THE NEW ARMENIAN MEDICAL JOURNAL

Vo l u m e 1 8 ( 2 0 2 4 ) , Issue 3, p .99-105

DOI: [Link]

COMBATING MULTI-DRUG RESISTANCE: POTENTIALS

OF KALANCHOE PINNATA EXTRACTS
AGAINST BACTERIAL PATHOGENS
Poyil M.M.1*, Shamna K.P.2, Raja K.3
1
Department of Basic Medical Sciences, College of Medicine, Prince Sattam bin Abdulaziz
University, Al-Kharj, Saudi Arabia
2
Deseeya Ayurvedic Pharmaceuticals Ltd, Calicut, Kerala, India
3
Genolites Research and Development Laboratory, Coimbatore, Tamil Nadu, India
Received 12.05023; Accepted for printing 04.08.2024
Abstract
Background: The rapid rise of microbial resistance to traditional antibiotics has caused grave
concerns for the treatment of infectious diseases. This serious problem increases the demand
for significant plant-based antibacterial and antimicrobial drugs. Kalanchoe pinnata is one of
the plants that has had significant antibacterial effects due to the presence of a wide range of
bioactive compounds, so it could be an effective substitute for the current synthetic antibiotics.
The study aimed to evaluate the anti-bacterial and antioxidant properties of a methanolic
extract of Kalanchoe pinnata leaves.
Materials and Methods: The preliminary phytochemical screening was performed using
standard biochemical assays. The anti-bacterial activity was determined against multidrug-
resistant E. coli and S. aureus using the well-diffusion method. The 2,2-diphenyl-1-picrylhydrazyl
and ferric ion reducing antioxidant potential assays were used to evaluate the antioxidant activity.
Results: The methanolic extract of Kalanchoe pinnata leaves showed the presence of flavonoids,
saponins, steroids, phenol, quinones, and proteins. The remarkable anti-bacterial activities were
displayed against multidrug-resistant E. coli and S. aureus, with minimum inhibitory concentration
values of 50 mg/mL and 12.5 mg/mL, respectively. The significant antioxidant activity was exhibited
in 2,2-diphenyl-1-picrylhydrazyl and ferric ion reducing antioxidant potential assays.
Conclusion: The results of this investigation suggested that the Kalanchoe pinnata extract
may be useful as an alternative for antibiotics and may have pharmacological promise in the
treatment of many diseases.
Keywords: anti-bacterial, antibiotics, antioxidant, E. coli, S. aureus, Kalanchoe pinnata, multidrug resistance.
Introduction
Infectious diseases are regarded as a serious which has been widely documented across the
concern for global health, and their consequences world [Sahin A et al., 2019]. It is a major issue
are on the increase throughout the globe, owing when harmful bacteria become resistant to specific
mostly to drug resistance to pathogenic bacteria, drugs, and the rise of multidrug-resistant strains
Cite This Article as:
Poyil M.M., Shamna K. P., Raja K. (2024). Combating multi-drug resistance: potentials of kalanchoe pinnata
extracts against bacterial pathogens: A systematic review, The New Armenian Medical Journal, vol.18(2), 99-105;
[Link] 10.56936/18290825-3.v18.2024-99
Address for Correspondence:
Muhammad Musthafa Poyil, [Link]., Ph.D, Lecturer & Lab. Safety In-charge,
Department of Basic Medical Sciences, College of Medicine Prince Sattam bin Abdulaziz University
Al-Kharj 11942, Saudi Arabia
Tel.: +966565634412 (mob.), +966 15886 176
E-mail: [Link]@[Link]

