Prostaglandin Analogues Research Articles

The economic burden of glaucoma on patients.

To determine the economic burden of glaucoma on patients. A cross-sectional study was conducted on glaucoma patients diagnosed at least 6 weeks prior to the study and on topical anti-glaucoma medications. After consenting, patients were asked about their monthly income, education, occupation, treatment duration, drugs being used, cost of drugs, one bottle lasts for, financial dependence for treatment, glaucoma surgery, transportation means and cost, etc. Also, information regarding government reimbursement of medical costs was collected. Seventy-four patients aged 60.18±11.5 years (40 males and 34 females) were enrolled. Majority were retirees (37.84%) and Homemakers (29.73%). Fifty (68%) participants didn't earn anything. Sixty-three patients had bilateral involvement and 52.70% were on treatment for >3 years. Prostaglandin analogs were most commonly used drugs (34.21%). Average cost of medications and travelling was ₹669.46 per month and ₹203.38 per visit respectively. Majority were financially responsible for their own treatment (62.16%). Patients had an average monthly income of ₹7108.11. Low-income group spent 26.08 % of their monthly salary on glaucoma treatment. Low-moderate and high-income group spent 5.17% and 1.50% of their monthly income respectively. Only 4.05% were covered by government reimbursement. Gender (P=0.019), occupation (P=0.010), whether undergone surgery (P=0.007), whether accompanied (P=0.027), hours lost during each visit (P=0.016) and treatment impression (P=0.027) showed statistical significance when associated with financial dependence. Treatment should be modified according to the patient's socioeconomic status. Glaucoma education programs and screening camps in remote areas would help in early detection of the disease.

Ингибиторы карбоангидразы в терапии глаукомы

Glaucoma is the leading cause of irreversible blindness. Its leading symptom and the most important initial link of the disease pathogenesis is represented by an increase of intraocular pressure (IOP). Decrease of IOP is a basic notion in the therapy of glaucoma. Drug-induced therapy is currently the most widely spread initial intervention to decrease IOP. Prostaglandin analogues are referred to the basic group of pharmacotherapeutic agents, because they are the most effective and well tolerated. Beta-blocking agents are selected as an alternative. Other medicinal products to treat glaucoma include inhibitors of carbonic anhydrase for systemic (acetazolamide and methazolamide) and local (dorzolamide and brinzolamide) use. Systemic inhibitors of carbonic anhydrase are, on the one hand, more active than non-systemic medicinal preparations, and, on the other hand, have numerous side effects which are not safe for humans. Thus, medicinal preparations for local use are most frequently applied in the therapy of glaucoma. If necessary, they are combined with beta-blocking agents or alpha-adrenergic agonists.

The Use of Prostaglandin Analogues and Cystoid Macular Edema after Uneventful Cataract Surgery: A Systematic Review and Meta-Analysis

ABSTRACT Purpose To evaluate whether using prostaglandin analogues (PGAs) perioperatively is associated with an increased rate of the development of clinical or subclinical cystoid macular edema (CME) after uneventful cataract surgery. Methods The PubMed, Scopus, and ScienceDirect databases were searched to June 2022 for this systematic review and meta-analysis. Two authors independently screened search results. Random-effects meta-analyses were performed to calculate the overall incidence rate and odds ratio (OR). Quality of studies was assessed using the modified Newcastle-Ottawa scale. The incidences of CME for continued vs discontinued use of PGAs perioperatively, continued use of PGAs, discontinued use of PGAs, and PGA users vs non-PGA antiglaucomatous users were main outcomes. Results Out of 544–articles, 9 studies that met the inclusion criteria were analyzed. The continued use of PGAs was not associated with an increased risk of the development of subclinical macular edema compared with discontinued use (OR = 1.32 [95% Confidence Interval (CI) = 0.49–3.51], p = .582). The overall incidence of CME was 34% (95% CI = 0.17–0.52) for continued use of PGAs and 7% (95% CI = 0.02–0.13) for discontinued use of PGAs. Using PGAs did not increase the risk of CME’s development compared with non-PGA antiglaucomatous usage (OR = 2.29 [95% CI = 0.84–6.23], p = .103) Conclusions Discontinuing treatment with PGAs during the perioperative period in eyes without any known risk factors for CME has no clinically significant effect on reducing the development of postoperative CME based on the existing studies. Further, well-designed randomized controlled trials need to be performed.

