Non-steroidal Anti-inflammatory Medicines Research Articles

Recent progress in alleviating orthodontic discomfort: Mechanism and management-the state of evidence

Orthodontic treatment has demonstrated efficacy in enhancing dental health and rectifying tooth misalignments. Nevertheless, patients experience substantial discomfort and distress. Advancements in orthodontic technology and treatment procedures have led to a decrease in orthodontic discomfort. Orthodontic discomfort refers to the inflammation that occurs due to the obstruction of blood vessels by orthodontic force. This leads to inflammatory responses, which encompass alterations in blood vessels, recruitment of inflammatory and immune cells, and heightened sensitivity of nerves along with the release of chemicals that promote inflammation. The body's inherent analgesic systems ultimately regulate the inflammatory response, thereby diminishing pain. Orthodontic pain signals are transmitted by three-order neurons, beginning with the trigeminal neuron located in the trigeminal ganglia. The signals subsequently arrive at the trigeminal nucleus caudalis located in the medulla oblongata, as well as the ventroposterior nucleus in the thalamus, where the sensation of pain is perceived. The processing of orthodontic pain involves the interplay of emotion, cognition, and memory in many parts of the brain. The structures encompassed in this list are the insular cortex, amygdala, hippocampus, locus coeruleus, and hypothalamus. The inherent analgesic neuronal pathway of the periaqueductal gray and dorsal raphe regions alleviates orthodontic discomfort. Various techniques are employed to manage orthodontic discomfort. These therapies encompass pharmacological, mechanical, behavioral, and low-level laser treatments. Nonsteroidal anti-inflammatory medicines (NSAIDs) alleviate pain, but their impact on tooth movement remains uncertain. Additional research is required to establish the effectiveness of alternative modalities. Gene therapy provides a new, practical, and hopeful approach to treating orthodontic pain. This article explores new advancements and techniques that have enhanced the level of comfort experienced by orthodontic patients.

BRIDGING GAPS: ADDRESSING TREATMENT CHALLENGES WITH ORAL PGE2 IN DUCTUS-DEPENDENT CONGENITAL HEART DEFECTS

circulation. During fetal development, it diverts approximately 90% of the right ventricular output from the high-resistance pulmonary circulation to the umbilical-placental circulation for gas exchange with maternal blood. After birth, the ductus arteriosus usually shuts within 72 hours to help with lung circulation. Failure to close leads to a persistent left-to-right shunt known as patent ductus arteriosus (PDA). PDA affects up to 80% of premature infants and constitutes 5–10% of all congenital cardiac abnormalities in term infants. Hemodynamically significant PDA is associated with various morbidities, including neurodevelopmental impairment and respiratory distress syndrome (Slaughter et al., 2019). Conversely, in ductus-dependent heart lesions, which account for 20–25% of all congenital heart defects, it is crucial to maintain patency of the neonatal DA to uphold life-saving pulmonary or systemic circulation before corrective surgery (Subramaniam and Solomon, 2013). Treatment for closing patent ductus arteriosus (PDA) mostly involves nonsteroidal anti-inflammatory medicines (NSAIDs) such as indomethacin and ibuprofen, which block cyclooxygenase enzymes necessary for prostaglandin production. Although effective, NSAIDs carry dangers such as renal impairment and intestinal problems. Acetaminophen is considered a safer option, although its effectiveness in premature infants is unclear because it may not fully inhibit prostaglandin synthesis. However, few medications exist for preserving ductus arteriosus (DA) patency, with prostaglandin E1 (PGE1) being the sole pharmacological option despite its associated side effects, such as peripheral vasodilation, apnea, fever, and physiological disturbances (Sear, 2019). Furthermore, the shortage of PGE1 in certain countries like Pakistan highlights the urgent need for alternate solutions. In such situations, adopting other available choices like PGE2, which is accessible in Pakistan as an oral drug, becomes crucial for the efficient management of ductus-dependent congenital heart anomalies. Prostaglandin E2 (PGE2) has been successfully utilized orally in newborns with ductus-dependent cyanotic congenital heart disease. In research by Silove et al., PGE2 was supplied orally in doses ranging from 12 to 65 micrograms/kg at 1 to 4 hours intervals. This treatment regimen resulted in consistent increases in oxygen saturation (SaO2) and plasma PGE2 concentrations within 15-30 minutes after administration, equivalent to those achieved with intravenous infusions. Treatment lasted for durations ranging from 5 days to 4 months, during which the ductus remained open for extended periods, allowing for delayed surgical intervention to support the growth of the infants and their pulmonary arteries. While adverse effects during oral medication were similar to those found with intravenous administration, they were generally less severe in this series, underlining the effectiveness and simplicity of oral PGE2 administration for long-term treatment (Nabavi et al., 2019). Furthermore, a 1987 study by B.D. Thanopoulos et al. supported the effectiveness of oral PGE2 in the treatment of neonates with cyanotic congenital heart disease, which primarily depends on the ductus. The data from this investigation revealed that oral PGE2 treatment, while less productive than intravenous infusions, nonetheless proved useful for long-term therapy, affording more convenience and lower morbidity (Fernández-Francos et al., 2021). It is crucial to highlight that side effects such as apnea and hypotension may occur in newborns following PGE2 therapy and require close monitoring during treatment. In conclusion, oral PGE2 offers a viable alternative for addressing congenital heart defects in resource-limited countries like Pakistan. Its effectiveness and convenience make it a viable choice, especially if access to injectable drugs is limited. This underlines the necessity to investigate alternative treatments for appropriate care in such circumstances.