99
Poyil M.M et al. The New Armenian Medical Journal, Vol.18 (2024), Is.3, p.99-105

constitute a growing challenge in the management have beneficial antibacterial properties. Hence,
of bacterial infections [Chattopadhyay D, 2010]. this plant is a viable alternative to the present syn-
In recent times, there have been increases in thetic antibiotics since it contains bioactive com-
antibiotic-resistant strains of clinically important ponents that suggest its antibacterial activity
pathogens, which have led to the emergence of against pathogenic microbes and has a number of
new bacterial strains that are multi-resistant therapeutic effects [Tajudin N, Ismail N, 2022].
[Pattewar S et al., 2013]. The search for novel an- The current study is to evaluate the anti-bacterial
timicrobial agents to combat resistance has always and antioxidant properties of methanolic extract of
been a primary research focus for the pharmaceuti- Kalanchoe pinnata leaves.
cal sector [Abreu A et al., 2012]. The discovery
and development of novel active compounds ca- Materials and methods
pable of partially or totally inhibiting the resis- Sample collection: The leaves of Kalanchoe
tance mechanisms of bacteria is a significant pro- pinnata were collected from nearby nursery. The
spective approach to addressing the resistance collected leaves were washed thoroughly using
issue [Walker E, Levy F, 2001]. sterile distilled water, and they were shade dried at
Numerous studies focused on developing novel room temperature. The dried leaves were finely
alternative pharmaceuticals to alleviate resistance is- pulverised and stored in sealed containers.
sues. Scientists have been interested in phytochemi- Extract preparation: 20 g of powdered Kalan-
cals from plants for a long time because of their vari- choe pinnata leaves were inserted in a porous bag in
ety in structure, lack of negative side effects, and the Soxhlet apparatus. A 200 mL methanol solution
higher level of public acceptance [Geddawy A et al., was added to the extractor, which was then heated to
2023; Ferrazzano G et al., 2015]. Traditional medi- 60°C and left for six hours for the optimum extrac-
cines are a vital component in healthcare sectors all tion of phytoconstituents. The solvent was evapo-
over the world. Plants and plant extracts are used as a rated, and the obtained extract was stored for further
primary source of healthcare for around three-quar- analysis [Mohamad C et al., 2023].
ters of the worldwide population. The medicinal Phytochemical screening: The preliminary
plants are regarded as a sustainable and appealing phytochemical screening was performed to detect
source of antimicrobial compounds, with several in the existence of phytochemicals such as tannins,
vitro studies proving the pharmacological activities flavonoids, saponins, steroids, terpenoids, glyco-
of phytoconstituents as an alternative source for anti- sides, phenols, alkaloids, quinones, and proteins
biotics [Abreu A et al., 2012]. The majority of thera- using the methods described in the previous works
peutically useful compounds derived from plants are [Jyothiprabha V, Venkatachalam P, 2016; Boggula
secondary plant metabolites. Depending on the spe- N, Peddapalli H, 2017].
cies, the geography, and the climate of the nation of Anti-bacterial activity: Bacterial strains: Two
origin, they have a broad spectrum of activities and different multi-drug-resistant bacterial strains,
may possess various types of bioactive components such as multidrug-resistant E. coli and S. aureus,
[Savoia D, 2012]. were used to analyse the anti-bacterial activity of a
Kalanchoe is a genus with numerous species, methanolic extract of Kalanchoe pinnata leaves.
the majority of which are employed as medicinal Antibiotic Sensitivity Test - Disc diffusion
agents to cure a variety of health conditions [Ra- method: The Mueller-Hinton medium was steril-
jsekhar P et al., 2016]. The bufadienolides found ised and poured into the sterile petri dishes. The
in the leaves are a class of extremely potent com- overnight-grown cultures of test bacteria such as
pounds that have attracted the attention of re- multidrug-resistant E. coli and S. aureus were in-
searchers [Quazi M et al., 2011]. oculated into the agar plates, respectively. The
Kalanchoe pinnata is traditionally used to treat standard antibiotic discs like cefmetazole, cipro-
diarrhoea, chlamydia, cithiasis, earaches, rheuma- floxacin, streptomycin, ampicillin, and tetracy-
tism, burns, inflammation, ulcers, abscesses, in- cline are placed on an agar surface seeded with test
sect bites, and whitlow [Biswas S et al., 2011]. Ka- bacterial strains. Then, the plates were incubated
lanchoe pinnata is one of the plants reported to overnight and checked for an inhibitory zone

