Dose Of Indomethacin Research Articles

Total Phenol Content and Gastric Anti-Ulcer Activity of Hydroalcoholic Extract of Persea caerulea (Ruiz & Pav.) Mez. Bark

Objective: Determine the content of total phenols and evaluate the gastroprotective effect of the extract of Persea caerulea (Ruiz & Pav.) Mez. in mice with induced gastric ulcer. Material and Methods: The bark of Persea caerulea was macerated in 70% ethanol and the phenol content was determined using the Folin-Ciocalteu method. The female Mus musculus Balb/c specimens were distributed in the following groups: White Control Group, without indomethacin dosing; Negative Control Group, dosing with indomethacin; Positive Control Group treated with ranitidine at a dose of 50 mg/kg; Groups P. caerulea treated with extract at doses of 50 mg/kg, 100 mg/kg and 200 mg/kg. Gastric ulcer was induced with indomethacin orally at a dose of 50 mg/kg, the procedure was repeated 12 hours later; Gastroprotective treatment was administered 60 minutes after each dose of indomethacin, 6 hours after the last dose, sodium pentobarbital was euthanized and the stomach was resected to determine ulceration using the Marhuenda Scale. Results: Higher percentages of gastric ulcer inhibition were obtained in the P. caerulea 100 mg/kg (80%) and P. caerulea 200 mg/kg (85.71%) groups. Conclusions: Extract of Persea caerulea (Ruiz & Pav.) Mez., At doses of 100 and 200 mg/kg of body weight, has a gastric antiulcerative effect which is related to its content of total polyphenols.

Antiulcer activity of Lagerstroemia indica leaves in Indomethacin Induced Gastric Ulcer in Rats

Lagerstroemia indica, is a natural plant which have traditional use from the ancient medicine for the treatment of many diseases. The gastroprotective effect of methanolic extract of Lagerstroemia indica and the possible mechanisms used to investigated the ulcer activity through indomethacin-induced ulcer model. Method: male Wistar rats were divided into three groups: (normal control, n=6), (standard omeprazole group, n=6) and (extract group, n=6). Each of control, omeprazole and extract were administered orally to the rats daily for 21 days before the induction of ulcer with the help of indomethacin. On the 21 days indomethacin was administered with single oral dose (20mg/kg). Four hours later after the administration of indomethacin dose treatment, the rats were sacrificed and gastric tissue was taken for histopathological investigation for the calculation of pH, ulcer inhibition, ulcer index. The observation significantly increased (p < 0.01) value that reduced the ulcer by the treatment with Lagerstroemia indica. Result: The result indicates the antiulcer effect of the Lagerstroemia indica extracts showed significant effect during comparision with control and standard group. The data of study revealed that the extracts of Lagerstroemia indica proved to show control over the model of indomethacin-induced gastric ulceration which gives potent activity against ulceration.

A 25 mg rectal dose of diclofenac for prevention of post-ERCP pancreatitis in elderly patients

Objectives A 50–100 mg rectal dose of diclofenac or indomethacin is recommended for prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP); however, limited data are available regarding the appropriate dose to prevent PEP in elderly patients. We aimed to evaluate the efficacy and safety of 25 mg diclofenac in preventing PEP in elderly patients. Material and methods: Overall, 276 patients with naive papilla, aged over 75 years, were included in the present study between April 2013 and March 2020. We retrospectively evaluated the risk of PEP in patients over 75 years, administered with or without 25 mg diclofenac 30 min before ERCP using inverse probability of treatment weighting (IPTW) analysis. Results: Patients were categorized into the diclofenac group (83 patients) or non-diclofenac group (193 patients). The incidence rate of PEP in the diclofenac group was significantly lower than that in the non-diclofenac group (4% vs. 14%, p = .01). Multivariate analysis revealed that 25 mg diclofenac was an independent protective factor against PEP in elderly patients aged over 75 years (odds ratio [OR] = 0.17; 95% confidence interval [CI] = 0.04–0.67; p = 0.01). This protective effect of diclofenac against PEP remained robust after IPTW analysis (OR = 0.11; 95% CI = 0.03–0.40; p = .001). No adverse events related to diclofenac were observed. Conclusion: Diclofenac (25 mg) was considered effective and safe for preventing PEP in elderly patients. Our results may provide a new strategy for preventing PEP in elderly patients.

