Displaying publications 341 - 360 of 372 in total

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  1. Fulltext Toxic keratouveitis secondary to Euphorbia lactea sap: a case report
    Yihui Goh, Pooi Wah Lott, Sujaya Singh
    Malaysian Journal of Medicine and Health Sciences, 2020;16(3):328-330.
    MyJurnal
    A 42-year-old gentleman presented with left eye pain after accidental contact with Euphorbia lactea sap while gar- dening. At presentation, left eye best-corrected visual acuity (BCVA) was 20/30. Ocular examination revealed left eye conjunctiva congestion and cornea abrasion. Eye symptoms and BCVA deteriorated over 12 hours. Cornea showed diffuse stromal oedema with presence of anterior uveitis. A diagnosis of toxic keratouveitis was made. He was treat- ed with intensive topical steroids, cycloplegics, lubricants, prophylactic antibiotics and oral non-steroidal anti-in- flammatory analgesic. Patient achieved complete resolution two weeks later. We aim to raise awareness among the ophthalmologists to detect and manage these injuries.
    Matched MeSH terms: Analgesics
  2. Fulltext A pilot study of the primary care management of knee osteoarthritis in the Northern States of Malaysia.
    Arshad, A., Rashid, R.
    International Medical Journal Malaysia, 2008;7(2):31-36.
    MyJurnal
    Introduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA.
    Matched MeSH terms: Analgesics
  3. Fulltext Clinical correlates of erectile dysfunction among male patients on methadone maintenance therapy (MMT) in Kuala Lumpur
    Nik Ruzyanei, N.J., Noormazita, M., Azlin, B., Normala, I., Hazli, Z., Abdul Aziz, S., et al.
    Malaysian Journal of Medicine and Health Sciences, 2012;8(1):27-35.
    MyJurnal
    Sexual dysfunction is common but not often assessed in the routine clinical care among males on opiate substitute treatment.
    Objective: To determine the association between clinical variables and erectile dysfunction (ED) among men on methadone maintenance therapy (MMT).
    Methods: A cross-sectional study involving 108 participants who attended the Drug Clinic, Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for DSM-IV Axis-I Disorder (SCID-I), Beck Depression Inventory (BDI) and International Index of Erectile Function-15 (IIEF-15).
    Results: Concurrent heroin abuse was significantly associated with presence of ED (p=0.024). Treatment factors including methadone dose and duration of methadone treatment were not significantly associated with ED.
    Conclusion: Education on sexual dysfunction as a potential adverse effect and its association with illicit heroin use should be considered in the doctor-patient consultation to encourage treatment adherence and abstinence from heroin.
    Study site: Drug Clinic, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Analgesics, Opioid
  4. Fulltext A cross sectional study of chronic pain relief after bekam (traditional malay "cupping") therapy
    Lim KG, Chuah SW, Ee MST, Wong ZG, Murugesan A, Syed Azman SA
    International e-Journal of Science, Medicine & Education, 2015;9(2):32-36.
    MyJurnal
    Introduction: Bekam, an Islamic variant of cupping, is an ancient form of traditional medicine still practised today in Malaysia. There are published findings indicating that cupping benefits patients with low back pain, other musculoskeletal pain and even pain from cancer, herpes zoster and trigeminal neuralgia when pain is measured on an analogue scale. We proposed to investigate whether in addition to pain improvement on an analogue scale we could show if pain relief might be demonstrated in terms of reduction of analgesic use.

    Methods: We carried out a retrospective cross sectional study on subjects who had been for outpatient clinic treatment with chronic pain of at least one month and who completed at least two bekam therapy sessions. In addition to documenting a pain score before and after therapy we documented their analgesic consumption.

    Results: A total of 77 respondents, with overlapping symptoms of headache, backache and joint pains were included. The mean pain score before bekam therapy was 6.74±1.78, and was 2.66±1.64 after two sessions of therapy. Twenty eight respondents completed six sessions of bekam therapy and had a mean pain score of 2.25±1.32 after. Thirty-four patients consumed analgesic medication before starting bekam therapy and only twelve did so after. The consumption of analgesics was significantly lower after bekam therapy.