100
The New Armenian Medical Journal, Vol. 18 (2024), Is.3, p. 99-105 Poyil M.M et al.

around each disc [Boggula N et al., 2017]. AC-AS

Inhibition (%) = ×100
Anti-bacterial activity - Well-diffusion method: AS
The anti-bacterial activity of the methanolic ex-
tract of Kalanchoe pinnata leaves was assessed where AC is Absorbance of Control, AS - Absor-
using the well diffusion method against multidrug- bance of Sample.
resistant E. coli and S. aureus. 0.1% of overnight FRAP assay: The FRAP reagent solution,
cultures of test organisms were swabbed through- which consists of 10 mM TPTZ, 20 mM FeCl3.6H2O,
out the Mueller –Hinton agar surface with a sterile and 300 mM sodium acetate buffer in a [Link]
cotton swab. Different concentrations of methano- ratio, was made and kept at 37°C. The various ali-
lic extract of Kalanchoe pinnata leaf extract such quots of methanolic extract of Kalanchoe pinnata
as 0.125 g, 0.25 g, 0.5 g, and 1 g were introduced leaves were mixed with 3 mL of FRAP reagent so-
to the wells, respectively and the plates were incu- lution. The test tubes with the reaction mixture
bated overnight at 37ºC. The diameter of the re- were incubated at 37°C for 30 min, and the absor-
sulting zone around the well was measured and bance was determined at a wavelength of 610 nm.
recorded in millimetres [Boggula N et al., 2017].
Results
Minimum Inhibitory Concentration: The resa-
zurin method was used to evaluate the minimum Phytochemical screening: The methanolic ex-
inhibitory concentration of the methanolic extract tract of Kalanchoe pinnata leaves showed the pres-
of Kalanchoe pinnata leaves against multidrug- ence of flavonoids, saponins, steroids, phenol, qui-
resistant E. coli and S. aureus, respectively. A ster- nones, and proteins. The phytochemicals such as
ile 96 well microtiter plate was added along with tannins, terpenoids, glycosides, and alkaloids were
100 µl of methanolic extract of Kalanchoe pinnata absent in the Kalanchoe pinnata extract. The re-
leaves, and 50 µl of nutritional broth was pipetted sults of preliminary phytochemical screening were
into each of the remaining wells. Each well con- given in table 1.
tained 50 µl of the test material, which was diluted Antibiotic sensitivity test: The tested bacteria,
in successive steps to ever-lower quantities. Fol- such as multidrug-resistant E. coli and S. aureus,
lowing the addition of 10 µl of Resazurin to each were resistant to standard antibiotics like strepto-
well, the appropriate test organisms [5 X106 cfu/ mycin, cefmetazole, ciprofloxacin, ampicillin, and
mL] were then added. tetracycline. No inhibitory zone was observed for
The minimum bactericidal concentration value multidrug-resistant S. aureus around any of the an-
was determined when there was no growth or de- tibiotic discs. The growth of multidrug-resistant E.
velopment of the bacterial colony from the directly coli was slightly inhibited by the streptomycin
plated contents of the microtiter plate wells [Sarker with zone of inhibition 4 mm (Fig. 1).
S et al., 2007; Elshikh M et al., 2016].
Antioxidant activity: The antioxidant activity Table 1.
of the methanolic extract of Kalanchoe pinnata Phytochemical screening of Meth-
leaves was determined using 2,2-di-phenyl-1-pic- anolic extract
rylhydrazyl (DPPH) radical scavenging and the of Kalanchoe pinnata leaves
ferric ion reducing antioxidant potential (FRAP) K. pinnata
Phytochemicals
assay. Ascorbic acid was used as a standard. extract
DPPH radical scavenging assay: Methanolic Tannin -
Flavonoids +
extracts of Kalanchoe pinnata leaves at various
Saponin +
concentrations [25, 50, 75, 100, 250, 500, 750, and
Steroid +
1000 µg/mL] were each combined with 3 mL of a Terpenoid -
0.1 mM methanolic DPPH solution and incubated Glycoside -
at room temperature for 30 min. The optical den- Phenol +
sity was assessed using a UV-Vis spectrophotom- Alkaloid -
eter at λ = 571 nm. Inhibition was estimated bythe Quinone +
following formula: Protein +

101
Poyil M.M et al. The New Armenian Medical Journal, Vol.18 (2024), Is.3, p.99-105

12.5 25 50 75 100 250 500 750 1000

Concentration Kalanchoe pinnata (µg/mL)
Figure 3. Minimum Inhibitory Concentration of the ex-
tract of Kalanchoe pinnata– Resazurin method

A B
Figure 1. Antibiotic sensitivity test for the bacterial
pathogens E. coli (A) and S. aureus (B).
Anti-bacterial activity: All the tested concen-
trations of methanolic extract of Kalanchoe pin-
nata leaves exhibited antibacterial activity against
the multidrug-resistant E. coli as well as the multi-
drug-resistant S. aureus. The maximum inhibitory
zone obtained for multidrug-resistant E. coli was
19 mm and 17 mm for S. aureus. The minimum in- Figure 4. Minimum Bactericidal Concentration of the ex-
hibitory zones observed for multidrug-resistant E. tract of Kalanchoe pinnata for the E. coli and S. aureus
coli and S. aureus were 9 mm and 8 mm, respec- Antioxidant activity
tively, at 0.125 g of extract. The multidrug-resis-
tant E. coli was found to be more susceptible to the DPPH radical scavenging assay: The absor-
methanolic extract of Kalanchoe pinnata than the bance shift caused by lowered DPPH was utilised
multidrug-resistant S. aureus. The anti-bacterial to assess the potential of plant extracts to serve as
activity of the Kalanchoe pinnata extract was in- antioxidants against free radicals. The methanolic
creased with increasing concentrations of the ex- extract of Kalanchoe pinnata scavenged the DPPH
tract (Fig. 2). radicals in a concentration-related manner. The
highest percentage of inhibition recorded was
73.98 at a concentration of 1000 µg/mL. The mini-
mum DPPH scavenging percentage was 1.43 at 25
µg/mL. The IC50 was found to be 154.52 µg/m.
FRAP assay: The maximum FRAP value ob-
tained at 1000 µg/mL was 71.62, whereas the min-
imum value was observed to be 16.01 at 25 µg/mL.
A B The IC50 value was calculated to be 127 µg/mL.
Figure 2. Anti-bacterial activity of methanolic extract of
Kalanchoe pinnata for the E. coli (A) and S. aureus (B). Discussion
Minimum inhibitory concentration and mini- Plants are now being looked at as potential
mum bactericidal concentration: The minimum sources of powerful antibacterial agents [Ojo O et
inhibitory concentration value of a methanolic ex- al., 2007]. Kalanchoe sp. have ethnopharmacolog-
tract of Kalanchoe pinnata was determined to be ical uses everywhere they are found and are some-
50 mg/mL and 12.5 mg/mL for multidrug-resistant times referred to as “wonder leaves” due to their
E. coli and S. aureus, respectively (Fig. 3). The usage in healing a variety of diseases. The potent
minimum inhibitory concentration of the methano- antibacterial capabilities of Kalanchoe species
lic extract of Kalanchoe pinnata plated on the agar have been proven [Richwagen N et al., 2019].
plates didn’t show any inhibitory zone. Hence, the The present study investigated the anti-bacte-
minimum bactericidal concentration value was rial and antioxidant properties of a methanolic ex-
also the same as the minimum inhibitory concen- tract of Kalanchoe pinnata leaves. Preliminary
tration (Fig. 4). phytochemical screening carried out using stan-

