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AIM: to evaluate the analgesic effect, the side effects and the safety of analgesics following endoscopic urological procedure. METHODS: eighty patients who underwent endoscopic urological surgery at Kardinah Hospital, Tegal from June to July 2015 were divided into four groups. The experimental group was administered analgesic for 4 days pipemidic acid (A) 400 mg bid, or phenazopyridine (B) 200 mg tid, or sodium diclofenac (C) 50 mg bid and the control (D) group was administered placebo tid for 4 days. The analgesic effects were assessed using Visual Analog Scale (VAS). Association between variables was assessed using Cramers V and Kruskall Wallis. RESULTS: the endoscopic urological procedures consisted of 30 patients for URS, 6 patients for lithotripsy, 17 patients for TURP, 24 patients for removal JJ stent and 3 patients for cystoscopy. The mean age of group A, B, C and D (control) was 50.1 (13.7), 50.7 (14.8), 49.1 (13.4), and 49.6 (14.3) years, respectively, and follow-up period was 7 days. The VAS score in all experimental groups was less than control group on day 1 to 7 following endoscopic urological procedures (p<0.05). In the experimental group, there was no difference between groups B and C (p>0.05). Group A demonstrated a more favourable analgesic effect than B and C (p<0.05). No serious side effects were detected in any of the cases. CONCLUSION: we conclude that oral analgesics are effective for pain relief following endoscopic urological surgery. Pipemidic acid was found to have a superior analgesic effect than phenazopyridine HCl and sodium diclofenac.

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Urinary Tract Infections are the largest group of infections after the respiratory tract infections. In 85% of the cases the causative organism is E. Coli. A clinical trial was conducted to evaluate the efficacy of coded herbal formulation "Cranoff" (Test drug) for the treatment of Urinary tract infection comparing with Urixin (Control). One hundred and thirty patients suffering from Urinary tract infection from both groups (Males: 45, mean age: 34±14 and females: 85, mean age: 33±13 year, range: 15-55) were enrolled in the trial and divided in to two groups according to treatment regimens. Cranoff (Test drug) 500mg two capsules and Urixin (Pipemidic Acid Trihydrate JP15) (Control) 400mg capsules twice daily were prescribed for 2-3 weeks. Urinary tract infection was improved in 23 (35.38%) patients out of 65 patients by the use of Cranoff (Test drug), and in 15 (23.07%) patients out of 65 by the use of Urixin (Control drug). Furthermore, there was a significant improvement in Urinary tract infection associated clinical features as compared to Urixin. It is concluded that Cranoff possesses a therapeutic value for the improvement of urinary tract infection and its associated symptoms as compared to Urixin.

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We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients' characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%, P < 0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P < 0.001). E. coli was the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

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The authors report a case of Schistosoma haematobium infection with delayed occurrence of Salmonella bacteriuria following treatment of schistosomiasis. Standard models of interaction between these two pathogens may not be fully satisfactory in such a case of co-infection. The role played by a decreased host immune response following schistosomiasis may thus be highlighted to explain a delayed or prolonged infection with Salmonella.

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Report of a retrospective study to evaluate susceptibility of Escherichia coli to quinolones covering the March-December 1992 interval. During this time, intra and extra-hospital strains were indistinctly studied in patients with urinary infections seen in a health district serving a total of 200.000 inhabitants. Resistance to Pipemidic acid, Norfloxacin and Ciprofloxacin was evaluated. The values found were 14.8% resistance to Pipemidic acid, 11.1% to Norfloxacin and 8.5% to Ciprofloxacin. It seems necessary to develop and apply methods addressed to minimize the appearance of quinolone resistance, which should be implemented in order to preserve the usefulness of these drugs.

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In a ten-year survey (1983-1992) of quinolone resistance in Escherichia coli causing urinary tract infections in a general practice patient population, 9,934 strains were tested. Resistance increased remarkably from 1989 onwards. The rate of resistance to pipemidic acid was < or = 6% before 1989 and 18% in 1992; the rate of resistance to ciprofloxacin (MIC > or = 4 mg/l) was 0.8% in 1989 and 7.1% in 1992. Although the consumption of older quinolones decreased the total consumption of quinolones increased yearly.

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OBJECTIVE: To make an assessment of the effectiveness and safety of a single oral dose compared with the conventional way of treating low-level Urinary Infections presenting no complications. DESIGN: This was an investigative and prospective study, using a control, a simple blind and randomised sample. SITE. Health Centres in Oviedo and Zaragoza. PATIENTS OR OTHERS PARTICIPANTS: We looked at 150 patients and included 106 females between the ages of 16 and 75 in the study. Their clinical symptoms were compatible with low-level urinary infections presenting no complications. INTERVENTIONS: 49 patients were given Trometamol Phosphomicine (TP) in a single oral dose; 36 took Pipemidic Acid (PA) and 21 Norfloxacine (NFX), both of these in a dose of 400 mg twice a day for 5 to 7 days. MAIN MEASUREMENTS AND RESULTS: Clinical and bacteriological assessments of the results were made 3, 7, and 28 days after treatment. A total of 75 gems were isolated: E. coli was the most common (68%). In all three groups, the main symptoms rapidly disappeared after the start of the treatment. CONCLUSIONS: Having considered the bacteriological and clinical findings, as well as tolerance levels, we are able to conclude that a single oral dose of Trometamol Phosphomicine is a good alternative to conventional therapy for the treatment of low-level Urinary Infections Which present no complications.