Genotype and Phenotype Influence the Personal Response to Prostaglandin Analogues and Beta-Blockers in Spanish Glaucoma and Ocular Hypertension Patients.

Analysis of the genotype that predicts the phenotypic characteristics of a cohort of glaucoma and ocular hypertension patients, and the correlation with their personal pharmacological response to beta-blockers (BB) and prostaglandin analogues (PGA). Prospective study that included 139 eyes from 72 patients under BB and/or PGA treatment, and in some cases other types of ocular hypotensive treatments. Five single-nucleotide polymorphisms were genotyped by real-time PCR assays: prostaglandin-F2α receptor (rs3766355, rs3753380); cytochrome-P450 2D6 (rs16947, rs769258); and beta-2-adrenergic receptor (rs1042714). Other studied variables were mean deviation (MD) of visual field, previous ocular interventions, medical treatment, baseline (bIOP), and treated intraocular pressure (tIOP). From a total of 139 eyes, 71 (51.1%) were left eyes. The main diagnosis was primary open angle glaucoma (66.2%). A total of 57 (41%) eyes were under three or more medications (PGA + BB + other) and, additionally, 57 eyes (41%) had had some kind of glaucoma surgery. The mean bIOP and tIOP were 26.55 ± 8.19 and 21.01 ± 5.54 mmHg, respectively. Significant differences in tIOP were found between heterozygous (HT) (21.07 ± 0.607 mmHg) and homozygous (HM) (20.98 ± 0.639 mmHg) rs3766355 with respect to wildtype individuals (16 ± 1.08 mmHg) (p = 0.031). The MD values presented significant differences between wildtype rs3766355 (-2 ± 2.2 dB), HT (-3.87 ± 4 dB), and HM carriers (-9.37 ± 9.51 dB) (p = 0.009). Significant differences were also observed between the MD in wildtype rs3753380 (-6.1 ± 8.67 dB), HT (-9.02 ± 8.63 dB), and HM carriers (-9.51 ± 7.44 dB) (p = 0.017). Patients carrying the variant rs3766355 in HM or HT presented clinically-significantly higher tIOP than wildtype patients. Additionally, some differences in MD were found in rs3766355 and rs3753380 carriers, and the more alleles that were affected, the worse the MD value, meaning greater severity of the glaucoma. Poor response to treatment and more visual field damage may be associated with being a carrier of these mutated alleles.

Efficacy of Prostaglandin Analogues for Induction of Labour and Associated Complications: A Retrospective Research Study conducted in Latifa Women and Children Hospital

Induction of labour has become a more common worldwide medical intervention during the last few years [1]. The ideal cervical ripening agent must be effective, safe, easy to be administered and acceptable for the pregnant woman. Utilizing prostaglandins (PG) for cervical ripening during induction of labour (IOL) was first described in the 1960s [2]. Since that time various types of prostaglandins including PGF2α, PGE2 (Dinoprostone) and PGE1 (Misoprostol) were extensively studied to elicit the best prostaglandin pharmacological agent for pre-induction cervical ripening [2]. Dinoprostone was found to be superior to the others, as it increased the rates of successful vaginal delivery within 24 h without increasing the operative delivery rates. Vaginal route was found to be a safe and effective approach of bringing on labor.

Safety profile of 0.0015% tafluprost eye drops in China: a post-marketing observational study.

