ABSTRACT
Pruritus is a well-known manifestation of various cholestatic disorders. Increased opioidergic tone is one of the mechanisms for this. This prospective, uncontrolled study was done to determine the efficacy of intravenous naloxone in pruritus of acute cholestasis. Twenty-two patients with severe pruritus (based on visual analogue scale [VAS] score of 0–100 and associated symptoms) were treated with intravenous naloxone (0.4 mg every 8 hours) for at least 48 hours. Viral hepatitis E was found to be the most common etiology for cholestatic pruritus (n=12). Eighteen patients (81.8%) patients had significant reduction in VAS after 48 hours of starting naloxone; these patients also showed reduction in alkaline phosphatase and gamma glutamyl transpeptidase. There was no side-effect or ‘breakthrough’ phenomenon noted in any patient over next 6 weeks. Naloxone is safe and efficacious in symptomatic improvement in cholestatic pruritus.
Subject(s)
Adult , Caroli Disease/complications , Child , Diagnosis, Differential , Female , Humans , Hypertension, Portal/diagnosis , MaleABSTRACT
OBJECTIVE: To assess ankle brachial index (ABI) as a screening method to target subclinical atherosclerosis in middle aged individuals. MATERIAL AND METHODS: Total 160 patients over the age of 40 years were included in the study for a period of 16 months. Their ABI was determined either by colour Doppler method (30 patients) and/or sphygmomanometry (all 160 patients). A value of < 0.9 was taken as cutoff point for significant stenosis. RESULTS: Total 69 patients out of total of 160 had significantly low ABI value (43.12%) which shows that there is a very high incidence of low ABI in the community. Overall > 50% of the patients were largely asymptomatic and had presence of two or more risk factors. ABI < 0.9 was a good screening test to detect such individuals at an earlier stage (sub-clinical). CONCLUSION: A significantly low (< 0.9) ABI value can detect subclinical atherosclerotic vascular involvement and predict future occurrence of preventable major vascular event.