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Article
The cytoprotective effect of different doses of Sildenafil on indomethacin-induced gastric mucosal damage in rats:

Authors: Mohammed J. Manna --- Samir Y. N. Matloub
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 426-431
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Sildenafil, a selective phosphodiesterase -5 (PDE-5) inhibitor increases cyclic guanosine monophosphate (cGMP) and amplifies many biological actions of nitric oxide (NO) which is an important mediator of gastric mucosal defense ; was evaluated in this study using different doses for its cytoprotective effect on gastric mucosal damage induced by indomethacin . We also evaluated the effect of this drug on NO production, Prostaglandin E2 (PGE2) synthesis, Myeloperoxidase (MPO) activity, and Interlukin-4 (IL-4) expression.
Methods: The study was performed between April and July 2008 in the Department of Pharmacology / College of Medicine /Baghdad University .It was conducted on 80 adult male albino rats, divided into 8 groups, the first served as a control received the vehicle, the second received indomethacin orally of 60mg/kg .The third and fourth groups were pretreated 30 minutes prior indomethacin with oral sildenafil 10 and 20mg/kg respectively. The other groups were pretreated 30 minutes prior to sildenafil (10and20mg/kg) with intraperitoneal NG-L-Arginine Methyl Ester (L-NAME) 20mg/kg with or without L-Arginine. The rats were then sacrificed after 4 hours and their stomachs were isolated and submitted to macroscopical assessment and for the measurement of the gastric PGE2, MPO, and IL-4.
Results: Sildenafil (10 and 20 mg/kg) pretreatment resulted in a significant (p<0.01) decrease in the gastric damage score. The MPO activity was significantly (p<0.01) decreased, while the level of IL-4 was significantly (p<0.01) increased. On the other hand PGE2 level was not changed. L-NAME given 30 min before 10 and 20 mg/kg sildenafil, significantly (p<0.01) abolished the protective effects of sildenafil and also reversed the effects of sildenafil on MPO activity and IL-4 levels. On the other hand addition of L-Arginine resulted in the restoration of the protective effects of sildenafil which was also reflected on the gastric damage score, MPO activity and IL-4 levels. Conclusions: The results demonstrate that the injurious effect of indomethacin can be reduced or ameliorated by sildenafil pretreatment, and that the protective effect of sildenafil against indomethacin was through an NO dependent pathway.


Article
Studying the Effect of Montelukast in the Treatment of Dysmenorrhea: A single-Blind, Placebo-controlled Trial

Authors: Bahir A. Mshemish --- Salima M. Sadik --- Ammar W. Ashor
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 1 Pages: 37-41
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: In the field of gynecology, studies have found high levels of leukotriene in the endometrium and uterine smooth muscles of patients with dysmenorrheal and menstrual pain.Aim: to evaluate the effectiveness of montelukast in relieving the symptoms of dysmenorrhea. Patients and methods: A randomized, single-blind, prospective, placebo-controlled study was designed. Seventy patients suffering from dysmenorrhea complete this study, divided randomly into two groups: montelukast group (34 patients) and placebo group (36 patients).Values before and after treatment were compared over two menstrual cycles, using visual analog scale (VAS) score and NSAID usage per menstrual cycle. Results: Post-treatment VAS score and NSAID usage decreased significantly in both montelukast and placebo group, compared to their pre-treatment values (P<0.05). The mean decreases in VAS score and NSAID usage were more in the montelukast group than in the placebo group, but the differences were not statistically significant (p>0.05). The ratio of the highly effective cases, for both VAS score and NSAID usage, was significantly higher in the montelukast group than placebo group (P<0.05). Means of VAS score and NSAID usage didn't change in all of endometriosis patients after administration of montelukast or placebo therapy. Conclusions: For some women, montelukast may be effective in relieving symptoms of primary dysmenorrhea. It's safe and has no serious adverse effects. Thus, it can be considered as a good option for treatment of primary dysmenorrhea before starting with hormonal therapy.