Gastroprotective effect of hydromethanolic extract of Ayapana triplinervis leaves on indomethacin-induced gastric ulcer in male Wistar rats.

This study investigated the gastroprotective effect of Ayapana triplinervis leaves against indomethacin-induced gastric ulcer in male albino rat. Gastric ulceration was developed by single oral dose of indomethacin (30mg/kg). Experimental rats were pretreated with omeprazole (positive control 20mg/kg), hydromethanolic extract of A. triplinervis (200mg/kg) for 28days just before the indomethacin treatment. Free acidity, total acidity, pepsin activity and gastric volume, gastric pH, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) in stomach and serum prostaglandin E2 levels were assessed in control, ulcerated group and A. triplinervis pretreated groups. Oxidative stress biomarkers, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum also evaluated. All the parameters were deviated from control in indomethacin-treated group but significantly protected in A. triplinervis-pretreated group. The active ingredient(s) present in the A. triplinervis have antioxidant and gastroprotective properties that prevent the indomethacin-induced gastric ulcer. PRACTICAL APPLICATIONS: A. triplinervis has been widely consumed from earlier time as traditional medicine for the treatment of gastric problem and gastric ulcer in India. This is the first report that hydromethanolic extract of A. triplinervis has potent therapeutic properties against gastric ulcer. This work will provide a clue to the pharmaceutical industry to develop an effective gastroprotective agent.

Nutraceutical intervention protects against bacterial and chemical-induced gastrotoxicity in a non-mammalian model, Galleria mellonella

Preparations of the fungus Cordyceps sinensis and bovine colostrum are considered nutraceuticals due to their anti-inflammatory, repair and gut alimentation properties in mammalian models. To reduce the reliance on rodents in routine experimentation, we gauged the capacity of nutraceuticals to alleviate gastric damage in an insect surrogate, Galleria mellonella. Larvae were reared on standard or supplemented diets – 10% (w/w) colostrum, 10% (w/w) C. sinensis, or 5% + 5% each – prior to receiving an oral dose of the NSAID indomethacin (30 mg/kg) or challenged with the bacterial pathogen Campylobacter jejuni (1-3 x106) via two inoculation routes. Insects reared on a cordyceps-supplemented diet proved most resistant to indomethacin-induced gut leakiness, and displayed stable health indices after C. jejuni challenge (~77% survival). Insects reared on a colostrum-supplemented diet also showed recalcitrance in the gut, but were more sensitive to C. jejuni when injected directly into the body cavity (50% survival). The nutraceutical blend yielded improved health outcomes when compared to the standard diet, but was not as effective as either nutraceutical alone. Our findings represent clear evidence that insects were more resistant to known chemical and microbial agitators when reared on nutraceutical-supplemented diets – toxicological endpoints that are shared with vertebrate studies.

ID: 3519020 A 25 MG RECTAL DOSE OF DICLOFENAC FOR THE PREVENTION OF POST-ERCP PANCREATITIS IN ELDERLY PATIENTS

Population aging has increased the demand for ERCP in elderly patients. Elderly patients experience a lower rate of post ERCP pancreatitis (PEP) than non-elderly patients, but once it occurs in elderly patients, PEP can become more severe and even life-threatening. Many clinical studies have confirmed the efficacy of 50-100 mg rectal dose of diclofenac or indomethacin to prevent PEP, these studies are mainly focused on non-elderly patients and resulted in difficulty in choosing suitable prevention for PEP in elderly patients. Furthermore, the recommended dose may be toxic for elderly patients, especially frail patients with a low body weight or decreased renal function, who are more prone to adverse reactions.

The Antenatal and Postnatal Consequences of Antenatal Exposure to Prolonged Low Dose Indomethacin.

