Oral Administration Of Sucrose Research Articles

Neokestose suppresses the increase in plasma glucose caused by oral administration of sucrose in a streptozotocin‑induced diabetic rat

Neokestose is considered to have a prebiotic function. However, the physiological activity of neokestose remains unknown. Neokestose has a blastose, a sucrose analog, in its structure. We previously demonstrated that oral administration of blastose to diabetic rats suppressed the increase in plasma glucose (PG) concentration after sucrose administration. Therefore, neokestose might have a similar effect. In this study, we investigated the effects of neokestose on PG concentrations and the mechanism of its action. We first administered neokestose orally to streptozotocin-induced diabetic rats and observed that the expected consequent increase in PG concentration was significantly suppressed. Next, we examined the inhibitory effect of neokestose on glycosidase activity, but observed only a slight inhibitory effect. Therefore, we hypothesized that neokestose might be hydrolyzed by gastric acid to produce blastose. We performed an acid hydrolysis of neokestose using artificial gastric juice. After acid hydrolysis, peaks corresponding to neokestose and its decomposition products including blastose were observed. Therefore, we suggest that neokestose and blastose, a decomposition product, synergistically inhibit glycosidase activity. These findings support the potential use of neokestose as a useful functional oligosaccharide that can help manage plasma glucose concentrations in patients with diabetes mellitus.

Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial.

Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Protective Effects of the Leaf Aqueous Extract of Manihot Esculenta Crantz Against High-Calorie Diet Combined with Alcohol and Sucrose Ingestion Induced Hypertension in Rats

Manihot esculenta commonly known as cassava is widely distributed across the world. In sub-Saharan Africa, its leaves and tubers are commonly eaten by local populations, who often lend this plant the properties of a traditional medicine. The present study was aimed to evaluate the protective effects of the leaf aqueous extract of Manihot esculenta Crantz against high-calorie diet combined with alcohol and sucrose ingestion induced hypertension in rats. Male wistar rats were randomly divided into three groups of six rats each. Antihypertension activity was evaluated by daily oral administration of Manihot esculenta aqueous extract at the dose of 200 mg/kg bw to rats exposed to high fat/high sucrose diet and daily oral ingestion of sucrose (15%, 5 mL/kg) and ethanol (40°, 5 mL/kg). At the same time, the group 2 or positive control group received high fat/high sucrose diet and daily oral ingestion of sucrose (15%, 5 mL/kg) and ethanol (40°, 5 mL/kg). The last group received standard diet and distilled water (5 mL/kg, orally). During the experimental period (8 weeks), the body weight of animals was daily recorded while the glycaemia was measured every two weeks. The hemodynamic (blood pressure and heart beat) and some serum markers of lipid profile (Triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol), endothelial (NO) and liver functions (AST and ALT) as well as oxidative stress parameters (SOD, CAT, GSH, MDA and TBARS) in the serum and aorta were measured at the end of the study. Our results indicated that Manihot esculenta aqueous extract significantly reduced the body weight gain, diastolic blood pressure, aorta diameter, glycaemia, of animals submitted to both oral administration of sucrose, ethanol and high fat fat/high sucrose diet, and plant extract. Moreover, the administration of Manihot esculenta extract improved the vasodilatation by increasing the endothelial NO secretion. Furthermore, the treatment with this extract improved the balance of the oxidative stress markers and the level of triglyceride, cholesterol and transaminases. Thereby, these results suggest that the leaf aqueous extract of Manihot esculenta could have protective effects against hypertension induced by high-calorie diet combined with alcohol and sucrose ingestion in rats.

Sucrose solution for alleviating needle pain during inferior alveolar nerve block in children aged 7-10 years: a randomized clinical trial.

Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

Evaluation of the Analgesic Effect of Oral Sucrose Solution on Neonates Undergoing a Minor Painful Procedure

Background: Pacifying newborns by nonpharmacological methods during painful procedures is a frequent and difficult problem in routine practice. Purpose: The purpose of the study was to determine the analgesic effects of oral sucrose solution in comparison to placebo (sterile water) in neonates. Materials and Methods: A prospective, double-blinded study of 100 neonates who were divided into two groups after simple randomization, to give either 30% sucrose solution (group A) or sterile water (group B) during an intravenous catheterization. Assessment of pain by the Douleur Aigue Nouveau-ne scale (DAN) and changes in the heart rate (HR), respiratory rate (RR), or arterial oxygen saturation (SpO2) during peripheral vein catheterization were analyzed. Results: The mean change of HR, RR, and SpO2 was more in group B compared to group A. The mean DAN scores were 2.24 ± 2.026 and 6.92 ± 2.538 in group A and group B, respectively. None of these results were statistically significant (P &gt; 0.05). Conclusion: There was a less prominent change in HR, RR, and SpO2 with response to noxious stimuli with oral sucrose administration in newborns when compared to placebo.

Effects of Erythrina senegalensis (Fabaceae) Stem Bark Aqueous Extract in Cardiovascular Complications on Hypertensive Diabetic Rat

Background and Aim: Cardiovascular complications are the main cause of morbidity and mortality in hypertensive diabetic patients. They develop due to microvasculopathy, myocardial hypertrophy and cardiac fibrosis. In the present study, the activity of aqueous extract of Erythrina senegalensis on cardiovascular complications in diabetic hypertensive rats was evaluated.&#x0D; Experimental Procedure: The model of hypertensive diabetic rats was obtained by daily oral administration of sucrose (15%) and 40° ethanol at doses of 1.5 and 5 g/kg respectively for six weeks, followed by an intravenous injection of streptozotocin (35 mg/kg). After four weeks of complications, the diabetic hypertensive rats were divided into six groups of 5 animals each, and received the different treatments for four weeks where blood glucose level was taken weekly. At the end of the treatments, the animals were anaesthetised and the arterial pressures and electrocardiograph were recorded by the direct method. Then the aorta and heart were removed for biochemical calorimetric analysis and histological evaluation.&#x0D; Results and Conclusion: In the diabetic hypertensive animals the results showed chronic hyperglycaemia associated with high blood pressure. On the electrocardiogram there was a cardiac arrhythmia manifested by a significant decrease in the duration of the PR, QRS, RR, QTc segments, ST interval, P, QRS and T waves, a decrease in the amplitude of the QRS and T waves. There was a significant increase in total cholesterol, triglyceride atherogenic index and a decrease in HDL-cholesterol with a change in the cardiac ionogram and oxidative status in the aorta and heart. The different treatments improved these parameters and cardiovascular function. These results suggest that the extract of E. senegalensis by the presence of several bioactive compounds would possess cardioprotective, hypoglycaemic, hypotensive and antioxidant properties.

Oral sucrose solution as a pre-immunization analgesic

Introduction: Painful procedures without adequate analgesia cause pain and suffering. The administration of oral sucrose is the most frequently studied behavioural and environmental intervention for the relief of procedural pain in newborn. Breast feeding is also an intervention studied frequently. Material and methods: The present study was a randomized controlled study conducted to assess and compare the analgesic effect of orally administered sucrose with that of breast feeding and controls during immunization in healthy infants using a validated behavioural acute pain rating scale. Approval was taken from institutional ethics committee prior to commencement of the study. 100 infants who met the inclusion criteria were included as study participants. They were randomly allocated into three groups, A (sucrose) and B (breast feeding) and C (control) [no intervention] of 33 to 34 infants each. Infants in group A (sucrose) receiving Inj Pentavac were given 2.0 ml of 24% oral sucrose 2 mins prior to vaccination and the infants behavior before and after the injection was observed and scored on FLACC Pain rating scale. Infants in group B (breast feeding) were breast fed 10 minutes prior to receiving vaccination and were also observed and scored on FLACC Pain rating scale.

