Effects of oral contraceptive therapy and its duration on the liver functions

Liver function tests were done in 75 females aged 20-40 year using oral contraceptives for 1-2-4 months and compared with 30 age matched controls. Use of any type of oral contraceptives either for 16 months [short term] or 6-24 months [long term], were associated with significantly higher levels of serum alkaline phosphatase, aspartate trasnaminase [AST], alanine transaminase [ALT], bilirubin and thymol turbidity as compared to controls. However. levels of these constituents of blood appear to be non-significantly different when compared among the two groups using oral contraceptives for short term and long. It is suggested that oral contraceptive drugs should be used with care and with proper investigation of the liver function before and during therapy

short term study of hypoglycemic effects of acarbose in diabetes mellitus

A six weeks trial of Acarbose [Glucobay], a glucoside-hydrolase inhibitor was conducted in 50 uncontrolled diabetic patients attending the Diabetic Clinic at PMRC Research Centre. Ganga Ram Hospital. Lahore. Eighteen patients were newly diagnosed, 18 were taking oral hypoglycaemics and 14 were on insulin therapy. All these patients were given Acarbose either alone [newly diagnosed]] or in combination [those on oral hypoglycaemics or insulin]. The results showed a statistically significant reduction In the blood sugar levels after the intake of Acarbose. Only 3 patients complained of abdominal distension. No other serious side effect was observed and drug was well tolerated. It is concluded that Acarbose can be effectively used as a primary drug or in combination with other hypoglycaemic agents to improve the glycemic control in all types of diabetes mellitus

Hyperlipidemia in a treated group of hypertensives: a general profile

One hundred patients of essential hypertension uncomplicated at the initial registration with an average of about 11 year followup attending the Hypertension Clinic, PMRC Research Centre, Sir Ganga Ram Hospital, Lahore were reviewed for various metabolic and cardiovascular complication. Hyperlipidaemia was observed in 44 [4% per annum] of which 50% developed cardiovascular complications compared to 41.07% of 56 non-hyperlipidaemic hypertensives. Incidence of coronary heart disease [CHD] was 38.64% and hypertensive heart disease [HHD] 20.45% compared to 23.21% of CHD and 12.50% HHD among non-hyperlipidaemics. Out of the hyperlipidaemics 6 were found to have obesity and diabetes mellitus with a familial predisposition in 4 [66.67%]. Different behavioural characteristics including age, sex, family predisposition, smoking habits, height and weight were comparable between the two groups. Severity of hypertension and control status of blood pressure did not differ significantly except that the hyperlipidaemic group were prescribed with diuretics and Beta-blockers more frequently and for longer durations. It is concluded from the results that with similar behavioural pattern and a comparable control status of hypertension, higher incidence of hyperlipidaemia is probably related to pharmacological therapy resulting in higher cardiovascular complications. It is, therefore, recommended to use these drugs with regular monitoring of lipid levels and cardiovascular status, particularly with familial tendencies

Long term follow-up of essential hypertension

One hundred patients registered at Hypertension Clinic, PMRC Research Center, Fatima Jinnah Medical College Lahore, suffering from uncomplicated essential hypertension of all grades with a minimum follow-up of 5 years, were re-evaluated. Mean duration of follow up in this group was about 11 years. Annual incidence rate of complications developing during follow-up period was: urinary tract infection [28%] retinopathy [4.28%] coronary heart disease [2.74%], hypertensive heart disease [1.46%], cerebrovascular accidents [0.73%] and arrythmias [0.46%]. Annual incidence of metabolic complications included diabetes mellitus [3.37%], hyperlipidaemia [3.10%] and hyperuriceamia [0.18%]. There was one case of renal failure [0.09%]. Annual incidence rate of hypertensive complications increased with increasing duration of disease. The cardiovascular diseases increased from 39.28% to 60% within 5 to 19 years, diabetes from 35.71% to 60% retinopathy from 32.14% to 80%, and hyperlipidaemia from 21.42 to 40%. No difference was observed in the incidence of complications within regular and irregular compliant groups, though the metabolic complications were more frequent in the former. Side effects were only mild except one case of severe bronchospasm with beta-blockers and one of postural hypotension with prazosin. One female with past history of viral hepatitis developed jaundice while on methyldopa

Experience with anti-hypertensive drug therapy in a hypertension clinic-1972-1983: a retrospective analysis

Retrospective experience with drug therapy in 747 patients with essential hypertension registered from 1972-1983 is reported. Five hundred patients were seen between 1972 to 1978 and 247 between 1979-1983; the latter group was characterised by the use of beta blockers as first line drugs.Hypertension was graded according to level of diastolic blood pressure as mild, moderate and moderately severe or severe in 423, 211, and 113 patients, respectively. The overall response to treatment at 6 months was satisfactory in 66.2% of mild, 50.2% of moderate and 58.4% of severe grades of hypertension. A large number of patients in both the groups having varying grades of severity needed at least 2 to 3 drugs for the control of hypertension. The side effects of drugs were generally mild which included general weakness with diuretics; skin rash, nasal congestion and pruritus with methyldopa; cold extremeties with beta blockers and palpitations with prazosin

Study of serum lipids and blood pressure in adolescents

Cardiovascular risk factors i.e. blood pressure, serum triglycerides, total cholesterol and high density lipoproteins were studied in 99 adolescents, aged 13-18 years. Height, weight and pulse were also recorded. No significant difference was found between the lipid profiles of male and female adolescents. Blood pressure, both systolic and diastolic, was significantly higher, though within the normal range, in boys with a family history of hypertension than in those with a negative family history. There was no significant difference between the blood pressures of girls with or without a family history of hypertension

Prevalence of obesity in patients with essential hypertension of varying severity

Five hundred patients with essential hypertension of varying severity were reviewed for ponderal index values. They were divided into 4 grades, i.e., mild, moderate, moderately severe and severe according to the level of diastolic blood pressure. The prevalence of obesity in the overall group was 56.2%. The mean ponderal index values in various groups did not show any significant difference. Hypertensives with diabetes mellitus who comprised 23.4% of all the patients did not materially affect the prevalence of obesity amongst hypertensives

Clinical evaluation of 'tenormin' [atenolol] in hypertension

An open 4 week study for evaluating the efficacy of Tenormin [100 mg 'Atenolol' once daily] with or without chlorthalidone was carried out in 52 hypertensive patients with uncomplicated mild to moderately severe essential hypertension. A tablet count at the end of study enabled patient compliance to be judged. Of the 52 patients, 41 completed the study; 8 patients were lost to follow up and in 3 drug had to be withdrawn because of side effects. A statistically significant fall in systolic and diastolic blood pressure was observed in 15 patients taking Tenormin alone and in 26 when combined with Chlorthalidone. 84% patients showed fair or excellent compliance to therapy over this short period. 5 of 44 patients taking the drug suffered from side effects which included gastrointestinal disturbances [2], skin rash [1], retrosternal discomfort [1] and numbness of hands and feet [1]

Comparative study of antihypertensive effect of a thiazide diuretic, propranolol and prazosin in mild to moderate hypertension

A short within patient trial was carried out to compare the anti-hypertensive effects of a Thiazide diuretic, Propranolol and Prazosin in 10 female patients with uncomplicated mild to moderate hypertension. The results show that all the three anti-hypertensive agents were reasonably effective in controlling the blood pressure in this group of patients. All the three drugs were well tolerated but Thiazide diuretic has the advantage of being cheaper than the others