Paracetamol Intake Research Articles

Prevalence of atopic eczema in adolescents from a very low prevalence area (Kosovo): role of wheezing, gender, exercise, and paracetamol

Background: The epidemiology of atopic eczema in adolescents in Kosovo is virtually unknown, and the risk factors for the condition in very low-prevalence areas (as it was the case) are not well studied. The objective of the present study was to better know those factors and whether the presence of comorbid wheezing symptoms modifies the factors. Methods: The cross-sectional survey, Global Asthma Network-validated questionnaire, which includes questions on eczema symptoms and environmental factors (such as smoking, pet ownership, paracetamol usage, truck traffic, siblings, time spent using screens or watching television, and physical exercise), was administered to adolescents in the following main cities of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina, and Prizren. Additionally, height and weight were measured at school. Results: Prevalence of eczema symptoms ranged from 2.2% in Ferizaj to 5.5% in Gjakova. Severe symptoms were <1% in all cities. Eczema ever ranged from 3.0% in Ferizaj to 6.4% in Prizren. Factors significantly associated with the prevalence of current eczema symptoms in the meta-analysis were males (pooled adjusted odds ratio [aOR] 0.50, 95% Confidence Interval [95% CI] 0.37–0.66); physical exercise (pooled aOR 2.79, 95% CI 1.89–4.10); and paracetamol intake (pooled 1.86, 95% CI 1.32–2.64). The corresponding figures for eczema ever were as follows: pooled aOR: 0.68, 95% CI 0.44–1.06; pooled aOR 2.07, 95% CI 1.48–2.90; and pooled aOR 1.19, 95% CI 0.88–1.60. The associations tended to be higher in the subpopulation with eczema and wheezing comorbidity. Conclusions: The prevalence of atopic eczema is very low in Kosovo and is associated with females, physical exercise, and paracetamol intake. These associations are higher when eczema and wheezing are comorbid conditions.

Prenatal determinants of anxiety symptoms in middle childhood. Evidence from Growing Up in New Zealand

BackgroundEarly life environments can have long-lasting impacts on future health and wellbeing. Maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life. Anxiety disorders are one of the most prevalent mental health conditions, affecting approximately 7 % of children and adolescents globally, with a lifetime prevalence of 15–20 %. Identifying prenatal risk factors can support future and current public health interventions and maternity care. MethodsData were obtained from the Growing Up in New Zealand longitudinal study of child development. Prenatally, mothers provided sociodemographic information as well as data on their mental health, potential teratogens, and lifestyle factors such as supplement intake and exercise levels. At 8-years old, 4922 children self-completed the PROMIS-SF anxiety measure. Bivariate analyses and backward stepwise regression were used to determine the best multivariable model. ResultsSignificant prenatal predictors of anxiety symptoms at 8-years old included elevated maternal depression symptoms, body mass index in the overweight/obese range, exercise patterns, and paracetamol, anti-inflammatory and alcohol intake. LimitationsSample attrition from baseline to 8-year may have affected statistical power. To further untangle the effect of timing and duration of the exposures reported in this study, larger sample sizes would be required. ConclusionsPrenatal mental health and wellbeing was significantly associated with child anxiety symptoms at 8-years of age. This study highlights the importance of supporting expectant mothers' health and wellbeing during pregnancy to ensure children have the best opportunity to have good mental health.

Maternal intake of paracetamol during pregnancy and biomarkers of male fecundity in young adult sons

Paracetamol is suggested to have endocrine disrupting properties possibly affecting fetal programming of reproductive health that might lead to impaired semen quality and changes in reproductive hormones. In this longitudinal study, we included 1058 young adult men born 1998–2000 into the Danish National Birth Cohort with follow-up at 18–21 years of age. The exposure, maternal intake of paracetamol, was modelled in three ways: dichotomized, trimester-specific, and as duration of exposure categorized into: short (1–2 weeks), medium (3–9 weeks) or long duration (>9 weeks) vs. no intake. Outcomes included semen characteristics, self-measured testis volume, and reproductive hormone levels. We used negative binominal regression to estimate the percentage difference and 95% confidence interval (CI) for each outcome. In total, 547 (48%) sons were prenatally exposed to paracetamol due to maternal intake at least once. Maternal intake of paracetamol during pregnancy was not associated with any of the biomarkers in the dichotomized or trimester-specific exposure models. For duration of exposure, sons of mothers with long duration of maternal intake of paracetamol showed tendencies towards lower semen concentration (-14% [95% CI: -31%; 8%]), a higher proportion of nonprogressive and immotile spermatozoa (8% [95% CI: -4%; 21%]) and higher DNA Fragmentation Index (16% [95% CI: -1%; 36%]) compared to son of mothers with no intake. Maternal intake of paracetamol during pregnancy was not clearly associated with biomarkers of male fecundity in adult sons. However, it cannot be ruled out that long duration of maternal intake of paracetamol might be associated with impaired semen characteristics.

