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Biomedical subjects

V S Mathur

Publications and source records attributed to V S Mathur.

134 records · Page 8Linked to original sources
PubMedDate not supplied

Antipyrine clearance, aminopyrine N-demethylase, and bilirubin UDP-glucuronyl transferase activity in patients with amoebic liver abscess.

Three indices of drug metabolism, antipyrine clearance in vivo, and aminopyrine N-demethylase and bilirubin UDP-glucuronyl transferase activity in liver biopsies, were studied in fifteen patients with amoebic liver abscess (with and without jaundice). The mean (+/- S.E.) antipyrine half-life in patients with jaundice was 21.64 (+/- 1.52) h and in patients without jaundice was 19.36 (+/- 0.93) h. It was significantly prolonged in both groups of patients as compared to controls (11.63 +/- 0.86 h). It showed a good correlation with serum albumin (p less than 0.01), prothrombin time index (p less than 0.01), and aminopyrine N-demethylase (p less than 0.05). Aminopyrine N-demethylase was found to be decreased in patients without jaundice but no significant change could be observed in patients with jaundice. Bilirubin UDP-glucuronyl transferase showed no significant change in either of the groups.

Adolescent↗
PubMedDate not supplied

Antihypertensive drug-associated sexual dysfunction: a prescription analysis-based study.

PURPOSE: To determine whether primary care physicians take into consideration age, gender and diabetes mellitus as risk factors for sexual dysfunction (SD) when prescribing antihypertensives. METHODS: A prescribing survey on hyperternsive patients with or without diabetes mellitus in primary care setting of Bahrain was carried out. RESULTS: In 5301 hypertensive patients, we found that a beta-blocker (atenolol) was the most commonly prescribed drug and was significantly more often prescribed for young male hypertensives (< 45 years). A relatively high dose of atenolol (100 mg/d) was extensively used as both mono- and combination-therapies. With the exception of middle-aged hypertensives (45-64 years) and elderly diabetic-hypertensives (> or = 65 years), no significant age- and gender-related differences were observed regarding the prescription of thiazide diuretics. A significant trend of prescribing methyldopa in females as monotherapy was evident. Angiotensin converting enzyme (ACE) inhibitors, the second most commonly prescribed drugs, were significantly more often prescribed for young, middle-aged hypertensive males and for middle-aged diabetic-hypertensive males. beta-blocker/diuretic combination was prescribed least for the young and elderly hypertensive males. However, prescription of an ACE inhibitor with either a diuretic or a calcium channel blocker (CCBs) was less frequent and lacked gender-related differences. CONCLUSIONS: We infer that antihypertensive-induced SD received little attention as was evident from: (a) over-prescription of relatively high dose of beta-blockers to young hypertensive males; (b) lack of gender- and age-related difference regarding the type and dose of diuretics prescribed; (c) underutilization of effective and complementary combinations expected to cause least impact on sexual function, such as ACE inhibitors with either a diuretic or with a CCB; and (d) a relative lack of discrimination while selecting antihypertensive drugs, particularly as monotherapy between hypertensive versus diabetic-hypertensive patients. With the exception of ACE inhibitors alone and combination of diuretic/beta-blocker, the choice of antihypertensives did not conform to international guidelines. In view of drug-induced SD adversely influencing the quality of life and thereby drug-compliance, interventions aimed at improving physicians' awareness should be attempted.

Adult↗
PubMedDate not supplied

Impairment of hepatic drug metabolism in patients with acute viral hepatitis.

Hepatic drug metabolism in patients with acute viral hepatitis was investigated under different conditions: pregnancy, postpartum, non-pregnancy, and among males. Liver function tests were altered in all of these conditions. The relationship between in vivo and in vitro drug metabolism was studied in twenty-two patients using diagnostic liver needle biopsies by comparing the drug metabolising enzymes (aminopyrine-N-demethylase and bilirubin-UDP-glucuronyl transferase) in these biopsies with the elimination kinetics of antipyrine. Drug clearance tests were repeated in the patients who had recovered. All patients gave altered liver function tests results. Antipyrine half-life was significantly higher in females as compared to males. Among females, it was maximum in the pregnant group. Activities of drug metabolising enzymes were found to be significantly lower in liver biopsy material. The half-life of antipyrine showed a significant correlation with drug metabolising enzymes. After recovery patients showed a normal antipyrine half-life.

Adolescent↗
PubMedDate not supplied

Extent of use of immediate-release formulations of calcium channel blockers as antihypertensive monotherapy by primary care physicians: multicentric study from Bahrain.

BACKGROUND: The issue of cardiovascular safety of calcium channel blockers (CCBs) has been widely debated in view of reflex increase in sympathetic activity induced by immediate release (IR) / short acting formulations. It is generally agreed that such CCBs should not be used alone in the management of hypertension. AIMS: We have determined the extent to which primary care physicians prescribe CCBs as monotherapy, especially the immediate release formulations, in the management of uncomplicated hypertension and diabetic hypertension - with an emphasis upon the age of the patients. SETTING, DESIGN AND METHODS: A retrospective prescription-based study was carried out in seven out of 18 Health Centres in Bahrain. The study involved a registered population of 229,300 representing 46% of registered individuals, and 35 physicians representing 43% of all primary care physicians. The data was collected between November 1998 and January 1999 using chronic dispensing cards. RESULTS: In all categories CCBs were the third commonly prescribed antihypertensive as monotherapy, with a prescription rate of 11.1% in uncomplicated hypertension, 18% in diabetic hypertension and 20.1% in elderly patients above 65 years of age. Nifedipine formulations were the most extensively prescribed CCBs. Almost half of the CCB-treated patients were on IR-nifedipine, whereas IR-diltiazem and IR-verapamil, and amlodipine were infrequently prescribed. CONCLUSION: Prescription of IR-formulations of CCBs as monotherapy by primary care physicians does not conform with recommended guidelines. In view of concerns about the safety of such practice, measures to change the prescribing pattern are required.

Adult↗
PubMedDate not supplied

Noninvasive assessment of left ventricular function in asymptomatic diabetics and its relation to metabolic control and microangiopathy.

Fifty otherwise healthy patients with diabetes mellitus (37 males, 13 females; mean age: 53 +/- 10 years) of more than five year duration were compared with twenty six healthy age and sex matched controls. Detailed echocardiographic evaluation was done in all and systolic time intervals (STI) were measured. In diabetics, metabolic control and presence of microangiopathy were evaluated. PEP Index (patients: 146.23 +/- 17.04; controls: 121.99 +/- 5.15; p less than 0.001), PEP/LVET ratio (patients: 0.38 +/- 0.07; controls: 0.32 +/- 0.02; p less than 0.001), LVEF% (patients: 54.1 +/- 10.56; controls: 64.71 +/- 6.33; p less than 0.001), all were significantly altered in diabetics suggesting left ventricular dysfunction. The left ventricular posterior wall thickness (patients: 0.96 +/- 0.23 cm; controls: 0.85 +/- 0.12 cm; p less than 0.01) and interventricular septal thickness (patients: 1.2 +/- 0.24 cm; controls: 0.87 +/- 0.25 cm; p less than 0.001) in diastole were increased in diabetics. The PEPI correlated with day-to-day control but not with chronic glycemic control of diabetes mellitus. The PEP/LVET was significantly increased in patients with severe, as compared to those with none or mild microangiopathy (p less than 0.05). Thus, significant left ventricular dysfunction is evident in asymptomatic, otherwise healthy diabetics. Both metabolic control and microangiopathy may be responsible for the abnormalities.

Diabetes Mellitus, Type 2↗