some of the known side effects that might arise from Nystatin therapy. The small sample size in the present study might have hindered us from encountering these complications.The Jatropha multifada fruit has been documented to contain toxins such as toxabulmin ricin. Ingestion of large quantities of this fruit has been documented to cause severe diarrhea, dehydration, shock and hepatic impairment in children. Ricin also has cardiotoxic and hemolytic effects and several deaths have been reported from it. On the converse the roots, stems and leaves of the Jatropha multifida plant possess useful ingredients and activities. The fruits are widely used in traditional folk medicine in many parts of West Africa. Other chemotherapeutic properties of this plant are used in the treatment of ascites, gout and constipation.In conclusion, Jatropha multifida is a plant whose juice provides a cure for oral candidiasis. It acts faster compared to Nystatin and compliance on the part of patients is likely to be better since it is a single dose application. It is recommended for use in communities where it is easily accessible. However, further studies need to be carried out on this plant in order determine the ingredient in it, having the anti-fungal activities. This can be selectively extracted and made into oral preparations for general and commercial use.According to The Useful Plants of West Tropical Africa, the leaves and leaf-sap are purgative, but not so violently as of Jatropha curcas. It reads: In the Antilles it is said that 1012 leaves lightly cooked and eaten in a salad provide a non-griping purge, but the leaf contains a saponin and an active toxic principle, jatrophin. Leaves and fruit are boiled and taken internally or used externally in a bath as a febrifuge in Nigeria, and an infusion of young leaves is used for most urinary complaints. Root-bark and the roots are ground up as a wound-dressing, and the root is taken internally for worms and, with salt added, for gonorrhoea in Nigeria.The root produces long tubers which can be eaten like tapioca/manihot/cassava root (Manihot esculenta) after roasting. The red inflorescences are attractive, and are an item of demand by florists in the Philippines. The seeds are strongly purgative. They are sometimes used in Ivory Coast-Upper Volta. They have a nutty flavour and there are records of fatalities from eating them. A single one is sufficient to produce violent illness. An antidote is said to be a glass of white wine or other stimulant with lime-juice. Seed-oil amounts to about 30 per cent and is know as Pinhoen Oil in Brazil. It has properties similar to the oil of Jatropha curcas, and has been used as an illuminant.There is latex throughout the plant and the rubber content of leaves has been reported as 0.52 per cent. Latex has been used in the Caribbean on cancers.
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