Effect of antiviral therapy on hematological parameters in patients with chronic hepatitis

To find out the effect of antiviral therapy on hematological parameters in patients of chronic hepatitis. Interventional descriptive study. Military hospital [MH] Rawalpindi Pakistan from May to Oct 2004. 31 patients admitted to M.H Rawalpindi for treatment of chronic hepatitis were studied. Their hematological parameters including Total Leucocyte count [TLC], Haemoglobin [Hb] and Platelet count [Plt] were recorded before starting antiviral therapy and then at 3 monthly intervals. All the patients were given Inj Alpha-Interferon [INF] and Tab Ribavirin as antiviral therapy. Data was collected over a period of 6 months. Descriptive statistics were applied to the recorded data using SPSS ver-10.0 for analysis. 31 patients with mean age +/- SD 38.58 +/- 8.85 years [range 16-49 years] were studied. There was mean hemoglobin [Hb] fall of 0.87g/dl at 3 months and 2g/dl at 6 months of antiviral therapy. Mean Total leukocyte count [TLC] fall of 1.30x10[9]/L at 3 months and 1.87x109/L was noted at 6 months. Similar downward trend was noted in Platelet [Plt] values with mean fall of 23.19x10[9]/mm[3] and 28.29/ mm[3] at 3 and 6 months of antiviral therapy respectively. 10% of the cases developed clinically significant anemia as evidenced by hemoglobin 11g/dl after 6 months of antiviral therapy. Clinically significant leucopenia [< 2.5x10[9]/l] was noted in 7% of the cases. This fall was noted only in first three months of treatment. There is significant decrimental response of hematological parameters to antiviral therapy

Chemotherapy of acute myeloblastic leukaemia with DAM regimen.

32 patients of denovo-ANLL were treated with Doxorubicin, Ara-C and 6-Mercaptopurine (DAM) regimen. Remission induction was instituted with 1-3 cycles of DAM regimen and maintenance was given by 6-MP continuously with intermittent DA (1,5) regimen. In the remission induction, Doxorubicin 30 mg/m2 for 3 days, Ara-C 150 mg/m2 for 5 days and 6-Mp 100 mg/m2 daily was given. Complete remission (CR) was observed in 60% cases. The probability of 2 years disease-free survival of patients with complete remission is 56.73%.

Effect of alkaloidal extract from Clerodendron colebrookianum on hematological parameters and hepatorenal functions in mice.

Effects of multiple weekly (20, 40 and 80 mg/kg) and daily therapeutic (2, 4 and 8 mg/kg) ip doses of C. colebrookianum leaf extract on liver and kidney functions and hematological parameters in mice were studied. No alteration in hematological and biochemical parameters at low and moderate dose level of daily and low dose level of weekly treatment of alkaloidal extract was observed. However, alkaloidal extract at moderate dose in weekly treatment increased significantly serum alanine aminotransferase, alkaline phosphatase, nonprotein nitrogen, blood urea, plasma protein and erythrocyte sedimentation rate. High dose of alkaloidal extract increased all the above parameters of weekly treated mice including serum aspartate aminotransferase and plasma cholesterol and decreased significantly serum bilirubin and clotting time. Whereas, in high dose daily treatment erythrocyte count and hemoglobin content were increased and serum bilirubin was decreased. The present study reveals that the high dose (above 40 mg/kg body weight) of alkaloidal extract of C. colebrookianum affects liver and kidney functions and metabolism and also alters only clotting time and ESR whereas the therapeutic dose level (hypotensive action at 2 to 8 mg/kg, i.v., dose level) did not exhibit any toxic action on the above mentioned system; the toxic action may be due to overdose. Hepatorenal dysfunction and alteration of hematological parameters were noted at moderate and high dose in a dose dependent manner.

Late effects of cyclophosphamide treatment of neonatal mice.

Swiss mice surviving early onset of wasting disease at 4-6 weeks following cyclophosphamide administration at birth suffer from delayed effects of this immunosuppressive drug. The late wasting syndrome developing at 6-8 months post-inoculation is characterized clinically by loss of weight, hunched posture, ruffled fur and diarrhoea. Lymphocyte and granulocyte levels are raised. The lymphocyte/granulocyte ratio is significantly inhibited. The development of various pathological lesions in thymus, spleen, lymph nodes and bone-marrow is frequently observed. Infiltration of lymphoid tissue in lungs, liver and kidneys is a common feature. It is hoped that further experimental studies would provide more insight into the delayed adverse effects of cyclophosphamide therapy.

Clinical study on antithrombotic effects of ticlopidine in ischemic stroke.

The investigators conducted a clinical study on antithrombotic effectiveness in ischemic stroke at Siriraj Hospital Medical School, Mahidol University from May 1987 to May 1989. Twenty-nine patients, 16 males and 13 females were enrolled in the study. The ages of the patients ranged from 30-87 years with a mean age of 63 +/- 11 years. Ticlopidine (250 mg) could significantly inhibit platelet aggregation induced by ADP and collagen within 24 hours of drug administration. After 1 week to 6 months, only aggregation by ADP was still inhibited significantly without significant effects on fibrinolytic activity and prostacyclin. Hematocrit was significantly decreased at the 1st and 2nd month of treatment. Serious side effects were skin rash and severe headache while the other common ones were dizziness, and diarrhea but these effects disappeared without discontinuing the drug. Most patients who suffered from nausea, diarrhea and headache, had temporary elevated SGPT. It may be concluded that only half of the recommended dose of ticlopidine has inhibitory effects on both phases of ADP-induced aggregation without interfering with fibrinolytic activity and can maintain prostacyclin. However, it also possesses either serious or common side-effects. This drug, therefore, should be used with the awareness of the clinician.