Topical vs oral ibuprofen therapy for knee disorders

Objective The study aimed to evaluate the efficacy of dual medication therapy (DMT) with oral acetaminophen and oral ibuprofen for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA). Study Design In a prospective case–control cohort study (July 2017–May 2019), infants <29 weeks' gestational age and birth weight <1,000 g at ≤14 postnatal days with hsPDA and ratio of the smallest ductal diameter to the ostium of the left pulmonary artery diameter >0.5 were eligible. Infants received 10 mg/kg oral ibuprofen followed by two additional doses of 5 mg/kg at 24 and 48 hours after the initial ibuprofen dose and concomitant treatment with 15 mg/kg oral acetaminophen every 6 hours for 3 days (12 doses). Success of PDA treatment was defined as a small or absent PDA as ascertained by echocardiographic measurements. The p-values of comparisons were adjusted for multiple comparisons to preserve an error rate of 5%. Results Overall, 20 infants received oral DMT and 11 infants received intravenous single medication therapy (SMT) with ibuprofen. The rates of successful PDA treatment following the first treatment in DMT and SMT groups were not statistically different (11/20 [55%] vs. 4/11 [36%], p = 0.46). However, DMT significantly decreased PDA size (mean difference = 0.54 mm, 95% confidence interval [CI]: 0.21–0.96, adjusted p-value = 0.0002) and PDA/LPA ratio (mean difference = 0.27, 95% CI: 0.10–0.47, adjusted p-value = 0.0004). We observed no evidence of hematologic, hepatic, or renal impairment. Conclusion DMT achieved a greater degree of PDA closure than SMT and did not result in abnormalities in hepatic and renal profile. Key Points

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Oral ibuprofen cost effective in neonates with patent ductus arteriosis

PharmacoEconomics & Outcomes News ◽

10.1007/s40274-021-7422-8 ◽

2021 ◽

Vol 870 (1) ◽

pp. 19-19

Keyword(s):

Cost Effective ◽

Oral Ibuprofen ◽

Patent Ductus Arteriosis ◽

Patent Ductus

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The Comparison of Efficiency of Oral Ibuprofen and Intravenous Indomethacin for Patent Ductus Arteriosus in Very Low Birth Weight Infants

Perinatology ◽

10.14734/pn.2018.29.1.33 ◽

2018 ◽

Vol 29 (1) ◽

pp. 33

Author(s):

Jong Woan Yun ◽

Hyun A Park ◽

Jong Hee Hwang

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Patent Ductus Arteriosus ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Low Birth Weight Infants ◽

Oral Ibuprofen ◽

Patent Ductus

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Dynamic Response Analyses of Rabbit Knee Joint

10.1115/imece1999-0447 ◽

1999 ◽

Author(s):

M. Kasra ◽

M. D. Grynpas ◽

A. Shirazi-Adl

Keyword(s):

Knee Joint ◽

Dynamic System ◽

Experimental Studies ◽

Knee Injuries ◽

Nonlinear Dynamic System ◽

Rabbit Knee ◽

Prediction And Prevention ◽

Joint Load ◽

Dynamic Loading Conditions ◽

Knee Disorders

Abstract The knee joint is a complex nonlinear dynamic system. It is generally known that mechanical factors play an important role in the etiology of knee injuries and diseases such as osteoarthritis. While performing daily activities such as walking, running, and climbing as well as during occupational operations, the joint is exposed to vibrations and multiple impacts. During these activities, according to an individual’s condition (e.g., age, fitness, weight), the joint load and stiffness may reach critical limits initiating or accelerating different knee disorders. This is the case in athletes or workers during occupational activities (1). Therefore, understanding the dynamic characteristics of the knee joint is essential in prediction and prevention of knee disorders as well as in subsequent joint replacement and rehabilitation procedures. There have been very few reported experimental studies investigating the dynamic behavior of the whole knee joint as a dynamic system (2). The objective of this study was to investigate the changes in mechanical properties of the rabbit knee joint under different compressive dynamic loading conditions. Rabbit has frequently been used as an osteoarthritic knee model (3). The data obtained in this study, hence, will also be beneficial in our future studies of osteoarthritic rabbit models.

