Muscle Relaxant Effects Research Articles

The Use of Peppermint Oil in Gastroenterology.

For decades, mint has been used worldwide for its relieving effects against gastrointestinal disturbances. Peppermint is a perennial herb common in Europe and North America. The active ingredient of peppermint oil is menthol and has various gastroenterological and non-gastroenterological uses, especially in the context of functional gastrointestinal disorders (FGIDs). We conducted a literature search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials, and case series using the following keywords and acronyms and their associations: peppermint oil, gastro-intestinal motility, irritable bowel syndrome, functional dyspepsia, gastrointestinal sensitivity and gastrointestinal endoscopy. Peppermint oil and its constituents exert smooth muscle relaxant and anti-spasmodic effects on the lower esophageal sphincter, stomach, duodenum, and large bowel. Moreover, peppermint oil can modulate visceral and central nervous system sensitivity. Taken together, these effects suggest using peppermint oil both for improved endoscopic performance and for treating functional dyspepsia and irritable bowel syndrome. Importantly, peppermint oil has an attractive safety profile compared to classical pharmacological treatments, especially in FGIDs. Peppermint oil is a safe herbal medicine therapy for application in gastroenterology, with promising scientific perspectives and rapidly expanding use in clinical practice.

In-vitro antioxidant, lipoxygenase inhibitory, and in-vivo muscle relaxant potential of the extract and constituent isolated from Diospyros kaki (Japanese Persimmon)

Diospyros kaki (Japanese persimmon) is cultivated specious of the Diospyros genus. D. kaki is a multi-medicinal application in the folk system for the cure of ischemic stroke, angina, atherosclerosis, muscle relaxation, internal hemorrhage, hypertension, high cough, and infectious disease. The main objective of this study was the isolated bioactive metabolites from chloroform fractions of D. kaki. The extract and fractions were then tested for various in-vitro (antioxidant and lipoxygenase) and in-vivo (muscle relaxant) activities. The repeated chromatographic separation of chloroform extract afforded compound 1. Compound 1, n-hexane, and chloroform fractions were evaluated for in vitro antioxidant, lipoxygenase inhibitory, and in vivo muscle relaxant potency. The chloroform extract has 79.54% interaction with DPPH at higher concentrations (100 μg/ml) while the compound exhibited a maximum effect of 95.09% at 100 μg/ml. Compound 1 exhibited significant lipoxygenase inhibitory activity with an IC50 value of 36.98 μM followed by a chloroform extract of 57.09 μM. Similarly, compound 1 and chloroform extract showed excellent muscle relaxant effects at a higher dose. From this investigation, it is concluded that extracts and pure compounds exhibited promising antioxidant, lipoxygenase inhibitory, and muscle relaxant activity. This study excellently rationalizes the traditional usage of D. kaki in curing various diseases. Furthermore, the docking results indicate, that the isolated compound fits well into the active site of the lipoxygenase, and makes strong interactions with the target protein.

Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial

Backgroundand purpose: Most patients with coronavirus disease 2019 (COVID-19) experience persistent physical and psychological symptoms. This study aimed to investigate the effects of pulmonary telerehabilitation (PTR) combined with progressive muscle relaxation (PMR) on the physical and psychological outcomes of discharged patients with COVID-19. Materials and methodsThis randomised, assessor-blinded, parallel-group study was conducted in hospitals affiliated with Qom University of Medical Sciences between May and October 2021. Discharged COVID-19 patients aged 18–65 years were randomly assigned to two groups of 26 patients each. The experimental group underwent PTR and PMR for six weeks, while the comparison group received PTR alone. Primary (functional capacity) and secondary (dyspnoea, anxiety, depression, fatigue, sleep quality, and quality of life) outcomes were evaluated at baseline and after six weeks. ResultsThe experimental group showed significantly higher sleep quality (P = 0.001, 95% confidence interval [CI]: 1.20–4.09) and significantly lower fatigue (P = 0.041, 95% CI: 4.79–5.25) and anxiety (P = 0.001, 95% CI: 1.21–4.47) than the comparison group. No between-group differences were observed in terms of other outcomes (P > 0.05). ConclusionPTR coupled with PMR was more effective for promoting sleep quality and alleviating anxiety and fatigue than PTR alone.

