1
|
Gupta AK, Wang T, Cooper EA, Summerbell RC, Piguet V, Tosti A, Piraccini BM. A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management. J Eur Acad Dermatol Venereol 2024; 38:480-495. [PMID: 38010049 DOI: 10.1111/jdv.19644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023]
Abstract
Nondermatophyte moulds (NDMs) are widely distributed and can be detected in association with mycotic nails; however, sometimes it can be challenging to establish the role of NDMs in the pathogenesis of onychomycosis (i.e. causative vs. contaminant). In studies where the ongoing invasive presence of NDMs is confirmed through repeat cultures, the global prevalence of NDMs in onychomycosis patients is estimated at 6.9% with the 3 most common genus being: Aspergillus, Scopulariopsis and Fusarium. NDM onychomycosis can, in many cases, appear clinically indistinguishable from dermatophyte onychomycosis. Clinical features suggestive of NDMs include proximal subungual onychomycosis with paronychia associated with Aspergillus spp., Fusarium spp. and Scopulariopsis brevicaulis, as well as superficial white onychomycosis in a deep and diffused pattern associated with Aspergillus and Fusarium. Longitudinal streaks seen in patients with distal and lateral onychomycosis may serve as an additional indicator. For diagnosis, light microscopic examination should demonstrate fungal filaments consistent with an NDM with at least two independent isolations in the absence of a dermatophyte; the advent of molecular testing combined with histological assessment may serve as an alternative with improved sensitivity and turnover time. In most instances, antifungal susceptibility testing has limited value. Information on effective treatments for NDM onychomycosis is relatively scarce, unlike the situation in the study of dermatophyte onychomycosis. Terbinafine and itraconazole therapy (continuous and pulsed) appear effective to varying extents for treating onychomycosis caused by Aspergillus, Fusarium or Scopulariopsis. There is scant literature on oral treatments for Neoscytalidium.
Collapse
Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Mediprobe Research Inc., London, Ontario, Canada
| | - Tong Wang
- Mediprobe Research Inc., London, Ontario, Canada
| | | | - Richard C Summerbell
- Sporometrics, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, University of Miami, Miami, Florida, USA
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
2
|
Balasubramanian A, Akbar Ali NA, Pugazhenthi A, Gopalan K, Tamil Selvan S, Ramalingam K. A clinical prevalence of dermatophytic mycoses with an assessment of its clinical manifestations in a tertiary care hospital at Salem, South India. Mycoses 2024; 67:e13707. [PMID: 38366126 DOI: 10.1111/myc.13707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Dermatophytosis is very common among all age groups throughout the world. The incidence of the same is increasing on a steady basis. AIM Estimating the clinical prevalence of dermatophytes mycoses among the patients visiting the outpatient unit and assessing its distinct manifestations. METHODOLOGY A prospective observational study was conducted with the patients attending the Skin and STD outpatient unit of a tertiary care teaching hospital in Salem. A total of 3068 outpatients attended the department, of which 420 patients were diagnosed with dermatophytic mycoses and were taken for investigating the prevalence. RESULTS A total of 420 dermatophytosis patients were included giving a percentage prevalence of 13.69%. There were more female patients (n = 213, 50.71%) than males (n = 207, 49.29%). The most common afflicted age group was 31-40 years (n = 99, 50.71%). Most of the patients had an atypical lesion called tinea incognita (n = 265, 63.09%) where there was no typical classic appearance of dermatophytic infections. The most prevalent clinical manifestation was tinea corporis (n = 73, 17.38%) followed by tinea cruris (n = 69, 16.43%). There were more newly diagnosed dermatophytosis cases (n = 326) than the previously diagnosed cases (n = 94). CONCLUSION This study concludes that dermatophytic mycoses were more prevalent among females than males and among the age groups of 31-40 years. The most common clinical presentation was tinea incognita followed by tinea corporis.
