| || || Khatri, Vaishali|
| || || Effect of aspirin intervention on platelet aggregation in non-kava drinking and kava drinking Fijian and Indo-Fijian healthy volunteers and determination of aspirin resistance|
Institution: University of the South Pacific.
Call No.: Pac QP 97 .K53 2011
Copyright:10-20% of this thesis may be copied without the authors written permission
Abstract: Fiji is a Pacific island country, located in the southwest Pacific. It is made up of 350 islands out of which 100 are inhabited. 95% of the population lives on the two main islands viz, Viti Levu and Vanua Levu. Fiji has two main ethnic groups—the original Melanesian/Polynesian inhabitants of the islands, and the descendants of the Indian laborers, who were brought in the late 19th century to work on the sugar plantation. Changing disease patterns due to urbanization and modern life style in Fiji is reflected clearly in mortality rates and risk factors in indigenous Fijians and Indo-Fijians. Mortality and morbidity due to cardiovascular disease and ischaemic heart disease are on the rise. Platelet reactions contribute to thrombus formation and these can be inhibited by various platelet inhibiting agents. Therefore, pharmacological inhibition of platelets is considered to be the cornerstone in acute and prophylactic treatment of ischaemic heart disease, peripheral vascular disease and stroke. Management of cardiovascular disease in Fiji includes antiplatelet drugs, especially aspirin which is prescribed routinely. Several laboratory studies have reported variations in response to aspirin treatment and also platelet function has been demonstrated to be normal in a considerable proportion of patients despite taking aspirin due to decreased sensitivity to aspirin, a phenomenon which is also referred to as aspirin resistance. At present no tests are being done to check if aspirin treatment of individual patients has been beneficial in terms of decreasing platelet aggregation. Numerous interactions between herbal medicines and conventional drugs have been documented. Non-steroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have the potential to interact with herbal supplements that are known to possess antiplatelet activity. Kava (Piper methysticum) is an ancient crop of the western Pacific. Kava use is so widespread throughout Oceania that it is considered an integral part of their culture that binds together most of the people of Oceania. Kava preparation and extracts are very popular in the Pacific as well as western society and the potential remains for herbal supplements like kava to interact negatively with other drugs like aspirin in vivo which needs to be thoroughly explored. iv This thesis describes studies undertaken to determine the effect of aspirin intervention (100 mg and 300 mg) on platelet aggregation (PA) in non-kava drinkers (NKD) and kava drinkers (KD) (subdivided into occasional kava drinkers (OKD) and regular kava drinkers (RKD), Fijian and Indo-Fijian healthy adult volunteers and thereby to determine aspirin sensitivity or aspirin resistance amongst these groups. The Fijian volunteers were divided into three groups, NKD (n=58), OKD (n=60) and RKD (n=58). Similarly the Indo-Fijian volunteers were also divided into three main groups, NKD (n=58), OKD (n=58) and RKD (n=52).