Dhanpat Kochar - Academia.edu (original) (raw)
Papers by Dhanpat Kochar
Abstract. A 31-year-old woman from Cameroon was admitted to the University of Strasbourg Hospital... more Abstract. A 31-year-old woman from Cameroon was admitted to the University of Strasbourg Hospital in December 2007 with pelvic pain and fever that developed over three days. Her condition rapidly worsened and she underwent emergency exploratory celioscopy. Surgeons found peritoneal and retrouterine abscesses. The high rectum had a 4-cm perforation with infiltrated, friable, and irregular edges. A biopsy specimen of this pseudotumoral specimen showed many Schistosoma haematobium eggs with an inflammatory reaction surrounding the eggs. The patient was treated with praziquantel (40 mg/kg/day) for 5 days and a 4-week course of antibiotic therapy. Her progress was good and digestive continuity surgery was performed four months later. Schistosomiasis frequently involves rectal mucosa, but perforation is unusual. Our review of the literature found only two cases of colon perforation associated with S. mansoni infection. To our knowledge, this is the first case of rectal perforation caused ...
QJM: An International Journal of Medicine, Dec 1, 1998
We studied 424 adults with falciparum malaria oedema, six (2.80%) cerebral and five non-cerebral ... more We studied 424 adults with falciparum malaria oedema, six (2.80%) cerebral and five non-cerebral malaria; disc pallor, five patients all with cerebral admitted over 28 months. They were divided into three groups: cerebral malaria (n=214); severe non-malaria; vitreous haemorrhage and hard exudate in one patient each, both cerebral malaria. Retinal cerebral malaria (n=58); and uncomplicated malaria (n=152). Fundus examination was done daily haemorrhage was associated with cerebral malaria and severe non-cerebral malaria, especially with from admission to discharge, and weekly thereafter in those with persistent changes. All patients were severe anaemia (p<0.001), as compared to uncomplicated malaria (p<0.01). The association of papil-treated by a protocol based on WHO guidelines. Ophthalmoscopic abnormalities were: retinal haem-loedema and cerebral malaria was highly significant compared to severe non-cerebral malaria (p< orrhages, 40 (9.43%) (25 cerebral malaria, 10 severe non-cerebral and five uncomplicated malaria); papil-0.001). None of these findings was associated with statistically significant mortality, except disc pallor loedema, 17 (7.94%) cerebral malaria and two uncomplicated malaria; blurring of disc margins, 25 in cerebral malaria (p<0.05).
PubMed, Aug 1, 2000
A case of acute aluminium phosphide poisoning is described, who presented in shock secondary to e... more A case of acute aluminium phosphide poisoning is described, who presented in shock secondary to electrolyte related cardiac rhythm disturbance and the judicious correction of the same could save his life without any consequence.
PubMed, Nov 1, 1998
A prospective study of blood glucose level at the time of admission was done on 532 cases of seve... more A prospective study of blood glucose level at the time of admission was done on 532 cases of severe and complicated malaria admitted in classified malaria ward at PBM Hospital, Bikaner. Eleven patients had blood glucose level < 40 mg% (< 2.2 mmol/L) and all were unconscious with diagnosis of cerebral malaria. Four patients became conscious with i.v. infusion of 25% dextrose only without receiving any specific antimalarial treatment. Recognition of these patients of "falciparum malaria with hypoglycaemia" by blood glucose estimation at the time of admission can significantly affect the ultimate outcome. The mortality trend was more in patients having blood glucose level < 40 mg% (< 2.2 mmol/L) in comparison to group of patients having blood glucose level between 41 to 60 mg% (2.2 to 3.3 mmol/L) and was least in those having blood glucose level > 60 mg% (> 3.3 mmol/L).
PubMed, Sep 1, 1998
Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitu... more Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortion, still births, intra uterine growth retardation (IUGR), and pre-mature labour. Two hundred eighty-eight admitted female patients of falciparum malaria were included in the study out of which 45 were pregnant. The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%); (p < 0.001). The incidence of various pernicious syndromes including cerebral malaria, severe anaemia (Hb < 5 g%) hepatic and renal failure were more in pregnant females in comparison to non-pregnant females. The incidence of infection was higher among primigravida and second gravida 30/45 (66.66%) as compared to multigravida 15/45 (33.33%) and the greater incidence of infection was seen during 14-28 wk of gestation 23/45 (51.11%). Pregnancy related complications in the form of preterm live birth (20%). Intra uterine death (IUD 31.11%), still births (13.33%) and abortions (11.11%) were more pronounced in primiparous women as compared to multiparous. Weight of placenta in majority of patients ranged between 200-400 g (22/31; 70.96%). Normal pregnancy continued in only 11 out of 45 pregnant females, out of which seven had low birth weight body (63.63%). As the pregnancy is associated with increased incidence and adverse outcome of falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemic therapy to reduce the risk of serious maternal and fetal complications.