    Conclusions: Bekam therapy appears to help patients experience less pain and reduce the amount of analgesic medication they consume. Nevertheless only a randomised prospective study will eliminate the biases a retrospective study is encumbered with and we believe would be worth doing.
    Matched MeSH terms: Analgesics
  5. Fulltext Trends and patterns of analgesic prescribing in Malaysian public hospitals from 2010 to 2016: tramadol predominately used
    Zin CS, Nazar NI, Rahman NS, Alias NE, Ahmad WR, Rani NS, et al.
    J Pain Res, 2018;11:1959-1966.
    PMID: 30288090 DOI: 10.2147/JPR.S164774
    Purpose: To examine the trends of analgesic prescribing at public tertiary hospital outpatient settings and explore the patterns of their utilization in nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, and opioid patients.
    Patients and methods: This cross-sectional study was conducted from 2010 to 2016 using the prescription databases of two tertiary hospitals in Malaysia. Prescriptions for nine NSAIDs (ketoprofen, diclofenac, celecoxib, etoricoxib, ibuprofen, indomethacin, meloxicam, mefenamic acid, and naproxen), tramadol, and five other opioids (morphine, fentanyl, oxycodone, dihydrocodeine, and buprenorphine) were included in this study. Annual number of patients and prescriptions were measured in repeat cross-sectional estimates. Descriptive statistics and linear trend analysis were performed using Stata version 13.
    Results: A total of 192,747 analgesic prescriptions of the nine NSAIDs, tramadol, and five other opioids were given for 97,227 patients (51.8% NSAIDs patients, 46.6% tramadol patients, and 1.7% opioid patients) from 2010 to 2016. Tramadol (37.9%, n=72,999) was the most frequently prescribed analgesic, followed by ketoprofen (17.5%, n=33,793), diclofenac (16.2%, n=31,180), celecoxib (12.2%, n=23,487), and other NSAIDs (<4.5%). All the analgesics were increased over time except meloxicam, indomethacin, and mefenamic acid. Opioids, primarily morphine (2.2%, n=4,021) and oxycodone (0.5%, n=1,049), were prescribed the least, but the rate of increase was the highest.
    Conclusion: Tramadol was the most frequently prescribed analgesic in hospital outpatient settings in Malaysia. Opioids were prescribed the least, but noted the highest increase in utilization.
    Data source: Prescription databases of two public tertiary hospitals in Malaysia

    Study site: two public tertiary hospitals in Malaysia
    Matched MeSH terms: Analgesics, Opioid
  6. Fulltext Accidental self-injection of Xylazine during work: a rare case
    Ganapathy, Ganesh Kumar, Dharmalingam, T. Kumaravadivel, Sathival, Mugunthan M.
    Borneo Journal of Medical Sciences, 2018;12(2):47-49.
    MyJurnal
    Xylazine is an alpha-2agonist often used as a sedative, analgesic and muscle relaxant agent
    in animals. Xylazine was not accepted by Food and Drug Administration (FDA) for human use
    due to hazardous side effect such as hypotension, bradycardia, respiratory depression and coma.
    This is a rare case report of a 64-year-old farmer who accidentally injected himself with Xylazine
    which was supposed to be given to a fractious cow. He developed altered conscious level, hypotension, bradycardia and respiratory failure requiring mechanical ventilation. Fortunately, he
    recovered and was discharged home after three days. This occurred due to improper handling of
    Xylazine without standard operating procedures. Xylazine is regulated for animal use only. Therefore, effects of Xylazine toxicity in human must be emphasized for awareness on proper handling as well as for right management of its poisoning incident in future.
    Matched MeSH terms: Analgesics
  7. Fulltext A comparison of sexual desire in opiate-dependent men receiving methadone and buprenorphine maintenance treatment
    Yee A, Loh HS, Loh HH, Riahi S, Ng CG, Sulaiman AHB
    Ann Gen Psychiatry, 2019;18:25.
