DocumentsDate added
Research article:
Elgylani,Hind, M.1,*& Wafa, Elhag, I,PHD2
Affiliation:-
1Msc-Student, faculty of Medical Laboratory Sciences- ALNeelain University,Khartoum, Sudan
2Assistant Professor, Microbiology department, faculty of Medical Laboratory Sciences-ALNeelain University, Khartoum ,Sudan
The name of the department(s) and institution(s) to which the work should be attributed:
Faculty of Medical Laboratory Sciences-ALNeelain University, Khartoum, Sudan
Microbiology department, faculty of Medical Laboratory Sciences-ALNeelain University ,Khartoum,Sudan
Address reprint requests to
Hind Mohamed Elgylani.
Microbiology Department, Faculty of Medical Laboratory Sciences AL-Neelain University, Kharoum, Sudan or at drhano4@yahoo.com
J Pharm Biomed Sci 2014; 04(06):559-562.
Article citation:
Elgylani, Hind M.& Wafa, Elhag I. Frequency of Aspergillus Spp. among chronic rhino sinusitis patients attending Khartoum ENT hospital,Sudan. J Pharm Biomed Sci 2014;04(05):559-562. Available at www.jpbms.info
ABSTRACT
Back ground: Chronic rhino sinusitis (CRS) is a common disease with significant morbidity and health care cost, although the medical and surgical treatments for CRS have improved markedly over the past few decades.
Objective: This study aimed to determine the frequency of Aspergillosis in the paranasal cavities in patients who had chronic rhino sinusitis.
Methodology: The Specimen was collected and processed by direct microscopy (using 10%KOH), conventional culture technique, observation of growth (colony configuration), lacto phenol cotton blue staining, and histopathological staining technique.
Results: Out of the total 50 nasal polyp specimens 13(26%), were positive for Aspergillosis by direct microscopy and cultural technique, also histopathological technique confirmed the positivity.
Among the total 13(26%) isolated fungi, (46.2%) were Aspergillus Niger, (38.5%) were Aspergillus flavus, and (15.3%) were Aspergillus fumigatus.
The remaining 37(74%) were negative with previously mentioned techniques.
Conclusion: Aspergillus spp. responsible for (26%) of chronic rhino sinusitis and most of them were due to Aspergillus Niger.
KEYWORDS: Chronic Rhino sinusitis; Mycotic chronic rhinosinusitis.
REFERENCES
1.Polzehl D, Moeller P, Riechelmann H, Perner S. Distinct features of chronic rhino sinusitis with and without nasal polyps. Allergy. 2006 ; 61:1275 - 1279.
2.Settipane GA. Epidemiology of nasal polyps. Allergy Asthma Proc 1996 ; 17: 231-236.
3.Demoly P, Crampette L, Daures JP. National survey on the management of rhinopathies in asthma patients by French pulmonologists in everyday practice. Allergy. 2003;58:233–238.
4.Kuhn F, Javer A. Allergic fungal rhino sinusitis: perioperative management, prevention of recurrence, and role of steroids and antifungal agents. Clin Otol North Am 2000 ; 33:419-432.
5.Anand VK. Epidemiology and economic impact of rhino sinusitis. Ann Otol Rhino Laryngol Suppl. 2004 ; 193 : 3–5 .
6.Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhino sinusitis. Otolaryngology Head Neck Surg. 2002 ; 126 : 623 - 627 .
7.Iro H, Mayr S, Wällisch C, Schick B, Wigand ME. Endoscopic sinus surgery :its subjective medium-term outcome in chronic rhino sinusitis. Rhinology. 2004 ; 42 : 200-206.
8.Stammberger H, Posawetz G. Functional endoscopic sinus surgery concept, indications and result of the MesserKlingers technique Eur Arch Otorhinolangol 1990;247:63-76.
9.Becker DG. Sinusitis. J Long Term Eff Med Implants 2003 ; 13: 94-175.
