Use Of Suppositories Research Articles

Bibliometric analysis of scientific literature on the use of suppositories in the treatment of prostate cancer patients

Nowadays, cancer remains one of the main causes of death worldwide. Statistical data from various literary sources indicate that more than 130,000 people in Ukraine receive this diagnosis as a sentence every year. Cancer can affect any organs of the human body and, over time, the entire organism. In 2024, the agency of the World Health Organization on cancer and the International Agency of Cancer Research published the latest statistical estimates of this pathology in a global format, where prostate cancer is among the five most common oncological pathologies and takes the fourth place. Oncological diseases are one of the priority areas of healthcare development in accordance with the Order of the Ministry of Health of Ukraine No. 1832 dated 07.10.2022 “On Approval of Priority Areas of Healthcare Development for 2023–2025”. It was this fact that determined the choice of the direction of this research in the matter of finding information on the provision of pharmaceutical care, namely the use of a drug – a rectal suppository for the treatment of prostate cancer. The aim of the work is to carry out a bibliometric analysis and further generalize the data of the scientific literature to study the prognostic value and features of the prescription of suppositories in the treatment of prostate cancer. Materials and methods. The data search was conducted in the PubMed electronic database using the following key terms: “prostate cancer and suppositories”, “prostate cancer”. To monitor and analyze international scientific research, with the help of visualization tools and modern SciVal citation metrics using the online platform, bibliometric analysis can be performed. Using the VOSviewer functional program, bibliometric networks were constructed and visualized. Results. A map of the relationships between the most used keywords on the topics of “prostate cancer” and “prostate cancer and suppositories”, grouped into clusters for the period from 1986 to 2024, was built. The clustering of the most used keywords on the subject of “prostate cancer” for the specified period is summarized. According to the bibliographic analysis, interest in the above topic was highest in 2014 and 2021. Conclusions. According to the bibliographic analysis, the interest in the subject of the patients’ treatment with prostate cancer disease continues to grow from 1998 up to the present. The analysis of publication activity using the visualization tool of bibliometric networks VOSviewer for the period from 2014 to 2024 for the key words “prostate cancer” has shown the presence of 14 clusters. The largest cluster is devoted to modern methods of prostate cancer treatment, studies of gene rearrangement, target therapy, carcinogenesis.

A survey-based, quasi-experimental study assessing a high-cannabidiol suppository for menstrual-related pain and discomfort

The endocannabinoid system is involved in gynecological functions, with cannabidiol (CBD) demonstrating promise for alleviating menstrual-related symptoms. This survey-based, quasi-experimental study assessed pro re nata (PRN) use of a commercially-available, hemp-derived, broad-spectrum, high-CBD (100 mg) vaginal suppository (Foria®) for menstrual-related pain and discomfort compared to a treatment-as-usual (TAU) group (CBD n = 77, TAU n = 230), with survey assessments collected at baseline and two monthly follow-ups (~2 menstrual cycles). The CBD group demonstrated significantly reduced frequency and severity of menstrual-related symptoms, impact of symptoms on daily functioning, need for analgesics, and number of analgesics used relative to the TAU group (ps ≤ 0.032). Correlation analyses indicated a potential dose-dependent response, with increased suppository use associated with greater reduction of symptoms (ps ≤ 0.025). Most CBD participants reported at least moderate improvement of symptoms (follow-up 1 = 72.9%, follow-up 2 = 81.1%). Future studies (including replication in randomized clinical trials) assessing pharmacokinetics/pharmacodynamics, mechanism(s) of action, efficacy for other gynecological indications, and potential adverse events (e.g., drug-drug interactions) are indicated.

Impact of prostate position-based image-guidance in intensity-modulated radiation therapy for localized prostate cancer.

