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Vol. 49, No. 2, December, 2000

In this issue :

Dr. Patnaik V.V.Gopichand

Gross Anatomy of the Caudate Lobe of the Liver
Sahni, D., Jit, I., Sodhi L. Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Branching Pattern of Axillary Artery - A Morphological Study
*Patnaik V.V.G., Kalsey, G; Singla Rajan, K. Department of Anatomy, Government Medical College, Amritsar, *Patiala. INDIA

The Course, Relations and The Branching Pattern Of The Middle Meningeal Artery In South Indians
Manjunath, K.Y. & Thomas, I.M. Department of Anatomy, St. John�fs Medical College, Bangalore-560 034 INDIA

Morphometry of the Human Inferior Olivary Nucleus
Dhall, U; Chhabra, S. & Rathi, S.K. Department of Anatomy, Pt. B.D. Sharma P.G.I.M.S., Rohtak. INDIA

Management of Turner Syndrome in India Using Anthropometric Assessment of Response to Hormone Replacement Therapy.
Sehgal R. and Singh A. Department of Anatomy, Maulana Azad Medical College and Associated Lok Nayak, G.B. Pant & G.N.E.C. Hospitals, New Delhi ? 110 002 INDIA.

Insertion Of Umbilical Cord On The Placenta In Hypertensive Mother
Rath* G, Garg** K, and Sood*** M. *Department of Anatomy, ***Department of Obstetrics & Gynaecology, Lady Hardinge Medical College, New Delhi-110001 **Department of Anatomy, Santosh Medical College, Gaziabad. INDIA

Utility Of Finger Prints in Myocardial Infarction Patients
Dhall, U; Rathee, S.K; *Dhall, A; Department of Anatomy & *Medicine, Pt. B.D. Sharma, PGIMS, Rohtak. INDIA

The Prenatal Parotid Gland
Fouzia Nayeem, Sagaff S., *Krishna G., **Rao S. Department of Anatomy, K.A.A.U. Jeddah. Department of *Pediatrics & **Surgery, Osmania Medical College, Hyderabad. INDIA

Possibility of Cell Death Induced Skeletal Malformations Of The Upper Limb
Sinha, D.N. Department of Anatomy, B.R.D. Medical College, Gorakhpur?273013 INDIA,

Efficacy of Manual Bladder Expression in Relieving Urine Retention After Traumatic Paraplegia In Experimental Animals.
Preeths, T.S., Sankar, V. Muthusamy, R. Department of Anatomy, Dr. A. Lakshmanasamy Mudaliar Postgraduate Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.

Stress And Serum Cholesterol Levels-An Experimental Study
Jain, S.K. *Pandey, S.N. *Srivastava, R.K. Ghosh, S.K. Department of Anatomy, D.R.P.G. Medical College, Kangra at Tanda. * Department of Anatomy, G.S.V. Medical College, Kanpur.

Effect of Ibuprofen On White Cell Series of Bone Marrow Of Albino Rats
* Bhargava, R., Chandra, N., Naresh, M., *Sakhuja S. * Department of Anatomy, M.L.N. Medical College, Allahabad * Lady Hardinge Medical College, N. Delhi, India.

JB4 An Embedding Medium For Flourescent Tracer Technique
*Gupta, M; **Mishra, S., ***Sengupta P. Department of Anatomy, *PGI, Chandigarh; **AIIMS, N. Delhi; ***UCMS, New Delhi. INDIA

Comparative Anatomy of Cardiac Veins in Mammals
Kumar Keshaw Department of Anatomy, Institute of Medical Sciences B.H.U., Varanasi?5. INDIA

Aplasia Cutis Type 9 With Trisomy-13 Syndrome ? A Rare Association
Adhisivam, B, Narayanan, P, Vishnu Bhat, B, *Ramachandra Rao. R*, *Rao. S*, Kusre, G.* Department Pediatrics & *Anatomy, JIPMER, Pondicherry - 605 006

Absence of Musculocutaneous Nerve And The Innervation of Coracobrachialis, Biceps Brachii And Brachialis From The Median Nerve
Sud, M.; Sharma A. Department of Anatomy, Christian Medical College, Ludhiana. Punjab INDIA.

