Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Does Continued Use Of Strocit-Plus Cause Any Side Effects?
Question: My 47 year old brother suffered a stroke on left side of brain with right side hemiparesis in March 2014. (CVA (LT)-MCA (ISCHEMIC) & BILATERAL CHRONIC LACUNAR INFARCT. He recovered well with physiotherapy. He is a non smoker.
Currently he is on : 1. Ecosprin (150 mg), 2. Perindopril (4 mg), 3. Atorvas (5 mg) – alternate day, 4. Strocit plus once a day, 5. Folic acid (5 mg), 5. Febuget 40 mg (alternate day), Finast.
Treating neurologist mentioned that the latest MRI (December 2014) shows some lesions which are areas with low circulation.
My first query is : He was on Strocit plus twice a day for 3 months from April 2014 and since on Strocit plus once a day. Would there be any side effects to the continued use of Strocit plus? Does it improve blood circulation in the brain? If so, the cause for the lesions?
Second query : Since the stroke, the patient has been unable to control the urge to urinate (not incontinent but has to void as soon as the need arises) and also has been urinating frequently. Blood test in November 2014 showed elevated levels of Uric acid (7.3 mg/dl) and he was prescribed Febuget 40 mg for a month. Latest blood report shows Uric acid at 4.8 mg/dl. The doctor has asked for Febuget to be continued for another month with Finast to help with frequent urination issue. Anaother scan recommended after 3 months. Ultrasound of the abdomen revealed Grade I BPH & a post void residual urine volume of 111 ml. Can Febuget or Finast have any side effects?
Is stroke responsible for the inability to control the urge to urinate as well as the enlarged prostate and incomplete voiding of bladder? Should the prostate be investigated independently of the neurology consult?
Third query : His blood test for CEA shows : 3.8 ng/ml (normal <3 for non-smokers) and serum IgM levels are 5.93 g/l (ref. range : 0.4 – 2.4), Serum IgG levels are 10.57 (ref. range : 7-16), serum ANA is negative. Our father had primary colorectal cancer and passed away of primary lung cancer. His brothers too had bladder cancer and colorectal cancer. A gastroenterologist opinion has been recommended for the elevated CEA. My query is : how to interpret the elevated serum IgM levels? Is it connected with the gastro or with the urological issue?
Will appreciate your guidance.
Currently he is on : 1. Ecosprin (150 mg), 2. Perindopril (4 mg), 3. Atorvas (5 mg) – alternate day, 4. Strocit plus once a day, 5. Folic acid (5 mg), 5. Febuget 40 mg (alternate day), Finast.
Treating neurologist mentioned that the latest MRI (December 2014) shows some lesions which are areas with low circulation.
My first query is : He was on Strocit plus twice a day for 3 months from April 2014 and since on Strocit plus once a day. Would there be any side effects to the continued use of Strocit plus? Does it improve blood circulation in the brain? If so, the cause for the lesions?
Second query : Since the stroke, the patient has been unable to control the urge to urinate (not incontinent but has to void as soon as the need arises) and also has been urinating frequently. Blood test in November 2014 showed elevated levels of Uric acid (7.3 mg/dl) and he was prescribed Febuget 40 mg for a month. Latest blood report shows Uric acid at 4.8 mg/dl. The doctor has asked for Febuget to be continued for another month with Finast to help with frequent urination issue. Anaother scan recommended after 3 months. Ultrasound of the abdomen revealed Grade I BPH & a post void residual urine volume of 111 ml. Can Febuget or Finast have any side effects?
Is stroke responsible for the inability to control the urge to urinate as well as the enlarged prostate and incomplete voiding of bladder? Should the prostate be investigated independently of the neurology consult?
Third query : His blood test for CEA shows : 3.8 ng/ml (normal <3 for non-smokers) and serum IgM levels are 5.93 g/l (ref. range : 0.4 – 2.4), Serum IgG levels are 10.57 (ref. range : 7-16), serum ANA is negative. Our father had primary colorectal cancer and passed away of primary lung cancer. His brothers too had bladder cancer and colorectal cancer. A gastroenterologist opinion has been recommended for the elevated CEA. My query is : how to interpret the elevated serum IgM levels? Is it connected with the gastro or with the urological issue?