Ewing sarcoma: A rare report from the Indian pediatric population

Ewing’s sarcomas are rare, aggressive tumors with a tendency toward recurrence following resection, and early metastasis. Although patients of younger or older age account for almost 30% of instances, peak incidences occur between the ages of 10 and 20. We, hereby, report the case of a 10-year-old girl who presented with a 3-month history of pain in her right hip that was unable to be relieved by non-steroidal anti-inflammatory medicine and physical therapy. On examination, bone marrow aspiration revealed that the infiltration of malignant small round blue cells was managed by anticancer therapy successfully.

The Role of Curcumin in Gastric Carcinoma by Modulating the Immune System and its SAR

The second most prevalent cancer in the world and the fifth most common malignant tumour is gastric carcinoma. It is thought that several factors, including genetics, epigenetics, and environmental impacts, contribute to the development of gastric cancer. One of the main pathogenic variables associated with stomach cancer risk has been identified as inflammation. There are currently few methods to treat the gastric carcinoma. Therefore, an alternative plan is urgently needed. Explaining the importance of curcumin derived from Curcuma longa Linn. in stomach cancer is the goal of this review. According to recent research, Curcumin (CUR) has a great effect against stomach mucosal injury brought on by non-steroidal anti-inflammatory medicines, gastric mucosal injury in rats, stress haemorrhage, and Helicobacter pylori infection. In this review article, we have discussed the chemistry of CUR, the role of CUR in immunomodulation, and gastric cancer. We have also highlighted the various signalling pathway of gastric cancer where CUR work. By controlling miRNAs on gastric cancer and other relevant signal pathways, CUR exhibits notable anti-inflammatory and anti-cancer properties. In future there are more research work will be done on CUR.

Analytical and bio-analytical methods of rofecoxib: A comprehensive review

A selective COX-2 inhibitor Rofecoxib it is a non-steroidal anti-inflammatory (NSAIDs) medicines work by inhibiting the COX enzyme, which is a mediator of inflammation. Rofecoxib is used to treat rheumatoid arthritis, osteoarthritis, and primary dysmenorrhea. The main objective of this study is to examine Rofecoxib in pharmaceutical and biological formulations both qualitative and quantitative. In this review paper, we have outlined the approaches based on UV/Vis spectroscopy, High-performance liquid chromatography (HPLC), High-performance thin layer chromatography (HPTLC) and Liquid chromatography-mass spectrometry (LC-MS) for estimating rofecoxib. We have also discussed the bioanalytical methods used to analyse RFX. In conclusion, this review paper will aid researchers in developing new techniques for drug estimation in biological fluids and pharmaceutical dosage forms.

Anti-inflammatory Activities of Sulfated Polysaccharides From Ethanol Crude Extract of Spyrida Species Red Seaweed.