Despite its many clinical applications, indomethacin is seldom used in pregnancy, principally because of concerns regarding the potential for constriction of the arterial duct. The aim of this study was to document adverse antenatal effects and postnatal outcomes after in utero exposure to low-dose indomethacin. We studied a retrospective cohort of pregnancies between 2005 and 2016 at the John Radcliffe Hospital, Oxford, UK, in which mothers at extremely high risk of preterm birth were treated as prophylaxis with indomethacin 25 mg, 12 hourly, before 29 weeks. Antenatal effects on the arterial duct and postnatal outcomes were analysed. Overall, 198 fetuses had in utero follow-up, and 13 (6.6%) had ductal constriction, all within 9 days of starting treatment. No ductal constriction was seen in pregnancies when therapy was started before 20 weeks, and all effects were reversed after cessation of therapy. An analysis of postnatal complications was possible in 181 neonates. There were eight (4.4%) neonatal deaths, all but one associated with extreme preterm birth. Seven (5%) patent ductus arteriosus cases occurred in the 140 neonates delivered after 28 weeks who were alive at discharge. Postnatal complications were not more common in neonates in whom antenatal ductal constriction had been demonstrated. In conclusion, fetuses exposed to prolonged low dose indomethacin have a low incidence of in utero complications; these complications can be diagnosed with ultrasound and are reversible. Adverse postnatal events are related to gestation at birth and do not appear more common.

Psychosis secondary to indomethacin. A case report

IntroductionIndomethacin, a non-steroidal anti-inflammatory treatment used in various inflammatory diseases, is one of the drugs that has been related to the appearance of psychotic symptoms as a side effect.ObjectivesPoint out the importance of knowing the possible psychiatric symptoms that some drugs can cause as a side effect.MethodsDescription of a clinical case and bibliography review.ResultsWe present the case of a 71-year-old woman, with no previous mental health history, who is referred by her primary care physician due to the presence of auditory hallucinations and self-referential ideas. As a somatic history, the patient presented Rheumatoid Arthritis under control by rheumatology and acoustic neuroma, under control by neurosurgery. Treatment with Risperidone was started, up to 2 mg, which helped control her symptoms. After an exhaustive study of her situation, the possibility that her symptoms were a side effect of her usual treatment was raised. It was evidenced that the patient had taken a higher dose of Indomethacin than prescribed by the rheumatologist, reason why its daily intake was suspended, and subsequently an improvement and even suppression of symptoms was seen. Later, due to a misunderstanding, the drug was reintroduced, and symptoms appeared again.ConclusionsThe appearance of psychotic symptoms has been related to the intake of various drugs, including Indomethacin. It is essential to carry out a differential diagnosis if psychotic symptoms appear in the subject.DisclosureNo significant relationships.

Effect of Ester Derivative of Indomethacin on Immune Inflammation.

The anti-inflammatory effect of the ester derivative of indomethacin (IML) in doses of 6.25, 12.5, and 25 mg/kg was studied in rats with modeled rheumatoid arthritis (adjuvant arthritis) and compared to the effects of the reference drug indomethacin in a dose of 1 mg/kg. IML in doses of 12.5 and 25 mg/kg reduced joint inflammation and promoted recovery of the microstructure of the synovial membrane and articular cartilage better than indomethacin. IML produced no ulcerogenic effect, while indomethacin concentration in the stomach wall after administration of IML was 1.8-3.4 times lower than after administration of the reference drug (p<0.05).

The enigma of cerebral blood flow and cognition.

The enigma of cerebral blood flow and cognition.

Indomethacin for symptomatic patent ductus arteriosus in preterm infants.