The long-term clinical impact of prostate position-based image-guided radiotherapy (IGRT) for localized prostate cancer remains unclear. We retrospectively compared clinical outcomes following intensity-modulated radiation therapy (IMRT) with cone-beam computed tomography-based prostate position-based IGRT (P-IGRT) or without P-IGRT (non-P-IGRT). From June 2011, we applied P-IGRT in IMRT for intermediate-risk (IR) prostate cancer (PCa) (D'Amico risk classification) (76Gy in 38 fractions, with smaller margins). Clinical outcomes of patients who received P-IGRT between June 2011 and June 2019 were retrospectively compared with those of patients with IR PCa who received IMRT without P-IGRT between October 2002 and May 2011 in our institution (74Gy in 37 fractions). A total of 222 consecutive patients were analyzed: 114 in the P-IGRT cohort and 108 in the non-P-IGRT cohort. The median follow-up period after IMRT was 7.1years for the P-IGRT cohort and 10.8years for the non-P-IGRT cohort. The biochemical failure-free rate was significantly better in the P-IGRT cohort (94.9% for the P-IGRT cohort vs 82.7% for the non-P-IGRT cohort at 10years, p = 0.041). The rate of rectal bleeding which needs intervention including the use of suppositories was significantly lower in the P-IGRT cohort (p < 0.001). The use of P-IGRT with higher doses and smaller margins was correlated with significantly better biochemical control, and a lower incidence of rectal bleeding in IMRT for intermediate-risk prostate cancer. The enhanced accuracy using P-IGRT has the potential to independently improve disease control and reduce late rectal bleeding.

3D-printed Laponite/Alginate hydrogel-based suppositories for versatile drug loading and release.

Traditional approaches to solid rectal therapies have halted progress, leading to a continual decline in the use of conventional suppositories. Additive manufacturing techniques have been recently explored as a suitable innovative tool for suppository fabrication. However, little advancement has been made in composition materials for 3D-printed suppository (3DPS) manufacturing and still, conventional vehicles are often used for construct fabrication, hindering the growth in the field. As a novelty, this study unveils a ground-breaking Laponite-alginate hydrogel-based 3DPS. Interestingly, this study proposes a novel approach for loading drugs into the 3DPS employing for the first time the post-printing loading. Thus, a passive loading strategy of molecular models is developed, demonstrating the versatility and capacity to load molecules of different charges and molecular sizes within the matrix systems. This novel strategy allows adapting the load of a wide range of drugs into a single ink, which simplifies and speeds up the 3DPS technological development process for drugs with different physico-chemical properties. Additionally, in this research, a displacement strategy of the three-dimensional Laponite matrices is developed in order to enhance the drug release capacity through the 3DPS and their disintegration capacity, resulting in a significant improvement of the drug diffusion through the hydrogel matrix and a rapid disintegration of the 3DPS. Finally, our study demonstrates that the obtained 3DPS have a suitable in vivo behavior, being non-obstructive and allowing the normal motility of the rats intestine.

Febrile seizure in children with COVID-19 during the Omicron variant-predominant era: A single-center study

ObjectiveCoronavirus disease 2019 (COVID-19) has significantly impacted medical services worldwide. During the Omicron variant-predominant era, febrile seizure (FS) in patients with COVID-19 increased compared to that in the pre-Omicron variant era. Therefore, this study aimed to demonstrate the clinical characteristics of FS in patients with COVID-19. MethodsWe surveyed patients aged < 16 years who presented with FS to the emergency room of Tottori University Hospital. The patients were divided into two groups: FS patients with COVID-19 (FS with COVID-19 group) and FS patients without COVID-19 (FS without COVID-19 group) as per the results of the respiratory multiplex array test. Patients with positive results for both SARS-CoV-2 and other microorganisms were excluded. We obtained data on the patients’ clinical backgrounds, symptoms, seizure duration, type of FS (simple or complex), diagnostic examinations, laboratory test results, and treatment. We compared the data between the FS with and without COVID-19 groups. ResultA total of 128 patients with FS met the inclusion criteria. Of these, 18 patients and 110 patients were included in the FS with COVID-19 group and without COVID-19 group, respectively. The late FS onset (>60 months) were significantly more common in the FS with COVID-19 group than that in the FS without COVID-19 group. Moreover, patients in the FS with COVID-19 group had significantly longer seizure durations than those in the FS without COVID-19 group. A diazepam (DZP) suppository was administered to 72% of FS patients with COVID-19 after the first seizure during a febrile episode. ConclusionFS patients with COVID-19 had different distributions of age at onset and seizure duration than those without COVID-19. The use of DZP suppositories was more frequent in FS patients with COVID-19 compared to those without COVID-19.