    PMID: 31649742 DOI: 10.1186/s12991-019-0249-z
    Background: Methadone is an effective therapy for opiate dependence. However, one of the commonest side effects is sexual dysfunction among male patients. Buprenorphine is an alternative to methadone. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT).

    Methods: This cross-sectional study involved 126 male opiate-dependent patient who were tested for total testosterone (TT) and prolactin levels, and were interviewed and completed the Sexual Desire Inventory-2 (SDI-2), Malay language of International Index of Erectile Function (Mal-IIEF-15) and the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) questionnaires.

    Results: There were 95 (75.4%) patients on MMT and 31 (24.6%) on BMT. Patients on MMT scored significantly lower in the sexual desire domain (Mal-IIEF-15 scores) (p 

    Matched MeSH terms: Analgesics, Opioid
  8. Fulltext Brain magnetic resonance Imaging of Regular Kratom (Mitragyna speciosa Korth.) users: A preliminary study
    Singh, Darshan, Chye, Yann, Chao, Suo, Yücel, Murat, Grundmann, Oliver, Muhamad Zabidi Ahmad, et al.
    Malaysian Journal of Medicine and Health Sciences, 2018;14(201):1-6.
    MyJurnal
    Mitragyna speciosa (Korth.) or kratom is a native medicinal plant of Southeast Asia. Commonly used by hard labours in harsh working environment, the ingestion of brewed kratom decoction is reported to produce dose-dependent stimulant and opioid-like effects. Kratom is also regularly consumed as a pain killer and as traditional cure for common maladies such as fever and cough. However, it remains unknown whether regular consumption of kratom decoction is associated with brain abnormalities in regular users in traditional settings. Methods: A total of 14 subjects (7 regular kratom users and 7 non-kratom users) voluntarily participated in this cross-sectional study. Face-to-face interviews were conducted with kratom users to determine history of kratom use and later these respondents underwent brain magnetic resonance imaging (MRI). Results: There were no significant differences (p>0.05) in the intracranial volume (ICV), cortical volumes (frontal, parietal, temporal, occipital, or cingulate lobe), or subcortical volumes (striatum, hippocampus, or amygdala), as well as in the diffusion tensor imaging (DTI) metrics, fractional anisotropy (FA) and mean diffusivity (MD) between kratom users and the controls. Conclusion: This preliminary study showed long-term consumption of kratom decoction is not significantly associated with altered brain structures in regular kratom users in traditional settings. However, further study is needed to establish more data for kratom use and its effects.
    Matched MeSH terms: Analgesics, Opioid
  9. Fulltext Serum concentration of ketamine and antinociceptive effects of ketamine and ketamine-lidocaine infusions in conscious dogs
    Kaka U, Saifullah B, Abubakar AA, Goh YM, Fakurazi S, Kaka A, et al.
    BMC Vet Res, 2016 Sep 9;12(1):198.
    PMID: 27612660
    Central sensitization is a potential severe consequence of invasive surgical procedures. It results in postoperative and potentially chronic pain enhancement. It results in postoperative pain enhancement; clinically manifested as hyperalgesia and allodynia. N-methyl-D-aspartate (NMDA) receptor plays a crucial role in the mechanism of central sensitisation. Ketamine is most commonly used NMDA-antagonist in human and veterinary practice. However, the antinociceptive serum concentration of ketamine is not yet properly established in dogs. Six dogs were used in a crossover design, with one week washout period. Treatments consisted of: 1) 0.5 mg/kg ketamine followed by continuous rate infusion (CRI) of 30 μg/kg/min; 2) 0.5 mg/kg ketamine followed by CRI of 30 μg/kg/min and lidocaine (2 mg/kg followed by CRI of 100 μg/kg/min); and 3) 0.5 mg/kg ketamine followed by CRI of 50 μg/kg/min. The infusion was administered up to 120 min. Nociceptive thresholds and ketamine serum concentrations were measured before drug administration, and at 5, 10, 20, 40, 60, 90, 120, 140 and 160 min after the start of infusion.