Experimental Parasitology, May 1, 2008
A number of stage-specific antigens have been characterized for vaccine development against Plasm... more A number of stage-specific antigens have been characterized for vaccine development against Plasmodium falciparum malaria. This study presents a comprehensive analysis of the sequence polymorphism in Plasmodium falciparum apical membrane antigen-1 (PfAM-A-1) in population samples from the eastern and western parts of India. This is the first study of its kind for the nearly full length PfAM-A-1 gene from these regions in India. Our observations confirmed that sequence diversity of PfAMA-1 confines only to point mutations and shows 4-8% variation as compared to the prototypes. As opposed to the previous studies on PfAMA-1, our study revealed a greater degree of polymorphism in the Domain II region of PfAMA-1 protein, though signature for diversifying selection is seen throughout the gene. Our present investigation also indicates a very high degree of variation in the reported T-and B-cell epitopes of PfAMA-1. Few noteworthy and unique observations made in this study are the substitution of Cysteine residues responsible for the disulfide bond structure of the protein and the presence of premature termination after 595 amino acids in 3 of the 13 isolates under consideration. These crucial findings add new perspectives to the future of AMA-1 research and could have major implications in establishing AMA-1 as a vaccine candidate.
International Journal of Diabetes in Developing Countries, 2009
Background: Erectile dysfunction in type-2 diabetes may be an independent marker for coronary art... more Background: Erectile dysfunction in type-2 diabetes may be an independent marker for coronary artery disease. Present study was undertaken to investigate whether type-2 diabetic patients with erectile dysfunction without having overt cardiovascular disease had increased cardiovascular risk. Aim: To fi nd out correlation between ED and cardiovascular risk in diabetic patients. Methods: Fifty type-2 diabetic patients were assessed for erectile dysfunction using international index of erectile dysfunction (IIEF-5), which include questionnaire and cardiovascular risk assessment by multiparameter cardiovascular analysis device (periscope). Results: The prevalence of erectile dysfunction in type-2 diabetics was very high (78%), mild, moderate and severe ED was present in 6, 36 and 36%, respectively. The total cardiovascular risk was more in patients with ED in comparison to patients without ED (34.87 ± 18.82 vs 20.91 ± 11.03 p = 0.002). The mean 10-years coronary risk and cardiac risk was 12.00 + 9.60 and 22.23 + 14.14 (p = 0.029) and 13.36 ± 1.22 and 28.85 ± 4.13 (p 0.002) in patients without ED and with ED respectively. The mean vascular and atherosclerosis risk was 28.73 ± 13.94 and 39.38 ± 19.51 (p > 0.05) and 26.18 ± 10.31 and 33.92 ± 13.40 (p > 0.05) in patients without ED and with ED, respectively. Total cardiovascular risk was found to increase with age, duration of diabetes and HbA1c levels. Conclusion: The total cardiovascular risk increases with increasing severity of erectile dysfunction in type-2 diabetic patients without having overt cardiovascular disease.
QJM: An International Journal of Medicine, Nov 1, 2000
We assessed the efficacy of rifampicin in the treatment of cutaneous leishmaniasis (oriental sore... more We assessed the efficacy of rifampicin in the treatment of cutaneous leishmaniasis (oriental sore) using a double-blind placebo-controlled study. We studied 46 patients with cutaneous leishmaniasis, of whom 23 received rifampicin (group A) and another 23 received placebo (group B) for a period of 4 weeks. Each patient was assessed clinically for size of lesion, type of lesion, duration of lesion, number of lesions, and distribution of lesions, initially, and at the end of 1 week, 2 weeks and 4 weeks. Biochemical tests including enzyme studies were done to detect any toxic effects of the drug. Group A patients received rifampicin 1200 mg/day in two divided doses and group B patients received two doses of an identical placebo capsule. Seventeen (73.9%) of the 23 patients receiving rifampicin had complete healing. Two (8.6%) had partial healing and four (17.3%) showed no response, whereas out of 23 patients receiving placebo one patient (4.3%) showed complete healing, eight (34.7%) patients showed partial healing and 14 (60.98%) patients showed no healing or exacerbation of lesion. The difference was statistically significant in favour of response to rifampicin. This dose of rifampicin was well-tolerated and no side-effects were seen in any patient. In cases of cutaneous leishmaniasis where injectable treatment is not feasible or not acceptable, as in cases of multiple lesions, rifampicin is a better alternative oral treatment. It is simple to administer, cheap, more effective and less toxic than other available oral drugs, and well-tolerated by patients.