10.Manning SC, Mabry RL, Schaefer SD, Close LG. Evidence of IgE -mediated hypersensitivity in allergic fungal sinusitis. Laryngoscope. 1993 ; 103:717-721.
11.Stammberger H, JaKse R, Beaufort F. Aspergillosis of the paranasal sinuses .X- ray diagnosis histopathology and clinical aspect. Ann Otol Rhino Laryngol 1984;93:251-256.
12.Min YG, Kim HS, Kang MK, Han MH.Aspergillus sinusitis:clinical aspect and treatment outcomes.Otol Head Neck Surgery 1996;115:49-52.
13.Casas G. Contribucion al estudio de Aspergillus y aspergillosis .Kasmera 1972;4:94-107.
14.Kinsella JB, Bradfield JJ, Gourley WK, Calhoun KH,RasseKh CH .Allergic fungal sinusitis.Clin Oto North Am. 1996 ; 21: 389-392.
15.Waxman JE,Spector JG,Sale SR,katzenstein AL.Allergic Aspergillus sinusitis concept in diagnosis and treatment of new clinical entity .Laryngoscope 1987 ; 9:260-261.
16.Magaldi S, Camero. T. Aspergillosis broncopulmonar alergica en Venezuela.Arch.Med Troo1998 ; 2:16- 21.
17.Ponikau J, Sherris D, Kern E et al. The diagnosis and incidence of allergic fungal sinusitis Mayo Clin Proc 1999;74:877-884.
18.Chakrabarti A, Sharma SC, Chander J. Epidemiology and pathogenesis of paranasal sinus mycoses .Otol Head Neck Surg1992 ; 107: 745 -750.
19.Corey JP, Romberger CF, Shaw GY. Fungal diseases of the sinuses.Otol Head Neck Surg 1990;103:1012-5.
Copyright © 2014 Elgylani, Hind M. & Wafa, Elhag I. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclosure forms provided by the authors are available with the full text of this article at jpbms.info
Case report
Ankit Srivastava.,MDS1,Puneet2, Chetna Arora.,MDS3,*,Preetinder Singh4 ,Radhika Lekhi5
Affiliation:-
1 Senior Lecturer, Department of Pedodontics and Preventive Dentistry
SGT Dental College, Hospital and Research Institute, Village Bhudera, Gurgaon,India
2Post-graduate Student, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Patiala,India
3Senior lecturer, Department of Conservative Dentistry, Swami Devi Dyal Dental College, Barwala, Panchkula, Haryana,India
4Reader, Department of Periodontics and Implantology, Swami Devi Dyal Dental College, Barwala, Panchkula, Haryana,India
5Senior lecturer, Department of Conservative Dentistry and Endodontics, Sudha Rastogi College of Dental Sciences and Research, Faridabad,India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Patiala, India
Address reprint requests to
Dr. Chetna Arora.
Senior lecturer, Department of Conservative Dentistry
Swami Devi Dyal Dental College, Barwala, Panchkula, Haryana,India
J Pharm Biomed Sci 2014; 04(06):521-524.
Article citation:
Srivastava A,Puneet,Chetna A,Singh P,Lekhi R. Endodontic Retreatment of maxillary canine with two separate root canals: A case report. J Pharm Biomed Sci 2014; 04(05):521-524.Available at www.jpbms.info
ABSTRACT
Failure to identify and adequately fill a canal may be a major reason in the failure of root canal herapy. A clear understanding of all the potential aberrant canal morphologies is essential to ensure predictable success in completing complex cases. This case report describes re-treatment of a maxillary canine with two canals.
KEYWORDS: Endodontic retreatment; Upper canine; Anatomical variations; Vertucci’s Type II.
REFERENCES
1.Krasner P, Rankow H J Anatomy of the Pulp-Chamber Floor. J Endod 2004; 30: 5-16.
