Informatics Publishing Limited

C. K. Prashant , Sudha Vidyasagar , Muralidhar Varma , Laxminarayana Bairy , Annamma Kurien , K. A. Ashwin Kamath

Abstract

Aspirin resistance may be biochemical or clinical. Data related to the presence of aspirin resistance in the Indian population is scarce. We conducted a cross sectional study to address the issue of clinical aspirin non responsiveness and to assess the association between inhibition of platelet aggregation, clinical risk factors and occurrence of vascular events. We studied platelet aggregation by optical aggregometry in 20 patients on aspirin. No patient was found to be aspirin-resistant on the basis of pr eviously defined criteria. This led us to relook at the current cut offs for resistance, and an analysis of 60 normal patients showed lower cut off values suggesting ethnic variabil ity. The data was reanalyzed using these cutoffs. An association between poor clinical aspirin response, older age, male sex, smoking and dyslipidemia was found, suggesting a trend, though not significant. 25% of patients had vascular events on aspirin sugges ting clinical aspirin resistance. A lower cut off value for aspirin resistance in normal Indians may be needed to detect true prevalence of this entity. In patients with mul tiple atherothrombotic risk factors lab detection of resistance may be useful in identifyi ng patients with high risk for recurrent vascular events. This may help to modify antiplatelet therapy to prevent vascular events.

Keywords

Aspirin, Platelet Function, Clinical Correlation, Risk Factor.

Full Text

   

Harika Cherukuri , K. Pramoda , D. Rohini , Girish Thunga , K. Vijaynarayana , N. Sreedharan , Muralidhar Varma , Vinay Pandit

Abstract

Herbicide poisoning is most common method of suicide in India and it is associated with high morbidity and mortality. Among different herbicidal poisonings the most predominantly found poisonings are paraquat and glyphosate. These compounds are highly toxic and their poisonings require proper management techniques. High fatality is seen in these cases which are mainly due to its inherent toxicity and lack of effective treatment. Common symptoms of these poisonings includes gastrointestinal corrosive effects with mouth and throat, epigastric pain and dysphagia, acid‑base imbalance, pulmonary edema, shock and arrhythmia. Long term health effects include pulmonary fibrosis, renal failure, hepatic failure, heart failure, multi‑organ failure or death. No proven antidote exists for these poisonings. So the treatment is mainly supportive. Initially gastric lavage or whole‑gut irrigation using adsorbents such as Fuller’s earth, bentonite or activated charcoal is recommended. In case of renal failure hemodialysis or hemoperfusion may be considered. However novel approaches like treatment with N‑acetylcysteine, vitamin C, vitamin E, cyclophosphamide may also be helpful.

Keywords

Glyphosate, herbicide, poisoning, paraquat, treatment

Full Text