QJM: An International Journal of Medicine, Apr 1, 1999
Diabetes Research and Clinical Practice, Mar 1, 2009
Objectives: Combination of drugs with different mechanisms of action helps in achieving synergist... more Objectives: Combination of drugs with different mechanisms of action helps in achieving synergistic analgesic effect in neuropathic pain. Keeping this point in view, the effect and safety aspects of sodium valproate and GTN were assessed alone as well as in combination in this study. Design: Prospective double-blind randomized placebo-controlled study. Material and method: Eighty-seven type 2 diabetics with painful neuropathy were enrolled. Four were excluded: three with HbA 1 c > 11 while one withdrew consent. The remaining 83 were given either sodium valproate and GTN spray (group A) or placebo drug and GTN spray (group B) or sodium valproate and placebo spray (group C) or placebo drug and placebo spray (group D). Quantitative assessment of pain was done by McGill pain questionnaire, visual analogue score (VAS) and present pain intensity (PPI) at the beginning of the study and after 3 months along with motor and sensory nerve conduction velocities measurements. Results: All the three treatment groups experienced significant improvement in pain score in their drug phase of trial (p < 0.001/ < 0.05) along with some of the electrophysiological parameters. The assessment of the magnitude of therapeutic effect of sodium valproate, GTN and their combination gave numbers needed to treat (NNT) of 7, 5 and 4, respectively. Conclusion: Sodium valproate and GTN are well tolerated and provide significant improvement in pain scores as well as in electrophysiological parameters.
The Lancet, Jun 1, 1996
proves deleterious effect in cerebral malaria: a double blind trial in 100 comatose patients. N E... more proves deleterious effect in cerebral malaria: a double blind trial in 100 comatose patients. N Engl J Med 1982; 306: 313. 3 White NJ, Warrell DA, Chanthavanich P, et al. Severe hypoglycemia and hyperinsulinaemia in falciparum malaria. N Engl J Med 1983; 309: 61-66. 4 Molyneux ME, Taylor TE, Wirima JJ, et al. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. QJ Med 1989; 265: 441-59.
Annals of Indian Academy of Neurology, 2012
Neuroradiology, Oct 1, 2003
Acta Neurologica Scandinavica, Oct 4, 2002
OBJECTIVE: To study the effectiveness and safety aspects of sodium valproate in the management of... more OBJECTIVE: To study the effectiveness and safety aspects of sodium valproate in the management of painful neuropathy in patients of type 2 diabetes mellitus. MATERIAL AND METHODS: A randomized double-blind placebo controlled trial of sodium valproate was done in type 2 diabetic patients to assess its efficacy and safety in the management of painful neuropathy. We screened 60 patients but eight patients could not complete the study; hence, the present study was done on 52 patients. Each patient was assessed by clinical examination, pain score by short form of the McGill pain questionnaire (SF-MPQ) and electrophysiological examination, which included motor and sensory nerve conduction velocity, amplitude and H-reflex initially and at the end of 1 month of treatment. RESULTS: Significant improvement was noticed in the pain score of patients receiving sodium valproate in comparison to patients receiving placebo at the end of 1 month (P < 0.05). The changes in electrophysiological data were not significant. The drug was well tolerated by all patients except one who developed a raised aspartate transaminase (AST)/ alanine transaminase (ALT) level after 15 days of treatment. CONCLUSION: Sodium valproate is a well-tolerated drug and provides significant subjective improvement in painful diabetic neuropathy. These data provide a basis for future trials of longer duration in a larger group of patients.