Features of diagnosis and therapy of febrile syndrome in young children

In this article, the authors raise the issue of the treatment of febrile conditions in young children. At the same time, the emphasis is on the definition of feverish conditions, etiopathogenesis, and the possibilities of modern diagnostics, taking into account various types of constitution in children. The authors provide their own data, based on many years of experience in monitoring children of the main three constitutional types according to M.S. Maslov. The features of fever therapy in children, indications and contraindications to the appointment of antipyretic drugs are discussed, emphasis is placed on side effects and contraindications of these drugs for infants. In recent years, the attention of many doctors has been drawn to the theory and practice of bioregulatory medicine, which is a branch of modern medicine that uses the experience of using natural remedies. The data of Russian and international researchers proving the expediency and effectiveness of treating fever symptoms with these drugs are presented. Special attention is paid to the drug Viburcol, which can be used for children starting from birth, which is undoubtedly important, since it is for children of the first year of life that safe and effective means are needed due to increased sensitivity to the toxic effects of all medicines. It is shown that the use of Viburcol suppositories in children is advisable, allows you to achieve the desired effect without any toxic and side effects. The authors, referring to international and Russian experience, recommend Viburcol for the treatment of fever, excitability, anxiety, pathological teething, as well as in the preparation and management of children during vaccination.

Effective bowel management in spinal cord injury during inpatient rehabilitation: data from the Dutch spinal cord injury database.

Retrospective Observational Study. To describe bowel management in individuals with a recently acquired spinal cord injury (SCI) both at admittance and discharge from first inpatient rehabilitation, and to determine factors that contribute to effective bowel management (EBM) at discharge. Specialized rehabilitation centers in the Netherlands. Data from the Dutch Spinal Cord Injury Database (DSCID) collected between 2015 and 2019 was used. EBM was defined by the variables of stool frequency and fecal incontinence. After univariate analysis, a multivariate regression analysis was conducted. Of 1,210 participants, 818 (68%) did not have EBM at admittance. At discharge, 308 (38%) did still not have EBM (in total 33% of all participants). The odds of having EBM at discharge was 2.82 times higher for participants with ASIA Impairment Scale (AIS) D compared to those with AIS-A (95% CI: 1.38-5.78). Participants with non-traumatic SCI had higher odds of having EBM than those with traumatic SCI (OR: 0.59, 95% CI 0.38-0.91). Use of suppositories, small enema, medication influencing bowel function, and oral laxatives at admittance did not influence EBM significantly at discharge. Bowel management improves during first inpatient rehabilitation. However, realizing EBM after a recently acquired SCI is a challenge. This endorses the importance of bowel management during inpatient rehabilitation, especially for people with AIS-A and non-traumatic etiology.

Can vaginal lactobacillus suppositories help reduce urinary tract infections?

Introduction and hypothesisRecurrent urinary tract infections (rUTIs) are a burden to patients and the health care economy. Vaginal probiotics and supplements have gained significant attention in mainstream media and lay press as a non-antibiotic alternative. We performed a systematic review to determine whether vaginal probiotics are an effective means of prophylaxis for rUTI.MethodsA PubMed/MEDLINE article search was performed from inception to August 2022 for prospective, in vivo use of vaginal suppositories for the prevention of rUTIs. Search terms included: vaginal probiotic suppository (34 results), vaginal probiotic randomized (184 results), vaginal probiotic prevention (441 results), vaginal probiotic UTI (21 results), and vaginal probiotic urinary tract infection (91 results). A total of 771 article titles and abstracts were screened.ResultsA total of 8 articles fit the inclusion criteria and were reviewed and summarized. Four were randomized controlled trials, with 3 of the studies having a placebo arm. Three were prospective cohort studies, and 1 was a single arm, open label trial. Five of the 7 articles that specifically evaluated for rUTI reduction with vaginal suppositories did find a decreased incidence with probiotic use; however, only 2 had statistically significant results. Both of these were studies of Lactobacillus crispatus and were not randomized. Three studies demonstrated the efficacy and safety of Lactobacillus as a vaginal suppository.ConclusionCurrent data support the use of vaginal suppositories containing Lactobacillus as a safe, non-antibiotic measure, but actual reduction of rUTI in susceptible women remains inconclusive. The appropriate dosing and duration of therapy remain unknown.

