In vitro evaluation of the comprehensive antimicrobial and antioxidant properties of Curtisia dentata (Burm.f) C.A. Sm: toxicological effect on the human embryonic kidney (HEK293) and human hepatocellular carcinoma (HepG2) cell lines

Curtisia dentata is used in African traditional medicine to treat variety of infections. C. dentata leaves were collected from Buffelskloof Nature Reserve, South Africa. The ethanol, chloroform, ethyl acetate and acetone extracts were evaluated for antimicrobial activity using micro dilution assay against Escherichia coli, Pseudomonas aeruginosa, Mycobacterium smegmatis, Mycoplasma hominis, Candida albicans and some clinical isolates of Moraxella catarrhalis, Proteus mirabilis and Staphylococcus aureus isolated from HIV patient. Acetone extract exhibited lowest MIC of 0.01 mg/ml against Candida albicans compared to other extracts. Besides lupeol, betulinic acid and ursolic acid, β-sitosterol was isolated for the first time from C. dentata leaves and exhibited antimicrobial activity with MIC values ranging from 0.20 to 6.25 mg/ml. Furthermore, the ethanol extract and the four isolated compounds revealed microbicidal effect, with MIC index of less than 4. Ethanol extract revealed the best total activity of 2400 ml/g against Mycoplasma hominis. Cytotoxicity of the isolated compounds was further investigated against the Human embryonic kidney (HEK293) and Human hepatocellular carcinoma (HepG2) cell lines using the MTT assay. Ursolic acid exhibited the lowest LD50 of 122.4 μg/ml against HEK293 cell line while lupeol exhibited LD50 of 278.8 and 289.4 μg/ml against HEK293 and HepG2 respectively. Lupeol exhibited low selectivity index. Ethyl acetate and acetone extracts were further investigated for antioxidant activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH). The acetone extract exhibited potent inhibition of DPPH compared to ethyl acetate extract. The findings of the current work validate the use of the plant species in the treatment of various human infections

Antimicrobial activity of Berkheya bergiana leaves extracts

The leaves of Berkheya bergiana Soderberg (Asteraceae) were screened for phytochemical composition and antimicrobial potential. Phytochemical screening of the crude methanol extract showed the presence of various secondary metabolites. In vitro antimicrobial activities of the extracts obtained from six solvents were carried out against 28 bacterial strains using traditional methods. Chloroform extract exhibited the highest broad spectrum antibacterial activity against the tested bacteria and decreased in the order chloroform > ethyl acetate > butanol > hexane > aqueous extract at a concentration of 5.0 mg mL-1 for bacteria. The minimum inhibitory concentration (MIC) exhibited by EtOAc, CHCl3 and HEX extracts against the bacterial strains range between 0.07 and 2.5 mg mL-1, while that of BuOH and aqueous extracts ranged between 0.07 and 5.0 mg mL-1. The antibacterial activities of the plant were compared with standard (neomycin, ampicilin and tetracycline) antibiotics at the same concentration. The leaves extracts showed antibacterial potential, inhibiting the growth of some of the tested bacterial more than the standard drugs. The results obtained appeared to confirm the antibacterial potential of the plant investigated.Key words: Berkheya bergiana, Asteraceae, antimicrobial activity, screening

Successful surgical treatment of a giant coronary artery aneurysm presenting with recurrent profuse haemoptysis

We present the case of successful resection of a giant aneurysm of the LAD presenting with recurrent severe haemoptysis in a 72-year old man. He was admitted to a regional hospital with fever, recurrent bloody sputum, weight loss and left sided chest pain, and developed respiratory failure requiring ventilation. Investigations are summarised and reviewed and the diagnosis was eventually reached by TTE, CT and MRI scans, confirmed by coronary angiography. Successful emergency surgery to resect the aneurysm and put a vein graft to the LAD is described. The presentation and management of coronary giant aneurysm is reviewed

Lactogenic Activity of Rats Stimulated by Gunnera Perpensa L. (Gunneraceae) from South Africa

Gunnera perpensa L. (Gunneraceae) is a medicinal plant used by Zulu traditional healers to stimulate milk production. The effect of an aqueous extract of the rhizome of the plant on milk production in rats was investigated. Female lactating rats that received oral doses of the extract of G.perpensa significantly (p<0.05) produced more milk than controls. The plant extract did not however, significantly influence the levels of prolactin, growth hormone, progesterone, cortisol, ALT, AST and albumin in the blood. The mammary glands of rats treated with the extract showed lobuloalveolar development. The extract (0.8 μg/ml) was also found to stimulate the contraction of the uterus and inhibit (23%) acetylcholinesterase activity. The cytotoxicity of the extract (LC50) to two human cell lines (HEK293 and HepG2) was 279.43 μg/ml and 222.33μg/ml, respectively. It is inferred that the plant extract exerts its activity on milk production and secretion by stimulating lobuloalveolar cell development and the contraction of myoepithelial cells in the alveoli. It is concluded that Gunnera perpensa contains constituents with lactogenic activity that apparently contribute to its effectiveness in folk medicine

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Antibacterial activity of root and leaf extracts of Jatropha zeyheri Sond (Euphorbiaceae)

Resistance of human pathogenic bacterial strains results in selective pressure against known antibiotics. Jatropha zeyheri is used by traditional medicine practitioners in the treatment of sexually transmitted and urinary tract infections. Acetone, methanol and ethyl acetate extracts of both leaves and roots of Jatropha zeyheri collected from Capricorn District, Limpopo Province, South Africa were investigated for antibacterial activity, against 14 human pathogenic bacterial strains, using disc diffusion method. Ethyl acetate extracts exhibited activity against 11 of the selected strains and showed zone of inhibition of 10.7 mm against Klebsiella pneumoniae. Largest zone of inhibition of 12 mm was obtained with the acetone leaf extract against Enterobacter cloacae and Acinetobacter calcaoceuticals and methanol extract of the leaf against Enterococccus faecalis. Acetone extract of the root exhibited minimal inhibitory concentration (MIC) of 0.39 mg/ml against Salmonella spp. followed by methanol and acetone extracts of the root (0.78 mg/ml) against Serratia marcescens. Methanol extract of the leaf exhibited MIC of 3.13 mg/ml against Staphylococcus aureus. This study validates the use of Jatropha zeyheri in the treatment of various illnesses.Keywords: Inhibition zone, antibiotics, Jatropha zeyheri, disc diffusion, MICAfrican Journal of Biotechnology Vol. 12(5), pp. 476-48