scholarly journals Genetic Polymorphism of ITGA2 C807T Collagen Receptor Encoding Gene of Aspirin Therapy among Javanese-Indonesian Healthy Respondents

2021 ◽  
Vol 9 (A) ◽  
pp. 1067-1073
Author(s):  
Vitarani Dwi Ananda Ningrum ◽  
Rochmy Istikharah ◽  
Ahmad H. Sadewa
Keyword(s):  
Genetic Polymorphism ◽  
Aspirin Resistance ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Aspirin Therapy ◽  
Antiplatelet Drug ◽  
Cross Sectional ◽  
Reverse Primer ◽  
Encoding Gene ◽  
Collagen Receptor

BACKGROUND: Aspirin is an antiplatelet drug commonly administered as primary and secondary prophylaxis to prevent thromboembolic events. However, there has been a common incidence of aspirin resistance that leads to a recurrent cerebrovascular disease. One of the causes of such event is the genetic polymorphisms of the integrin alpha-2 (ITGA2) gene that encodes the glycoprotein Ia (GPIa) receptor in the pharmacodynamics of aspirin. AIM: This study analyzed the genetic polymorphism of ITGA2 as the GPIa collagen receptor encoding gene of aspirin therapy among healthy Javanese, the largest ethnic group in Indonesia. METHODS: This cross-sectional study involved 100 respondents who met the inclusion criteria with their blood sample taken for DNA isolation. Identification of genetic polymorphism in the target SNPs was done using the PCR-RFLP method with 5’-CCTTAAAGCTACCGGCCCATGT-3’ forward primer and 5’-TTGGCCTATTAGCACCAAAACTTACC-3’ reverse primer as well as Hpy188Irestriction enzyme to fragment the target at position 244 in the C base. RESULTS: This study found that the dominant genotype and allele were CT (51%) and C (66.5%), respectively. CONCLUSION: The allele frequency of ITGA2 gene in this study was similar to that of the populations in other Asian countries. Further research regarding the effects of ITGA2 C807T polymorphism on the pharmacodynamics of aspirin as an antiplatelet is recommended to minimize atherothrombotic events and examine its interactions as a biomarker of the risk and prognosis of some cancer types.

scholarly journals Aspirin Prophylaxis for the Prevention of Thrombosis: Expectations and Limitations

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Gundu H. R. Rao ◽  
Jawad Fareed
Keyword(s):  
At Risk ◽  
Cerebral Arteries ◽  
Aspirin Resistance ◽  
Secondary Prophylaxis ◽  
Aspirin Therapy ◽  
Antiplatelet Drug ◽  
Vascular Events ◽  
Heart Attacks ◽  
Degree Of Protection ◽  
Drug Of Choice

Platelets play a very important role in the pathogenesis of acute vascular events leading to thrombosis of the coronary and cerebral arteries. Blockage of these arteries leading to regional ischemia of heart and brain tissues precipitate heart attacks and stroke. Acetyl salicylic acid (Aspirin) has been the drug of choice for over half a century for the primary and secondary prophylaxis of thrombotic events. In spite of its extensive use as an antiplatelet drug for the prevention of vascular thrombosis, there is considerable concern about the degree of protection it offers, to patients under aspirin therapy. In this paper, we explain the phenomenon of aspirin resistance, discuss the limitations of aspirin therapy, and suggest methods to monitor “at-risk” individuals. Ability to monitor and determine at risk patients will provide opportunities for the clinicians to customize antiplatelet therapies.

scholarly journals Evaluation of post-extraction bleeding in patients taking low dose aspirin