2.Vertucci F.J. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005; 10: 3–29.
3.Hargreaves KM, Cohen S. Pathways of the Pulp, 10th edition, Mosby, 2011; 10th edition.
4.Giuseppe C, Elio B, Arnaldo C. Missed anatomy: frequency and clinical impact. Endod Topics 2009; 15: 3-31.
5.Gandhi B, Majety KK, Gowdra. Root Canal treatment of bilateral three-rooted maxillary first premolars. J Orofac Sci 2012; 4 (1): 56-59.
6.Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg, Oral Med, Oral Pathol, Oral Radiol and Endod1984; 58: 589 -99.
7.Weisman MI. A rare occurrence: a bi-rooted upper canine. Aus Endod J 2000; 26: 119-20.
8.Onay OE, Ungor M. Maxillary Canines with two root canals. Hacettepe Dis Hekimligi Fakultesi Dergisi. 2008; 32: 20–24.
9.Shin DR, Kim JM, Kim DS, Kim SY, Abbott PV, Park SH. A maxillary canine with two separated root canals: A case report. J Korean Acad Cons Dent 2011 Sep; 36(5): 431-35.
10.Alapati S, Zaatar EI, Shyama M, Al-Zuhair N. Maxillary canine with two root canals. Med Princ Pract 2006; 15: 74-76.
Copyright © 2014 Srivastava A, Puneet, Chetna A, Singh P, Lekhi R. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclosure forms provided by the authors are available with the full text of this article at jpbms.info.
Research article:
Whyte Odigiyo Iyowuna., B. Sc., M. Sc1 , Kotingo Ebikabowei Lucky., MBBS, DMAS, FMAS,2,*,Kotingo Isuomo Victoria., B. Med Sc., MBBS.3
Affiliation:-
1Department of Science Foundation, School of Foundation Studies, Bayelsa State College of Health Technology, Otuogidi, Ogbia town, Bayelsa State, Nigeria
2Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria
3Department of Anatomy, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State, Nigeria
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Science Foundation, School of Foundation Studies, Bayelsa State College of Health Technology, Otuogidi, Ogbia town, Bayelsa State, Nigeria
2.Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria
3.Department of Anatomy, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State, Nigeria
Address reprint requests to
Ebikabowei Lucky Kotingo.
Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
J Pharm Biomed Sci 2014; 04(06):509-514.
Article citation:
Whyte IO, Kotingo EL,Kotingo IV. Effects of Vitamin C supplementation on urinary Sodium and Potassium among exercising and non-exercising individuals in South West Nigeria. J Pharm Biomed Sci 2014; 04(05):509-508. Available at www.jpbms.info
ABSTRACT
Aim: The present study was carried out to investigate the effect of Vitamin C (300mg of Ascorbic acid) on the urinary excretion of sodium and potassium ion in exercising and non-exercising individuals.
Methodology: A total of 20 subjects all males were used for the study, 10 of whom were regularly exercising and the other 10 non-exercising (sedentary) individuals.
The Study lasted for a period of 6 weeks (42 days). The Subjects were all between the ages of 19-29. 20 to 26 (21.70 ± 1.26 years) for the exercising group, and 19 to 29 (23.90 ± 1.26 years) for the non-exercising group.
Results: The result obtained indicated that there was a significant reduction in urine potassium concentration by 6.31 ± 2.39 mmol/ L ( p ˂ 0.05) in non-exercising subjects. Exercising subjects like their non-exercising counterparts also showed a significant decrease in their urine potassium concentration by 6.62 ± 3.96 mmol/L ( p ˂ 0.05). In this case the significant decrease was accompanied by a significant increase in urine sodium concentration by 39.19 ± 11.65 mmol/ L (p ˂ 0.05).
Conclusion: The study indicates that Vitamin C supplementation facilitates the excretion of sodium while decreasing potassium expulsion via the kidney. This could possibly mean that Vitamin C can be classified as a potassium sparing diuretic. This action of Vitamin C could be used to explain its ability to decrease heart rate as well as blood pressure.