Effectiveness of Sugammadex on muscle relaxant reversal in preterm neonates

ABSTRACT Background & objective Sugammadex is a drug used to reverse the muscle relaxation effect of rocuronium. Its use is still limited in preterm neonates. The aim of this study was to compare the efficacy of Sugammadex with that of neostigmine in reversing rocuronium-induced muscle relaxation in preterm neonates and to evaluate the safety of its use in this age group. Patients and methods This randomized clinical trial was carried out on Sixty preterm neonates, planned for elective inguinal hernia repair under general anaesthesia. The patients were divided into two equal groups. Group N used neostigmine and group S used Sugammadex as the reversal agent for rocuronium. Results In Sugammadex group the mean reversal time (1.15 ± 0.42) min and the mean recovery time (17 ± 6.64) min were significantly shorter than in the neostigmine group (8.9 ± 1.6) min and (27.16 ± 9.26) min respectively, with p value <0.001.The patients in the Sugammadex group showed significantly lower heart rate than those in neostigmine group but showed no significant difference as regard mean blood pressure at 3, 6, 9,12,15 and 18 min after drug injection.There were no significant complications noted in both group Conclusion Sugammadex is well tolerated in the Preterm neonates with shorter recovery and reversal time when compared to neostigmine.

Effect of atracurium and rocuronium on the state and response entropy during isoflurane anesthesia: randomized prospective study

BackgroundSeveral researches have examined the impact of inhalation anesthetics, intravenous anesthetics, and muscle relaxants on spectral entropy, but many did not evaluate the extent of neuromuscular block. Besides, they did not inspect the impact of distinct degrees of neuromuscular blockade on spectral entropy under dissimilar saturations of isoflurane inhalation. Hence, this study has evaluated variant degrees of minimum alveolar concentration (MAC) to estimate the isoflurane concentration, along with various levels of neuromuscular blockade.This study aims to evaluate the effect of muscle relaxants (atracurium and rocuronium) on entropy readings (state, response entropy, and response-state difference) during isoflurane anesthesia.This is a prospective randomized study, as forty patients have been included and divided into two study groups: patients in group A received atracurium, while patients in group R received rocuronium. Under 50% and 100% neuromuscular blockage, state and response entropy were observed at MACs of 0.8% and 1%, respectively.ResultsThere was a positive correlation between state (SE) and response entropy (RE) at baseline, different MACs, and different trains of four (TOF) for both atracurium and rocuronium. State and response entropy decreased with increasing MAC of isoflurane (P < 0.001), while atracurium and rocuronium at TOF 50% and 100% showed no effect on SE, RE, or RE-SE (P > 0.05).ConclusionsState and response entropy can be used effectively to evaluate the depth of anesthesia at different isoflurane MAC and atracurium or rocuronium doses.Registration numberClinicalTrials.gov identifier: NCT 05097508, Registered October 5, 2021 (prospectively registered), http://www.ClinicalTrial.gov

