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1.
Arq. bras. cardiol ; 118(3): 548-555, mar. 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1364352

ABSTRACT

Resumo Fundamento É importante saber qual medicamento usar como tratamento de primeira linha para fechar o duto. Objetivos O objetivo deste estudo é comparar a eficácia e os efeitos colaterais das formas intravenosas (IV) de ibuprofeno e paracetamol e contribuir para a literatura investigando o primeiro medicamento selecionado no tratamento clínico da persistência do canal arterial (PCA). Métodos Nosso estudo foi realizado entre janeiro de 2017 e dezembro de 2019. Foram incluídos no estudo bebês prematuros com peso ao nascer (PN) ≤1500 g e idade gestacional (IG) ≤32 semanas. No período do estudo, todos os bebês com persistência do canal arterial hemodinamicamente significativa (hsPCA) receberam ibuprofeno intravenoso (IV) como resgate como tratamento clínico primário ou tratamento com paracetamol IV se houvesse contraindicações para o ibuprofeno. Os pacientes foram divididos em dois grupos: pacientes que receberam ibuprofeno IV e pacientes que receberam paracetamol IV. Resultados Desses pacientes, 101 receberam paracetamol IV e 169 receberam ibuprofeno IV. A taxa de sucesso do fechamento da PCA com o primeiro curso do tratamento foi de 74,3% no grupo de paracetamol IV e 72,8% no grupo de ibuprofeno IV (p=0,212). Conclusões Nossos resultados mostram que o paracetamol IV é tão eficaz quanto o ibuprofeno IV no tratamento de primeira linha de hsPCA, podendo se tornar o tratamento preferencial para o controle de hsPCA.


Abstract Background It is important which medicine to use as a first-line treatment to close the duct. Objectives The aim of this study is to compare the effectiveness and side effects of intravenous (IV) forms of ibuprofen and paracetamol and to contribute to the literature investigating the first drug selected in the medical treatment of patent ductus arteriosus (PDA). Methods Our study was conducted between January 2017 and December 2019. Premature infants with birth weight (BW) ≤1500 g and gestational age (GA) ≤32 weeks were included in the study. In the study period, all infants with hemodynamically significant patent ductus arteriosus (hsPDA) were given rescue intravenous (IV) ibuprofen as a primary medical treatment or IV paracetamol treatment if there were contraindications for ibuprofen. The patients were divided into two groups: patients receiving IV ibuprofen and patients receiving IV paracetamol. Results Of these patients, 101 were given IV paracetamol and 169 were given IV ibuprofen. The success rate of PDA closure with first-course treatment was 74.3% in the IV paracetamol group and 72.8% in the IV ibuprofen group (p=0.212). Conclusions Our results show that IV paracetamol is as effective as IV ibuprofen in the first-line treatment of hsPDA, and can become the preferred treatment for the management of hsPDA.


Subject(s)
Humans , Infant, Newborn , Infant , Ductus Arteriosus, Patent/drug therapy , Infant, Low Birth Weight , Infant, Premature , Ibuprofen/adverse effects , Ibuprofen/therapeutic use , Acetaminophen/adverse effects , Acetaminophen/therapeutic use
2.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 39: e2020013, 2021. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1143850

ABSTRACT

ABSTRACT Objective: To characterize the number and methods of closure of Persistent Ductus Arteriosus (PDA) over a span of 16 years in a third level maternity hospital. Methods: Retrospective study of neonates born between January 2003 and Deccember 2018, who underwent ductus arteriosus closure by pharmacological, surgical and/or transcatheter methods. Gestational age, birth weight, number and methods of closures per year were evaluated. The success rate of the pharmacologic method was calculated, as well as the mortality rate. The association between mortality and birthweight, treatment used and treatment failure was explored. Results: There were 47,198 births, 5,156 were preterm, 325 presented PDA and 106 were eligible for closure (median gestational age - 27 weeks, birthweight <1000 g - 61%). Frequency of PDA closure decreased during the study period, especially starting in 2010. Success rate with pharmacologic treatment was 62% after the first cycle and 74% after the second. After drug failure, 12 underwent surgical ligation and two underwent transcatheter closure. Exclusive surgical ligation was indicated in four infants. Ibuprofen replaced indomethacin in 2010, and acetaminophen was used in three infants. Among the 106 infants, hospital mortality was 12% and it was associated with birthweight <1000 g (13/65 <1000 vs. 0/41 >1000 g; p=0.002) and with failure in the first pharmacologic treatment cycle (13/27 with failure, vs. 0/75 without failure; p<0.001). Conclusions: The national consensus published in 2010 for the diagnosis and treatment of PDA in preterm infants led to a decrease in the indication for closure. Pharmacological closure was the method of choice, followed by surgical ligation. Birthweight <1000 g and first cycle of pharmacologic treatment failure were associated with higher mortality.