The extracts derived from red seaweed have shown characteristics that may reduce inflammation. The abovementioned effects can potentially provide positive outcomes in managing inflammatory illnesses, including arthritis, inflammatory bowel disease, and other skin problems. The polysaccharides were isolated from theSpyridaspecies. The water-soluble polysaccharides were extracted and fractionated from several Indian seaweeds (Red) using a simple, cost-effective approach. Anti-inflammatory effects were further evaluated and validated by FTIR and FESEM analyses. FT-IR and FESEM were used to assess the structural features of polysaccharides and the surface morphology. In addition, the red seaweed species of the genusSpyrida, which includes polysaccharides, was shown to significantly inhibit the denaturation of bovine serum albumin (BSA), further proving that the substance has anti-inflammatory qualities. In this work, an assay to suppress protein activity was utilized to investigate the potential anti-inflammatory effects of polysaccharides derived from Spyrida.As predicted, increasing concentrations of the extract, ranging from 25 to 100 µg/ml, led to a rise in the percentage of inhibited protein denaturation. A statistically significant difference was found between these findings and those obtained with aspirin, a commonly used non-steroidal anti-inflammatory medicine (NSAID). The red algae that grow in the shallow waters of the southern Indian Ocean may be used in medicine.

Nonsteroidal Anti-inflammatory Drug (NSAID) Toxicity in Emergency Room

Nonsteroidal anti-inflammatory medicines, collectively referred to as NSAIDs in academic context, exhibit chemical diversity while concurrently manifesting comparable therapeutic and harmful effects. All pharmaceutical substances under this particular category function by diminishing inflammation, alleviating pain, and reducing fever by means of inhibiting enzymes responsible for the creation of endoperoxides, often referred to as cyclooxygenase (COX) enzymes. The two cyclooxygenase isozymes, COX-1 and COX-2, are responsible for the conversion of arachidonic acid into its endoperoxide metabolites. These metabolites include prostacyclin, prostaglandins, and thromboxane, each exhibiting a wide range of biological activities such as inflammation, regulation of smooth muscle tone, and promotion of thrombosis. The COX-1 enzyme is consistently produced and is recognized as the main provider of prostanoids required for maintaining physiological balance, such as safeguarding the stomach epithelium. In contrast, the COX-2 enzyme is capable of being induced, leading to a substantial increase in the synthesis of prostanoids in circumstances characterized by stress and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) may induce toxicity via the same pharmacological mechanisms that contribute to their therapeutic efficacy. This review aims to discuss NSAIDs toxicity in details, its symptoms, and possible management in the emergency room.

Potential Pharmacological Applications of Nigella Seeds with a Focus on Nigella sativa and Its Constituents against Chronic Inflammatory Diseases: Progress and Future Opportunities.

The leading cause of death worldwide has been identified as chronic illnesses, according to the World Health Organization (WHO). Chronic inflammatory conditions such as asthma, cancer, diabetes, heart disease, and obesity account for three out of every five deaths. Although many people benefit from using nonsteroidal anti-inflammatory medicines (NSAIDs) for pain and inflammation relief, there are significant adverse effects to using these medications. Medicinal plants possess anti-inflammatory properties with minimal or no side effects. Nigella sativa (NS), also known as black cumin, is one of the plants used in traditional medicine the most. Many studies on the NS have shown that their therapeutic properties are attributed to the seed, oil, and secondary metabolites. This plant has been studied extensively and has many medical uses, such as anti-inflammatory. NS or its phytochemical compounds, such as thymoquinone, can cause cell apoptosis via oxidative stress, block efflux pumps, enhance membrane permeability, and exert potent biocidal effects. Notwithstanding the extensively documented anti-inflammatory effectiveness observed in the experimental model, the precise mechanisms underlying its anti-inflammatory effects in diverse chronic inflammatory diseases and its multi-targeting characteristics remain largely unexplored. This review examines NS or its secondary metabolites, a valuable source for the therapeutic development of chronic inflammatory diseases. Most clinical studies were done for diabetes and cardiovascular disease; therefore, more studies are required to examine the NS extracts and phytoconstituents to treat cancer, obesity, diabetes, asthma, neurological disorders, and COVID-19. This study will be a significant resource for clinicians and biologists seeking a pharmaceutical solution for inflammatory diseases.