102
The New Armenian Medical Journal, Vol. 18 (2024), Is.3, p. 99-105 Poyil M.M et al.

dard assays showed the presence of flavonoids, al- methanolic Kalanchoe pinnata leaf extract (60%)
kaloids, saponins, tannins, steroids, and phenols in was tested for antibacterial activity, and the mini-
the ethanolic and aqueous leaf extracts of Kalan- mum inhibitory concentration and minimum bac-
choe pinnata [Hamilton-Amachree A, Uzoekwe N, tericidal concentration values against Staphylo-
2022]. The methanolic extract (60%) of Kalanchoe coccus aureus were determined to be 30 mg
pinnata leaves exhibited bactericidal action against [Pattewar S, Patil D, 2014], which showed simi-
five out of eight tested bacteria at a concentration larities to our findings.
of 25 mg/mL. Shigella dysenteriae, Proteus vul- It has been suggested that the phenolic chemi-
garis, Bacillus subtilis, and S. aureus were shown cals, especially flavonoids, present in these medici-
to be inhibited, while Klebsiella pneumoniae, P. nal plants may be responsible for their antioxidant
aeruginosa, and Candida albicans were found to properties since they include hydroxyl functional
be resistant to the extract [Akinpelu D, 2000]. The groups [Borkataky M et al., 2014]. The highest ab-
findings of Biswas et al. (2011) demonstrated the sorption of DPPH (a stable free radical) with a rich
potent anti-bacterial activity of the ethanolic ex- purple colour occurs at 517 nm. Thus, the methano-
tract of the Kalanchoe pinnata leaves against S. lic extract of Kalanchoe pinnata leaves inhibited the
dysenteriae, E. coli, and P. aeruginosa, with the DPPH free radicals in a concentration-related man-
zone of inhibition ranging from 6.0 0.35 to 8.2 ner. The ethanolic extracts of Kalanchoe pinnata
0.22 mm. Interestingly, the growth of pathogenic showed a concentration-related inhibitory impact in
bacteria such as Clostridium perfringens, Salmo- the DPPH assay, where the maximal inhibitory ef-
nella typhimurium, Staphylococcus aureus, and fect was reported to be 49.5% (2000 g/mL) [Cano L
Enterobacter aerogenes were inhibited by the et al., 2021]. The treatment of an alcoholic extract
methanolic extract of Kalanchoe pinnata [Jassal P of Kalanchoe pinnata leaf extract in a dose-depen-
et al., 2019]. The bactericidal potential of the Ka- dent manner successfully scavenged the hydroxyl
lanchoe mortagei and Kalanchoe fedtschenkoi ex- radicals produced in vitro. The extract dispersed the
tracts was evaluated against the ESKAPE patho- superoxide radicals generated in the in vitro media
gens [Richwagen N et al., 2019]. The study of Su- in a dose-related manner. The total antioxidant
dayasa et al. (2022) disclosed the anti-bacterial property of Kalanchoe pinnata extract was substan-
activity of different concentrations of ethanolic tial when compared to controls [Mohan S et al.,
extract [7.5%, 15%, 30%, 60%, and 100%] of Ka- 2012]. Similarly, the work done by Jassal et al.
lanchoe pinnata leaves against Staphylococcus au- (2019) with a methanolic extract of Kalanchoe pin-
reus and Salmonella typhi. The maximum zone of nata leaves and stem exhibited concentration-de-
inhibition was recorded for 100% of Kalanchoe pendent DPPH inhibition.
pinnata leaves against Staphylococcus aureus and The ability of plant extracts to convert the Fe3+-
Salmonella typhi, with average inhibitory zone di- TPTZ complex to Fe2+ ions in acidic environments
ameters of 22.25 mm and 23 mm, respectively. is used as a sign of their potential as an antioxidant
The current study showed that the minimum in- [Suksungworn et al., 2021]. Hence, according to
hibitory concentration values were 50 mg/mL and our result, the methanolic extract of Kalanchoe
12.5 mg/mL for multidrug-resistant E. coli and S. pinnata affects the reduction of the Fe+3 TPTZ
aureus, respectively. Similarly, the minimum in- complex to a ferrous ion by acting as an electron
hibitory concentration of an absolute methanol- donor. Likewise, the hydroalcoholic extract of the
derived Kalanchoe pinnata extract was found to be Kalanchoe pinnata leaves was evaluated using the
10.6 0.53 mg/mL and 11.7 0.60 mg/mL for S. au- ferric ion reducing antioxidant potential and Cu-
reus and E. coli, respectively, using the Resazurin pric Reducing Antioxidant Capacity assays [Phatak
microtiter-plate assay [Saleem et al., 2015]. The and Hendre, 2014].
findings of Desai P. (2014) revealed that the meth-
Conclusion
anol extract of Kalanchoe pinnata leaves inhibited
the growth of E. coli and S. aureus with minimum The methanolic extract of Kalanchoe pinnata
inhibitory concentration values of 0.35 and contains the phytochemicals such as flavonoids, sa-
0.7mg/100l of extract, respectively. However, the ponins, steroids, phenol, quinone, and protein.

