Takayasu’s arteritis in 174 Thai patients.

A testrospective study of 174 patients (46 male, 128 female, male: female = 1 : 2.78) suffered from Takayasu’s arteritis since 1980 was performed. Most cases were found in age range from 11 to 30 year old. The major symptoms observed in this disease were headache 45.98%, dyspnea on exertion 34.48%, blurred vision 24.14%, intermittent claudication 18.39%, fever 17.24%, chest pain 16.09% and hemiplegia 14.37%. Physical signs detected included hypertension 75.29%, unequal pulses 66.67%, pulsatile mass and/or vascular bruits at the abdomen and neck 27.59% and 10.34%, respectively. Congestive cardiac failire and left ventricular hypertrophy were observed in a quarter of the patients. For laboratory findings, the frequently sedimentation rate (ESR) was found to be a good indicator of arch and abdominal aortogram of 137 Takayasu’s arteritis patients revealed that aorta and nearly all of its main branches were involved, renal arteries 65.69%, abdominal aorta 51.82%, subclavian arteries 40.15% and thoracic aorta 29.93%. Two patients died, one was from cerebral hemorrhage and the other was from renal failure.

Radiotherapy and malignant pheochromocytoma.

This is a report of a case of a 19-year old female patient who suffered from malignant pheochromocytoma with metastasis to abdominal paraaortic lymph nodes, liver and spleen. She was treated with partial resection of the tumor mass and received 2,000 rads radiation twice within 5 years on the metastasized lesions combined with antihypertensive deugs: prazosin (blocker) and propranolol (blocker). Reduction in size of the metastatic lesions and controlled blood pressure were achieved. Now, the patient in still alive, enjoying life and happy after 12 years of treatment.

Plasma renin activity in Thai essential Hypertension.

Plasma renin activity was measured by redioimmunoassay in 38 Thai essential hypertension. There were three types detected : -Low renin = 7 cases (18.42%) normal renin = 27 cases (71.05%) and high renin = 4 cases (10.53%) No relationship was found between 24 hours specimen urine sodium and plasma renin as is found in normal populations. However, cardiovascular complication were observed in the high and normal renin subgroups especially in the high renin subgroup but no stroke or heart attack was observed in the low renin subgroup.

Mulicentre study on once daily ramipril in Thai hypertensives.

One hundred and one mild to moderate hypertensive patients were given ramipril 2.5 mg once daily in an open study carried out in 10 hospitals from different parts of Thailand. Eighty-five patients completed the study. Mean sitting and supine blood pressures from the 85 patients were significantly reduced after 3 weeks treatment with ramipril, reductions being 12/9 mmHg (p<0.001) and 9/7 mmHg (p<0.001) respectively. Thirty six out of these patients who received the initial dose of 2.5 mg ramipril achieved target blood pressure (sitting diastolic blood pressure of <90 mmHg) at week 3. Continuation of treatment for another 3 weeks resulted in no further reduction of blood pressure. Forty nine patients needed dose-adjustment to 5 mg for the second 3 weeks and this adjustment resulted in further significant decreases in both sitting and supine blood pressure (17/10 mmHg, p<0.001 and 13/10 mmHg, p<0.001 respectively). No significant change in pulse rates and laboratory parameters were observed. No adverse events of clinical significance were reported in 95 patients except cough which was found in 4 patients and headache, dizziness and insomnia in only 3 patients. In conclusion, ramipril given once daily was found to be safe and effective in the treatment of mild to moderate hypertension in Thai adults.

Efficacy and safety of cilazapril versus nifedipine retard in essential hypertension.

A double-blind study of cilazapril (ACE inhibitor) versus nifedipine retard (calcium antagonist) in the treatment of 18 (10 on cilazapril and 8 on nifedipine) mild to moderate essential hypertensive patients (diastolic B.P. 95-115 mmHg) was performed. Both drugs were effective in lowering blood pressure to satisfactory levels by using cilazapril 2.5-5 mg once daily and 20 mg twice a day of nifedipine retard for 10 weeks. There were no adverse effects on hematological or biochemical parameter studies and no other side-effect, especially cough which is usually attributed to the ACE inhibitor therapy. This study showed that cilazapril, a new once daily ACE inhibitor, and nifedipine are safe and effective antihypertensive agents.

Felodipine ER in the treatment of hypertension.

Twenty-two patients with mild to moderate hypertension were treated with felodipine ER 5 mg once daily for the three weeks of treatment at the out patient department. At the end of the three-week period, if diastolic blood pressure still exceeded 90 mmHg, then dose of felodipine ER would be increased to 10 mg/day until the end of the trail (6 weeks). After three and six weeks of treatment, systolic blood pressure was significantly reduced from 164.6+14.6 to 149.4+17.3 and 140.4+14.5 mmHg, diastolic blood pressure also was significantly reduced from 102.8+7.8 to 94.7+7.6 and 91.9+8.4 mmHg, repectively. The responder rate (diastolic blood pressure < 90 mmHg) was 64 percent at the end of the trial. No changes of blood sugar, serum lipid and renal function were observed, but the Na+ level was decreased, and SGOT and SGPT were increased significantly from the pre-treatment level; however, they remained within the normal range. Therefore, felodipine ER is one of the calcium antagonists which is suitable for treatment of mild to moderate hypertension.

Double-blind trial on ornidazole and tinidazole in a single low dosage regimen in amoebic liver abscess.

A double-blind trial on ornidazole and tinidazole was studied with 46 patients suffering from the amoebic liver abscess. Thirty eight patients were male and eight patients were female. Group I consisted of 21 males and 4 females and single dose of ornidazole 2,000 mg. was given orally. Group II consisted of 17 males and 4 females and the same dose of tinidazloe was given orally. The treatment also included liver aspiration every other day from the big abscess and every 3 days from the small abscess. The results of treatment were successful and there was no significant difference between the two groups, except one case treated by tinidazole had a recurrence of the abscess after follow up 4 months later. The cure rate of group I was 100 percent and of group II 95.45 percent. The observed side effects were loss of consciousness for a few minutes in one case from group I and dizziness and vomiting in one case from group II.