RESUMO
Background: The objective of the study is to estimate platelet volume indices in patients of cerebral ischemic vascular disease. Methods: The present study was conducted on 170 subjects in Department of Medicine, NIMS Medical College and Hospital, Jaipur, Rajasthan over eighteen months. The study was conducted on 60 patients admitted in the wards and ICU under the Department of Medicine and 110 controls who were the normal and healthy during the study period. In this study the values of platelet indices – MPV, PDW and platelet count were observed in patients of cerebral ischemia. It was found that large platelets contribute to the prethrombotic state in ischemic syndromes and they may play a specific role in infarction. Because larger platelets are haemostatically more active and hence, their presence is probably a risk factor for developing thrombosis. Statistical analysis was done using Chi – square test, unpaired ‘t’ test and ANOVA test. A p value <0.05 was considered statistically significant. Results: In this study it was found that in cerebrovascular disease patients, MPV was 10.30±0.83 fL, PDW was 14.50±0.55 fL, platelet count was 260×109 ± 29×109 /L while in control, MPV was 8.14± 0.72 fL, PDW was 10.71±0.48 fL, platelet count was 285×109 ± 50 ×109 /L. MPV and PDW were higher and platelet count lower in cerebrovascular disease group and a highly significant difference (p<0.001) was found on comparing with controls. Conclusion: In this study, it was found that MPV and PDW were raised in cerebrovascular disease suggestive of statistically highly significant when compared to normal control group.
RESUMO
<p><b>OBJECTIVE</b>To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.</p><p><b>METHODS</b>108 patients with visceral hypersensitivity accompanying IBS, divided into three groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.</p><p><b>RESULTS</b>Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS.</p><p><b>CONCLUSIONS</b>Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.</p>