Does interferential current provide additional benefit to orthopedic rehabilitation for the patients with proximal humeral fractures? A randomized controlled study

BackgroundApproximately 80% of all proximal humeral fractures (PHFs) are non-displaced or minimally displaced fractures, which can be treated with conservative treatment. This study investigated the effect of interferential current (IFC) added to orthopedic rehabilitation on shoulder function, pain, and disability in patients with PHF.MethodsThis study was a prospective, double-blind, randomized, placebo-controlled conducted in physical medicine and rehabilitation outpatient clinic. Thirty-five patients were randomly separated into the IFC group (n = 18) and the sham group (n = 17). The orthopedic rehabilitation program was applied to all patients by the same physiotherapist three times a week for four weeks. Patients in the IFC group received the intervention for 20 minutes 3 times a week before the exercise. The same pads were performed for the sham group, but no electrical stimulation was applied. Constant-Murley score (CMS) for shoulder function, visual analog scale (VAS) activity pain, disabilities of the arm, shoulder, and hand (DASH) score, and paracetamol intake were recorded post-treatment, at 6 weeks and 18 weeks post-treatment.ResultsThe demographic and fracture characteristics were not different between the groups. Significant differences were observed in the IFC and sham group in intragroup comparisons of total CMS, VAS activity pain, DASH score, and paracetamol intake over time (p < 0.001). Significant improvement over time was valid for all pairwise comparisons in both groups. However, no significant differences were detected between the IFC and sham group.ConclusionIFC added to orthopedic rehabilitation could not appear to be an electrotherapy modality that could potentially benefit shoulder function and disability in patients with PHF.

Maternal prenatal paracetamol ingestion and scholastic attainments of the offspring.

Background: Fetal exposure to paracetamol (acetaminophen) has been shown to be associated with asthma and other atopic disorders, as well as behavioural problems including hyperactivity, in childhood. However, there is little information on scholastic abilities among children exposed to paracetamol in pregnancy. Objectives: To determine whether there are any differences in scholastic abilities among the offspring of women who ingested paracetamol during pregnancy compared with non-exposed children. Methods: Mothers enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) had recorded the frequency with which they had taken the medication over two time periods during pregnancy: i) the first 18weeks and ii) 18-32weeks. The offspring have been followed up ever since. For this study we use as outcomes: a) 14 tests of ability at reading and 2 of spelling using the study's tests and the national education system test results; b) 6 of mathematical abilities including tests of arithmetic and mathematical reasoning, and c) 1 of scientific understanding. Multiple regression was used, adjusting for 15 different exposures including reasons for taking the medication as well as demographic features. Results: Almost all unadjusted and adjusted mean differences were negative (i.e., those exposed to maternal intake of paracetamol did less well), but negative associations for exposures between 18 and 32weeks of gestation were much more evident than for exposures earlier in pregnancy. Of the later exposures, after adjustment, 12 of the 23 scholastic tests were associated with prenatal exposure to paracetamol at p < 0.05. These negative effects were found in the girls (12 tests at p < 0.05) but not boys (0 tests at p < 0.05). Conclusion: Evidence from this longitudinal study suggests that maternal exposure to paracetamol is associated with disadvantages to the offspring in scholastic abilities such as mathematics and reading at secondary school ages. This raises the question as to whether there are longer-lasting effects on educational attainment from age 15years onwards, including at university level. Clearly these results should be tested in other settings, but meanwhile they add to a growing accumulation of known adverse effects of exposure to paracetamol in pregnancy.