Collapse
Affiliation(s)
- Arul Balasubramanian
- Department of Pharmacy Practice, Vinayaka Mission's College of Pharmacy, Vinayaka Mission's Research Foundation, (Deemed to be University), Salem, Tamil Nadu, India
| | - Nazer Ali Akbar Ali
- Department of Pharmacy Practice, Vinayaka Mission's College of Pharmacy, Vinayaka Mission's Research Foundation, (Deemed to be University), Salem, Tamil Nadu, India
| | - Atchaya Pugazhenthi
- Department of Pharmacy Practice, Vinayaka Mission's College of Pharmacy, Vinayaka Mission's Research Foundation, (Deemed to be University), Salem, Tamil Nadu, India
| | - Kannan Gopalan
- Department of Skin and STD, Vinayaka Mission's Kirupanandha Variyar Medical College and Hospitals, Vinayaka Mission's Research Foundation (Deemed to be university), Salem, Tamil Nadu, India
| | - Silambarasan Tamil Selvan
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - Kothai Ramalingam
- Department of Pharmacy Practice, Vinayaka Mission's College of Pharmacy, Vinayaka Mission's Research Foundation, (Deemed to be University), Salem, Tamil Nadu, India
| |
Collapse
|
3
|
Bouazzi D, Andersen PL, Jacobsen EW, Arendrup MC, Jemec GBE, Saunte DML. Nationwide epidemiology and treatment pattern of superficial fungal infections in the Faroe Islands: a retrospective study from 2003 to 2019. APMIS 2023; 131:564-566. [PMID: 37186327 DOI: 10.1111/apm.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Dorra Bouazzi
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Lindsø Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ester Weihe Jacobsen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maiken Cavling Arendrup
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ditte M L Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
4
|
Chen XQ, Yu J. Global Demographic Characteristics and Pathogen Spectrum of Tinea Capitis. Mycopathologia 2023; 188:433-447. [PMID: 37012556 DOI: 10.1007/s11046-023-00710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/07/2023] [Indexed: 04/05/2023]
Abstract
Tinea capitis is an important superficial fungal infection with a global distribution. It mainly affects prepubertal children and is more common in males. Anthropophilic and zoophilic dermatophytes are responsible for most infections. The pathogen spectrum of tinea capitis varies across different regions and changes over time, and is influenced by multiple factors, such as economic development, changes in lifestyle, immigration and animal distribution. This review aimed to clarify the demographic and etiological characteristics of tinea capitis worldwide and determine the common trends of causative pathogens. By mainly analyzing the literature published from 2015 to 2022, we found that the incidence and demographic characteristics of tinea capitis remained generally stable. Zoophilic Microsporum canis, anthropophilic Trichophyton violaceum and Trichophyton tonsurans were the predominant pathogens. The pathogen spectra in different countries changed in different directions. In some countries, the main pathogen shifted to an anthropophilic dermatophyte, such as T. tonsurans, Microsporum audouinii or T. violaceum; in contrast, it shifted to a zoophilic agent, such as M. canis, in some other countries. Dermatologists are advised to continue monitoring the pathogen spectrum and implement preventive measures according to the reported changes.
Collapse
Affiliation(s)
- Xiao-Qing Chen
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
- Department of Dermatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Jin Yu
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China.
| |
Collapse
|
5
|
Marquez L, Lee Y, Duncan D, Whitesell L, Cowen LE, Quave C. Potent Antifungal Activity of Penta- O-galloyl-β-d-Glucose against Drug-Resistant Candida albicans, Candida auris, and Other Non- albicans Candida Species. ACS Infect Dis 2023; 9:1685-1694. [PMID: 37607350 PMCID: PMC10496123 DOI: 10.1021/acsinfecdis.3c00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 08/24/2023]
Abstract
Among fungal pathogens, infections by drug-resistant Candida species continue to pose a major challenge to healthcare. This study aimed to evaluate the activity of the bioactive natural product, penta-O-galloyl-β-d-glucose (PGG) against multidrug-resistant (MDR) Candida albicans, MDR Candida auris, and other MDR non-albicans Candida species. Here, we show that PGG has a minimum inhibitory concentration (MIC) of 0.25-8 μg mL-1 (0.265-8.5 μM) against three clinical strains of C. auris and a MIC of 0.25-4 μg mL-1 (0.265-4.25 μM) against a panel of other MDR Candida species. Our cytotoxicity studies found that PGG was well tolerated by human kidney, liver, and epithelial cells with an IC50 > 256 μg mL-1 (>272 μM). We also show that PGG is a high-capacity iron chelator and that deletion of key iron homeostasis genes in C. albicans rendered strains hypersensitive to PGG. In conclusion, PGG displayed potent anti-Candida activity with minimal cytotoxicity for human cells. We also found that the antifungal activity of PGG is mediated through an iron-chelating mechanism, suggesting that the compound could prove useful as a topical treatment for superficial Candida infections.