103
Poyil M.M et al. The New Armenian Medical Journal, Vol.18 (2024), Is.3, p.99-105

Moreover, it has exhibited bactericidal action 1-picrylhydrazyl and ferrous ion reducing power.
against multidrug strains such as multidrug-resis- Hence, the methanolic extract of Kalanchoe pinnata
tant E. coli, and S. aureus. The potent antioxidant have the ability to serve as the antimicrobial agent
properties of the Kalanchoe pinnata extract was to combat the multidrug resistance and also aids in
proved by its scavenging activity of 2,2-di-phenyl- the reduction of the reactive oxygen species levels.
Acknowledgments: The authors are grateful to the Deanship of Scientific Research, Prince Sattam bin
Abdulaziz University, Al-Kharj, Saudi Arabia for its support and encouragement in conducting the re-
search and publishing this report.

REFERENCES
1. Abreu AC, McBain AJ, Simoes M (2012). Plants oxidant and anti-inflammatory activity. Euro-
as sources of new antimicrobials and resistance- pean Journal of Medicinal Plants. 32(5): 45-54
modifying agents. Natural product reports. DOI: 10.9734/EJMP/2021/v32i530392
29(9): 1007-1021 DOI: 10.1039/c2np20035j
8. Chattopadhyay D (2010). Ethnomedicine: a
2. Akinpelu DA (2000). Antimicrobial activity source of complementary therapeutics. Re-
of Bryophyllum pinnatum leaves. Fitotera- search Signpost, Beliaghata, Kolkata.
pia. 71(2): 193-194 DOI: 10.1016/s0367-
9. Christiana KA, Mary KL, Esther AA (2019). Phy-
326x(99)00135-5
tochemical, antioxidant and antimicrobial evalu-
3. Biswas SK, Chowdhury A, Das J, Karmakar ation of nigerian Kalanchoe pinnata (LAM.).
UK, Shill MC (2011). Assessment of cytotox- Journal of Chemical Society of Nigeria. 44(6)
icity and antibacterial activities of ethanolic
10. Desai PV (2014). Phytochemical Analysis and
extracts of Kalanchoe pinnata Linn. (Fam-
In-Vitro Antibacterial Activity of Kalanchoe
ily: Crassulaceae) leaves and stems. Inter-
pinnata against Human Pathogens Isolated from
national Journal of Pharmaceutical Sciences
UTI. International Conference on Multidisci-
and Research. 2(10): 2605 DOI: 10.13040/
plinary Research & Practice. 1(7): 103-106
IJPSR.0975-8232.2(10).2605-09
11. Elshikh M, Ahmed S, Funston S, Dunlop P,
4. Boggula N, Peddapalli H (2017). Phytochemi-
McGaw M, Marchant R, Banat IM (2016).
cal analysis and evaluation of in vitro antioxi-
Resazurin-based 96-well plate microdilution
dant activity of Punica granatum leaves. Inter-
method for the determination of minimum in-
national Journal of Pharmacognosy and Phy-
hibitory concentration of biosurfactants. Bio-
tochemical Research. 9(8): 1110-1118 DOI:
technology letters. 38(6): 1015-1019 DOI:
10.25258/phyto.v9i08.9618
10.1007/s10529-016-2079-2
5. Boggula N, Reddy SRN, Alla TS, Farhana A,
12. Ferrazzano GF, Cantile T, Roberto L, Ingenito
Battineni J, Bakshi V (2017). Phytochemical
A, Catania MR, Roscetto E, Pollio A (2015).
evaluation and in vitro anti-bacterial activity
Determination of the in vitro and in vivo an-
of dried seeds of Abrus precatorius. Interna-
timicrobial activity on salivary Streptococci
tional journal of pharmaceutical sciences re-
and Lactobacilli and chemical characterisation
view and research. 44(1): 101-107
of the phenolic content of a Plantago lanceo-
6. Borkataky M, Kakoti BB, Saikia LR (2014). lata infusion. BioMed research international.
Influence of total phenolic content and total DOI: 10.1155/2015/286817
flavonoid content on the DPPH radical scav-
13. Geddawy A, Shamna KP, Poyil MM (2023).
enging activity of Costus speciosus (Koen Ex.
Catheter-associated urinary tract biofilms: can
Retz.) Sm. South Asian Journal of Experimen-
achyranthes aspera extract work against them?
tal Biology. 4(5): 261-266 DOI: 10.38150/
Тhe New Armenian Medical Journal. 17(2): 110-
sajeb.4(5).p261-266
117 DOI: 10.56936/18290825-2023.17.2-110
7. Cano LPP, León E, Mero A, Morán-Pinzón J,
14. Hamilton-Amachree A, Uzoekwe NM (2022).
León EGD, Quintero EJ (2021). Evaluation
Phytochemical analysis and assessment of the
of the leaf extracts of Kalanchoe pinnata and
antibacterial and antioxidant activities of the
Kalanchoe daigremontiana chemistry, anti-

