Anti-inflammtory activity of Ocimum Sanctum (linn) in formalin induced acute models of albino rats.

The inflammatory process is the response to an injurious stimulus. It can be evoked by a wide variety of noxious agents (e.g., infections, antibodies, physical injuries). Many nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, phenylbutazone, indomethacin etc. are in clinical use but all these are not completely devoid of adverse effects2. In this study, the anti-inflammatory activity of 0. sanctum alone and in combination with indomethacin was studied using formalin-induced rat paw edema. Aqueous extract of O. sanctum (200mg/kg, 300mg/kg or 400mg/kg) was administered alone and in combination with indomethacin (25mg/kg) to separate group of rats and paw volume was measured by plethysmometer and compared with control group. All the test groups showed significant (P<0.05) anti-inflammatory effect in formalin-induced rat paw edema. The reduction of edema by 0. sanctum was better than that of the standard anti-inflammatory drug, indomethacin and on co-administration marginally improved the anti-inflammatory profile of indomethacin. O.sanctum possesses significant anti-inflammatory activity probably due to inhibition of both cyclooxygenase and lipooxygenase pathways of arachidonic acid metabolism (dual inhibitory property).

Nicolau Syndrome Following Intramuscular Diclofenac Injection / 대한정형외과학회잡지

Nicolau syndrome is a rare complication causing severe pain and tissue necrosis after intramuscular injection. In Korea, the Korea Dermatological Association has reported 12 cases, and some severe cases required surgical treatment. Most cases have been related to the administration of a variety of drugs, including nonsteroidal anti-inflammatory drugs, corticosteroids, and antibiotics. We present two patients who developed this complication, 1 case of typical Nicolau syndrome and 1 case of atypical Nicolau syndrome.

Dolor crónico o persistente / Chronic or persistent pain

Introducción: la carencia de experiencia en el tratamiento del dolor crónico en el hospital «Dr. Luis Díaz Soto¼, determinó la implementación de la consulta de dolor crónico. Métodos: se realizó una investigación en 2 etapas. La primera (descriptiva), diseñada para aproximarnos al comportamiento del dolor crónico en el hospital sede de la investigación (incidencia) y la segunda (cohorte), para evaluar la efectividad de 2 propuestas terapéuticas analgésicas. Resultados: se evidenció errores de diagnóstico, al no dominar conceptos esenciales de la temática en cuestión, predominó el sexo femenino (61 %), con una edad promedio de 52,6 años; las especialidades que más remitieron a la consulta de dolor crónico fueron: oncología (201 casos), ginecología (137 casos) y ortopedia (68 casos). La combinación de tramadol-paracetamol-piroxican-amitriptilina fue más eficaz que la de cosedal-paracetamol-piroxican-amitriptilina, con menos efectos indeseables y mayor posibilidad de ajuste de dosis. El tiempo promedio de resolución del síntoma dolor fue de 19 ± 4 días, las consultas promedio fueron de cuatro, y el alta promedio se logró a los 151 días. Los síntomas reaparecieron en 16 casos y en solo 9 no fue posible controlarlos de manera óptima. Conclusiones: implementar una consulta de dolor crónico permitió atender a pacientes aquejados por este tipo particular de dolor, conocer su comportamiento en la institución, e implementar medidas que mejoraron su calidad de vida.

Background: The lack of experience in the treatment of chronic pain in "Luis Díaz Soto" Central Military Hospital led to the implementation of a consultation for chronic pain. Methods: Research was done in two stages. The first, (the descriptive stage) was designed to come closer to the behaviour of chronic pain in the hospital in which the investigation was done and the second (the cohort phase) was intended to evaluate the effectiveness of two analgesic and therapeutic proposals. Results: Diagnostic mistakes were shown which also revealed that there was no control of the essential concepts of the subject matter of the investigation. The sex that predominated was the female one (61%) and the average age was 52,6 years. The specialties that referred the most patients to the chronic pain consultation were: Oncology (201 cases), Gynaecology (137 cases) and Orthopaedics (68 cases). The combination of tramadol-paracetamol-piroxicam-amitriptyline was more effective than the one of cosedal-paracetamol-piroxicam-amitriptyline, with less undesirable effects and higher probabilities of dose adjustment. The average time resolution of pain symptoms was 19 ± 4 days. The average number of consultations was four and the average patients´ discharge was achieved at the 151 days of treatment. Symptoms reappeared in 16 cases and in only 9 cases it was impossible to control them in an optimal way. Conclusions: The implementation of a consultation for chronic pain allowed us to attend patients suffering from this particular type of pain, to know their behaviour in this hospital and to implement measures that improve their quality of life.