Antihypertensive and antidiabetic activities of Erythrina senegalensis DC (Fabaceae) stem bark aqueous extract on diabetic hypertensive rats

Erythrina senegalensis is traditionally used in Cameroon for its relaxing and hypoglycemic properties in the treatment of cardiovascular diseases and diabetes. High blood pressure and diabetes mellitus are frequently linked. These pathologies represent major risk factors for cardiovascular and renal diseases. The present study was designed to evaluate the antidiabetic and antihypertensive activity of the stem bark of Erythrina senegalensis aqueous extract in male hypertensive diabetic rats (HDR). Hypertension and diabetes were induced by oral administration of sucrose (15%) and ethanol (40°) at doses of 1.5g/kg and 5g/kg respectively for 30 days, followed by an intravenous injection of streptozotocin (STZ; 40mg/kg). A control group of 5 rats received distilled water (10mL/kg) followed by intravenous injection of 0.9% NaCl (1 mL/100g). HDR were divided into 4 groups of 5 rats each according to their blood glucose level and continued to receive ethanol in association with: distilled water (10mL/kg); group I, metformin (200mg/kg)+nifedipine (10mg/kg); group II, plant extract (100 and 200mg/kg) group IV and V, respectively for 28 days. At the end of the treatment, hemodynamic parameters were recorded by the direct method. Animals were sacrificed; blood and organs (aorta, heart, liver, and kidneys) were collected for biochemical and histological analysis. Phytochemistry and HPLC-DAD-HRESI-MS were used to determine the major compounds of the extract. The administration of sucrose, alcohol, and STZ resulted in a significant increase in blood glucose, hemodynamic parameters, and body weight loss. A significant decrease in pancreatic islets size, nitrite, GSH, SOD and catalase activity was observed in HDR. There was also a significant increase in serum triglycerides, total cholesterol, creatinine, bilirubin, and transaminases activity in HDR. The aqueous extract of E. senegalensis, as well as the metformin+nifedipine combination, significantly improved all these parameters. HPLC coupled to both diode array and mass spectrometry detectors revealed the presence of 15 compounds and 11 of them were identified. These results suggest that the aqueous extract of E. senegalensis possess antihypertensive, hypoglycemic, hypolipidemic, cardiomodulator and antioxidant properties involved in the improvement of the metabolic disorders found in HDR. This may be due at least in part to the presence of Erysenegalensein (D, O, N, E), Warangalone, senegalensin and 6,8-diprenylgenistein identified in the extract.

Neonatal painful stimuli: skin conductance algesimeter index to measure efficacy 24% of sucrose oral solution

Pain management is one of the main challenges in addressing the improved care of hospitalized newborns. The administration of oral sucrose with and without non-nutritive suction has been proposed as a nonpharmacological intervention to relieve procedural pain in newborns. The effects have not yet been well characterized. The aim of this study is to investigate, using skin conductance algesimeter (SCA) pain monitor index, the effects of 24% sucrose solution on pain perception during capillary and arterial blood sampling. It is a prospective, randomized controlled study: sucrose versus placebo. Sucrose was given orally to infants who were submitted to arterial or capillary sampling. The SCA was measured during, and for 3 min before and after the intervention. Fifty-six infants were enrolled: 31 in the sucrose group and 25 in the placebo group. SCA showed that the measurement of peaks per second of pain during and 3 min after the procedures was lower in the sucrose group than the placebo group and that this difference was statistically significant (p < .05). In conclusion, 24% sucrose administered orally is effective in reducing pain during and after capillary and arterial sampling in newborns and can be used for the prevention and treatment of pain in the Neonatal Intensive Care Unit.Brief rationaleTo treat neonatal pain, a tiered approach with nonpharmacological and pharmacological method can be used.Among nonpharmacological therapies, sucrose administration is safe and effective in reducing single episodes of minor procedural pain. This study aimed to investigate, the effects of 24% sucrose solution on pain perception during capillary and arterial blood withdrawn by using an objective method: skin conductance algesimeter (SCA) pain monitor index.This randomized controlled trial in which term and/or preterm neonates (postnatal age maximum of 28 days corrected for postmenstrual age) received sucrose for procedural pain. Oral sucrose was administered directly by a disposable plastic vial. SCA was measured by means of a specific device.We demonstrated, using SCA pain monitor index, the efficacy of 24% sucrose solution on pain perception during capillary and arterial blood withdrawn. The results of this study provide an objective evidence of sucrose efficacy for the prevention and treatment of neonatal painful procedures.