Will appreciate your guidance.
Brief Answer:
Strocit plus don't improve circulation.Stroke can cause urge incontinence.
Detailed Answer:
Hi XXXX
Thanks for being here on haealthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your queries.
I have gone through your brother's reports and shall adderss your query here.
Your queries:
1)No,there are no side effects of continuing strocit plus beyond 3 months of acute stroke but there are no effects either.Actually after a brain infarct,strocit plus is given to hasten patient's recovery in terms of strength in weak limbs,language functions and other deficits.It does not improve brain circulation. Once infarct has occurred,that area is a dead part of brain and increasing circulation will not help revive it.Strocit just promotes neurons regeneration and thus improving the speed of recovery of functions which the person has lost.The cause of the new lesions may be several-poor drug compliance,other risk factors like Hypertension, Diabetes or any cardiac illness.
2)'Febuget' is almost safe.Uncommonly,it can have few side effects like rash,joint pains,loose stools or elevation in liver enzymes.
'Finast' can have a few side effects-gynaecomastia,decreased libido,decrease in the quantity of ejaculate,testicular pain or some hypersensitivity reactions like swelling of lips or face,urticaria and rash.
Stroke can cause urge incontinence or inability to control the urge to urinate.But stroke does not cause enlargement of prostrate(with incomplete voiding of bladder) and that is a separate issue to be managed by the urologist.
3)Elevation of serum IgM levels can occur in certain diseases like acute or chronic infections,liver disease(hepatitis or cirrhosis),connective tissue disorders,monoclonal gammopathies like myeloma,amyloidosis and a few others.
Increased IgM immunoglobulins in serum has been found in gastrointestinal cancers(colon cancer) in various studies and have been related to the bad prognosis of the disease.But here the report is just borderline high,and theexact significance of these levels in absence of any gastrointestinal symptoms is doubtful.I advise you to consult some medical oncologist regarding this issue who can better tell you about the significance as they are the specialists who have a better experience with gastrointestinal cancers.It has no relation to urological issues like BPH.
Hope I have answered your queries.If you have follow-up queries,I shall be glad to answer them.
Dr.Ajay Panwar
MD,DM(Neurology)
Strocit plus don't improve circulation.Stroke can cause urge incontinence.
Detailed Answer:
Hi XXXX
Thanks for being here on haealthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your queries.
I have gone through your brother's reports and shall adderss your query here.
Your queries:
1)No,there are no side effects of continuing strocit plus beyond 3 months of acute stroke but there are no effects either.Actually after a brain infarct,strocit plus is given to hasten patient's recovery in terms of strength in weak limbs,language functions and other deficits.It does not improve brain circulation. Once infarct has occurred,that area is a dead part of brain and increasing circulation will not help revive it.Strocit just promotes neurons regeneration and thus improving the speed of recovery of functions which the person has lost.The cause of the new lesions may be several-poor drug compliance,other risk factors like Hypertension, Diabetes or any cardiac illness.
2)'Febuget' is almost safe.Uncommonly,it can have few side effects like rash,joint pains,loose stools or elevation in liver enzymes.
'Finast' can have a few side effects-gynaecomastia,decreased libido,decrease in the quantity of ejaculate,testicular pain or some hypersensitivity reactions like swelling of lips or face,urticaria and rash.
Stroke can cause urge incontinence or inability to control the urge to urinate.But stroke does not cause enlargement of prostrate(with incomplete voiding of bladder) and that is a separate issue to be managed by the urologist.
3)Elevation of serum IgM levels can occur in certain diseases like acute or chronic infections,liver disease(hepatitis or cirrhosis),connective tissue disorders,monoclonal gammopathies like myeloma,amyloidosis and a few others.