RESUMO Objetivo: Caraterizar o número e métodos de fechamento de canal arterial durante 16 anos numa maternidade de nível terciário. Métodos: Estudo retrospetivo de nascidos entre 01 de janeiro de 2003 a 31 de dezembro de 2018 submetidos a fechamento do canal arterial por métodos farmacológico, cirúrgico e/ou percutâneo. Avaliaram-se idade gestacional, sexo, peso ao nascimento, número de fechamentos por ano e método utilizado. Aferiram-se as taxas de sucesso de método farmacológico e de mortalidade e sua associação com peso ao nascer, fármaco utilizado e insucesso do fechamento. Resultados: Verificaram-se 47.198 recém-nascidos, 5.156 prematuros, dos quais 325 com canal arterial patente, sendo 106 com indicação para fechamento (idade gestacional mediana 27 semanas, peso <1000 g em 61%). Verificou-se diminuição do número de fechamentos ao longo dos anos, sobretudo a partir de 2010. O fechamento ocorreu em 62% após primeiro ciclo de tratamento farmacológico e em 74% após segundo. Após insucesso farmacológico, 12 realizaram ligadura cirúrgica e dois, fechamento percutâneo. Houve indicação de ligadura cirúrgica exclusiva em quatro. O ibuprofeno substituiu a indometacina em 2010. O acetaminofen foi usado em três doentes. A mortalidade nos 106 pacientes foi de 12%, associando-se ao peso ao nascer (13/65 <1000 vs. 0/41 >1000 g; p=0,002) e à falha do primeiro ciclo de tratamento farmacológico (13/27 com falha vs. 0/75 com sucesso; p<0,001). Conclusões: Consenso nacional de 2010 para diagnóstico e tratamento do canal arterial nos prematuros levou à diminuição do número de fechamentos desse canal. O fechamento farmacológico foi o método mais utilizado, seguido da ligadura cirúrgica. Peso <1000 g e falha no primeiro ciclo de fechamento farmacológico se associaram à maior mortalidade.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Premature Birth/epidemiology , Ductus Arteriosus, Patent/epidemiology , Ibuprofen/therapeutic use , Indomethacin/therapeutic use , Retrospective Studies , Gestational Age , Infant, Very Low Birth Weight , Ductus Arteriosus, Patent/surgery , Ductus Arteriosus, Patent/drug therapy , Infant, Extremely Premature , Tertiary Care Centers/statistics & numerical data , Acetaminophen/therapeutic use
3.
Clinics ; 76: e2780, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278921

ABSTRACT

This study aimed to systematically review the literature to assess the effect of preemptive intravenous ibuprofen on pain reduction after lower third molar surgery. Nine databases (PubMed, Scopus, LILACS, SciELO, Embase, Web of Science, Cochrane, Open Gray, and Open Thesis) were used as sources of research, including "grey literature." The protocol was registered in PROSPERO. Only randomized clinical trials evaluating the effects of preemptive intravenous ibuprofen on pain during and immediately after the extraction of lower third molars were included, without restrictions of year and language. Two reviewers independently performed the study selection, data extraction, and assessment of the risk of bias. The "Joanna Briggs Institute for Randomized Controlled Trials" tool was used to assess the risk of bias. Each study was categorized according to the percentage of positive responses to the questions corresponding to the assessment instrument. The results were measured narratively/descriptively. The initial search resulted in 3,257 records, of which only three studies (n=150 participants) met the eligibility criteria and were included in the qualitative analysis. All studies were published in 2019. The risk of bias ranged from low to moderate. Two studies found significant pain reduction within 48 h after the procedure. In conclusion, the use of preemptive intravenous ibuprofen for extracting third molars reduces pain and analgesic consumption after the surgical procedure.


Subject(s)
Humans , Ibuprofen/therapeutic use , Molar, Third/surgery , Pain, Postoperative/prevention & control , Randomized Controlled Trials as Topic
4.
Article | IMSEAR | ID: sea-205233

ABSTRACT

Among various types of arthritis Osteoarthritis (OA), Psoriatic arthritis (PA) and Gouty arthritis (GA) are the major ones which have been studied and cause hindrance in movements in many patients. Here we have discussed the treatment modality, a combination of manual therapy and NSAIDs (Ibuprofen) for relieving the symptoms of arthritis. A total of six patients were included consisting of osteoarthritis, psoriatic arthritis and gouty arthritis who presented at the medical office of Dr. Barengolts (MD in USA) and Aybek Izzatov (MD in Uzbekistan) Tyan Anmo Massage School. The study was conducted from October 2019 to March 2020. The treatment consisted of 30 sessions performed for half a year, one week per month (5 days in a month). Significant improvement in symptoms was seen as after 6 months we saw there was reduction in morning stiffness and improved range of motion. The pain score shifted from 5-6 to 2-3 on VAS pain scale. The results signify that the combination therapy wherein manual therapy and NSAIDs worked in an effective way to reduce the level of severity of pain and other associated symptoms.

5.
Rev. colomb. ciencias quim. farm ; 49(2): 374-386, May-Aug. 2020. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1144357

ABSTRACT

SUMMARY The objective was evaluating the antifungal activity of ibuprofen alone and when associated with amphotericin B or ketoconazole against Candida species. Strains of C. albicans, C. tropicalis, C. guilliermondii, C. krusei and C. parapsilosis were used. The minimum inhibitory concentration (MIC) was determined by the microdilution method and the association study performed through the checkerboard assay. The concentration of 512 μg/mL inhibited approximately 65% of the tested strains, while against 35% of the strains presented MIC values above 2048 μg/mL. Associations of ibuprofen with amphotericin B against C. tropicalis and ibuprofen with ketoconazole against C. krusei showed synergistic effect. Antagonistic effects were evidenced in the combination of ibuprofen with amphotericin B against C. guilliermondii and C. albicans, as well as in the association of ibuprofen with ketoconazole against C. albicans and C. tropicalis. Through the experiments, it was found that ibuprofen showed antifungal activity against most of the Candida species tested. The combinations of ibuprofen and antifungals had synergistic effects. However, antagonistic results were evidenced in the association with ibuprofen, which would make clinical applicability difficult. Therefore, studies of this combined activity should be investigated, considering that this association may be positive for anti-fungal therapy.