Updates on Novel Treatments for Rheumatoid Arthritis

Chronic joint inflammation is a hallmark of the systemic inflammatory illness known as rheumatoid arthritis (RA), which ultimately causes severe disability and early death. Around 1% of people worldwide are affected by it, and women are 2-3 times more likely to be affected than males. Preclinical RA, genetic influences and environmental influences all have a role in the etiology of the illness. Since there is no recognized treatment for RA, achieving the lowest disease activity and, if possible, recovery remains the key goals of care. The literature on the various RA therapy options, their mechanisms of action, side effects and innovative drug delivery systems that are currently being used for medication administration are highlighted in this review, with non-steroidal anti-inflammatory drug delivery systems receiving the most attention. The most popular medications from each class are reviewed, including corticosteroids, non-steroidal anti-inflammatory medicines (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs) and biologics. Traditional medication therapy has various drawbacks, including inadequate bioavailability, first pass metabolism, gastrointestinal enzyme degradation, limited solubility and permeability, food interactions and toxicity. Innovative drug delivery technologies such as microspheres, nanoparticles, dendrimers, liposomes and others, hold great promise since they have been able to overcome the drawbacks of traditional drug delivery systems. The current review compares and contrasts numerous unique drug delivery methods that have been investigated for using anti-rheumatic medications, as well as the benefits of using these novel methods over traditional drug delivery methods.

Modifiable Risk Factors Linked to Late Stages of Chronic Kidney Disease in Saudi Arabia

The present study aims to identify modifiable risk variables associated with late-stage chronic renal disease (CKD) in Saudi Arabia. During a cross-sectional survey in the Hail region, 256 Saudi participants were recruited for this study. Participants were chosen based on their estimated GFR. Only CKD patients in stages III, IV or V were eligible. Females had a higher prevalence of CKD, but male patients had a higher risk of end-stage disease, with an RR (95% CI) of 3.2893 (1.4416 to 7.5055), P = 0.0047. Hypertension was found in 62% of the participants (43% in Stage IV and 45.5% in Stage V). T2DM was found in 54% of the patients, with 60% having Stage IV and 27% having Stage V. Nonsteroidal anti-inflammatory medicines (NSAIDs) were used by 23% of the individuals (including 27% in Stage IV and 27% in Stage V). Herbal treatment was used by 21% of the patients (including 27% Stage IV and 36% Stage V). Late-stage CKD is prevalent in Saudi Arabia and is more common among women, rural residents, and people over 55. The findings of this study indicate that hypertension, diabetes, herbal medication use, nonsteroidal anti-inflammatory drugs (NSAIDs), and obesity are responsible for the increased prevalence of CKD in Saudi Arabia. Awareness and education programs focusing on modifiable risk factors for CKD are suggested for lowering the CKD prevalence rate.

Comparative effect of ginger (an anti-inflammatory medicinal herb) and aspirin (a non-steroidal anti-inflammatory drug) on cytoprotection and body weight changes in male albino Wistar rats

Nonsteroidal anti-inflammatory medicines (NSAIDs) are used to treat acute and chronic musculoskeletal problems (osteoarthritis, rheumatoid arthritis, and gout injuries), headaches, dental aches, surgical pains, and dysmenorrhea. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) can cause ulcers. Ginger, a common spice, is anti-inflammatory. Ginger's anti-inflammatory qualities make it suitable for the herbal treatment of inflammatory diseases in numerous cultures. This study examined the effects of ginger, an anti-inflammatory plant, and aspirin, a NSAID, on animal stomachs and body weight. Both are used to treat inflammatory conditions in various nations. Given that aspirin has been linked to stomach ulcers, the study sought to determine if ginger had a larger stomach cytoprotective impact. The study hopes to determine if ginger, a medicinal herb, might reduce inflammation and weight. This study used 45 male Wistar rats. Three 15-rat groups—Control, Ginger, and Aspirin—were created. Five (5) rats in each group were utilized to assess mucus, ulcer scores, and pepsin secretion from the 15 rats in each group. Three animal groups received food and water daily. For four weeks, ginger group mice received 150 mg/kg aqueous ginger extract, while aspirin group animals received 150 mg/kg aspirin. At the end of the trial, ginger group animals had considerably lower mucus secretion than the control and aspirin groups. At 0.05 significance difference, the ginger group's pepsin secretion was significantly higher than the control and aspirin groups, although the ulcer score was significantly higher in the aspirin group. Ginger and aspirin groups had lower body weight changes than the control group at 0.05 significant differences. Ginger may treat inflammatory diseases, according to ulcer scores, and decrease weight gain.