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2013
Journal of Veterinary Public Health, 2003
Indian journal of animal health, 1990
Abstract. A 31-year-old woman from Cameroon was admitted to the University of Strasbourg Hospital... more Abstract. A 31-year-old woman from Cameroon was admitted to the University of Strasbourg Hospital in December 2007 with pelvic pain and fever that developed over three days. Her condition rapidly worsened and she underwent emergency exploratory celioscopy. Surgeons found peritoneal and retrouterine abscesses. The high rectum had a 4-cm perforation with infiltrated, friable, and irregular edges. A biopsy specimen of this pseudotumoral specimen showed many Schistosoma haematobium eggs with an inflammatory reaction surrounding the eggs. The patient was treated with praziquantel (40 mg/kg/day) for 5 days and a 4-week course of antibiotic therapy. Her progress was good and digestive continuity surgery was performed four months later. Schistosomiasis frequently involves rectal mucosa, but perforation is unusual. Our review of the literature found only two cases of colon perforation associated with S. mansoni infection. To our knowledge, this is the first case of rectal perforation caused ...
QJM: An International Journal of Medicine, Dec 1, 1998
We studied 424 adults with falciparum malaria oedema, six (2.80%) cerebral and five non-cerebral ... more We studied 424 adults with falciparum malaria oedema, six (2.80%) cerebral and five non-cerebral malaria; disc pallor, five patients all with cerebral admitted over 28 months. They were divided into three groups: cerebral malaria (n=214); severe non-malaria; vitreous haemorrhage and hard exudate in one patient each, both cerebral malaria. Retinal cerebral malaria (n=58); and uncomplicated malaria (n=152). Fundus examination was done daily haemorrhage was associated with cerebral malaria and severe non-cerebral malaria, especially with from admission to discharge, and weekly thereafter in those with persistent changes. All patients were severe anaemia (p<0.001), as compared to uncomplicated malaria (p<0.01). The association of papil-treated by a protocol based on WHO guidelines. Ophthalmoscopic abnormalities were: retinal haem-loedema and cerebral malaria was highly significant compared to severe non-cerebral malaria (p< orrhages, 40 (9.43%) (25 cerebral malaria, 10 severe non-cerebral and five uncomplicated malaria); papil-0.001). None of these findings was associated with statistically significant mortality, except disc pallor loedema, 17 (7.94%) cerebral malaria and two uncomplicated malaria; blurring of disc margins, 25 in cerebral malaria (p<0.05).
PubMed, Aug 1, 2000
A case of acute aluminium phosphide poisoning is described, who presented in shock secondary to e... more A case of acute aluminium phosphide poisoning is described, who presented in shock secondary to electrolyte related cardiac rhythm disturbance and the judicious correction of the same could save his life without any consequence.
PubMed, Nov 1, 1998
A prospective study of blood glucose level at the time of admission was done on 532 cases of seve... more A prospective study of blood glucose level at the time of admission was done on 532 cases of severe and complicated malaria admitted in classified malaria ward at PBM Hospital, Bikaner. Eleven patients had blood glucose level < 40 mg% (< 2.2 mmol/L) and all were unconscious with diagnosis of cerebral malaria. Four patients became conscious with i.v. infusion of 25% dextrose only without receiving any specific antimalarial treatment. Recognition of these patients of "falciparum malaria with hypoglycaemia" by blood glucose estimation at the time of admission can significantly affect the ultimate outcome. The mortality trend was more in patients having blood glucose level < 40 mg% (< 2.2 mmol/L) in comparison to group of patients having blood glucose level between 41 to 60 mg% (2.2 to 3.3 mmol/L) and was least in those having blood glucose level > 60 mg% (> 3.3 mmol/L).
PubMed, Sep 1, 1998
Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitu... more Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortion, still births, intra uterine growth retardation (IUGR), and pre-mature labour. Two hundred eighty-eight admitted female patients of falciparum malaria were included in the study out of which 45 were pregnant. The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%); (p < 0.001). The incidence of various pernicious syndromes including cerebral malaria, severe anaemia (Hb < 5 g%) hepatic and renal failure were more in pregnant females in comparison to non-pregnant females. The incidence of infection was higher among primigravida and second gravida 30/45 (66.66%) as compared to multigravida 15/45 (33.33%) and the greater incidence of infection was seen during 14-28 wk of gestation 23/45 (51.11%). Pregnancy related complications in the form of preterm live birth (20%). Intra uterine death (IUD 31.11%), still births (13.33%) and abortions (11.11%) were more pronounced in primiparous women as compared to multiparous. Weight of placenta in majority of patients ranged between 200-400 g (22/31; 70.96%). Normal pregnancy continued in only 11 out of 45 pregnant females, out of which seven had low birth weight body (63.63%). As the pregnancy is associated with increased incidence and adverse outcome of falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemic therapy to reduce the risk of serious maternal and fetal complications.