RESUMEN El objetivo fue evaluar la actividad antifúngica del ibuprofeno solo y asociado con anfotericina B o ketoconazol contra especies de Candida. Se utilizaron cepas de C. albicans, C. tropicalis, C. guilliermondii, C. krusei y C. parapsilosis. La concentración inhibitoria mínima (MIC) se determinó mediante el método de microdilución y el estudio de asociación fue realizado a través del ensayo de checkboard. La concentración de 512 μg/mL inhibió aproximadamente el 65% de las cepas analizadas, mientras 35% de las cepas presentaron valores de MIC superiores a 2048 μg/mL. Las asociaciones de ibuprofeno con anfotericina B contra C. tropicalis e ibuprofeno con ketoconazol contra C. krusei mostraron un efecto sinérgico. Se evidenciaron efectos antagonistas en la combinación de ibuprofeno con anfotericina B contra C. guilliermondii y C. albicans, así como en la asociación de ibuprofeno con ketoconazol contra C. albicans y C. tropicalis. Se descubrió, a través de los experimentos, que el ibuprofeno mostró actividad antifúngica contra la mayoría de las especies de Candida probadas. Las combinaciones de ibuprofeno y antifúngicos tuvieron efectos sinérgicos. Sin embargo, se evidenciaron resultados antagónicos en la asociación con ibuprofeno, lo que dificultaría la aplicabilidad clínica. Por lo tanto, los estudios de esta actividad combinada deben investigarse, considerando que esta asociación puede ser positiva para la terapia antimicótica.


RESUMO O objetivo do estudo foi avaliar a atividade antifúngica do ibuprofeno sozinho e quando associado com anfotericina B ou cetoconazol contra espécies de Candida. Foram utilizadas cepas fúngicas de C. albicans, C. tropicalis, C. guilliermondii, C. krusei e C. parapsilosis, entre isolados clínicos e cepas padrão. A concentração inibitória mínima (CIM) foi determinada pela técnica de microdiluição e o estudo de associação realizado através do ensaio checkerboard. A concentração de 512 μg/mL foi capaz de inibir, aproximadamente, 65% das cepas ensaiadas, enquanto que 35% das estirpes apresentaram valores da CIM acima de 2048 μg/mL. Associações do ibuprofeno com anfotericina B contra C. tropicalis e ibuprofeno mais cetoconazol contra C. krusei mostraram efeito sinérgico. Efeitos antagônicos foram evidenciados na combinação do ibuprofeno com anfotericina B contra C. guilliermondii e C. albicans, como também na associação do ibuprofeno com cetoconazol contra C. albicans e C. tropicalis. Por meio dos experimentos, pôde-se afirmar que o ibuprofeno exerceu atividade antifúngica contra a maioria das espécies de Candida ensaiadas. Os efeitos das combinações entre o ibuprofeno e os antifúngicos promoveram efeitos sinérgicos. No entanto, resultados antagônicos foram evidenciados na associação com o ibuprofeno, o que dificultaria aplicabilidade clínica. Logo, estudos dessa atividade combinada devem ser investigados, pois esta associação pode traçar pontos positivos na terapia antifúngica.

6.
Article | IMSEAR | ID: sea-210215

ABSTRACT

Aim:This study investigated the curative effect of the aqueous leaf extract of Azadirachta indicaon Ibuprofen-induced nephrotoxicity in Wistar rat Study Design:This is an experimental researchPlace of Research:Department of Anatomy, College of Medicine, Enugu State University of Science and Technology.Methodology:Twenty-four male Wistar rats were divided into 6 groups, with 4 rats in each group. Group 1 was control and received oral normal saline 0.5ml daily. Group 2-6 had induction of nephrotoxicity using oral Ibuprofen 400mg/Kg daily for 5 days. Group 3-5 were subsequently treated with gavage Azadirachta indicaleaf extract 200mg/Kg, 400mg/Kg and 800mg/Kg, respectively, for 5 days. And Group 6 was treated with oral Vitamin E 1000 iu/kg for 5 days Results:Ibuprofen induced nephrotoxicity as evidenced by elevation of serum creatinine level in group 2 (1.99 ± 0.83), when compared to 0.48 ± 0.07 obtained in group 1 (control), and Bowman’s capsule enlargement with glomerular degeneration observed in group 2. The serum creatinine levels progressively approached the level of that of the control in groups treated with Azadirachta indicaleaf extract, groups 3 (1.69 ± 0.52), 4 (0.69 ± 0.10) and 5 (0.49 ± 0.10). Also, the histoarchitecture progressively normalized to that of control with each increase in dose of the extract.Conclusion:Azadirachta indica(neem) leaf extract administration led to the resolution of Ibuprofen-induced kidney injury in this study. Thus, it can serve as a treatment option for kidney injury resulting from ingestion of Ibuprofen, after the identification of the molecule responsible for this effect.

7.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(1): 58-65, jun 17, 2020. fig, tab
Article in English | LILACS | ID: biblio-1358677

ABSTRACT

Introduction: non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are widely used throughout the world. In the psychiatric hospital, where this study was conducted, drugs such as selective serotonin reuptake inhibitors (SSRI) and lithium are widely used and may interact with ibuprofen (IBU). The literature also shows that ibuprofen may lead to changes in the central nervous system, which may trigger the imbalance of psychiatric disorders. Objective: to evaluate whether both the frequency of use and the prescriptions of ibuprofen are in agreement with the information contained in the literature regarding safety, indication, and dose. Methodology: retrospective observational cross-sectional study to evaluate the use of ibuprofen on patients from a psychiatric hospital. The prescriptions were evaluated for a 10-month period. Results: of the total number of prescriptions, 43 contained ibuprofen 600 mg. Note that in most cases, the drug was being prescribed according to the literature. However, in some cases there were divergences in the literature regarding: i) safety ­ information about the absence or presence of ulcers (1; 2.3%), gastrointestinal events (0; 0%) and absence of dyspepsia, abdominal pain and discomfort gastrointestinal (11; 25.5%) ­ ii) and the dose, in which in 19 cases (44%) it was higher than recommended by the literature. In addition, in 2 prescriptions (4.7%), the concomitant use of IBU and SSRI was observed and in 5 (11.6%) of IBU and lithium. Conclusion: the use of this drug often escaped safety and dosage criteria concerning scientific literature.