O PAPEL DO RELAXAMENTO MUSCULAR EM JOGADORES DE BADMINTON

ABSTRACT Introduction: In training, fatigue and recovery are antagonistic factors. Physical rehabilitation of athletes and elimination of sports fatigue have gradually become essential factors in improving competitiveness. Muscle relaxation exercises can reduce badminton players' physical effort, allowing them to recover quickly. Objective: Analyze muscle relaxation's effect on fatigue relief until the normalization of physical strength in badminton players. Methods: Twelve badminton players were grouped in cross-sectional tests. During the three weeks of physical training, players performed two training methods: muscle relaxation and complete rest. Laboratory analysis encompassed blood biomarkers such as urea and creatine kinase. Data were collected before and after the interventions, confronted, and studied mathematically and statistically. Results: The proportions of leukocytes and lymphocytes in the muscle relaxation group after resistance exercise were lower than before. The decrease of morning leukocytes in the muscle relaxation group on the second day was less than in the resting group. The recovery effect of the lymphocyte ratio was also better. After special strength training, the value of creatine kinase was significantly higher than before exercise in both the muscle relaxation group and the complete rest group. Conclusion: Muscle relaxation can reduce exercise fatigue in badminton players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Comparing the effect of internet-delivered short-term progressive muscle relaxation and psychoeducation on mindful ability, visceral hypersensitivity and symptoms of patients with irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a functional bowel disorder that psychological interventions are effective on it. The present study aimed to compare the effect of internet-delivered short-term PMR (iPMR) and psychoeducation on mindful ability (MA), visceral hypersensitivity (VH), and symptoms of patients with IBS. This randomized clinical trial was performed on individuals with IBS in 2020, recruiting a total of 60 patients fulfilling the inclusion criteria. Prior to the intervention, the Freiburg Questionnaire- Short Form (FMI-SF), the Visceral Sensitivity Questionnaire (VSI), and the Gastrointestinal Symptoms Rating Scale (GSRS) were filled out for the patients. Patients were divided into iPMR and psychoeducation groups randomly. All training in both groups was accomplished via WhatsApp social network. FMI-SF, VSI, and GSRS questionnaires for patients were completed 1 month (post-test) and 2 months later (follow-up). The data was analyzed by SPSS-23 software and one-way analysis of variance (ANOVA). Compared to the psychoeducation group, the MA of the iPMR group increased significantly in post-test and follow-up (43.06 ± 7.12 and 42.88 ± 6.28 vs 51.23 ± 11.7 and 56.74 ± 12.36 and P < 0.001) and their VH decreased significantly (37.85 ± 11.6 and 38.03 ± 11.8 vs 26.9 ± 6.45 and 22.46 ± 5.32 and P < 0.001). Also, their GSRS had significant decreases (43.27 ± 10.73 and 41.18 ± 9.31 vs 32.33 ± 8.21 and 25.79 ± 6.30 and P < 0.001). The findings showed iPMR in patients with IBS, in spite of a few sessions and internet-delivered approach, increased MA and decreased VH and gastrointestinal symptoms of them.

Pharmacological effects of Safranal: An updated review.

Safranal (a monoterpene aldehyde) is the major volatile component of saffron which is responsible for the saffron unique odor. Several studies have shown the pharmacological activities of safranal including anti-oxidant, anti-inflammatory, cardioprotective, neuroprotective, nephroprotective, gastrointestinal protective, etc. This study was designed to review the pharmacological and medical effects of safranal and up-to-date previous knowledge. Moreover, some patents related to the pharmacological effects of safranal were gathered. Therefore, electronic databases including Web of Sciences, Scopus, and Pubmed for pharmacological effects and US patent, Patentscope, and Google Patent for patents were comprehensively searched by related English keywords from 2010 to June 2022. According to our review, most of the studies are related to the safranal effects on CNS such as antianxiety, analgesic, anticonvulsant, antiischemic, anti-tremor, memory enhancement and its protective effects on neurodegenerative disorders such as Alzheimer's, Parkinson and Huntington diseases. Other effects of safranal are antiasthmatic, antihypertensive, antiaging, anticataract, etc. Moreover, the protective effects of this agent on metabolic syndrome and diabetic nephropathy have been shown. Different mechanisms including anti-oxidant, anti-inflammatory, muscle relaxation, antiapoptotic, and regulatory effects on the genes and proteins expression related to signaling pathways of oxidative stress, inflammation, apoptosis, proliferation, etc. are involved in safranal pharmacological effects. Some patents for the prevention and/or treatment of different diseases such as liver cancer, sleep disorder, depression, cognitive disorder, obesity and PMS were also included. Based on the documents, safranal is considered a promising therapeutic agent although more clinical studies are needed to verify the beneficial effects of safranal in humans.

