Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers Based on Wagner Grading: A Systematic Review and Meta-analysis.

Background: Diabetic foot ulcers (DFUs) are common complications of uncontrolled diabetes mellitus that can result in infection and amputation of the lower extremities. This study compared the benefits and risks of hyperbaric oxygen therapy with those of other DFU treatments, based on the Wagner grading system. Methods: Systematic searches for randomly controlled trials using hyperbaric oxygen therapy for DFUs were performed using PubMed, the Cochrane Library, and Embase. Data regarding demographics, wound healing, minor and major amputations, operative debridement, nonhealing wounds, and adverse effects were analyzed based on Wagner grades, using RevMan 5.4.1 and Microsoft Excel. Results: Hyperbaric oxygen therapy was significantly superior to other treatments for wound healing rates 8 or more weeks after the final treatment (RR = 2.39; 1.87-3.05; P < 0.00001) minor/distal amputations (RR = 0.58; 0.43-0.80; P < 0.007), and major/proximal amputations (RR = 0.31; 0.18-0.52; P < 0.00001) for the 14 studies analyzed. In addition, this therapy increased the rate of complete wound healing for Wagner grades II (RR = 21.11; 3.05-146.03; P = 0.002), III (RR = 19.58; 2.82-135.94, P = 0.003), and IV (RR = 17.53; 2.45-125.44; P = 0.004); decreased the minor/distal amputation rate for grade III (RR = 0.06; 0.01-0.29; P = 0.0004) and the major/proximal amputation rate on for grade IV (RR = 0.08; 0.03-0.25; P < 0.0001); and decreased the operative debridement rate for Wagner grade II (RR = 0.09; 0.01-0.60; P = 0.01). Conclusions: Moderate-quality evidence revealed that adjunctive hyperbaric oxygen therapy improved DFU wound healing for Wagner grades II, III, and IV; prevented minor and major amputations for grades III and IV, respectively; and prevented operative debridement in grade II wounds.

Antimicrobial Potential of Rhynchophorus Beetle Larval Haemolymph Against Methicillin-Resistant Staphylococcus aureus and Neisseria gonorrhoeae.

<b>Background and Objective:</b> The emergence of methicillin-resistant community-acquired <i>Staphylococcus aureus </i>and antibiotic-resistant <i>Neisseria gonorrhoeae</i> has raised significant concerns. Efforts to combat resistance involve the exploration of novel alternative therapies, particularly those derived from insect components. <i>Rhynchophorus</i> sp., a coconut pest commonly found in Southeast Asia, has haemolymph that exhibits bactericidal properties<i>.</i> The objective of this study was to assess the potential of the haemolymph of <i>Rhynchophorus</i> sp., larvae as an antimicrobial agent against Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and <i>Neisseria gonorrhoeae</i>. <b>Materials and Methods:</b> In this study, <i>Rhynchophorus</i> sp., larvae were gathered for the purpose of haemolymph extraction. These larvae were then divided into distinct groups, with one group subjected to immunization using <i>Escherichia coli</i>, while another group was left unimmunized. The study utilized the well diffusion method to evaluate antibacterial effectiveness. <b>Results:</b> Haemolymph fluid extracts from <i>Escherichia</i> coli-immunized <i>Rhynchophorus</i> sp., larvae, exhibited strong antibacterial activity, with an average value of 19.3±0.47 mm, against MRSA, more enhanced compared to unimmunized larvae. In contrast, haemolymph fluid extracts from <i>Escherichia coli</i>-immunized <i>Rhynchophorus</i> sp., larvae demonstrated a more moderate antibacterial activity, with a mean of 14.17±0.27 mm, against <i>Neisseria gonorrhoeae</i>, a level similar to unimmunized larvae. <b>Conclusion:</b> The haemolymph extracted from <i>Rhynchophorus </i>sp., beetles larvae exhibited antimicrobial effects against MRSA and <i>Neisseria gonorrhoeae</i>, particularly when it is enhanced through <i>Escherichia coli</i> immunization.

Molecular Insight into the Pharmacological Potential of Clerodendrum minahassae Leaf Extract for Type-2 Diabetes Management Using the Network Pharmacology Approach.