    Matched MeSH terms: Analgesics
  10. Comparative Evaluation of Dental and Skeletal Fluorosis in an Endemic Fluorosed District, Salem, Tamil Nadu
    Ramesh M, Malathi N, Ramesh K, Aruna RM, Kuruvilla S
    J Pharm Bioallied Sci, 2017 Nov;9(Suppl 1):S88-S91.
    PMID: 29284943 DOI: 10.4103/jpbs.JPBS_77_17
    Background: High levels of fluoride in the drinking water, especially ground water, results in skeletal fluorosis which involves the bone and major joints. This study was conducted to assess the prevalence of skeletal fluorosis to compare with dental fluorosis in an endemically fluorosed population in the District of Salem, Tamil Nadu.

    Materials and Methods: Institutional ethical clearance was obtained. A total of 206 patients who reported to the Department of Hematology for blood investigations were the participants in this study. Age, sex, place, weight, height, dental fluorosis, and skeletal complaints were noted down. Body mass index was calculated, and statistical analysis was performed.

    Results: Dental fluorosis was present in 63.1% and absent in 36.9% of the samples reported. Skeletal fluorosis was present in 24.8% and was absent in 75.2%. A large number of the patients had knee pain and difficulty in bending. Chi-square test was used for statistical analysis. Skeletal fluorosis and age were compared and P value was 0.00 and was significant. Dental fluorosis and skeletal fluorosis were compared and P value was found to be 0.000 and significant.

    Discussion and Conclusion: There is a need to take measures to prevent dental and skeletal fluorosis among the residents of Salem district. Calcium balance should be maintained, and fluoride intake should be minimized to reduce the symptoms. The government should provide water with low fluoride level for drinking and cooking. Once the symptoms develop, treatment largely remains symptomatic, using analgesics and physiotherapy.

    Matched MeSH terms: Analgesics
  11. Fulltext Nephroprotective Effect of Herbal Extract Eurycoma longifolia on Paracetamol-Induced Nephrotoxicity in Rats
    Chinnappan SM, George A, Thaggikuppe P, Choudhary Y, Choudhary VK, Ramani Y, et al.
    Evid Based Complement Alternat Med, 2019;2019:4916519.
    PMID: 31214269 DOI: 10.1155/2019/4916519
    Paracetamol (PCM) is a well-known drug widely used for its analgesic and antipyretic properties. PCM is generally considered as safe but overdose of PCM can cause nephrotoxicity. Traditionally, herbs have been used for the treatment of drug or toxin-induced renal disorders and numerous medicinal plants were tested for nephroprotection effect in PCM-induced nephrotoxicity model. The aim of the present study was to evaluate the protective effect of the herbal extract Eurycoma longifolia (EL) against PCM-induced nephrotoxicity rat model. Forty Wistar rats were randomly divided into five groups of eight rats each: control (vehicle 10 ml/kg), PCM alone (200 mg/kg PCM), EL 100 (EL 100 mg/kg+200 mg/kg PCM), EL 200 (EL 200 mg/kg+200 mg/kg PCM), and EL 400 (EL 400 mg/kg+200 mg/kg PCM). All animals from control group received vehicle daily and animals from groups PCM alone, EL 100, EL 200, and EL 400 received repeated dose of PCM and the assigned treatment of EL daily for a period of 14 days. On the 15th day, serum creatinine, blood urea nitrogen, protein, and albumin were measured in blood and creatinine clearance was measured in urine collected over 24 hours. Kidney sections of all experimental groups underwent histopathological analysis. There was a significant (p<0.05) increase in serum creatinine and blood urea levels in the PCM alone group compared to the treatment groups due to nephrotoxicity. In the treatment groups, there was a dose-dependent protection against PCM-induced changes observed in serum total protein, albumin, urea, and creatinine. Significant (p<0.05) drop was seen in serum creatinine and blood urea content in EL 200 and EL 400 groups. Creatinine clearance significantly increased for EL 200 (p<0.01) and EL 400 (p < 0.001) groups. Serum total protein and serum albumin content were significantly increased (p<0.05) in EL 200 and EL 400 groups compared to PCM alone group. Histopathological examination (H&E staining) of the rat kidneys revealed severe degeneration in the PCM alone group, while there was evidence of significant dose-dependent protection in the treatment groups against PCM-induced changes. The serum and urine biochemical results and histopathology analysis of the kidney indicate the nephroprotective potential of EL extract against PCM-induced nephrotoxicity.