104
The New Armenian Medical Journal, Vol. 18 (2024), Is.3, p. 99-105 Poyil M.M et al.

aqueous and ethanolic leaf extracts of life plant 23. Quazi MA, Tatiya AU, Khurshid M, Nazim S, Siraj
(Kalanchoe pinnata l.) in the Niger Delta Ni- S (2011). The miracle plant (Kalanchoe pinnata):
geria. Faculty of Natural and Applied Sciences a phytochemical and pharmacological review. Int
Journal of Scientific Innovations. 3(3): 1-10 J Res Ayurveda Pharm. 2(5): 1478-1482
(Retrieved from: [Link]
24. Rajsekhar PB, Bharani RA, Ramachandran
com/[Link]/FNAS-JSI/article/view/72)
M, Angel KJ, Rajsekhar SP (2016). The “won-
15. Jassal PS, Joshi R, Sharma M (2019). Evalu- der plant” Kalanchoe pinnata (linn.) pers.: A
ation of Antioxidant, Antibacterial and Phyto- review. Journal of Applied Pharmaceutical
chemical Properties of Kalanchoe pinnata, Ka- Science. 6(3): 151-158 DOI: 10.37191/Map-
lanchoe Robusta and Kalanchoe Blossfediana. sci-2582-4937-4(2)-029
Think India Journal. 22(16): 611-626
25. Richwagen N, Lyles JT, Dale BL, Quave CL
16. Jyothiprabha V, Venkatachalam P (2016). Pre- (2019). Antibacterial activity of Kalanchoe
liminary phytochemical screening of different mortagei and K. fedtschenkoi against ES-
solvent extracts of selected lndian spices. Int KAPE pathogens. Frontiers in pharmacology.
J Curr Microbiol App Sci, 5(2): 116-122 DOI: 10: 67 DOI: 10.3389/fphar.2019.00067
10.20546/ijcmas.2016.502.013
26. Sahin AZ, Mou MA, Pervin A, Karim M, Tajwar
17. Kendeson CA, Kagoro ML, Adelakun EA A, Asim MH (2019). Antimicrobial activity of
(2021). Phytochemical and pharmacologi- natural compounds from Kalanchoe crenata
cal evaluation of Nigerian Kalanchoe pinnata against pathogenic bacteria. Clin Microbiol
(Lam.) stem-bark. Journal of Chemical Soci- Infect. 4: 1-4 DOI: 10.15761/CMID.1000162
ety of Nigeria. 46(4): 0751-0756
27. Sarker SD, Nahar L Kumarasamy Y (2007).
18. Mohamad CWSR, Zaini SZ, Jamaluddin NJ, Microtitre plate-based antibacterial assay in-
Kasim KF, Sulaiman SF (2023). Antimicro- corporating resazurin as an indicator of cell
bial activity and phytochemical analysis of growth, and its application in the in vitro
Azadirachta Indica (neem) and Clinacanthus antibacterial screening of phytochemicals.
Nutans (snake grass) leaves extract. In AIP Methods. 42(4): 321-324 DOI: 10.1016/j.
Conference Proceedings. AIP Publishing LLC. ymeth.2007.01.006
2562(1): p070002 DOI: 10.1063/5.0115900
28. Savoia D (2012). Plant-derived antimicrobial
19. Mohan SC, Balamurugan V, Elayaraja R, Pra- compounds: alternatives to antibiotics. Future
bakaran AS (2012). Antioxidant and phyto- microbiology. 7(8): 979-990 DOI: 10.2217/
chemical potential of medicinal plant Kalan- fmb.12.68
choe pinnata. International journal of pharma-
29. Sudayasa IP, Dewi GAK, Ariasnitra S, Purna-
ceutical sciences and Research. 3(3): 881
masari Y (2022). Antibacterial test of ethanol
20. Ojo OO, Ajayi AO, Anibijuwon II (2007). extract of “Cocor-Bebek” leaves (Kalanchoe
Antibacterial potency of methanol extracts pinnata) against the growth of Staphylococcus
of lower plants. Journal of Zhejiang Univer- aureus and Salmonella typhi. GSC Biological
sity. Science. B. 8(3): 189-191 DOI: 10.1631/ and Pharmaceutical Sciences. 19(3): 204-212
jzus.2007.B0189 DOI: 10.30574/gscbps.2022.19.3.0226
21. Pattewar SV, Patil DN, Dahikar SB (2013). 30. Tajudin NJ, Ismail INA (2022). Antimicrobial
Antimicrobial potential of extract from leaves Activity of Kalanchoe pinnata: A review. Ma-
of Kalanchoe pinnata. International Journal of laysian Journal of Science Health & Technol-
Pharmaceutical Sciences and Research. 4(12): ogy. 8(1): 31-37 DOI: 10.33102/2022245
4577 DOI: 10.13040/IJPSR
31. Walker ES, Levy F (2001). Genetic trends in
22. Pattewar SV, Patil DN (2014). Formulation a population evolving antibiotic resistance.
of herbal antibacterial cream by using extract Evolution. 55(6): 1110-1122 DOI: 10.1111/
from Kalanchoe pinnata leaves. Research Jour- j.0014-3820.2001.tb00631.x
nal of Topical and Cosmetic Sciences: 5(1): 1-4

