Form Of Rectal Suppositories Research Articles

Assessment of Efficiency and Safety of Phytocomposition with Prostate-Protective Properties in the form of Rectal Suppositories

Assessment of Efficiency and Safety of Phytocomposition with Prostate-Protective Properties in the form of Rectal Suppositories

Удосконалення комплексного підходу до лікування функціональних закрепів у дітей

Functional constipation in children has become a serious medical issue that needs to be addressed immediately. They can significantly limit children’s physical activity and social integration, which emphasizes the importance of providing them with effective care. Purpose - to analyze and improve the results of the complex use of a lactulose-based drug and prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract in the treatment of functional constipation in children. Materials and methods. We examined 78 children with constipation over the past 3 years. They were divided into two groups. The first group included 36 (46.2%) patients, the second - 42 (53.8%). Patients of the first group received standard treatment according to the protocols of the Ministry of Health of Ukraine, patients of the second group received similar treatment and additionally lactulose in the form of syrup and a preparation based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract during the course of treatment daily in the form of rectal suppositories. Results. Most patients were female (60.2%), had average physical development parameters. The duration of constipation ranged from 1 to 3 months, and stool retention - from 3 to 5 days. At the beginning of the observation, there were complaints of changes in the shape and consistency of stools, painful defecation, flatulence, periodic abdominal pain, strong straining during defecation, fear or anxiety in children before the act of defecation. An analysis of anamnestic data showed that in one third of patients, constipation was observed during the transition from breastfeeding to artificial feeding. Conclusions. The analysis of the addition to the complex of treatment of functional constipation, in addition to lactulose, of preparations based on prophylactic phytocylinders with a lipophilic complex of rose hips and chamomile extract is a safe and quite effective method of correcting these disorders in young children, as evidenced by the results obtained. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Rectal diclofenac; an effective modality for pain relief after vaginal birth

<p><strong>Background and Objective:</strong> Vaginal delivery (VD) is the safest delivery option for the mother and is associated with quick recovery and minimal maternal morbidity and mortality. However, one of the commonest fears among women about VD is pain. This study aims to assess the effectiveness of diclofenac suppositories (per rectum) compared to the intramuscular diclofenac for the pain relief in females after VD.<br /><strong>Methods: </strong>This prospective comparative was study conducted at the Emergency Section (labor room) of Obstetrics & Gynecology Department in one of the tertiary care teaching hospitals of Lahore, Pakistan. A total of 182 female patients undergoing VD were selected and further divided into group A and group B. Group A was administered rectal analgesia in the form of rectal suppositories (100 mg) immediately after perineal tear (first and second degree only) repair and repeated after 6 hours. While group B received one injection of intramuscular diclofenac, immediately after perineal tear repair. The pain score was measured on a graphical score using Graphic Rating Scale, immediately at rest, during movement, and during urination. The pain score was reassessed after 6 hours with the same parameters and compared between both groups.<br /><strong>Results:</strong> The overall pain score was significantly lower immediately (p = 0.004) and 6 hours (p = 0.002) after VD in group A at rest, during movement, and during urination as compared to group B.<br /><strong>Conclusion:</strong> The use of rectal diclofenac suppositories is a simpler and more effective and acceptable method of reducing the pain experienced by the women following perineal trauma after vaginal childbirth.</p>

<i>In vitro</i> antiviral activity of VIFERON® rectal suppositories against SARS-CoV-2

In 2020–2021, the world was engulfed by the pandemic of a new coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus. The low population coverage with vaccination against COVID-19 and the lack of herd immunity result in the need to find an effective and safe etiotropic treatment. Medicinal agents for treatment of COVID-19, approved while preparing this publication, have several limitations related to the conditions of their use and/or population category. In this situation, interferon-containing drugs widely used in Russia and the CIS for prevention and treatment of viral infectious diseases, i.e. ARVI and influenza, may hold promise. This study aims to confirm in vitro antiviral activity against SARS-CoV-2 for the preparation VIFERON® containing recombinant human interferon alpha-2b (IFNα-2b). Materials and methods. Vero CCL-81 cells were infected with hCoV-19/StPetersburg-RII3524VR4/2020 strain of SARS-CoV-2 at doses of 10 TCID50 or 100 TCID50 per well. The suppressive effect of IFN-2b, extracted from VIFERON® in dosage form of rectal suppositories, was evaluated by qRT-PCR at 24 h and 48 h after the infection of cells in two schemes, simulating preventive (24 h before infection) and therapeutic (2 h after infection) use of drugs. Results. IFNα-2b at concentrations of 800, 400, 200, 100 and 50 IU/ml, extracted from rectal suppositories of VIFERON®, showed high biological activity, displayed as inhibition of SARS-CoV-2 strain replication in both infectious doses evaluated either at 24 h or at 48 h after cell infection. The “preventive” vs. “therapeutic” scheme was found to be more effective. In the “preventive” scheme the virus titre decreased by more than 3 lg TCID50 at 24 hours post-infection and by 5–6 lg TCID50 at 48 hours post-infection after administration of 800 IU/ml IFNα-2b. Conclusion. The study results evidence that VIFERON® in dosage form of rectal suppositories may be promising for prevention and treatment of new coronavirus infection in clinical practice.