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ORAL VERSUS INTRAVENOUS IBUPROFEN FOR THE EARLY CLOSURE OF PATENT DUCTUS ARTERIOSUS IN LOW BIRTH WEIGHT PRETERM INFANTS

European Medical Health and Pharmaceutical Journal ◽

10.12955/emhpj.v6i0.388 ◽

2013 ◽

Vol 6 ◽

Cited By ~ 4

Author(s):

Alketa Hoxha ◽

Ermira Kola ◽

Numila Kuneshka ◽

Eduard Tushe

Keyword(s):

Birth Weight ◽

Adverse Effects ◽

Preterm Infants ◽

Premature Infants ◽

Ductus Arteriosus ◽

Ductal Closure ◽

Oral Ibuprofen ◽

Intravenous Ibuprofen ◽

Ibuprofen Group ◽

Patent Ductus

Background Patent ductus arteriosus (PDA) is common in very premature infants. Pharmacological closure of PDA with indomethacin, a prostaglandin inhibitor, has remained the mainstay of treatment in premature infants over the last three decades. Intravenous ibuprofen was recently shown to be as effective and to have fewer adverse reaction in preterm infants. If equally effective, then oral ibuprofen for PDA closure would have several important advantages over the intravenous route.This study was designed to assess the efficacy and safety of oral ibuprofen and intravenous ibuprofen for the early pharmacological treatment of PDA in LBW preterm infants with respiratory distress syndrome.MethodsA randomized, single-blinded, controlled study was performed on premature neonates at the neonatal care unit of the University Hospital for Obstetrics and Gynecology”Koco Gliozheni”, Tirana, Albania, from January 2010 to December 2012. The study enrolled 68 preterm infants with gestational age between 28-32 weeks, birth weight ≤ 2000 g, postnatal age 48-96 h, and had echocardiographically confirmed significant PDA. The preterm infants received either intravenous or oral ibuprofen randomly as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. After the first dose of treatment in both groups, echocardiographic evaluation was performed, to determine the need for a second or third dose. The rate of ductal closure, adverse effects, complications, and the patient’s clinical course were recorded.Results All patients were born after 28 until 32 weeks’ gestation. 36 patients were treated with oral ibuprofen and 32 with intravenous ibuprofen in this period. After the first course of the treatment, the PDA closed in 30 (83.3%) of the patients assigned to the oral ibuprofen group versus 23 (71.8%) of those enrolled in the intravenous ibuprofen group (p = 0.355). There was no difference between treatment groups in demographics or baseline renal function. In the evaluation of renal tolerance, none of the patients had oliguria. There were no significant differences with respect to complications during the stay.Conclusions In low birth weight infants, the rate of early ductal closure with oral ibuprofen is at least as good as with the intravenous route. Oral ibuprofen is associated with fewer adverse effects

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Azadirachta indica (Neem) Leaf Extract Effect as an Option of Treatment of Ibuprofen-induced Nephrotoxicity

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1130533 ◽

2020 ◽

pp. 56-62

Author(s):

Ifeanacho Ezeteonu Abireh ◽

Onyinye Mary Ozioko ◽

Ignatius Ikemefuna Ozor ◽

Elizabeth Finbarrs- Bello ◽

Uche Sebastine Ozioko ◽

...

Keyword(s):

Serum Creatinine ◽

Azadirachta Indica ◽

Leaf Extract ◽

Kidney Injury ◽

Wistar Rat ◽

Male Wistar Rats ◽

Oral Ibuprofen ◽

Group 2 ◽

Neem Leaf Extract ◽

Group 1

Aim: This study investigated the curative effect of the aqueous leaf extract of Azadirachta indica on Ibuprofen-induced nephrotoxicity in Wistar rat Study Design: This is an experimental research Place 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 0.5 ml daily. Group 2-6 had induction of nephrotoxicity using oral Ibuprofen 400 mg/Kg daily for 5 days. Group 3-5 were subsequently treated with gavage Azadirachta indica leaf extract 200 mg/Kg, 400 mg/Kg and 800 mg/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 indica leaf 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.

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