Background and objective: Commiphora swynnertonii (Pax) is used in traditional medicine to treat infectious diseases. Previous studies have reported antimicrobial activity of this plant,however, the activity of compounds that are present in extracts of this plant has not been thoroughly documented. Likewise, the primary mode of action (bactericidal or bacteriostatic) and the possible toxicity on red blood cells have not been reported. Methods: Extracts of leaves, whole root, root bark, root wood, whole stem, stem bark and stem wood, were produced using hexane, dichloromethane, methanol and water. Cold and hot extraction methods were employed. Antibacterial activity of extracts was tested against selected medically important Gram-positive and Gram-negative bacteria by growth inhibition, minimum inhibitory concentrations and time kill assays. Moreover, HAEMOLYTIC activity against sheep red blood cells was determined in vitro. Results: The hexane extracts of whole root and root bark, methanol extracts of root wood, and dichloromethane extracts from the leaves of C. swynnertonii inhibited the growth of S. aureus. MIC values for the extracts and compounds, indicated moderate activity against Gram-positive bacteria (Staphylococcus aureus, Streptococci species and Enterococci species) while the activity against Gram-negative bacteria (Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, Salmonella species, Shigella sonnei and Yersinia enterocolitica) was weak. Time kill profiles showed the extracts have bacteriostatic activity against S. aureus, and low HAEMOLYTIC effect, except for extracts of whole root and leaves at the concentration of 1000 µ, g/mL. Conclusion: Extracts of C. swynnertonii showed bacteriostatic activity against Gram-positive bacteria with low toxicity on red blood cells.

Background: Substituted urea herbicide is widely used in the agricultural industry and is accessible to most people around the globe. Accidental or deliberate poisoning is an anticipated complication of these agrochemical products. Case presentation: We present a 15-year-old girl following deliberate self-ingestion of substituted urea herbicide (Diuron). She was diagnosed with Diuron induced methemoglobinemia and treated with intravenous methylene blue. Later she developed hemolytic anemia and needed 3 units of blood transfusions. Her haemolysis was thought to be due to methylene blue with concomitant Glucose‐ 6‐ phosphate dehydrogenase (G6PD) deficiency as no other possible cause was found for haemolysis. But on follow-up visits, G6PD deficiency was excluded by the screening test and enzyme level assay. Conclusion: Heamolytic anemia is a possible rare complication that should be anticipated in patients presented with a significant amount of substituted urea herbicide poisoning. Studies have found the possibility of reactive oxygen species accumulation in cells leading to oxidative damage. But we were unable to find any reported cases of haemolysis in humans. We postulate that the inhibition of NADPH production like G6PD deficiency may be the key mechanism that causes haemolysis in humans by creating an acquired G6PD deficiency status in red blood cells. However, further studies are needed to identify the exact mechanism of hemolysis in humans.