To investigate the treatment pattern and safety of tafluprost for glaucoma and ocular hypertension (OH) in clinical practice in China. This post-marketing observational study included patients who received tafluprost to lower intraocular pressure (IOP) within 30d between September 2017 and March 2020 in 20 hospitals in China. Adverse drug reactions (ADRs) during tafluprost treatment and within 30d after the treatment were collected. A total of 2544 patients were included in this study, of them 58.5% (1488/2544) had primary open angle glaucoma (POAG), 21.9% (556/2544) had OH and 19.7% (500/2544) used tafluprost for other reasons. Of 359 ADRs occurred in 10.1% (258/2544) patients, and no serious adverse event occurred. The most common ADR was conjunctival hyperemia (128 ADRs in 124 patients, 4.9%). Totally 1670 participants (65.6%) combined tafluprost with carbonic anhydrase inhibitors (CAIs; 37.1%, 620/1670), sympathomimetics (33.5%, 559/1670), β-blockers (33.2%, 555/1670), other prostaglandin analogs (PGAs; 15.6%, 260/1670) and other eye drops (15.1%, 253/1670). The highest incidence of conjunctival hyperemia was noted in patients who received tafluprost in combination with other PGAs (23 ADRs in 23 patients, 8.8%, 23/260) and the lowest was in combination with CAIs (16 ADRs in 16 patients, 2.6%, 16/620). Tafluprost was applied in primary angle-closure glaucoma (41.6%, 208/500), after glaucoma surgery (17.8%, 89/500) and after non-glaucoma surgery (15.8%, 79/500). Tafluprost is safe for POAG and OH, and tolerable when combined with other eye drops and under various clinical circumstances.

Gaseous mediators (H2S, NO and CO) a new approach in gastrointestinal protection

Gastrointestinal damage is generated by a wide range of harmful agents, and is the result of the activation of inflammatory, oxidant and cytotoxic mechanisms, that together overwhelm the “mucosa defense” of the gastrointestinal (GI) tract. It is currently known that the mechanisms by which gastric damage is generated are slightly different from those that generate intestinal damage. The treatments available on the market such as citoprotectors, the use of selective Ciclooxigenase 2 (COX-2) inhibitors, the co-prescription of acid suppressive agents and the use of prostaglandin analogues are mainly focused on the mechanisms of gastric damage, and their use has begun to be limited due to its adverse effects at intestinal and cardiovascular level. Due to its multifactorial origin, the prevention and treatment of GI damage requires effective therapies that can protect both gastric and intestinal level modulating more than one mechanism. Recently, has been reported the contribution of gaseous mediators nitric oxide (NO), hydrogen sulfide (H2S) and carbon monoxide (CO) in many physiological processes in the gastrointestinal tract, including the maintenance of GI mucosal barrier integrity. Experimental evidence has shown promising results regarding the gastric safety of these gasotransmitters, especially those coupled to NSAIDs. This review will try to give a general overview of the mechanisms of gastric and intestinal damage, their main differences, the existing therapies for their treatment and the information available on gas transmitters with a brief description of roles of each of these gaseous molecules.

Comparison of two analyzer measurements focusing on material stiffness among normal, treatment-naïve, and treated glaucoma eyes

To investigate differences in biomechanical properties focusing on stiffness parameters between normal, treatment-naïve primary open-angle glaucoma (POAG), and treated POAG eyes. Retrospective case–control study, This study included 46 treatment-naïve POAG eyes, 46 POAG eyes treated with prostaglandin analogues, and 49 normal eyes used as controls; matched in terms of age and axial length. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using an ocular response analyzer (ORA). Fifteen biomechanical parameters were measured with the Corneal Visualization Scheimpflug Technology (Corvis ST), including biomechanical glaucoma factor (BGF) and two stiffness parameters of ‘SP A1’ and ‘stress–strain index (SSI)’, which were compared among the three groups. Additionally, the area under the curve (AUC) values of the receiver-operating curve to discriminate control and treatment-naïve POAG eyes were calculated for BGF and CH. Treatment-naïve POAG eyes had higher ‘SSI’ than normal eyes even after controlling for IOP (p < 0.05, Tukey-Cramer test). Treated POAG eyes had significantly lower CRF, and higher BGF than treatment-naïve POAG eyes. There were also significant differences in CH or SP A1 among the three groups. BGF and CH had similar AUC values (0.61 and 0.59). Treatment-naïve POAG eyes had stiffer corneas compared to normal eyes, which seemed to result from the material/structure of the cornea rather than higher intraocular pressure. Antiglaucoma topical medication alters biomechanical properties measured with Corvis ST. These results are important for understanding the pathogenesis and improving the management of POAG.