Improving Bowel Management in Children With Spina Bifida.

In individuals with spina bifida (SB), bowel incontinence is associated with lower quality of life and lower likelihood of employment. In an effort to maximize bowel continence in children and adolescents, we created a bowel management assessment and follow-up protocol in a multidisciplinary clinic. Here we report the results of this protocol using quality-improvement methodology. Continence was defined as no unplanned bowel movements. Our protocol involved: (1) a standardized 4-item questionnaire about bowel continence and consistency; (2) if the patient was not achieving continence, an intervention starting with oral medication (stimulant and/or osmotic laxatives), and/or suppositories (glycerin or bisacodyl) followed by an escalation to trans-anal irrigation, or continence surgery; and (3) follow-up phone calls at regular intervals to monitor progress and make changes as needed. Results are summarized with descriptive statistics. We screened 178 eligible patients in the SB clinic. Eighty-eight agreed to participate in the bowel management program. Of those who did not participate, the majority (68/90, 76%) were already achieving continence with their bowel regimen. Of children in the program, most (68/88, 77%) had a diagnosis of meningomyelocoele. At 1 year, the proportion of patients who were bowel accident free improved to 46% (vs 22% initially, P = 0.0007). A standardized bowel management protocol, primarily the use of suppositories and trans-anal irrigation to achieve social continence, as well as frequent telephone follow-up, can reduce bowel incontinence in children and adolescents with SB.

Parents/Caregivers' perceptions towards use of analgesic suppositories in paediatric elective surgery.

Despite the benefits of analgesic suppositories, there remains controversy around their administration. The perceptions of the parents and caregivers regarding this are unknown in our population. We investigated the perceptions of parents/caregivers towards the use of analgesic suppositories in elective paediatric surgery. We also explored whether parents/caregivers perceived a need for additional consent for the administration of suppositories. This was a prospective cross-sectional study conducted at Charlotte Maxeke Johannesburg Academic Hospital, South Africa. The primary outcome was to describe perceptions of parents/caregivers towards analgesic suppositories. Questionnaire-guided interviews were conducted with parents/caregivers of children presenting for elective paediatric surgery. Three hundred and one parents/caregivers were enrolled in the study. Two hundred and sixty-two (87%) were female and 174 (13%) were male. Two hundred and seventy-six (92%) were parents and 24 (9%) were caregivers. There was a high level of acceptability of suppository use in 243 (81%) parents/caregivers. Majority (235, 78%) felt that they should be asked for permission before their child was given a suppository, and more than half (134, 57%) expressed that it should be in a written consent format. The parents/caregivers did not believe that suppositories would cause pain (unadjusted odds ratio [uOR]: 2.49; 95% confidence interval [CI]: 1.29-4.79; P = 0.006) but were unsure whether they would relieve post-operative pain (uOR: 0.25; 95% CI: 0.11-0.57; P = 0.001). Those who had previously used a suppository themselves were significantly more likely to accept the use of suppositories in children (uOR: 4.34; 95% CI: 1.56-12.07; P = 0.005). There was a high level of acceptability of the use of analgesic suppositories. Our population showed a unique preference for written consent over verbal consent. There was a strong positive association between previous use of suppositories by parents/caregivers and acceptance for use in children.

