Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with adverse effects. However, NSAIDs are among the most popular pain killers and easily available over the counter. This study aimed to determine the prevalence of NSAIDs use in Malaysian adults and among those with chronic diseases such as arthritis, kidney disease, hypertension, heart disease and asthma. It also examined the factors associated with NSAIDs use. Data from the National Health Morbidity Survey (NHMS) 2011, a nation-wide survey was analysed. A total of 18231 respondents aged 18 years and above responded to this module. Multivariate logistic regression was used to investigate the association between NSAIDs use and associated factors. The overall prevalence of NSAIDs use among Malaysian adults was 14.2% (95%CI 13.3-15.1). Of the respondents, 4.2% (95%CI 3.8-4.7) took NSAIDs once daily. NSAIDs use was highly associated with those who were ever-told to have arthritis (aOR: 3.03; 95%CI 2.60-3.52) and have difficulty of performing daily activities or work (aOR: 2.06; 95%CI 1.86-2.28). Those who were ever-told to have kidney disease (aOR: 2.36; 95%CI 1.74-3.20), ever-told to have asthma (aOR: 1.36; 95%CI 1.17-1.58), ever-told to have heart disease (aOR: 1.34; 95%CI 1.08-1.65), known hypertension (aOR: 1.22; 95%CI 1.08-1.37) also were associated with NSAIDs use. By socio-demographic profiles, NSAIDs use was positively associated with those who have government benefit scheme or private health insurance (aOR: 1.44; 95%CI 1.31-1.58), higher education level (aOR: 1.35; 95%CI 1.20-1.51), higher household income (aOR: 1.26; 95%CI 1.11-1.44, aOR: 1.12; 95%CI 1.02-1.24), currently working (aOR: 1.25; 95%CI 1.13-1.39) and female (aOR: 1.17; 95%CI 1.07-1.28). NSAIDs use was less likely among those aged 60 years and above (aOR: 0.83; 95% CI 0.72-0.97), Chinese (aOR: 0.41; 95% CI 0.36-0.47) and ‘Others’ ethnicity (aOR: 0.82; 95% CI 0.67-0.99) compared to Malay ethnicity. NSAIDs use is prevalent in Malaysian adults and associated with co-morbidities and higher socio-demographic status, thus appropriate awareness should be promoted and highlighted in the community.
non-steroidal anti-inflammatory drugs ; NSAIDs use ; NHMS ; prevalence ; Malaysia.

Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; Humans ; Immunosuppressive Agents ; pharmacology ; Tripterygium ; adverse effects ; chemistry

Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

PURPOSE: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. METHODS: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). RESULTS: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. CONCLUSION: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.
Acetaminophen ; Anti-Inflammatory Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Commerce* ; Emergencies ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Intention ; Mortality ; Nonprescription Drugs* ; Pharmacy ; Poisoning ; Retrospective Studies

Anti-Infective Agents ; pharmacology ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Research Design

Lower back pain is one of the major health problems in the general population. The causes of lower back pain are heterogeneous and its treatment is complicated. The administration of oral analgesics is the basic step in the treatment of acute somatic pain. Most physicians advocate the three step analgesic ladder method, and NSAIDs are a mainstay of therapy for both acute and chronic lower back pain. Among the patients with chronic pain narcotics with psychotropic drugs have a better efficacy especially in the patients with neuropathic pain. Successful long-term analgesia is a challenge for physicians. The administration of a single agent or a combination of the above drugs to the specifically individualized patients could improve the function and quality of life and achieve the last goal of treatment of chronic lower back pain.
Analgesia ; Analgesics* ; Anti-Inflammatory Agents, Non-Steroidal ; Chronic Pain ; Humans ; Low Back Pain* ; Narcotics ; Neuralgia ; Nociceptive Pain ; Psychotropic Drugs ; Quality of Life

Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; Humans ; Immunosuppressive Agents ; pharmacology ; Research Design ; Tripterygium ; adverse effects ; chemistry

OBJECTIVETo explore the therapeutic effects of Xiaozhong Zhitong mixture preventing heterotopic ossification (HO) after total hip arthroplasty.

