Combination of St. John's Wort Oil and Neem Oil in Pharmaceuticals: An Effective Treatment Option for Pressure Ulcers in Intensive Care Units.

Background and Objectives: Phytotherapeutically, various herbal remedies, such as St. John's wort oil, have been introduced as wound care options. Recently, Neem oil has been considered a herbal option for the management of superficial wounds. Wound care is a complex process that involves several factors including the patient, caregiver, and medications. Herbal combinations could be an alternative to the chemical counterparts in the wound care area. This report includes an investigation of the possible supportive impacts of the St. John's wort and Neem oil containing ointment (W Cura G Plus ®) in the management of pressure ulcers (PUs) in three intensive care unit (ICU) patients. Materials and Methods: The ointment was administered to individuals once daily for 42 consecutive days. The status of individuals was macroscopically monitored by measuring the PU area and histopathological assessment of the tissue sections taken on the first and last days of wound treatment. Results: The outcomes of the macroscopic and histopathological techniques exhibited that St. John's wort and Neem oil containing ointment provided a remarkable supportive impact on the patients that suffered from PUs in the ICUs. Conclusions: The combination of St. John's wort and Neem oil could be suggested as an efficient active phytoconstituent for the management of PUs. The herbal ointments may be suggested as an alternative for the patients that have PUs in the ICUs.

[Complex treatment of patients with pyo-necrotic complications of the neuropathic form of diabetic foot syndrome]. / Kompleksnoe lechenie bol'nykh s gnoino-nekroticheskimi oslozhneniyami pri neiropaticheskoi forme sindroma diabeticheskoi stopy.

OBJECTIVE: Of study is improving the results of treatment of patients with pyo-necrotic complications of diabetic foot syndrome by including the method of negative pressure wound treatment in the complex treatment program in combination with using of the combined antibacterial drug Cifran ST and immunocorrective therapy. MATERIAL AND METHODS: The results of examination and treatment of 184 patients with pyo-necrotic complications of the neuropathic form of diabetic foot syndrome were analyzed. According to choice of treatment methods in the postoperative period all patients were divided into two groups. In 95 patients (group I), iodine-containing ointments based on polyethylene glycol were used for local treatment of purulent foot wounds and standard systemic antibacterial therapy was performed. In 89 patients (group II), negative pressure wound treatment (NPWT) was used to treat wounds in the postoperative period. In addition to standard parenteral antimicrobial therapy, these patients also received an oral combined antibacterial drug Cifran ST and immunocorrective cytokine therapy (Leukinferon). The analysis of the dynamics of the wound process was carried out based on the clinical picture and the results of cytological, bacteriological and immunological studies of the wound exudate. RESULTS: The presented strategy of complex treatment of pyo-necrotic complications of the neuropathic form of diabetic foot syndrome allowed group II patients to significantly reduce the degree of microbial contamination of wounds, to achieve a faster regression of the content of proinflammatory and inflammatory cytokines in the wound exudate, as well as to reduce the time of wound cleansing and the transition of the pyo-necrotic process to the reparative stage in comparison with group I patients. This allowed group II patients to reduce the time of plastic closure of the wound from 24.3±0.5 to 15.6±1.7 days, to avoid generalization of infection, death and high level amputation of the limb. At the same time, 11.6% of patients in group I had high level limb amputation due to generalization of infection. The mortality rate in group I was 5.3%. CONCLUSIONS: Adding of vacuum therapy of wounds, systemic antimicrobial therapy using the combined antibacterial drug Cifran ST and immunocorrective cytokine therapy in the complex treatment program for patients with neuropathic form of diabetic foot syndrome after radical surgical treatment of the pyo-necrotic lesion allows reducing the time of wound cleansing and the transition of the pyo-necrotic process to the reparative stage. On the other hand, this makes it possible for this category of patients to perform plastic closure of the wound at an earlier date, avoid generalization of infection and high level amputation of the limb.

TREATMENT OF PYOINFLAMMATORY COMPLICATIONS WITH INDIVIDUALLY SELECTED OZONE DOSE IN PATIENTS WITH DIABETES.

The severity of purulent-inflammatory process in patients with diabetes mellitus is determined by lymphocytotoxic test. The test shows that application of intravenous ozone therapy with individually selected ozone dose significantly decreases the spread of necrotic suppurative focus already on the third day of treatment. Granulation tissue and marginal epithelization in the wound develops on the 6-8th day of hospitalization; normalization of glycemic levels shorten of the period of the hospital stay up to 3-5 days, compared to the control group.