Keywords

Montelukast --- NSAIDs --- Dysmenorrhea


Article
Cytoprotective Action of Omeprazole in Indomethacin-Induced Gastric Mucosal Injury in Rats.

Authors: Mohammed J.Manna محمد جاسم --- Samir Y.N.Matloub سمير مطلوب
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 1 Pages: 79-83
Publisher: Baghdad University جامعة بغداد

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Article
Synthesis, characterization and biochemical study of novel ester prodrugs containing aspirin and ibuprofen
تحضير ودراسة بايوكيميائية وتشخيصية لادوية مصاحبة استرية تحتوي الاسبرين والايبوبروفين

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Aspirin and ibuprofen are aryl acids of nonsteroidal anti inflammatory drugs with goodanalgesic. For reducing the gastrointestinal toxicity associated with presence free carboxylicacid functional group in aspirin and ibuprofen, therefore the present work is aimed tosynthesize a novel ester prodrugs of these two drugs. These two novel prodrugs were preparedby the reaction of aspirin or ibuprofen acid chloride with 1,2:5,6-di-O-isopropylidene-α-Dglucofuranose,then deprotection of ester prodrug of aspirin was also accomplished using 70%acetic acid. The purity of the synthesized compounds was established by (TLC), columnchromatography, while their structures were confirmed by (FT-IR, 1HNMR, 13CNMR). Then36 rabbits has been obtained and divided to six groups to show the bioavailability of theprepared prodrugs at some biochemical parameters and compared with the parent drugs andcontrol group. Statistical analysis revealed significant increases in the levels of creatinekinase, alkaline phosphatase, aspartate aminotransferase, alanine amino transferase,glutathione, malondialdehyde, creatinine, uric acid, concentration of Cu, and significantdecreases in the levels of choline esteras, total protein, Zn concentration, while the resultsshowed no significant increases in the activity of lactate dehydrogenase, acid phosphataseand no significant decreases in the levels of albumin, globulin, and iron concentration for theprepared prodrugs compared with the control group. Finally, to ensure the release of parentdrugs(aspirin or ibuprofen), hydrolytic studies of the ester prodrugs were obtained at differentpH (2, 4, 10 and 12) at 25οC, the results showed that the hydrolysis at basic pH were fasterthan acidic pH, so it means that the most hydrolysis will obtain at intestine not at stomach.

Keywords

Prodrug --- Aspirin --- Ibuprofen --- NSAIDs


Article
Pre– and post– operative effectiveness of naproxen and ibuprofen on pain, swelling, and trismus following surgical removal of impacted mandibular third molar

Authors: Tahani A Al–Sandook --- Harith H Kaskos --- Mohammad S Suleiman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2003 Volume: 3 Issue: 2 Pages: 116-126
Publisher: Mosul University جامعة الموصل

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Abstract

This study focused on the clinical evaluation of naproxen and ibuprofen efficacy on pain, swelling and trismus after surgical removal of impacted mandibular third molar, whether they used only pre–operatively or pre– and post–operatively. The number of patients included in the present study was 40, divided into four groups: Each group is 10 patients, the first group received naproxen as sodium 1hour pre-operatively followed by three times daily for five days post–operatively. Whereas the second group received naproxen as sodium three times daily for five days begins 1hour post–operatively. However, the third group had been given ibuprofen 1hour pre–operatively followed by three times daily for five days post– operatively. The fourth group administered ibuprofen three times daily for five days begins 1hour post–operatively. The pain was evaluated by the number of paracetamol tablets taken by the patients recorded on the pocket chart, whereas the swelling was measured subjectively. The trismus was evaluated by measuring the maximum mouth opening between the incisal edges of the maxillary and mandi-bular central incisors using the graduated vernier. The results showed that the use of naproxen as sodium 1hour pre–operatively minimized the pain, swelling and trismus significantly compared to ibuprofen.

