A comparative study of racecadotril and single dose octreotide as an anti-secretory agent in acute infective diarrhoea.

OBJECTIVE: To assess the efficacy of single dose of octreotide and compare it with another antisecretory agent racecadotril in the management of acute infective diarrhea. METHODS: A randomized control study was done in the Department of Medicine and Infectious Disease Hospital (Department of Preventive and Social Medicine) of SMS Medical College and Hospital. 150 patients with moderate to severe acute diarrheal illness needing hospitalization were randomly allotted into 3 categories of 50 patients each. The control group received only fluids and antibiotics, the racecadotril group received fluid, antibiotics and oral racecadotril at dose of 1.5 mg/kg three times a day and the octreotide group received octreotide (100 microgram stat) along with fluid and antibiotics. The following end points of the study were compared, namely- frequency, quantity and consistency of stools and fluid requirement per day. RESULTS: The mean (+/- SE) frequency of stools was significantly less (p < 0.001) from day 2 onwards in the octreotide group compared to the control and racecadotril group. Diarrhea stopped in half of the patients in the octreotide group by day 3. The consistency of stools changed significantly in the octreotide group (p < 0.001). No significant difference was seen between the racecadotril and control group (p > 0.05) in terms of the frequency and consistency of stools. The mean (+/- SE) quantity of stools was significantly decreased in the octreotide group (p < 0.001) on day 2 compared to the other two groups. The mean (+/- SE) quantity of fluid required was almost the same in all 3 groups on day 1 (p > 0.05) but it was significantly less in the octreotide group on day 2 (p < 0.001). No significant difference was seen with respect to the fluid requirement between the control and racecadotril group (p > 0.05). CONCLUSION: Patients who received single dose of octreotide fared better than those patients in control and racecadotril group in terms of frequency, quantity and consistency of stools passed. The fluid requirement was also less in octreotide group. However more trials need to be done to substantiate this finding before octreotide becomes a standard of therapy in acute infective diarrhea.

Protein S deficiency: Recurrent ischemic stroke in young.

Stroke in young poses a major health problem. Thrombophilic factors have been implicated in 4-8% of the young strokes worldwide. Protein S deficiency is a rare cause of recurrent ischemic stroke in young population. Only a few sporadic cases have been described in the literature. We are reporting a case of protein S deficiency-related recurrent ischemic stroke in a 16-year-old girl. Early diagnosis and targeted approach can help such patients to prevent recurrent thrombotic episodes.

Lipid profile in smokers and tobacco chewers--a comparative study.

OBJECTIVE: The present study was undertaken to evaluate lipid profile in cigarette smokers and tobacco chewers and to see whether tobacco chewing causes same degree of alteration in lipid profile as done by smoking. METHODS: Serum lipid profile was studied in 30 smokers (Group A), 30 tobacco chewers (Group B) and 30 controls i.e., non-smokers and non-tobacco chewers (Group C). RESULTS: High density lipoprotein-cholesterol was lower both in smoker (P < 0.01) as well as in tobacco chewers (P < 0.001) than the controls. Both smokers and tobacco chewers had higher values of total cholesterol, low density lipoprotein cholesterol, very low density lipoprotein-cholesterol and, triglycerides as compared to non-smoker, non-tobacco chewer group whereas the differences in levels of lipids in smokers and tobacco chewers were not statistically significant. CONCLUSION: Though different mode of addictions, smoking and tobacco chewing have an equal and comparable adverse effects on lipid profile and therefore raising cardiovascular risk in same proportion.

Multigated radionuclide ventriculography during in-hospital phase of acute myocardial infarction.

Global and regional left ventricular performance was assessed by multigated radionuclide technique in thirty patients sustaining acute myocardial infarction on two occasions during in-hospital phase. Thirteen (76.5%) of the seventeen patients with anterior infarction had depressed initial left ventricular ejection fraction compared with seven (53.8%) of the thirteen patients with inferior infarction. From initial to discharge study, change in ejection fraction was statistically insignificant in either group of infarctions. All except three (10%) patients had regional wall motion abnormality on initial evaluation with little subsequent alteration. Our data demonstrates that ejection fraction changes variably during the course of illness, and location of infarction has profound effect upon degree of left ventricular dysfunction. Assessment by non-invasive radionuclide technique may have prognostic implications.

Pressor effects of alcohol in normotensive and hypertensive subjects.

The effects of acute alcohol consumption and abstinence on blood pressure were studied in normal healthy subjects and in non-drinking and regularly drinking hypertensive patients. All subjects drank alcohol (1 g/kg body weight daily) for 5 days then abstained for 5 days. There was no significant difference in blood pressure in normal subjects during and after alcohol ingestion. However, in hypertensive non-drinkers both systolic and diastolic pressures when standing were significantly higher during the period of alcohol intake; supine blood pressure was not significantly higher. In hypertensive patients who drank regularly, standing and supine systolic and diastolic blood pressures were significantly higher during the period of drinking.