Identification and Pharmacological Evaluation of Syzygium cumini Derived Fixed Oils

Syzygium cumini L is an evergreen medicinal plant belonging to the family Myrtaceae, and is one of the important species of the genus Syzygium. S. cumini is traditionally used to treat various infections such as sore throat, bronchitis, dysentery, and other painful conditions. The aim of the current study was to evaluate fixed oil extracted from S. cumini for various in vitro and in vivo biological activities and identification of its fatty acids constituents. GC-MS analysis of the fixed oil revealed that the major constituents are palmitic acid methyl ester (56.45%) and stearic acid methyl ester (29.54%). Fixed oil isolated from S. cumini exhibited significant effect against Staphylococcus aureus, Shigella flexenari, and Bacillus subtilis with zone of inhibition of 28.09, 27.34, and 22.76 mm, respectively. In addition, the oil exhibited antifungal effect against Aspergillus flavus, Candida glabrata, Microsporum canis, and Fusarium solani with zone of inhibition of 80.77, 75.08, 70.98, and 65.56 mm, respectively. The oil also exerted analgesic potential at the dose of 10, 20, 40, and 60 mg/Kg with 35.44, 50.45, 65.98, and 80.34 % activity in acetic acid-induced writhing model. A mild muscle relaxant effect was noted in animal models. Taken all together, the fixed oil from S. cumini exhibits significant antimicrobial, antifungal and analgesic effects, which justifies the use of this plant in folk medicine.

The Effect of Progressive Muscle Relaxation on Sleep Quality and Anxiety Level of Students Confirmed Covid-19

Coronavirus disease is a virus that causes respiratory system disorders. Based on data from the Indonesian Ministry of Health, 2022, the number of covid-19 exposures that have been confirmed positive is 6,512,913, recovered as 6,319,990 died 158,768. Progressive muscle relaxation focuses on muscle activity. The purpose of this exercise is to lower the tension. This study aims to measure the effectiveness of exercise on sleep quality and anxiety levels. This study is a quantitative research method, using purposive samples with a quasi-experimental study pretest-posttest one-group research design. This study sampled 24 students who declared confirmed Covid-19. The value of sleep quality is 2.17, with a standard deviation of 0.761. The results obtained a p-value of 0.000, then the p &lt; α where H0 was rejected, significant influence on sleep quality before and after exercise. The value of the level of anxiety after exercise is 2.17, with a standard deviation of 0.381. The results p-value of 0.000, then the p &lt; α where H0 was rejected, significantly influenced the level of student anxiety before and after exercise. The contribution of this research can be used for nursing information, especially for patients who are confirmed Covid-19.

The Effect of Lavender Inhalation on the Pain Perception of Orthodontic Separator Placement: An Open-Label Randomized Controlled Trial

Lavandula angustifolia Mill. (lavender) is known for its antibacterial, muscle relaxant, antispasmodic, sedative, and anesthetic effects, and is also proposed to be used as an analgesic agent. Despite several studies on the analgesic activity of lavender, this is the first experiment in patients with orthodontic pain. This "2-arm parallel" study aims to evaluate the effect of lavender oil inhalation on reducing pain after elastomeric separator placement as a part of orthodontic treatment. Patients who needed elastic separator placement in mesial and distal of first permanent molars of all quadrants prior to their first-ever fixed orthodontic treatment, with the age range of 20 to 24, were randomly assigned to one of the two study groups: lavender oil and sesame oil. Participants had to breathe in their medication for 2 minutes just before separator insertion, as well as 4, 8, 12, 24, 36, and 48 h afterward. A visual analog scale (VAS) was used to measure the level of pain during three oral situations, including rest, fitting posterior teeth, and chewing at the following periods: just before separator placement (T0), immediately after insertion (T1), 3 h post-insertion (T2), 12 h post-(T3), 24 insertion h post-insertion (T4), and 48 h after separator placement (T5). The current study indicated the effectiveness of lavender oil inhalation in reducing pain perception while chewing 48 h after elastic separator placement. The pain level in lavender inhalation was lower from 12 h to 48 h after separator insertion, although not considerable, indicating the probability of its effectiveness on delayed responses to orthodontic pain.