KEYWORDS: Vitamin C supplementation, Ascorbic acid, Urinary Sodium, Urinary Potassium, Exercising.
REFERENCES
1.Jacob, R.A., Vitamin C. In: Modern Nutrition in Health and Disease. Ninth Edition. Edited by Maurice Shils, James Olson, Moshe Shike, and A. Catharine Ross. Baltimore: Williams & Wilkins, 1999, p. 467-482.
2.Singh S,Edzard Ernst. Trick of Treatment: The Undeniable Facts about Alternative Medicine. WW Norton & Company. 2008; pp. 15–18. ISBN 978-0-393-06661-6.
3.SvirbelyJL, Szent-Györgyi A; Waugh. "The chemical nature of vitamin C". Biochem. J.1932; 26 (3): 865–70. Bibcode:1932Sci....75..357K. doi:10.1126/science.75.1944.357-a. PMC 1260981. PMID 16744896
4.Padayatty, S.J., Katz, A., Wang, Y., et al. Vitamin C as an antioxidant evaluation of it’s role in disease prevention. American college of Nutrition. 2003; 22 (1): 18 – 35 PMID 12569111.
5.Carl, F.S. The diuretics effect of ascorbic acid: preliminary report on its use in cardiac decompensation. JAMA. 1944; 124 (11): 700 – 701. Dol: 10.1001/ jama1944. 02850110024006.
6.Mohammed, A. A. The diuretic effect of vitamin C. Biochem J. 1937; 31 (2): 339 – 342. Retrieved from http:// www.ncbi. nLm. nih. gov/pmc/articles/PMC1266938/
7.Kaminski, M., and R. Boal. An effect of ascorbic acid on delayed-onset muscle soreness. Pain. 1992; 50:317-321.
8.Keith, R.E. Ascorbic Acid. In: Sports Nutrition Vitamins and Trace Minerals. Edited by Ira Wolinsky and Judy A. Driskell. New York: CRC Press, 1997, p. 29-45119-131.
9.Vasankari, T., U. Kujala, S. Sarna, and M. Ahotupa. Effects of ascorbic acid and carbohydrate ingestion on exercise induced oxidative stress. J. Sports. Med. Phys. Fitness.1998; 38(4): 281-285.
10.Howald, H., B. Segesser, and W.F. Korner. Ascorbic acid and athletic performance. Ann. N.Y. Acad. Sci. 1975; 258: 458-464.
11.Anne, W., Allison, G. (2001) Anatomy and Physiology in Health and Illness. 9th Edition. Edinburg. Elsevier Church Living Stone. 2001; p. 89-91. ISBN 0443064695.
12.Savini I, Rossi A, Pierro C. et al. "SVCT1 and SVCT2: key proteins for vitamin C uptake". Amino Acids. 2008;34 (3): 347–55. doi:10.1007/s00726-007-0555-7. PMID 17541511.
13.Rumsey SC, Kwon O, Xu GW. et al. Glucose transporter isoforms GLUT1 and GLUT3 transport dehydroascorbic acid. J. Biol. Chem.1997; 272 (30): 18982–9. doi:10.1074/jbc.272.30.18982. PMID 9228080.
14.May JM, Qu ZC, Neel DR, Li X. Recycling of vitamin C from its oxidized forms by human endothelial cells. Biochim. Biophys. Acta. 2003; 1640 (2–3): 153–61. doi:10.1016/S0167-4889(03)00043-0. PMID 12729925.
15.Packer L. "Vitamin C and redox cycling antioxidants". In Fuchs J, Packer L. Vitamin C in health and disease. New York: M. Dekker. 1997; ISBN 0-8247-9313-7.
16.Gerard, J.T., Sandra, R. G. Principles of Anatomy and Physiology, 8thEdition.Carlifornia.HarperCollins College Publishers. 1996; p. 896-897. ISBN 067399354X.