A Rare Pseudo Ansa Cervicalis: A Case Report
Indrasingh I. and Vettivel S. Department of Anatomy, Christian Medical College, Vellore, India

A Rare Variation In The Relation Of Omohyoid Muscle: A Case Report
Vettivel, S. Korula, A. and Koshy S. Department of Anatomy, Christian Medical College, Vellore, India

Surgical Incisions ? Their Anatomical Basis Part II - Upper Limb
1Patnaik V.V.G., 2Singla Rajan. K., 3 Gupta P.N. Department of Anatomy, Government Medical College, Patiala1, Amritsar2, 3Department of Orthopedics, Government Medical College, Chandigarh. INDIA

Anatomy Of Temporomandibular Joint?A Review
1Patnaik V.V.G., 3Bala Sanju; 2Singla Rajan K. Department of Anatomy, Govt. Medical College, 1Patiala, 2Amritsar, 3Department of Oral & Maxillofacial Surgery, Pb. Govt. Dental College, Amritsar


J Anat. Soc. India 49(2) 168 (2000)
Effect of Ibuprofen On White Cell Series of Bone Marrow Of Albino Rats

* Bhargava, R., Chandra, N., Naresh, M., *Sakhuja S. * Department of Anatomy, M.L.N. Medical College, Allahabad * Lady Hardinge Medical College, N. Delhi, India.

Abstract : Ibuprofen, a non steroidal anti inflammatory drug (NSAID) is one of the most commonly prescribed drug and due to its easy access to the patient, drug abuse is very common leading to various side effects. The effect of ibuprofen was seen on bone marrow of 48 albino rats for a period of six weeks. A gradual reduction in the precursor cells of white cell series was noticed which became marked in the later weeks. It was concluded that long term therapy with ibuprofen leads to a bone marrow depression specially of the white cell or myeloid series.

Keywords : Ibuprofen, bone marrow depression, myeloid series.

Introduction :

The effect of ibuprofen on bone marrow has recently come into limelight because of many fatal cases reported due to the chronic use of this drug. Ibuprofen tablets contain the active ingredient ibuprofen which is (+/-) -2 - (p-isopheny I) propionic acid. Its mode of action is probably related to prostaglandin synthetase inhibition. Gastrointestinal and renal symptoms are the most common side effects associated with ibuprofen toxicity. Bone marrow effects include agranulocytosis and bone marrow depression leading to fatal anaemias.

Material and Methods :

Forty eight albino rats were taken and divided into an experimental group and a control group. The experimental group were given 50mg of ibuprofen dissolved in 2ml of distilled water per day, orally in two divided doses. The control group received 2ml of distilled water, used as a dissolvent in two divided doses. Two control and six experimental rats were sacrificed at weekly intervals for six weeks.

Pieces of femur were cut and bone marrow was taken. Smears were prepared and stained with Leishman's stain. Observations were then recorded under oil immersion of light microscope.

Observations and Results :

A gradual reduction in the number of myeloblast, promyelocyte, myelocyte and metamyelocyte was noticed from the first week onwards. This is evident from the percentages of these cells as shown in table-1 and Fig no. 1 & 2. To summarize, long term therapies with ibuprofen leads to a severe bone marrow depression specialy effecting the precursor cells of white blood cell series.

Table - 1 : Percentage Changes in Cells per Week

% of Cells/Wks 1 2 3 4 5 6
Myeloblast 12 15 20 21 20 20
Promyelocyte 20 15 20 19 10 10
Myelocyte 23 20 10 19 15 14
Metamyelocyte 25 25 20 11 15 16
Total 80% 75% 70% 70% 60% 60%

Discussion :

The results obtained in the present work are supported by the works of Korsager (1978). Arnold (1980), Gualde & Malinvaud (1982) and Yunis & Bloomberg (1986).

Korsager (1978) had reported a case of haemolysis complicating ibuprofen treatment where the bone marrow showed severe erythroid hyperplasia with a myeloid to erythroid ration of one. Arnold (1980) had studied the bone marrow of a patient who had been taking Naproxen, a NSAID for a long period. The bone marrow showed severe aplasia with only a few myeloid cells. Gualde and Malinvaud (1982) had studied the effect of drug dependent antibodies on blood cells and suggested that the damaging effect of immune complexes is not necessarily limited to mature cells but can also be demonstrated on precursor cells. Yunis and Bloomberg (1986) had suggested that bone marrow failure was due to a fundamental defect in cell division involving DNA synthesis.

References :

1. Arnold R (1980). Aplastic anaemia after naproxen ? Lancet 1: 321.
2. Gualde and Malinvaud (1982), Non narcrotic analgesics today. Benefits and risks, seminar in print: Drugs, Vol. 32 suppl 4.
3. Korsagar S (1978). Haemolysis complicating ibuprofen treatment. British Medical Journal 1: 79.
4. Yunis, Bloomber (1986) cited in Lasagna L, Prescott LF Non necrotic Analgesic today. Benefits and risks, seminar in print: Drugs, Vol.32, suppl 4.

Fig. No. 1: Microphotograph of the bone marrow (H & E stain, 100 x) showing ibuprofen induced changes at the end of third week. The cells seen are a myelocyte (M). orthochromatic erythroblast (OE) and a myeloblast (Mb).

Fig. No. 2 : Microphotograph of the bone marrow (H & E stain, 100 x) showing a ibuprofen induced hypocellular bone marrow at the end of sixth week. Fat cells (F) are seen along with a Basophilic erythroblast (BE).

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