The purpose of this study will be to review several studies regarding the repair or treatment of perineal tears after vaginal delivery. This is expected to be an update for a midwife in daily caring. Two electronic databases (PubMed and Sciencedirect) were searched to locate relevant literature about perineal tears/wound/laceration/trauma that is published in 2016-2021. 124 Pubmed articles and 452 ScienceDirect articles filtered successfully. The articles that have been obtained will be evaluated based on the inclusion criteria in this study. We summarize place and date, objective, design, samples, the measurement used, and research results. 9 articles were found that matched the inclusion criteria. Three articles examined the effect of the type of suture on perineal pain, and another 6 discussed therapy to reduce the adverse effects of perineal tears. The therapies used are far-infrared radiation therapy, capacitive-resistive radiofrequency therapy, pelvic floor muscle training in early postpartum, cold therapy, and treatment with TheresienOl (natural oil). Sutures and technique/suturing second-degree perineal tears or a postpartum episiotomy can affect perineal pain. Cold gel pad therapy and treatment with natural oil on perineal wounds can affect perineal pain and wound healing.

In recent years, the emergence of newly identified acute and chronic infectious disorders caused by diverse combinations of pathogens, termed polymicrobial diseases, has had catastrophic consequences for humans. Antimicrobial agents have been clinically proven to be effective in the pharmacological treatment of polymicrobial diseases. Unfortunately, an increasing trend in the emergence of multi-drug-resistant pathogens and limited options for delivery of antimicrobial drugs might seriously impact humans’ efforts to combat polymicrobial diseases in the coming decades. New antimicrobial agents with novel mechanism(s) of action and new pharmaceutical formulations or delivery systems to target infected sites are urgently required. In this review, we discuss the prospective use of novel antimicrobial compounds isolated from natural products to treat polymicrobial infections, mainly via mechanisms related to inhibition of biofilm formation. Drug-delivery systems developed to deliver antimicrobial compounds to both intracellular and extracellular pathogens are discussed. We further discuss the effectiveness of several biofilm-targeted delivery strategies to eliminate polymicrobial biofilms. At the end, we review the applications and promising opportunities for various drug-delivery systems, when compared to conventional antimicrobial therapy, as a pharmacological means to treat polymicrobial diseases.

Context: Methicillin-resistant Staphylococcus aureus (MRSA) has been a significant challenge in health problems. Aims: To investigate synergistic properties of green tea extract that can potentially enhance the antibacterial activity of amoxicillin against methicillin-resistant Staphylococcus aureus (MRSA) in vitro and ex vivo. Methods: Green tea coarse powder was extracted by distilled water using high-pressure extraction. The total of phenolic and tannin contents was determined using spectrophotometry, and epigallocatechin gallate (EGCG) content was analyzed using Ultra-Fast Liquid Chromatography. Minimum Inhibitory Concentration (MIC) against MRSA was determined using a microdilution assay. Antibacterial assay of the combination of the extract and amoxicillin was performed using employing-checkerboard microdilution and agar diffusion assays. Results: The results exhibited that the green tea extract (GTE) contained total phenolic content of 545.6 ± 4.7 mg GAE/g extract; total tannin content of 356.6 ± 4.1 mg EGCG equivalent /g extract and EGCG of 221.1 ± 11.6 mg/g extract. The MICs combinatorial of GTE and ¼ MIC of amoxicillin was 75 µg/mL. Fractional Inhibitory Concentration Index value was 0.28, indicating that there was a synergy effect between amoxicillin and green tea extract. Essentially, the inhibitory zone diameter obtained by amoxicillin combined with ¼ MIC of GTE was two-fold than the zone produced by only amoxicillin. Although not significant, in ex vivo study, this combination was able to enhance the antibacterial activity of rat’s plasma against MRSA in vivo after the oral administration of GTE and amoxicillin. Conclusions: The results presented here serve as proof of concept for the enhancement of the antimicrobial activity of synthetic antibiotics when combined with a natural product.