17.Klaus, D; Böhm, M; Halle, M. et al. "Die Beschränkung der Kochsalzaufnahme in der GesamtbevölkerungversprichtlangfristiggroßenNutzen" [Restriction of salt intake in the whole population promises great long-term benefits]. Deutsche MedizinischeWochenschrift (in German). 2009;3: S108–18. doi:10.1055/s-0029-1222573. PMID 19418415
18.Saito, T., Ishikawa, S., Higashiyama. et al. Inverse distribution of serum sodium and potassium in uncontrolled in patients with diabetes mellitus. Endocr J. 1999; 46(1): 75 – 80. PMID – 10426570.
19.Arthur. C.G., John, E. H. (2000). Text book of Medical Physiology. 10thEdition.Philadelphia, Pennsylvanna. W.B Saunders Company. 2000; p. 40-51. ISBN 072168677X
20.Rehrer, N.J. Fluid and Electrolyte balance in ultra-endurance sport. Med. 2001;31(10):701–15.
21.Breitwieser, G.E. Mechanism of potassium channel regulation. J Member. Biol.1996;152:1.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclosure forms provided by the authors are available with the full text of this article at jpbms.info
Copyright © 2014 Whyte IO, Kotingo EL,Kotingo IV. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:
Whyte Iyowuna Odigiyo., B. Sc., M. Sc1 , Kotingo Ebikabowei Lucky., MBBS, DMAS, FMAS,2,*,Kotingo Isuomo Victoria., B. MED Sc., MBBS.3
Affiliation:-
1Department of Science Foundation, School of Foundation Studies, Bayelsa State College of Health Technology, Otuogidi, Ogbia town, Bayelsa State, Nigeria.
2Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
3Department of Anatomy, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State, Nigeria.
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Science Foundation, School of Foundation Studies, Bayelsa State College of Health Technology, Otuogidi, Ogbia town, Bayelsa State, Nigeria.
2.Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
3.Department of Anatomy, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa State, Nigeria.
Address reprint requests to
Ebikabowei Lucky Kotingo.
Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. med Sci 2014; 04(06):515-520.
Article citation:
Whyte IO, Kotingo EL,Kotingo IV. Effects of Vitamin C supplementation on blood oxygen saturation among exercising and non-exercising individuals in South West Nigeria. J Pharm Biomed Sci 2014; 04(05):515-520. Available at www.jpbms.info
ABSTRACT
Aim: The present study was carried out to investigate the effect of Vitamin C (300mg of Ascorbic acid) on blood oxygen saturation in exercising and non-exercising individuals.
Methodology: A total of 20 subjects all males were used for the study, 10 of whom were regularly exercising and the other 10 non-exercising (sedentary) individuals.
The Study lasted for a period of 6 weeks (42 days) during which each subject was given 3 tablets of Vitamin C daily. Each tablet contained 100mg of Ascorbic acid and 2mg of Aspartame. The Subjects were all between the ages of 19-29. 20 to 26 (21.70 ± 1.26 years) for the exercising group, and 19 to 29 (23.90 ± 1.26 years) for the non-exercising group.
Results: The result obtained showed that there was no significant difference in the blood oxygen saturation after Vitamin C supplementation. However a significant change was observed when the changes in blood oxygen saturations for exercising and non-exercising where compared. (Non-exercising SPO2=1.86 ± 1.15, Exercising SPO2= 0.39 ± 0.14, p < 0.05).
Conclusion: In this study series, Vitamin C supplementation showed no effect on a blood oxygen saturation level in both exercising and non-exercising individuals. However, a significant association was observed when the change in the exercising subjects was compared with the non-exercising subjects. Vitamin C has been widely investigated as it relates to several biological factors yet with scanty literature on its relationship with oxygen saturation.