Hepatorenal and renocardial syndrome in young patients with acute glomerulonephritis

In this paper we discuss classical types of acute glomerulonephritis in young adults, when the intake of paracetamol and diclofenac led to a dysfunctional and organic liver injury, at the same time it negatively affected the course of acute glomerulonephritis. To study the characteristics of the development of acute reno-cardial syndrome (ARCS) Goal: Assessment of cause and effect relations of renal, hearts and liver injuries in young adults in acute post-streptococcal glomerulonephritis (APSG). With acute nephritic syndrome (ANS) complicated by acute kidney injury (AKI) and without it, to identify the role of the etiological factor on the course of APSG. Methods and Material: 220 male patients with APSG with ANS aged 18-20 were examined. The patients were divided into 2 groups based on the functional state of kidneys. The first group included 140 patients with APSG without ANS, the second group included 80 patients with AKI. Results: Out 66 patients had subclinical liver injury, which resulted from the effect of antipyretic hepatotoxic drugs taken in the initial stage of the disease. Due to the toxic and immunological liver injury, levels of transaminases increase, and albumin levels decrease. These changes occur along with the development of APSG and are correlated with some laboratory values. Impairment of cardiovascular function was observed in all 220 patients. ECG and Echocardiography studies conducted during the cardiac asthma attacks occurred as a decrease of voltage, broadening of the P wave, lengthening of the PQ interval, broadening of the QRS complex, dilatations of the right and left atrium. The severity of clinical manifestations of AKI and ARCS correlates with the degree of macrohematuria, GFR decrease, complement C3 fraction, monocyte. Conclusion. In APSG liver injury has a toxicoallergic character. Frequency of liver injury depends on specific features of a particular organism, it does not depend on the dose of the taken drug. In case of any type of acute glomerulonephritis it is necessary to assess the functional state of liver and after the treatment of the main disease hepatologist follow-up of patients is recommended. Thus in the development of acute reno-cardial syndrome (ARCS) the degree of manifestation of hypervolemia with hypertension, as a result of active immune inflammation of the glomerular apparatus with the development of AKI, plays the main role in the development of ARCS with APSG.. As a rule ARCS in case of APSG with ANS in young adults has a successful outcome.

Adverse drugs reactions to paracetamol and ibuprofen in children: a 5-year report from a pediatric poison control center in Italy

BackgroundThis study aimed to analyze all the patients who contacted the hospital’s pediatric poison control center (PPCC) for exposure to ibuprofen and acetaminophen, in order to assess the incidence of any adverse reactions.MethodsWe retrospectively reported the clinical data of children who accessed the PPCC of the Bambino Gesù Children’s Hospital, IRCCS, Rome, from January 1, 2018 to September 30, 2022 due to wrong, accidental or intentional intake of inappropriate doses of acetaminophen and/or ibuprofen. In addition, we compared patients according to the intake of one of the two drugs and reported the trimestral distribution of cases during the study period.ResultsA total of 351 patients accessed the PPCC during the study period. The median age was 3.0 years. Most patients were females (57.8%). The most common reason for inappropriate oral intake of paracetamol or ibuprofen was a wrong use or an accidental intake (78.6%), with a fifth of patients taking the drug with suicidal intent (21.1%). According to the PPCC evaluation, most patients were not intoxicated (70.4%). Hospitalization was required for 30.5% of patients. Adverse reactions were reported in 10.5% of cases, with a similar incidence in patients who took paracetamol or ibuprofen. Nausea and vomiting were the most commonly reported adverse reactions. A higher frequency of moderate intoxication was found in patients who took paracetamol compared to ibuprofen (p = 0.001). The likelihood of intoxication was also higher in the paracetamol cohort. A spike of cases was registered at the end of 2021.ConclusionsWe analyze exposures to the two most commonly used pediatric molecules, paracetamol and ibuprofen, to assess the frequency of adverse reactions. We demonstrated that these relatively “safe” drugs may be associated with intoxications and adverse reactions when inappropriately administered.

Neurodevelopmental effects of prenatal exposure to anaesthesia for maternal surgery: a systematic review and classification of the reported effect sizes.

Neurodevelopmental effects of prenatal exposure to anaesthesia for maternal surgery: a systematic review and classification of the reported effect sizes.

