ABSTRACT
Background: childbirth is one of the most painful events of a woman's life. The experience of labor pain is a complex, multidimensional response to sensory stimuli generated during parturition and its intensity can vary greatly. Unlike other acute and chronic pain experiences, labor pain is not associated with pathology, but with the most basic and fundamental of life's experiences
Aim of the work: this work aimed to study the efficacy of intravenous tenoxicam for labor analgesia
Patient and methods: this was two-arm, randomized controlled trial. The first arm [Group T] represented subjects who received tenoxicam. The second arm [Group R] represented subjects who received routine analgesic pethidine and it is given at a dose of 50 mg diluted over 10 ml of normal saline. The parturient woman was given 3-4 cm of diluted pethidine whenever she has intolerable pain
Results: this study included 260 subjects that were allocated into two arms: tenoxicam arm [n=118] and pethidine arm [n=142] as the control group. Tenoxicam group included 118 subjects and the pethidine group included 142 subjects. Maternal age was 23.74 +/- 3.76 in tenoxicam group vs 23.99 +/- 3.5 in pethidine group. Gestational age was 39.04 +/- 1.42 in tenoxicam group vs 38.93 +/- 1.5 in pethidine group. Birth weight was 3.43 +/- 0.26 in tenoxicam arm vs 3.41 +/- 0.26 in pethidine arm, average fetal heart rate was 140.1 +/- 17.12 in tenoxicam arm vs 138.1 +/- 16.39 pethidine arm, cervical dilatation was 4.19 +/- 0.77 in tenoxicam arm vs 4.25 +/- 0.7 and interval to delivery was 5.89 +/- 1.29 in tenoxicam arm vs 6.2 +/- 1.62 in pethidine arm
Conclusion: tenoxicam [40 mg iv], a long acting NSAID that induces analgesia by inhibiting peripheral prostaglandin synthesis, reduced postpartum uterine contraction pain without apparent maternal or neonatal adverse effects. Furthermore, tenoxicam exhibits superior analgesic properties over the routinely used pethidine as labor analgesic. Further studies should evaluate analgesic effects vs side effects of iv tenoxicam as a function of dosage or as part of combination therapy with different opioid analgesics
ABSTRACT
The study was targeted to report the appearance of coproantigens in feces and circulating antibodies in the serum of Fasciola gigantica experimentally infected rabbits. Copro Hyper Immune Serum [HIS] and Excretory-Secretory Hyper Immune Serum [ES HIS] antigens were used in a sandwich ELISA for the detection of F. gigantica antigens in feces of 12 rabbits experimentally infected with different doses of F. gigantica encysted metacercariae [EMC] [10, 25 and 30 EMC]. The relation between time of appearance of coproantigens in feces and anti-Fasciola antibodies in serum was evaluated. The earliest diagnostic coproantigen was recorded at 21[st], 25[th] and 28[th] day post-infection [p.i.] in groups of rabbits infected with 30, 25 and 10 F. gigantica EMC respectively. Both HIS and ES HIS were able to detect coproantigens in feces of rabbits infected with 30 EMC at day 21 p.i. The appearance of F. giganticacoproantigens in feces of infected rabbits was concurrent to the appearance of anti-Fasciola antibodies in blood [3[rd] week p.i.]. However, coproantigen has specific ability for direct assessment of active infection with minimal cross-reaction with other heterologous parasitic infections. The findings hold promise for a more accurate diagnostic technique in the near future for suspected Fasciola infection