KEYWORDS: Vitamin C supplementation, Ascorbic acid, Blood oxygen saturation, Exercising subjects, Non-exercising subjects.
REFERENCES
1.Groff, J.E., Gropper, S.S., and Hunt, S.M. The Water Soluble Vitamins in Advanced Nutrition and Metabolism. Minneapolis: West Publishing Company. 1995; p222 – 237.
2.Howald, H., Segesser, B., and Korner, W.F. Ascorbic acid and athletic performance. Annuals of the New York Academy of Sciences.2006; 258, 458 – 464. Retrieved from http://onlinelibrary. Wiley.com. Doi: 10.1111/j.1749 – 6632. 1975 tb29304.x. Retrieved from http: // Americancollegeofnutrition.org/content/full/22/1/18.
3.Padayatty, S.J., Katz, A., Wang, Y., Eck, P., Kwon, O., Lee, J.H., Chen, S, Corpe, C., Dutta, A., Dutta, S.K., Levine, M. Vitamin C as an antioxidant evaluation of it’s role in disease prevention. American college of Nutrition. 2003; 22 (1): 18-35 PMID 12569111.
4.Jacob, R.A., Vitamin C. In: Modern Nutrition in Health and Disease. Ninth Edition. Edited by Maurice Shils, James Olson, Moshe Shike, and A. Catharine Ross. Baltimore: Williams & Wilkins, 1999, p. 467-482.
5.Lind J. A Treatise of the Scurvy. London: A. Millar.http://www.bruzelius. info/ Nautica/ Medicine/Lind. Html. 1753.
6.Carpenter KJ. The History of Scurvy and Vitamin C. Cambridge, UK: Cambridge University Press Book reviews Nature (1986);324:177 J Hist Med Allied Sci (1987);42:386-7 Med Hist (1987);31:231-2 Yale J Biol Med. 1989;62(3):333–334 CMAJ (1986)135(10):1160
7.Hallberg L, Brune M, Rossander L. The role of vitamin C in iron absorption. Int J Vitam Nutr Res Suppl; 1989; 30: 103 – 8. PMID: 2507689.
8.Elaine, N.M., Katja, H. Human Anatomy and Physiology. 8th Edition. San Francisco, Pearson Benjamin Cummings (Pearson Education Inc). ISBN-13: 978-0-321-60261-9. ISBN-10: 0-321-60261-7. 2010; p. 638-642
9.Hypoxemia (Low blood Oxygen). Mayo Clinic. Retrieved October 28, 2013 from http://www.mayoclinic.org/symptoms/hypoxemia/basic/defination/sym - 20050930
10.Amperordirect.http://www.amperodirect.com/pc/help-pulse-oximeter/z-what is oxygen saturation.html. 2011.
11.O’Driscoll, B.R, Howard, L.S., Davison, A.G. BTS guideline for emergency oxygen use in adult patients. British Thoracic Society. 2008
12.Odunuga, A.C., Jaja, S.I, Ojo, G.O. Some Ventilatory Parameters in well trained Nigerian Atheletes. Nigerian Journal of Physiological Sciences. 1989; 5:7-16.
13.Amy, D. Oxygen Saturation Exercise. Retrieved October 30, 2013 from http; // www. Live strong. Com / article / 278796 – Oxygen Saturation exercise.
14.Fayed, N.M., Modrego, P.J., Morales, H. Evidence of brain damage after high – altitude climbing by means of magnetic resonance imaging. The American Journal of Medicine (Elsevier). 2006; 199 (2): 168.
15.Keith, R.E. Ascorbic Acid. In: Sports Nutrition Vitamins and Trace Minerals. Edited by Ira Wolinsky and Judy A. Driskell. New York: CRC Press. 1997; p. 29-45119-131.
Copyright © 2014 Whyte IO, Kotingo EL, Kotingo IV. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source of support: None
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclosure forms provided by the authors are available with the full text of this article at jpbms.info.
