Current medical research and opinion
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
A multi-centre, double-blind trial of tizanidine, a new antispastic agent, in spasticity associated with hemiplegia.
A double-blind study was carried out in 105 patients with chronic spasticity associated with hemiplegia in order to compare the efficacy and tolerability of tizanidine with that of diazepam. Dosage was increased progressively, if tolerated, to a maximum of 24 mg tizanidine or 30 mg diazepam per day at the end of 2 weeks. The optimum dosage was then maintained for 6 weeks. ⋯ Evaluation of the effect of therapy revealed an improvement with each drug in approximately 83% of patients, with the overall evaluation being slightly (but non-significantly) in favour of tizanidine. There were fewer discontinuations of treatment in the tizanidine group as a result of side-effects. It would appear, therefore, that tizanidine is an effective and well-tolerated drug in the treatment of cerebral spasticity.
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Randomized Controlled Trial Comparative Study Clinical Trial
Multi-centre, double-blind trial of a novel antispastic agent, tizanidine, in spasticity associated with multiple sclerosis.
A multi-centre, double-blind study was carried out in 100 patients suffering from chronic spasticity due to multiple sclerosis to compare the effectiveness of tizanidine hydrochloride with that of baclofen. Patients were allocated at random to receive treatment initially with daily doses of either 6 mg tizanidine or 15 mg baclofen and the dose was increased during the first 2 weeks up to a maximum of 24 mg tizanidine or 60 mg baclofen per day. Patients were then treated with the optimum dose for 6 weeks. ⋯ The antispastic efficacy of tizanidine was greater after 8 weeks than after 2 weeks, whereas the efficacy of baclofen decreased slightly with time. Both drugs showed good overall tolerability in more than 60% of patients. Thus, tizanidine is a well tolerated and effective muscle relaxant, the antispastic efficacy of which is well maintained over time, and it promises to be particularly useful in the treatment of spasticity due to multiple sclerosis.
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One hundred and eight patients who had been taking phenytoin for a year or more, either alone or in combination with other drugs, were examined for gum hypertrophy by three observers independently. Approximately 90% of the patients showed either mild or no gum hypertrophy and severe swelling occurred in only 1%. ⋯ A tendency for higher serum phenytoin levels to be associated with greater gum hypertrophy was observed. Because the condition was causing no problems in over 90% of patients, it is considered that gum hypertrophy per se should not deter a physician from using phenytoin in the treatment of epilepsy.
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The prevalence of iron deficiency anaemia in Karachi, Pakistan, was examined in a group of 100 children, aged 2 to 6 years, and 200 adult females, aged 17 to 35 years. Anaemia, defined as a haemoglobin level less than 11.5 g/dl, was present in 47% of the children and 30% of the adult females. The majority of subjects had normal red cell counts and MCV, but haematocrit and MCH were below normal in one-quarter of the children and one-third of the adult females. ⋯ Many also had elevated iron binding capacity and reduced serum iron levels. Iron deficiency may be superimposed on folate deficiency in this population. The potentially serious consequences and higher prevalence of iron deficiency anaemia in children and women of childbearing age demand greater efforts toward diagnosis and eradication in developing countries.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of diabetic control in type 2 (non-insulin dependent) diabetic patients treated with different sulphonylureas.
Diabetic control was compared in groups of Type 2 (non-insulin dependent) diabetic patients treated concurrently for 1 year with five different sulphonylurea drugs: chlorpropamide (21), glipizide (24), gliquidone (22), gliclazide (22) and glibenclamide (23). Glycosylated haemoglobin (HbA1) levels decreased in all groups over the first 2 months, but tended to level off or increase thereafter. ⋯ Only the glibenclamide group had a significant change in weight (p less than 0.05). There may be differences between different sulphonylureas which could be of clinical advantage in certain patients.