Topical application of Charmil plus gel for treatment of FMD Myiasis: A case report

From the centuries, herbal medicines are used to treat various diseases and now they had become an entity of global importance, with both medicinal and economic implications (Yadav et al, 2012).  People's perception towards herbal medicine has also changed and is very encouraging (Dorai, 2012). Wound is defined simply as the disruption of the cellular and anatomic continuity of a tissue (Bennet, 1988) may be produced by physical, chemical, thermal, microbial or immunological insult (Rajinder et al, 2008). Delayed wound healing increases the chances of myiasis which presents a significant burden for the patient and healthcare system. Myiasis is a problem in cattle farms badly afflicting the wound healing process, induces severe pain and causes heavy economic losses through poor hide quality, reduced weight gain, loss of fertility and reduction in the production of milk (Otranto and Stevens, 2002). With the advancement of veterinary practices antibiotics are used indiscriminately to treat wound of animals. The use of synthetic antibiotics is being increasingly discouraged because their presence in dairy milk may have potential downstream effects on population health and the Agri-food chain (Taga et al., 2012). Due to emergence of multi-resistant organisms, decrease in newer antibiotics and to improve the process of wound healing and to prevent development of unwanted complications like myiasis wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management (Dorai, 2012). For this World Health Organization (WHO) has been promoting traditional medicine as a source of less expensive, comprehensive medical care, especially in developing countries (Shafiuddin et al, 2009). By their antibacterial potency (Watkins et al, 2012, Pazyar et al, 2012), emollient, astringent, antiseptic, anti-inflammatory, biostimulator, antioxidant, and cytotoxicity (Chusri et al, 2013, Hsiao et al, 2012, Mukherjee et al, 2003) epithelizing and cicatrizing effect, active principles from herbal products contribute to the acceleration of the wound-healing process (Mogosanu et al, 2013). Today more than 70% of wound healing pharma products are plant based, 20% are mineral based and remaining containing animal products as their base material (Kumarasamyraja et al, 2012). Wound healing herbal extracts promote blood clotting, fight infection, and accelerate the healing of wounds (Thakur et al, 2011). Herbal topical application Charmil plus gel contains the oils of Pongamia pinnata, Cedrus Deodara, Azadirachta indica as chief ingredients. therapeutic efficacy of Charmil gel against various skin ailments, wound healing has been documented by many authors (Sharma et al, 1995., Pathak et al, 1995., Gahlot et al, 1995., Khurana et al, 1994., Sangwan et al, 1994). Treatment of herbal topical preparation Charmil Plus gel was evaluated in FMD Myiasis.

Present investigation was conducted by C. V. Sc & A.H., R. K. Nagar, on cattles of surrounding villages of R. K. Nagar, of Tripura state. Six (n=6)  of FMD Myiasis were tentatively diagnosed and given treatment with Charmil plus gel (Supplied by M/s Ayurvet Ltd, Baddi, HP; India). Clinical observation of animals e.g. heart beat, respiration rate, rectal temperature, behavioral change, mobility and seclusion were recorded. Wound healing action was determined on the basis of larvicidal/maggoticidal activity of gel, weekly estimation of bacterial count from wound exudate, blood serum protein, albumin-globulin ratio. The gross physical appearance of the wound and the status of healing was recorded as per the method of Kumar (1999) on 0-3 scale as swelling (0-3), exudation (0-3), warmth (0-2), pain (0-2). Record of percentage of wound contraction, time taken for recovery of lesion, time taken for complete healing of wound, number of applications required, larvicidal action of test products was done.

The site of myiasis was interdigital space. All the animals exhibited clinical signs of loss of appetite, poor to no mobility, seclusion, irritation at the site of wound & margin induration at wound site. Topical preparation charmil plus gel was applied to wound site twice daily. After application for 3-4 days, signs of wound healing were evident. There was significant normalizations of physiological parameters , improvement in appetite and in appearance of wound site. Average time taken for recovery of wound when treated with Charmil Plus gel was 5.17 days. Average time taken for complete healing of wound when treated with Charmil Plus gel was 9.34 days. Recovery was confirmed from bacterial count (cfu/cm²), the mean value before the treatment with Charmil plus gel was 185367 and it significantly reduced to 184.83. Physiological and biochemical parameter after treatment values were significantly normalized in both the treated groups as compared to untreated control. Charmil plus gel exhibited the profound maggoticidal action in the current investigation (Fig. 1).All of the physiological parameters after treatment of wound with Charmil plus gel were normalized indicative of recovery. Charmil plus gel contains oils of Pongamia pinnata and Cedrus deodara and Azadirachta indica as main ingredients. Their use in healing FMD wound and controlling maggots has been mentioned by Singh & Misri, 2006 and Subrahmanyeswari & Chander, 2013.  The findings in the present study are in corroboration with the earlier study where use of oils of Pongamia pinnata and Azadirachta indica are mentioned for healing FMD wound and controlling maggots (Singh & Misri, 2006 and Subrahmanyeswari & Chander, 2013). Pongamia pinnata is also  reported to be useful as potential anti-inflammatory agent in the treatment of acute, sub acute and chronic models of inflammation (Srinivasan et al, 2001, Porwal et al, 2010) as analgesic and antipyretic (Srinivasan et al, 2003) . The results in present study are also in close resemblance to another study where anti-microbial activity and wound contraction studies of other herbal formulation containing Azadirachta indica was studied. In it the rate of wound contraction was found to reach a maximum on the 12th day in the treated groups (Bhat et al, 2007). In addition to above, use of Pongamia pinnata oil for effective treatment of mange was done earlier with significant findings. (Ansari et al, 1997., Thakur et al, 1997., Latasana Devi et al, 1997., Sharma et al, 1995., Pathak et al, 1995., Gahlot et al, 1995., Khurana et al, 1994., Sangwan et al, 1994). 

From the present study, it can be concluded that Charmil Plus gel is efficacious in treatment & complete wound healing of FMD Myiasis and it possesses potent antibacterial and maggoticidal activity.

Fig: 1. FMD Myiasis (Before treatment)

Fig: 1. FMD Myiasis (After treatment)