Reducing Blood Pressure on Elderly with Hypertension with Progressive Muscle Relaxation Therapy

Elderly is a process of life's journey of getting old. Physiological changes in the cardiovascular system experienced by the elderly are hypertension which occurs due to decreased elasticity of the arteries in the aging process. The purpose of this research was to analyze the effect of progressive muscle relaxation on reducing blood pressure in hypertensive elderly in Banjarejo Village. Pre-experimental research design with One group Pre-Post Test Design approach. The research sample is 30 elderly hypertension people with Quota Sampling. Research variables are progressive muscle relaxation therapy and blood pressure. Collecting data using observation sheets, using the Wilcoxon statistical test. The results showed that there were changes in blood pressure before and after therapy, namely systolic blood pressure -7.82 mmHg and diastolic blood pressure -5.54 mmHg. Wilcoxon statistical test showed p value = 0.000 which means there is a change in blood pressure in the elderly after doing progressive muscle relaxation therapy. The conclusion of this research shows that progressive muscle relaxation is a therapy that can be used to lower blood pressure in hypertensive patients.

THE EFFECT OF PROGRESSIVE MUSCLE RELAXATION ON REDUCING STRESS AND BLOOD SUGAR IN TYPE 2 DIABETES MELLITUS PATIENTS IN THE WORK AREA OF TANIWEL PUBLIC HEALTH CENTER

The main problems that often occur in people with Diabetes Mellitus (DM) are stress and an increase in blood sugar. Uncontrolled stress for a long time can lead to an increase in blood sugar levels, which can lead to various complications. One of the physical activities that can be done with relaxation is Progressive Muscle Relaxation (PMR) is an intervention that can be done in people with diabetes. The purpose of the study was to determine the effect of Progressive Muscle Relaxation (PMR) on increasing stress and blood sugar levels. The research design used a quasi-experimental approach with a pre-post-test control group design approach. The sample consisted of 36 respondents who were divided into 18 intervention groups and 18 control groups. The group was given a therapeutic intervention for 1 week with a duration of 2 times a day, namely in the morning and afternoon for 10-15 minutes. The instruments used are a glucometer, blood sugar level observation sheet, and Diabetes Distress Scale (DDS) questionnaire. Data analysis used the Wilcoxon test and Paired t-test to see pair data. Then for the research group, the data used the Man-Whitney Test. The results showed that there was a significant effect on decreasing blood pressure (p=0.013) and that there was an effect on decreasing blood sugar levels (p=0.034). Conclusion: Progressive Muscle Relaxation (PMR) affects reducing stress and blood sugar levels in Type 2 DM patients.

The Effectiveness of Progressive Muscle Relaxation (PMR) Against Anxiety in Breast Cancer Patients Undergoing Chemotherapy at Dr Wahidin Sudirohusodo Hospital Makassar

Breast cancer is a malignant disease that most commonly attacks women. One pharmacological therapy for breast cancer is chemotherapy, but this treatment can cause anxiety due to the side effects it causes. Non-pharmacological treatment is really needed, one of which is Progressive Muscle Relaxation (PMR) which can reduce anxiety. The aim of the research was to determine the effectiveness of Progressive Muscle Relaxation (PMR) on anxiety in breast cancer patients. Sampling used purposive sampling technique. The total sample was 30 respondents (15 respondents were given PMR therapy) and (15 respondents were given deep breathing). Anxiety measurement uses the State Trait Anxiety Inventory (STAI) questionnaire. The test used to correlate PMR with disease duration is the Pearson test. Differences in cancer stage and mean anxiety score independent t-test. One-way anova test chemotherapy cycle. Meanwhile, the difference between pre and post PMR and control used the paired t-test. The results of the study showed no significant values for the duration of suffering from total anxiety p = 0.476, state anxiety p = 0.424, trait anxiety p = 0.464. At stage 3 it showed significant values for total anxiety p = 0.004, state anxiety p = 0.003, trait anxiety p = 0.018, at stage 4 total anxiety p = 0.009, state anxiety p = 0.009, trait anxiety p = 0.020. The chemotherapy cycle was not significant for total anxiety p = 0.084, and state anxiety p = 0.177, while trait anxiety showed a significant value of p = 0.026. Pre and post PMR showed significant values for total anxiety, state anxiety, and trait anxiety p = 0.001. The PMR and control groups showed significant values for PMR total anxiety, state anxiety, and trait anxiety p = 0.001 and the control was significant for total anxiety p = 0.028 and state anxiety p = 0.026, while trait anxiety was not significant p = 0.100. The mean anxiety scores (mean difference) of PMR and controls showed significant values for total anxiety p = 0.042, state anxiety p = 0.027 and trait anxiety p = 0.033. Conclusion Progressive Muscle Relaxation (PMR) exercise therapy is effective in reducing anxiety in breast cancer patients undergoing chemotherapy.

