ABSTRACT
Sitagliptin is a newer oral hypoglycemic drug of the dipeptidyl peptidase-IV inhibitor class. It appears to be a promising newer oral hypoglycemic agent. The advantages are the absence of hypoglycemia when used as monotherapy and they cause less gain weight. We report a case of sitagliptin-induced hemolysis, a rare side effect, not reported in the literature. As sitagliptin is widely used in type 2 diabetes mellitus physicians should be aware of the possibility of this rare but potentially serious adverse drug reaction.
ABSTRACT
AIM: To study the value of platelet count to spleen diameter ratio as a noninvasive parameter for diagnosing esophageal varices (EVs) in liver cirrhosis. METHODS: The laboratory and ultrasonographic variables were prospectively evaluated in 150 patients with liver cirrhosis. Only stable patients were included in the study. Patients with active gastrointestinal bleeding at the time of admission were excluded. All patients underwent screening upper gastrointestinal endoscopy. RESULTS: The platelet count, spleen diameter and platelet count to spleen diameter ratio in patients with EVs were significantly different from patients without EVs. The platelet count to spleen diameter ratio had the highest accuracy among the three parameters. By applying receiver operating characteristic curves, a platelet count to spleen diameter ratio cut-off value of 1014 was obtained, which gave positive and negative predictive values of 95.4% and 95.1%, respectively. The accuracy of this cut-off value as evaluated by applying receiver operating characteristic curves was 0.942 (95% CI 0.890 to 0.995). CONCLUSION: Among the noninvasive parameters studied, platelet count to spleen diameter ratio had the highest accuracy for diagnosing EVs. However, the evidence for the noninvasive diagnosis is not yet sufficient to replace endoscopy as a diagnostic screening tool for EVs in all cirrhotic patients. The platelet count to spleen diameter ratio may be a useful tool for diagnosing EVs in liver cirrhosis noninvasively when endoscopy facilities are not available.
Subject(s)
Esophageal and Gastric Varices/diagnosis , Platelet Count/methods , Spleen/pathology , Adult , Aged , Aged, 80 and over , Endoscopy, Gastrointestinal/methods , Esophageal and Gastric Varices/pathology , Female , Humans , Male , Middle Aged , Organ Size , Predictive Value of Tests , Prospective Studies , Young AdultABSTRACT
BACKGROUND: Cryptosporidiosis caused by the protozoa Cryptosporidium, is the common cause of diarrhoea in Acquired Immune Deficiency Syndrome (AIDS). AIM: To study the efficacy of short-term azithromycin in the management of cryptosporidiosis. SETTINGS AND DESIGN: Randomised, controlled trial. MATERIAL AND METHODS: All consecutive patients infected with Human Immunodeficiency Virus (HIV), who were positive for cryptosporidial oocysts were taken for this prospective randomised study. RESULT: Short-term azithromycin treatment for cryptosporidial diarrhoea in AIDS patients was associated with good clinical improvement but parasitological benefit was doubtful. All 13 patients, who had symptoms of cryptosporidiosis, symptomatically improved with 5 days of treatment with azithromycin and became asymptomatic after 7 days of antibiotic, but stool sample was positive for cryptosporidium even after 7 days of therapy. After 14 days of treatment with azithromycin in 13 patients, in five patients stool was free of cryptosporidial oocyst. The drug was well tolerated in all the patients. CONCLUSION: Short-term azithromycin can be used as a safe and effective treatment for symptomatic Cryptosporidiosis but not effective in eradicating Cryptosporidial infection.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Anti-Bacterial Agents/administration & dosage , Azithromycin/administration & dosage , Cryptosporidiosis/drug therapy , AIDS-Related Opportunistic Infections/diagnosis , Adult , Cryptosporidiosis/diagnosis , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , India , Male , Middle Aged , Reference Values , Treatment OutcomeABSTRACT
The serum adenosine deaminase (ADA) level was estimated in 30 patients with pleural effusion and 18 healthy controls and was found to be significantly elevated in the former (P less than 0.001). The pleural fluid ADA level in tubercular pleural effusion was always above 50 U/L and was significantly higher than in nontubercular effusions (P less than 0.001). Pleural fluid ADA to serum ADA ratio was not helpful in the aetiologic diagnosis of pleural effusions. Thus, estimation of pleural fluid ADA is a safe, simple, reliable and non-invasive test in distinguishing tubercular and non-tubercular pleural effusions.
