In Vitro Antibacterial and Phytochemical Screening of Hypericum perforatum Extract as Potential Antimicrobial Agents against Multi-Drug-Resistant (MDR) Strains of Clinical Origin

Background

The perennial plant Hypericum perforatum is widely distributed around the world. It has been used for many years in conventional medicine to treat a variety of illnesses, including stress, mild to moderate depression, and minor injuries. This study examined the antimicrobial activity of the H. perforatum total extract and its fractions (n-hexane, ethyl acetate, chloroform, and aqueous) against multi-drug-resistant (MDR) isolates that were gathered from clinical samples, including methicillin-resistant Staphylococcus aureus (MRSA), Enterococcus faecalis, Escherichia coli, and Klebsiella pneumonia.

Materials and Methods

Aerial parts of H. perforatum were collected and extracted using various solvents and were tested versus different isolated bacterial species. The inhibition zone of tested extracts was detected using an agar diffusion assay, and MICs were measured. Phytochemical analysis of promising H. perforatum extract was done using LC-ESI-MS/MS. Ultrastructure examination for the most altered bacteria used transmission electron microscopy. Antioxidant assays were done using DPPH and ABTS scavenging capacity methods. Cytotoxicity was reported versus Vero cells.

Results

Different extracts of H. perforatum showed promising antibacterial activity against the pathogens. While the subfractions of the total extract were observed to show lesser inhibition zones and higher MIC values than the total extract of H. perforatum against MDR strains, the total extract of H. perforatum demonstrated the most potent antimicrobial action with an inhibition zone range of 17.9-27.9 mm. MDR-K. pneumoniae was discovered to be the most susceptible strain, which is consistent with the antibacterial inhibitory action of H. perforatum whole extract. Additionally, after treatment at the minimum inhibitory concentration (MIC 3.9 μg/ml), the transmission electron microscope showed alterations in the ultrastructure of the K. pneumoniae cells. Methanol extract from H. perforatum has a CC₅₀ value of 976.75 μg/ml.

Conclusion

Future inhibitors that target MDR strains may be revealed by these findings. Additionally, the extracts that were put to the test demonstrated strong antioxidant effects as shown by DPPH or ABTS radical-scavenging assays.

V-Y dorsal metacarpal flap: a new technique for the correction of syndactyly without skin graft

A new technique for web reconstruction in congenital syndactyly is described. Twenty-one web spaces in 12 patients were treated using this method. The dorsal metacarpal flap was used as an island V-Y advancement to cover the newly created web space, thus avoiding skin graft in this space. A follow-up of 6 months to 2 years showed neither recurrence of the deformity nor web creep of any degree. The operation is rapid, easy, and reproducible. It is suggested that this technique can be used in all types of syndactyly.

Management of tissue breakdown and exposure associated with orbital hydroxyapatite implants

A new surgical approach for the management of tissue breakdown and exposure of an orbital hydroxyapatite (HA) implant is presented. The implant was placed after evisceration of an atrophic globe. Tissue breakdown and exposure developed 3 weeks after implantation. After a 3-month waiting period for spontaneous healing, a pedicled conjunctival flap from the lower eyelid was fashioned to cover the defect. This technique can be used to cover conjunctival defects over HA implants and is specifically recommended for large defects.

First dorsal metacarpal artery flap in hand reconstruction. I. Anatomical study

Twenty-one human hands were dissected to study the anatomy of the first dorsal metacarpal artery (FDMA). The artery was found in all the dissected hands. It constantly gave three fascial branches: a radial branch, an ulnar branch, and an intermediate branch. A cutaneous branch was also observed, which may arise either from the radial artery or from the FDMA. It runs with the radial nerve supplying dorsal hand skin. This branch may supplement the vascularization of FDMA flap. The FDMA supplies the dorsal hand skin from the thumb metacarpal to the long metacarpal, as well as the skin on the dorsal surfaces of the thumb and index to the proximal interphalangeal joint.

First dorsal metacarpal artery flap in hand reconstruction. II. Clinical application

The first dorsal metacarpal artery flap was used in 23 patients for coverage of soft tissue hand defects. This flap was used as a fasciocutaneous flap or as a fascial flap. Vascularized periosteum or tendon can also be raised with the flap.

Severe thermal hand burns--factors affecting prognosis

This paper presents the results of the analysis of clinical data from a series of 132 thermally injured patients with 214 burned hands. The objective was to identify the factors affecting the pathogenesis of postburn hand deformities. The study indicates that deep burns have the worst prognosis and that circumferential burns are always followed by secondary sequelae. The incidence of secondary hand deformity rises sharply when the burn affects more than 25 per cent of the total body surface area (TBSA). Given the same physical therapy programme, early tangential excision and immediate grafting yield better results than conservative treatment. The results underline the role of patient motivation in maximal hand rehabilitation.

Hepatitis B virus infection in upper and lower Egypt

The relative prevalence of hepatitis B surface antigen (HBsAg), anti-HBs, and anti-hepatitis B virus core antigen (HBc), as markers of hepatitis B virus infection, among 1,866 apparently healthy residents of two Egyptian provinces representing Upper and Lower Egypt populations was determined using solid-phase radioimmunoassay (SPRIA). The prevalence rate of HBsAg in the Egyptian population was moderately high (10.1%); it was higher in the Upper Egypt (11.7%) than the Lower Egypt (8.0%) population and more frequent in young adults--especially those of Upper Egypt--and males than females in both populations. The prevalence of anti-HBs gradually increased with age; it was higher in the Lower Egypt (51.1%) than the Upper Egypt (41.7%) population, and it was higher in females than males. A remarkably high infection rate, as shown by the prevalence of anti-HBc, was found in both populations (88.0%), with minor variations depending on age, sex, and geographic area.

Serum inhibitory factor in lepromatous leprosy: its effect on the pre-S-phase cell-cycle kinetics of mitogen-stimulated normal human lymphocytes

The sera of ten Egyptian man with long-standing lepromatous leprosy (LL) (mean duration 17.4 years) that had failed to respond to dapsone treatment were shown to inhibit mitogen stimulation responses of normal human lymphocytes. When first tested, the sera partly inhibited the response to phytohaemagglutinin (PHA) and pokeweed mitogen and virtually abolished that to concanavalin A (Con A): after repeated freezing and thawing, the Con A inhibition had disappeared, whereas the PHA response was still partly inhibited. The inhibitory serum factor(s) had similar actions on lymphocytes from each of six normal donors. Although the sera varied in potency, they showed similar dose-response curves when tested against lymphocytes from a single donor. The principal action of the sera was to reduce the number of cells responding to mitogen, without modifying the kinetics of recruitment or rate of volume growth during G1-phase in those cells that were unaffected by the inhibitory substances(s). Study of PHA dose-response curves and of the effect of delayed addition of LL serum suggested that the serum factor(s) act by diminishing the responsiveness of the cells, rather than by reducing the concentrations of free mitogen or by blocking cell membrane mitogen receptors. The serum from one apparently healthy attendant, who had nursed leprosy patients for 30 years but who did not have leprosy or other chronic infective disease, inhibited completely stimulation by all three mitogens in a manner different from that of LL sera. Serum from the other 13 control patients did not modify the response of normal lymphocytes to stimulation by any of the three mitogens studied. It was concluded that the inhibitory factor(s) in the serum of patients with LL were a consequence of the disease and not of the environment in which the patients lived. Microscopy confirmed that the techniques used for recovery of the cultured cells did not introduce bias into the volume spectroscopy measurements.