The use of medicinal plants to cure human illness has been practiced from time immemorial. Nowadays, the vast majority of people still rely on their traditional materia medica for their daily health care needs. The use of plant species for treatment of various human ailments has been mentioned in Ayurveda and other Indian literature. Some of these drugs are believed to enhance the natural resistance of body to infection. So there are many plants having immunostimulatory activity. This paper reviews plants which have shown reported immunostimulatory activity.

Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in ‘ESBL’ than in ‘non-ESBL’ group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.
Extended-spectrum beta lactamase ; Hospitals ; Adult ; Respiratory ; lower case pea

INTRODUCTIONIn Malaysia, Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalisation.

PATIENTS AND METHODSWith concern over its rising microbial resistance, we explored the association of empiric antibiotics choices with the hospital outcomes of patients treated for microbial proven K. pneumoniae pneumonia in an urban-based teaching hospital.

RESULTSIn 313 eligible cases reviewed retrospectively, hospital mortality and requirement for ventilation were 14.3% and 10.8% respectively. Empiric regimes that had in vitro resistance to at least one empiric antibiotic (n = 90) were associated with higher hospital mortality (23.3% vs. 10.8%, P = 0.004) with risk increased by about two-fold [Odds ratio (OR), 2.5; 95% confidence interval (CI), 1.3 to 4.8]. Regimes (n = 84) other than the commonly recommended "standard" regimes (a beta-lactam stable antibiotic with or without a acrolide) were associated with higher ventilation rates (16.7% vs. 8.8%, P = 0.047) with similar increased risk [OR, 2.0; 95% CI, 1.0 to 4.3].

CONCLUSIONSOur findings reiterate the clinical relevance of in vitro microbial resistance in adult K. pneumoniae pneumonia and support empiric regimes that contain beta-lactam stable antibiotics.

Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Community-Acquired Infections ; Drug Resistance, Bacterial ; Hospital Mortality ; Hospitals, Teaching ; Humans ; In Vitro Techniques ; Inpatients ; Klebsiella Infections ; drug therapy ; Klebsiella pneumoniae ; drug effects ; Malaysia ; epidemiology ; Medical Audit ; Outcome Assessment (Health Care) ; Respiration, Artificial ; Retrospective Studies

BACKGROUND: Human mesenchymal stem cells are being used for various regenerative applications in past decades.This study chronicled a temporal profile of the transcriptional pattern and promoter methylation status of the osteogenic related gene in dental pulp stem cells (DPSCs) derived from 3-dimensional spheroid culture (3D) vis a vis 2-dimensional (2D) monolayer culture upon osteogenic induction. METHODS: Biomimetic properties of osteogenesis were determined by alkaline phosphatase assay and alizarin red staining. Gene expression and promoter methylation status of osteogenic genes such as runt-related transcription factor-2, collagen1α1, osteocalcin (OCN), and DLX5 (distal-homeobox) were performed by qPCR assay and bisulfite sequencing, respectively. Furthermore, μ-Computed tomography (micro-CT) was performed to examine the new bone formation in critical-sized rat calvarial bone defect model. RESULTS: Our results indicated a greater inclination of spheroid culture-derived DPSCs toward osteogenic lineage than the monolayer culture. The bisulfite sequencing of the promoter region of osteogenic genes revealed sustenance of low methylation levels in DPSCs during the progression of osteogenic differentiation. However, the significant difference in the methylation pattern between 2D and 3D derived DPSCs were identified only for OCN gene promoter. We observed differences in the mRNA expression pattern of epigenetic writers such as DNA methyltransferases (DNMTs) and methylcytosine dioxygenases (TET) between the two culture conditions. Further, the DPSC spheroids showed enhanced new bone formation ability in an animal model of bone defect compared to the cells cultivated in a 2D platform which further substantiated our in-vitro observations. CONCLUSION The distinct cellular microenvironment induced changes in DNA methylation pattern and expression of epigenetic regulators such as DNMTs and TETs genes may lead to increase expression of osteogenic markers in 3D spheroid culture of DPSCs which make DPSCs spheroids suitable for osteogenic regeneration compared to monolayers.

OBJECTIVE: To extract and isolate berberine from Berberis aristata (Berberidaceae). Isolated berberine was characterised using spectroscopy and its antioxidant and antiarthritic activity was analyzed. METHODS: The berberine was isolated from B. aristata using microwave-assisted extraction (MAE) and characterised by a spectroscopic technique. The isolated berberine was evaluated for its antioxidant activity in DPPH, nitric oxide, and superoxide scavenging assays, while antiarthritic activity was evaluated in the complete freund's adjuvant (CFA)-induced arthritis rat model. RESULTS: The antioxidant activity of berberine revealed potent antioxidant activity in DPPH, nitric oxide, and superoxide scavenging assays. The in vivo antiarthritic activity of berberine in the CFA-induced arthritis rat model showed a significant reduction in paw diameter, arthritic score, and an increase in body weight. Furthermore, a concentration-dependent ameliorating action of berberine on haematological parameters was noticed. Proinflammatory biomarkers, including IL-6, IL-10, and TGF-b in serum were reported, and histopathology examination revealed that berberine decreased pannus formation, synovial hyperplasia, and bone erosion. Radiographic investigation showed soft tissue inflammation, bone resorption and erosion, joint gap reduction, and substantial connective tissue expansion after treatment with berberine. CONCLUSION The ameliorating action on haematological parameters and proinflammatory biomarkers of berberine makes them a suitable remedy for the treatment of arthritis.

Cesarean Section ; Cohort Studies ; Emergencies ; Female ; Humans ; Length of Stay ; Nylons ; Obstetric Surgical Procedures ; Pain Perception ; Patient Satisfaction ; Pregnancy ; Seroma ; Skin ; Sutures ; Wounds and Injuries