Is L-PRF an effective hemostatic agent in single tooth extractions? A cohort study on VKA and DOAC patients

ObjectivesThe aim of this clinical observational study was to assess the efficacy of L-PRF as a hemostatic agent in patients under treatment with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs).Materials and methodsPatients under oral anticoagulant therapy (VKA or DOACs) who needed a single simple tooth extraction were enrolled. L-PRF plug was positioned inside the alveolus and secured with non-absorbable sutures. Surgical time, pain-VAS, paracetamol intake, intra-operative, post-operative biological complications, and bleeding events have been registered.ResultsA total of 112 patients (59 patients for DOAC and 53 for VKA group) were enrolled. Post-operative bleeding was recorded in nine patients (17%) for VKA group and nine patients (15.3%) for DOACs group. None of the patients needed a medical support for managing of bleeding. Seven days after surgery, no cases of post-extractive complications occurred.ConclusionsThe use of L-PRF resulted in limited mild late post-operative bleedings without the need of medical intervention.Clinical relevanceThe use of L-PRF can be adopted for an uneventful post-operative curse in anticoagulated patients without chasing their therapy for single tooth extraction.

The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial

BackgroundIn the early COVID-19 pandemic concerns about the correct choice of analgesics in patients with COVID-19 were raised. Little data was available on potential usefulness or harmfulness of prescription free analgesics, such as paracetamol. This international multicentre study addresses that lack of evidence regarding the usefulness or potential harm of paracetamol intake prior to ICU admission in a setting of COVID-19 disease within a large, prospectively enrolled cohort of critically ill and frail intensive care unit (ICU) patients.MethodsThis prospective international observation study (The COVIP study) recruited ICU patients ≥ 70 years admitted with COVID-19. Data on Sequential Organ Failure Assessment (SOFA) score, prior paracetamol intake within 10 days before admission, ICU therapy, limitations of care and survival during the ICU stay, at 30 days, and 3 months. Paracetamol intake was analysed for associations with ICU-, 30-day- and 3-month-mortality using Kaplan Meier analysis. Furthermore, sensitivity analyses were used to stratify 30-day-mortality in subgroups for patient-specific characteristics using logistic regression.Results44% of the 2,646 patients with data recorded regarding paracetamol intake within 10 days prior to ICU admission took paracetamol. There was no difference in age between patients with and without paracetamol intake. Patients taking paracetamol suffered from more co-morbidities, namely diabetes mellitus (43% versus 34%, p < 0.001), arterial hypertension (70% versus 65%, p = 0.006) and had a higher score on Clinical Frailty Scale (CFS; IQR 2–5 versus IQR 2–4, p < 0.001). Patients under prior paracetamol treatment were less often subjected to intubation and vasopressor use, compared to patients without paracetamol intake (65 versus 71%, p < 0.001; 63 versus 69%, p = 0.007). Paracetamol intake was not associated with ICU-, 30-day- and 3-month-mortality, remaining true after multivariate adjusted analysis.ConclusionParacetamol intake prior to ICU admission was not associated with short-term and 3-month mortality in old, critically ill intensive care patients suffering from COVID-19.Trial registration.This prospective international multicentre study was registered on ClinicalTrials.gov with the identifier “NCT04321265” on March 25, 2020.

Using structural topic modelling to reveal patterns in reports on opioid drugs in a pharmacovigilance database.

Adverse drug reaction (ADR) reports in pharmacovigilance databases often contain coded information and large amounts of unstructured or semi-structured information in plain text format. The unstructured format and sheer volume of these data often render them neglected. Structural topic modelling (STM) represents a potentially insightful way of harnessing these valuable data and to detect grouping or themes in spontaneous reports to aid signal detection. This was an explorative study of the potential for structural topic modelling to identify useful patterns in ADR reports involving opioid drugs in a pharmacovigilance database. A dataset of ADR reports on opioid drugs reported to the Netherlands Pharmacovigilance Centre Lareb from 1991 to December 2020 was used, comprising a total of 3069 unique reports. Qualitative text analysis was combined with STM, an automated text analysis method, to examine these data. In reports submitted directly by patients and healthcare professionals, 11 meaningful topics were identified, whereby patient experience reports, particularly in relation to pain (relief), and the timing of intake and ADRs of tramadol and paracetamol, were the most common. Of the 12 topics identified in reports received via marketing authorization holders, patch and skin-related side effects, addiction and constipation were the most prevalent. The STM-based analysis identified information that cannot always be captured by coding with the Medical Dictionary for Regulatory Activities (MedDRA®). The identified topics reflect findings in the literature on opioids.