[The improvement of complex treatment of odontogenous periostitis in elderly patients].

The paper presents the results of clinical examination of 114 patients aged 60-88 years with acute odontogenous periostitis receiving treatment in in-patient maxillofacial surgery unit. The dynamic of clinical symptoms is used to carry out the comparative effectiveness study of several peroral antibiotics in elderly patients.

[Microflora dynamics in purulent skin wound in rats after ozonized perftorane applications].

In 30 Wistar rats divided in 3 groups with 10 rats in each skin defects were reproduced under anaesthesia and wound surface was fixed with the help of plastic rings. The wounds were contaminated with microbe dredge consisting of St. aureus, Ps. aeruginosa and E. coli in the concentration of 10(9) cells/ml. After 24, 48, 72, 96 and 120 hours the wound was irrigated with 10-15 ml of the following solutions: in the 1st group - commercial perftorane solution, in the 2nd group - ozonized perftorane, in the 3rd group - physiological solution. Hard medium inoculation let determine total number of growing microbe colonies. The material was taken each 3rd day. 9 experimental series were executed with the total length of experiment equal to 30 days. It was established that from 15th day of the experiment in the group with ozonized perftorane irrigations the mean number of microorganisms in the wound was reduced, granulation tissue growth and epithelization were speeded up if compared with the groups of animals irrigated with physiological solution and non-ozonized perftorane. Ozone action was connected not only with its bactericidal properties but in considerable degree with comprehensive local immunity activation.

[Hentaxan as an immunoregulator in purulent wounds in parturient women]. / Hentaksan iak imunorehuliator pry hniinykh ranakh u porodil'.

Hentaxan, a new silicon sorbent, is a complex drug preparation containing hentamycin sulfate and zinc-tryptophan, endowed with antioxidant and immunomodulating activities. We used it for treating suppurating wounds in those women in labour. As many as 65 parturient women were examined. The conclusion drawn from the obtained results is that the immunomodulating potential of hentaxan is not very high, for which reason we recommend that hentaxan be combined with laferon which effects the T-link of immunity. The proposed method is at present under study.

[Use of ofloxacin in the treatment of suppurative-inflammatory complications in surgery]. / Opyt primeneniia ofloksatsina v lechenii gnoino-vospalitel'nykh oslozhnenii v khirurgii.

Analysis of ofloxacin use in clinical surgery over the latest decade showed that despite its wide clinical application for the prevention and therapy of postoperative complications, this drug remains highly active for the majority of micro-organisms. Hence, a wide spectrum, high bactericidal activity of the drug, optimal pharmacokinetics, and a high bio-availability (95-100%) still recommend ofloxacin, a highly effective agent for the treatment of infectious complications of surgery.

[Effect of miliacin oil on the healing of purulent wounds]. / Vliianie miliatsinovogo masla na zazhivlenie gnoinykh ran.

The efficacy of miliaceum (millet) oil in local application for the treatment of purulent wounds was studied for the first time. The oil is obtained from the waste products of millet processing. It was demonstrated in experiments on 55 rabbits with a model of a purulent wound that the studied preparation causes a marked anti-inflammatory effect, promotes rapid cleansing of the wounds from the pyonecrotic contents, and significantly activates the reparative processes. With the use of millet oil the term of wound healing reduced by 6-12 days on the average as compared to healing in treatment with buckthorn oil and Vishnevsky's ointment.

Reproductive performance in dairy cows following postpartum treatment with gonadotrophin releasing hormone and/or prostaglandin: a field trial.