Synthesis and characterization of biodegradable gum ghatti-cl-poly(AA-co-NIPAm)/GO based hydrogel for metformin and sodium diclofenac combined drug delivery system

In the current study, we investigated whether combining metformin with diclofenac, a non-steroidal anti-inflammatory medicine (NSAID), would be effective in examining the complex formation and analyzing the types and intensities of complexes that may occur from interactions between metformin and diclofenac. At varied pH levels and at body temperature, the interaction of metformin with diclofenac was examined in-vitro. FTIR spectra, FE-SEM analysis, DSC analysis, DLS analysis, and drug loading studies were used to characterize the structure, morphology, thermal analysis, and average size values of the generated hydrogel. Hydrogel was loaded with metformin hydrochloride and sodium diclofenac (DS) as a model drug, and the drugs were released in a pH-dependent manner. The zero-order, and first-order kinetic models, the Korsemeyar-Peppas model, the Higuchi model, and the Hixson-Crowell model have all been used to study the drug release kinetics and mechanism. Studies on drug release showed noteworthy behaviors in relation to physiologically modeled pH’s, with a high release rate at pH = 7.4. However, both metformin and sodium diclofenac medication showed a Fickian mechanism at pH 7.4. Combination therapy may lower the single agent's effective dosage and inhibit metabolic rescue mechanisms. To identify potential adverse effects on people, more research is required.

During Resistance Training the Effect of Ibuprofen on Muscle Hypertrophy Regarding Strength and Soreness. A Population Based Cross-Sectional Study

Background: Non-steroidal anti-inflammatory medicines (NSAIDs) are frequently used to speed up post-exercise recovery and lessen discomfort and soreness in muscles. There is a concept that Ibuprofen at high doses has been found to prevent the production of muscle proteins following a session of resistance training. Aims and Objectives: To examine the effects of 400 mg/ day dose of ibuprofen on muscular hypertrophy and strength following resistance exercise. Study Design: This was a population based cross-sectional study. Place and Duration: Present study was conducted in different work out gyms of Lahore region from October 2022 to April 2023. Research Rationale: The combined findings of in vitro and human studies indicate that NSAIDs may blunt the early skeletal muscle responses to exercise. Their widespread use is due to their effectiveness in reducing inflammation, fever, and discomfort. Methodology: Total 100 participants were in this study and all of them provided written informed consent and completed questionnaires about their past training experiences. 70 males and 30 females 20-30 years of age trained their right and left biceps on alternate days 6 sets of 4–10 repetitions, 5 days in week–1, for 8 weeks. All subjects before selection for study completed medical examination blood analysis and health history questionnaires. All participants were received, 400 mg/day of ibuprofen after training their left or right arm. Before and after training muscle thickness of both biceps was measured using ultrasound, and 1 repetition maximum (1 RM) arm curl strength was assessed on both arms. The weights of the dumbbells were chosen so that the required number of repetitions would result in training till failure on each individual set.

A Review on Gastroprotective Mechanisms and their Augmentation by External Agents

Abstract: The oral route is the most typical way to provide medication due to its benefits, including non-invasiveness, patient compliance, and ease of medication delivery. One of the most often recommended pharmacological groups for the treatment of pain and inflammatory disease is non-steroidal anti-inflammatory medicines. However, the major side effect of non-steroidal anti-inflammatory medicines is PUD (peptic ulcer disease). An imbalance in the action of gastroprotective and aggressive agents causes gastric ulcers. Gastroprotective mechanisms include the mucus layer, mucosal repair capacity, gastric epithelium, and gastric blood flow. The purpose of this review is to provide an update on gastroprotective mechanisms. As discussed, mucin acts as a filter, and gastric epithelial defenses include the cell barrier, stem cells, and a sensor on the mucosal surface.

A Review on Traditional Anti-ulcer Medicinal Plants

Abstract: Traditional remedies have been used for generations to treat and maintain people's health and indigenous medicinal plants are an important part of this system, which, unlike western medicine, provides cures for practically all illnesses with no side effects. Such an ulcer is a chronic ailment that affects most of the world's population and has no absolute cure. An ulcer is the erosion of mucous lining in the gastrointestinal tract due to over secretion of HCl in the stomach, leading to inflammation and soreness. Consumption of highly spicy meals, an obese lifestyle, an unplanned diet, the use of excessive non-steroidal anti-inflammatory medicines, smoking, stress, an irregular sleep cycle, and regular alcohol consumption are all possible causes of ulcers. Ayurvedic and traditional medicine practitioners employ a variety of indigenous medicinal plants to cure ulcers. This review covers a wide variety of medicinal plants that may work as anti-ulcer and deserves more investigation.