2019 ◽  
Vol 9 (1) ◽  
pp. 32-36
Author(s):  
Sajid Hasan ◽  
Mahmuda Akhter ◽  
Saeed Hossain Khan ◽  
Dilruba Sharmin ◽  
Md Manjurul Karim ◽  
...  
Keyword(s):  
Low Dose ◽  
Bleeding Time ◽  
Cross Sectional Study ◽  
Aspirin Therapy ◽  
Antiplatelet Drug ◽  
Gelatin Sponge ◽  
Excessive Bleeding ◽  
Cross Sectional ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Background: Acetylsalicylic acid (ASA) generically known as Aspirin is an analgesic, antipyretic, anti-inflammatory and also an antiplatelet drug. In order to avoid excessive bleeding and to be on the safer side, dentists have traditionally advised their patients to stop taking aspirin before extraction of teeth although this surgical procedure can be done without cessation of aspirin intake. Objective: The purpose of the study was to assess the necessity of interrupting aspirin therapy prior to dental extraction. Materials and Methods: A cross sectional study was conducted in November 2015 at outpatient department of dentistry, BIRDEM Hospital, Dhaka. Sample of 50 patients who took low dose aspirin (75mg) once daily were purposely selected for this study. The blood pressure of all the subjects was recorded preoperatively. The extractions were done atraumatically under local anesthesia using 2% lidocaine with 1:100,000 epinephrine. A gelatin sponge piece was placed in socket and closed by atraumatic silk. The subjects were instructed to apply pressure pack with sterile gauze for 30 min. Evaluation was done in every 10 minutes for 30 minutes. Results: Among 50 patients, 82.0% patients were suffering from IHD. Simple extraction was done in 92.0% of patients while the remaining extractions were done surgically. 68% was managed by pressure pack and gelatin sponge while 26.0% were managed by pressure pack only. According to Post-extraction bleeding, it was found that the bleeding time was 10 min in case of 94% patients while only 2% showed 30 minutes of bleeding time. Conclusion: The study revealed that it is not necessary to alter or stop aspirin therapy and local hemostatic measures are sufficient to control bleeding. Therefore it can be assumed that extraction can be done without cessation of low dose aspirin and avoiding the life threatening issues. Update Dent. Coll. j: 2019; 9 (1): 32-36

Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

scholarly journals FACTORS LEADING TO POOR ADHERENCE TO SECONDARY PROPHYLAXIS OF RHEUMATIC FEVER

2021 ◽  
Vol 54 (2) ◽  
pp. 167-171
Author(s):  
Romana Awan ◽  
Muhammad Faisal ◽  
Muhammad Asad Bilal Awan ◽  
Samra Khan ◽  
Kanwal Aamir ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Common ◽  
Rheumatic Heart ◽  
Structured Questionnaire ◽  
Painful Injection

Objectives: The objective of this study was to determine the level of adherence and possible barriers to secondary prophylaxis among patients with Rheumatic heart disease (RHD). Methodology: It is a cross-sectional study conducted at the largest tertiary care cardiac center of Karachi, Pakistan. We included patients with RHD, based on transthoracic echocardiography and adherence to the secondary prophylaxis and possible barriers were assessed using a structured questionnaire. Results: Among total of 195 patients 66.7% (130) were female, mean age was 32.25 ± 13.78 years. Rural residents were 51.3% (100) and 59.5% (116) of the patients were illiterate. Benzathine Penicillin injection was prescribed to 56.4% (110) patients, out of them 70.0% (77) of the patients were counseled regarding duration of secondary prophylaxis. The most common reason for non-adherence was reported to be a painful injection (19.1%). Conclusion: Majority of the RHD patients are not being prescribed and effectively counseled regarding secondary prophylaxis. Low adherence to the secondary prophylaxis was observed and the common reasons for non-adherence were painful injection, non-availability of nearby health facility, friends/family advising them otherwise, allergic reaction, and patients feeling sick and unable to take injection.

scholarly journals Throat colonization and antibiotic susceptibility of group A β-hemolytic streptococci among rheumatic heart disease patients attending a cardiac referral hospital in Tanzania, A descriptive cross-sectional study

2019 ◽  
Author(s):  
Sarah Wangilisasi ◽  
Pilly Chillo ◽  
Delila Kimambo ◽  
Mohammed Janabi ◽  
Appolinary Kamuhabwa
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Group A ◽  
Rheumatic Heart

