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   2015| April-June  | Volume 5 | Issue 2  
    Online since March 30, 2015

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Assessment of drug-drug interactions in hypertensive patients at a superspeciality hospital
Divya Sivva, Uday Venkat Mateti, Venu Madhav Neerati, Nimbagiri Swamy Thiruthopu, Srinivas Martha
April-June 2015, 5(2):29-35
DOI:10.4103/2231-0770.154194  PMID:25878964
Objective: The objective of the study was to assess the incidence and pattern of drug-drug interactions (DDIs) in hypertensive patients by using Micromedex and Medscape databases. Materials and Methods: A prospective observational study was carried out in a superspeciality hospital setting in South India for period of 9 months. Hypertensive patients who admitted into the hospital with the age more than 18 years, received more than 3 drugs per prescription and length of hospital stay for more than 24 hours were included in the study. An appropriate data was collected and assessed for DDIs with the help of Micromedex and Medscape databases. Results: A total of 227 patients were enrolled during the study period. Among the 227 patients, 48 of them developed 53 clinically significant DDIs. Out of 48 patients, most of them were in the age-group of 50-60 years [18 (37.49%)]. The percentage of DDIs were higher in males [30 (62.5%)] compared to females [18 (37.5%)]. The most common drugs responsible for DDIs in the present study were Insulin [18 (33.96%)] followed by Metoprolol [10 (18.86%)], Torsemide [8 (15.09%)], and Hydrochlorothiazide [8 (15.09%)]. The most commonly interacting pairs were Ciprofloxacin-Insulin [6 (11.32%)], followed by Metoprolol-Insulin [4 (7.54%)] and Atenolol-Insulin [4 (7.54%)]. The most common consequences of interacting pairs were reduced serum potassium levels and hyperglycemia. Conclusion: The overall incidence rate of DDIs was found to be 21.14% and the increasing number of co-morbidities ( P ≤ 0.003) and polypharmacy ( P ≤ 0.002) were the risk factor for the development of significant number of DDIs.
  4,904 404 -
Oral manifestations of Parry-Romberg syndrome: A review of literature
Nader A Al-Aizari, Saleh Nasser Azzeghaiby, Hashem Motahir Al-Shamiri, Shourouk Darwish, Bassel Tarakji
April-June 2015, 5(2):25-28
DOI:10.4103/2231-0770.154193  PMID:25878963
Parry-Romberg syndrome (PRS) or progressive facial hemiatrophy is a developmental craniofacial disorder of unknown etiology characterized by a slowly progressive unilateral facial atrophy. It is associated with different systemic manifestations particularly, maxillofacial, neurologic and ophthalmologic abnormalities. Dentists must be aware of PRS to identify this invalidating disorder. In this article, we review the etiology, clinical features (especially craniofacial and dental manifestations) and treatment of PRS. We searched in PubMed line using specific words such as PRS from 2008 to 2014 (August). We identify 14 papers have described oral manifestations of this syndrome. We excluded all the article papers that did not indicate to oral manifestations of PRS.
  4,075 456 11
Biweekly gemcitabine and paclitaxel in patients with relapsed or metastatic squamous cell carcinoma of the head and neck
Ammar Sukari, Marwan Al-Al-Hajeili, Mohamed Salem, Amin Alousi, Lance Heilbrun, Daryn Smith, George Yoo, John R Jacobs, Ho-Sheng Lin, Omer Kucuk
April-June 2015, 5(2):36-41
DOI:10.4103/2231-0770.154195  PMID:25878965
Purpose: We conducted a Phase II, clinical trial to evaluate the efficacy and safety of a biweekly gemcitabine and paclitaxel (GEMTAX) regimen as second-line treatment in patients with recurrent or metastatic unresectable, squamous cell carcinoma of the head and neck (SCCHN). The primary endpoint was response rate. Patients and Methods: Patients with recurrent unresectable or metastatic platinum refractory SCCHN, who had performance status ≤2 and adequate organ function, were eligible. Gemcitabine (3000 mg/m 2 intravenous) and paclitaxel (150 mg/m 2 intravenous) was given on days 1 and 15of 4 weeks cycle, until patients had disease progression or unacceptable toxicity. Results: Disease control (partial response [PR] + complete response [CR] + stable disease [SD]) was noted in 19 patients (54%) and overall response (CR + PR) was noted in 8 patients (23%). However, the most frequent response outcomes were progressive disease in 16 patients (46%) and SD in 11 patients (31%). The most frequent Grade 3-4 adverse events were lymphopenia in 38 patients (75%), anemia in 20 patients (39%), and infection in 16 patients (31%). Median progression-free survival was 3.6 months; median overall survival was 6.3 months. Conclusion: The biweekly GEMTAX regimen has statistically significant grade 3 and 4 adverse events and has meaningful clinical activity as a second-line treatment in patients with recurrent or metastatic SCCHN who have received prior chemotherapy. This regimen may particularly be a useful treatment option in patients who progressed in <6 months of concurrent chemoradiotherapy with high-dose cisplatin and/or have recurrent/metastatic platinum refractory SCCHN.