Ophthalmic prostaglandin analogs revisited - A systematic review of commonly used formulations

Aim: To systematically review the randomized control trials (RCTs) of the various prostaglandin(PG) analogues, comparing the effectiveness in treating glaucomas, safety and adverse effects of the individual agents. Methods: Articles were searchedusing the following key words “PG analogues”, “Latanoprost”, “ Bimatoprost”, “Travoprost”, “ Tafluprost”, “Unoprostone”, “ophthalmology”, “randomized controlled trial”, either singly or variably combined. Databases searched included Pubmed, Embase, Cochrane library, and Science direct. The search strategy was to identify randomized control trials (RCTs), either singly or variably combined. Results: 24 Randomised control trials that had evaluated the efficacy and adverse effects of different PG analogue agents were selected and were used in this review Average JADAD value of the researches was found to be 2.83. Bimatoprost was found to be the most effective agent in IOP lowering efficacy but it had the maximal incidence of local adverse effects. Latanoprost, Travoprost and Tafluprost had similar efficacy. Latanoprost had the best tolerability. Unoprostone had weaker antiglaucoma action, compared to the other agents. Conclusions: Bimatoprost is probably one of the best antiglaucoma medications available at present. Its tolerability could be improved by using preservative free formulations. Latanoprost is a well tolerated agent with reasonably good antiglaucoma action.

Reactions to Misoprostol: A Case Report

Background: Most of abortions occur before the 13th week of pregnancy. Nowadays, non-surgical approaches for evacuation of uterine have been replaced with surgical ones due to the reduction in bleeding, fewer complications, ease of management, and cost-effectiveness. Misoprostol is a prostaglandin E1 analog that is used for labor induction. It is known as a safe drug with very few side effects. Case Presentation: A 29-year-old woman with the gestational age of 11 weeks and 6 days with a diagnosis of cystic hygroma introduced herself to the labor ward. At the time of hospitalization, the patient was conscious. The heart sounds were normal. A vaginal exam indicated no pathological findings. Totally, she received 1000 mg of Misoprostol. Approximately, 2 hours after the last placement of Misoprostol, the patient developed bending and mild cyanosis of fingers and showed tachycardia with a pulse rate of 140 beats/min. Her O2 saturation decreased to 78%. At this time, the patient had a successful miscarriage. Echocardiography showed an ejection fraction of 55% and normal right ventricular size. The electrocardiogram showed sinus tachycardia. Therefore, she was sent to CCU with a possible diagnosis of embolism. The cardiologist administered a heparin drip of 5000-unit IV stat, and 1000 unit/h heparin and asked for a D-Dimer test. However, the laboratory reported that the patient’s blood sample was hemolyzed and they could only check her hemoglobin which was 4 g/dl. Immediately, the heparin drip was held and the patient received 3 packed cells. Her Hb was 6.5 g/dl. 12 hours later she showed tachycardia, and her O2 saturation reduced to 70%. She lost her consciousness. Nearly 40 minutes later, she had cardiorespiratory arrest and CPR wasn’t successful and she died. Conclusions: In Conclusion, even a frequently used drug such as Misoprostol can cause life-threatening side effects, leading to emergent situations.

Retracted: Clinical Efficacy of Topical Tacrolimus on Conjunctival Hyperemia Caused by Prostaglandin Analogues.

[This retracts the article DOI: 10.1155/2022/3700720.].

Investigating the Use of Pilocarpine, Timolol, and Prostaglandin Analogues in English Publications

Investigating the Use of Pilocarpine, Timolol, and Prostaglandin Analogues in English Publications

A prospective comparative study of 3 different regimens involving mifepristone and oral/ vaginalmisoprostol combination in medical termination of pregnancy at less than 9 weeks gestation