Collapse
Affiliation(s)
- Lewis Marquez
- Molecular
and Systems Pharmacology, Laney Graduate School, Emory University, Atlanta, Georgia 30322, United States
- Jones
Center at Ichauway, Newton, Georgia 39870, United States
| | - Yunjin Lee
- Department
of Molecular Genetics, University of Toronto, Toronto, Ontario M5G 1M1, Canada
| | - Dustin Duncan
- Department
of Molecular Genetics, University of Toronto, Toronto, Ontario M5G 1M1, Canada
- Department
of Chemistry, Brock University, St. Catharines, Ontario L2S 3A1, Canada
| | - Luke Whitesell
- Department
of Molecular Genetics, University of Toronto, Toronto, Ontario M5G 1M1, Canada
| | - Leah E. Cowen
- Department
of Molecular Genetics, University of Toronto, Toronto, Ontario M5G 1M1, Canada
| | - Cassandra Quave
- Center
for the Study of Human Health, Emory University, Atlanta, Georgia 30322, United States
- Department
of Dermatology, Emory University, Atlanta, Georgia 30322, United States
| |
Collapse
|
6
|
Pathogenic Drug Resistant Fungi: A Review of Mitigation Strategies. Int J Mol Sci 2023; 24:ijms24021584. [PMID: 36675092 PMCID: PMC9863602 DOI: 10.3390/ijms24021584] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Fungal pathogens cause significant human morbidity and mortality globally, where there is a propensity to infect vulnerable people such as the immunocompromised ones. There is increasing evidence of resistance to antifungal drugs, which has significant implications for cutaneous, invasive and bloodstream infections. The World Health Organization (WHO) published a priority list of fungal pathogens in October 2022, thus, highlighting that a crisis point has been reached where there is a pressing need to address the solutions. This review provides a timely insight into the challenges and implications on the topic of antifungal drug resistance along with discussing the effectiveness of established disease mitigation modalities and approaches. There is also a need to elucidate the cellular and molecular mechanisms of fungal resistance to inform effective solutions. The established fungal decontamination approaches are effective for medical device processing and sterilization, but the presence of pathogenic fungi in recalcitrant biofilms can lead to challenges, particularly during cleaning. Future design ideas for implantable and reusable medical devices should consider antifungal materials and appropriates for disinfection, and where it is relevant, sterilization. Preventing the growth of mycotoxin-producing fungi on foods through the use of appropriate end-to-end processes is advisable, as mycotoxins are recalcitrant and challenging to eliminate once they have formed.
Collapse
|
7
|
Recent Advances in the Application of Essential Oils as Potential Therapeutic Candidates for Candida-Related Infections. Appl Microbiol 2022. [DOI: 10.3390/applmicrobiol2020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Candidiasis (oral, vulvovaginal, or systemic bloodstream infections) are important human fungal infections associated with a high global prevalence in otherwise healthy adults but are also opportunistic infections in immunocompromised patients. With the recent discovery of the multidrug resistant—and often difficult to treat—Candida auris, as well as the rising costs associated with hospitalisations and the treatment of infections caused by Candida species, there is an urgent need to develop effective therapeutics against these pathogenic yeasts. Essential oils have been documented for many years as treatments for different ailments and are widely known and utilised in alternative and complementary therapies, including treating microbial infections. This review highlights knowledge from research on the effects of medicinal plants, and in particular, essential oils, as potential treatments against different Candida species. Studies have been evaluated that describe the experimental approaches used in investigating the anticandidal effects of essential oils (in vivo and in vitro), the established mode of action of the different compounds against different Candida species, the effect of a combination of essential oils with other compounds as potential therapies, and the evidence from clinical trial studies.
Collapse
|
8
|
Correia NS, Balbinot RTS, Bonacorsi C, Donofrio FC. Epidemiology of dermatomycoses in children in Northern Mato Grosso 2015-2020. Mycoses 2022; 65:560-566. [PMID: 35315158 DOI: 10.1111/myc.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Dermatomycoses, fungal diseases that affect the superficial layers of skin, hair, or nails, are a public health concern due to their high prevalence. In Brazil, dermatomycoses are not notifiable diseases, so only fragmented epidemiological studies have been reported in the national literature. To evaluate the epidemiological profile of dermatomycoses in preschoolers and school children in Sinop, Mato Grosso (MT), Brazil. METHODS Classic methods were used to perform 782 mycological examinations to identify dermatophytosis, cutaneous candidosis, and pityriasis versicolor in preschoolers and school children aged between 6 months and 12 years in 11 educational institutions in Sinop - MT. RESULTS Among the evaluated clinical specimens, 5.2% tested positive for dermatophytosis, with 58.45% of these cases corresponding to tinea capitis, followed by skin (tinea corporis and tinea pedis) and toenail (tinea unguium) lesions; zoophilic fungi predominated. Microsporum canis and Trichophyton mentagrophytes complex were isolated in 53.66% and 24.39% of the cases, respectively. Regarding cutaneous candidosis, 9.1% of the specimens tested positive for this disease, with 59.16% and 12.7% of the cases corresponding to toenails and interdigitoplantar lesions, respectively. Candida albicans caused 70.43% of the lesions. The remaining specimens (85.7%) tested positive for pityriasis versicolor; children aged between 6 and 12 were the most affected (71.79%). CONCLUSION Our results agree with most epidemiological studies carried out in Brazil and demonstrate the high frequency of mycoses in preschoolers and school children, a result of poor personal hygiene and favorable weather conditions in Northern Mato Grosso, Brazil.
