Abstract:No national data on drug resistance is available in Bangladesh. The
Objectives: To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry. Methods:The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from August 2011 to February 2012. Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate® platelet analyser. Results: A total of 74 patients (63 male, 11 female), with a mean age of 57.93 ± 74.1years were enrolled in the study. The patients were divided into two groups –first-ever coronary event group (n=52) and recurrent coronary event group (n=22). Aspirin resistance was observed in 12 out of 74 (16%) of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age (r = -0.627; p = 0.029), total cholesterol (r = 0.608; p = 0.036) and LDL (r = 0.694; p = 0.012). LDL was the main predictor for area under the curve (AUC) for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study. Conclusions: Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events.
17-α methyl testosterone is a major endocrine disrupting chemical (EDCs), reported harmful effect on endocrine system of aquatic animals. To study the impact of 17-αMT on olive barb (Puntius sarana) gonad, sixty fishes were collected for in vitro experiment. Hormonal treatments were carried out 90 days with three distinct hormonal dosages (T1:40 mg/kg; T2:60 mg/kg and T3:90 mg/kg) mixed with pelleted feed and no hormone in control tank (C). Each 30 days intervals, histological analysis was performed to observe alterations in the gonad due to the effect of 17α-MT. Four gamete developmental stages of female P. sarana ovary were identified through microscopic examination named immature, previtellogenic, vitellogenic and mature stage. Mild to moderate histological abnormalities has been observed in ovary for different treatments. T1 showed apparently normal histology except some alterations like empty follicle (ef), lipid droplet (ld), vitelline envelop breakdown (veb), but pronounced alterations were detected at higher concentration T2 and T3, increasing with longer exposures for instance degenerated nucleus (dn), atretic follicle (af), thickened vitelline envelop (tve), residual oocyte (roc). This preliminary study revealed more profound responses to EDCs exposure in the olive barbs which could serve as a model bio-indicator in ecotoxicological study.
Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Beximco Pharmaceutical Limited, Bangladesh OnBehalf Cardiology Study Group (Bangladesh) Background The fact that SAARS-Cov2 virus enters cells through ACE2 receptors and the Renin-Angiotensin-Aldosterone System Inhibitors (RAASi) upregulate the ACE2 receptors, there was speculation that use of RAASi may lead increased cellular entry of the virus. There was a pause for a brief period of the use of RAASi in COVID 19 patients. But clinically the speculation has been found to be incorrect. Different professional societies come up with the assertion to continue to use RAASi. As the hesitancy among the clinicians appears to continue and there is no first hand data regarding the safety of the use of RAASi in Bangladeshi population, the study was undertaken to evaluate the safety of RAASi in COVID 19 patients. Aims & Methods This study was a prospective, observational multi-center study to evaluate the outcome of COVID-19 patients receiving RAAS inhibitors. Adult Hypertensive patients (age ≥18 years) with diagnosed COVID-19 confirmed by RT-PCR test who have a history of taking either ACE inhibitor/ARB or any other anti-hypertensive medication. Evaluation of outcome was assessed by rate of hospitalization, requirement of oxygen therapy, requirement of high flow nasal cannula, admission to ICU and mortality between two groups. All statistical analyses were performed using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results We collected data from 147 Covid-19 positive patients confirmed by RT-PCR. Among them, 117 (79.6%) had a history of taking RAAS inhibitor and 30 had history of taking other antihypertensive medications. Of them, two-third patients had more than 50 years of age and more than half of the patients had overweight or obesity. Other than hypertension they had several comorbidities such as Diabetes Mellitus (45.4%), Ischemic Heart Diseases (35.4%), Asthma or COPD (15%) etc. Rate of hospitalization had no statistical difference between RAAS inhibitor group and other hypertensive group (48.7% vs 46.70% respectively; p-value - 0.841). There was no statistical difference between two groups in terms of requirement of oxygen therapy (p-value - 0.297), High Flow Nasal Cannula (p-value - 0.430), intensive care unit (p-value - 0.194) and death (p-value – 0.383) also. Almost half and one-third of the patients had persistence of symptoms even after 14 days and 28 days respectively. Fatigue, cough, breathlessness, loss of appetite and taste were the most common symptoms among those. Conclusion In our study we found that RAAS inhibitor treatment had no adverse effect on the outcome of COVID-19 patients compared with other antihypertensive drugs. Patients may continue receiving ACEIs and ARBs for the treatment of any indication for RAASi without an increased risk of worse outcomes.
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