METHODSFrom July 2006 to October 2009, 154 patients underwent total hip replacement surgery were randomly divided into sham group (group A, 50 cases), indomethacin group (group B, 55 cases) and Xiaozhong Zhitong mixture group (group C, 49 cases). Among 154 patients, 9 cases were primary osteoarthris, 34 cases osteoarthritis secondary to acetabular dysplasia, 98 cases osteoarthritis secondary to avascular necrosis of the femoral head, 2 cases rheumatoid arthritis, 5 cases femoral neck fracture, 6 cases other diseases. Modified Gibson approach was used during the operation. After operation, group A was no preventing treatment, group B was treated by indomethacin 50 mg every time, twice a day; group C was treated by Xiaozhong Zhitong mixture 50 ml every time, twice a day for 4 weeks. Eighteen months after operation was study termination point and X-ray (including the double hip anteroposterior,obturator oblique and iliac oblique film) was used to observe whether heterotopic ossification was formed (Brooker classification was used to evaluate ossification degree); Harris scoring was used to evaluate the function of hip joint,including PAHSS 80 scores and IAHSS 20 scores.

RESULTSAll the patients were followed up,with the average of duration of 21.2 months. The condition of heterotopic ossification: for group A,there were 27 cases with heterotopic ossification(54%) ,and Brooker I in 8 cases, II in 9 cases, III in 8 cases and IVin 2 cases; for group B, there were 12 cases heterotopic ossification (21.82%), and Brooker I in 10 cases, II in 2 cases; for group C, there were 11 cases heterotopic ossification(22.45%), and Brooker I in 9 cases, I in 2 cases. There was significant difference among three group in heterotopic ossification by rank test (P<0.05), but no difference between group B and C (P>0.05); there were no significant difference among three groups before treatment in Harris, PAHSS and IAHSS by analysis of variance (one-way ANOVA) (P>0.05), and has significant difference at 18 months after treatment (P<0.01). There were significant difference in Harris, PAHSS and IAHSS before and after treatment at 18 months (P<0.01). LSD-t was used to analyzed the scoring of Harris, PAHSS and IAHSS, there was significant difference among group A and group B and group C (P>0.05), but no difference between group B and C (P<0.01). There were gastrointestinal reaction in 5 of group A, 35 in group B and 4 in group C.

CONCLUSIONThe effect of Xiaozhong Zhitong mixture on the prevention of heterotopic ossification after total hip arthroplasty is similar to indomethacin, but Xiaozhong Zhitong mixture has the advantages of less side effects and easily acceptance by patients.

Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; prevention & control

OBJECTIVETo compare the pharmacological effect of the main coumarin constituents of Peucedanum praeruptorum from Jiangxi and He'nan.

METHODThe constituents were isolated by column chromatography on silica gel and ODS and identified by NMR and MS spectroscopic methods. The antitussive, expectorant and anti-inflammatory effects of main coumarin constituents of P. praeruptorum observed in the present study.

RESULTThe main constituents of P. praeruptorum from both Jiangxi and He'nan showed the significant antitussive and anti-inflammatory effects without obviously expectorant effect.

CONCLUSIONThe pharmacological effects of the main coumarin constituents of Qian-hu from Jiangxi and He'nan are similar.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; isolation & purification ; pharmacology ; Antitussive Agents ; isolation & purification ; pharmacology ; Apiaceae ; chemistry ; China ; Coumarins ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; Female ; Male ; Mice

OBJECTIVETo observe the clinical effect of Huatan Zhuyu Jiedu Decoction (HZJD) in treating ankylosing spondylitis (AS).

METHODSOne hundred AS patients were randomly divided into two groups, the 60 patients in the treated group were treated with HZJD, the 40 patients in the control group were treated with Duhuo Jisheng Decoction. Treatment for both groups was orally given 1 dose per day in decoction form for 1 month as a treatment course. The efficacy of treatment was evaluated after 1-3 treatment courses.

RESULTSThe effect of treatment in the treated group was short-term controlled in 12 patients, markedly effective in 29, improved in 16 and ineffective in 3, the total effective rate was 95% (57 cases), while in the control group, the corresponding figure was 2, 8, 20, 10 and 75% (30 cases), comparison between the two groups showed significant difference (chi 2 = 20.85, P < 0.01). The manifestation of symptoms of patients in both groups improved obviously, the pain in loin and back alleviated, spinal motion (flexion forward, extension backward and lateral inclination) improved and thoracic expansion increased. Laboratory indices such as ESR, C3, IgA and CRP reduced obviously after treatment (P < 0.01 or P < 0.05), and better effect was shown in the treated group (P < 0.05). X-ray film after treatment showed improvement in 11 cases in the treated group and 4 in the control group, inter-group comparison showed significant difference (chi 2 = 7.99, P < 0.01), the effect of HZJD was better than that of the control.

CONCLUSIONHZJD has definite therapeutic effect in treating AS.

Adolescent ; Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Phytotherapy ; Spondylitis, Ankylosing ; drug therapy