ABSTRACT… Objectives:To compare the efficacy of duloxetine with amitriptyline for reduction in the frequency of pain management in patients with diabetic neuropathy. Study Design: It is a Comparative, Randomized and Prospective study. Setting: Medical Unit-4, DHQ, Hospital, Faisalabad. Study Duration: 5 months, October, 2016 to February 2017. Methods: A total of 100 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included while those with co-existing other causes of peripheral neuropathy (porphyria, chronic renal failure, amyloidosis, leprosy, hypothyroidism), pregnant and lactating women and use of Duloxetine or amitriptyline in previous three months were excluded from the study. Randomization was done by computer generated random number table, to allocate patients to either group A (Duloxetine group) or group B (Amitriptyline group). Patients were instructed to take study medication in the morning, with a glass of water for up to 6 weeks. Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. Baseline pain was recorded on VAS. Diary card was provided to all patients at the baseline visit. Each morning during the 1st 3 weeks, patients would be instructed to record the severity of the symptoms in term of reduction in pain score recorded by visual analogue scale. After 3 weeks, an additional three weeks supply of medication was dispensed and patients were scheduled to return at week 6 for the final evaluation that was recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Patients were followed up by keeping telephonic contacts of patients. Results: In our study, out of 200 cases (100 in each group) 21%(n=21) in Group-A and 17%(n=17) in Group-B were between 20-40 years of age while 79%(n=79) in Group-A and 83%(n=83) in Group-B were between 41-65 years of age, mean+SD was calculated as 47.08+11.43 and 48.37+10.83 respectively, 56%(n=56) in Group-A and 49%(n=49) in Group-B were male while 44%(n=44) in Group-a and 51%(n=51) in Group-B were females, comparison of efficacy in both groups was done which shows that 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: It is concluded that the efficacy of duloxetine as compared to the amitriptyline in terms of reduction in frequency of pain in the management of patients of diabetic neuropathy is significantly higher. Key words:Diabetic neuropathy, management, duloxetine, amitriptyline, efficacy.
Objectives: To compare the efficacy of duloxetine with amitriptyline for reductionin the frequency of pain management in patients with diabetic neuropathy. Study Design: It isa Comparative, Randomized and Prospective study. Setting: Medical Unit-4, DHQ, Hospital,Faisalabad. Study Duration: 5 months, October, 2016 to February 2017. Methods: A total of100 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5years historyof diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5%were included while those with co-existing other causes of peripheral neuropathy (porphyria,chronic renal failure, amyloidosis, leprosy, hypothyroidism), pregnant and lactating womenand use of Duloxetine or amitriptyline in previous three months were excluded from the study.Randomization was done by computer generated random number table, to allocate patientsto either group A (Duloxetine group) or group B (Amitriptyline group). Patients were instructedto take study medication in the morning, with a glass of water for up to 6 weeks. Group A wasgiven 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose.Baseline pain was recorded on VAS. Diary card was provided to all patients at the baseline visit.Each morning during the 1st 3 weeks, patients would be instructed to record the severity of thesymptoms in term of reduction in pain score recorded by visual analogue scale. After 3 weeks,an additional three weeks supply of medication was dispensed and patients were scheduled toreturn at week 6 for the final evaluation that was recorded by me in terms of reduction in painscore and also assessed for 50% reduction in pain score from base line that was labeled asreduced. Patients were followed up by keeping telephonic contacts of patients. Results: In ourstudy, out of 200 cases (100 in each group) 21%(n=21) in Group-A and 17%(n=17) in Group-Bwere between 20-40 years of age while 79%(n=79) in Group-A and 83%(n=83) in Group-Bwere between 41-65 years of age, mean+SD was calculated as 47.08+11.43 and 48.37+10.83respectively, 56%(n=56) in Group-A and 49%(n=49) in Group-B were male while 44%(n=44)in Group-a and 51%(n=51) in Group-B were females, comparison of efficacy in both groupswas done which shows that 62%(n=62) in Group-A and 35%(n=35) in Group-B were treatedeffectively, which shows a significant difference between the two groups. Conclusion: It isconcluded that the efficacy of duloxetine as compared to the amitriptyline in terms of reductionin frequency of pain in the management of patients of diabetic neuropathy is significantly higher.
Objectives: To determine the frequency of common factors leading to stroke inyoung local population. Study Design: It is Descriptive Cross-Sectional study. Setting: Medicalfloor, DHQ, Hospital, Faisalabad. Period of Study: 6 Months, September, 2016 to February,2017. Methodology: A total of 150 diagnosed cases of stoke between 18-40 years of age ofeither gender were enrolled in this trial. We excluded all those cases with recurrent historyof cerebrovascular accidents, space occupying lesion, head injury, hypoglycemia, transientischemic attack, CNS infection. We used CT brain showing either infarct or hemorrhage. Aftera detailed history from patient/relative including the common factors of stroke, all patientsundergoing thorough physical examination, CT/MRI Scan brain, lipid profile and fasting bloodglucose measurement to rule out the presence/absence of hypertension, smoking, Dyslipidemiaand diabetes mellitus being the common risk factors. Results: Age distribution shows 38%(n=57) were between 18-30 years while 62% (n=93) between 31-40 years, mean+sd wascalculated as 35.21+6.47 years. (Table-I) Gender distribution shows 64% (n=96) male and36% (n=54) females. (Table-II). Frequency of common factors leading to stroke in young adultsreveals hypertension in 60.67% (n=91), diabetes mellitus in 41.33% (n=62), smoking in 31.33%(n=47) and dyslipidemia in 23.33% (n=35). Conclusion: The results of the study conclude thatamong common factors hypertension, smoking, dyslipidemia and diabetes mellitus are theleading causes of stroke and these factors are modifiable and by controlling on these factors,the frequency of stroke in young adults may be avoided.
ABSTRACT… Objectives:To determine the frequency of common factors leading to stroke in young local population. Study Design: It is Descriptive Cross-Sectional study. Setting: Medical floor, DHQ, Hospital, Faisalabad. Period of Study: 6 Months, September, 2016 to February, 2017. Methodology: A total of 150 diagnosed cases of stoke between 18-40 years of age of either gender were enrolled in this trial. We excluded all those cases with recurrent history of cerebrovascular accidents, space occupying lesion, head injury, hypoglycemia, transient ischemic attack, CNS infection. We used CT brain showing either infarct or hemorrhage. After a detailed history from patient/relative including the common factors of stroke, all patients undergoing thorough physical examination, CT/MRI Scan brain, lipid profile and fasting blood glucose measurement to rule out the presence/absence of hypertension, smoking, Dyslipidemia and diabetes mellitus being the common risk factors. Results: Age distribution shows 38% (n=57) were between 18-30 years while 62% (n=93) between 31-40 years, mean+sd was calculated as 35.21+6.47 years. (Table-I) Gender distribution shows 64% (n=96) male and 36% (n=54) females. (Table-II). Frequency of common factors leading to stroke in young adults reveals hypertension in 60.67% (n=91), diabetes mellitus in 41.33% (n=62), smoking in 31.33% (n=47) and dyslipidemia in 23.33% (n=35). Conclusion: The results of the study conclude that among common factors hypertension, smoking, dyslipidemia and diabetes mellitus are the leading causes of stroke and these factors are modifiable and by controlling on these factors, the frequency of stroke in young adults may be avoided.
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