The Possible Antidiabetic Effect of Ficus carica L. Tablet on lloxan-Induced Diabetes Model in Rats

BACKGROUND: Fig leaves are reported to have an effect on reducing blood glucose levels. However, the use of fresh leaves makes the effects obtained is not measurable and efficient. AIM: The purpose of this research was to determine the antidiabetic potential of ethanol extract of fig leaves and to optimize tablet dosage formulations. METHODS: Four tablet formulas were made using the wet granulation method. Formula I (FI), Formula I (FII), and Formula III (FIII) groups to give a tablet of ethanol extract of fig leaves with a dose of 40 mg, 60 mg, and 80 mg and placebo treatment group. There were eight groups of male rats strain Wistar treated as follows: Normal control, negative control, positive control (metformin tablets), basis group, placebo treatment group, F1, F2, and F3 groups. The antidiabetic activity was evaluated from a decrease in rat blood glucose levels. Previously, rats were induced first using alloxan 150 mg/kg intraperitoneally to damage β-pancreatic cells so that the rats could experience increased blood glucose levels. After giving treatment to each group for 14 days, a rat blood sample was then taken on days 9 and 14, which were then analyzed by the GOD PAP method with readings carried out using a spectrophotometer with a wavelength of 500 nm. RESULTS: The average weight (mg) of FI tablets (617.8 ± 3.21%), FII (629.35 ± 8.16%), and FIII (643.6 ± 6.21%), and placebo tablet (666.45 ± 4.36%). As for the uniformity of size, all formulas have a diameter of 0.9 ± 0.0 (cm). For the hardness values of FI (5.7 kg), FII (1.31 kg), and FIII (3.09 kg), placebo tablet (2.98%). The value of friability FI (1.42%), FII (11.8%), and FIII (0.84%), placebo tablet (1.16%). While the disintegration time of FI (11.02 min), FII (10.10 min), and FIII (17.00 min), placebo tablet (12.23%). As for the uniformity of size, all formulas have a diameter of 0.9 ± 0.0 (cm). Whereas the dissolution rate (DE45) of each formulation decreased with increasing dose of extract, FI (73.73%), FII (74.80%), and FIII (69.80%). The treatment group of the ethanol extract of fig leaves at a dose of 40 mg, ethanol extract of fig leaves at a dose of 60 mg, and ethanol extract of fig leaves at a dose of 80 mg could reduce rats’ blood glucose levels with statistically significant results (p < 0.05) compared to negative group. When it was compared to the positive group, it had significant results with a statistical value (p < 0.05). CONCLUSION: Ethanol extract of fig leaf tablets had a significant effect on lowering rats’ blood glucose levels.

The Effect of Broccoli Sprout Extract on Seasonal Grass Pollen-Induced Allergic Rhinitis

Patients exposed to pollutants are more likely to suffer from allergic rhinitis and may benefit from antioxidant treatment. Our study determined if patients diagnosed with grass-induced allergic rhinitis could benefit from broccoli sprout extract (BSE) supplementation. In total, 47 patients were confirmed with grass-induced allergic rhinitis and randomized to one of four groups: group 1 (nasal steroid spray + BSE), group 2 (nasal steroid spray + placebo tablet), group 3 (saline nasal spray + BSE) and group 4 (saline nasal spray + placebo tablet). Peak Nasal Inspiratory Flow (PNIF), Total Nasal Symptoms Scores (TNSS) and nasal mucus cytokine levels were analyzed in samples collected before and after the 3-week intervention. Comparing before and after the intervention, PNIF improved significantly when comparing Groups 1 and 2, vs. placebo, at various time points (p ≤ 0.05 at 5, 15, 60 and 240 min) following nasal challenge, while TNSS was only statistically significant at 5 (p = 0.03), 15 (p = 0.057) and 30 (p = 0.05) minutes. There were no statistically significant differences in various cytokine markers before and after the intervention. Combining nasal corticosteroid with BSE led to the most significant improvement in objective measures.