Increased IgM immunoglobulins in serum has been found in gastrointestinal cancers(colon cancer) in various studies and have been related to the bad prognosis of the disease.But here the report is just borderline high,and theexact significance of these levels in absence of any gastrointestinal symptoms is doubtful.I advise you to consult some medical oncologist regarding this issue who can better tell you about the significance as they are the specialists who have a better experience with gastrointestinal cancers.It has no relation to urological issues like BPH.
Hope I have answered your queries.If you have follow-up queries,I shall be glad to answer them.
Dr.Ajay Panwar
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank you Dr. Panwar for your prompt and detailed revert. I would like your assistance with the following :
You mentioned that the fresh lesions in the MRI could be caused by several-poor drug compliance & other risk factors like Hypertension, Diabetes or any cardiac illness.
1. My brother has been on Ecosprin, Perindopril, Atorvas and Folic acid supplement from March 2014, post stroke. Strocit plus was introduced after 3 weeks. Febuget was introduced in mid November and Finast is a recent addition since 22nd Dec.
My query is, of the above which medications or combinations constitute poor drug compliance?
He is not diabetic and has no known cardiac illness and prior to the stroke was not hypertensive. His profession requires him to be medically tested twice a year and his last medical report in September 2013, 6 months before the stroke did not show any anomalies.
How should these new lesions be investigated? What are the implications?
2. When viewed physically, the patient has fully recovered his motor functions and strength in the right side of the body.
My query is, has this recovery been by new neurons or the physiotherapy, which helped train his brain to revert to normal? How long post stroke does the regeneration continue? What can the patient do to train the undamaged part of brain or new neurons to assist with the urge incontinence?
3. A gastro consult has been obtained and a colonoscopy is pending to screen for colorectal cancer.
My query is, though you have given various instances for an elevated serum IgM level, how should the fact that it is elevated be handled? Should it be ignored for the time being or should any other test be done to support or rule out issues?
Thanks and regards,
You mentioned that the fresh lesions in the MRI could be caused by several-poor drug compliance & other risk factors like Hypertension, Diabetes or any cardiac illness.
1. My brother has been on Ecosprin, Perindopril, Atorvas and Folic acid supplement from March 2014, post stroke. Strocit plus was introduced after 3 weeks. Febuget was introduced in mid November and Finast is a recent addition since 22nd Dec.
My query is, of the above which medications or combinations constitute poor drug compliance?
He is not diabetic and has no known cardiac illness and prior to the stroke was not hypertensive. His profession requires him to be medically tested twice a year and his last medical report in September 2013, 6 months before the stroke did not show any anomalies.
How should these new lesions be investigated? What are the implications?
2. When viewed physically, the patient has fully recovered his motor functions and strength in the right side of the body.
My query is, has this recovery been by new neurons or the physiotherapy, which helped train his brain to revert to normal? How long post stroke does the regeneration continue? What can the patient do to train the undamaged part of brain or new neurons to assist with the urge incontinence?
3. A gastro consult has been obtained and a colonoscopy is pending to screen for colorectal cancer.
My query is, though you have given various instances for an elevated serum IgM level, how should the fact that it is elevated be handled? Should it be ignored for the time being or should any other test be done to support or rule out issues?
Thanks and regards,
Brief Answer:
He seems to be improving.Please upload MRI images or CD.
Detailed Answer:
Hi XXXX
Thanks for being in follow-up.
You are welcome for the day.
Answers to your queries-
1)Drug compliance does not refer to any particular set combination of medicines.It actually means whether the patient is taking his/her prescribed medicines regularly or not.If doses are being missed in between,then It is called poor drug compliance.His current medicines are correctly prescribed and he should take them regularly.
2)Magnetic resonance imaging(MRI) report says there are new lesions as FLAIR hyper intensities in left thalamus and corona radiata. It is hard to comment about the significance of these lesions unless you upload either scanned good quality MRI images or MRI CD.(You can upload MRI CD on google drive and share the link here). Once I see them,then I shall be in a better position to say how to approach them or investigate them and what are their implications?
3)It's good that your brother has recovered his motor deficits.Regular physiotherapy actually sends stimulation to brain neurons for regeneration.Like if there is limb weakness,then doing passive physiotherapy exercises with that limb sends stimulation to brain neurons that this limb has to move and its then that they adapt to it and start regenerating accordingly.Regeneration may continue for months,even years sometimes.