    Matched MeSH terms: Analgesics
  12. Fulltext Neurological effects of honey: current and future prospects
    Mijanur Rahman M, Gan SH, Khalil MI
    Evid Based Complement Alternat Med, 2014;2014:958721.
    PMID: 24876885 DOI: 10.1155/2014/958721
    Honey is the only insect-derived natural product with therapeutic, traditional, spiritual, nutritional, cosmetic, and industrial value. In addition to having excellent nutritional value, honey is a good source of physiologically active natural compounds, such as polyphenols. Unfortunately, there are very few current research projects investigating the nootropic and neuropharmacological effects of honey, and these are still in their early stages. Raw honey possesses nootropic effects, such as memory-enhancing effects, as well as neuropharmacological activities, such as anxiolytic, antinociceptive, anticonvulsant, and antidepressant activities. Research suggests that the polyphenol constituents of honey can quench biological reactive oxygen species and counter oxidative stress while restoring the cellular antioxidant defense system. Honey polyphenols are also directly involved in apoptotic activities while attenuating microglia-induced neuroinflammation. Honey polyphenols are useful in improving memory deficits and can act at the molecular level. Therefore, the ultimate biochemical impact of honey on specific neurodegenerative diseases, apoptosis, necrosis, neuroinflammation, synaptic plasticity, and behavior-modulating neural circuitry should be evaluated with appropriate mechanistic approaches using biochemical and molecular tools.
    Matched MeSH terms: Analgesics
  13. Fulltext Alpinia calcarata Roscoe: A potential phytopharmacological source of natural medicine
    Rahman MA, Islam MS
    Pharmacogn Rev, 2015 Jan-Jun;9(17):55-62.
    PMID: 26009694 DOI: 10.4103/0973-7847.156350
    Alpinia calcarata Roscoe (Family: Zingiberaceae), is a rhizomatous perennial herb, which is commonly used in the traditional medicinal systems in Sri Lanka. Alpinia calcarata is cultivated in tropical countries, including Sri Lanka, India, and Malaysia. Experimentally, rhizomes of Alpinia calcarata are shown to possess antibacterial, antifungal, anthelmintic, antinociceptive, anti-inflammatory, antioxidant, aphrodisiac, gastroprotective, and antidiabetic activities. Phytochemical screening revealed the presence of polyphenols, tannins, flavonoids, steroid glycosides and alkaloids in the extract and essential oil of this plant. Essential oil and extracts from this plant have been found to possess wide range of pharmacological and biological activities. This article provides a comprehensive review of its ethnomedical uses, chemical constituents and the pharmacological profile as a medicinal plant. Particular attention has been given to the pharmacological effects of the essential oil of Alpinia calcarata in this review so that the potential use of this plant either in pharmaceutics or as an agricultural resource can be evaluated.
    Matched MeSH terms: Analgesics
  14. Fulltext Profound swim stress-induced analgesia with ketamine
    Ahmad AH, Ismail Z, Than M, Ahmad A
    Malays J Med Sci, 2008 Jan;15(1):13-22.