Collapse
Affiliation(s)
- Neocimar Saraiva Correia
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso - Campus Sinop, Sinop, Brazil
| | | | - Cibele Bonacorsi
- Instituto de Ciências da Saúde, Universidade Federal de Mato Grosso - Campus Sinop, Sinop, Brazil
| | | |
Collapse
|
9
|
Bilal H, Hou B, Shafiq M, Chen X, Shahid MA, Zeng Y. Antifungal susceptibility pattern of Candida isolated from cutaneous candidiasis patients in eastern Guangdong region: A retrospective study of the past 10 years. Front Microbiol 2022; 13:981181. [PMID: 35992679 PMCID: PMC9389287 DOI: 10.3389/fmicb.2022.981181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
Cutaneous candidiasis is one of the most prevalent mycotic infections caused by Candida species. The severity of infection mounts faster when the species shows antifungal resistance. In the current retrospective study, we aimed to analyze the occurrence, causes of cutaneous candidiasis, and antifungal susceptibility pattern of Candida isolates from Skin and Venereal Diseases Prevention and Control Hospital of Shantou, located in eastern Guangdong, China. The laboratory data of all patients (n = 3,113) suffering from various skin and venereal infections during January 2012 to December 2021 was analyzed through Excel and GraphPad prism. Our analysis indicate that cutaneous candidiasis was 22.29% (n = 694), of which 78.53% (n = 554) of patients were males and 21.47% (n = 149) of patients were females. The median age of patients with cutaneous candidiasis was 38-year [interquartile range (30-48)]. Most cases occurred in the adult age group (19-50 years). Regarding the species type, the Candida albicans were prominently detected (n = 664, 95.68%), while non-C. albicans were found only in 30 (4.32%) patients, which were C. glabrata (n = 18), C. krusei (n = 8), C. tropicalis (n = 3), and C. parapsilosis (n = 1). The C. albicans susceptibility rate for terbinafine, miconazole, voriconazole, itraconazole, fluconazole, ketoconazole, nystatin, 5-flucytosine and amphotericin B were 10.83, 29.32, 59.39, 78.53, 85.28, 87.75, 99.59, 99.41, and 100%, respectively. Finally, all C. glabrata isolates were found susceptible to all tested azole drugs with exception to miconazole against which 8.33% of isolates showed resistance. The findings of this study will help healthcare officials to establish better antifungal stewardship in the region.
Collapse
Affiliation(s)
- Hazrat Bilal
- Department of Dermatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Bing Hou
- Skin and Venereal Diseases Prevention and Control Hospital of Shantou City, Shantou, Guangdong, China
| | - Muhammad Shafiq
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, China
| | - Xinyu Chen
- Department of Dermatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Muhammad Akbar Shahid
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Yuebin Zeng
- Department of Dermatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Yuebin Zeng,
| |
Collapse
|
10
|
Savarirajan D, Ramesh VM, Muthaiyan A. In vitro antidermatophytic activity of bioactive compounds from selected medicinal plants. J Anal Sci Technol 2021; 12:53. [PMID: 34745684 PMCID: PMC8563824 DOI: 10.1186/s40543-021-00304-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022] Open
Abstract
Fungal infections are among the most difficult diseases to manage in humans. Eukaryotic fungal pathogens share many similarities with their host cells, which impairs the development of antifungal compounds. Therefore, it is desirable to harness the pharmaceutical potential of medicinal plants for antifungal drug discovery. In this study, the antifungal activity of sixteen plant extracts was investigated against selected dermatophytic fungi. Of the sixteen plants, the cladode (leaf) of Asparagus racemosus, and seed extract of Cassia occidentalis showed antifungal activity against Microsporum gypseum, Microsporum nanum, Trichophyton mentagrophytes and Trichophyton terrestre. The plant antifungal compounds were located by direct bioassay against Cladosporium herbarum. IR and NMR spectrometry analyses of these compounds identified the presence of saponin (in A. racemosus) and hydroxy anthraquinone (in C. occidentalis) in these antifungal compounds. The antidermatophytic activity of plant anthraquinone and saponins with reports of little or no hemolytic activity, makes these compounds ideal for alternative antifungal therapy and warrants further in-depth investigation in vivo.
Collapse
Affiliation(s)
- Daisy Savarirajan
- Centre for Advanced Studies in Botany, University of Madras, Chennai, 600025 India.,College of Science, Engineering and Technology, Grand Canyon University, 3300 W. Camelback Rd, Phoenix, AZ 85017 USA
| | - V M Ramesh
- Centre for Advanced Studies in Botany, University of Madras, Chennai, 600025 India.,College of Science, Engineering and Technology, Grand Canyon University, 3300 W. Camelback Rd, Phoenix, AZ 85017 USA
| | | |
Collapse
|