Symptomatic patent ductus arteriosus (PDA) is associated with mortality and morbidity in preterm infants. In these infants, prophylactic use of indomethacin, a non-selective cyclooxygenase inhibitor, has demonstrated short-term clinical benefits. The effect of indomethacin in preterm infants with a symptomatic PDA remains unexplored. To determine the effectiveness and safety of indomethacin (given by any route) compared to placebo or no treatment in reducing mortality and morbidity in preterm infants with a symptomatic PDA. We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 7), in the Cochrane Library; Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R); and Cumulative Index to Nursing and Allied Health Literature (CINAHL), on 31 July 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomized controlled trials (RCTs) and quasi-RCTs. We included RCTs and quasi-RCTs that compared indomethacin (any dose, any route) versus placebo or no treatment in preterm infants. We used the standard methods of Cochrane Neonatal, with separate evaluation of trial quality and data extraction by at least two review authors. We used the GRADE approach to assess the certainty of evidence for the following outcomes: failure of PDA closure within one week of administration of the first dose of indomethacin; bronchopulmonary dysplasia (BPD) at 28 days' postnatal age and at 36 weeks' postmenstrual age; proportion of infants requiring surgical ligation or transcatheter occlusion; all-cause neonatal mortality; necrotizing enterocolitis (NEC) (≥ Bell stage 2); and mucocutaneous or gastrointestinal bleeding. We included 14 RCTs (880 preterm infants). Four out of the 14 included studies were judged to have high risk of bias in one or more domains. Indomethacin administration was associated with a large reduction in failure of PDA closure within one week of administration of the first dose (risk ratio (RR) 0.30, 95% confidence interval (CI) 0.23 to 0.38; risk difference (RD) -0.52, 95% CI -0.58 to -0.45; 10 studies, 654 infants; high-certainty evidence). There may be little to no difference in the incidence of BPD (BPD defined as supplemental oxygen need at 28 days' postnatal age: RR 1.45, 95% CI 0.60 to 3.51; 1 study, 55 infants; low-certainty evidence; BPD defined as supplemental oxygen need at 36 weeks' postmenstrual age: RR 0.80, 95% CI 0.41 to 1.55; 1 study, 92 infants; low-certainty evidence) and probably little to no difference in mortality (RR 0.78, 95% CI 0.46 to 1.33; 8 studies, 314 infants; moderate-certainty evidence) with use of indomethacin for symptomatic PDA. No differences were demonstrated in the need for surgical PDA ligation (RR 0.66, 95% CI 0.33 to 1.29; 7 studies, 275 infants; moderate-certainty evidence), in NEC (RR 1.27, 95% CI 0.36 to 4.55; 2 studies, 147 infants; low-certainty evidence), or in mucocutaneous or gastrointestinal bleeding (RR 0.33, 95% CI 0.01 to 7.58; 2 studies, 119 infants; low-certainty evidence) with use of indomethacin compared to placebo or no treatment. Certainty of evidence for BPD, surgical PDA ligation, NEC, and mucocutaneous or gastrointestinal bleeding was downgraded for very serious or serious imprecision. High-certainty evidence shows that indomethacin is effective in closing a symptomatic PDA compared to placebo or no treatment in preterm infants. Evidence is insufficient regarding effects of indomethacin on other clinically relevant outcomes and medication-related adverse effects.

The Role of Sacroiliac Joint Steroid Injections in the Treatment of Axial Spondyloarthritis.

Objectives This study aims to investigate the effects of fluoroscopy-guided sacroiliac joint steroid injection in patients with acute bilateral sacroiliitis diagnosed with axial spondyloarthritis (axSpA) and how those injections affect the current need for nonsteroidal anti-inflammatory drug (NSAID) usage.Patients and methods We retrospectively evaluated 43 patients (28 males, 15 females; mean age, 31.7±6.3 years; range, 18 to 44 years) fulfilling the Assessment of SpondyloArthritis international Society 2009 criteria for axSpA between June 2015 and May 2016. One group included 22 patients (injection group) treated with sacroiliac joint steroid injection (triamcinolone acetonide) and the other group included 21 patients (non-injection group) not receiving the injection. All 43 patients in both groups were treated with indomethacin peroral. Pre-treatment, first week and first, third and sixth month follow-up examinations were evaluated.Results A ≥50% reduction in the numeric rating scale score compared with the baseline was considered as significant pain relief. The mean pain relief rates in patients receiving injections were higher at all inspections. This difference was statistically significant at first week (p<0.05). When groups were compared, no difference was found in the Bath Ankylosing Spondylitis Disease Activity Index scores (p>0.05). There was no statistically significant difference between the two groups when indomethacin dose was evaluated cumulatively for six months (p>0.05).ConclusionFluoroscopy-guided sacroiliac joint steroid injections can be recommended in patients with active sacroiliitis, particularly in those with severe axial pain, for rapid analgesia in the initial term. It was concluded that steroid injections applied to the sacroiliac joint did not affect disease activity. It is noteworthy that there is a trend to reduce the use of NSAIDs in patients receiving these injections, although it does not make a statistically significant difference in the long term.

