Background: Wound infections constitute a significant problem in surgical procedures. In cesarean sections (CS), this is particularly important as a wound infection not only results in increased morbidity but also has far-reaching implications by way of pelvic organ disease, disturbance of the bonding process between mother and baby in the puerperium, and a longer hospital stay with its inherent problems. Objective: This study was conducted with the aim to determine the incidence and risk factor associated with surgical site infection (SSI) following cesarean section. Methodology: A retrospective cross-sectional study was conducted for 400 women undergoing cesarean section procedures during an 18-month period from January 2013 to June 2014 at Hospital Pulau Pinang, Malaysia. Patients’ socio-demographic, clinical data and incidence of SSI following the CS were noted using a standardized data collection form. SPSS v 21 was used for data analysis. Results: In total, 18.8% of the study participants developed SSI. Multivariate logistic regression analysis identified the following: higher body mass index (≥30 kg/m2) (odds ratio [OR]: 0.555; 95% confidence interval [CI] = 0.313-0.985, P = .044), increase in the blood loss during surgery (≥500 mL) (OR: 0.757; 95% CI = 0.423-1.354, P = .034), prolonged hospital stay (≥4 days) (OR: 0.439; 95% CI = 0.260-0.740, P = .002), spinal anesthesia (OR: 1.543; 95% CI = 1.230-1.937, P = .021), breech baby presentation (OR:2.927 95% CI = 1.020-8.400, P = .046), and intrathecal analgesia (OR:1.567; 95% CI = 1.246-1.970, P = .001) had statistically significant association with incidence of SSI. Conclusions: Surgical site infections are common among women undergoing CS at Hospital Pulau Pinang. Special attention and enhanced clinical management of patients with identified risk factors for developing SSI may decrease its incidence.

L-Theanine is an amino acid derivative primarily found in tea. It has been reported to promote relaxation and have neuroprotective effects. The present study was designed to investigate the role of oxidative stress and the status of antioxidant system in the management of aluminum chloride (AlCl3) induced brain toxicity in various rat brain regions and further to elucidate the potential role of L-Theanine in alleviating such negative effects. Aluminium administration significantly decreased the level of reduced glutathione and the activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, Na(+)/K(+) ATPase, Ca(2+) ATPase and Mg(2+) ATPase and increased the level of lipid peroxidation and the activities of alkaline phosphatase, acid phosphatase, alanine transaminase and aspartate transaminase in all the brain regions when compared with control rats. Pre-treatment with L-Theanine at a dose of 200 mg/kg b.w. significantly increased the antioxidant status and activities of membrane bound enzymes and also decreased the level of LPO and the activities of marker enzymes, when compared with aluminium induced rats. Aluminium induction also caused histopathological changes in the cerebral cortex, cerebellum and hippocampus of rat brain which was reverted by pretreatment with L-Theanine. The present study clearly indicates the potential of L-Theanine in counteracting the damage inflicted by aluminium on rat brain regions.

Pharmacological properties exhibited by latex of plants are due to various biologically active compounds including several proteolytic enzymes. Present study evaluates hemostatic potential of Tabernaemontana divaricata and Artocarpus altilis from Apocynaceae and Moraceae families respectively. The latex of these plants were initially subjected to dialysis and crude extracts were estimated for proteolytic activity using casein as the substrate. Mean caseinolytic activity for 100 μg of latex protein was found to be 56.16 ± 0.57 and 45 ± 0.3 U/h for T. divaricata and A. altilis respectively. Caseinolytic activity by both the plant extracts was higher than standard proteases, papain and trypsin. However the difference was significant (p < 0.05) with papain alone. Crude enzymes (CE) from both plants exhibited coagulant activity on human platelet poor plasma by recalcification time. A significant reduction in clotting time was exhibited by T. divaricata compared to A. altilis (p < 0.05). These results were further substantiated with fibrinogen agarose plate assay. Crude enzyme of both plants also hydrolyzed blood clot. Mean % of thrombolysis by T. divaricata was 80.75 ± 1.2 and that of A. altilis was 70.24 ± 1.52. Inhibition studies confirmed cysteine protease nature of CE. Comparative analysis revealed T. divaricata to be the best among the two for its hemostatic potential. This study scientifically validates the use of latex from these plants in the management of fresh cuts or wounds.

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