PROSTATOPROTECTIVE EFFECT OF MACLURA POMIFERA OIL EXTRACT AND THE WAY IT IS IMPLEMENTED

Relevance. In the experiment, it was shown that in rats with a sulpiride induced prostate hyperplasia (SGP) which was treated by the Maclura Pomifera oil extract (OEM), a prostatic index is normalized, biochemical indicators and morphofunctional state of the prostate are improved. However, the mechanism of implementing corrective influence remains unknown. Objective: to exam the contribution of hormonally mediated signaling pathways of the mechanism of pharmacological effect of oil extract in the form of rectal suppositories at the experimental hyperplasia of the prostate in rats. Materials and methods. On 60 rats of both sexes, acute toxicity of the active substance was studied with intragastric administration of OEM (dose on the active substance 5000 mg/kg, n = 12) or suppositories mass with OEM (dose for the active substance of 1500 mg/kg, n = 12). Under rectal administration, toxicity was investigated with the introduction of OEM (dose of the active substance 1000 mg/kg, n = 12) or suppositories mass with OEM (dose for the active substance 300 mg/kg, n = 12). A group of intact control amounted to 12 rats. The SGP model was created in rats (age 9-11 months, body mass 330-360 g, n = 18) by sulpiride (40 mg / kg, i.p., 30 days). The rats of the control group (n = 6) were obtained with 0.5 ml of 0.9% NaCl, i.m. From 31 to 51 days of the experiment, rats in the therapeutic mode were treated with OEM suppositories (380 mg/kg, n = 12) or a reference drag Prostaplant Forte (35 mg/kg, n = 6) once a day. The testosterone (Tc) and E2 content, level 5α-dihydrotestosterone (5α-DHT) were determined by the immunoferment method in serum. In the prostate homogenate, the content of 5α-reductase (5αR) was studied, as well as the concentration of androgenic (AR) and estrogenic (Erα) receptors. Results. Toxic influence on the internal organs and deaths of animals after the introduction of the maximum possible amounts of OEM was not observed. The use of suppositories with OEM in rats with SGP normalized the content of sex hormones. Significant inhibition of 5αR activity and a decrease in the content of AR, as well as an increase in the content of ERα, were detected. The group with the introduction of the Prostaplant forte was observed similar improvements. It was assumed that the implementation of the antiproliferative effect of the MEM is carried out due to the coexpression of the ERα and ERβ, which leads to the blocking of the ERα ability to react to the ligand (estrogen) and to a decrease in cell proliferation. Conclusions. 1. Extract of Maclura refers to the ІV class of toxicity with intragastric and rectal administration (low-toxic substances). 2. The use of suppositories with OEM in rats with SGPH normalizes the functional activity of the prostate, which is confirmed by the normalization of the content of sex hormones. 3. Extract of Maclura in the prostate cells inhibits 5α-reductase activity, reduces androgen receptors and the testosterone ratio/androgen receptors as the same to drugs with 5α-reductase inhibition action. 4. Phytosuppositories with OEM in a dose of 380 mg/kg do not inferior on the efficiency of the prostatoprotective action of the referens drag Prostaplant forte in a dose of 35 mg/kg.

