Justification for the use of Ocimum gratissimum L in herbal medicine and its interaction with disc antibiotics

<p>Abstract</p> <p>Background</p> <p>The ethanolic extract of the leaves of <it>Ocimium gratisimum </it>L. (Lamiaceae), used in traditional medicine for the treatment of several ailments such as urinary tract, wound, skin and gastrointestinal infections, was evaluated for its antibacterial properties against four clinical bacteria isolates namely: <it>Escherichia coli, Proteus mirabilis, Staphylococcus aureus and Pseudomonas aeruginosa </it>and the antifungal properties using a clinical isolate of <it>Candida albicans</it>. A typed bacterium of <it>Escherichia coli </it>ATCC 11775 and another typed fungal strain of <it>Candida albicans </it>(ATCC 90028) were also included. The study also intended to verify if the concomitant administration of conventional antibiotics with <it>Ocimium gratisimum </it>which is normally taken as food (spice) will negatively affect its activity.</p> <p>Methods</p> <p>The agar diffusion method was used to test the in vitro activity of the plant extract. The interaction of the plant extract with some disc antibiotics namely: ciprofloxacin, septrin, streptomycin, ampicillin, nystatin and ketoconazole was tested using the agar overlay inoculum susceptibility disc method. Phytochemical analysis of the extract was performed following established methods.</p> <p>Results</p> <p>The extract showed good but varying <it>in vitro </it>activities against all the isolates tested. While ampicillin showed synergistic interaction with the plant extract against clinical isolates of <it>E. coli </it>and <it>P. mirabilis</it>, septrin was synergistic against the clinical isolate of <it>E. coli </it>only. Similarly, the activity of the extract against <it>C. albicans </it>isolate was synergistic with ketoconazole and nystatin.</p> <p>Conclusion</p> <p>The study has validated the folkloric use of <it>O. gratissimum </it>in traditional medicinal practice and goes further to show that the use of this plant material as food spice may not really threaten the efficacy of some conventional antibiotics that may have been taken concomitantly with it as is the popular belief in the practice of herbal medicine in local/rural communities of many countries in the world.</p

Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage

Background: Delays in the detection or treatment of postpartum hemorrhage can result in complications or death. A blood-collection drape can help provide objective, accurate, and early diagnosis of postpartum hemorrhage, and delayed or inconsistent use of effective interventions may be able to be addressed by a treatment bundle.Methods: We conducted an international, cluster-randomized trial to assess a multicomponent clinical intervention for postpartum hemorrhage in patients having vaginal delivery. The intervention included a calibrated blood-collection drape for early detection of postpartum hemorrhage and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination, and escalation), supported by an implementation strategy (intervention group). Hospitals in the control group provided usual care. The primary outcome was a composite of severe postpartum hemorrhage (blood loss, ≥1000 ml), laparotomy for bleeding, or maternal death from bleeding. Key secondary implementation outcomes were the detection of postpartum hemorrhage and adherence to the treatment bundle.Results: A total of 80 secondary-level hospitals across Kenya, Nigeria, South Africa, and Tanzania, in which 210,132 patients underwent vaginal delivery, were randomly assigned to the intervention group or the usual-care group. Among hospitals and patients with data, a primary-outcome event occurred in 1.6% of the patients in the intervention group, as compared with 4.3% of those in the usual-care group (risk ratio, 0.40; 95% confidence interval [CI], 0.32 to 0.50; P&lt;0.001). Postpartum hemorrhage was detected in 93.1% of the patients in the intervention group and in 51.1% of those in the usual-care group (rate ratio, 1.58; 95% CI, 1.41 to 1.76), and the treatment bundle was used in 91.2% and 19.4%, respectively (rate ratio, 4.94; 95% CI, 3.88 to 6.28).Conclusions: Early detection of postpartum hemorrhage and use of bundled treatment led to a lower risk of the primary outcome, a composite of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding, than usual care among patients having vaginal delivery

Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage

Background: Delays in the detection or treatment of postpartum hemorrhage can result in complications or death. A blood-collection drape can help provide objective, accurate, and early diagnosis of postpartum hemorrhage, and delayed or inconsistent use of effective interventions may be able to be addressed by a treatment bundle.Methods: We conducted an international, cluster-randomized trial to assess a multicomponent clinical intervention for postpartum hemorrhage in patients having vaginal delivery. The intervention included a calibrated blood-collection drape for early detection of postpartum hemorrhage and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination, and escalation), supported by an implementation strategy (intervention group). Hospitals in the control group provided usual care. The primary outcome was a composite of severe postpartum hemorrhage (blood loss, ≥1000 ml), laparotomy for bleeding, or maternal death from bleeding. Key secondary implementation outcomes were the detection of postpartum hemorrhage and adherence to the treatment bundle.Results: A total of 80 secondary-level hospitals across Kenya, Nigeria, South Africa, and Tanzania, in which 210,132 patients underwent vaginal delivery, were randomly assigned to the intervention group or the usual-care group. Among hospitals and patients with data, a primary-outcome event occurred in 1.6% of the patients in the intervention group, as compared with 4.3% of those in the usual-care group (risk ratio, 0.40; 95% confidence interval [CI], 0.32 to 0.50; P&lt;0.001). Postpartum hemorrhage was detected in 93.1% of the patients in the intervention group and in 51.1% of those in the usual-care group (rate ratio, 1.58; 95% CI, 1.41 to 1.76), and the treatment bundle was used in 91.2% and 19.4%, respectively (rate ratio, 4.94; 95% CI, 3.88 to 6.28).Conclusions: Early detection of postpartum hemorrhage and use of bundled treatment led to a lower risk of the primary outcome, a composite of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding, than usual care among patients having vaginal delivery