Introdução: os anti-inflamatórios não esteróides (AINEs), como o ibuprofeno, são amplamente utilizados no mundo todo. No hospital psiquiátrico em que este estudo foi realizado, medicamentos como inibidores seletivos da recaptação de serotonina e lítio são amplamente utilizados e sabe-se que podem interagir com o ibuprofeno. A literatura também mostra que o ibuprofeno pode levar a alterações no sistema nervoso central, o que pode desencadear o desequilíbrio dos distúrbios psiquiátricos. Objetivo: avaliar a frequência da utilização do ibuprofeno e se suas prescrições estão de acordo com as informações contidas na literatura com relação à segurança, indicação e dose. Metodologia: realizou-se um estudo transversal observacional retrospectivo para avaliar o uso de ibuprofeno em pacientes de um hospital psiquiátrico. As prescrições foram avaliadas por um período de 10 meses. Resultados: entre as 43 prescrições avaliadas, recomendou-se a dose de 600 mg. Foi observado que, na maioria dos casos, o medicamento estava sendo usado conforme prescrito na literatura. No entanto, em alguns casos houve divergências da literatura em relação a i) segurança ­ informações sobre a ausência ou presença de úlceras (1; 2,3%), de eventos gastrointestinais (0; 0%) e ausência de dispepsia, dor abdominal e desconforto gastrointestinal (11; 25,5%) ­ ii) dose, em que em 19 casos (44%) foi maior do que o preconizado pela literatura. Além disso, em duas (4,7%) prescrições, foi observado o uso concomitante de IBU e ISRS) e em cinco (11,6%) de IBU e lítio. Conclusão: o uso desse medicamento frequentemente de modo geral não obedeceu aos critérios de segurança e dosagem referentes à literatura científica.


Subject(s)
Humans , Male , Female , Pharmacy , Pharmaceutical Preparations , Ibuprofen , Drug Utilization , Patient Safety , Anti-Inflammatory Agents , Cross-Sectional Studies , Retrospective Studies , Observational Study
8.
Article | IMSEAR | ID: sea-215940

ABSTRACT

Aim:Ibuprofen is analgesic, antipyretic and anti-inflammatory drug, which is widely used as a cheap over-the counter drug(OTC); however, this drug accompanies anti coagulation/anti platelets effects which sometimes might illicit adverse effects. In this study, we investigated effect of ibuprofen on prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelet count using wistar albino rats.Methods:A total of 21 rats grouped into 3(control, acute and chronic exposure groups, with all consisting of 7rats each) was used. The acute and chronic exposure group were given 0.7mg of ibuprofen orally for 1 and 21 days, respectively. Blood sample was collected via cardiac puncture thenanalyzed.Results:PT was significantly higher in both group 2 and 3 (acute and chronic exposure, respectively)than that of the control. Acute exposure group showed the highest PT rise.A PTT was not significantly different between group 2 and 3 versus the control group. Platelet count was significantly lower in both group 2 and 3than that in the control group (p<0.05). Group 3 (chronic exposure) showed the lowest platelet count.Conclusion:Oral administration of ibuprofen affected coagulation parameters and a longer exposure reduce platelets count. A strictly prescription for this drug may be needed to prevent its indiscriminate use

9.
J. pediatr. (Rio J.) ; 96(2): 177-183, Mar.-Apr. 2020. tab
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1135011

ABSTRACT

Abstract Objective: Management of patent ductus arteriosus is still controversial. This study aimed to describe the impact of a more conservative approach on treatment rates and on main outcomes of prematurity, especially in preterm infants with <26 weeks of gestation. Method: Clinical charts review of infants ≤30 weeks with patent ductus arteriosus between 2009 and 2016 at two centers. In 2011, the authors changed patent ductus arteriosus management: in first period (2009-2011), patients who failed medical treatment underwent surgical closure; in second period (2012-2016), only those with cardiopulmonary compromise underwent surgical ligation. Medical treatment, surgical closure, mortality, and survival-without-morbidity were compared. Results: This study included 188 patients (27 ± 2 weeks, 973 ± 272 grams); 63 in P1 and 125 in P2. In P2, significantly lower rates of medical treatment (85.7% P1 versus 56% P2, p < 0.001) and surgical closure (34.5% P1 versus 16.1% P2, p < 0.001) were observed. No differences were found in chronic lung disease (28.8% versus 13.9%, p = 0.056), severe retinopathy of prematurity (7.5% versus 11.8%, p = 0.403), necrotizing enterocolitis (15.5% versus 6.9%, p = 0.071), severe intraventricular hemorrhage (25.4% versus 18.4%, p = 0.264), mortality (17.5% versus 15.2%, p = 0.690) or survival-without-morbidity adjusted OR = 1.10 (95% CI: 0.55-2.22); p = 0.783. In P2, 24.5% patients were discharged with patent ductus arteriosus. The subgroup born between 23 and 26 weeks (n = 82) showed significant differences: lower incidence of chronic lung disease (50% versus 19.6%, p = 0.019) and more survival-without-morbidity (20% versus 45.6%, p = 0.028) were found. Conclusion: A conservative approach in preterm infants with patent ductus arteriosus can avoid medical and surgical treatments, without a significant impact in survival-without-morbidity. However, two-thirds of preterm infants under 26 weeks are still treated.