Healing potentials of aqueous extract of irish potato tubers on indomethacin-induced peptic ulcer in albino rats

The healing potential of aqueous extract of Irish potato tubers (IPT) on indomethacin-induced peptic ulcer was investigated. Freshly harvested and dried IPT were milled into fine powder and extracted using water. Forty albino rats weighing 165.00 ± 21.21g were fasted overnight and ulcer induced with a single oral dose of indomethacin (30 mg/kg body weight). After confirmation of ulceration, 35 animals were randomly divided into 5 groups. Groups 1, 2 and 3 ulcer-induced animals were treated with 400 and 800 mg/kg of IPT extracts and omeprazole (20 mg/kg) respectively. Groups 4 and 5 animals served as the indomethacin ulcer-induced but untreated, and normal control animals respectively. All drug treatments were done once daily via oral route for 21 days. Thereafter animals were anaesthetized, their stomach excised and ulcer index and gastric acid output determined using standard methods. The stomach tissues of 5 animals per group were homogenized and assayed for superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and pepsin activities as well as malondialdehyde (MDA) and reduced glutathione (GSH) concentrations. The remaining 2 stomach tissues per group were processed for histological analysis. The results showed that treatment with 400 and 800 mg/kg IPT extracts significantly (p

Association between changes in urine output and successful indomethacin treatment for patent ductus arteriosus in preterm neonates.

To investigate the relationship between changes in urine output during indomethacin treatment and ductal closure in preterm neonates. It is a retrospective study in neonates ≤32 weeks who had received two courses of indomethacin for PDA treatment over a 5-year period. Indomethacin courses with pre- and post-echocardiography confirmation of PDA status were included. Various urine output indices were collected and compared between successful versus unsuccessful indomethacin courses. Indomethacin treatment success was defined as: (i) where PDA closed or became haemodynamically insignificant (hisPDA) after treatment and (ii) only including neonates where PDA had complete closure after treatment. ROC analysis was performed to examine predictive ability of urine output during indomethacin for treatment success. One hundred and eight indomethacin courses (first course: 52, second course: 56) in 80 neonates were included. The mean gestational age and birthweight were 25.4 ± 1.3 weeks and 762 ± 165 g, respectively. Irrespective of the definition used, there was no significant differences seen in any of urine output parameters between groups, except for a higher urine output during indomethacin associated with complete PDA closure (3.6 ± 1.3 vs. 3.0 ± 1.0 mL/kg/h, P = 0.02). The incidence of significant oliguria, hyponatraemia and need to withhold/delay indomethacin doses were also similar across groups. Urine output was not a useful predictor of ductal response to indomethacin treatment in preterm neonates.

التأثیر الوقائی للموز والزبادی على تقرحات المعدة فی الفئران The protective effect of banana and yoghurt on gastric ulceration in rats

This study was carried out to evaluate the nutrition value for green banana and yoghurt and there can be effective in reducing the indomethacin-incidence of gastric ulcer and its complications..The biological experimental on gastric ulcers were induced in rats using one oral dose of indomethacin 50mg/kg body weight (5 ml/kg) after feeding different rats groups for fourteen days on basal diet as healthy control negative. Different groups were taken indomethacin was fed on basal diet as control positive and the third groups fed on basal diet and it's substituted separately with 25% yoghurt, 25% green banana and equal weight 12.0% for each from yoghurt and green banana.. The results showed that increasing the gastric MDA level in the control positive by 402.17µM/g/ protein. The normal group was 133.81 µM/g/ protein. The different rat groups fed on yoghurt, green banana and its blends and taken orally Indomethacin the MDA was decreased gradually by 305.57, 283.45 and168.256 µM/g/ protein, , yoghurt, green banana and their blend pre-treatment significantly increased the gastric levels of enzymatic and non- enzymatic antioxidants namely SOD, and GSH with a concomitant reduction in MDA level compared with those in the positive control group. The superoxide dismutase SOD in the groups receiving yoghurt, banana and their blends showed a significant increase gradually by 15.810, 18.803 and 21.793u/mg/ protein. The positive group control was found to be significantly lower (12.606 u/mg/ protein) than the negative control group was26.77 u/mg/ protein. The superoxide dismutase SOD was significantly increased.