Experimental Parasitology, May 1, 2008
A number of stage-specific antigens have been characterized for vaccine development against Plasm... more A number of stage-specific antigens have been characterized for vaccine development against Plasmodium falciparum malaria. This study presents a comprehensive analysis of the sequence polymorphism in Plasmodium falciparum apical membrane antigen-1 (PfAM-A-1) in population samples from the eastern and western parts of India. This is the first study of its kind for the nearly full length PfAM-A-1 gene from these regions in India. Our observations confirmed that sequence diversity of PfAMA-1 confines only to point mutations and shows 4-8% variation as compared to the prototypes. As opposed to the previous studies on PfAMA-1, our study revealed a greater degree of polymorphism in the Domain II region of PfAMA-1 protein, though signature for diversifying selection is seen throughout the gene. Our present investigation also indicates a very high degree of variation in the reported T-and B-cell epitopes of PfAMA-1. Few noteworthy and unique observations made in this study are the substitution of Cysteine residues responsible for the disulfide bond structure of the protein and the presence of premature termination after 595 amino acids in 3 of the 13 isolates under consideration. These crucial findings add new perspectives to the future of AMA-1 research and could have major implications in establishing AMA-1 as a vaccine candidate.
International Journal of Diabetes in Developing Countries, 2009
Background: Erectile dysfunction in type-2 diabetes may be an independent marker for coronary art... more Background: Erectile dysfunction in type-2 diabetes may be an independent marker for coronary artery disease. Present study was undertaken to investigate whether type-2 diabetic patients with erectile dysfunction without having overt cardiovascular disease had increased cardiovascular risk. Aim: To fi nd out correlation between ED and cardiovascular risk in diabetic patients. Methods: Fifty type-2 diabetic patients were assessed for erectile dysfunction using international index of erectile dysfunction (IIEF-5), which include questionnaire and cardiovascular risk assessment by multiparameter cardiovascular analysis device (periscope). Results: The prevalence of erectile dysfunction in type-2 diabetics was very high (78%), mild, moderate and severe ED was present in 6, 36 and 36%, respectively. The total cardiovascular risk was more in patients with ED in comparison to patients without ED (34.87 ± 18.82 vs 20.91 ± 11.03 p = 0.002). The mean 10-years coronary risk and cardiac risk was 12.00 + 9.60 and 22.23 + 14.14 (p = 0.029) and 13.36 ± 1.22 and 28.85 ± 4.13 (p 0.002) in patients without ED and with ED respectively. The mean vascular and atherosclerosis risk was 28.73 ± 13.94 and 39.38 ± 19.51 (p > 0.05) and 26.18 ± 10.31 and 33.92 ± 13.40 (p > 0.05) in patients without ED and with ED, respectively. Total cardiovascular risk was found to increase with age, duration of diabetes and HbA1c levels. Conclusion: The total cardiovascular risk increases with increasing severity of erectile dysfunction in type-2 diabetic patients without having overt cardiovascular disease.
QJM: An International Journal of Medicine, Nov 1, 2000
We assessed the efficacy of rifampicin in the treatment of cutaneous leishmaniasis (oriental sore... more We assessed the efficacy of rifampicin in the treatment of cutaneous leishmaniasis (oriental sore) using a double-blind placebo-controlled study. We studied 46 patients with cutaneous leishmaniasis, of whom 23 received rifampicin (group A) and another 23 received placebo (group B) for a period of 4 weeks. Each patient was assessed clinically for size of lesion, type of lesion, duration of lesion, number of lesions, and distribution of lesions, initially, and at the end of 1 week, 2 weeks and 4 weeks. Biochemical tests including enzyme studies were done to detect any toxic effects of the drug. Group A patients received rifampicin 1200 mg/day in two divided doses and group B patients received two doses of an identical placebo capsule. Seventeen (73.9%) of the 23 patients receiving rifampicin had complete healing. Two (8.6%) had partial healing and four (17.3%) showed no response, whereas out of 23 patients receiving placebo one patient (4.3%) showed complete healing, eight (34.7%) patients showed partial healing and 14 (60.98%) patients showed no healing or exacerbation of lesion. The difference was statistically significant in favour of response to rifampicin. This dose of rifampicin was well-tolerated and no side-effects were seen in any patient. In cases of cutaneous leishmaniasis where injectable treatment is not feasible or not acceptable, as in cases of multiple lesions, rifampicin is a better alternative oral treatment. It is simple to administer, cheap, more effective and less toxic than other available oral drugs, and well-tolerated by patients.