Background and Objectives: Medical abortion with a combination of mifepristone and a prostaglandin analogue (Misoprostol) is a well-established and adequately studied as an alternative to surgical abortion in early pregnancy for many years now but still no consensus has been reached regarding superiority of one route and dosage. This study is an attempt to compare efficacy in terms of rate of complete abortion, side effects and women’s perceptions of three mifepristone/misoprostol regimens and to study the effect of continued oral misoprostol for one week in medical termination of pregnancies of less than nine weeks gestation. Materials and Methods: Abortion seeking women of less than nine weeks period of gestation were included in this study and were divided into three groups: GROUP I also referred as O+O group, GROUP II the V+O group, and GROUP III referred as V ONLY group. This is an outpatient regimen requiring minimum three visits on day 1, 3 and 15. Initially, tablet mifepristone 200 mg was administered orally in all three groups on day 1. This was followed on day 3 by oral misoprostol 0.8 mg in group I and vaginal 0.8 mg misoprostol in group II & III. It was placebo controlled. Patients were sent home after 4 hour observation period. The oral group and one of the vaginal groups i.e. group I and II continued 0.4 mg of oral misoprostol twice daily for 7 days. Final assessment was done on day 15. Results: All three groups were comparable in terms of rates of complete abortion: Group I 93.06%; II 94.44% and group III 93.06%. Incomplete abortion occurred in 9.72% women in group I, 5.52% in group II and 6.94% women in group III. 73.61 % of women in group I, 76.38% women in group II and 77.76% in group III suffered from lower abdominal pain & cramping. 100% women cited oral route as their preferred route and overall 199 (92%) women were satisfied with treatment, 12(5.6%) were unsure and 5(2.4%) were dissatisfied. For future purposes 100 % women cited medical abortion to be their preferred mode compared to surgical one Conclusion: In light of previous studies establishing superiority of vaginal route over oral, continuation of misoprostol for 7 days possibly improved the efficacy for oral misoprostol group(group I) but it did not seem to further increase the efficacy for vaginal Misoprostol (group II) as all three groups were of comparable efficacy. Additional misoprostol did not shorten the duration of bleeding or induction abortion interval compared to group not continuing additional one week misoprostol. Successful abortion was associated more with lower gestational age,multigravidas and multiparas.Oral group had higher frequency of nausea, vomiting and diarrhea than vaginal administration. Statistically insignificant but still lower number of women were satisfied in the end with the treatment in the oral group compared to vaginal groups despite oral mode being the preferred mode. Additional larger studies are required on initial oral misoprostol administration and its continuation to establish its equivalence to vaginal route.

«Ландшафт» глаукомы в России, странах СНГ и Восточной Европы: что поменялось за 15 лет? Результаты многоцентрового международного исследования

Aim: to assess the changes in clinical and epidemiological characteristics, diagnostic and treatment options of primary open-angle glaucoma (POAG) in the Russian Federation and multiple near- and far-abroad countries over the period of 2005–2020. Patients and Methods: the final protocol of this retrospective multi-center research and clinical study included 289 patients with POAG from 7 states (Russia, Belarus, Serbia, Moldova, Kyrgyzstan, Slovakia, and Slovenia). The authors analyzed the methods used for establishing POAP diagnosis, clinical and demographic patient characteristics (gender, age and place of residence), as well as the process of glaucoma development (age of onset, disease duration and stages, intraocular pressure, ocular hypotensive medications, and the used laser and surgical procedures). All patients were divided into four groups depending on the time of making the initial diagnosis: 2004–2005, 2009–2010, 2014–2015, 2019–2020. Results: tonometry with Maklakov and Goldmann tonometers is still considered the gold standard for measuring intraocular pressure (IOP) (95% of cases). The percentage of pneumotonometry increased from 40% in 2005 to 60% in 2020. Approximately a third of clinics are still using electronic tonography as a supplementary method. Static automated perimetry is a basic tool for diagnosis and follow-up of patients with POAG (more than 95% of cases). Manual kinetic perimetry (Foerster's perimetry) is used in less than 10% of cases. Ophthalmoscopy (direct and binocular) was involved in the diagnostic process in all clinics and in all cases. The range of instrumental visualization technologies includes optical coherence tomography (OCT), Heidelberg Retina Tomography (HRT), and scanning laser polarimetry. Currently, OCT is utilized in 90% of clinics. It was found out that in 2005 the standard of initial POAG diagnosis encompassed a set of Maklakov/Goldmann tonometry, ophthalmoscopy and kinetic perimetry. In 2020, this list includes Maklakov/ Goldmann tonometry, pneumotonometry as a supplemental tool, static automated perimetry, ophthalmoscopy and OCT. The percentage of newly diagnosed POAG at the early stage has increased twofold over the past 15 years (from 20% in 2005 to 38% in 2020). The mean age of patients at the time of initial POAG diagnosis in 2005 was 62 (52; 67) years, in 2020 — 65 (50; 70) years, respectively (р=0.694). The proportion of prostaglandins in medication therapy increased by 20% over the past 15 years, while the proportion of beta-blockers reduced by the same percentage. The use of cholinomimetic drugs was almost discontinued. The total number of glaucoma laser surgeries has grown, and in the last decade the top priority has been given to selective laser trabeculoplasty, while the share of argon laser trabeculoplasty has decreased by 10%. The rate of primary glaucoma surgeries (trabeculectomy) keeps going down. Conclusion: a gradual and consistent implementation of high-tech diagnostic methods (static automated perimetry and OCT) in the routine practice occurred over 2005–2020. Also, there was a clear trend in more extensive use of objective data. The evolution of pharmaceutical "landscape" in the disease management is associated with an increasing proportion of more effective and safe drugs (prostaglandin analogues) and a diminishing role of beta-blockers as drugs of choice for starting therapy. The share of glaucoma surgeries as a starting strategy of POAG management was running down steadily from 2005 to 2010. Keywords: glaucoma, intraocular pressure, tonometry, perimetry, optical coherence tomography, trabeculectomy. For citation: Brezhnev A.Yu., Egorov E.A., Erichev V.P. et al. Glaucoma "landscape" in Russia, CIS and Eastern European countries: what has changed over 15 years? Russian Journal of Clinical Ophthalmology. 2023;23(2):73–79 (in Russ.). DOI: 10.32364/2311-7729- 2023-23-2-73-79.