4)Urge incontinence can be improved by specific physiotherapy exercises like pressing thighs inwards against resistance.Please meet an expert physiotherapist and he will tell you in details.
5)In view of no gastrointestinal symptoms,exact significance of these borderline high IgM levels is doubtful.A gastroenterologist and a medical oncologist are better persons to tell.
Hope,I have answered your queries.If you have some follow-up queries,I shall be glad to answer them else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
He seems to be improving.Please upload MRI images or CD.
Detailed Answer:
Hi XXXX
Thanks for being in follow-up.
You are welcome for the day.
Answers to your queries-
1)Drug compliance does not refer to any particular set combination of medicines.It actually means whether the patient is taking his/her prescribed medicines regularly or not.If doses are being missed in between,then It is called poor drug compliance.His current medicines are correctly prescribed and he should take them regularly.
2)Magnetic resonance imaging(MRI) report says there are new lesions as FLAIR hyper intensities in left thalamus and corona radiata. It is hard to comment about the significance of these lesions unless you upload either scanned good quality MRI images or MRI CD.(You can upload MRI CD on google drive and share the link here). Once I see them,then I shall be in a better position to say how to approach them or investigate them and what are their implications?
3)It's good that your brother has recovered his motor deficits.Regular physiotherapy actually sends stimulation to brain neurons for regeneration.Like if there is limb weakness,then doing passive physiotherapy exercises with that limb sends stimulation to brain neurons that this limb has to move and its then that they adapt to it and start regenerating accordingly.Regeneration may continue for months,even years sometimes.
4)Urge incontinence can be improved by specific physiotherapy exercises like pressing thighs inwards against resistance.Please meet an expert physiotherapist and he will tell you in details.
5)In view of no gastrointestinal symptoms,exact significance of these borderline high IgM levels is doubtful.A gastroenterologist and a medical oncologist are better persons to tell.
Hope,I have answered your queries.If you have some follow-up queries,I shall be glad to answer them else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you Dr. Panwar for once again reverting with detailed clarifications. As instructed, I have uploaded the MRI CD for your reference at the following link on google drive -
https://drive.google.com/folderview?id=0B3RIPOqXRr6XanRLR2g4T2h6NlU&usp=sharing
Shall appreciate your opinion after viewing the MRI scans to throw light on the fresh lesions.
Thanks and regards,
https://drive.google.com/folderview?id=0B3RIPOqXRr6XanRLR2g4T2h6NlU&usp=sharing
Shall appreciate your opinion after viewing the MRI scans to throw light on the fresh lesions.
Thanks and regards,
Brief Answer:
Please upload it in CD format.
Detailed Answer:
Hi XXXX
Thanks for being in follow-up.
You are welcome for the day.
I looked at your google drive link. The images hosted there are not loading in my image viewer. Moreover, the way you have uploaded the images in separate folders, even if they would have loaded in my image viewer, it would have taken more than a hour for me to view them all and that too in an incoherent manner.
Please upload it as a standard CD-ROM(ISO) format so that I can load the dicom. file in Microdicom viewer. Please discuss this with the radiologist who has given the MRI report and he will give you the CD with dicom file in standard CD format.
Please follow-up with the relevant task done and I shall be glad to answer your query.
Dr.Ajay Panwar,
MD,DM(Neurology)
Please upload it in CD format.
Detailed Answer:
Hi XXXX
Thanks for being in follow-up.
You are welcome for the day.
I looked at your google drive link. The images hosted there are not loading in my image viewer. Moreover, the way you have uploaded the images in separate folders, even if they would have loaded in my image viewer, it would have taken more than a hour for me to view them all and that too in an incoherent manner.
Please upload it as a standard CD-ROM(ISO) format so that I can load the dicom. file in Microdicom viewer. Please discuss this with the radiologist who has given the MRI report and he will give you the CD with dicom file in standard CD format.
Please follow-up with the relevant task done and I shall be glad to answer your query.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