“A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF IN POSTOPERAT ETORICOXIB IN PAIN RELIEF IN PATIENTS IN UNDERGOING LUMBAR SPINE SURGERY ”

AIMS AND OBJECTIVES: To evaluate the efcacy of Etoricoxib in different doses in postoperative pain relief in patients undergoing lumbar spine surgery. MATERIALAND METHOD : 80 patients of ASA grade І & ІІ of either sex scheduled for lumbar spine surgery under general anaesthesia were divided into 2 groups (n=40 each) randomly.Group E (n=40) Patients who received a 90 mg Etoricoxib 1 hour before surgery and another tablet the following morning. Group 'P'(n=40) Patients who received a placebo tablet 1 hour before surgery and again the following morning. Pulse rate, blood pressure, respiratory rate and severity of pain on NRS scale was noted at 0 hr, 4 hr, 8 hr, 12 hr, 16 hr, 20 hr, 24 hr, 28 hr, 32 hr and 48 hr after surgery. And the presence or absence of adverse effects, such as headache, nausea, vomiting, dizziness, and drowsiness were noted. RESULT:Analysis revealed that time for rst analgesic requirement was signicantly longer with oral Etoricoxib 90 mg than with placebo. Pre-emptive oral Etoricoxib 90 mg decreases the severity of pain postoperatively but not signicantly as compared to placebo in patients posted for lumbar spine surgery under general anaesthesia. Oral Etoricoxib 90 mg had no signicant effect on cardiovascular and respiratory parameters. Patients receiving Etoricoxib had higher incidence of nausea, vomiting. CONCLUSION: that time for rst analgesic requirement was signicantly longer with oral Etoricoxib than placebo.

COMPARISION OF ORAL PREGABALIN VERSUS BOLUS DOSE OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING THE HEMODYNAMIC RESPONSES DURING LARYNGOSCOPY, INTUBATION AND PNEUMOPERITONIZATION IN LAPROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED STUDY

Background: Laryngoscopy, intubation and pneumoperitoneum during general anaesthesia are severe noxiousstimuli that can produce many adverse effects. Aim of the study was to compare the efcacy of oral pregabalin versus intravenous bolus dose of dexmedetomidine as premedication for attenuating the haemodynamic pressor response during intubation, pneumoperitonization and extubation as well as perioperative stability and requirement of postoperative analgesics. Methods: A Randomised study was conducted in 100 patients undergoing Laparoscopic Cholecystectomy. Participants were divided into two groups in which group P (n=50) received oral pregabalin 150mg with sips of water 1 hour prior to surgery and intravenous normal saline (0.9%) 10ml, 10 mins prior to induction over 10 minutes and those in group D (n=50) received oral placebo tablet with sips of water 1 hour prior to surgery and intravenous dexmedetomidine at 1mcg/kg diluted with normal saline (total volume 10ml), 10 minutes prior to induction over 10 minutes. Hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), oxygen saturation (SPO2) and ETCO2 were noted before premedication and induction (baseline), at the end of induction and at laryngoscopy and intubation (I0) and then at 1,3,5,10 minutes after intubation as well as atstart of pneumoperitoneum and then after every 10 minutesinterval till the deation of CO2 and also at the time of extubation and 10 minutes thereafte

The effect of propolis supplementation on clinical symptoms in patients with coronavirus (COVID-19): A structured summary of a study protocol for a randomised controlled trial

Objectives This study aims to assess the effect of propolis supplementation on clinical symptoms in patients with coronavirus (COVID-19). Trial design This is a Double-Blind, Placebo-Controlled, Parallel Arm, Randomized Phase ΙΙ Clinical Trial. Participants Patients with the confirmed COVID-19 based on the PCR test are eligible to participate in the trial if they are 18 to 75 years of age and have no history of the current use of warfarin or propolis supplement and presence of sensitivity to bee products. Patients will be recruited from the Al-Zahra hospital in Isfahan city, Isfahan, Iran. Intervention and comparator Participants (N=40) in the intervention group will receive an identical propolis tablet (containing 300 mg Iranian green propolis extract) three times a day for a period of 2 weeks. Participants (N=40) in the control group will receive an identical placebo tablet (containing 300 mg microcrystalline cellulose) three times a day for 2 weeks. All tablets are prepared by the Reyhan Naghsh Jahan Pharmaceutical Co., Isfahan, Iran. Main outcomes The main outcomes are changes in the coronavirus disease’s clinical symptoms including duration and severity from baseline to the end of 2 weeks. Randomization Eligible patients will be randomly allocated in a 1:1 ratio to the intervention or control group. Randomization will be performed on the basis of permuted block sizes of 4 and will be stratified according to sex categories. Randomization sequences will be prepared by the trial’s pharmacist with the use of random-number tables. Blinding (masking) The trial-group assignment will be concealed from all participants, clinicians, and investigators throughout the trial. To ensure blinding, randomization sequences will be kept in identical, opaque, sealed, sequentially numbered envelopes. Only the trial's pharmacist has access to the randomization list. Also, the placebo tablet will be similar to the propolis tablet in terms of texture, taste, color, odor, and weight. Both tablets will be provided in containers that are completely identical in weight, shape, labelling, and packaging. Numbers to be randomized (sample size) The calculated total sample size is 80 patients, with 40 patients in each group. Trial status The protocol is Version 1.0, October 10, 2020. Recruitment began August 22, 2020, and is anticipated to be completed by March 21, 2021. Trial registration The name of the trial register: The effect of propolis supplementation on clinical symptoms in patients with coronavirus (COVID-19): A randomized, double-blind, placebo-controlled clinical trial. IRCT registration number: IRCT20200802048267N1. Date of trial registration: 20 October 2020, retrospectively registered. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting the dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Comparison of the effects of preoperative melatonin or vitamin C administration on postoperative analgesia