Drugs Causing Cystoid Macular Edema: Pathogenesis, Diagnosis, and Treatment

Cystoid macular edema (CME) is a disorder that usually develops in association with ocular pathologies or systemic diseases. Various topical or systemic drugs are also known to lead to the formation of cystoid macular edema. Anti-hyperlipidemic drug niacin (nicotinic acid), antineoplastic agents taxanes (paclitaxel/docetaxel), oral antidiabetic drugs glitazones, iron, and aluminum chelator deferoxamine, and fingolimod used in the treatment of multiple sclerosis are drugs used systemically and shown to be associated with macular edema. In addition, epinephrine and prostaglandin analogs are ocular agents known to be associated with CME. The purpose of this article is to provide an overview of the available scientific evidence on the development of drug-induced cystoid macular edema and to provide insight into possible pathophysiological mechanisms and therapeutic approaches.

Предпочтения практикующих российских врачей-офтальмологов при определении стратегии лечения пациентов с первичной открытоугольной глаукомой (результаты многоцентрового научно-аналитического исследования)

The aim of the study was to establish the preferences of domestic ophthalmologists in the selection of prescribing schemes and approaches in the treatment of patients with different stages of primary open-angle glaucoma (POAG). The results of a questionnaire survey of 472 ophthalmologists conducted during the period from August to November 2022 were analyzed. The main part of the questionnaire contained questions concerning the preferences of specialists in selecting the tactics of treatment of patients with glaucoma, for example, treatment schemes for patients with different stages of POAG, including priorities of particular prescriptions (groups of drugs and other approaches), details of current clinical practice — patients' compliance with the prescribed treatment and its cost, expediency of using combined antiglaucoma drugs in the form of their fixed combinations (FC), as well as preservative-free drugs. It was established that 328 (69.5%) ophthalmologists prefer to use the possibility of combined mechanism of action of antiglaucoma hypotensive drugs, 92 (19.5%) - the possibility of targeted influence on uveoscleral outflow. In patients with the initial stage of glaucoma the prescription of monotherapy with the use of prostaglandin analogs (PGAs) is used, in persons with the advanced stage of glaucoma the priority in the prescription of combined forms of drugs is determined, and at the highly advanced stage of the disease surgical treatment is performed. Polypragmasy in prescriptions of antiglaucoma topical drugs impedes effective treatment, and in this regard, ¾ of respondents were in favor of a more active use of FC drugs, considering their use more justified to achieve the goal of treatment than the use of separate prescription schemes. The use of preservative-free forms of drugs allows to keep the ocular surface of glaucoma patients intact for a long time, to predict the results of the expected (and imminent) surgical treatment and to increase the compliance to treatment. The results of the study indicate a confident adherence of ophthalmologists to the guidelines of current clinical recommendations when choosing drug regimens and treatment regimens in patients with different stages of glaucoma.