CUIDADOS DE ENFERMAGEM EM PROGRAMAS DE REEDUCAÇÃO INTESTINAL PARA PACIENTES COM INTESTINO NEUROGÊNICO

ABSTRACT Objective: to analyze the available evidence on nursing care in Bowel Reeducation Programs for Neurogenic Bowel patients with constipation. Method: bibliographic, descriptive, integrative review type study of articles published between 2011 and 2021 in the LILACS, SciELO, BDENF, SCOPUS, and PubMed databases, using the descriptors “Neurogenic Bowel”; “Constipation”; “Nursing”; “Neurogenic Bowel”; “Constipation” and “Nursing”. The analysis was performed through reflective and careful reading about the theme of the study. Results: it was perceived that the most frequently performed nursing care in patients with neurogenic bowel included: bowel massage, abdominal press, vessel training, digit-anal stimulation, transanal irrigation, and use of suppositories, contributing positively to the institution of an effective and safe Bowel Re-education Program. Conclusion: the present study contributes to the nursing care actions of patients with NB and to the dissemination of findings on the benefits of the Bowel Reeducation Program.

Clinical Background Factors as Predictors of the Efficacy of 5-Aminosalicylic Acid Suppositories in Patients with Ulcerative Colitis

Introduction: Although the efficacy of 5-aminosalicylic acid (ASA) suppositories for ulcerative colitis (UC) has been reported in many studies, many studies have also described poor adherence to 5-ASA suppository regimens. We aimed to identify the clinical background factors that influence adherence to 5-ASA suppositories to improve adherence and efficacy of the treatment. Methods: We conducted a retrospective cohort study of 61 patients with active UC who were using 5-ASA suppositories. All patients underwent endoscopy and rectal biopsy for histological diagnosis prior to 5-ASA suppository treatment. The efficacy of 5-ASA suppository treatment was compared in relation to clinical background factors (sex, age, disease duration, disease type, clinical activity, Ulcerative Colitis Endoscopic Index of Severity, histological activity, serum C-reactive protein level, concomitant use of immunomodulators, history of steroid use, and dose of oral 5-ASA). Results: The efficacy of 5-ASA suppositories was significantly related to low Lichtiger Colitis Activity Index (LCAI) scores and proctitis type prior to its use. In terms of sex, females tended to show higher efficacy. Multivariate logistic regression analysis using these three factors showed high predictive value for the efficacy of 5-ASA suppositories (AUC, 0.788; sensitivity, 87.2%; and specificity, 63.7%). Conclusion: This study is the first to extract clinical background factors for predicting the efficacy of 5-ASA suppositories. The use of 5-ASA suppositories in patients who are expected to show efficacy will be effective in improving patient co-operation.

Комбинированная терапия больных рецидивирующим циститом с применением комплекса природных антимикробных пептидов и цитокинов: первые результаты

Urinary tract infections (UTIs) remain an important problem in urology due to their high prevalence and tendency to relapse. The improvement of the treatment outcomes in chronic cystitis is still relevant.A total of 91 patients were included in prospective, multicenter, randomized, comparative, controlled study. They were randomized into three groups: in the comparison group 1 (n=32) basic therapy was administered for 5 days. In the comparison group 2 (n=28) basic therapy was combined with rectal suppositories Superlymph 25 IU once a day for 10 days. In the main group (n=31) basic therapy in combination with rectal suppositories Superlymph 10 IU once a day for 20 days were prescribed. The basic therapy included a combination of two antimicrobial drugs: fosfomycin trometamol 3.0 g at night once on the first day of therapy, and furazidin 100 mg three times a day after meals for 5 days. Pathogenetic treatment was not prescribed in comparison group 1, but administered for 10 days and 20 days in comparison group 2 and main group, respectively.After the completion of etiotropic therapy, a significant effect in all groups was shown. At the same time, at the 2nd visit, there was a significantly better results in patients who received Superlymph rectal suppositories, both at a dose of 10 U and at a dose of 25 U, without any differences between two schemes. The frequency and severity of cystitis symptoms at the end of etiopathogenetic therapy in the main group was less pronounced than in the comparison groups (p=0.0001), and a significant difference was found between comparison groups 1 and 2 (p=0.0001). The use of Superlymph significantly improved the parameters of microcirculation in the urethra, however, there was no difference between comparison group 2 and main group.Etiopathogenetic therapy, including Superlymph rectal suppositories at a dose of 10 IU and 25 IU in patients with chronic cystitis, can significantly improve the results of combination therapy. Analysis of the symptoms score of acute cystitis showed the superiority of longer-term use of Superlymph rectal suppositories at a reduced dosage (10 units). Peptide-cytokine therapy led to a significant improvement in local microcirculation in comparison group 2 and the main group.