THE EFFECTIVENESS OF ORAL SUCROSE IN MANAGING INFANTS' PAIN DURING IMMUNIZATION

Treating pain during vaccination should be a part of pediatric primary health care around the world, as untreated pain in children has short and long-term consequences. Few studies of pharmacologic and non-pharmacologic methods of pain relief during immunization have been conducted in low-and-middle-income countries. Finding a cheap and effective pain intervention would improve primary health care. The current study aimed to evaluate the effectiveness of oral sucrose as a method of pain management during immunization among infants through six months of age. A randomized controlled experimental design was used. The study sample included 80 infants distributed into sucrose and control groups. Data were collected in an Egyptian primary health center. Outcome measures, including pain, as measured by the FLACC pain scale, crying time, and heart rate, were measured at three time points (before, during, and after injection). There were statistically significant differences during and after immunization (p < .001) reflecting lower: scores of pain, crying duration, and rising in heart rate for the sucrose group compared to the control group. The study supports the effectiveness of oral sucrose in managing infants' immunization pain and recommends for providing clinical setting with safe resources and education for proper administration of oral sucrose in pain management.

THE EFFECTIVENESS OF ORAL SUCROSE IN MANAGING INFANTS' PAIN DURING IMMUNIZATION

Treating pain during vaccination should be a part of pediatric primary health care around the world, as untreated pain in children has short and long-term consequences. Few studies of pharmacologic and non-pharmacologic methods of pain relief during immunization have been conducted in low-and-middle-income countries. Finding a cheap and effective pain intervention would improve primary health care. The current study aimed to evaluate the effectiveness of oral sucrose as a method of pain management during immunization among infants through six months of age. A randomized controlled experimental design was used. The study sample included 80 infants distributed into sucrose and control groups. Data were collected in an Egyptian primary health center. Outcome measures, including pain, as measured by the FLACC pain scale, crying time, and heart rate, were measured at three time points (before, during, and after injection). There were statistically significant differences during and after immunization (p < .001) reflecting lower: scores of pain, crying duration, and rising in heart rate for the sucrose group compared to the control group. The study supports the effectiveness of oral sucrose in managing infants' immunization pain and recommends for providing clinical setting with safe resources and education for proper administration of oral sucrose in pain management.

Effect of Nonpharmacologic Pain Control During Examination for Retinopathy of Prematurity

ObjectivesTo examine the effects of infant swaddling with oral administration of sucrose, swaddling with oral administration of breast milk, and swaddling with oral administration of distilled water (control) on pain perception in premature infants during a screening examination for retinopathy of prematurity (ROP). DesignA prospective, randomized controlled design was used. SettingThe research was conducted in the NICU of a Level III university hospital in Istanbul. ParticipantsData were obtained from 87 premature infants (54% female) who were less than 32 weeks gestation and 1500 g body weight. MethodsThe nonpharmacologic methods of swaddling with orally administered 0.2 ml of 24% sucrose, swaddling with orally administered breast milk, and swaddling with orally administered distilled water were implemented immediately before the ROP examination. The Premature Infant Pain Profile was used to evaluate pain. Means, standard deviations, and repeated-measures analysis of variance and one-way analysis of variance tests were used to evaluate pain score data. ResultsFor 72.4% of the infants, the experimental session was the first time they were examined for ROP. No significant differences in Premature Infant Pain Profile scores were found across the three groups. ConclusionInfant swaddlings with oral administration of sucrose or breast milk were no more effective than swaddling with oral administration of distilled water to reduce pain in premature infants during ROP examinations.

