Efficacy and safety of itopride SR for upper gastrointestinal symptoms in patients with diabetic gastroparesis: real-world evidence from Pakistan.

Background: Gastroparesis is a serious condition that can be caused by diabetes, surgery or infection, or can be idiopathic. When there is no mechanical obstruction, gastroparesis is characterized by delayed stomach emptying. Itopride, a prokinetic drug, inhibits acetylcholinesterase activity in addition to antagonizing dopamine D2 receptors. Methods: This prospective, multicentre study is based on real-world data from 988 patients with a diagnosis of diabetic gastroparesis for index (PAGI-SYM2) evaluation at baseline and week 4 of treatment for upper gastrointestinal disorder symptoms. Results: Upper gastrointestinal symptom severity scores improved significantly after 4 weeks of treatment (p<0.001), with significant improvement across all categories of gastroparesis (very mild (37-58.6%), mild degree (24.6-31.6%), moderate (29.3-7.3%) and severe (8.8-2.6%). Conclusion: Itopride SR (Nogerd SR) in a 150 mg once-daily dose showed promising results in reducing the severity of upper gastrointestinal disorder symptoms associated with diabetic gastroparesis. Both statistical and clinical effectiveness were observed. Moreover, the treatment demonstrated a favourable tolerability profile, with a low incidence of adverse effects.

Early predictability of virological response in patients of chronic hepatitis-C with genotype-3, treated with pegylated interferon and ribavirin.

BACKGROUND: This study was conducted to assess the early predictability of virological response in chronic hepatitis-C patients (Genotype-3), treated with pegylated interferon alpha-2a and ribavirin with an objective of determining predictive values of Rapid Virological Response (RVR) and Early Virological Response (ETR) on Sustained Virological Response (SVR). METHOD: This cross sectional study was conducted in January 2014, at Holy Family Hospital, Rawalpindi by inclusion of 582 patients of chronic hepatitis being treated with Pegylated Interferon a 2b and ribavirin. Based on Polymerase Chain Reaction (PCR) for HCV RNA Qualitative on 4th, 12h and 24th week of treatment regimen, RVR, EVR and End treatment Response (ETR) was assessed respectively whereas 24th week post treatment PCR concluded as SVR. Effect of treatment was determined as proportions for responses in total and then compared for treatment naive, responders and relapsers to previous conventional therapy using Chi square test. Positive and Negative Predictive Values were also calculated. RESULTS: Qualitative PCR for HCV revealed that 281 (69.2%) achieved RVR where 60.3% attained SVR. PPV and NPV of RVR in study population were 67.41% and 44.45% respectively and 66.29% and 57.14% respectively for EVR..Statistically significant differences in RVR, EVR and ETR were observed in patients based on conventional treatment response. CONCLUSION: Attainment of RVR is a prospect to categorize patients appropriate for abridged treatment and this study supported the evidence that failure to achieve EVR was congruent with failure to achieve SVR.

Prevalence and risk factors for diabetes mellitus in a selected urban population of a city in Punjab.

OBJECTIVE: To estimate the prevalence of diabetes mellitus (diagnosed and undiagnosed), impaired fasting glucose and possible risk factors for diabetes mellitus among Pakistani population. METHODS: This cross sectional study was performed in Rawalpindi which is one of the cities in Northern Punjab of Pakistan in July 2008. An area was selected in Rawalpindi city, with mixed population representative of almost all provinces with different socioeconomic groups. Three hundred and thirteen houses were selected through systematic random sampling technique and fasting blood glucose was obtained and subjects were labeled to have diabetes according to WHO criteria of diagnosing diabetes mellitus. The statistical analysis was performed by using Stata version 10. RESULTS: There were 1091 respondents who were selected after cleaning the data, among them 293 were males and 798 were females. Of the total 15.41% of the males and 12.31% of females were found to have diabetes mellitus. Thus making a total prevalence of 13.14%. Impaired fasting glucose (IFG) was found in 5.14% males and 5.78% females making a total prevalence of 5.61%. Over all (DM & IFG) was found to be 20.55% in males and 18.09% in females. The main risk factors identified were obesity, family history, hypertension and increasing age. CONCLUSION: There is an increased prevalence of Type 2 diabetes in Pakistan and main risk factors identified were obesity, overweight, family history of diabetes mellitus, and hypertension.