The analgesic benefit of melatonin and vitamin C as primary or adjuvant agents has been reported in various studies; however, their analgesic effects in the treatment of postoperative pain remain unclear. Thus, we aimed to evaluate the effect of single preoperative dose of oral melatonin or vitamin C administration on postoperative analgesia. In this study, we recruited 165 adult patients undergoing elective major abdominal surgery under general anesthesia. Patients were randomly divided into three equal (n = 55) groups. One hour before surgery, patients received orally melatonin (6 mg) in group M, vitamin C (2 g) in group C, or a placebo tablet in group P. Pain, sedation, patient satisfaction, total morphine consumption from a patient-controlled analgesia device, supplemental analgesic requirement, and the incidence of nausea and vomiting were recorded throughout 24 h after surgery. The mean pain score and total morphine consumption were found significantly lower in both M and C groups compared with group P (p < 0.001). There were no significant differences between group M and C with respect to pain scores (p = 0.117) and total morphine consumption (p = 0.090). Patients requested less supplemental analgesic and experienced less nausea and vomiting in groups M and C compared with group P. In conclusion, preoperative oral administration of 6 mg melatonin or 2 g vitamin C led to a reduction in pain scores, total morphine consumption, supplemental analgesic requirement, and the incidence of nausea and vomiting compared with placebo.

Changes in Serum TSH and T4 Levels after Switching the Levothyroxine Administration Time from before Breakfast to before Dinner

Background. Levothyroxine is commonly used in the treatment of patients with hypothyroidism. Levothyroxine is most often administered in the morning, on an empty stomach, in order to increase its oral absorption. However, many patients have difficulties taking levothyroxine in the morning.Aim. The aim of this study was evaluating the effect of changing levothyroxine administration time from before breakfast to before dinner on the serum levels of TSH and T4.Subjects and Methods. Fifty patients between 18 and 75 years old with hypothyroidism were included in the study and were randomly divided into two groups. Each group received two tablets per day (one levothyroxine tablet and one placebo tablet) 30 minutes before breakfast and 1 hour before dinner. After two months, the administration time for the tablets was changed for each group, and the new schedule was continued for a further two-month period. The serum TSH and T4 levels were measured before and after treatment in each group.Results. Changing the levothyroxine administration time resulted in 1.47 ± 0.51 µIU/mL increase in TSH level (p=0.001) and 0.35 ± 1.05 µg/dL decrease in T4 level (p=0.3).Conclusions. Changing the levothyroxine administration time from before breakfast to before dinner reduced the therapeutic efficacy of levothyroxine.

Tablet Disintegrant Derived from Crosslinked Methacrylic Acid and Divinylbenzene Copolymers

Methacrylic acid copolymers crosslinked with 0.25-16 % divinylbenzene were synthesized by free radical polymerization using benzoyl peroxide as an initiator. The products were washed, dried and passed through a 80-mesh sieve prior to determining their infrared spectra, swelling capacity in water and disintegrant efficacy for microcrystalline cellulose (MCC) placebo tablet. The crosslinked methacrylic acid and divinylbenzene copolymers were successfully prepared as indicated by IR spectra, yielding around 50-80 %. The sieved particles of copolymers were white to faint yellow. In contact with water, they hydrated and swelled, where their swelling capacity was lowered with increasing the level of crosslink (divinylbenzene) in the copolymer structure. The copolymer with 0.25 % crosslink caused the MCC tablet to disintegrate fastest (1.2 min), corresponding to its highest swelling capacity. The disintegration efficacy increased with an increase in copolymer concentrations, but decreased with an increase in compression forces.

Lubiprostone Decreases the Small Bowel Transit Time by Capsule Endoscopy: An Exploratory, Randomised, Double-Blind, Placebo-Controlled 3-Way Crossover Study

The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117–407) minutes in the P-P regimen, 122.5 (27–282) minutes in the L-P regimen, and 110.5 (11–331) minutes in the P-L regimen (P=0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE.