Antipyretic therapy in critically ill septic patients: A systematic review and meta-analysis

OBJECTIVE: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. DATA SOURCES: Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. STUDY SELECTION: Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available. Studies were excluded if they enrolled pediatric patients, patients with neurologic injury, or healthy volunteers. Criteria were applied by two independent reviewers. DATA EXTRACTION: Two reviewers independently extracted data and evaluated methodologic quality. Outcomes included mortality, frequency of shock reversal, acquisition of nosocomial infections, and changes in body temperature, heart rate, and minute ventilation. Randomized and observational studies were analyzed separately. DATA SYNTHESIS: Eight randomized studies (1,507 patients) and eight observational studies (17,432 patients) were analyzed. Antipyretic therapy did not reduce 28-day/hospital mortality in the randomized studies (relative risk, 0.93; 95% CI, 0.77–1.13; I(2) = 0.0%) or observational studies (odds ratio, 0.90; 95% CI, 0.54–1.51; I(2) = 76.1%). Shock reversal (relative risk, 1.13; 95% CI, 0.68–1.90; I(2) = 51.6%) and acquisition of nosocomial infections (relative risk, 1.13; 95% CI, 0.61–2.09; I(2) = 61.0%) were also unchanged. Antipyretic therapy decreased body temperature (mean difference, –0.38°C; 95% CI, –0.63 to –0.13; I(2) = 84.0%), but not heart rate or minute ventilation. CONCLUSIONS: Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis

Antipyretic activity of azima tetracantha in experimental animals

In the present study, the ethanolic leaf extract of Azima tetracantha Lam (A. tetracantha) was investigated for antipyretic activity in rats using Brewer’s yeast induced Pyrexia. The leaves of A. tetracantha were collected from Ponnamaravathi and cut into small pieces and shade dried. The dried powdered leaves (100 gm) were extracted in a Soxhlet apparatus by using 95% ethanol. Albino rats weighing (200-250g) were taken for the experiment divided into four groups of six animals each. Group 1 received 3% aqueous suspension of gum Acacia (1 ml/200g) as vehicle orally, group 2 and group 3 received ethanolic leaf extract of A. tetracantha 100 and 200 mg/kg with 3% aqueous suspension of gum Acacia orally and the group 4 served as standard received paracetamol 25 mg/kg with 3% aqueous suspension of gum Acacia orally. The subcutaneous injection of yeast suspension markedly elevated the rectal temperature after 18h of administration. Treatment with A. tetracantha extract at a dose of 100, 200 mg/kg decreased the rectal temperature of the rats in dose dependent manner. This effect was maximal at dose of 200 mg/kg and it caused significant lowering of body temperature (P< 0.01) up to 4 hour after its administration. The antipyretic effect started as early as 1h and the effect was maintained for 4h, after its administration. Both the standard drug paracetamol 25 mg/kg and tested drug A. tetracantha extract were significantly reduced the yeast elevated rectal temperature, at 2nd, 3rd and 4th hour compared to control group

Ethnobotany Study of Seaweed Diversity and Its Utilization in Warambadi, Panguhalodo Areas of East Sumba District

This paper reports the ethnobotany study of seaweed diversity in Warambadi –Panguhalodo areas of East Sumba District, the island of Sumba. The study recorded19 genera of 54 species of seaweed, which were utilized as food or edible seaweed.The group consisted of 17 species of green algae, 17 species of red algae, and 20species of brown algae. The study also reported that 18 genera of 38 species weretraditionally utilized for medicinal purposes as herbal medicine. The herbal speciesconsisted of 7 species of green algae, 13 species of red algae, and 18 species ofbrown algae.Seaweed is traditionally consumed as food in various forms: raw as salad and vegetable,as pickle with sauce of allspice or with vinegar, as relish or sweetened jellies and alsocooked for vegetable soup. As herbal medicine seaweed is usually used for traditionalcosmetics, as antipyretic and antiseptic, as vermifuges, and treatments for cough andasthma, hemorrhoid, nosebleed and boils, goiter and scrofula, stomach ailments andurinary diseases.Indigenous knowledge on seaweed still exist and are continually employed bypeople living in particular areas such as the Sumba and Sabu ethnic groups. Yet,the knowledge is gradually decreasing due to localities, socio-economic change andcultural development

Antibiotics for sore throat

Background: Sore throat is a common reason for people to present for medical care. Although it remits spontaneously, primary care doctors commonly prescribe antibiotics for it. Objectives: To assess the benefits of antibiotics for sore throat for patients in primary care settings. Search methods: We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to July week 1, 2013) and EMBASE (January 1990 to July 2013). Selection criteria: Randomised controlled trials (RCTs) or quasi‐RCTs of antibiotics versus control assessing typical sore throat symptoms or complications. Data collection and analysis: Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. We contacted trial authors from three studies for additional information. Main results: We included 27 trials with 12,835 cases of sore throat. We did not identify any new trials in this 2013 update. 1. Symptoms - Throat soreness and fever were reduced by about half by using antibiotics. The greatest difference was seen at day three. The number needed to treat to benefit (NNTB) to prevent one sore throat at day three was less than six; at week one it was 21. 2. Non‐suppurative complications - The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure. Several studies found antibiotics reduced acute rheumatic fever by more than two‐thirds within one month (risk ratio (RR) 0.27; 95% confidence interval (CI) 0.12 to 0.60). 3. Suppurative complications - Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0.30; 95% CI 0.15 to 0.58); acute sinusitis within 14 days (RR 0.48; 95% CI 0.08 to 2.76); and quinsy within two months (RR 0.15; 95% CI 0.05 to 0.47) compared to those taking placebo. 4. Subgroup analyses of symptom reduction - Antibiotics were more effective against symptoms at day three (RR 0.58; 95% CI 0.48 to 0.71) if throat swabs were positive for Streptococcus, compared to RR 0.78; 95% CI 0.63 to 0.97 if negative. Similarly at week one the RR was 0.29 (95% CI 0.12 to 0.70) for positive and 0.73 (95% CI 0.50 to 1.07) for negative Streptococcus swabs. Authors' conclusions: Antibiotics confer relative benefits in the treatment of sore throat. However, the absolute benefits are modest. Protecting sore throat sufferers against suppurative and non‐suppurative complications in high‐income countries requires treating many with antibiotics for one to benefit. This NNTB may be lower in low‐income countries. Antibiotics shorten the duration of symptoms by about 16 hours overall.Griffith Health, School of MedicineFull Tex

Antipyretic Drug Candidates Through Reverse Docking Techniques Used In Science Learning

Red ginger (Zingiber officinale var. Rubrum) is a commonly used rhizome known for its fragrant and spicy taste. It contains gingerol and shogaol compounds that have antipyretic effects by inhibiting prostaglandin formation and stimulating the production of interleukin-10, an endogenous antipyretic. This study aimed to evaluate the potential of gingerol and shogaol compounds as antipyretic drug candidates through reverse docking techniques targeting interleukin-10 (IL-10). Ten natural compounds from red ginger were predicted for their potential as antipyretic drugs and docked with the IL-10 receptor protein using various computer programs. The molecular docking results showed that (6)-shogaol had four amino acid bond residues that were the same as the ibuprofen control compound, indicating its potential as an antipyretic drug candidate. Furthermore, (6)-shogaol had the same binding affinity as the control compound and was safe for oral consumption based on pharmacokinetic and toxicity tests using Lipinski's Rule, Toxtree, and admet-T. These findings suggest that (6)-shogaol is a promising antipyretic drug candidate compared to other compounds. In conclusion, this study identified the potential of (6)-shogaol as an antipyretic drug candidate through reverse docking techniques targeting interleukin-10. Red ginger could provide a natural alternative for antipyretic drugs, and further research is recommended to explore the role of gingerol and shogaol compounds in targeting other protein

The analgesic effects of anti-inflammatory drugs from the point of view of different pharmacological test methods

1. The forms of irritation causing inflammation and pain are reviewed, with reference to the significance of histamine, serotonin and bradykinin and in particular to the interrelationship between inflammation and pain. 2. The various types of experimental pain are reviewed and mention is made of the human and animal analgesia test methods derived from them. 3. More detailed descriptions are given of the analgesia test methods used by us, namely: a) Silver nitrate gonarthritis-pain, rat, in which both strong and weak analgesics with an anti-inflammatory action are effective. b) Phenylquinone-induced abdominal pain, mouse, in which all the analgesics and anti inflammatory agents mentioned in this article are effective in a greater or lesser degree. c) Tail-flick and hot-plate tests, mouse, in which the strong analgesics, the weaker analgesics and the anti-inflammatory agents, with the exception of the salicylates, are effective. d) Dental-pain test, guinea pig, which can be used to demonstrate the activity of the various analgesics, including the salicylates and also colchicine, which is not active in any other test. e) Pressure-pain, mouse, in which only the strong analgesics (narcotics) are effective. 4. The action of a large number of analgesics, anti-inflammatory agents and related drugs in the various analgesia-tests and in acute experimental inflammation is presented in tabular form. 5. It is concluded that the use of several pain and inflammation tests is essential for screening both analgesics for special indications (severe, mild pain, pain due to inflammation, etc.) and universal pain-killing drugs.</p

ANTIPYRETIC ACTIVITY OF ETHANOL AND AQUEOUS EXTRACT OF ROOT OF ASPARAGUS RACEMOSUS IN YEAST INDUCED PYREXIA

ABSTRACT Objective: To evaluate and compare the in vivo antipyretic activity of the aqueous and the ethanol extract of root of Asparagus racemosus. Methods: The presence of phytochemicals like flavonoids and saponins were identified by TLC and the invivo antipyretic activity was determined by brewer's yeast induced pyrexia method. Results: The results showed that the ethanol extract of root of Asparagus racemosus possessed significant antipyretic effect compared to the aqueous extract which may be attributed to the presence of flavonoids and saponins in the extracts whose presence were observed in TLC. Conclusion: This study provides evidences for the antipyretic activity of Asparagus racemosus which could partly contribute to its ethno medical use.   Key Words: Asparagus racemosus, Antipyretic effect, flavonoids ,saponins, TL

Preclinical research and development of a herbal antipyretic drug based on leaves of Ceiba pentandra (Malvaceae)

Background: Faced with the limits of synthetic antipyretic substances, in particular their involvement in the occurrence of numerous and often serious adverse effects; the challenge is in search of new antipyretics especially from the African traditional pharmacopoeia. The objective of this study was to evaluate the antipyretic activity of an aqueous extract and a formulation of Ceiba pentandra, with a view to designing an herbal antipyretic drug.Methods: Trials of formulation of an antipyretic syrup with leaves extract of Ceiba pentandra were carried out. The antipyretic activity was investigated by the bewer's yeast induced pyrexia. Physicochemical and microbiological stability tests were carried out on the syrup.Results: It was found with the extract an antipyretic activity at doses of 125 mg/kg and 150 mg/kg. The effect was greater for the 125 mg/kg dose with inhibition percentages ranging from 27.58% to 71.25%. This antipyretic activity was early (from 30 minutes) and was preserved during the four hours of the experiment. The syrup dosed at 125 mg/kg gave an activity similar to that of the extract by significantly reducing the hyperthermia in the rats. Regarding the stability tests, the syrup remained stable both physico-chemically and microbiologically throughout the study period (28 days) both when exposed to low temperature (5 °±3 ° C) and at high temperature (40°±2° C).Conclusions: Ceiba pentandra leaves have antipyretic activity and could be used for the development of an herbal antipyretic drug

ANTIPYRETIC ACTIVITY OF CENTELLA (CENTELLA ASIATICA (L.) URBAN) HERB IN VACCINE INDUCED MICE

Objective: This study aimed to determine the antipyretic activity of the infusion of centella (Centella asiatica (L.) Urban) herb, based on empirically usage of Indonesian people. Methods: Antipyretic activity assay was conducted to Swiss-Webster mice, which induced by diphtheria-pertussis-tetanus (DPT) vaccine with paracetamol as positive control. Results: Centella herb was contained tannins, flavonoids, monoterpenoids, sesquiterpenoids, triterpenoids, steroids, and saponins. The antipyretic activity of centella infusion has a ratio 1:44.6, compare to paracetamol. Conclusion: Antipyretic activity of centella herbs was predicted due to its secondary metabolites