Resumo Objetivo O tratamento da persistência do canal arterial ainda é controverso. Nosso objetivo foi descrever o impacto de uma abordagem mais conservadora em nossas taxas de tratamento e nos principais desfechos da prematuridade, especialmente em prematuros com < 26 semanas de gestação. Método Revisão de prontuários de lactentes com ≤ 30 semanas e persistência do canal arterial entre 2009-2016 em dois centros. Em 2011, mudamos o manejo da persistência do canal arterial: no primeiro período (2009-2011), os pacientes que não apresentaram sucesso com o tratamento clínico foram submetidos a fechamento cirúrgico; no segundo período (2012-2016), apenas aqueles com comprometimento cardiopulmonar foram submetidos ao fechamento cirúrgico. Comparamos o tratamento clínico, fechamento cirúrgico, mortalidade e sobrevida sem morbidade. Resultados Foram incluídos 188 pacientes (27 ± 2 semanas, 973 ± 272 gramas); 63 em P1 e 125 em P2. Em P2, foram observadas taxas significativamente mais baixas de tratamento clínico (85,7% no P1 versus 56% no P2, p < 0,001) e fechamento cirúrgico (34,5% no P1 versus 16,1% no P2, p < 0,001). Não foram encontradas diferenças em relação à doença pulmonar crônica (28,8% versus 13,9%, p = 0,056), retinopatia grave da prematuridade (7,5% versus 11,8%, p = 0,403), enterocolite necrosante (15,5% versus 6,9%, p = 0,071), hemorragia intraventricular grave (25,4% versus 18,4%, p = 0,264), mortalidade (17,5% versus 15,2%, p = 0,690) ou OR ajustado pela sobrevida sem morbidade = 1,10 (IC95%: 0,55-2,22); p = 0,783. Em P2, 24,5% dos pacientes receberam alta com persistência do canal arterial. O subgrupo nascido entre 23 a 26 semanas (n = 82) apresentou diferenças significativas, foram encontradas menor incidência de doença pulmonar crônica (50% versus 19,6%, p = 0,019) e maior sobrevida sem morbidade (20% versus 45,6%, p = 0,028). Conclusão Uma abordagem conservadora em prematuros com persistência do canal arterial pode evitar tratamentos clínicos e cirúrgicos, sem um impacto significativo na sobrevida sem morbidade. No entanto, dois terços dos prematuros com menos de 26 semanas ainda são tratados.


Subject(s)
Humans , Infant, Newborn , Infant , Ductus Arteriosus, Patent/therapy , Infant, Low Birth Weight , Infant, Premature , Treatment Outcome , Conservative Treatment , Ligation
10.
Rev Assoc Med Bras (1992) ; 66(5): 596-599, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136257

ABSTRACT

SUMMARY AIMS Omentin is an adipokine primarily produced by visceral adipose tissue and its reduced levels have been shown to be associate with worse metabolic outcomes. We aimed to study the effects of preoperative ibuprofen on postoperative omentin levels in rats after surgery. METHODS Forty-eight albino Wistar rats, 6 in each of 8 groups according to the surgical procedure (laparotomy, laparotomy plus ibuprofen (IBU), nephrectomy, nephrectomy plus IBU, hepatectomy, hepatectomy plus IBU, splenectomy and splenectomy plus IBU). The Omentin levels of the groups were postoperatively analyzed. RESULTS The mean omentin was significantly higher in the laparotomy plus IBU group compared to the laparotomy group (p<0.001). Mean Omentin was significantly higher in the hepatectomy plus IBU group compared to the hepatectomy group (p=0.01). Mean Omentin was significantly higher in the nephrectomy plus IBU group compared to the nephrectomy group (p=0.001). CONCLUSION We suggest that preoperative ibuprofen may enhance circulating levels of Omentin, which has beneficial effects in trauma and inflammation settings in subjects that undergo minor or major abdominal surgery.


RESUMO OBJETIVOS A omentina é uma adipocina produzida principalmente pelo tecido adiposo visceral e níveis reduzidos dela foram associados a piores desfechos metabólicos. Nosso objetivo foi estudar os efeitos do uso pré-operatório do ibuprofeno nos níveis pós-operatórios da omentina em ratos. METODOLOGIA Quarenta e oito ratos Wistar albinos foram divididos em 8 grupos (6 em cada), de acordo com o procedimento cirúrgico: laparotomia, laparotomia e ibuprofeno (IBU), nefrectomia, nefrectomia e IBU, hepatectomia, hepatectomia e IBU, esplenectomia, e esplenectomia e IBU. Os níveis de omentina dos grupos foram analisados após a cirurgia. RESULTADOS A omentina média foi significativamente maior no grupo de laparotomia e IBU do que no grupo de laparotomia (p<0,001). A omentina média foi significativamente maior no grupo de hepatectomia e IBU do que no grupo de hepatectomia (p = 0,01). A omentina média foi significativamente maior no grupo de nefrectomia e IBU do que no grupo de nefrectomia (p = 0,001). CONCLUSÃO Sugerimos que o uso pré-operatório de ibuprofeno pode aumentar os níveis circulantes de omentina, que têm efeitos benéficos em um contexto de trauma e inflamação em indivíduos submetidos cirurgia abdominal.


Subject(s)
Humans , Rats , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Ibuprofen/pharmacology , Lectins/blood , Splenectomy , Cytokines/blood , Rats, Wistar , Adipokines , Inflammation
11.
Braz. J. Pharm. Sci. (Online) ; 56: e18599, 2020. tab
Article in English | LILACS | ID: biblio-1132042

ABSTRACT

The present study investigated the association of the non-steroidal anti-inflammatory drug ibuprofen with itraconazole, fluconazole and amphotericin B against Cryptococcus neoformans isolates. The minimal inhibitory concentration (MIC) was found according to M27-A3 protocol and in vitro interactions were evaluated using checkerboard microdilution method. Synergism was demonstrated between azoles and ibuprofen for most isolates. However, no synergistic effects were seen when amphotericin B was combined with ibuprofen. Therefore, our results suggest that ibuprofen presents clinical potential when combined with azole drugs in the treatment of cryptococcosis.