Increasing concerns on the adverse effect of synthetic antioxidants and the emergence of antibiotic-resistant Staphylococcus aureus have become two essential problems to be addressed. To tackle them, exploration of natural resources to discover novel antioxidants and/or antibacterial agents is urgently required. The aim of this research was to investigate the correlation of phenolic and flavonoid contents of extracts to their antioxidant and antibacterial activities. Green tea, green coffee, cocoa pod husks, bee pollen, and rosella calyces were processed and subjected to 80% ethanol-based maceration procedure to obtain extracts with appropriate condition. Each extract was examined for its phenolic and flavonoid concentrations using the Folin–Ciocalteau method and the aluminum chloride colorimetric assay, respectively. Further analysis on the free-radical scavenging potential and antibacterial/antibiofilm activity against S. aureus were carried out. Samples were found to contain total phenolics (TP) and total flavonoids (TF) at different concentrations. The highest level of TP and TF was identified in green tea extract and corresponded to the lowest IC₅₀ against DPPH and the lowest MIC against S. aureus colonies or to their respective biofilm. In contrast, low amounts of TP and TF were found in cocoa pod husks and bee pollen which were further demonstrated high IC₅₀ and high MIC. Collectively, our results suggested the linear correlation of phenolic- and flavonoid contents to the antioxidant and antibacterial/antibiofilm activities of plant extracts. The higher the phenolics and flavonoids level, the better the antioxidant and antibacterial/antibiofilm activities obtained from the corresponding extracts.

Drug discovery is a complex process, and the use of a comprehensive approach is deemed necessary to discover new chemical entities with novel mechanisms of action. This research was carried out to determine whether Drosophila melanogaster can serve as an appropriate model organism in the initial screening of drug candidates with immunomodulatory activities. To test this, we performed phenotypic assay and molecular analysis to investigate the immunomodulatory activities of aspirin, dexamethasone, curcumin, and epigallocatechin gallate (EGCG), that have been reported to yield such effects in the mammalian model system. In vivo survival analysis demonstrated that all drugs/compounds were relatively safe at the tested concentrations. In the infection assay, curcumin and EGCG showed a protective signature to bacterial infection in flies lacking Toll-mediated immune responses. Furthermore, dexamethasone and aspirin, drugs with immunosuppressive activity, could improve the survival of PGRP-LB^Δ mutant flies with hyperactivated immune system. These phenotypes were supported by RT-qPCR-based molecular analysis, revealing that drugs/compounds used in this study could modulate the expression level of genes related to the immune system. In conclusion, while curcumin and EGCG could promote the improvement of fly survival against infection, aspirin and dexamethasone were able to suppress overactivation of immune responses in D. melanogaster. These results are in line with the ones observed in the mammalian model system, further emphasizing the notion that flies would serve as a prospective model organism in the initial screening of drug candidates for their immunomodulatory activities prior to further checking in the mammalian animal models. In the end, this will reduce the use of mammalian animal models for preliminary experiments in an effort to discover/repurpose drugs with immunomodulatory activity.

Introduction: The emergence of antibiotic-resistant Staphylococcus aureus is a major threat for worldwide communities. To overcome such serious problem, the discovery of novel antibacterial agents through exploration of diverse potential sources is essential. The aim of this research was to investigate the in vivo anti-staphylococcal activity of roselle (Hibiscus sabdariffa L.) calyx extract against S. aureus in fruit flies (Drosophila melanogaster) model of infection.Methods: Roselle calyces were dried and extracted with ethanol using maceration method. Wildtype fruit flies were infected with S. aureus and subjected to survival assay, bacterial load examination, and gene expression analysis, in the presence or absence of roselle calyx extract. Survival and bacterial load analysis were subsequently performed on immunodeficient fruit flies using similar protocols.Results: Reduction of host survivorship accompanied by increasing level of bacterial proliferation was observed in group of wildtype fruit flies infected with S. aureus. These phenotypic events were further augmented in mutant flies devoid of component for antibacterial immune responses. Nevertheless, reduction of bacterial load and improvement of host survival were demonstrated in either wildtype or immunodeficient fruit flies upon treatment with roselle calyx extract after bacterial challenge, irrespective of immune status.Conclusion: Collectively, our results demonstrated the in vivo antibacterial activity of roselle calyx extract against S. aureus in Drosophila model of infection and this was not due to induction of immune response in the host.