Study on the safety profile of Latanoprost and Timolol in primary open angle glaucoma

Background: Topical beta blockers, Timolol and the prostaglandin F2α analogue Latanoprost are the most common prescribed medications as first line therapy. Their safety profiles have to be compared to justify the same. The objectives of this study were to compare the safety profile of Latanoprost with that of Timolol in the treatment of primary open angle glaucoma.Methods: In this randomized open label 12-week study, 60 patients were randomized to receive either 0.005% of Latanoprost once daily in the evening or 0.5% of Timolol twice daily. Their safety was concluded by monitoring their adverse effects during follow-up visits at 2, 4, 6, and 12 weeks.Results: Bradycardia was seen only in Timolol group whereas ocular adverse effects such as periocular pigmentation, the growth of eyelashes, and conjunctival hyperemia were seen only in Latanoprost group. Ocular discomfort was present equally in both the groups. Foreign body sensation was seen in both the groups, but it was more frequent in Latanoprost group. The blurring of vision was predominantly seen in Timolol group. Corneal anesthesia was seen in one of the patients on Timolol.Conclusions: The incidence of adverse effects was not significantly different between Latanoprost and Timolol therapy. Both had favorable safety profiles. However, Latanoprost has safer systemic side effects profile when compared to Timolol.

Efficacy, safety and cost effectiveness of levocetrizine and ebastine in allergic rhinitis: a comparative study

Background: Allergic rhinitis is a ubiquitous aliment affecting a large population of individuals. The mainstay of treatment includes antihistamines and topical steroids. With a large assortment available, the choice of the drugs needs to be non-random and evidenced based. Hence this study was undertaken to compare Levocetrezine and Ebastine in terms of efficacy, safety and cost effectiveness in treatment of allergic rhinitis.Methods: Newly diagnosed patients with allergic rhinitis were categorized into two groups and treated with Levocetrizine 5mg and Ebastine 20mg per day respectively. Severity of the symptoms at the commencement and at the end of second and the fourth weeks of therapy were assessed using a four-point Likert scale and assigning a Total Nasal Symptoms Score (TNSS). The primary efficacy measure was mean change from baseline TNSS at each follow up visit. Change in TNSS was compared using Independent sample test. Adverse effects in both the groups were compared using Chi square test. Cost effectiveness was inferred by calculation of the Average Cost Effectiveness Ratio.Results: A total of 159 patients 84 from Levocetrizine group (L group) and 75 from the Ebastine group (E group) were available for study. At the end of second week, the E group showed a better reduction in TNSS(p-0.04). However, both the groups showed similar reduction in TNSS at the concluding visit (p-value of 0.09). The incidence of adverse effects was significantly higher in the L than in E. Levocetrezine was found to be more cost effective than Ebastine.Conclusions: Levocterezine and Ebastine are equally efficacious in treatment of allergic rhinitis. Hence treatment will have to be personalized to the individual patients based on other factors such as adverse drug effects and cost effectiveness

Study on the safety profile of Latanoprost and Timolol in primary open angle glaucoma

Background: Topical beta blockers, Timolol and the prostaglandin F2α analogue Latanoprost are the most common prescribed medications as first line therapy. Their safety profiles have to be compared to justify the same. The objectives of this study were to compare the safety profile of Latanoprost with that of Timolol in the treatment of primary open angle glaucoma.Methods: In this randomized open label 12-week study, 60 patients were randomized to receive either 0.005% of Latanoprost once daily in the evening or 0.5% of Timolol twice daily. Their safety was concluded by monitoring their adverse effects during follow-up visits at 2, 4, 6, and 12 weeks.Results: Bradycardia was seen only in Timolol group whereas ocular adverse effects such as periocular pigmentation, the growth of eyelashes, and conjunctival hyperemia were seen only in Latanoprost group. Ocular discomfort was present equally in both the groups. Foreign body sensation was seen in both the groups, but it was more frequent in Latanoprost group. The blurring of vision was predominantly seen in Timolol group. Corneal anesthesia was seen in one of the patients on Timolol.Conclusions: The incidence of adverse effects was not significantly different between Latanoprost and Timolol therapy. Both had favorable safety profiles. However, Latanoprost has safer systemic side effects profile when compared to Timolol.

Assessing the Role of MAPH Score in Predicting Acute Coronary Syndrome: A Cross-sectional Study

Introduction: Incorporating the concepts of hyperviscosity, platelet hyperactivity, and age-related risk of Acute Coronary Syndrome (ACS), a new score has been put forward-the Mean platelet volume-Age-total Protein-Haematocrit (MAPH) score, which can determine the increased thrombotic tendency associated with ST-Segment Elevation Myocardial Infarction (STEMI). The MAPH score includes parameters such as Mean Platelet Volume (MPV), age, total protein, and haematocrit. Researchers have found that a high MAPH score is associated with a high thrombus burden in cases with STEMI and Non ST-Elevation Myocardial Infarction (NSTEMI). However, the association between MAPH score and ACS is undefined. Aim: To assess the role of MAPH score in predicting ACS. Materials and Methods: This cross-sectional study was conducted in the Department of Pathology, Srinivas Institute of Medical Sciences and Research Centre Mangalore, Karnataka, India for six months. The study included 100 clinically diagnosed cases of ACS and 100 healthy controls. The demographic data, MPV, total protein, and haematocrit values of all cases and controls were collected and tabulated, and statistical analysis was performed. Receiver Operating Characteristic (ROC) curve analysis was performed on each MAPH score parameter, and cut-off values for each parameter were obtained based on the Youden index. After calculating the MAPH score of cases and controls, multivariate logistic regression analysis was performed to evaluate the role of the MAPH score as an independent predictor of ACS. Results: A statistically significant increase in MPV (p-value =0.017) and total protein (p-value<0.001) was noted among the cases. The calculated cut-off values for MPV, age, total protein, and haematocrit were 8.4 fL, 54 years, 6.8 g/dL, and 49.1%, respectively. A statistically significant increase in the MAPH score was noted among the cases compared to the controls. Finally, multivariate logistic regression analysis identified the MAPH score as an independent predictor of ACS. Conclusion: This was the first study investigating the association between MAPH scores in patients with ACS. The MAPH score was identified as an independent predictor of ACS and can be used as a screening tool to predict and diagnose the condition in primary healthcare settings. This helps to ensure early coronary revascularisation and reduce Coronary Artery Disease (CAD)-related mortality and morbidity to a greater extent