title: A preliminary pilot randomized crossover study of uzara (Xysmalobium undulatum) versus ibuprofen in the treatment of primary dysmenorrhea.
abstract: OBJECTIVE
  Preliminary evaluation of efficacy and safety of uzara use in treatment of moderate and severe primary dysmenorrhea in comparison to ibuprofen.
  
  
  METHODS
  This randomized, comparative two way cross-over study comprised 60 single female students at Faculty of Medicine, Ain Shams University, Egypt, aged 19-28 years with moderate (n = 46) or severe (n = 14) primary dysmenorrhea. Participants were randomized to take either uzara (80 mg/8 hours for two doses, then 40 mg/8 hours) then ibuprofen (400 mg/6 hours) in two subsequent cycles or vice versa. The pain intensity, using VAS, was recorded immediately before taking the medication (0 hour) and after 4, 12, 24, 48-60, 96-120 hours. Main outcome measures included effectiveness of pain relief defined as drop of VAS to 3 or less, patient's global evaluation of the drug, absence from school, the use of a rescue medication, and, in those who continued the treatment, the pain intensity difference (PID) at different points after start of medication and its sum (SPID).
  
  
  RESULTS
  Uzara was comparably effective to ibuprofen (78.3% vs. 86.7% of cycles; respectively), with comparable rates of effectiveness on global evaluation (being around 50% for either drug), and rates of school absences (11.7% vs. 13.3%; respectively). The need for rescue medication was different (18.3% and 10%; respectively), albeit with no statistical significance. The means of PID at different time points and SPID were comparable, with significantly lower average mean of VAS scores compared to that felt with no medication (1.6 vs. 6.8, p<0.001). Side effects were less with uzara than ibuprofen (0% vs. 8.3%, p<0.05).
  
  
  CONCLUSIONS
  Uzara might be as effective as ibuprofen in management of primary dysmenorrhea but with less side effects. These findings need to be confirmed by a properly designed trial with a larger sample size.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN25618258.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Karim H I
authors.initials: KH
authors.lastname: Abd-El-Maeboud
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed A M F
authors.initials: MA
authors.lastname: Kortam
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Ali
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mostafa I
authors.initials: MI
authors.lastname: Ibrahim
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Radwa M M Z
authors.initials: RM
authors.lastname: Mohamed
mesh_terms: D000328:Adult; D029062:Apocynaceae / Q000737:chemistry*; D018592:Cross-Over Studies; D004412:Dysmenorrhea / Q000188:drug therapy*; D004534:Egypt; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D010147:Pain Measurement; D010865:Pilot Projects; D010936:Plant Extracts / Q000494:pharmacology*; D011897:Random Allocation; D013997:Time Factors
chemical_list: D010936:Plant Extracts; D007052:Ibuprofen