Three hundred and five Holstein Friesian cows were given either 250 micrograms gonadotrophin releasing hormone (GnRH) or saline on day 15 postpartum followed by 500 micrograms cloprostenol or saline on day 24 postpartum. Four treatment groups were formed using random allocation: Group I -- placebo (Day 15)/placebo (Day 24), Group II -- GnRH (Day 15)/placebo (Day 24), Group III -- placebo (Day 15)/cloprostenol (Day 24), Group IV -- GnRH (Day 15)/cloprostenol (Day 24). Double blind techniques were used during the follow-up period. Rectal palpation, to assess uterine involution and ovarian activity was performed just prior to each treatment and again at 28 days postpartum. In addition blood samples were collected at 15, 24 and 28 days postpartum for measurement of plasma progesterone. There were no significant differences among treatment groups with respect to services per conception, number of heats detected before first service and culling for infertility. Cows treated only with GnRH had an increased calving to first estrus and calving to first breeding interval, and tended to have an increased calving to conception interval. Treatment with cloprostenol significantly decreased calving to conception and calving to first observed estrus intervals. Treatment with GnRH on day 15 postpartum resulted in a significant increase in the subsequent incidence of pyometra and prebreeding anestrus. On the other hand, cloprostenol treatment on day 24 postpartum resulted in a decreased incidence of pyometra, regardless of GnRH treatment and a decreased incidence of prebreeding anestrus in GnRH treated cows compared to cows receiving only GnRH at day 15 postpartum.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]. / Klinicheskaia éffektivnost' karbenitsillina pri gnoino-vospalitel'-nykh protsessakh razlichnoi lokalizatsii.

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.

[Effectiveness of gentamicin sulfate in suppurative-inflammatory processes of varying localization]. / Effektivnost' gentamitsina sul'fata pri gnoino-vospalitel'nykh protsessakh razlichnoi lokalizatsii.

Antibiotic sensitivity of 486 strains of grampositive and gramnegative organisms isolated from patients with purulent infections was studied in vitro. Gentamicin was shown to be highly active as compared to kanamycin and other antibiotics against the main causative agents of purulent inflammatory infections including multiresistant E. coli, Proteus, Ps. aeruginosa, Staphylococcus. High efficiency of gentamicin in therapy of peritonitis, septic conditions, purulent postoperative wounds, infections of the urinary tract, pneumonia, etc. (197 patients) was shown. Positive results were obtained in 87.4 per cent of the cases. Side effects, such as albuminuria, hyperthermic reaction, rash, pruritus were registered in 3 per cent of the patients.

Amoxycillin trihydrate (Ibeamox) in the treatment of pyogenic meningitis-a preliminary report.

Amoxycillin a new broad spectrum antibiotic has been found to be effective against common gram positive and negative bacteria diagnosed in clinical practice. Moreover, it achieves higher blood levels as compared to Ampicillin. Since it was available only for oral use it had not been tried in the treatment of bacterial meningitis. Recently Amoxycillin Trihydrate became available for parenteral administration. Here we report its use as a single drug in 11 cases of Pyogenic meningitis. The dose administered by intravenous route was 200-400 mg/kg/day. All the cases recovered. Only three had minor neurological sequelae. Amoxycillin Trihydrate appears to be a safe and effective drug as there were no side effects or toxic manifestation even with the high dosage schedule.

[Fucidin, its basic properties and place in the modern therapy of suppurative and inflammatory processes]. / Fuzidin--osnovnye svoistva i mesto v sovremennoi terapii gnoino-vospalitel'nykh protsessov

Sodium fusidin prepared at the All-Union Research Institute of Antibiotics was studied experimentally and clinically. High antibacterial activity of fusidin especially against methicillin-resistant staphylococci was found. The clinical trials showed high efficacy of fusidin in treatment of perichondritis, osteomyelitis, pyodermia, pseudofurunculosis, multiple abscesses of the skin because of its satisfactory penetration into the skin and cartilage tissues, skin and subcutaneous cellular tissue. The tolerance of the drug by most of the patients was satisfactory.

[Dynamics of the antibiotic sensitivity of the staphylococci in suppurative, inflammatory foci in patients during the period of the hospital stay]. / Dinamika chuvstvitel'nosti k antibiotikam stafilokkov v gnoino-vospalitel'nykh ochagakh bol'nykh v period prebyvaniia v statsionare

The dynamics of staphylococci sensitivity to antibiotics in purulent foci of 242 in patients was studied. Two criteria were used for estimation of the above process, i.e. (I) sensitivity to the antibiotics of the whole staphylococcal population isolated and (2) sensitivity to the antibiotics of separate strains isolated from the population. In 10 or more days the number of the in-patients with staphylococci resistant to streptomycin, monomycin or oxacillin in the purulent foci increased. The number of the in-patients with penicillin, neomycin or chloramphenicol resistant staphylocci was statistically doubtful. The average number of the antibiotic resistant microbial cells in the staphylococcal populations of the foci in the patients during their stay in the hospital increased 2-4 times.