Review of De Quervain's tendinopathy

The tendons of the long thumb abductor (APL) and short thumb extensor (EPB), which travel through a fibroosseous tunnel in the styloid process of the radius, are afflicted by De Quervain's tendinopathy. This condition causes the tendons and the tunnel (or sheath) through which they pass to thicken non-inflammatorily. Individuals with this illness report radial side wrist discomfort that gets worse when the wrist and thumb are moved. The radial side of the wrist often has some swelling and discomfort. The physical examination findings, such as sensitivity and enlargement of the radial styloid in the first dorsal compartment and radial styloid pain with active or passive stretching of the thumb tendons over the radial styloids at thumb flexion, are used to make the diagnosis of de Quervain's tendinopathy (Finkelstein manoeuvre or test). The differential diagnosis includes calcified arthritis or tenosynovitis, intersection syndrome, ganglia, radial sensory nerve entrapment in the forearm, and osteoarthritis of the trapeziometacarpal joint (TMC). De Quervain's tendinopathy typically responds well to self-limiting therapies that alleviate symptoms. The patient's unique values and preferences have a significant role in the therapeutic decision. Nonsteroidal anti-inflammatory medicines (NSAIDs) for pain management, a forearm-based thumb splint, glucocorticoid injections, and surgery are all possible treatments. A forearm-based thumb splint with a free interphalangeal joint and a simultaneous NSAID pain reduction test are advised for individuals with de Quervain's tendinopathy. Patients with chronic pain and edema despite non-surgical therapy with splints and NSAIDs are advised to have glucocorticoid injections. Those who continue to experience symptoms despite nonsurgical treatment and glucocorticoid injection are typically the only ones who need surgery. De Quervain's tendinopathy is benign and self-limiting, therefore most patients are aware of this.

Synthesis, Characterization and Preliminary Antimicrobial and Antiinfl ammatory Evaluation of New Ibuprofen Hydrazide Derivatives

Non-steroidal anti-infl ammatory medicines (NSAIDs) are medicines that are distributed widely across the world due to their ability to reduce pain and infl ammation. In order to boost the drug’s effi cacy and reduce its harmful side eff ect like GIT ulcers and bleeding, a newly synthesized series of 25-(1-(4-isobutylphenyl) ethyl)-1,3,4-oxadiazole-2-thiol derivatives compounds (C, C 1-3) were prepared from the reaction of ibuprofen hydrazide with carbon disulfi de followed by reaction with various Aryl/ alkyl halide. All target compounds were tested for antimicrobial effi cacy against various strains of bacteria (G+ve, S. pyrogenes and S. aureus) and (G-ve, E. coli and 1Klebsiella pneumoniae). Additionally, fungus species (Candida albicans). Compound C showed good antimicrobial activity for both bacterial strains. At the same time, Compound C1 have the best ant-bacterial activity compared with other synthesized compounds for1 both (G+ve), and (G-ve) bacteria, and compound C3 was the most aff ected one as antifungal. The compound C2 was with lowest antimicrobial activity. All of the produced compounds were examined for their anti-infl ammatory activity using (egg-white generate edema) and the compounds (C, C1, C3) showed good effi cacy when compared to ibuprofen (stander) FTIR and 1H-NMR spectroscopy were used to analyze all of the fi nal products.

An Analytical Study of NSAIDs Affecting Heart Functions

Local production of vasodilating prostaglandins is necessary to sustain renal perfusion in a number of clinical situations, such as congestive heart failure, cirrhosis, and renal insufficiency. Inhibition of these prostaglandins permits unopposed vasoconstriction to occur when patients with these illnesses are given nonsteroidal anti-inflammatory medicines (NSAIDs), putting them at risk for an acute ischemic insult to the kidney. Acute kidney injury (AKI) and chronic kidney disease are only two of the many nephrological problems that can result from using NSAIDs (CKD). Nonsteroidal anti-inflammatory medicines (NSAIDs) have been shown to increase blood pressure and to antagonize the blood pressure-lowering action of antihypertensive therapy, both of which have the potential to enhance hypertension-related morbidity. Diclofenac was the drug that caused the most noticeable decrease in COX-2 activity, increase in blood pressure, and decrease in heart rate. In a complicated way, non-aspirin, non-steroidal anti- inflammatory medicines (NANSAIDs) can either protect against or contribute to the development of coronary heart disease. The cardiovascular effects of all the medicines studied were unclear, although Naproxen looked the safest. When compared to lumiracoxib, the findings show that ibuprofen may increase the incidence of thrombotic and CHF events in aspirin users with high cardiovascular risk. Before giving a non-steroidal anti-inflammatory medicine, doctors should evaluate the patient for cardiovascular risk.