Subject(s)
Fluconazole/antagonists & inhibitors , Ibuprofen/agonists , Itraconazole/antagonists & inhibitors , Cryptococcus neoformans/isolation & purification , In Vitro Techniques/methods , Pharmaceutical Preparations/analysis , Amphotericin B/analogs & derivatives
12.
Braz. J. Pharm. Sci. (Online) ; 56: e18629, 2020. tab, graf
Article in English | LILACS | ID: biblio-1249158

ABSTRACT

Few topical products have been developed specifically to treat acute and chronic arthritis and inflammation, using non-steroidal anti-inflammatory drugs (NSAIDs). The lack of dosing accuracy commonly found in locally applied semisolid products for cutaneous use is a critical issue that leads to treatment failure. The aim of the present work is to develop a differentiated and innovative topical patch based on a monolithic hydrogel for ibuprofen skin delivery, in order to provide a safer and accurate way of drug administration along with improved treatment compliance. Topical patches based on hydroxypropylmethylcellulose (HPMC) were optimized in composition, in terms of enhancer and adhesive, supported on a systematic assessment of in vitro release and permeation behavior and adhesion properties. Several mathematical models were used to scrutinize the release mechanisms from the patches. In vitro release kinetics was shown to be mainly driven by diffusion. However, other mechanisms seemed to be also present, supporting the feasibility of using patches for sustained drug delivery. PEG 200 provided the best permeation rate, with a permeation enhancement ratio of ca. 3 times higher, than the commercial reference. The addition of Eudragit L30D 55 to the formulation led to the best adhesion profile, thus achieving a successful development based on a safe-by-design concept.


Subject(s)
Pharmaceutical Preparations/administration & dosage , Adhesives/analysis , Drawing , Arthritis/pathology , In Vitro Techniques/methods , Ibuprofen/agonists , Patient Compliance , Hydrogels/analysis , Inflammation/pathology
13.
RGO (Porto Alegre) ; 68: e20200040, 2020. graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1136044

ABSTRACT

ABSTRACT Objective The aim of this study was to evaluate the influence of ibuprofen-arginine on the concentration of amoxycillin in the plasma and periapical tissues of rats with induced apical periodontitis. Methods Twenty-eight Wistar rats were divided into the following four groups: PL: placebo (saline); AM: amoxycillin (100 mg/kg); IB: ibuprofen-arginine (100 mg/kg); and AM+IB: amoxycillin (100 mg/kg) + ibuprofen-arginine (100 mg/kg). The animals were submitted to pulp exposure in the first lower left molar, which remained open for fifteen days; this was then closed with composite resin and remained for a further seven days. The treatments were performed using a single dose of the medication (gavage) one hour before taking the samples. Two mL of blood was collected from the aorta to obtain the blood plasma and the periapical tissue samples, which were homogenized to obtain the supernatant. The samples (plasma and the supernatant periapical tissue) were used to obtain the antibiogram for the analysis of the levels of amoxycillin in the plasma and periapical tissues. Results The amoxycillin concentration was higher in the AM group compared to the other groups (p < 0.05, ANOVA with Tukey's test). Ibuprofen-arginine interfered with plasma concentration of amoxycillin; however, the AM+IB group had a higher concentration of amoxycillin than the PL and IB groups (p < 0.05, ANOVA with Tukey's test). The analysis of the supernatant from the periapical tissues showed no significant difference between the groups (p > 0.05, Kruskal-Wallis test). Conclusion Ibuprofenarginine can interfere with the plasma concentration of amoxycillin but this study failed to show the effect of ibuprofen-arginine on the concentration of amoxycillin in the periapical tissues .


RESUMO Objetivo A proposta desta pesquisa foi avaliar a influência do ibuprofeno arginina, sobre a concentração de amoxicilina no plasma e no tecido periapical de ratos com periodontite apical induzida. Métodos Foram utilizados 28 ratos Wistar, divididos em 4 grupos:PL: placebo (salina); AM: amoxicilina (100mg/kg); IB: ibuprofeno arginina (100mg/kg); e AM+IB: amoxicilina (100mg/kg) + ibuprofeno arginina (100mg/kg). Os animais foram submetidos à exposição pulpar do primeiro molar inferior esquerdo que permaneceu aberto por 15 dias e, então, fechado com resina composta, permanecendo por mais 07 dias. Os tratamentos foram realizados com dose única dos medicamentos (gavagem), uma hora antes da obtenção das amostras. Foram coletados 2mL de sangue da artéria aorta para a obtenção do plasma sanguíneo e amostras do tecido periapical que foram homogeneizadas para a obtenção do sobrenadante. A partir das amostras (plasma e sobrenadante do tecido periapical) realizou-se o antibiograma para análise da concentração plasmática e tecidual de amoxicilina. Resultados A concentração de antibiótico foi maior no grupo AM em comparação aos demais grupos (p<0,05, ANOVA com Tukey). O ibuprofeno arginina interferiu na concentração plasmática de amoxicilina, no entanto, a concentração de amoxicilina no grupo AM+IB foi maior que nos grupos PL e IB (p<0,05, ANOVA com Tukey). A análise do sobrenadante do tecido periapical não mostrou diferença significativa entre os grupos (p>0,05, Kruskal-Wallis). Conclusão O ibuprofeno arginina podeinterferir com a concentração plasmática de amoxicilina, porém o estudo não foi capaz de mostrar o efeito do anti-inflamatório na concentração de amoxicilina no tecido periapical.