105
 THE NEW ARMENIAN MEDICAL JOURNAL
Vo l u m e 1 8 ( 2 0 2 4 ) . Issue 3

CONTENTS
4. Kalmatov R.K., Rahim F., Akhunbaeva T., Toguzbaeva K., Dzhusupov K
CUBN GENE POLYMORPHISMS AND SUSCEPTIBILITY TO TYPE 2 DIABETES VERSUS
TYPE 1 DIABETES: A SYSTEMATIC REVIEW
13. Afroughi F., Padyab Z., Sharifi M., Salehnasab C., Afroughi S.
PREVALENCE AND RISK FACTORS OF GESTATIONAL DIABETES MELLITUS AMONG
PREGNANT WOMEN: A CROSS-SECTIONAL STUDY IN SOUTHERN IRAN
22. Harutyunyan K.R., Abrahamyan H.T., Adamyan S.H., Ter-Markosyan A.S.
MECHANISM OF BACTERIAL LIPOPOLYSACCHARIDE EFFECT ON THE FUNCTIONAL
ACTIVITY OF THE HEART IN VITRO. CORRECTION OF ITS EFFECTS BY THE CALCIUM
REGULATING HORMONE SYSTEM
35. Nourbakhsh S.M.K., Hashemi E., Kheyri M., Bahadoram M., Keikhaei B., Hassanzadeh S.
COMPARISON OF LEPTIN AND FERRITIN LEVELS IN BETA-THALASSEMIA MAJOR AND
HEALTHY INDIVIDUALS
42. Ismailov I. D., Kalmatov R. K., Rahim F., Momunova A. A., Kılınç N.
COMPARATIVE CHARACTERISTICS OF THE CONDITION OF TISSUE UPPER
RESPIRATORY TRACT IN CHILDREN WITH RESPIRATORY DISEASES LIVING IN
KYRGYZSTAN, LOCATED AT DIFFERENT ALTITUDES ABOVE SEA LEVEL
51. Tadevosyan N.S., Poghosyan S.B., Muradyan S.A., Khachatryan B.G., Ter-Zaqaryan
S.H., Kirakosyan G.V., Guloyan H.A., Babayan T.L.
ENVIRONMENTAL POLLUTION OF SOME FOOTHILL REGIONS OF ARMENIA WITH
ORGANOCHLORINE PESTICIDES AND ISSUES OF MORBIDITY
60. Bari Md N., Osman E.H.A., Alfaki M.A. , Ansari Md R.
NONINVASIVE PROTEOMIC BIOMARKER IN DISORDERS OF THE NONALCOHOLIC
FATTY LIVER
68. Bari Md. N., Ansari Md.R., Alfaki M.A.
THE ROLE OF EVOLVING TECHNIQUES AND PROSPECTIVE IMPLICATIONS OF
BIOMARKERS IN LIVER DISEASE
82. Mohammad I., Khan M.S., Ansari M.R.
GINGER REVITALIZED: EXPLORING THE MODERN APPLICATIONS OF ZINGIBER
OFFICINALE IN MEDICINE AND BEYOND
93. Mohammed I., Osman E.H.A., AlFaki M.A.M.
ANTI-NEURODEGENERATIVE ACTIVITY OF THE PROBIOTIC STRAIN LACTOBACILLUS
ACIDOPHILUS
99. Poyil M.M., Shamna K. P., Raja K.
COMBATING MULTI-DRUG RESISTANCE: POTENTIALS OF KALANCHOE PINNATA
EXTRACTS AGAINST BACTERIAL PATHOGENS
106. Qamer S., Bakar I., Alsanousi N.
ANTIOXIDANT DRUGS FROM HYDRO-ETHANOLIC FLORAL EXTRACTS OF IMPATIENS
BALSAMINA L.: AN IN VITRO ANALYSIS
112. Saad Ahmed O., Saad Ahmed S., Talib Dheyab R.
A COMPREHENSIVE EXERCISE PROGRAM IMPROVES FOOT ALIGNMENT IN
CHILDREN WITH FLEXIBLE FLAT FOOT
119. Bqlein A. S.
COMPREHENSIVE REVIEW OF LABOR PAIN MANAGEMENT, PERINEAL TEARS, AND
EPISIOTOMY COMPLICATIONS: A FOCUS ON PREVENTION AND THE ROLE OF NURSES
 THE NEW ARMENIAN MEDICAL JOURNAL
Vo l u m e 1 8 ( 2 0 2 4 ) . Issue 3