FEATURES OF THE CLINICAL COURSE AND COMPLEX TREATMENT OF HEMORRHOIDS IN CHILDREN

The aim: to analyze the current state of the issue of hemorrhoid disease in children of different age on the basisof first-hand experience.Materials and methods: author conducted examinations in 71 children with hemorrhoids: general clinical,laboratory, rectal finger, anoscopy, rectoscopy and additional research complexes. There were 56 (78,8%) boys and15 (21,2%) girls.Results and discussion: The features of the cause of the disease, clinical manifestation, course, localization havebeen studied and tactical treatment approaches in the age aspect have been developed. In infants, a common cause ofhemorrhoids were: a two-stage act of defecation with increased diarrheal syndrome; in children of early and preschoolage, periodic and prolonged potty sitting and congenital inferiority of the venous network of the small pelvis in schoolage children played an important role. The frequency of occurrence is more marked in preschool age – 71.7%. Theexternal form of hemorrhoids was revealed – in 90% and combined – in 10% of sick children. Frequent localizationof hemorrhoids occurred in children at 4 o'clock (35%) and 7 o'clock (30%).Comprehensive treatment of hemorrhoids in children was carried out: conservative - in 34 (83%) and surgical - in7 (17%) patients. In infancy and early age, the complex of conservative treatment included: treatment of the mainprimary disease (ChD, diarrheal syndrome, pathology of the colon, etc.) and local treatment; in preschool children- the use of medical enemas and rectal suppositories, ointments and the use of SCL, LL and school and older age- treatment of ChD. Indications for the operation were: the presence of large varicose nodes that violate the act ofdefecation, inflammation, prolapse, infringement and constantly falling out nodes and causing pain. In children, moregentle surgical methods are used. Surgical treatment is more susceptible to school age. There were no complicationsin the postoperative period.Conclusions. 1. Persistent constipation is a common cause of hemorrhoids in children; increased diarrhea, atwo-stage act of defecation, tension in sports, tense cough and urination are also causes of hemorrhoids.2. The clinical features of the course of hemorrhoids in children 1-3 years old is the transient nature of the coursein 70% of cases.3. Hemorrhoids are often found in children of preschool age, with the absence of pain and bleeding.4. The most frequent (65%) localization is 4 and 7 on the clock face.5. In children under 3 years of age with hemorrhoids, only conservative treatment is an effective method. Surgicaltreatment is more susceptible to school age.6. Indications for hemorrhoid surgery in children are: the presence of large varicose nodes that violate the act ofdefecation, inflammation, prolapse, infringement, as well as easily or constantly falling out nodes and causing pain.

Pre-referral intranasal artesunate powder for cerebral malaria: a proof-of-concept study