QJM: An International Journal of Medicine, Apr 1, 1999
Diabetes Research and Clinical Practice, Mar 1, 2009
Objectives: Combination of drugs with different mechanisms of action helps in achieving synergist... more Objectives: Combination of drugs with different mechanisms of action helps in achieving synergistic analgesic effect in neuropathic pain. Keeping this point in view, the effect and safety aspects of sodium valproate and GTN were assessed alone as well as in combination in this study. Design: Prospective double-blind randomized placebo-controlled study. Material and method: Eighty-seven type 2 diabetics with painful neuropathy were enrolled. Four were excluded: three with HbA 1 c > 11 while one withdrew consent. The remaining 83 were given either sodium valproate and GTN spray (group A) or placebo drug and GTN spray (group B) or sodium valproate and placebo spray (group C) or placebo drug and placebo spray (group D). Quantitative assessment of pain was done by McGill pain questionnaire, visual analogue score (VAS) and present pain intensity (PPI) at the beginning of the study and after 3 months along with motor and sensory nerve conduction velocities measurements. Results: All the three treatment groups experienced significant improvement in pain score in their drug phase of trial (p < 0.001/ < 0.05) along with some of the electrophysiological parameters. The assessment of the magnitude of therapeutic effect of sodium valproate, GTN and their combination gave numbers needed to treat (NNT) of 7, 5 and 4, respectively. Conclusion: Sodium valproate and GTN are well tolerated and provide significant improvement in pain scores as well as in electrophysiological parameters.
The Lancet, Jun 1, 1996
proves deleterious effect in cerebral malaria: a double blind trial in 100 comatose patients. N E... more proves deleterious effect in cerebral malaria: a double blind trial in 100 comatose patients. N Engl J Med 1982; 306: 313. 3 White NJ, Warrell DA, Chanthavanich P, et al. Severe hypoglycemia and hyperinsulinaemia in falciparum malaria. N Engl J Med 1983; 309: 61-66. 4 Molyneux ME, Taylor TE, Wirima JJ, et al. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. QJ Med 1989; 265: 441-59.
Annals of Indian Academy of Neurology, 2012
Neuroradiology, Oct 1, 2003
Acta Neurologica Scandinavica, Oct 4, 2002
OBJECTIVE: To study the effectiveness and safety aspects of sodium valproate in the management of... more OBJECTIVE: To study the effectiveness and safety aspects of sodium valproate in the management of painful neuropathy in patients of type 2 diabetes mellitus. MATERIAL AND METHODS: A randomized double-blind placebo controlled trial of sodium valproate was done in type 2 diabetic patients to assess its efficacy and safety in the management of painful neuropathy. We screened 60 patients but eight patients could not complete the study; hence, the present study was done on 52 patients. Each patient was assessed by clinical examination, pain score by short form of the McGill pain questionnaire (SF-MPQ) and electrophysiological examination, which included motor and sensory nerve conduction velocity, amplitude and H-reflex initially and at the end of 1 month of treatment. RESULTS: Significant improvement was noticed in the pain score of patients receiving sodium valproate in comparison to patients receiving placebo at the end of 1 month (P < 0.05). The changes in electrophysiological data were not significant. The drug was well tolerated by all patients except one who developed a raised aspartate transaminase (AST)/ alanine transaminase (ALT) level after 15 days of treatment. CONCLUSION: Sodium valproate is a well-tolerated drug and provides significant subjective improvement in painful diabetic neuropathy. These data provide a basis for future trials of longer duration in a larger group of patients.
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2013
Journal of Veterinary Public Health, 2003
Indian journal of animal health, 1990