14.
Medwave ; 20(5): e7733, 2020.
Article in English, Spanish | LILACS | ID: biblio-1116976

ABSTRACT

INTRODUCCIÓN: El mal agudo de montaña es una condición frecuente en individuos sanos, sin aclimatación que se exponen a alturas desde 2500 metros sobre el nivel del mar. Clásicamente se ha utilizado acetazolamida para prevenirlo, pero en los últimos años ha surgido evidencia a favor de ibuprofeno. Sin embargo, no está claro cuál de estos tratamientos es más efectivo. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos dos revisiones sistemáticas que en conjunto incluyeron un estudio primario, el cual corresponde a un ensayo aleatorizado. Concluimos que no es posible establecer con claridad si ibuprofeno es mejor o peor que acetazolamida debido a que la certeza de evidencia existente ha sido evaluada como muy baja.


INTRODUCTION: Acute mountain sickness is a common condition occurring in healthy subjects that undergo rapid ascent without prior acclimatization, as low as 2500 meters above sea level. The classic preventive agent has been acetazolamide, although in the last decade there has been evidence favoring ibuprofen. However, it is unclear which method is more efficient. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis) and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified two systematic reviews that included only one primary study, which is a randomized trial. We concluded it is not possible to establish whether ibuprofen is better or worse than acetazolamide because the certainty of evidence has been evaluated as very low.


Subject(s)
Humans , Ibuprofen/therapeutic use , Altitude Sickness/prevention & control , Acetazolamide/therapeutic use , Carbonic Anhydrase Inhibitors/therapeutic use , Randomized Controlled Trials as Topic , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Acute Disease , Databases, Factual
15.
Rev. colomb. ciencias quim. farm ; 48(3): 589-614, sep.-dic. 2019. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1138772

ABSTRACT

RESUMEN El ibuprofeno es uno de los fármacos más utilizados e indicado para terapias antiinflamatorias, dolor, entre otras patologías. Sin embargo, este fármaco presenta una baja y errática biodisponibilidad, debido a la pobre solubilidad acuosa intrínseca del mismo, por lo cual esta categorizado como clase II en el sistema de clasificación biofarmacéutica. El objetivo de este trabajo fue desarrollar, diseñar y evaluar un sistema de entrega de fármaco autoemulsificable (SEDDS) para mejorar la solubilidad y velocidad de disolución de ibuprofeno. Aceites, cosolventes, tensioactivos y portadores porosos fueron evaluados por su capacidad de mejorar la solubilidad del ibuprofeno, habilidad de autoemulsificación, robustez en diferentes pH y capacidad de adsorción. El aceite de coco, Tween 80 y propilenglicol lograron un aumento significativo de la solubilidad acuosa del ibuprofeno en un tiempo de autoemulsificación menor a 2 minutos. Neusilin US2® fue seleccionado como portador, dando como resultado un pequeño granulo de excelente fluidez, que permitió obtener comprimidos que cumplieron satisfactoriamente las pruebas de control de acuerdo con las especificaciones establecidas. Los SEDDS líquidos y sólidos son una alternativa de formulación ventajosa y prometedora para mejorar la solubilidad de fármacos pobremente solubles de acuerdo al sistema de clasificación biofarmacéutica, a través de sus propiedades de solubilización.


SUMMARY Ibuprofen is one of the most used drugs and it's indicated for anti-inflammatory therapies and pain, among other pathologies. However, this drug has a low and erratic bioavailability, due to its poor aqueous intrinsic solubility, which is categorized as class II in the Biopharmaceutical Classification System. The objective of this work was to develop, design and evaluate a self-emulsifying drug delivery system (SEDDS) to improve the solubility and dissolution rate of ibuprofen. Oils, co-solvents, surfactants and carriers were evaluated for their ability to improve the solubility of ibuprofen, self-emulsification ability, robustness at different pH levels and adsorption capacity. Coconut oil, Tween 80 and propylene glycol achieved a significant increase in the aqueous solubility of ibuprofen in a self-emulsification time of less than 2 minutes. Neusilin US2® was selected as carrier, resulting in a small granule of excellent fluidity, which allowed to obtain tablets that satisfactorily fulfilled the control tests according to the established specifications. The liquid and solid SEDDS are an advantageous and promising formulation alternative to improve the solubility of poorly soluble drugs according to the biopharmaceutical classification system, through their solubilization properties.

16.
Int J Pharm Pharm Sci ; 2019 Oct; 11(10): 26-32
Article | IMSEAR | ID: sea-205960

ABSTRACT

Objective: The preliminary goal was to develop and validate 1st order derivative spectroscopic method for quantitative analysis of Pamabrom (PAMA) which is a xanthine diuretic and ibuprofen (IBU) which is a non-steroidal anti-inflammatory agent from its synthetic mixture. Methods: Analytical method was developed on Shimadzu double beam spectrophotometer equipped with UV probe 2.42 as software using methanol as solvent. Quantification of PAMA was carried out at zero cross over point of IBU that is 291 nm and for IBU, it was achieved at 278 nm which is zero cross over point of PAMA. Method was validated according to ICH Q2 R1 guidelines. Results: Method showed a linear response in the range of 2-12 µg/ml of PAMA and 20-120 µg/ml of IBU. Method was found to be accurate with recovery between 99.7–100.9 % for PAMA and 100.3–100.7 % for IBU. The method was found to be accurate and precise for quantitative analysis of PAMA and IBU. Conclusion: The developed method was successfully validated as per ICH Q2 R1 guidelines and was successfully applied for quantitative analysis of a synthetic mixture of PAMA and IBU.

17.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(3): 382-385, July-Sept. 2019. tab
Article in English | LILACS | ID: biblio-1041340

ABSTRACT

ABSTRACT Objective: To report a case of a male adolescent with the diagnosis of ibuprofen-induced meningitis. We discuss themain causes of drug-induced aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented. Only few DIAM cases have been reported in pediatric age. Case description: A healthy 15-year-old boy presented to the emergency department with headache, nausea, dizziness, fever, conjunctival hyperemia and blurred vision 30 minutes after ibuprofen-intake. During his stay, he developed emesis and neck stiffness. Cerebrospinal fluid analysis excluded infectious causes, and DIAM was considered. He totally recovered after drug withdrawal. Comments: DIAM is a rare entity, that should be considered in the differential diagnosis of an aseptic meningitis. The major causative agents are nonsteroidal anti-inflammatory drugs, particularly ibuprofen. Suspicion is made by the chronologic link between drug intake and the beginning of symptoms, but infectious causes should always be ruled out.