Keywords

NSAIDs --- naproxen --- ibuprofen --- impaction


Article
Evaluation of the effect of using NSAIDs on ovulation in women during reproductive age: a case control study
تقييم تأثير استخدام مضادات الالتهاب غير الستيروئيدية على الإباضة لدى النساء خلال سن الإنجاب: دراسة مراقبة الحالة

Author: Saba Shamran
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2019 Volume: 15 Issue: 1 Pages: 109-112
Publisher: Al-Qadisiyah University جامعة القادسية

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AbstractBackground:Unovulation is an important cause of female infertility whether primary or secondary. Prostaglandins play an important role in normal physiology of ovulation. Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed for treatment of a variety of medical conditions in the field of obstetrics and gynecology. Sufficient controversy about the role of NSAIDs on ovulation exists. Aim of the study:to evaluate rate of ovulation in two groups one was healthy fertile women receiving NSAIDs and the other group include healthy fertile women receiving placebo treatment.Patients and methods:The present case control study included two groups of healthy fertile women. The first groups included 30 women who were given the NSAIDdiclofenac sodium (olfen, Novartis) as 100 mg daily oral dose for 2 months duration and the other group included 30 women who were given placebo treatment for the same 2 months period. In the cycle following the completion of the intended period the following investigations were performed: serum progesterone level at day 10 and day 20 of menstrual cycle and ultrasound examination for identification of ovarian follicle size ate day 10 of the cycle and then at day 20 to confirm or exclude ovulation. The study extended from November 2017 to January 2018 and was carried out at Al-Diwaniyah maternity and child teaching hospital at Al-Diwaniyah province, Iraq. Results:Conclusion:TheNSAID diclofenac sodium interferes significantly with ovulation in women during their reproductive life and should be use with caution in women seeking pregnancy.

نبذة مختصرةالخلفية: الإباضة هي سبب مهم لعقم الإناث سواء الأساسي أو الثانوي. تلعب البروستاجلاندين دورًا مهمًا في فسيولوجيا الإباضة الطبيعية. وغالبا ما توصف العقاقير المضادة للالتهابات غير الستيرويدية (مضادات الالتهاب غير الستيروئيدية) لعلاج مجموعة متنوعة من الحالات الطبية في مجال التوليد وأمراض النساء. يوجد جدل كافٍ حول دور مضادات الالتهاب غير الستيروئيدية في الإباضة.الهدف من الدراسة: لتقييم معدل الإباضة في مجموعتين ، كانت المرأة الخصبة الصحية التي تتلقى مضادات الالتهاب غير الستيروئيدية والمجموعة الأخرى تشمل النساء الخصبات الأصحاء اللائي يتلقين العلاج الوهمي.المرضى والطرق: شملت دراسة مراقبة الحالة الحالية مجموعتين من النساء الخصيات الأصحاء. شملت المجموعات الأولى 30 امرأة تم إعطاؤهن NSAIDdiclofenac sodium (olfen، Novartis) كجرعة فموية يومية 100 ملغ لمدة شهرين ، بينما شملت المجموعة الأخرى 30 امرأة تلقين العلاج الوهمي لنفس فترة الشهرين. في الدورة التالية لاستكمال الفترة المقصودة تم إجراء التحقيقات التالية: مستوى هرمون البروجسترون في الدم في اليوم 10 واليوم 20 من الدورة الشهرية والفحص بالموجات فوق الصوتية لتحديد حجم بصيلات المبيض أكلت يوم 10 من الدورة ثم في اليوم 20 لتأكيد أو استبعاد الإباضة. امتدت الدراسة من نوفمبر 2017 إلى يناير 2018 ونفذت في مستشفى الديوانية للأمومة والطفولة في محافظة الديوانية ، العراق.النتائج:خاتمة: يتداخل TheNSAID ديكلوفيناك الصوديوم بشكل كبير مع الإباضة عند النساء أثناء حياتهم الإنجابية ويجب أن يستخدم بحذر عند النساء اللائي يسعين للحمل.

Keywords

NSAIDs --- ovulation --- reproductive age


Article
Synthesis of 5-Fluorouracil Derivatives as Possible Mutual Prodrugs with Meloxicam and Ibuprofen for Targeting Cancer Tissues

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In the present study, five derivatives have been designed to be synthesized as possible mutual prodrugs for 5-Fluorouracil (5-FU) and non steroidal anti-inflammatory drugs (NSAIDs) to selectively deliver the drugs into the cancer cells. The synthesis of the target compounds were accomplished following multistep reaction procedures, the chemical reaction followed up and the purity of the products were checked by TLC. The structure of the final compounds and their intermediates were confirmed by their melting points, infrared spectroscopy and elemental microanalysis, the hydrolysis of compound III was studied using HPLC technique. According to the results mentioned above, compounds (I&#8722;V) can be good candidates as possible mutual prodrugs of 5-FU and NSAIDs that can selectively deliver the parent drugs into the cancer cells by the effect of enzymes that elevated in tumor tissues compared with normal tissues.

تم في ھذه الدراسة تصمیم خمسة مشتقات لتخلیقھا كمقدمات دوائیة ثنائیة محتملة لل ( 5- فلورویوراسیل) والادویة المضادةللالتھابات غیرالستیرویدیة لایصال الادویة وتحریرھا بأنتقائیة في الخلایا السرطانیة. تم تحضیر ھذه المركبات باتباع طریقة التفاعلمتعدد الخطوات، وتم مراقبة جمیع التفاعلات والتأكد من نقاوة المركبات بواسطة كروماتوغرافیا الطبقة الرقیقة، كما تم متابعةالمركبات الوسطیة والمركبات النھائیة والتأكد من تحضیرھا من خلال قیاس درجات الانصھار والتحلیل الطیفي للاشعة تحت الحمراء،بأستخدام تقنیة الاستشراب السائل عالي الاداء وفقآ للنتائج المبینة اعلاه، (III) والتحلیل الدقیق للعناصر. وقد تم دراسة تحلل المركبمرشحات كمقدمات دوائیة ثنائیة محتملة لل ( 5- فلورویوراسیل) والادویة المضادة للالتھابات (I−V) یتضح بأن المركباتغیرالستیرویدیة لھا القدرة على ایصال الادویة بأنتقائیة للخلایا السرطانیة وبألیة تحریر تتضمن تأثیر الانزیمات الموجودة بمستوىاعلى في الانسجة السرطانیة مقارنة مع الانسجة الطبیعیة.

Keywords

Anticancer --- 5-Fluorouracil --- NSAIDs --- prodrug.


Article
Synthesis and Preliminary Pharmacological Study of Sulfonamide Conjugates with Ibuprofen and Indomethacin as NewAnti-Inflammatory Agents

Authors: Mohammed H. Mohammed محمد حسن محمد --- Monther F. Mahdi منذر فيصل مهدي --- Bader S. Salem
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2009 Volume: 18 Issue: 2 Pages: 39-45
Publisher: Baghdad University جامعة بغداد

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Abstract

4-aminobenzenesulfonamide conjugates of ibuprofen (compound 10) and indomethacin (compound 11) have been designed and synthesized by the reaction of sulfanilamide (compound 7) with 2-(4-isobutylphenyl) propanoic acid (ibuprofen) and 2-(1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1H-indol-3-yl)acetic acid (indomethacin) for the evaluation as potential anti-inflammatory agents with expected selectivity against COX-2 enzyme. In vivo acute anti-inflammatory activity of the synthesized final compounds (10 and 11) was evaluated in rats using egg-white induced edema model of inflammation in a dose equivalent to (10mg/Kg) of ibuprofen and (2mg/kg) of indomethacin. The tested compounds produced significant reduction of the rat paw edema with respect to the effect of propylene glycol 50% v/v (control group). Moreover, compound (10) exhibited comparable anti-inflammatory activity to diclofenac (3mg/Kg) (reference group) while compound (11) exhibited less anti-inflammatory activity than diclofenac. The result of this study indicate that the incorporation of the 4-aminobenzenesulfonamide pharmacophore into ibuprofen and indomethacin maintained their anti-inflammatory activity & may increase their selectivity toward COX-2 enzyme which can be confirmed in future by assessing COX-2:COX-1 inhibitory ratio.

تم تصميم و تحضير مقترنات ]4-امينوبنزين سلفونامايد[ للايبوبروفين (مركب 10) و للاندوميثاسين مركب (11) عن طريق تفاعل السلفانيلامايد (مركب 7) مع 2(4-ايزوبيوتيل فنيل) بروبانويك اسيد (الايبوبروفين) و 2-(1-(4-كلوروبنزويل)-5-ميثوكسي-2-مثيل-1H-اندول-3-يل)استيك اسيد (الاندوميثاسين) لتقييمهما كعوامل مضادة للالتهاب جديدة مع احتمالية انتقائية مضادة لانزيم الكوكس الثاني (COX-2) .اجري تقييم الفعالية المضادة للالتهاب في الجسم الحي للمركبان النهائيان (10 و 11) في الجرذ باستخدام زلال البيض مستحدثة وذمة التهابية تحت الجلد بجرعة مكافئة للايبوبروفين (10ملغم/كغم) و بجرعة مكافئة للاندوميثاسين (2ملغم/كغم).المركبات المختبرة انتجت انخفاض مؤثرا للوذمة بالمقارنة مع البروبلين كلايكول 50%(propylene glycol) كمجموعة ضابطة.لقد اظهر المركب (10) فعالية مضادة للالتهاب مقارنة للدايكلوفيناك (diclofenac ) (3ملغم/كغم) كمجموعة مرجعية بينما المركب (11) اظهر فعالية مضادة للالتهاب اقل من الدايكلوفيناك.تشير نتيجة هذه الدراسة الى ان اندماج الجزء العقاقيري 4- امينوبنزين سلفونامايد مع الايبوبروفين و الاندوميثاسين قد حافظ على فعاليتهما المضادة للالتهاب مع احتمال زيادة انتقائيتهما تجاه انزيم الكوكس الثاني والذي يمكن ان تثبت مستقبلا بتحصيل النسبة المثبطة للكوكس-2 الى الكوكس-1 .


Article
Effectiveness of Non Steroidal Anti Inflamatery Drug "Diclofenac Sodium" in Treatment of Nocturia in Benign Prostatic Hyperplasia Patien

Authors: Ayad Ali Al-Beer --- Abdull-Sattar Jubaiir Allii --- Ehab jasiim Muhammad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 311-316
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:We explored the effectiveness of enteric coated diclofenac sodiumfor patients with benign prostatic hyperplasia (BPH) complaining of nocturia. A total of 30 BPH patients aged 50-75 years were enrolled in the study. They each took a single 50-mg tablet of diclofenac sodium prior to sleeping at night for 14 days in addition to their BPH treatments In the questionnaire ,21 of 30 patients (70%) felt more satisfaction than previous treatments.OBJECTIVE:In this study, we attempted to investigate the role of enteric coated diclofenac sodium (voltaren) in the therapeutic management of BPH patients with nocturia.METHODS:Thirty patient with BPH ( 63.6± 6.56 years old) more than two episodes of nocturia per night were involved. These patients had received standard drug therapy. Although these patients had received standard drug therapy for more than half a year, they had still three or more episodes of nocturia. The patients took a single dose of 50 mg of diclofenac sodium enteric coated at night prior to sleep. Before and 2 week after the initiation of this therapy, the effects of this treatment were assessed by frequency volume chart and a questionnaire.RESULT:In the questionnaire ,21 of 30 patients (70%) felt more satisfaction than previous treatments. Patients were grouped into a diclofenac sodium-effective (n = 23) and ineffective groups (n = 7) based on the results of the frequency-volume chart. In the effective group, interestingly, night-time urine volume showed significant reduction (P < 0.001). On the other hand, the average single voided volume at night showed no significant change. There was a statistically significant difference in the night-time urine volume after treatment between groups (P < 0.05). In frequency volume chart, total void per day, total void per night, total urine volume per day, total night urine volume per day and single voided volume in the night before and after this treatment were 9.9±0.56and 10.1±0.69per day, 3.9±0.87 and 2.3±1.1 per night, 1500.2±106.9 and1508.7±107.3 mL per day, 580.2±136.9 and 350.4±169.3 mL per night, and 150±7.2 and 150.4±7.05mL, respectively, in a diclofenac sodium-effective group.CONCLUSION:Diclofenac sodium can be effective and useful for BPH patients with nocturia

Keywords

BPH --- diclofenac --- nocturia --- NSAIDs --- overactive bladder


Article
Non-hormonal treatment for mastalgia-a topical non-steroidal anti-inflammatory agent versus Evening Primrose Oil: prospective comparative analysis
العلاج الغير هرموني لحالات ألم الثدي- مقارنه أستباقيه تحليليه بين مضادات الالتهاب غير الاسترويديه الموضعية وعقار زيت زهره الربيع

Author: Mohammed Kamil Mohammed د. محمد كامل محمد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 4 Pages: 282-286
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract:Aim of the study: to compare a topical non-steroidal anti-inflammatory drug (NSAID) and Evening Primrose Oil (EPO) regarding effectiveness, rapidity of response, safety, and patient compliance in the primary treatment of mastalgia.Setting: Author’s Private clinic**Design: A prospective interventional non-blinded comparative clinical trial between the two drugs carried out over a period of 4 years.Patients & Methods: seventy female patients with moderate to severe mastalgia were prospectively selected and given one of the two agents alternatively. Data pertaining to each patient were collected and analyzed at one month, two months and three months period.Results: after three months of treatment, out of 35 patients treated with topical NSAI gel, 96.5% had clinically significant response compared with 45.7% of 35 patients treated with EPO. Two patients (5.7%) had side effects with EPO treatment while none had any side effects with NSAI gel treatment. Response to NSAI gel reported earlier than response to EPO. 82.8% of patients found the cost of NSAI gel treatment acceptable versus 85.7% for EPO.Conclusions: Topical NSAIDs are effective, safe and acceptable mode of treatment for mastalgia.Keywords: Mastalgia. Evening Primrose Oil (EPO). Topical NSAIDs.

الملخص:هدف البحث: مقارنه مضادات الالتهاب غير الاسترويديه الموضعية مع عقار زيت زهره الربيع من حيث الفعالية, سرعة الاستجابة, الأمان وتجاوب المرضى وذلك بالنسبة لحالات آلام الثدي.مكان أجراء البحث: عيادة الباحث الخاصه تصميم البحث: دراسة أستباقيه تداخليه غير محجوبة للمقارنه سريريا بين عقارين وعلى مدى أربعه سنوات (أيلول 2005 ولغايه نهايه ايلول 2009)عينه المرضى وطرق البحث: تم استباقيا اختيار سبعين مريضه يشكين من ألام في الثدي معتدلة الشده إلى شديدة وتم علاجهن باستعمال عقارين أعطيا بالتناوب. تم جمع المعلومات الخاصة بكل مريضه وتحليلها خلال شهر, شهرين وثلاثة اشهر من بدء العلاج.النتائج: بعد مضي ثلاثة اشهر من بدء العلاج بمضادات الالتهاب غير الاسترويديه الموضعية استجاب 96.5% من اصل 35 مريضه عولجت بهذا العقار مقابل استجابة 45.7% من اصل 35 مريضه عولجت باستخدام عقار زيت زهره الربيع. حدثت مضاعفات للعلاج بعقار زيت زهره الربيع عند مريضتين بينما لم تحدث أي مضاعفات للعلاج بمضادات الالتهاب غير الاسترويديه الموضعية. كانت الاستجابة لمضادات الالتهاب غير الاسترويديه الموضعية مبكرة مقارنه بعقار زيت زهره الربيع. كلفه العلاج كانت مقبولة لدى 82.8% من المريضات اللواتي عولجن بمضادات الالتهاب غير الاسترويديه الموضعية مقابل 85.7% بالنسبة لزيت زهره الربيع.الاستنتاجات: يمكن اعتبار مضادات الالتهاب غير الاسترويديه الموضعية علاجا فعالا وامنا ومقبولا للمريضات اللواتي يشكين من ألام الثدي.

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