Effect of progressive muscle relaxation technique for anxiety among menopause women

This study aimed to o analyze the effect of muscle relaxation for anxiety among menopause women. This study is a systematic review and meta-analysis. The articles used in this study were obtained from three database, namely PubMed, Science Direct, and Google Scholar. The articles included are full-text article with a study design of randomized controlled trial from 2013 to 2022. Articles were analyzed using the Review Manager 5.3 application. A total of 9 articles from Asia (India, Taiwan &amp; Turkey), Africa (Ethiopia), Europe (Spanyol), and North America (Canada). The data collected showed that anxiety in meno­pausal women who do PMRT will decrease by 0.37 units compared to menopausal women who do not do PMRT, and the results were statistically significant (SMD= -0.37; 95% CI= -0.63 to -0.12; p= 0.004).

The Effectiveness of Progressive Muscle Relaxation on Reducing Joint Pain in the Elderly at Jember Nursing Home

Increasing age and the aging process can cause various problems, especially physical dissatisfaction, which results in impaired musculoskeletal function, namely joint pain which makes the elderly experience problems in carrying out daily activities. Pain management with non-pharmacological nursing actions that can be used to relieve joint pain in the elderly, namely progressive muscle relaxation therapy (ROP). This study aims to determine the impact of progressive muscle relaxation (ROP) on joint pain in the elderly at Wisma Melati UPT PSTW Jember. This research was conducted quantitatively with the type of quasi-experimental research using a research design approach (one group pre-test and post-test design). Samples were taken by purposive sampling. The sample population used in this study was elderly at Wisma Melati UPT PSTW Jember, with nine elderly people selected. The results showed that the respondents who took part were on average 77.11 years old (SD=5.732), the youngest was 70 years old and the oldest was 90 years old. The average value of the pain scale before performing progressive muscle relaxation (ROP) is 3.44 with a minimum value of 2 and a maximum value of 5. The mean value of the pain scale after administration of progressive muscle relaxation (ROP) is 2.67 with a minimum value of 0 (no pain) and the maximum value is 5. Based on the results of the analysis test using the t-test paired sample test the results of the joint pain scale before and after progressive muscle relaxation (ROP) was carried out, namely 0.0023 (p &lt;0.005). There was a change or difference in the decrease in pain scale before and after giving progressive muscle relaxation therapy (ROP) to the elderly.

A potential host and virus targeting tool against COVID-19: Chemical characterization, antiviral, cytoprotective, antioxidant, respiratory smooth muscle relaxant effects of Paulownia tomentosa Steud

COronaVIrus Disease 2019 (COVID-19) is a newly emerging infectious disease that spread across the world, caused by the novel coronavirus Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2). Despite the advancements in science that led to the creation of the vaccine, there is still an urgent need for new antiviral drugs effective against SARS-CoV-2. This study aimed to investigate the antiviral effect of Paulownia tomentosa Steud extract against SARS-CoV-2 and to evaluate its antioxidant properties, including respiratory smooth muscle relaxant effects. Our results showed that P. tomentosa extract can inhibit viral replication by directly interacting with both the 3-chymotrypsin-like protease and spike protein. In addition, the phyto complex does not reduce lung epithelial cell viability and exerts a protective action in those cells damaged by tert-butyl hydroperoxide , a toxic agent able to alter cells’ functions via increased oxidative stress. These data suggest the potential role of P. tomentosa extract in COVID-19 treatment, since this extract is able to act both as an antiviral and a cytoprotective agent in vitro.

