Efficacy of thrombolytic therapy in preserving left ventricular function following acute myocardial infarction

This study is a prospective study to determine the value of thrombolytic agents in restoring patency in the infarct related artery and its consequent effect on left ventricular function. At total of 48 patients were investigated, all presenting with symptoms of chest pain. Clinical, electrocardiography and echocardiographic criteria were used to document myocardial infarction. 2-D and M-mode echocardiography was used to detect abnormalities of contraction and relaxation of myocardium. Two group of patients were formed giving thrombolytic and non thrombolytic therapy. Echocardiography was done on admission, discharge and three weeks after discharge from hospital. Patients in both group were evaluated for clinical signs of left ventricular dysfunction according to Killip criteria. The study showed a better left ventricular function in group receiving thrombolytic therapy. Patients who could not be given thrombolytic therapy showed deteriorating left ventricular function which progressed even after one week. It is concluded that addition of thrombolytic therapy definitely improves left ventricular function by restoring patency of infarct related artery, and thereby improving perfusion of ischemic myocardium

Efficacy of monotherapy versus combination therapy in moderate hypertension

This prospective study was conducted to ascertain the difference in efficacy of a long term ACE inhibitor, Ramipril, used alone and in combination with a dihydropyridine calcium antagonist, amlodipine, in moderate hypertension. The patients were free from long term complications of hypertension. This study included 60 patients aged 25-62 years [42 males, 18 females] with essential hypertension, stage II i.e. systolic B.P ³160 mmHg and diastolic B.P[3] 100mmHg [JNCVI ]. Two groups of patients were formed, group A included patients treated with Ramipril alone and group B included patients treated with combination of Ramipril and amlodipine over a period of six weeks. The study showed a prominent decline in blood pressure of patients in both groups, however target blood pressure was achieved and sustained more effectively in group B. It is concluded that in order to obtain a more stable drop in blood pressure, combination therapy is more beneficial both in efficacy and cost effectiveness than monotherapy