    PMID: 22589610 MyJurnal
    The potential of ketamine, an N-methyl D-aspartate (NMDA) receptor antagonist, in preventing central sensitization has led to numerous studies. Ketamine is increasingly used in the clinical setting to provide analgesia and prevent the development of central sensitization at subanaesthetic doses. However, few studies have looked into the potential of ketamine in combination with stress-induced analgesia. This study looks at the effects of swim stress, which is mediated by opioid receptor, on ketamine analgesia using formalin test. Morphine is used as the standard analgesic for comparison. Adult male Sprague-Dawley rats were assigned to 6 groups: 3 groups (stressed groups) were given saline 1ml/kg intraperitoneally (ip), morphine 10mg/kg ip or ketamine 5mg/kg ip and subjected to swim stress; 3 more groups (non-stressed groups) were given the same drugs without swim stress. Formalin test, which involved formalin injection as the pain stimulus and the pain score recorded over time, was performed on all rats ten minutes after cessation of swimming or 30 minutes after injection of drugs. Combination of swim stress and ketamine resulted in complete analgesia in the formalin test which was significantly different from ketamine alone (p<0.05) and saline with stress (p<0.01). There is no significant difference between ketamine stressed and morphine stressed. These results indicate that ketamine and swim stress act synergistically to produce profound analgesia in the formalin test. This suggests that in the clinical setting, under stressful situations such as operative stress, ketamine is capable of producing profound analgesia at a subanaesthetic dose.
    Matched MeSH terms: Analgesics
  15. Burden and nutritional deficiencies in opiate addiction- systematic review article
    Nabipour S, Ayu Said M, Hussain Habil M
    Iran J Public Health, 2014 Aug;43(8):1022-32.
    PMID: 25927032
    Addiction to the illicit and prescribed use of opiate is an alarming public health issue. Studies on addictive disorders have demonstrated severe nutritional deficiencies in opiate abusers with behavioral, physiological and cognitive symptoms. Opiate addiction is also link with a significant number of diseases including Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV) and other blood borne diseases generally stem from the use of needles to inject heroin. The use of medication assisted treatment for opioid addicts in combination with behavioural therapies has been considered as a highly effective treatment. Methadone is a long-lasting μ-opioid agonist and a pharmacological tool which attenuates withdrawal symptoms effectively replacement therapies. This review article aims to explain opiate addiction mechanisms, epidemiology and disease burden with emphasis on dietary and nutritional status of opiate dependent patients in methadone maintenance therapy.
    Matched MeSH terms: Analgesics, Opioid
  16. Therapeutic potential of Moringa oleifera extracts against acetaminophen-induced hepatotoxicity in rats
    Sharifudin SA, Fakurazi S, Hidayat MT, Hairuszah I, Moklas MA, Arulselvan P
    Pharm Biol, 2013 Mar;51(3):279-88.
    PMID: 23043505 DOI: 10.3109/13880209.2012.720993
    Moringa oleifera Lam. (Moringaceae) is a rich source of essential minerals and antioxidants; it has been used in human and animal nutrition. The leaves and flowers are being used by the population with great dietary importance.
    Matched MeSH terms: Analgesics, Non-Narcotic/poisoning
  17. Fulltext Histopathology and biochemistry analysis of the interaction between sunitinib and paracetamol in mice
    Lim AY, Segarra I, Chakravarthi S, Akram S, Judson JP
    BMC Pharmacol., 2010;10:14.
    PMID: 20950441 DOI: 10.1186/1471-2210-10-14
    BACKGROUND: Sunitinib, a tyrosine kinase inhibitor to treat GIST and mRCC may interact with paracetamol as both undergo P450 mediated biotransformation and P-glycoprotein transport. This study evaluates the effects of sunitinib-paracetamol coadministration on liver and renal function biomarkers and liver, kidney, brain, heart and spleen histopathology. ICR male mice (n = 6 per group/dose) were administered saline (group-A) or paracetamol 500 mg/kg IP (group-B), or sunitinib at 25, 50, 80, 100, 140 mg/kg PO (group-C) or coadministered sunitinib at 25, 50, 80, 100, 140 mg/kg PO and paracetamol IP at fixed dose 500 mg/kg (group-D). Paracetamol was administered 15 min before sunitinib. Mice were sacrificed 4 h post sunitinib administration.