Research article:
Dosunmu Adedoyin O1,*, Daniel Folashade A2 , Richards Atinuke K1, Arogundade Olarenwaju1, Akinbo Akinyemi2, Bonadventure Basil1,Oke David A3
Affiliation:-
1Department of Hematology, Lagos State University College of Medicine. 1 Oba Akinjobi street, P.M.B. 21266 Ikeja, Lagos. Nigeria
2Department of Medicine, Lagos State University College of Medicine, 1 Oba Akinjobi street, P.M.B. 21266 Ikeja, Lagos. Nigeria
3Chief Medical Director’s Office Lagos State University Teaching Hospital, 1 Oba Akinjobi street, P.M.B. 21266 Ikeja, Lagos. Nigeria
The name of the department(s) and institution(s) to which the work should be attributed:
Lagos State University College of Medicine,1 Oba Akinjobi street, P.M.B. 21266 Ikeja, Lagos. Nigeria
*To whom it corresponds:-
Dr. Dosunmu Adedoyin O.
Department of Hematology, Lagos State University College of Medicine,1 Oba Akinjobi street, P.M.B. 21266 Ikeja, Lagos. Nigeria
E mail Address: doyin_dosunmu@yahoo.com
Abstract
Objective: To compare the anti platelet aggregation effect of clopidogrel (CPG) and aspirin (ASP) in stable hypertensive patients.
Method: A randomized, crossover and blinded study was conducted in hypertensive patients attending the outpatient clinic between January and March 2013. Patients were randomly assigned to take 75mg of CPG and 150mg of ASP once daily for two weeks. After a 2 week wash out period, subjects were switched. Platelet aggregation test was run every 2 weeks. The primary end point was percent inhibition of maximum platelet aggregation while the secondary end points were the incidence of adverse events and changes in the hematological and biochemical profiles.
Results: Thirty two patients were enrolled and 4 were lost to follow up. The inhibition of maximum aggregation tended to be higher in patients treated with clopidogrel than those on aspirin (36.7% vs. 25.4%; p=0.06). There were more patients who achieved more than 30% inhibition while on clopidogrel than aspirin (51.9% vs. 25.9%; p= 0.05). At the end of the study, there was significant reduction in hemoglobin, erythrocyte sedimentation rates, fasting blood sugar and prothrombin time international normalized ratio but values were within normal ranges.
Conclusion: This study supports the existing view that both aspirin and clopidogrel reduce platelet aggregation effectively with minimal but comparable adverse events. There is a wide individual variation in the efficacy of these drugs. It is therefore suggested that, platelet aggregation studies be done on patients in order to ensure the efficacy of medications and to avoid their undue usage.
Keywords: Aspirin; clopidogrel; inhibition of platelet aggregation; platelet aggregation test.
REFERENCES
1.Antithrombotic Trialists Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high-risk patients. BMJ. 2002; 324: 71–86.
2.Behan M W H, Storey R F. Antiplatelet therapy in cardiovascular disease. Postgrad Med J. 2004; 80: 155-1642.
3.Brook R.D, Julius S. Autonomic imbalance, hypertension and cardiovascular risk. Am. J. Hypertens. 2000; 13: 1128.
4.Catella-Lawson F, Reily MP, Kapoor SC et al. Cyclooxygenase inhibitors and the antiplatelet effect of aspirin. N Engl J Med 2001, Dec 20; 345: 1809-17
5.Celi A, Pellegrini G, Lorenzet R, De Blaisi A, Ready N, Furie B C, Furie B. P-selectin induces the expression of tissue factor on monocytes. Proc. Natl Acad Sci USA. 1994; 91: 8767-8771.
6.Cermuzynsky J. Col, Commerford P.J, Diaz R, Flather M, Franzosi M.G, Gersh B, et. Al. CURE Study Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001; 345: 494–502.
