<b><i>Introduction:</i></b> Many pharmaceutical, surgical, and complementary medical interventions are used for primary dysmenorrhea treatment. However, no consensus has been reached about the most effective intervention. <b><i>Objective:</i></b> To compare the efficacy and safety of IV tramadol versus IV paracetamol in relieving acute pain of primary dysmenorrhea. <b><i>Methods:</i></b> This randomized controlled trial was conducted in a tertiary referral hospital and included 100 patients between 18 and 35 years old diagnosed with primary dysmenorrhea. Patients received either 1-g paracetamol or 100-mg tramadol in 100-mL normal saline as an IV infusion over 10 min. Pain intensity was measured by using a visual analog scale at 15, 30, 60 min, and 2 h. We recorded drug side effects and requirements for rescue analgesics. <b><i>Results:</i></b> Pain scores were significantly lower in the tramadol group compared with the paracetamol group at 15, 30, 60 min, and 2 h (<i>p</i> &#x3c; 0.001). Fewer patients in the tramadol group needed rescue analgesics compared with the paracetamol group (<i>p</i> = 0.04). No significant differences were reported in side effects between both groups. <b><i>Conclusions:</i></b> IV tramadol is superior to IV paracetamol in relieving acute pain of primary dysmenorrhea with a comparable side effect profile.

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

Catfish Clarias lazera (C. gariepinus) was used to study the effect of aqueous lupine seed suspension (ALSS) (Lupinus termis) on normal or treated fish with alloxan or glucose after 5, 24 and 4 days. Injection of alloxan was followed by hyperglycemia, hyperlipidemia, hypercholesterolemia, and rise in serum levels of total free amino acids (TFAA), AST and ALT compared with control. In liver, alloxan significantly reduced glycogen and total lipid/triglyceride ratio, while it accumulated lipids and elevated AST and ALT compared with control values. Also, alloxan induced lipid and glycogen depletion in red and white muscles. However, all disturbances in these parameters were restored to normal after ALSS administration. In glucose-treated fish, ALSS significantly increased glycogen content in white and red muscles. Also, glucose plus ALSS treatment increased red muscle contents of TFAA, total lipids and triglycerides. ALSS treatment did not induce any histological changes in liver. Both glucose and alloxan treatments induced damage effect on liver besides, ultrastructural alterations in the liver were observed. Furthermore, histochemical observation revealed a high liver glycogen following repeated glucose doses, while liver glycogen was depleted in response to alloxan injection. Alloxan induced necrosis, mitochondrial damage, few ribosomes on the surface of rough endoplasmic reticulum (rER) with disrupted cisternae in liver cells. Repeated doses of glucose injection for 4 days led to necrosis, clumps of rarefied cytoplasm as well as some cisternae of rER appeared to be devoid of ribosomes. However, most histological and ultrastructural changes in the liver were restored to normal after ALSS administration. In conclusion, it could be suggested that the lupine seeds have a protecting effect against both metabolic disturbances and damaging effect on liver cells in response to repeated doses of glucose or to alloxan treatments.

No abstract

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, hypoinsulinemia and/or increased cellular resistance to insulin. Type 1 diabetes used to be referred as insulin-dependent DM. It is an autoimmune disease where immune system mistakenly destroys the insulin-secreting β-cells of the pancreas. Type 2 DM is called non-insulin-dependent diabetes and it is the most common type all over the world.