    RESULTS: Group-A serum ALT and AST levels were 14.29 ± 2.31 U/L and 160.37 ± 24.74 U/L respectively and increased to 249.6 ± 222.7 U/L and 377.1 ± 173.6 U/L respectively in group-B; group-C ALT and AST ranged 36.75-75.02 U/L and 204.4-290.3 U/L respectively. After paracetamol coadministration with low sunitinib doses (group-D), ALT and AST concentrations ranged 182.79-221.03 U/L and 259.7-264.4 U/L respectively, lower than group-B. Paracetamol coadministration with high sunitinib doses showed higher ALT and AST values (range 269.6-349.2 U/L and 430.2-540.3 U/L respectively), p < 0.05. Hepatic histopathology showed vascular congestion in group-B; mild congestion in group-C (but lesser than in group-B and D). In group-D, at low doses of sunitinib, lesser damage than in group-B occurred but larger changes including congestion were observed at high sunitinib doses. BUN levels were higher (p < 0.05) for group-B (33.81 ± 5.68 mg/dL) and group-D (range 35.01 ± 6.95 U/L to 52.85 ± 12.53 U/L) compared to group-A (15.60 ± 2.17 mg/dL) and group-C (range 17.50 ± 1.25 U/L to 26.68 ± 6.05 U/L). Creatinine remained unchanged. Renal congestion and necrosis was lower in group-C than group-B but was higher in group-D (p > 0.05). Mild cardiotoxicity occurred in groups B, C and D. Brain vascular congestion occurred at high doses of sunitinib administered alone or with paracetamol. Hepatic and renal biomarkers correlated with histopathology signs.
    CONCLUSIONS: Paracetamol and sunitinib coadministration may lead to dose dependent outcomes exhibiting mild hepatoprotective effect or increased hepatotoxicity. Sunitinib at high doses show renal, cardiac and brain toxicity. Liver and renal function monitoring is recommended.
    Matched MeSH terms: Analgesics, Non-Narcotic/toxicity*
  18. Association between gastrointestinal manifestations following acetaminophen poisoning and outcome in 291 acetaminophen poisoning patients
    Zyoud SH, Awang R, Sulaiman SA, Al-Jabi SW
    Pharmacoepidemiol Drug Saf, 2010 May;19(5):511-7.
    PMID: 20333776 DOI: 10.1002/pds.1940
    Acetaminophen poisoning is a common clinical problem, and early identification of patients with more severe poisoning is key to improving outcomes.
    Matched MeSH terms: Analgesics, Non-Narcotic/poisoning*
  19. Pre-admission therapy for childhood acute diarrhoea--a hospital-based study
    Ng YJ, Lo YL, Lee WS
    J Clin Pharm Ther, 2009 Feb;34(1):55-60.
    PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x
    Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.
    Matched MeSH terms: Analgesics, Non-Narcotic/therapeutic use
  20. Moringa oleifera Lam prevents acetaminophen induced liver injury through restoration of glutathione level
    Fakurazi S, Hairuszah I, Nanthini U
    Food Chem Toxicol, 2008 Aug;46(8):2611-5.
    PMID: 18514995 DOI: 10.1016/j.fct.2008.04.018
    Initiation of acetaminophen (APAP) toxicities is believed to be promoted by oxidative stress during the event of overdosage. The aim of the present study was to evaluate the hepatoprotective action of Moringa oleifera Lam (MO), an Asian plant of high medicinal value, against a single high dose of APAP. Groups of five male Sprague-Dawley rats were pre-administered with MO (200 and 800 mg/kg) prior to a single dose of APAP (3g/kg body weight; p.o). Silymarin was used as an established hepatoprotective drug against APAP induced liver injury. The hepatoprotective activity of MO extract was observed following significant histopathological analysis and reduction of the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in groups pretreated with MO compared to those treated with APAP alone. Meanwhile, the level of glutathione (GSH) was found to be restored in MO-treated animals compared to the groups treated with APAP alone. These observations were comparable to the group pretreated with silymarin prior to APAP administration. Group that was treated with APAP alone exhibited high level of transaminases and ALP activities besides reduction in the GSH level. The histological hepatocellular deterioration was also evidenced. The results from the present study suggested that the leaves of MO can prevent hepatic injuries from APAP induced through preventing the decline of glutathione level.
    Matched MeSH terms: Analgesics, Non-Narcotic/toxicity*
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