Comparison between continuous femoral–sciatic block with continuous epidural block on reduced level of high-sensitivity C-reactive protein, prostaglandin E2, interleukine-6, and visual analog scale in lower limb surgery: Randomized, pre, and post-test trials

Comparison between continuous femoral–sciatic block with continuous epidural block on reduced level of high-sensitivity C-reactive protein, prostaglandin E2, interleukine-6, and visual analog scale in lower limb surgery: Randomized, pre, and post-test trials

Evaluation of prostaglandin E1 analogues to promote wound healing after infrapopliteal angioplasty in patients with critical limb ischemia

Evaluation of prostaglandin E1 analogues to promote wound healing after infrapopliteal angioplasty in patients with critical limb ischemia

A randomized clinical trial of Premaquick biomarkers versus transvaginal cervical length for pre-induction cervical assessment at term among pregnant women.

To compare Premaquick biomarkers (combined insulin-like growth-factor binding protein 1 and interleukin-6) and cervical length measurement via transvaginal ultrasound for pre-induction cervical evaluation at term among pregnant women. A randomized clinical trial of consenting pregnant women at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. The women were randomized equally into Premaquick group (n = 36) and transvaginal ultrasound group (n = 36). The cervix was adjudged 'ripe' if the Premaquick test was positive or if the trans-vaginal measured cervical length was less than 28 mm. The primary outcome measures were the proportions of women who needed prostaglandin analogue for cervical ripening and the proportion that achieved vaginal delivery after induction of labour. The trial was registered in Pan African clinical trial registry (PACTR) registry with approval number PACTR202001579275333. The baseline characteristics were similar between the two groups (p > 0.05). There was no statistically significant difference between the two groups in terms of proportion of women that required prostaglandins for pre-induction cervical ripening (41.7 versus 47.2%, p = 0.427), vaginal delivery (77.8 versus 80.6%, p = 0.783), mean induction to delivery interval (22.9 ± 2.81 h versus 24.04 ± 3.20 h, p = 0.211), caesarean delivery (22.2 versus 19.4%, p = 0.783), proportion of neonate with birth asphyxia (8.30 versus 8.30%, p = 1.00) and proportion of neonate admitted into special care baby unit (16.7 versus 13.9%, p = 0.872). Subgroup analysis of participants with 'ripe' cervix at initial pre-induction assessment showed that the mean induction to active phase of labour interval and mean induction to delivery interval were significantly shorter in Premaquick than transvaginal ultrasound group. Pre-induction cervical assessment at term with either Premaquick biomarkers or transvaginal ultrasound for cervical length is effective, objective and safe with similar and comparable outcome. However, when compared with women with positive transvaginal ultrasound at initial assessment, women with positive Premaquick test at initial assessment showed a significantly shorter duration of onset of active phase of labour and delivery of baby following induction of labour.

Use of monosodium-glutamate as a novel dietary supplement strategy for ovarian stimulation in goats.

This study aimed to investigate the reproductive effects of adding monosodium glutamate (MSG) to the diet of goats. Eleven adult goats received synchronized estrus and follicular waves using three prostaglandin analog injections every seven days. Goats allocated to individual pens received 1 g/kg BW of MSG in their diet for 23 days (MOGLU group, n = 6), whereas the control group (n = 5) maintained the base diet. The supplemented animals showed an increase in dry matter intake (P < 0.0001) and a reduction in heart rate (P < 0.05), respiratory rate, and ruminal movement (P < 0.001). Surface and rectal temperatures were higher in the MOGLU group, (P < 0.0001) with a significant increase in the afternoon. There was an increase (P < 0.05) in the frequency of behaviors related to rumination, defecation, and urination in the MOGLU group, and a reduction in behaviors associated with stress (P < 0.05). No differences were observed in the plasma levels of proteins, albumin, urea, cholesterol, or triglycerides. Glucose levels were lower (P < 0.05) in the MOGLU group, which also showed increased glutathione peroxide levels during the induction of ovulation. Supplemented animals recorded a larger number (P < 0.05) of follicles throughout the experimental period and higher intraovarian blood perfusion (P < 0.05) during ovulation induction. We conclude that MSG exerts a positive effect on the reproductive response in goats and therefore represents an effective nutritional supplement.