Study of viral markers, clinical and biochemical profile of viral hepatitis in patients of alcoholic liver disease

Background: There is a significant worldwide burden of Alcoholic Liver Disease (ALD). Both alcohol abuse and infection with hepatitis viruses can lead to liver disease. Alcohol and hepatitis viruses have synergistic effects in the development of liver disease. Thus, early detection of virus hepatitis and targeted interventions can improve prognosis in ALD.Methods: This cross-sectional study was conducted among 180 patients coming to Baroda medical college and SSG hospital, Vadodara having alcoholic liver disease were studied and evaluated for markes of viral hepatitis and its clinical and biochemical profile in alcoholic liver disease.Results: our study we had taken 180 patients of alcoholic liver disease out of which male were 92% and female were 8%. Prevalence of viral hepatitis was 27.7% in ALD patients. Out of which hepatitis E was 13% followed by hepatitis A 11%, hepatitis B 4.44% and least was Hepatitis C 0.5%. In clinical profile fever was significantly higher in patients of viral hepatitis with ALD than patients without viral hepatitis. Bilirubin was not significant differ in both groups of patients but SGOT and SGPT had higher values in patients of viral hepatitis with ALD and thus ratio of SGOT/SGPT was also affected due to higher value of SGOT and SGPT.Conclusions: Alcohol consumption and hepatitis virus infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. Patients starting treatment for chronic viral hepatitis infection should be specifically advised to stop or reduce alcohol consumption because of its potential impact on treatment efficacy and adherence and may benefit from additional support during antiviral therapy specially in chronic hepatitis

Study of prevalence of hypertension and its various risk factor in type 2 diabetes mellitus patients

Background: Surgical diabetes is syndrome of hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiency of insulin secretions. Diabetes mellitus and hypertension considered as a major medical and public health issues worldwide, and both are important risk factors for both macrovascular and microvascular diseases like coronary artery disease, heart failure and cerebrovascular diseases.Methods: This cross-sectional study was conducted among 175 patients coming to Govt. medical college and SSG hospital, Vadodara from 2014 to 2015 having diabetes mellitus were studied and evaluated for hypertension and its various risk factor like age, obesity.Results: one hundred and twenty-nine (127) out of 175 subjects had hypertension, thus giving a prevalence rate of 73.7% of which 64 males (49.6%) were hypertensive compared with 65 (50.3%) females. Mean age of patients having hypertension with Diabetes Mellitus (case) is 59.87 compare to DM without hypertension (control) was 56.21. Mean BMI in diabetes cases with hypertension was 30.93 while without hypertension was 23.47 suggest obese are more prone to develop hypertension. Waist hip ratio DM with hypertension was 0.96 while was 0.81 in DM without hypertension.Conclusion: Hypertension and its associated risk factor like obesity, dyslipidemia are important risk factor for development of complication in diabetes patients so early detection and intervention measures should be undertaken for aggressive control of blood pressure control , obesity and it will likely to offer the greatest promise for reducing the incidence of complications and its associated mortality.

A study on mean platelet volume in ischemic cerebrovascular stroke

Background: Ischemic Cerebrovascular stroke is one of the largest cause of death and disability. It is usually caused by thrombosis or thromboembolic phenomena. Large platelets are more reactive, produce more prothrombotic factors and aggregate more easily, and can be a major risk factor/indicator for stroke. While the Mean Platelet Volume (MPV) has been studied in detail in cases of IHD, very few studies have been done in stroke, and none in India � prompting this study. We aim to determine whether an association exists between MPV and incidence/severity of stroke.Methods: The study was carried out among fifty patients with an acute ischemic stroke. Clinical severity was assessed using Modified Rankin憇 scale. MPV was measured using an automated analyzer. Fifty controls were recruited and analysed.Results: MPV has got a statistically significant correlation with Ischemic stroke with a p value of < 0.0001. Average MPV in cases was 9.78+1.25 fl vs. controls who average 8.30+1.14 fl. We did not find a statistically significant correlation between clinical severity of stroke and MPV (P = 0.550).Conclusions: This study has shown an elevation of MPV in acute phase of Ischemic stroke. Within this relationship and adjusting for other significant variables in multivariate regression analysis, it can be stated that an increase in MPV is independently associated with stroke. Further research is required into the role of platelet volume in stroke pathology, outcome, and, most importantly, in individuals at risk for stroke.