Bovhyaluronidaze azoximer as an antimicrobial alternative in companion animals

Antimicrobial resistance formation in various bacteria is a serious biosafety threat. In this regard, the important issue in medical and veterinary fields is not only the rational use of antibacterial drugs, but also the search for ways to significantly reduce the need for antibiotics. Three studies designed to research into these challenges are described. The results indicated that (1) the bacteriuria presences in 62.4 +/- 4.1% of urine samples obtained from companion animals (the microflora count in urine samples is estimated from ‘++’ to ‘Entire Field-of-View’); (2) 16.3 +/- 4.0% of samples from companion animals showed bacteria with low antibiotics sensitivity, and 8.1 +/- 3.0% of samples contained bacteria resistant to 30 antibiotics included in the susceptibility test; (3) the Bovhyaluronidaze azoximer reduce antimicrobial therapy duration statistically significant (p=0.0089). The studies were conducted at the facilities of St. Petersburg State University of Veterinary Medicine and Bars veterinary clinic chain in St. Petersburg, Russia. A randomized clinical trial of Bovhyaluronidaze azoximer effect on course of disease and treatment duration of acute and chronic prostatitis and urocystitis, including complicated by urolithiasis, was conducted in 54 animals. Animals were randomly assigned to intervention (n=34) and control (n=20) groups. The animals of both groups received the antimicrobial therapy. Interventional group patients additionally received Bovhyaluronidaze azoximer in the form of rectal suppositories. The antimicrobial therapy mean duration in intervention group animals took 14.88 +/- 4.98 days, in control group animals — 18.65 +/- 5.40 days. The study findings imply that bacteriuria is widely prevalent in companion animals and antimicrobial resistance is increasing issue in veterinary medicine. Bovhyaluronidaze azoximer contributes to microcirculation restore and increases the bioavailability of antibacterial drugs at the site of infection. This makes its relevant for use in the complex treatment for septic and inflammatory processes. This allows to reduce the antimicrobial course duration (and completely decline antibiotic therapy in some cases) and prevent the formation of chronic inflammation and infection sites.

Bovhyaluronidaze azoximer as an antimicrobial alternative in companion animals

Antimicrobial resistance formation in various bacteria is a serious biosafety threat. In this regard, the important issue in medical and veterinary fields is not only the rational use of antibacterial drugs, but also the search for ways to significantly reduce the need for antibiotics. Three studies designed to research into these challenges are described. The results indicated that (1) the bacteriuria presences in 62.4 +/-4.1% of urine samples obtained from companion animals (the microflora count in urine samples is estimated from ’++’ to ’Entire Field-of-View’); (2) 16.3 +/-4.0% of samples from companion animals showed bacteria with low antibiotics sensitivity, and 8.1 +/-3.0% of samples contained bacteria resistant to 30 antibiotics included in the susceptibility test; (3) the Bovhyaluronidaze azoximer reduce antimicrobial therapy duration statistically significant (p=0.0089). The studies were conducted at the facilities of St. Petersburg State University of Veterinary Medicine and Bars veterinary clinic chain in St. Petersburg, Russia. A randomized clinical trial of Bovhyaluronidaze azoximer effect on course of disease and treatment duration of acute and chronic prostatitis and urocystitis, including complicated by urolithiasis, was conducted in 54 dogs. Animals were randomly assigned to intervention (n=34) and control (n=20) groups. Animals of both groups received the antimicrobial therapy. Interventional group patients additionally received Bovhyaluronidaze azoximer in the form of rectal suppositories. The antimicrobial therapy mean duration in intervention group animals took 14.88 +/-4.98 days, in control group animals — 18.65 +/-5.40 days. The study findings imply that bacteriuria is widely prevalent in companion animals and antimicrobial resistance is increasing issue in veterinary medicine. Bovhyaluronidaze azoximer contributes to microcirculation restore and increases the bioavailability of antibacterial drugs at the site of infection. This makes its relevant for use in the complex treatment for septic and inflammatory processes. This allows to reduce the antimicrobial course duration (and completely decline antibiotic therapy in some cases) and prevent the formation of chronic inflammation and infection sites.

Experience in the treatment of chronic endometritis

At present, bacterial biofilms play a significant role in chronic endometritis. In our clinical case, a patient with a history of infertility has had no sex life for several years, but bacterial vaginosis recurs monthly. Ascending bacterial infection with chronic endometritis was confirmed by immunohistochemistry data (detection of CD138), as well as microbiological data (detection of anaerobic microorganisms, including Gardnerella vaginalis and Atopobium vagine, in the endometrium). To treat chronic endometritis, we used antibiotic moxifloxacin, followed by administration of bovhyaluronidase azoximer (Longidaza) in the form of rectal suppositories. As a result of complex therapy, the patients endometrium improved (CD138 and anaerobic bacteria revealed), subsequent repeated insemination with donor sperm led to the onset of progressive pregnancy.