A CROSS SECTIONAL ONLINE SURVEY ON SYMPTOMS FOLLOWING COVID-19 VACCINATION

Background: COVID-19 vaccination is the administration of a vaccine to help the individuals to protect from COVID-19. COVID-19 vaccines have been unfurled in several parts of the world. Although the protective efficacy was frequently discussed and analysed, little is known about post-vaccination experience outside of clinical trial conditions. The aim of the study was symptoms following COVID-19 vaccination in selected area, Puducherry, with the objectives of to assess the immediate response to the first dose of COVID-19 vaccine and to study the spectrum of post-vaccination symptom profile for individual vaccines.&#x0D; Methodology: Quantitative approach and non-experimental cross-sectional design was used. The study was conducted in selected areas in Puducherry. 30 subjects were recruited by using convenience sampling technique. Demographic variable questionnaire and self-developed binary tools was used.&#x0D; Results: The study results revealed that the Overall, all 30(100%) of respondents reported at least one post-vaccination symptom. 9(30%) had the symptoms of body ache, 7(23.3%) had fever, 6(20%) had local pain at injection site, 5(16.7%) had tiredness and 3(10%). Among male 10(33.3%) had paracetamol intake, 3(10%) had symptoms following vaccine, 4(13.3%) had symptoms within duration of hours and only 1(3.3%) had symptoms after onset in hours. Among female 10(33.3%) had taken paracetamol, 9(30%) had symptoms following vaccine, 7(23.4%) had symptoms within duration of hours and only 4(13.4%) had symptoms after onset in hours.&#x0D; Conclusion: Body ache and fever was most commonly reported. These symptoms were consistent with an immune response commonly associated with vaccines. In 90% cases, the symptoms were either milder than expected or meeting the expectation of the vaccine recipient. No serious events were reported. Symptoms were more common among younger individuals.

Maternal Paracetamol Intake During Pregnancy-Impacts on Offspring Reproductive Development.

Paracetamol (acetaminophen) is the preferred antipyretic/analgesic for pregnant women as it is believed there are no adverse fetal effects at the recommended dose. However, emerging evidence suggests that intrauterine paracetamol exposure may be associated with certain urogenital/reproductive disorders in the offspring. In this mini-review, we describe human fetal sex development and possible pharmacological mechanisms by which paracetamol may disrupt this process, including reduced testicular production of testosterone and/or insulin-like peptide 3. We then review the available epidemiological literature on associations between maternal paracetamol exposure and offspring sexual development. Three epidemiological studies have reported associations between maternal paracetamol intake and increased risk of cryptorchidism, although five others have not. None have found associations with hypospadias or penile length. Two out of three studies have reported a shorter anogenital distance (a marker of androgen action during the masculinisation programming window, ∼8–14 weeks of gestation) in male infants antenatally exposed to paracetamol. One study has described a dose-dependent relationship between maternal paracetamol consumption and earlier female (but not male) attainment of puberty. Such epidemiological analyses are complicated by various factors, including method of paracetamol exposure assessment (usually retrospective self-report), variation in diagnostic accuracy, selection bias, confounding by clinical indication, and demographic/genetic differences between geographically separated populations. There is an urgent need for stronger evidence in this area, from both relevant experimental studies and large, carefully-designed prospective studies. In the meantime, a precautionary attitude to gestational paracetamol usage should be considered as the evidence for clinically significant reproductive effects in humans is limited.

Association Between Exposure to Effervescent Paracetamol and Hospitalization for Acute Heart Failure: A Case-Crossover Study.

We investigated whether effervescent paracetamol, as an important source of nondietary sodium and fluid load, is associated with a transient increase in the risk of hospitalization for acute heart failure (AHF). We conducted a unidirectional case-crossover study using data from the 1 in 97th representative sample from the French health care database. Subjects aged ≥18 years, hospitalized for AHF during the 2014-2016 period, were included. Exposure to effervescent paracetamol was compared between a risk period (ie, 15 days immediately before admission for AHF) and 3 earlier 15-day control periods, to test a possible trigger effect of effervescent paracetamol intake on AHF. Adjusted odds ratios (aORs) were estimated with a conditional logistic regression. We identified 4301 patients hospitalized for AHF. We found that 5.7% of AHF subjects were exposed to effervescent paracetamol during the risk period, as compared with 4.1% during the control periods (aOR, 1.56 [95% confidence interval [CI], 1.27-1.90]; P < .001). This association was also found in the subgroup of subjects with hypertension (aOR, 1.45 [95%CI, 1.13-1.87]; P = .004, n = 2648) and in the subgroup of subjects aged ≥83 years (aOR, 1.70 [95%CI: 1.28-2.24], P < .001, n = 2238). A similar analysis, considering exposure to noneffervescent paracetamol, did not support the existence of an indication bias likely to explain the association observed for effervescent paracetamol. This study suggests an association between effervescent paracetamol and admission for AHF and should be confirmed with other complementary study designs.