Effect of Expressed Breast Milk versus Swaddling versus Oral Sucrose Administration on Pain Associated with Suctioning in Preterm Neonates on Assisted Ventilation: A Randomized Controlled Trial.

Objective:The objective of our study was to assess the pain associated with suctioning in preterm neonates on assisted ventilation and comparing the use of expressed breast milk (EBM), sucrose, and swaddling to alleviate pain.Methods:Study design: A randomized controlled clinical trial.Inclusion Criteria:Preterm neonates on assisted ventilation.Exclusion Criteria:Major congenital anomalies and severe encephalopathy.Study Duration and Site:6 months in level III neonatal Intensive Care Unit. In the first phase, we used premature infant pain profile (PIPP) score to assess pain associated with suctioning in preterm neonates on assisted ventilation. In the second phase, the effect of EBM, swaddling, and sucrose on pain relief during suctioning in neonates on assisted ventilation was assessed.Results:There was a significant increase in pain associated with suctioning in preterm neonates on assisted ventilation (preprocedure PIPP score 7.90 ± 2.50; procedural PIPP score 13.63 ± 2.57; P < 0.05). The postintervention mean procedural PIPP score was not significantly different between the EBM, swaddling, and sucrose groups (P = 0.24).Conclusions:Suctioning is painful for preterm neonates on assisted ventilation. There was no difference between EBM, swaddling, and sucrose in relieving pain associated with suctioning.

Impact of acute metabolic acidosis on the acid-base balance in follicular fluid and blood in dairy cattle

Acid-base balance is one of the most vigorously regulated variables of the body, including genital organs. Subacute ruminal acidosis is a common disturbance in dairy cows that disturbs several biochemical indices in the blood, cerebrospinal fluid, and urine. The possible negative effects of metabolic acidosis on the follicular fluid (FF) composition and, subsequently, on oocyte quality, are not fully elucidated. This study aimed to evaluate the changes in acid-base balance (ABB) in FF and blood during acute metabolic acidosis in dairy heifers. Ten Holstein heifers were stimulated with FSH in eight decreasing doses at 12-hour intervals (D0–D3). Acidosis was induced by oral administration of sucrose at 9 g/kg of body weight, dissolved in 10 L of warm tap water, at D3. Samples were collected from each cow at 0, 8, 12, 16, 24, 32, 40, and 48 hours after treatment. Samples of FF, obtained by transvaginal follicular aspiration, and peripheral blood were examined for ABB parameters: pH, pCO2, pO2, HCO3−, and base excess (BE). A significant decrease in pH, HCO3−, and BE values in the blood, as well as FF, occurred after sucrose treatment. The lowest pH values occurred in blood at 16 hours, and in FF at 24 hours, after treatment (7.30 ± 0.05 and 7.33 ± 0.05, respectively). The lowest HCO3− values in blood (18.75 ± 3.2 mmol/L) and FF (18.07 ± 2.84 mmol/L) occurred 24 hours after treatment, as did the lowest BE values (−6.61 ± 3.7 mmol/L and −7.53 ± 3.89 mmol/L, in blood and FF, respectively). Significant correlations for HCO3− (r = 0.928), BE (r = 0.946), pH (r = 0.889), and pCO2 (r = 0.522) existed between blood and FF samples. The results demonstrated that metabolic acute acidosis substantially influences the characteristics of both serum and FF.

Sucrose for analgesia in newborn infants undergoing painful procedures.

Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. To determine the efficacy, effect of dose, method of administration and safety of sucrose for relieving procedural pain in neonates as assessed by validated composite pain scores, physiological pain indicators (heart rate, respiratory rate, saturation of peripheral oxygen in the blood, transcutaneous oxygen and carbon dioxide (gas exchange measured across the skin - TcpO2, TcpCO2), near infrared spectroscopy (NIRS), electroencephalogram (EEG), or behavioural pain indicators (cry duration, proportion of time crying, proportion of time facial actions (e.g. grimace) are present), or a combination of these and long-term neurodevelopmental outcomes. We used the standard methods of the Cochrane Neonatal. We performed electronic and manual literature searches in February 2016 for published randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, Issue 1, 2016), MEDLINE (1950 to 2016), EMBASE (1980 to 2016), and CINAHL (1982 to 2016). We did not impose language restrictions. RCTs in which term or preterm neonates (postnatal age maximum of 28 days after reaching 40 weeks' postmenstrual age), or both, received sucrose for procedural pain. Control interventions included no treatment, water, glucose, breast milk, breastfeeding, local anaesthetic, pacifier, positioning/containing or acupuncture. Our main outcome measures were composite pain scores (including a combination of behavioural, physiological and contextual indicators). Secondary outcomes included separate physiological and behavioural pain indicators. We reported a mean difference (MD) or weighted MD (WMD) with 95% confidence intervals (CI) using the fixed-effect model for continuous outcome measures. For categorical data we used risk ratio (RR) and risk difference. We assessed heterogeneity by the I(2) test. We assessed the risk of bias of included trials using the Cochrane 'Risk of bias' tool, and assessed the quality of the evidence using the GRADE system. Seventy-four studies enrolling 7049 infants were included.Results from only a few studies could be combined in meta-analyses and for most analyses the GRADE assessments indicated low- or moderate-quality evidence. There was high-quality evidence for the beneficial effect of sucrose (24%) with non-nutritive sucking (pacifier dipped in sucrose) or 0.5 mL of sucrose orally in preterm and term infants: Premature Infant Pain Profile (PIPP) 30 s after heel lance WMD -1.70 (95% CI -2.13 to -1.26; I(2) = 0% (no heterogeneity); 3 studies, n = 278); PIPP 60 s after heel lance WMD -2.14 (95% CI -3.34 to -0.94; I(2) = 0% (no heterogeneity; 2 studies, n = 164). There was high-quality evidence for the use of 2 mL 24% sucrose prior to venipuncture: PIPP during venipuncture WMD -2.79 (95% CI -3.76 to -1.83; I(2) = 0% (no heterogeneity; 2 groups in 1 study, n = 213); and intramuscular injections: PIPP during intramuscular injection WMD -1.05 (95% CI -1.98 to -0.12; I(2) = 0% (2 groups in 1 study, n = 232). Evidence from studies that could not be included in RevMan-analyses supported these findings. Reported adverse effects were minor and similar in the sucrose and control groups. Sucrose is not effective in reducing pain from circumcision. The effectiveness of sucrose for reducing pain/stress from other interventions such as arterial puncture, subcutaneous injection, insertion of nasogastric or orogastric tubes, bladder catherization, eye examinations and echocardiography examinations are inconclusive. Most trials indicated some benefit of sucrose use but that the evidence for other painful procedures is of lower quality as it is based on few studies of small sample sizes. The effects of sucrose on long-term neurodevelopmental outcomes are unknown. Sucrose is effective for reducing procedural pain from single events such as heel lance, venipuncture and intramuscular injection in both preterm and term infants. No serious side effects or harms have been documented with this intervention. We could not identify an optimal dose due to inconsistency in effective sucrose dosage among studies. Further investigation of repeated administration of sucrose in neonates is needed. There is some moderate-quality evidence that sucrose in combination with other non-pharmacological interventions such as non-nutritive sucking is more effective than sucrose alone, but more research of this and sucrose in combination with pharmacological interventions is needed. Sucrose use in extremely preterm, unstable, ventilated (or a combination of these) neonates needs to be addressed. Additional research is needed to determine theminimally effective dose of sucrose duringa single painful procedure and the effect of repeated sucrose administration on immediate (pain intensity) and long-term (neurodevelopmental) outcomes.