Abstract Background: Secondary prophylaxis against repeated attacks of acute rheumatic fever is an important intervention in patients with rheumatic heart disease (RHD) and it aims to prevent throat infection by group A beta-hemolytic streptococcus (GAS), however its implementation faces many challenges. This study aimed to assess throat colonization, antibiotic susceptibility and factors associated with GAS colonization among patients with RHD attending care at Jakaya Kikwete Cardiac Institute in Dar-es-Salaam, Tanzania. Methods: A descriptive cross sectional study of RHD patients attending the Jakaya Kikwete Cardiac Institute was conducted from March to May 2018, where we consecutively enrolled all patients known to have RHD and coming for their regular clinic follow-up. A structured questionnaire was used to obtain patients’ socio-demographic information, factors associated with GAS colonization as well as status of secondary prophylaxis use and adherence. Throat swabs were taken and cultured to determine the presence of GAS, and isolates of GAS were tested for antibiotic susceptibility using Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) version 2015. Antibiotics of interest were chosen according to the Tanzanian Treatment Guidelines. Results: In total 194 patients with RHD were enrolled, their mean age was 28.4 ±16.5 years and 58.2% were females. Only 58 (29.9%) patients were on regular prophylaxis, 39 (20.1%) had stopped taking prophylaxis, while 97 (50.0%) had never been on prophylaxis. Throat cultures were positive for GAS in 25 (12.9%) patients. Patients who stopped prophylaxis were 3.26 times more likely to be colonized by GAS when compared to patients on regular prophylaxis. Majority (96%) of GAS isolates were susceptible to Penicillin, Ceftriaxone and Ciprofloxacin, while the highest resistance (20%) was observed with Vancomycin. No GAS resistance was observed against Penicillin. Conclusion: The prevalence of GAS throat colonization is high among this population and is associated with stopping prophylaxis. The proportion of patients on regular secondary prophylaxis is unacceptably low and interventions should target both patients’ and physicians’ barriers to effective secondary prophylaxis.

scholarly journals Association Between PON1 (L55M and Q192R) Genetic Polymorphism and Recurrent Pregnancy Loss in North Indian Women Exposed to Pesticides

2021 ◽  
Vol 43 (11) ◽  
pp. 805-810
Author(s):  
Shyam Pyari Jaiswar ◽  
Apala Priyadarshini ◽  
Apurva Singh ◽  
Mohd Kalim Ahmad ◽  
Sujata Deo ◽  
...  
Keyword(s):  
Genetic Polymorphism ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pcr Amplification ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Indian Women ◽  
Increased Risk ◽  
Polymerase Chain ◽  
Pon1 Polymorphisms

Abstract Objective The aim of the present study was to examine the relation between the PON1 polymorphisms and recurrent pregnancy loss (RPL). Methods In a cross-sectional study, blood samples were collected from 100 females. DNA was extracted and PON1 genotypes were determined by polymerase chain reaction (PCR) amplification. Results Regarding PON1 L55M, the mutated allele (M) frequency was found in 70.5% in RPL and in 53.5% in controls; the M allele was significantly associated with an increased risk of RPL (adjusted odds ratio [ORadj] = 2.07; 95% confidence interval [CI]; p < 0.001). However, regarding PON1 Q192R, the R mutated allele frequency was found in 28.5% in RPL and in 33% in controls. The R allele did not show any risk for RPL (ORadj 0.81; 95%CI; p = 0.329). Conclusion The present study suggests that there is an effect of genetic polymorphism on RPL and provides additional evidence that combines with the growing information about the ways in which certain PON1 genotypes can affect the development of the fetus in the uterus.

Recommendation of Aspirin-Guide App and Physicians Clinical Decision of Aspirin Use to Prevent CVD Among Diabetic Patients, Is there any Differences?