Effects of Diclofenac Sodium on Seizure Activity in Rats with Pentylenetetrazole-Induced Convulsions.

Epilepsy is a disease which affects between 1 and 2% of the population, and a large proportion of these people do not react to currently available anticonvulsant medications, indicating the need for further research into novel pharmacological therapies. Numerous studies have demonstrated that oxidative stress and inflammation occur during epilepsy and may contribute to its development and progression, indicating higher levels of oxidative and inflammatory parameters in experimental models and clinical patients. This research aimed to assess the impact of diclofenac sodium, a nonsteroidal anti-inflammatory medicine, on seizure and levels of oxidative stress and inflammatory biomarkers in a rat model of epilepsy triggered by pentylenetetrazole (PTZ). 60 rats were randomly allocated to one of two groups: electroencephalography (EEG) recordings or behavioral evaluation. Rats received diclofenac sodium at three various doses (25, 50, and 75mg/kg) intraperitoneally (IP) or a placebo, followed by intraperitoneal (IP) pentylenetetrazole, a powerful seizure-inducing medication. To investigate if diclofenac sodium had antiseizure properties, seizure activity in rats was evaluated using EEG recordings, the Racine convulsion scale (RCS) behaviour score, the duration of the first myoclonic jerk (FMJ), and the levels of MDA, TNF-α, and SOD. The average percentage of EEG spike waves decreased from 76.8% (placebo) to 64.1% (25mg/kg diclofenac), 55.9% (50mg/kg diclofenac), and 37.8% (75mg/kg diclofenac). FMJ had increased from a mean of 58.8s (placebo), to 93.6s (25mg/kg diclofenac), 185.8s (50mg/kg diclofenac) and 231.7s (75mg/kg diclofenac). RCS scores decreased from a mean score of 5.6 (placebo), to 3.75 (25mg/kg diclofenac), 2.8 (50mg/kg diclofenac) and 1.75 (75mg/kg diclofenac). MDA levels reduced from 14.2ng/gr (placebo) to 9.6ng/gr (25mg/kg diclofenac), 8.4ng/gr (50mg/kg diclofenac) and 5.1ng/gr (75mg/kg diclofenac). Likely, TNF-α levels decreased from 67.9ng/gr (placebo) to 48.1ng/gr (25mg/kg diclofenac), 33.5ng/gr (50mg/kg diclofenac) and 21.3ng/gr (75mg/kg diclofenac). SOD levels, however, enhanced from 0.048U/mg (placebo) to 0.055U/mg (25mg/kg diclofenac), 0.14U/mg (50mg/kg diclofenac), and 0.18U/mg (75mg/kg diclofenac). Diclofenac sodium (25, 50, and 75mg/kg i.p.) effectively lowered the spike percentages and RCS scores linked with PTZ-induced epilepsy in rats, as well as significantly decreased MDA, TNF-α, IL-1β, PGE2 and increased SOD levels. Probably as a result of its anti-oxidative and anti-inflammatory effects, diclofenac sodium dramatically lowered seizure activity at both doses compared to placebo control. Each of these results were significant, with p-values of < 0.01, < 0.05. Therefore, the therapeutic application diclofenac sodium as a potential anticonvulsant should be investigated further.

Cardiac tamponade in a male as an initial presentation of SLE. An interesting case report

A relapsing and remitting illness that may affect any organ system, systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition. Autoantibodies and immune complex development are its defining features. The heart is one of the organs that it might impact. In patients with SLE, the immune system’s response to dying cells is aberrant. The diagnosis of SLE is made on the basis of distinctive clinical findings in the skin, joints, kidneys, and central nervous system, as well as serological indicators like antinuclear antibodies (ANA), specifically antibodies to dsDNA. Nonsteroidal anti-inflammatory medicines (NSAIDs), corticosteroids, immunosuppressive medications, and biological agents may be used to treat lupus, depending on the symptoms, findings of blood tests, and the specific organs affected. Here we are reporting a rare case of a male with pericardial tamponade as a first symptom of SLE.