In vitro and in vivo reduction of post-prandial blood glucose levels by ethyl alcohol and water Zingiber mioga extracts through the inhibition of carbohydrate hydrolyzing enzymes.

BackgroundType 2 diabetes is a serious problem for developed and developing countries. Prevention of prediabetes progression to type 2 diabetes with the use of natural products appears to be a cost-effective solution. Zingiber mioga has been used as a traditional food in Asia. Recent research has reported the potential health benefits of Zingiber mioga, but the blood glucose reducing effect has not been yet evaluated.MethodsIn this study Zingiber mioga extracts (water and ethanol) were investigated for their anti-hyperglycemic and antioxidant potential using both in vitro and animal models. The in vitro study evaluated the total phenolic content, the oxygen radical absorbance capacity (ORAC) and the inhibitory effect against carbohydrate hydrolyzing enzymes (porcine pancreatic α-amylase and rat intestinal sucrase and maltase) of both Zingiber mioga extracts. Also, the extracts were evaluated for their in vivo post-prandial blood glucose reducing effect using SD rat and db/db mice models.ResultsOur findings suggest that the ethanol extract of Zingiber mioga (ZME) exhibited the higher sucrase and maltase inhibitory activity (IC50, 3.50 and 3.13 mg/mL) and moderate α-amylase inhibitory activity (IC50, >10 mg/mL). Additionally, ZME exhibited potent peroxyl radical scavenging linked antioxidant activity (0.53/TE 1 μM). The in vivo study using SD rat and db/db mice models also showed that ZME reduces postprandial increases of blood glucose level after an oral administration of sucrose by possibly acting as an intestinal α-glucosidase inhibitor (ZME 0.1 g/kg 55.61 ± 13.24 mg/dL)ConclusionThe results indicate that Zingiber mioga extracts exhibited significant in vitro α-glucosidase inhibition and antioxidant activity. Additionally, the tested extracts demonstrated in vivo anti-hyperglycemic effects using SD rat and db/db mice models. Our findings provide a strong rationale for the further evaluation of Zingiber mioga for the potential to contribute as a useful dietary strategy to manage postprandial hyperglycemia.

In Vitro and In Vivo α-Glucosidase and α-Amylase Inhibitory Effects of the Water Extract of Leaves of Pepper (Capcicum Annuum L. Cultivar Dangjo ) and the Active Constituent Luteolin 7-O-Glucoside

This study was conducted to evaluate the in vitro and in vivo hypoglycemic potential of the water extract of pepper (Capcicum annuum L. cultivar Dangjo) leaves (WEPL) and the active constituent luteolin 7-O-glucoside (LG) isolated from WEPL. WEPL showed in vitro α-glucosidase and α-amylase inhibitory activity. LG also showed a similar α-glucosidase and α-amylase inhibitory activity, suggesting that the ability of WEPL to inhibit both enzymes may be due to the presence of LG and other polyphenols in WEPL. Supporting this observation, both WEPL and LG significantly reduced blood glucose levels in streptozocin-induced diabetic mice when challenged with oral administration of sucrose, but not after oral glucose challenge. Hence, inhibition of α-glucosidase and α-amylase may possibly be one of the mechanisms for WEPL and LG to exert hypoglycemic activity, indicating that pepper leaves may be considered as a potential candidate for the management of type 2 diabetes mellitus. Practical Applications Leaves of pepper cultivars, including Dangjo pepper, are commonly consumed as food in Korea. The findings of this study demonstrate that the water extract of pepper leaves exhibits the capacity to inhibit carbohydrate hydrolyzing enzymes (α-glucosidase and α-amylase) in vitro and in vivo and these beneficial effects appear to be due to some specific bioactive compounds in pepper leaves, in particular luteolin 7-O-glucoside. Our preliminary observation provides a rationale for a possible use of pepper leaves for the management of postprandial hyperglycemia.