Background and Objectives: The increasing occurrence and prevalence of type-2 diabetes mellitus (T2DM) have led to a growing interest in researching available treatment alternatives. Clerodendrum minahassae, a native plant species of North Sulawesi, has been a focus of ethnopharmacological studies due to its significance contributions to drug development, particularly its potential antidiabetic properties. This study investigated the pharmacological potential of Clerodendrum minahassae (CM) leaf extract for managing type-2 diabetes (T2DM) using a network pharmacology approach. Materials and Methods: Active compounds were extracted from CM leaves, and their interactions with target proteins in T2DM were explored through various in silico analyses. Results: SAR analysis using Way2Drug Pass Online identified 29 bioactive CM leaf extract compounds with promise as T2DM treatments. Additionally, 26 of these met Ro5 criteria for favorable drug-likeness. Most compounds exhibited positive pharmacodynamic and pharmacokinetic profiles, with 22 considered safe, while 7 posed potential toxicity risks when ingested individually. CM leaf extract targeted 60 T2DM-related proteins, potentially affecting T2DM via cytokine regulation, particularly in proteins linked to metabolic processes, cellular response to angiotensin, and the sphingosine-1-phosphate signaling pathway. The network pharmacology analysis identified five genes targeted by CM leaf extract, namely, STAT3, MAPK1, ESR1, PIK3R1, and NFKB1. Among these genes, PIK3R1's interaction with the insulin receptor (INSR) positions it as a crucial candidate gene due to its pivotal role in insulin signal transduction during T2DM development. Conclusions: This research sheds light on the therapeutic potential of CM leaf extract for treating T2DM. This potential is attributed to the diverse array of bioactive compounds present in the extract, which have the capacity to interact with and inhibit proteins participating in the insulin signal transduction pathway crucial for the progression of T2DM. The findings of this study may open up possibilities for future applications of CM leaf extract in the development of novel T2DM treatments.

Bactericidal effect of hyperbaric oxygen therapy in burn injuries.

INTRODUCTION: Burn injuries are frequently encountered in emergency cases and often become the port of entry for pathogens. More than 450,000 burn injuries occur annually causing nearly 3,400 deaths in the United States. The prevalence of burn injury in Indonesia is 0.7% in 2013. More than half of these According to several studies on the use of patients were treated for bacterial infections, some of which were resistant to certain antibiotics. Using hyperbaric oxygen therapy (HBOT) to treat burns has several positive effects including managing bacterial infections, as well as accelerating the wound healing process. Therefore, this study aims to prove the effectiveness of HBOT in inhibiting bacterial growth. METHODS: This is an experimental research study in rabbits using a post-test control group design. 38 rabbits were given second-degree burns on the shoulder region with a metal iron plate that has been previously heated for 3 min. Bacterial cultures were taken on days 5 and 10 after exposure to the burns. The samples were divided into two groups, HBOT and control. Statistical analyses were performed using the Mann-Whitney U method. RESULTS: Gram-negative bacteria were the most frequently found pathogen in both groups. Citrobacter freundi was the most common Gram-negative bacteria (34%) found in the culture results of both groups.In contrast to the control group, there was no bacterial growth found in the HBOT group's culture results, (0%) vs (58%). A significant reduction of bacterial growth was observed in the HBOT group (69%) compared with the control group (5%). Bacterial levels stagnated in 6 rabbits (31%) in the HBOT group and 7 rabbits (37%) in the control group. Overall, there was significantly less bacterial growth in the HBOT treatment group compared with the control group (p < 0.001). CONCLUSION: HBOT administration can significantly reduce bacterial growth in burn injuries.

Data on the docking of phytoconstituents of betel plant and matcha green tea on SARS-CoV-2.

Betel (Piper betle L.) and green tea (Camellia sinensis (L) O. Kuntze) have been used for a long time as traditional medicine. The docking of phytoconstituents contained in the betel plant was evaluated against Mpro, and matcha green tea was evaluated against five target receptors of SARS-CoV-2 as follows: spike ectodomain structure (open state), receptor-binding domain (RDB), main protease (Mpro), RNA-dependent RNA polymerase (RdRp), dan papain-like protease (PLpro). The evaluation was carried out based on the value of binding-free energy and the types of interactions of the amino acids at the receptors that interact with the ligands.