7.Denninger MH, Necciari J, Serre-Lacroix E, Sissmann J. Clopidogrel antiplatelet activity is independent of age and presence of atherosclerosis. Seminar in thrombosis and haemeostatsis. 1999; 25 Supply, 2: 41-5.
8.Eugenia Gkaliagkousi, Gabriella Passacquale, Stella Douma, Chrysanthos Zamboulis, Albert Ferro. Platelet activation in hypertension: Implications for antiplatelet treatment. American Journal of Hypertension. 2010; 233: 229-236.
9.Gawaz M, Langer H, May A E. Platelet in inflammation and arterosclerogenesis. J Clin Invest. 2005; 3378-3384.
10.Gent M, Beaumont D, Blanchard J, Bousser M.G, Coffman J, Easton J.D, et al, CAPRIE Steering Committee. A randomized, blinded, trial of clopidogrel versus aspirin in patients at risk of ischemic events. Lancet. 1996; 348: 1329-39.
11.Hanson L, Zanchetti A, Carruthers S G, Dahlof B, Elmfeldt D, Julius S, Menard J, Rahn K H, Wedel H, Westerling S. HOT Study Group Effects of intensive blood pressure lowering and low dose aspirin in patients with hypertension: principal result of the hypertension optimal treatment (HOT)randomized trial.. Lancet. 1998; 351: 1755-1762.
12.Klinkhardt U, Bauersachs R, Adams J, Graff J, Lindhoff-Last E, Harder S. Clopidogrel but not aspirin reduces P-selectin expression and formation of platelet-leikocyte aggregation in patients with atherosclerotic vascular disease. Cin Pharmacol Ther. 2003; 73: 232-241.
13.Leslie V Parise, Susan S Smith, Arun S Shet, Barry S Coller. Platelet morphology, biochemistry, and function. Williams Haematology. 7th Edition. Mc Graw-Hill Companies Inc. 2006; pp 1587-1635.
14.Lorddzipanki M, Pharand C, Nguyen T A, et al. Comparison of four tests to assess inhibition of platelet function by clopidogrel in stable coronary artery disease. Eur Heart J. 2008; 29: 2877-2885
15.Medical Research Council’s General Practice Research Framework. Thrombosis prevention trial of low intensity oral anticoagulation with warfarin and low dose aspirin in the primary prevention of ischemic heart disease in men at increased risk. Lancet. 1998; 24: 233-241.
16.Radomski MW, Palmer RM, Moncada S. Endogenous nitric oxide inhibits human platelet adhesion to vascular endothelium. Lancet. 1987; 2: 1057-1058.
17.Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee.Hypertension. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.2003 Dec;42(6):1206-52. Epub 2003 Dec 1.
18.Touyz RM, Schiffrin E.L. Effects of angiotensin II and endothelin-1 on platelet aggregation and cytosolic Ph and free calcium ion concentrations in essential hypertension. Hypertension. 1993; 22: 853-862
19.Wei C L, Paul A G, Paul B W, Charlene J Neer, Amy S Hopp, David G M Carville, Kirk E Guver, Allan R Tait. Contribution of Hepatic Cytochrome P450 3A4 Metabolic Activity to the Phenomenon of Clopidogrel Resistance. Circulation. 2004; 109: 166-171.
20.Yun KH, Rhee SJ, Park HY, Yoo NJ, Kim NH, Oh SK, Jeong JW. Effects of omeprazole on the antiplatelet activity of clopidogrel. International Heart Journal. 2010, Jan.; 51(1): 13-6.
Source of support: Kalbe International, Nigeria
Competing interest / Conflict of interest
The investigators are all staff of Lagos State University and the Teaching Hospital. They have no financial commitment with Kalbe International, Nigeria or any other entity mentioned above that may constitute a conflict of interest. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Copyright © 2014 Dosunmu AO, Daniel FA, Richards AK, Arogundade OA, Akinbo A, Bonadventure B et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.