Q: I am 41 years old. I had mitral stenosis and was operated 26 years ago. Later BMV was done twice. I started feeling better after every BMV procedure. Two years back, I had a Transient Ischaemic Attack (TIA) and the right side of my body got affected. Later, I recovered. But still there is a little problem with the speech. After the TIA, I was prescribed Acitrom medicine and the Penidura LA12 injection was stopped. At present, I am taking Acitrom (3 mg daily + 4 mg two days in a week) along with Ecospirin 75 mg daily and Lacilactone tablet daily. I have to regularly undergo the PT test, which sometimes is in the normal range. However, sometimes it fluctuates very badly and goes to 1.2 or 4.0. I feel worried. I am taking dietary restrictions and not taking leafy vegetables in my diet. The doctors have told me to control my diet. I wish to have the full list of what to eat and what not to eat?

A:Variable results of PT (INR) are seen frequently in people taking anticoagulants like acitrom and warfarin. The drug interactions are there with many dietary items and it is not possible to avoid many of them. It is usually advocated to take the drug 1 to 2 hours before dinner to minimise these alterations. Frequent monitoring of PT is also advocated in individuals where wide variations are often seen. The other problem is the variability in results from lab to lab according to the batches of agents and the amount of blood taken. It is always better to get the test done from the same lab. There are some healthy developments in this field. Monitoring equipment, like a stick test for sugar testing, is available in many countries and is likely to come to India soon. In addition newer agents like ximiilagatren are being evaluated. With these agents drug inter actions do not occur and PT (INR) is not necessary.