Participation of cannabinoid receptors in peripheral nociception induced by some NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used extensively to control inflammatory pain. Several peripheral antinociceptive mechanisms have been described, such as opioid system and NO/cGMP/KATP pathway activation. There is evidence that the cannabinoid system can also contribute to the in vivo pharmacological effects of ibuprofen and indomethacin. However, there is no evidence of the involvement of the endocannabinoid system in the peripheral antinociception induced by NSAIDs. Thus, the aim of this study was to investigate the participation of the endocannabinoid system in the peripheral antinociceptive effect of NSAIDs. All experiments were performed on male Wistar rats (160-200 g; N = 4 per group). Hyperalgesia was induced by a subcutaneous intraplantar (ipl) injection of prostaglandin E2 (PGE2, 2 μg/paw) in the rat’s hindpaw and measured by the paw pressure test 3 h after injection. The weight in grams required to elicit a nociceptive response, paw flexion, was determined as the nociceptive threshold. The hyperalgesia was calculated as the difference between the measurements made before and after PGE2, which induced hyperalgesia (mean = 83.3 ± 4.505 g). AM-251 (80 μg/paw) and AM-630 (100 μg/paw) were used as CB1 and CB2 cannabinoid receptor antagonists, respectively. Ipl injection of 40 μg dipyrone (mean = 5.825 ± 2.842 g), 20 μg diclofenac (mean = 4.825 ± 3.850 g) and 40 μg indomethacin (mean = 6.650 ± 3.611 g) elicited a local peripheral antinociceptive effect. This effect was not antagonized by ipl CB1 cannabinoid antagonist to dipyrone (mean = 5.00 ± 0.9815 g), diclofenac (mean = 2.50 ± 0.8337 g) and indomethacin (mean = 6.650 ± 4.069 g) or CB2 cannabinoid antagonist to dipyrone (mean = 1.050 ± 6.436 g), diclofenac (mean = 6.675 ± 1.368 g) and indomethacin (mean = 2.85 ± 5.01 g). Thus, cannabinoid receptors do not seem to be involved in the peripheral antinociceptive mechanism of the NSAIDs dipyrone, diclofenac and indomethacin.

Effect of topical nonsteroidal anti-inflammatory drugs versus topical steroids after strabismus surgery

PURPOSE: The purpose of this study is to compare the effect of topical nonsteroidal anti-inflammatory drugs (NSAID) with topical steroid in conjunctival inflammation, wound healing, and intraocular pressure when used after strabismus surgery. METHODS: Twenty five patients who received bilateral horizontal rectus muscle recession were selected. 0.1% prednisolone acetate (Optilon(R), Chongkundang Pharma Corporation) was applied to the right eye of each patient and 0.1% pranoprofen (Pranopulon(R), Choongwae Pharmacology Corporation) was applied to the left eye four times a day after surgery. Both eyes were compared at one day, 1 week, 2 weeks and 4 weeks after surgery to measure the extent of inflammation (injection, chemosis, discharge), pain and conjunctival incisional healing. The intraocular pressure was compared at the day before surgery and 1 week, 2 weeks and 4 weeks after surgery. RESULTS: The steroid group showed earlier improvement of inflammation and pain and faster conjunctival incisional healing than the NSAID group (p>0.1). The steroid group showed a significantly higher IOP than the NSAIDs group throughout the periods (p<0.001), and showed a progressive increasement in IOP during the study periods (p<0.001). CONCLUSIONS: Topical NSAIDs were proved to be as effective as topical steroids in controlling inflammation and pain, and in the healing of conjunctival wounds. In addition, topical NSAIDs showed no side effect of increasing IOP. Therefore, topical NSAIDs may be a safe alternative to topical steroids after strabismus surgery in children who have difficulty in measuring IOP.