BackgroundMalaria still kills young children in rural endemic areas because early treatment is not available. Thus, the World Health Organization recommends the administration of artesunate suppositories as pre-referral treatment before transportation to the hospital in case of severe symptoms with an unavailable parenteral and oral treatment. However, negative cultural perception of the rectal route, and limited access to artesunate suppositories, could limit the use of artesunate suppositories. There is, therefore, a need for an alternative route for malaria pre-referral treatment. The aim of this study was to assess the potential of intranasal route for malaria pre-referral treatment.MethodsThe permeability of artesunate through human nasal mucosa was tested in vitro. The Transepithelial Electrical Resistance (TEER) of the nasal mucosa was followed during the permeation tests. Beside, regional deposition of artesunate powder was assessed with an unidose drug delivery device in each nostril of a nasal cast. Artesunate quantification was performed using Liquid Chromatography coupled to tandem Mass Spectrometry.ResultsThe experimental model of human nasal mucosa was successfully implemented. Using this model, artesunate powder showed a much better passage rate through human nasal mucosa than solution (26.8 ± 6.6% versus 2.1 ± 0.3%). More than half (62.3%) of the artesunate dose sprayed in the nostrils of the nasal cast was recovered in the olfactory areas (44.7 ± 8.6%) and turbinates (17.6 ± 3.3%) allowing nose-to-brain and systemic drug diffusion, respectively.ConclusionArtesunate powder showed a good permeation efficiency on human nasal mucosa. Moreover it can be efficiently sprayed in the nostrils using unidose device to reach the olfactory area leading to a fast nose-to-brain delivery as well as a systemic effect. Taken together, those results are part of the proof-of-concept for the use of intranasal artesunate as a malaria pre-referral treatment.

Rectal diclofenac; an effective modality for pain relief after vaginal birth

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; Vaginal delivery (VD) is the safest delivery option for the mother and is associated with quick recovery and minimal maternal morbidity and mortality. However, one of the commonest fears among women about VD is pain. This study aims to assess the effectiveness of diclofenac suppositories (per rectum) compared to the intramuscular diclofenac for the pain relief in females after VD.&lt;br /&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective comparative was study conducted at the Emergency Section (labor room) of Obstetrics &amp;amp; Gynecology Department in one of the tertiary care teaching hospitals of Lahore, Pakistan. A total of 182 female patients undergoing VD were selected and further divided into group A and group B. Group A was administered rectal analgesia in the form of rectal suppositories (100 mg) immediately after perineal tear (first and second degree only) repair and repeated after 6 hours. While group B received one injection of intramuscular diclofenac, immediately after perineal tear repair. The pain score was measured on a graphical score using Graphic Rating Scale, immediately at rest, during movement, and during urination. The pain score was reassessed after 6 hours with the same parameters and compared between both groups.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; The overall pain score was significantly lower immediately (p = 0.004) and 6 hours (p = 0.002) after VD in group A at rest, during movement, and during urination as compared to group B.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The use of rectal diclofenac suppositories is a simpler and more effective and acceptable method of reducing the pain experienced by the women following perineal trauma after vaginal childbirth.&lt;/p&gt;

Glycerin Suppositories and Enemas in Premature Infants: A Meta-analysis.

Premature infants are often given glycerin suppositories or enemas to facilitate meconium evacuation and the transition to enteral feeds. We reviewed the best-available evidence for the use of glycerin suppositories and enemas in premature infants. We searched MEDLINE, Embase, and Cochrane Central for randomized controlled trials (RCTs) of premature infants treated with glycerin suppositories or enemas through January 2022. Studies were screened and data extracted independently and in duplicate. We included RCTs of premature infants <32 weeks gestation and/or birth weight <1500 g who were treated with glycerin suppositories or enemas. Meta-analysis was performed using random effects and reported as relative risk or mean difference. We identified 6 single-center, RCTs of 389 premature infants treated with glycerin suppositories (n = 207) or enemas (n = 182). Mortality rates ranged from 0% to 17%, and the meta-analysis revealed no differences between treatment groups (P = .86). Active treatment was associated with earlier meconium evacuation (mean, 1.5 days; 95% confidence interval, 3.0 to 0.01; P = .05) but not a faster time to enteral feeds (mean, 0.5 days; P = .48). We identified 1 ongoing trial with a target recruitment of 220 premature infants. The quality of evidence was very low to moderate because of inadequate statistical power and other methodologic issues. The use of glycerin suppositories and enemas in premature infants is associated with earlier meconium evacuation, but the clinical significance of this finding is uncertain. Treatment has no definitive effects on mortality, necrotizing enterocolitis, or enteral feeds.