Cinitapride Extended-Release Tablets Versus Cinitapride Immediate-Release Tablets in the Treatment of Functional Dyspepsia and Gastroesophageal Reflux Disease : A Randomized Clinical Trial.

Prokinetics are commonly used for Functional Dyspepsia (FD) and GastroEsophageal Reflux Disease (GERD). Aims and Objectives: To evaluate the safety and efficacy of cinitapride Extended-Release (ER) tablets versus conventional cinitapride Immediate-Release (IR) tablets for the treatment of FD and GERD. Materials and Methods: Patients with FD and GERD received either cinitapride ER 3 mg tablets OD or cinitapride IR 1 mg tablets TID for 4 weeks in this randomized, multicentre study. Change in the mean intensity score of gastrointestinal (GI) symptoms (overall and individual) at the end of the study and at each weekly follow up visit as compared to baseline, patients with complete resolution of GI symptoms, patients with > 50% reduction from baseline in overall intensity score, rescue medication use and overall efficacy were recorded. The safety variables were reported adverse events (AEs), laboratory parameters, electrocardiogram, and overall tolerability. Unpaired t test, chi square test or Fisher’s exact test were used for analysis. p < 0.05 was considered significant. Results: Total 218 patients were enrolled Cinitapride ER tablets were non-inferior (non-inferiority margin -2.5) to cinitapride IR tablets for the change in the mean overall GI symptom intensity score at the end of the study as compared to the baseline (treatment difference - 0.2 (95% CI: -2.2, 1.7)); also, no significant difference was found for other efficacy variables (p > 0.05). Eight AEs of mild-to-moderate intensity were reported. There was also no difference in the overall tolerability between the study groups (p = 0.875). Conclusions : Both the study treatments were comparable in terms of safety and efficacy for the treatment of FD and GERD.

An Open label, Prospective, Multi-Center, Observational Study to Evaluate the Lipid Lowering Efficacy and Safety of Rosuvastatin in Indian Dyslipidemics in Routine Clinical Practice.

Altered cholesterol levels in the blood or dyslipidemia is a major modifiable risk factor for CVD and is closely associated with the pathophysiology of CVD. Asians, particularly Indians, have a unique pattern of dyslipidemia; with lower HDL cholesterol, increased triglyceride levels and higher proportion of small dense LDL cholesterol, with characteristic centripetal obesity. ‘Statins’ belong to the group of 3-hydroxy-3-methylglutaryl Coenzyme A reductase inhibitors that have been shown to reduce levels of total and LDL cholesterol. Study Objective: To evaluate the lipid lowering efficacy and safety of Rosuvastatin in Indian dyslipidemics in routine clinical practice by measuring the percent change in Total Cholesterol, LDL, TG and HDL over a period of 16 weeks. Methodology : This was a multicentric, open-labeled, post-marketing surveillance study. A committee of key opinion leaders was formed. A total of 1200 doctors were approached of whom 800 provided us with subject data. Each participating doctor was given case report forms and requested to recruit patients according to the inclusion and exclusion criteria. Lipid profile of each recruited patient was done before initiating therapy and at the end of 4 months. Rosuvastatin was given at a dose of either 5mg/ 10mg OD for 4 months. Results : A total of 11, 656 subjects were recruited into this study out of which 10, 410 complete case report forms were considered (n=10410). The study included 65% males and 35% females. Majority of the subjects were in the age group of 46-55years (35.2%) and 56-65 years (29.4%). In this study, the total cholesterol (TC), LDL-C, Triglycerides (TG) has significantly decreased by 46.13%, 53.74% and 41.93% respectively. Also the HDLC levels increased by 26.84%, thereby, indicating a significant change in the levels of all the dyslipidemic indicators. With the reported number of adverse events (n=4) related to Rosuvastatin, it is evident that the drug is safe and tolerable. There were no significant changes observed in the liver and renal function tests with Rosuvastatin reiterating their safety. Conclusion : Rosuvastatin has shown greater efficacy in lowering LDL cholesterol and non-HDL-cholesterol concentrations. It has been shown to enable more patients to reach their LDL cholesterol goals and to do so with an acceptable safety profile.