The Protective Roles of Butein on Indomethacin Induced Gastric Ulcer in Mice.

Butein is a potential agent first isolated from Rhus verniciflua that has medicinal value in East Asia and has been used in the treatment of gastritis, gastric cancer, and atherosclerosis since ancient times. The aim of our study is to show, for the first time, the anti-ulcerative effect of butein in indomethacin induced gastric ulcer in mice. A total of 42 mice were fasted 24 hours for the ulcer experiment, and 10, 20, and 40 mg/kg doses of butein were evaluated for their antiulcer activity. Famotidine 40 mg/kg was used as a positive control group. For ulcer induction, 25 mg/kg dose of indomethacin was administered to the mice and after 6 hours all stomachs were dissected out. After macroscopic analyses, tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), COX-1, and COX-2 mRNA levels of stomachs were evaluated by Real Time PCR, and Superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) were determined by ELISA. Butein administration exerted 50.8%, 65.9%, and 87.1% antiulcer effects at 10, 20, and 40 mg/kg, respectively. Butein administration decreased oxidative stress and inflammatory parameters in stomach tissues dose dependently. Furthermore, butein administration increased stomach PGE2 levels and decreased COX-1 and COX-2 mRNA levels. Butein has been shown to have a healing effect on ulcers in macroscopic examinations in our study. We observed that butein has antioxidant and anti-cytokine properties in gastric tissue. Butein could be an important alternative in the treatment of indomethacin-induced ulcers. Whether butein is a partial agonist of the COX enzyme should be investigated in future studies.

Neuroprotective effect of indomethacin in normal perfusion pressure breakthrough phenomenon

Loss of cerebral autoregulation in normal perfusion pressure breakthrough (NPPB) phenomenon has been reported in other Central Nervous System diseases such as neonatal intraventricular haemorrhage. Several studies have demonstrated that low-dose indomethacin prevents this latter condition. A previous rat model was used to resemble NPPB phenomenon. Study animals were distributed in 4 groups that received 3 doses of indomethacin at different concentrations prior to fistula occlusion 60 days after its creation. Control animals received saline solution. Intracranial pressure (ICP) increased in all groups following fistula creation, whereas mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) decreased as a manifestation of cerebral hypoperfusion and intracranial hypertension. The administration of indomethacin was associated with raised MAP and CPP, as well as decreased ICP. Sodium fluorescein extravasation was slight in study animals when comparing with control ones. Histological analysis evidenced diffuse ischaemic changes with signs of neuronal apoptosis in all brain layers in control animals. These findings were only focal and slight in study animals. The results suggest the usefulness of indomethacin to revert, at least partially, the haemodynamic effects of NPPB phenomenon in this experimental model, as well as to reduce BBB disruption and histological ischemia observed in absence of indomethacin.

Evaluation of the Risk Factors for Acute Kidney Injury in Neonates Exposed to Antenatal Indomethacin.