EXPERIMENTAL STUDY OF ANTIMICROBIAL PROPERTIES AND ACUTE TOXICITY OF THE PEO-BASED COMBINED SUPPOSITORIES

Aim. The research of antimicrobial and toxicological parameters of a promising pharmaceutical composition with indole-3-carbinol and meloxicam in the form of rectal suppositories. Materials and methods. The research of antimicrobial activity was carried out in vitro by diffusion in nutrient agar in the modification of "holes" on the reference strains of common pathogens Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Bacillus subtilis, Candida albicans. Adult rats were used for the study of acute toxicity. Suppository mass were administrated in the largest possible volume rectally or orally. The animals were periodically monitored according to the experimental plan – the assessment of physiological parameters before administration and after 6, 12, 18, 24 hours, at 3, 7 and 14 days. The animals were removed from experiment and necropsy provided after 1, 3, 7, and 14 days. Results. The sizes of zones of inhibition of the microorganisms growth were most significant (from 19.27±0.61 mm of E. coli to 40.80±0.42 mm of S. aureus) near sample of the combined composition suppository compared with other combination of active substances and excipients. During the observation of animals for 14 days and the study of internal organs after autopsy, deviations in physiological (weight, temperature, activity, respiratory rate) and macroscopic morphological indicators of animals from reference values were not detected. Conclusion. According to the results of microbiological studies, a moderate antimicrobial effect of suppositories of combined composition in relation to all the studied pathogens was revealed. The absence of manifestations of acute toxicity allows us to conclude that the pharmaceutical composition can be classified as practically non-toxic substances. The obtained results allow us to recommend a pharmaceutical composition with indole-3-carbinol and meloxicam on a polyethylene oxide basis in the form of suppositories for further preclinical studies of specific pharmacological effects as a prostate protective agent.

Clinico-laboratory efficacy of the drug Viferon® in viral lesions of the gastroin-testinal tract in children

In recent years, viral lesions of the gastrointestinal tract take the leading place in the etiological structure of acute intestinal infections. The study of the clinical course and treatment of viral diarrhea in children is an urgent task in modern conditions. We analyzed the disease of 2568 children aged 1 month to 17 years who were hospitalized in a Hospital No 3 in St. Petersburg in the period of 2016-2017. All patients underwent a standard laboratory examination. The etiological interpretation was carried out with the help of polymerase chain reaction, bacteriological and serological methods of investigation. Of the 2568 children in 1502 (58.5%) patients, the diagnosis was confirmed. The share of bacterial diarrhea was 31.8%, viral lesions of the gastrointestinal tract – 68.2%. Among the decoded viral lesions of the gastrointestinal tract, the share of rotavirus infection was 52.8%, norovirus infection – 24.8%, mixed infection – 19.6%. A high proportion of viral lesions of the gastrointestinal tract was established in children under 3 years of age (71.7%). The main reason for hospitalization of children under 5 years of age is rotavirus infection, from 5 to 12 years – norovirus infection. Almost always (87.6%), viral diarrhea proceeded in a moderate form. In infants, mixed viral infection was recorded in severe form. The use of Viferon® in the form of rectal suppositories to supplement the basic therapy of viral intestinal infections significantly reduces the duration of intoxication syndrome, fever, diarrhea, catarrhal syndrome, the duration elimination of viruses, and the length of stay in the hospital.

Perinatal HIV-infection in Sankt Petersburg and Modern Therapy Concomitant Viral Infections

The study included 338 HIV-infected children (B-23) and 350 children with perinatal contact HIV infection (R-75), consisting on the dispensary in the department of maternal and child the St. Petersburg City AIDS Center. In 32 persons (9.5%) diagnosed with secondary infections. In the structure of viral opportunistic infections (herpesvirus, SARS) amounted to 39.8%, bacterial (bronchitis, tonsillitis, pyoderma, tuberculosis) — 34.8%, fungal and parasitic (candidiasis of the oral mucosa, PCP) — 25.4 %. Combined therapy (causal, pathogenetic, symptomatic) SARS in children with B-23 and R-75, allows you to get in early (6th d. Treatment) regress the main symptoms of acute respiratory diseases. Modern therapy of congenital cytomegalovirus infection (VTSMI) in children with B-23 and R-75 of the first year of life with antitsitomegalovirusnogo immunoglobulin and preparation of human recombinant interferon alfa-2b in the form of rectal suppositories — VIFERON, causes persistent normalization of clinical and laboratory parameters.

