A comparative study of efficacy and safety of glucosamine plus chondroitin sulphate versus rosehip as add on therapy to NSAIDs in patients suffering from osteoarthritis

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients

A review on thimerosal: an irreplaceable element of long-term immunisation strategy in low income countries

Thimerosal, an organic-mercury (Hg) compound containing 49.55% Hg by weight, is added to vaccines as a preservative permitting formulation of multi-dose vaccine vials. Being a derivative of ethylmercury, it has been linked with autism as a possible risk factor based on the assumption that exposure to ethylmercury would have similar neurotoxic effects as another mercurial compound, methylmercury. In 1999, AAP issued a joint statement emphasising the removal of thimerosal from vaccines. Subsequently, several studies have been conducted; those showing positive association between thimerosal exposure and autism have been recognised to be fraught with methodological flaws. On the other hand, many well controlled studies have failed to find any such causal relation and there are others that have clearly demonstrated a much favourable kinetic profile of ethylmercury as compared to methylmercury. Owing to the lack of data, AAP retired its original statement in 2002. Recently, thimerosal has been exempted from regulation by Minamata Convention on Mercury resulting in the continued use of low cost thimerosal containing vaccines in low income countries which cannot afford to run their immunisation program using single dose thimerosal free vaccines, that comparatively cost much higher, as is the case in high income countries. Some bodies view this as a discrimination on the basis of wealth of a nation and have opposed this decision. This review presents various studies regarding the causal association between thimerosal containing vaccines and autism. The current evidence fails to support any such association. Hence this review supports the exemption of thimerosal from regulation and also justifies its use in LICs for uninterrupted vaccination of the most vulnerable population

Effect of benzalkonium chloride-preserved latanoprost and benzalkonium chloride-free latanoprost on intraocular pressure in patients of primary open angle glaucoma

Background: To evaluate the change in mean IOP with BKC-preserved latanoprost versus BKC-free latanoprost in patients of primary open angle glaucoma (POAG).Methods: This was an open-label, randomized, interventional, switch trial. Thirty patients of primary open angle glaucoma (POAG) who were already on benzalkonium chloride (BKC)-preserved latanoprost for a minimum of three months were recruited. Their intraocular pressure (IOP) was recorded at the baseline. Then, they were switched over to benzalkonium chloride (BKC)-free latanoprost for another three months. Their intraocular pressure (IOP) was recorded at both 6 and 12 weeks of follow-up.Results: IOP decreased from 15.57±0.85mm Hg at baseline to 15.40±0.89mm Hg at 6 weeks to 15.30±0.70mm Hg at 12 weeks. p value was found to be 0.209 and 0.115 at 6 and 12 weeks respectively. No statistically significant change was observed between mean IOP at both 6 and 12 weeks as compared to the baseline.Conclusions: BKC-free medications have equal IOP lowering effect as BKC-preserved medications in glaucoma patients

Evaluation of antihypertensive efficacy of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension: a randomized controlled trial

Background: Cardiovascular disease (CVD) is the most common contributor of morbidity and mortality in underdeveloped and developing countries including the South Asian countries (including India and Pakistan). Amongst the cluster group of CVDs, Hypertension (HTN) represents the most common cardiovascular risk factor. The aim of this trial was to evaluate of antihypertensive efficacy and effect on biochemical parameters of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension with a randomized controlled trial.Methods: This was a prospective, randomized controlled trial of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension. The primary endpoint on treatment was analysis of antihypertensive efficacy of these drug combinations. The variables were compared at different time points- baseline, 3 and 6 months.Results: In the present study, 76 patients were enrolled with 38 patients each allocated to each treatment groups. The effect of Losartan 50mg + Hydrochlorthiazide 12.5mg OD was found to be significant on SBP and DBP in both supine as well as sitting position than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group at 3 and 6 months.Conclusions: The results on anti- hypertensive efficacy was far better in Losartan 50mg + Hydrochlorthiazide 12.5mg OD group than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group

TO ESTIMATE THE LEVELS OF CA19-9 AND ITS SIGNIFICANCE IN DIAGNOSIS AND TREATMENT OF PANCREATICOBILIARY AND GASTROINTESTINAL MALIGNANCIES

Objective: This study was designed and conducted to establish the relationship of biomarker CA19-9 levels in pancreaticobiliary and gastrointestinal malignancies. Methods: 50 patients with confirmed diagnosis of pancreaticobiliary and gastrointestinal malignancies and 30 age and gender matched controls were included in the study. Serum values of CA19-9 were determined in patients before surgery and chemotherapy. Results: In our present study, maximum number of patients were in the age group of 51–60 years. Mean levels of serum CA19-9 in patients (n=50) are 146.28±156.87 U/mL. Total patients (n=50), in 19 patients CA19-9 levels were ≤37 U/mL and in 31 patients CA19-9 levels were >37 U/mL. CA19-9 levels were highest in pancreatic and cholangiocarcinoma. Conclusion: High sensitivity and specificity of CA19-9 in pancreatic and biliary tract tumors identified CA19-9 as a best validated biomarker