RESUMO Objetivo: Descreve-se o caso de um adolescente do sexo masculino com diagnóstico de meningite asséptica por ibuprofeno. Discutem-se as causas de meningite asséptica induzida por medicamentos (MAIM) e a importância do reconhecimento precoce dessa situação, para que a medicação envolvida seja suspensa e as recorrências prevenidas. Poucos casos foram descritos em idade pediátrica. Descrição do caso: Adolescente de 15 anos, gênero masculino, saudável, procurou o serviço de urgência por cefaleia, náuseas, tonturas, febre, hiperemia conjuntival e visão desfocada 30 minutos após o uso de ibuprofeno. Durante a internação, iniciou vômitos e rigidez na nuca. A análise do líquido cefalorraquidiano excluiu causas infeciosas, e considerou-se como diagnóstico mais provável a MAIM. A recuperação foi total após a suspensão do medicamento. Comentários: A MAIM é rara, mas deve ser considerada no diagnóstico diferencial de meningite asséptica. A principal causa são os anti-inflamatórios não esteroides, principalmente o ibuprofeno. A suspeita clínica é evocada pela relação temporal entre o uso do medicamento e o início dos sintomas, mas as causas infeciosas devem ser sempre excluídas.


Subject(s)
Humans , Male , Adolescent , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Ibuprofen/adverse effects , Meningitis, Aseptic/chemically induced , Vomiting , Treatment Outcome , Diagnosis, Differential , Drug Hypersensitivity , Fever , Headache , Meningitis, Aseptic/diagnosis
18.
Rev. cienc. salud (Bogotá) ; 17(2): 321-333, may.-ago. 2019. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1013877

ABSTRACT

Resumen Introducción : el uso de terapias analgésicas para controlar el dolor postexodoncia es muy variado y depende muchos factores. El objetivo de este estudio fue comparar la efectividad analgésica del paracetamol asociado con el clonixinato de lisina y compararlo con monoterapias de paracetamol e ibuprofeno en el tratamiento posoperatorio de exodoncias. Materiales y métodos : la muestra estuvo conformada por 39 pacientes distribuidos aleatoriamente en tres grupos. El dolor posoperatorio se midió utilizando la Escala Visual Análoga (EVA) 1 h, 8 h y 24 h postexodoncia. El análisis estadístico de la evolución de las tres terapias, se realizó empleando el test t de Student, ANOVA y test de Tuckey, con un nivel de significancia de p < 0.05. Resultados : los valores obtenidos demostraron que la combinación analgésica de paracetamol asociado con el clonixinato de lisina fue más efectiva 1 h y 8 h después. A las 24 h no existieron diferencias en los tres grupos de estudio. Conclusión : la analgesia de la terapia combinada de Paracetamol asociada con el Clonixinato de lisina es superior a la producida por la dosis estándar de Ibuprofeno y Paracetamol en el tratamiento del dolor posoperatorio de exodoncias simples.


Abstract Introduction : The use of analgesic therapies to control post-exodontia pain is very varied and depends on many factors. The study had two aims: to compare the analgesic effectiveness of paracetamol associated with lysine clonixinate and to compare it with monotherapies of paracetamol and ibuprofen in exodontias' postoperative treatment. Materials and methods : The sample consisted of 39 patients randomized into three groups. The postoperative pain was measured using the Visual Analogue Scale (VAS), at 1h, 8h, and 24h after exodontia. Statistical analysis of the evolution of the three therapies was performed using Student's t-test, ANOVA and Tuckey's test, with a level of significance of p <0.05. Results : The values obtained showed that the analgesic combination of paracetamol associated with clonixinate of lysine was more effective at 1h and 8h. At 24h, there were no differences in the three study groups. Conclusion : The analgesia of the combined therapy of paracetamol associated with clonixinate of lysine is superior to that produced by the standard dose of ibuprofen and paracetamol in the treatment of post-operation pain of simple extractions.


Resumo Introdução : o uso de terapias analgésicas para controlar a dor pós-exodontia é muito variada e depende de muitos fatores. O objetivo deste estudo foi comparar a efetividade analgésica do paracetamol associado ao clonixinato de lisina e compará-lo com monoterapias de paracetamol e ibuprofeno no tratamento pós-operatório de exodontias. Materiais e métodos : a amostra esteve conformada por 39 pacientes distribuídos aleatoriamente em três grupos. A dor pós-operatória mediu-se utilizando a Escala Visual Análoga (EVA) às 1 h, 8 h e 24 h pós-exodontia. A análise estatística da evolução das três terapias, se realizaram empregando o teste t de Student, ANOVA e teste de Tuckey, com um nível de significancia de p<0.05. Resultados : os valores obtidos demostraram que a combinação analgésica de paracetamol associado a clonixinato de lisina, foi mais efetiva às 1 h e 8 h. Às 24 h, não existiram diferenças nos três grupos de estudo. Conclusão : a analgesia da terapia combinada de Paracetamol associado a Clonixinato de lisina, é superior à produzida pela dose standard de Ibuprofeno e Paracetamol no tratamento da dor pós-operatória de exodontias simples.


Subject(s)
Humans , Surgery, Oral , Pain , Ibuprofen , Treatment Outcome , Acetaminophen
19.
Article | IMSEAR | ID: sea-183632

ABSTRACT

Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.

20.
Article | IMSEAR | ID: sea-183570

ABSTRACT

Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.

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