Evidence is limited about important maternal and neonatal risk factors that affect neonatal renal function. The incidence of acute kidney injury (AKI) and identification of associated risk factors in neonates exposed to antenatal indomethacin was studied. A retrospective cohort of neonates exposed to antenatal indomethacin within 1 week of delivery was analyzed for development of AKI up to 15 days of life. Adjusted hazard ratios (HRs) and 95% CIs for AKI risk were calculated in time-dependent Cox proportional hazards models. Among 143 neonates with mean gestational age of 28.3 ± 2.4 weeks, AKI occurred in 62 (43.3%), lasting a median duration of 144 hours (IQR, 72-216 hours). Neonates with AKI had greater exposure to postnatal NSAIDs (48.4% vs 9.9%, p < 0.001) and inotropes (37.1% vs 3.7%, p < 0.001) compared with neonates without AKI. In multivariable-adjusted models, increased AKI risk was observed with antenatal indomethacin doses received within 24 to 48 hours (HR, 1.6; 95% CI, 1.28-1.94; p = 0.036) and <24 hours (HR, 2.33; 95% CI, 1.17-4.64; p = 0.016) prior to delivery. Further, postnatal NSAIDs (HR, 2.8; 95% CI, 1.03-7.61; p = 0.044), patent ductus arteriosus (HR, 4.04; 95% CI, 1.27-12.89; p = 0.018), and bloodstream infection (HR, 3.01; 95% CI, 1.37-6.60; p = 0.006) were associated significantly with increased risk of AKI following antenatal indomethacin. Neonates with AKI experienced more bloodstream infection, severe intraventricular hemorrhage, patent ductus arteriosus, respiratory distress syndrome, and longer hospitalization. Extended risk of AKI with antenatal indomethacin deserves clinical attention among this population at an already increased AKI risk.

EFFECT OF Salvia officinalis and Thyme Vulgaris OIL ON HEMATOLOGICAL PARAMETERS OF INDUCED GASTRIC ULCER IN MATURE FEMALE RATS

The present study has been carried out at the department of physiology, Collegeof Veterinary Medicine of Basrah, to evaluate the role of oil extracted from salviaofficinalis and Thymus vulgaris leaves in some structural and functionalcharacteristics of mature female rats experimentally induced with gastriculcer.Oils of thyme and sage were extracted from dry leaves available in Basrahmarket by normal hexane, oils components have been analyzed in a manner GCMAS (Gas chromatography). Gastric ulcers were induced in starved female rats bygiving indomethacin orally by mouth gavage in a dose 25mgkg for one day. Theanimals have been divided into seven equal groups(8 females in each group). Thefirst group was received normal saline and served as a negative control. Secondgroup serve as positive group that received only single dose of indomethacin,whereas third group treated with thyme crude oil for two week ,fourth group thattreated with thyme dilution oil for two weeks,fifth group treated with sage crudeoil for two week, sixth group treated with sage dilution oil for two weeks andseventh group treated with cimetidine for two weeks. The blood has been obtainedfor hematological assessment the present results: showed no changed in RBCs ,PCV of female rats groups treated with thyme crude,thyme dilution, sage crudeoil and cimetidine and just group treated with sage dilution caused a significant decrease in RBCs and PCV among treated group. So, the results revealed thatthere is no- changed in WBC in groups treated with thyme crude, thyme dilutionand sage dilution ,whereas showed a decreased in gastric ulcer group, sage crudeand cimetidine group. Also neutrophils existed increase significantly in all treatedgroups compared with control negative group ,whereas no change recorded inthyme dilution and sage crude groups compared with control negative group

Maternal low body mass index is a risk factor for fetal ductal constriction following indomethacin use among women undergoing fetal repair of spina bifida.

The objectives were to determine the prevalence of and to identify risk factors associated with constriction of the fetal ductus arteriosus (DA) following perioperative indomethacin use for fetal myelomeningocele (MMC) repair. Study design A retrospective chart review study included 100 consecutive fetuses who underwent fetal MMC repair between 2011 and 2018. All patients had fetal echocardiography (FE) on postoperative day (POD)#1 and 2 to detect constriction of the DA. All patients received indomethacin for tocolysis using a standardized protocol. Multivariate regression analysis was carried out to identify the predictors for fetal ductal constriction. Eighty patients met our study eligibility criteria. Median gestational age at time of surgery was 25 (24-25) weeks. Constriction of the DA was detected in 14 fetuses (17.5%). In five fetuses, this was observed on POD# 1, in seven on POD# 2, and in two on both days. The only independent risk factor for predicting DA constriction was maternal body mass index (BMI) <25 kg/m2 (P = .002). Indomethacin therapy following fetal MMC surgery requires careful daily FE surveillance. The association of DA constriction and low BMI suggests that BMI-based dosing of indomethacin may be recommended for perioperative tocolysis in fetal MMC surgery.