  3,491 285 2
Sorafenib induced acral pigmentation: A new entity
Mrinal Gupta, Heena Gupta, Anish Gupta
April-June 2015, 5(2):46-48
DOI:10.4103/2231-0770.154199  PMID:25878967
Sorafenib is a multikinase inhibitor commonly used for the treatment of advanced renal cell and hepatocellular carcinoma. The commonly reported dermatological adverse effects of Sorafenib include hand-foot syndrome (HFS), alopecia, pruritus, facial and scalp erythema, splinter hemorrhages, keratoacanthomas, squamous cell carcinomas and eruptive melanocytic naevi. We report a case of asymptomatic hyperpigmentation of the palms and soles in a patient receiving Sorafenib therapy for advanced renal cell carcinoma, in the absence of features of classic HFS, which has not been previously reported in the literature.
  3,504 225 1
Extensive vascular occlusions as initial presentations of systemic lupus erythematosis. A case report and review of literature
Mohamed Elsharawy, Manal Hasan, Ibrahiem Saeed Abdul-Rahman, Bandar Al-Dhofairy, Ayman Elsaid
April-June 2015, 5(2):42-45
DOI:10.4103/2231-0770.154197  PMID:25878966
Widespread arterial and venous thrombosis is a very rare initial presentation of systemic lupus erythematosus (SLE). We report a case with extensive vascular occlusion as the initial manifestation of SLE. Although these cases have high morbidity and mortality, yet our patient recovered with minimal complications.
  3,078 256 1
A rare case of coronary artery fistula presented with acute myocardial infarction
Osama Abdalhadi Smettei, Rami Mahmood Abazid
April-June 2015, 5(2):49-51
DOI:10.4103/2231-0770.154200  PMID:25878968
Coronary artery fistulas (CAFs): Are anomalous connections of the coronary arteries (CA) with major vascular structures or heart chambers. Most of CAFs are incidental findings during invasive coronary angiography (ICA) or computed tomography angiography (CTA). Many patients with CAFs are asymptomatic; only a minority has been associated with various clinical features and outcomes. We have reported a rare CAF complicated with acute myocardial infarction (AMI) in 43 years old female Patient who was admitted to our institution with a Diagnosis of Acute Infero-Posterior Myocardial Infarction (AMI). ICA and CTA showed a thrombosed CAF between left main coronary artery and right atrium with totally occluded left circumflex artery by a thrombus extended from the fistula. As there was a high risk associated with immediate intervention, the patient was kept on conservative management with a future plan of catheter-assisted or surgical closure. We have shown a rare case of CAF presenting with AMI that is unusual for such an anomaly, and have highlighted the role of CTA in the diagnosis and management of such rare disorder.
  2,901 228 3
Colorectal carcinoma then and now: What we are learning by comparing two Libyan cancer studies
Zuhir Bodalal
April-June 2015, 5(2):52-53
DOI:10.4103/2231-0770.154201  PMID:25878969
  2,365 259 -
Assessment of pathogenic micro-organisms in commercially available smokeless tobacco products
Pooja J Shetty, Vijaya Hegde
April-June 2015, 5(2):54-55
DOI:10.4103/2231-0770.154202  PMID:25878970
  2,075 137 -