ABSTRACT
Objective: the objective of this study was to identify the risk factors in NSAID users
Study design and setting: comparative prospective study, performed at the Department of Pharmacology and Therapeutics BMSI, JPMC with the collaboration of Departments of Medicine and Rheumatology JPMC Karachi from February 2008 to August 2008
Materials and methods: this study was performed on endoscopically diagnosed patients of NSAID induced peptic ulcers, in whom a clinical trial was performed between Ranitidine [H2 Receptor blocker] and new proton pump inhibitor Esomeprazole. Eighty Patients were selected and evaluated for presence of risk factors and dyspepsia after consumption of NSAIDs or low dose aspirin for last 6 months to 1 year. They were asked to fill in a specially designed proforma regarding the use of NSAIDs, which also included the questions for their social setup, habits and diseases for which they were taking them. All the patients were tested for presence of H. pylori infection and anti-H. Pylori IgG antibody titers were determined by enzyme-linked immunosorbent assay. Patients taking anticoagulants and steroids were excluded from the study
Results: important factors that have been shown to increase the risk of NSAID-associated GI complications in our study included female gender [76%] presence of H.pylori infection [71%], combination of two NSAIDs [23.75%] and high-dose NSAID use [20%]. Other factors that may increase risk include social habits like heavy consumption of tea [30%], pan or Gutka consumption [8.75%]. Current evidence supports that H. pylorus potentates the risk of NSAID-induced gastrointestinal ulcers or clinical events, and a strategy of H. pylori testing and treatment in NSAID users may be adopted
Conclusions: the incidence of NSAID related gastrointestinal problems was present in 10- 15% of patients who belonged to high risk group. Identifying them is strongly recommended to avoid serious complications. H. pylori infection may also be eradicated before initiating NSAID therapy
ABSTRACT
Objective: To determine the safety of Losartan in hypertensive patients with Thiazide induced hyperuricemia. Design: Randomized, open label, prospective, comparative study. Setting: Basic Medical Sciences Institute Jinnah Postgraduate Medical Centre Karachi from February 2006 to July 2006
Methods: Total 60 hypertensive hyperuricemic patients were enrolled in this study, selected from medical OPD of Jinnah Postgraduate Medical Centre, Karachi. Patients were divided in three groups. Group DR-1 patients were treated with Thiazide 50 mg/day, Group DR-2 with Losartan + Thiazide 50 mg/day, and Group DR-3 with Losartan 50 mg/day. The effect on serum uric acid level was measured fortnightly
Results: Treatment with Thiazide + Losartan group DR-2 and Losartan group DR-3 significantly showed decrease in serum uric acid level. Whereas, Thiazide group DR-1 increased serum uric acid level. In contrast to Thiazide and Losartan + Thiazide, Losartan alone led to a greater reduction in serum uric acid level. The average percentage reduction in serum uric acid level in Thiazide + Losartan group was -12.75% and the average percentage reduction of serum uric acid level was -24.60% in Losartan group
Conclusion: These finding suggest that, Losartan in hypertensive hyperuricemic patients is more effective drug in lowering serum uric acid level. It may be worth pointing out that the serum uric acid level lowering effect of Losartan might be particularly useful in hyperuricemic patients those on Thiazide diuretic [for hypertension and heart failure]