Randomized placebo-controlled trial of sucrose analgesia on neonatal skin blood flow and pain response during heel lance.

To evaluate the effect of oral sucrose on skin blood flow (SBF; perfusion units; PU) measured by Laser Doppler Imager (LDI) in term newborns and pain response (Neonatal Infant Pain Scale score; NIPS score) during heel lance; (2) determine SBF changes during heel lance; and (3) the relationship between SBF and NIPS. Term infants ≤7 days old (n=56) undergoing routine heel lance were randomized to pretreatment with 2.0 mL oral 24% sucrose (n=29) or sterile water (n=27) in a double-blinded, placebo-controlled trial. SBF was assessed by LDI scans and NIPS scores at 10 minutes before lance, immediately after lancing, and 5 minutes after blood extraction. Mean SBF and median NIPS scores were compared between groups using General Linear Model or Kruskal-Wallis. Regressions examined the relationship between SBF immediately after heel lance and NIPS score. Mean SBF and median NIPS scores immediately after heel lance were lower in sucrose-treated infants (167.9±15.5 vs. 205.4±16.0 PU, P=0.09; NIPS 1 [interquartile range 0 to 4] vs. NIPS 3 [interquartile range 0 to 6], P=0.02), although no significant difference in mean SBF. During heel lance NIPS score was predictive of SBF. An increase of 1 in NIPS score was associated with 11 PU increase in SBF (R=0.21; P=0.09) for sucrose, and 16 PU increase for placebo-treated infants (R=0.20; P=0.014). Increased SBF assessed by LDI is a pain response among term neonates after routine heel lance, which was not completely attenuated by oral sucrose administration. Increased SBF is associated with NIPS scores. Sucrose analgesic efficacy evidenced by decreased NIPS scores for the sucrose group. Association of SBF with NIPS scores suggests that LDI is potentially useful for assessing newborn procedural pain.

Effect of 24% Oral Sucrose in Pain Reduction during Venipuncture in Neonates

Neonates frequently undergo various painful procedures without analgesia and routinely experienced pain in the Neonatal Intensive Care Unit. The issue of pain management among new born has been largely neglected and commonly overlooked in most of the clinical settings can lead to long term adverse consequences and deleterious effect. Administrating sucrose before painful procedure like venipuncture can relief pain in new born. The present study was carried out in (NICU) of IMS and SUM Hospital, Bhubaneswar with the purpose to determine the effect of 24% oral sucrose administration on pain reduction during venipuncture. 30 neonates undergoing venipuncture were selected through purposive sampling. The pain level was assessed by using Neonatal Infant Pain Scale (NIPS) with routine care during venipuncture and then same neonates were administered 24% sucrose solution orally just 2 minutes before undergoing venipuncture second time. A highly significant reduction of pain during venipuncture in experimental group was observed at (p<0.001, t=9.38).

Oral sucrose administration to reduce pain response during immunization in 16-19-month infants: a randomized, placebo-controlled trial.

Although the analgesic effect of sucrose on newborns is well established, little is known about whether these solutions are effective in reducing procedural pain in infants beyond the newborn period. The purpose of this study was to determine the effect of sucrose solution given orally on infant crying times and measure the distress in a 16-19-month age group. A total of 537 healthy, 16-19-month-old infants attending for their immunizations with intramuscular diphtheria, tetanus, and acellular pertussis (DTaP)/Haemophilus influenza type b/IPV (along with oral polio vaccination (OPV)), intramuscular pneumococcus and intramuscular hepatitis A were randomized to receive 2mL of a 75% sucrose solution, a 25% sucrose solution or sterile water 2min before injections. Infants receiving a 75% sucrose solution had significantly reduced total crying times and Children's Hospital of Eastern Ontario Pain Scale scores (CHEOPS) compared with infants in the control and 25% sucrose solution groups (p < 0.001). Sucrose solution reduces infant distress and is safe and clinically useful even for 16-19-month-old infants.