The Effect of Hydrotherapy and Progressive Muscle Relaxation (PMR) on Cortisol Levels in Primigravida Pregnant Women

This study aims to measure cortisol levels in pregnant women who have intervened with Hydrotherapy and Progressive Muscle Relaxation to reduce anxiety in pregnant women in facing labor. This type of research uses quantitative with a quasi-experimental design, and a pretest-posttest approach with a control group [10]. The sampling technique used was purposive sampling so that a total sample of 30 respondents was obtained. Analysis of the data collected in the study was processed analytically with the T-Paired test and the Independent Test. The results of this study showed that the hydrotherapy and Progressive Muscle Relaxation group with Paired T test results worth P Value 0.017 = 0.05, meaning that there is no effect of hydrotherapy and Progressive Muscle Relaxation on cortisol levels. Hydrotherapy and Progressive Muscle Relaxation therapy are effective in reducing anxiety levels and cortisol levels in primigravida pregnant women in the face of childbirth.&#x0D;

Respiratory function under anaesthesia

General anaesthesia can affect every aspect of ventilation. It produces dose dependent depression of control of respiration. Carbon dioxide response curve is shifted to the right. Muscle tone is reduced and the airway can get obstructed. One of the most prominent changes is reduction in functional residual capacity (FRC) with the adoption of supine function and induction of anaesthesia. The closing capacity increases with age. The atelectasis that occurs consequent to the fall in FRC and increasing age is compounded by the use of high concentrations of oxygen, cephalad movement of the diaphragm, residual effect of muscle relaxants and inadequate analgesia after thoracic or abdominal surgery. One of the important causes of ventilation perfusion mismatch during anaesthesia is atelectasis. This has been shown to contribute to hypoxia as well as increased postoperative pulmonary complications. A lot of research is being conducted as to reduce the effects of atelectasis during anaesthesia, including the best ventilator strategy during anaesthesia. Most inhalation anaesthetics are good bronchodilators. Inhalation anaesthetics depress hypoxic pulmonary vasoconstriction (HPV) beyond 1 MAC. The movement of ciliary movements is reduced with the use of dry gases. All these can increase postoperative pulmonary complications which are important causes of postoperative morbidity. Appropriate preoperative preparation has to be combined with optimal management of ventilation intraoperatively to minimise postoperative pulmonary complications. The role of lower tidal volume, use of positive end-expiratory pressure, limiting oxygen concentrations and the utility of recruitment manoeuvres are increasingly being recognised and have been the topics of recent research.

Treatment of Primary Dysmenorrhea Affecting Menstruating Women Using Herbs: A Review

Abstract: Primary dysmenorrhea is a common condition that affects menstruating women, especially young women. Painful cramping in the lower abdominal area, nausea, vomiting, headache, and fatigue is associated with primary dysmenorrhea, which restricts women from normal living life. The productivity and work performance of women are heavily affected by the symptoms of primary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) and low dose oral contraceptive pills (OCPs) are commonly prescribed for the treatment of primary dysmenorrhea. However, variability in individual response to the drugs and their side effects hinder their long-term use among women. Complementary medicine such as herbs is a promising alternative for the treatment of primary dysmenorrhea, but it lacks scientific evidence. The pharmacological and clinical studies of 9 herbs were included in this review. Although excellent analgesic effects of herbs were reported by clinical studies, the detailed mechanism of action of most herbs remains unelucidated. Several studies discovered that herbs exert analgesic effects through direct uterine muscle relaxation effect, inhibition of cyclooxygenase-2 (COX-2), inhibition of intracellular calcium level, and reduction of prostaglandin synthesis. Further investigation of pharmacological action and the recommended dosages of the herbs for the optimal analgesic effect is needed.