Prenatal determinants of depressive symptoms in childhood: Evidence from Growing Up in New Zealand

BackgroundYoung people who experience depression are at an increased risk of adverse psychosocial and developmental outcomes that can persist over the lifecourse. Identifying maternal prenatal risk factors that may contribute to childhood depressive symptoms can be useful when considering mental health intervention. MethodsThe current study included 3,925 children from the Growing Up in New Zealand (GUiNZ) study who had complete data for self-reported depressive symptoms and mothers' antenatal information. Depressive symptoms were measured at age 8 using the Centre for Epidemiological Studies Depression Scale for Children (CESD-10) short form questionnaire. Hierarchical linear regression was used to determine the relationship between prenatal factors and depressive symptoms at age 8. ResultsWhen controlling for sociodemographic characteristics, our hierarchical linear regression revealed that the most significant maternal prenatal predictors of high depressive symptoms at age 8 were maternal perceived stress, smoking during pregnancy, body mass index (BMI) in the overweight/obese range, and paracetamol intake. LimitationsOne limitation with the current study was a reduction in the sample due to attrition. This may have affected our statistical power, reflected in our modest effect sizes. The sample remained both socioeconomically and ethnically diverse, however our results should be interpreted with respect to the sample and not the whole New Zealand population. ConclusionsA combination of maternal mental health and lifestyle factors contribute to depressive symptoms for children, possibly through foetal programming. Our results emphasise the importance of mental and physical health support for expectant mothers.

Hepatoprotective Effect of Indigenous Medicinal Plants-A Review

Liver is an important part in human beings and plays a very important and major role in metabolism and excretion of xenobiotics from the body. Further, hepatotoxicity is caused by different types of toxic chemicals, such as antibiotics and chemotherapeutic agents, paracetamol (C8H9NO2), thioacetamide (C2H5NS), carbon tetrachloride (CCl4), silymarin (C25H22O10), ethanol (C2H5OH) and excessive alcohol intake and microbes is well researched. The markedly available synthetic drugs to treat liver sickness in this condition also cause further damage to the liver. Therefore, herbal medicines have become increasingly famous and their utilization is wide-spread. In medicinal plant derived drugs have been utilized in the treatment of liver diseases for a long time the protection of a healthy liver has been essential for the overall well-being of an individual. Liver injury induced by toxins is more common now-a-days. Herbal remedies are focused in the pharmaceutical industry to evolve a safe route for liver disorders and it is very low cost, no side effects compare with synthetic drugs. Therefore, hepatoprotective plants such as Avicennia alba, Anisochilus carnosus, Baliospermum montanum, Centella asiatica, Clitoria ternatea, Eclipta alba, Justicia adhatada, Phyllanthus emblica, Pisonia Grandis and Syzgium cuminiare were reviewed. The present review is aimed at compiling data on promising phytochemicals from medicinal plants that have tested in hepatotoxicity models using modern scientific system.

N-acetyl-p-benzoquinonimine metabolite as a factor of possible neurotoxicity of paracetamol

BACKGROUND: Currently, the possible negative effects of paracetamol on the central nervous system are widely discussed in the modern scientific literature. The relationship between the intake of paracetamol during pregnancy by women and the risk of autism spectrum disorders in their children is being studied. However, such conclusions are often met with serious criticism as there are many questions about the methods of assessing behavioral disorders and processing research results. Therefore, experimental data obtained on neuronal cells may be a sufficient ground to confirm or refute assumptions about the neurotoxicity of paracetamol and its metabolites.&#x0D; AIM: To study the effect of paracetamol and its metabolite N-acetyl-p-benzoquinonimine (NAPQI) on the neurons of the cerebral cortex of fetal rats.&#x0D; MATERIALS AND METHODS: The study of the effect of paracetamol and its metabolite NAPQI on cell viability has been carried out by a method based on the reduction of 3-(4,5-dimethylthiazole-2-yl)-2,5-tetrazolium bromide (MTT).&#x0D; RESULTS: It has been shown that during preincubation of neurons in the cerebral cortex of the rats with paracetamol at a concentration of 1 mg/ml for 24 hours and subsequent incubation with 0.3 mM hydrogen peroxide, both hydrogen peroxide and paracetamol itself reduce the viability of neurons. Joint incubation with paracetamol and hydrogen peroxide also reduces the viability of neurons. The same effect of paracetamol and its metabolite is observed with the joint preincubation of paracetamol or NAPQI and hydrogen peroxide.&#x0D; CONCLUSIONS: Paracetamol as well its metabolite NAPQI reduce the viability of neurons in the fetal cortex of rats.

