Aspirin efficacy in Vernal
A comparative study on the
role of Aspirin in Vernal Keratoconjunctivitis by M. Shakaib Anwar1
has showed significant reduction (70%) in itching, lacrimation, limbal edema and
had improved photophobia with reduction in size of the palpebral lesions and
group I, patients were given topical preparations of 2% cromolyn sodium and 2%
fluorometholone, to be instilled thrice a day. In group II, oral aspirin was
added to the above regime. 2% fluorometholone was tapered off over two weeks,
while aspirin was continued for four to eight weeks and 2% cromolyn sodium
continued for the rest of the period. Group III, received a placebo. In the
patient with vernal ulcer, a prophylactic antibiotic cover with topical
preparation of ciprofloxacin was given for initial two weeks. The dosage for
aspirin was adjusted at the rate of 25 mg per kg of body weight. Informed
consent was taken from all the patients regarding the study program. Regular
follow-up visits were arranged weekly for the first two weeks, fortnightly for
two month and then monthly for six months to one year.
2nd week of therapy patients in Aspirin group were still better
showing an overall reduction in symptoms of about 85%. After four & six
weeks treatment group I & group II showed 90-93% and 95-98% reduction in
their symptoms respectively.
is basically an allergic disorder in which IgE (humoral) and cell mediated
immune mechanisms play a vital role. Corticosteroids inhibit the production of
prostaglandins by inhibiting the conversion of phospholipids to arachidonate in
the initial stage by inducing an inhibitory lipocortin and also inhibiting the
induction of cyclooxygenase which is vital for conversion of arachidonate to
prostaglandin in the final stage. Aspirin also acts at this final stage and
inhibits prostaglandin production. It can reduce the duration of topical
corticosteroid use or even replace it when combined with topical sodium
cromomglycate. Therefore, its use is recommended especially in the first four to
eight weeks along with 2% sodium cromoglycate, which can alone be continued
later on, while topical corticosteroids can be added in severe cases only in the
initial one to two weeks to reduce discomfort and make the patients more
compliant. Hypersensitivity to aspirin, bleeding disorder and peptic ulcer are
some of the contra indications for aspirin therapy. These conditions should be
ruled out before using Aspirin.
1. Anwar MS. The role of aspirin in vernal keratoconjunctivitis. J Coll
Physicians Surg Pak 2003; 13(3):178-179.
Aspirin use after coronary
artery bypass graft surgery
Initiation of Aspirin therapy within 48 hours
among patients who underwent coronary artery bypass graft surgery (CABG)
resulted in significant reduction in mortality as well as other events.
study was conducted at 70 centers in 17 countries. The authors prospectively
studied 5065 patients undergoing coronary bypass surgery of whom 5022 survived
the first 48 hours after surgery. Their primary focus was to discern the
relation between early aspirin use, fatal and non-fatal outcomes.
who received Aspirin (upto 650mg) after revascularization, subsequent mortality
was 1.3% (40 of 2999 patients) as compared with 4.0% among those who did not
receive Aspirin during this period (81 of 2023, P<0.001). Aspirin therapy was
associated with 48% reduction in the incidence of myocardial infarction, 50%
reduction in the incidence of stroke, a 74% reduction in the incidence of renal
failure and a 62% reduction in the incidence of bowel infarction. Multivariate
analysis showed that no other factor or medication was independently associated
with reduced rates of these outcomes and that the risk of hemorrhage, gastritis,
infection, or impaired wound healing was not increased with aspirin use.
authors of the study have concluded that early use of aspirin after coronary
bypass surgery is safe and is associated with a reduced risk of death and
ischemic complications involving the heart, brain, kidneys and gastrointestinal
Mangano DT. Aspirin and mortality from coronary bypass surgery. Multicenter
study of perioperative ischemia Research Group. N Eng J Med. 2002; 347(17):
EJ. Aspirin with Bypass Surgery – From Taboo to New standard of Care. N Eng J
Med 2002; 347(17):1359-1360.