2020 ◽  
pp. 107424842095897
Author(s):  
Mohammed Ali Batais ◽  
Khalid M. Almutairi ◽  
Turky H. Almigbal ◽  
Abdulaziz Alodhayani ◽  
Wadi B. Alonazi ◽  
...  
Keyword(s):  
Clinical Decision ◽  
Cross Sectional Study ◽  
Aspirin Therapy ◽  
Mobile App ◽  
University Hospital ◽  
Diabetic Patients ◽  
Patient Acceptability ◽  
Cross Sectional ◽  
Significant Difference

Objective: This study aims to identify the prevalence of aspirin use among type 2 diabetic (T2DM) patients and assess the concordance in aspirin use among these patients as prescribed by physicians and as recommended by the Aspirin-Guide app. Methods: A total of 301 T2DM patients from King Khalid University Hospital in Riyadh, Saudi Arabia participated in this cross-sectional study. Patient’s electronic medical records through eSihi system were reviewed and all data included in the free online and mobile app called Aspirin-Guide were collected in a specially designed data checklist. Result: The prevalence of aspirin use was more common in patients who were in the age group of 51 to 59 and male participants’ with T2DM. Males were nearly twice more likely to use aspirin compared to females (p = 0.001). Based on recommendations from the Aspirin-Guide app, 26% of the patients who were on aspirin (N = 51) were not eligible for aspirin therapy, while 37.7% (N = 40) of the patients eligible for aspirin therapy had not been put on aspirin by their physicians (p = 0.039). Male sex (P = 0.003), use of statins (P = 0.001), and being advised to use aspirin (P = 0.041), were significantly associated with aspirin use in T2DM patients. Conclusion: There was a significant difference in the proportion of patients currently on aspirin as prescribed by their physicians and those eligible for aspirin therapy as per the Aspirin-Guide app. The use of an app to uniformized aspirin use among eligible patients should be based on up-to-date guidelines and account for patient acceptability and willingness to commence treatment.

scholarly journals Allele Frequency of Carbamazepine Major Efflux Transporter Encoding Gene ABCB1 C3435T among Javanese-Indonesian Population

2020 ◽  
Vol 8 (A) ◽  
pp. 406-413
Author(s):  
Rochmy Istikharah ◽  
Septiayu D. Hartienah ◽  
Sandra Vitriyani ◽  
Vitarani Dwi Ananda Ningrum
Keyword(s):  
Allele Frequency ◽  
Cross Sectional Study ◽  
Allele Frequency Distribution ◽  
Protein Overexpression ◽  
Cross Sectional ◽  
European Continent ◽  
C3435t Polymorphism ◽  
Increased Risk ◽  
Reverse Primer ◽  
Dose Variability

BACKGROUND: Genetic variations in ABCB1 gene that encodes P-glycoprotein, the main transporter in the efflux of carbamazepine (CBZ) from the brain cells, can lead to pharmacodynamic and pharmacokinetic variability. Polymorphism of C3435T is widely known to cause protein overexpression that contributes to an increased risk of CBZ resistance. AIM: This study determined the allele frequency distribution of ABCB1 C3435T gene in healthy subjects of the Javanese population as a major ethnic group in Indonesia. METHODS: This cross-sectional study involved 100 healthy volunteers who fulfilled the inclusion criteria. The genotype analysis to detect polymorphism in the targets employed the polymerase chain reaction-restriction fragment length polymorphism method with 5’-TGCTGGTCCTGAAGTTGATCTGTGAAC-3’ as the forward primer and 5’-ACATTAGGCAGTGACTCGATGAAGGCA-3’ as the reverse primer. RESULTS: The frequency of subjects with C allele in ABCB1 C3435T gene reached 53%, higher than that with T allele. CONCLUSION: This finding was nearly the same as that in studies of the populations in China, Turkey, and four countries in the South European continent. It is recommended to conduct further research on the correlation between C3435T polymorphism and CBZ dose variability to provide a comprehensive approach to epilepsy management in patients receiving CBZ.

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