RESUMO
Chronic kidney disease [CKD] coexisting with type 2 diabetes mellitus [DM] leads to coronary artery disease. The present study compares clopidogrel and low dose aspirin as prophylactic therapy against coronary events in patients with CKD with diabetes. Total 80 patients of CKD with type 2 DM were randomized and allocated to clopidogrel and aspirin groups to receive the drug at a dose of 75 mg and 150 mg once daily respectively for 8 weeks as add on therapy. Main outcome was change in blood pressure, metabolic parameters, renal function, inflammatory biomarkers, platelet aggregability and [UKPDS] United Kingdom Prospective Diabetes Study risk scoring. Significant decrease in blood pressure [P < 0.01], total cholesterol [P = 0.02], LDL [P < 0.01], triglyceride [P < 0.01] and a better glycemic control [P < 0.01] was found in clopidogrel group. Renal markers and electrolytes have been improved in clopidogrel group but in aspirin group there was deterioration [2.5%] of creatinine clearance. Clopidogrel group has shown a significant decrease in hsCRP [P < 0.01], UKPDS risk scoring [P < 0.01] and better anti aggregatory effect. Clopidogrel has prophylactic role in CKD with type 2 DM due to better control of metabolic parameters, renal function and inflammatory burden in comparison to aspirin
RESUMO
Contact lens induced trauma to the corneal epithelium results in increased release of inflammatory mediators. The keratocyte apoptosis is directly related to epithelial injury and has been correlated with increased production of nitric oxide. Potent antioxidant enzymes protect cells from oxidative damage by inactivating reactive oxygen species and thus inhibiting apoptosis. This study aims at determination of total nitric oxide and antioxidant enzymes in tears which will be an indirect criteria for assessing apoptosis. Nitric oxide and antioxidant enzymes were estimated in tears of 25 soft contact lens wearers and compared with 25 age and sex matched controls. Statistically significant increase of nitric oxide [P<0.001], superoxide dismutase [P<0.001] and glutathione peroxidase [P<0.001] levels was seen in tears of contact lens wearers as compared to controls. There was also statistically significant increase in the levels of antioxidant enzymes, superoxide dismutase [P<0.05] and glutathione peroxidase [P<0.01], with increase in the total duration of contact lens wear in years. Increase in the level of nitric oxide and antioxidant enzymes in tears of contact lens wearers suggested that contact lens wear suppresses the process of apoptosis. However, it was also postulated that the increased levels of nitric oxide balances the anti-apoptotic activities of increased levels of antioxidant enzymes by its pro-apoptotic activity leading to protective outcomes in contact lens wearers