Возможности сохранения и восстановления фертильности после хирургического лечения трубной беременности

The efficacy of measures that improved postoperative rehabilitation of natural fertility in women after conservative surgical treatment of progressive tubal pregnancy (TP) was assessed. A randomized, controlled, open examination of 102 those who planned pregnancy, have undergone treatment endovideosurgical progressive TP was held. The improved complex of rehabilitation: 1) used anti-adhesive barrier; 2) bacteriological and virological examination of discharge from the fallopian tubes, followed by determination of sensitivity to antibiotics; 3) for the rehabilitation of the reproductive system, improve the regenerative processes in the fallopian tubes, and effective contraception for women of the main group in the postoperative period were appointed individually combined oral contraceptives (drospirenone 3 mg/ethinylestradiol 30 mcg) the duration of 9-12 months; 4) anti-inflammatory therapy (nonsteroidal anti-inflammatory drugs in the form of rectal suppositories, enzyme) was determined. The effectiveness of the improved complex to recovery of fertility in women after conservative surgical treatment of progressive TP was 80%.

Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial.

BackgroundRenal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen® is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketoprofen 100 mg and hyoscine butylbromide 10 mg. This combination is intended for the rapid relief of severe colicky pain in the renal system, hepatobiliary system, or gastrointestinal tract. This trial aims to compare a single-dose of Spasmofen rectal suppository to a single intravenous (IV) ketorolac tromethamine 30 mg/2 mL dose in patients with acute renal colic.MethodsA total of 80 eligible consecutive patients presenting to the emergency departments of two medical centers with acute renal colic were included in the study. Eligible patients who signed the informed consent were randomly assigned into two treatment groups: an experimental group (Spasmofen group) who received one Spasmofen rectal suppository plus an IV injection of 2 mL of normal saline solution; and a control group (ketorolac group) who received one ketorolac 30 mg/2 mL ampoule IV plus one placebo suppository. Treatment success, defined as a change in the verbal rating score from severe or moderate pain to none or mild at 60 minutes after the dose, was compared between groups using the chi-square/Fisher’s exact test. Percentage reductions in visual pain analog scale (VPAS) scores at 15 and 60 minutes after the dose were compared between groups using the Z-test for proportions.ResultsSuccessful treatment at 60 minutes occurred in 35 of 40 (87.5%) of Spasmofen-treated patients and in 33 of 40 (82.5%) of ketorolac-treated patients. The difference was not statistically significant by Fisher’s exact test (P=0.755). The mean percentage reduction of VPAS after 15 minutes was 61.82% in the Spasmofen-treated group and 64.76% in the ketorolac-treated group. The difference was also not statistically significant by the Z-test for proportions (P=0.795). Sixty minutes after being treated, Spasmofen was associated with a statistically significant greater reduction in VPAS (mean% reduction =92.36%) than ketorolac (75.06%; P=0.0466).ConclusionSingle-dose Spasmofen rectal suppository might be a safe and effective first-aid treatment for the emergency department relief of acute renal colic.

Application of physiobalneotherapeutic factors in the combined rehabilitative treatment of patients with chronic bacterial prostatitis complicated by erectile dysfunction

Patients with chronic bacterial prostatitis complicated by erectile dysfunction received combined rehabilitative treatment based on the use of various combinations of physiobalneotherapeutic factors, such as ultrasound, local negative pressure, white and yellow turpentine or sodium chloride baths, supplemented by basal medicamentous therapy in the form of rectal suppositories. Efficiency of therapy involving sodium chloride, white and yellow turpentine baths was estimated at 85, 60, and 75% respectively.

Rectal Absorption From Aspirin Suppositories in Children and Adults

Absorption of salicylate was determined by means of urinary excretion techniques after rectal administration of a commercial aspirin suppository to eight children and four adults. The absorption of drug from the suppository was exceedingly slow; perhaps an order of magnitude slower than that observed after oral administration of conventional tablets. The amount of drug absorbed was highly dependent on the time between insertion and the first defecation (retention time ). Retention times as long as four to five hours resulted in only about 60% of the dose being absorbed. In our judgment the use of aspirin in the form of rectal suppositories provides the clinician with little control over drug therapy.