Tranexamic Acid Intravenous Overdose Administration in Primary Total Knee Arthroplasty: Case Report

Background: Topical application of tranexamic acid (TXA) to bleeding wound surfaces reduces blood loss in patients undergoing some major surgeries, without systemic complications. TXA decreases blood loss and, therefore, may minimize pain. Objective: To know the efficacy and safety of tranexamic acid intravenous overdose administration in primary total knee arthroplasty. Case study: We reported a 53 years old Saudi female ambulatory with no assisting aid and was not known to have any medical illnesses, presented to the orthopedic clinic complaining of bilateral knee pain and difficulty to ambulate for long distances for the last 5 years. This complain gradually worsened since last 2 years with no history of trauma prior to presentation or even after the follow up. The pain was localized at the knee joints and it was sharp in nature. The pain used to improve with rest and paracetamol intake and aggravated while standing or walking for long period of time. She was treated surgically by total knee arthroplasty, however during the operation by mistake she was given 4000 mg of tranexamic acid through IV route instead of topical application. Conclusion: Administration of 4000 mg of tranexamic acid through IV route is unusual but it seems to be safe without side effect on the patient in the early postoperative period.

Paracetamol Is Associated with a Lower Risk of COVID-19 Infection and Decreased ACE2 Protein Expression: A Retrospective Analysis

Ibuprofen is a common over-the-counter drug taken for pain relief. However, recent studies have raised concerns about its potential toxic effect with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been proposed that ibuprofen may increase levels of angiotensin-converting enzyme 2 (ACE2), the human receptor for SARS-CoV-2 infection. Therefore, paracetamol is suggested as an alternative to ibuprofen for treating COVID-19 symptoms. Nevertheless, the relationship between intake of paracetamol or ibuprofen and either susceptibility to infection by SARS-CoV-2 or modulation of cellular ACE2 levels remains unclear. In this study, we combined data from human medical records and cells in culture to explore the role of the intake of these drugs in COVID-19. Although ibuprofen did not influence COVID-19 infectivity or ACE2 levels, paracetamol intake was associated with a lower occurrence of COVID-19 in our cohort. We also found that paracetamol led to decreased ACE2 protein levels in cultured cells. Our work identifies a putative protective effect of paracetamol against SARS-CoV-2 infection. Future work should explore the molecular mechanisms underlying the relationship between paracetamol and COVID-19.

Paracetamol Is Associated with a Lower Risk of COVID-19 Infection and Decreased ACE2 Protein Expression: A Retrospective Analysis

Ibuprofen is a common over-the-counter drug taken for pain relief. However, recent studies have raised concerns about its potential toxic effect with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been proposed that ibuprofen may increase levels of angiotensin-converting enzyme 2 (ACE2), the human receptor for SARS-CoV-2 infection. Therefore, paracetamol is suggested as an alternative to ibuprofen for treating COVID-19 symptoms. Nevertheless, the relationship between intake of paracetamol or ibuprofen and either susceptibility to infection by SARS-CoV-2 or modulation of cellular ACE2 levels remains unclear. In this study, we combined data from human medical records and cells in culture to explore the role of the intake of these drugs in COVID-19. Although ibuprofen did not influence COVID-19 infectivity or ACE2 levels, paracetamol intake was associated with a lower occurrence of COVID-19 in our cohort. We also found that paracetamol led to decreased ACE2 protein levels in cultured cells. Our work identifies a putative protective effect of paracetamol against SARS-CoV-2 infection. Future work should explore the molecular mechanisms underlying the relationship between paracetamol and COVID-19.