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Trinta e cinco pacientes, com idades de 45 a 86 anos, submetidos à cirurgia endoscópica de próstata e sondados por um período médio de dois dias no pós-operatório, receberam ácido pipemídico por via oral na dosagem diária de 800 mg, divididos em doses de 400 mg a cada 12 horas. O período de utilizaçäo da droga foi de oito dias. Foram realizadas uroculturas antes da intervençäo e, no mínimo, três dias após o termino do tratamento antimicrobiano. Consideraram-se infectadas todas as amostras de urina que apresentavam crescimento bacteriano, independente do número de colônias. Dos 35 pacientes estudos, 22 näo apresentaram infecçäo pós-operatória (63 por cento). De 26 pacientes sem infecçäo antes da operaçäo, 18 se mantiveram estéreis (69 por cento); dos nove previamente infectados, quatro se curaram após a ressecçäo (44 por cento). Considerando a praticidade posológica, a tolerabilidade e o baixo custo do ácido pipemídico, os autores concluem pela viabilidade da sua utilizaçäo em pacientes submetidos à ressecçäo endoscópica da próstata sem infecçäo prévia, sendo preferível, naqueles previamente infectados, o uso de antibióticos específicos, conforme orientaçäo do antibiograma

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75 patients with acute ame bic dysentery treated with pipemidic acid (PPA) alone and 11 patients with norfloxacin (NFX) alone constituted two study groups and 30 patients treated with metronidazole (MNZ) formed a control group. It was found that the cure rates of PPA, NFX and MNZ were similar (P greater than 0.05), being 98.67%, 100% and 93.33%, respectively; the number of days to become afebrile and to stop abdominal pain in these three groups was also similar (P greater than 0.05); the number of days to stop diarrhea in PPA group was similar to that in NFX (P greater than 0.05), but it was significantly shorter in these two groups than that in the controls (P less than 0.01 and 0.05). As to adverse drug reactions, PPA had the least, NFX was similar to PPA (P greater than 0.05), but MNZ had significantly more than PPA (P less than 0.01).

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The paper examines to treatment of 40 cases of urinary infections and compares the efficacy of pipemidic acid, norfloxacin, cinoxacin and ofloxacin. All these compounds demonstrated a good level of therapeutic efficacy, both in terms of management and effectiveness; in particular, norfloxacin and ofloxacin were preferable to the other compounds since they caused fewer side-effects.

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The authors carried out clinical trial of the preparation Palin (pipemidinic acid) on 43 women with persistent colpitis after preliminary testing. There was negative microbiological finding in 67% of women. The results of the authors differed from those of other authors, since Palin was used mainly in women with chronic colpitis resistant to routine treatment. Minimal side effects were found. Usage of Palin is recommended in women with colpitis, caused by: E. coli, Enterococcus, Klebsiella and mixed aerobic flora.

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In order to evaluate the efficacy and safety of fosfomycin trometamol as single dose oral treatment for acute cystitis in women, an open, multicenter comparative study was carried out in general practices in France, 386 women, aged 16 to 75 years, with clinical symptoms of acute cystitis were enrolled in the study to receive either a single 3 g oral dose of fosfomycin trometamol or a five-day course of 400 mg pipemidic acid twice daily. The diagnosis of cystitis was based on clinical symptoms and significant bacteriuria (greater than or equal to 10(5) cfu/ml midstream urine). Follow-up examinations were carried out five to ten and 28 days after the end of treatment, 289 and 244 patients, respectively, were available for clinical and bacteriological evaluation at short-term (five to ten days) and medium-term (28 days) post-treatment follow-up. Both regimens were comparable for clinical and bacteriological efficacy with short-term eradication rates of 122/146 in the fosfomycin trometamol group and 130/143 in the pipemidic acid group. The results of medium-term follow-up were 113/122 and 114/122 for the eradication rates of the respective groups. Both drugs were well tolerated. Side effects were mild and of significantly shorter duration in the fosfomycin trometamol group.

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The Italian multihospital study of bacteriuria in pregnancy randomized 153 pregnant bacteriuric patients to receive fosfomycin trometamol (FT) as a single dose of 3 g and 138 such patients to receive conventional therapy with pipemidic acid (PA), 400 mg b.i.d. for seven days. The two groups were well matched for age, parity, pregnancy course, symptoms and past history of cystitis. Infecting organisms were eradicated in 147 (96%) of FT and 129 (94%) of PA patients. Similar recurrence rates occurred. Minimal side effects (mostly nausea and dyspepsia) occurred (9%) FT; 15% PA). Single-dose FT appeared equivalent to conventional treatment with PA.

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Urinary tract infection in children is still an important problem in uronephrology. The disease tends to develop recurrently and results in chronic progressive renal disease in the future. Pipemidic acid is a bactericidal quinolone derivate, with a wide spectrum against gram positive and negative bacteria. Compared with nalidixic acid, pipemidic acid proves to be more effective against Pseudomonas, E. coli, Alkaligenes and Salmonella. Thirty one cases with acute urinary tract infection had been studied descriptively. The etiology revealed as follows: E. coli (45.2%), Alkaligenes (16.2%), Enterobacter (9.6%), Staphylococcus (9.6%), Pseudomonas (9.6%), Paracolon (6.5%), and Proteus (3.3%). Pipemidic acid was administered orally to these patients, 15-20 mg/kg/day divided in 2 equal doses for 10 days. Bacteriological examinations was repeated on the 6th day and 11th day treatment. The result revealed that on the 6th day of treatment, in 27 patients (87.09%) there was no bacteriuria while on the 11th day the urine of 29 patients (93.54%) were sterile. In conclusion, a 5 day treatment of acute urinary tract infection in children with pipemidic acid is quite effective.

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