Оценка эффективности методов профилактики COVID-19 у беременных

Objective. To assess the effectiveness of different preventive measures for novel coronavirus infection in pregnant women. Patients and Methods. This study included 125 pregnant women hospitalized with moderate to severe laboratory-confirmed SARS-CoV-2 infection between September and November 2021 (the fourth pandemic wave), and 175 pregnant women who were not infected with COVID-19 during the same period. All women in these two groups were comparable for gestational age (II–III trimesters, 24–39 weeks), age (20–40 years), social status, parity, body mass index, and had no known COVID-19 risk factors. Results. Our findings revealed that vaccination 3-5 months before pregnancy (OR = 4.12; 95% CI 1.28–13.27; χ2 = 0.022), inconsistent use and/or non-timely replacement of face masks (OR = 5.71; 95% CI 2.83–11.51) were associated with the increased risk of COVID-19 in the second and third trimesters of gestation. It was showed that systematic (once in the morning at 24–48-hour intervals) intranasal administration of recombinant interferon alpha-2b (IFN-α; Grippferon) as compared with a single application after exposure to COVID-19 reduced the disease incidence rate and there was no evident risk of illness (OR = 0.08; 95% CI 0.05–0.14; 19.2% vs 74,3%, p &lt; 0.001). This can be explained by the fact that women were mostly infected in unpredictable conditions (e.g., 29.2% of pregnant women were infected from family members, 23.9% had unknown source of exposure). The use of umifenovir, not currently authorised for the medication-assisted prevention of COVID-19 in pregnant women, and rectal administration of IFN-α suppositories did not reduce the disease incidence rate. Rectal use of IFN-α suppositories by pregnant women off-label increased the incidence (32.0 vs 15.4%, p = 0.001) and risk of developing novel coronavirus infection (OR = 2.58; 95% CI 1.48–4.50). Conclusion. There is a need to improve awareness among pregnant women about the mandatory and timely vaccination against COVID-19 during pregnancy and the importance of strict adherence to wearing face masks. Increased efforts should be made to monitor and inform pregnant women about the use of only authorised medication-assisted preventive measures of SARS-CoV-2 infection, such as intranasal administration of recombinant IFN α-2b (Grippferon). During the epidemic rise in COVID-19 cases, the systematic intranasal administration of recombinant interferon-based medication Grippferon (once in the morning at 24–48-hour intervals) is recommended for pregnant women. Key words: pregnancy, COVID-19, incidence rate, vaccination, recombinant interferon alpha-2b, Grippferon, prevention

Development of a Virtual Reality Nursing Assistance System to Positively Enhance Rectal Medication Adherence in Children

Children may feel uneasy, anxious and fearful when faced with an invasive procedure because they cannot understand the reason for their illness and they fear the destruction of the integrity of their bodies. In rectal drug delivery (the use of anal suppositories), children often move their hips and cry during the procedure, which may cause the suppository to inadvertently break, slip out, or be misplaced in the vagina. In order to find to a solution to the clinical issue, this study focuses on the application of virtual reality in developing a VR nursing assistance system that can be used in clinical practice with only ordinary cell phones and simple VR headsets, called “Little Hero Saves the Earth”. This system allows children to immerse themselves in the plot of a story through a first-person perspective (as the “little hero”). When the little hero needs to have the superpower rocket fitted (what the child perceives in the first-person perspective), the nurse places the child in a side-lying position before inserting the suppository (superpower rocket) in sync with the plot. This serves to reduce the child’s fear of invasive procedures, encourage the child to think of anal suppositories in a positive way, and lead to a sense of autonomy and accomplishment in the child, thus creating a positive, successful experience.

Применение ректальных свечей с окисленным декстраном при калькулезном простатите

This article presents its own experience of using suppositories with oxidised dextran in the treatment of a patient with recurrent bacterial prostatitis complicated by prostate calcifications, these are the positive effects on the use of suppositories with oxidised dextran: a decrease in the size of calcified areas, a stable elimination of opportunistic microflora and the achievement of long-term remission of the disease.