Antiviral activity and mode of action of extracts from neem seed kernel against duck plague virus in vitro1.

Four fractions obtained from alcohol extracts of neem (Azadirachta indica) seed kernel by column chromatography were investigated for antivirus activity against the duck plague virus (DPV) in vitro. Duck embryo fibroblasts (DEF) infected with DPV were treated with the neem seed kernel extracts, and the effect of antivirus was judged by 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide colorimetric method assay and direct immunofluorescence assay. The mode of action was tested by the plaque reduction assay. The results showed that fractions 1 to 3 were inactive. The median inhibitory concentration (IC(50)) of fraction 4 was 10.9 µg/mL and inhibited the virus protein expression in the direct immunofluorescence assay. In the plaque reduction assay, fraction 4 could significantly reduce the number of plaques compared with the negative control (P < 0.01) in all modes of action. This study indicated that the fourth fraction obtained from neem seed kernel could improve the viability of infected cells, and reduce the cytopathic effects caused by DPV and the amount of the virus protein expressed in virus-infected cells. The antiviral activity works in the whole process of virus infecting the normal cells.

Improved susceptibility of Gram-negative bacteria in an intensive care unit following implementation of a computerized antibiotic decision support system.

OBJECTIVES: Emergence of multiresistant Gram-negative organisms in intensive care units (ICUs) throughout the world is a concerning problem. Therefore we undertook a study to follow the resistance patterns of the most common clinically isolated Gram-negative organisms within our ICU following an antibiotic stewardship intervention to evaluate whether a reduction in broad-spectrum antibiotics improves local antibiotic resistance patterns. METHODS: This prospective study was conducted over a 7 year period within an ICU at a tertiary teaching hospital in Melbourne, Australia. All clinically isolated Gram-negative organisms were identified and extracted from the hospital pathology system. Three monthly antibiograms were created. The pre-interventional period occurred between January 2000 and June 2002 (10 quarters) and the post-interventional period was defined from July 2002 to December 2006 (18 quarters). Segmented linear regression was used to analyse for a difference in the rates of change in susceptibility. RESULTS: A total of 2838 Gram-negative organisms were isolated from clinical sites from ICU patients during the study period. There was significant improvement in susceptibility of Pseudomonas to imipenem 18.3%/year [95% confidence interval (CI): 4.9-31.6; P = 0.009] and gentamicin 11.6%/year (95% CI: 1.8-21.5; P = 0.02) compared with the pre-intervention trend. Significant changes in the rates of gentamicin and ciprofloxacin susceptibility were also observed in the inducible Enterobacteriaceae group although these were less clinically significant. CONCLUSIONS: This study demonstrates improved antibiotic susceptibility of ICU Gram-negative isolates including Pseudomonas following an intervention aimed at reducing broad-spectrum antibiotics.

The treatment of headaches employing acupuncture.

Thirty-three patients have been treated by acupuncture since July 8, 1974, using body loci, ear points and electrical stimulation. Of the 33 cases, 18 were female and 15 were male, ranging in age from 25 to 77 years. Sixteen patients suffered from migraines, 12 from tension headaches, 2 from cluster headaches, 1 from vascular headaches, and for 2 patients the etiology was uncertain. The duration of the headaches ranged from 3 months to 40 years. The patients received from 3 to 16 treatments. Of the 33 cases, 5 patients had only 3 treatments and 10 patients had 5 or less treatments. Eighteen patients had good results, i.e., no headache at all. Twelve patients had fair results, that is they sometimes had headaches, but they could be controlled with a few repetitions of treatment or by analgesics at a lesser dosage than they were taking at the beginning of treatments. Three patients had no response at all or poor results; however, these discontinued treatment before the author could evaluate whether they were actual absolute no-response cases. Of the 33 patients, 2 patients had a good response after only 2 treatments; 4 had a good response after 10 treatments. However, most of the patients had a good response after 6-8 treatments. A course of treatment usually requires 10 to 14 visits befor definite evaluation of the results can be made. It was observed that patients with fair or particularly poor results usually discontinued treatment too early and/or had concomitant conditions as well. Even though a longer period of time for follow-up is necessary before drawing any conclusions, results have already shown that acupuncture, perhaps, can be a valuable form of treatment for headaches.