Editor-in-Chief
Arto V. Zilfyan (Yerevan, Armenia)
Deputy Editors
Hovhannes M. Manvelyan (Yerevan, Armenia)
The Journal is founded by Hamayak S. Sisakyan (Yerevan, Armenia)
Yerevan State Medical Executive Secretary
University after M. Heratsi. Stepan A. Avagyan (Yerevan, Armenia)
Rector of YSMU Editorial Board
Armen A. Muradyan (Yerevan, Armenia)
Armen A. Muradyan
Drastamat N. Khudaverdyan (Yerevan, Armenia)
Address for correspondence:
Levon M. Mkrtchyan (Yerevan, Armenia)
Yerevan State Medical University Foregin Members of the Editorial Board
2 Koryun Street, Yerevan 0025, Carsten N. Gutt (Memmingen, Germay)
Republic of Armenia Muhammad Miftahussurur (Indonesia)
Alexander Woodman (Dharhan, Saudi Arabia)
Phones: Hesam Adin Atashi (Tehran, Iran)
(+37410) 582532 YSMU Coordinating Editor (for this number)
(+37493 588697 Editor-in-Chief Mahdi Esmaeilzadeh (Mashhad, Iran)
Fax: (+37410) 582532 Editorial Advisory Council
Ara S. Babloyan (Yerevan, Armenia)
E-mail:[Link]@[Link], ysmiu@[Link]
Aram Chobanian (Boston, USA)
URL:http//[Link]
Luciana Dini (Lecce, Italy)
Azat A. Engibaryan (Yerevan, Armenia)
Our journal is registered in the databases of Scopus, Ruben V. Fanarjyan (Yerevan, Armenia)
EBSCO and Thomson Reuters (in the registration process) Gerasimos Filippatos (Athens, Greece)
Gabriele Fragasso (Milan, Italy)
Samvel G. Galstyan (Yerevan, Armenia)
Arthur A. Grigorian (Macon, Georgia, USA)
Armen Dz. Hambardzumyan (Yerevan, Armenia)
Scopus EBSCO
Reuters Seyran P. Kocharyan (Yerevan, Armenia)
Aleksandr S. Malayan (Yerevan, Armenia)
Mikhail Z. Narimanyan (Yerevan, Armenia)
Levon N. Nazarian (Philadelphia, USA)
Yumei Niu (Harbin, China)
Copy editor: Tatevik R. Movsisyan
Linda F. Noble-Haeusslein (San Francisco, USA)
Arthur K. Shukuryan (Yerevan, Armenia)
Suren A. Stepanyan (Yerevan, Armenia)
Gevorg N. Tamamyan (Yerevan, Armenia)
Printed in "LAS Print" LLC Hakob V. Topchyan (Yerevan, Armenia)
Director: Suren A. Simonyan Alexander Tsiskaridze (Tbilisi, Georgia)
Armenia, 0023,Yerevan, Konstantin B. Yenkoyan (Yerevan, Armenia)
Acharyan St. 44 Bulding,
Phone: (+374 10) 62 76 12, Peijun Wang (Harbin, Chine)
E-mail: [Link]@[Link]