scholarly journals Comparison of efficacy and safety of cilnidipine and losartan in patients of hypertension with or without diabetes from Gwalior, India

Author(s):  
Mayuri K. Bhalerao ◽  
Saroj Kothari ◽  
Puneet Rastogi

Background: Hypertension (HTN) is the most common cardiovascular disease. The objectives of present study are to investigate the comparison between cilnidipine and losartan with respect to changes in blood pressure (BP) and heart rate (HR) in hypertensive patients with or without type 2 diabetes mellitus (DM).Methods: We conducted a longitudinal, prospective, open labelled, comparative clinical study of hypertensive patients with or without type 2 DM. Of 161 enrolled hypertensives, 130 completed the study with follow up over a period of one year. Group I (n=34); and Group III (n = 32) patients with type 2 DM received cilnidipine 10-20mg orally OD. Group II (n =33); and Group IV (n = 31) patients with type 2 DM received losartan 50-100mg orally OD. The dosages were adjusted if the magnitude of reduction was insufficient. The parameters were monitored during follow – up at 4, 8 and 12 weeks.Results: Levels of systolic and diastolic BP and HR significantly decreased with both drugs. However, magnitude of HR reduction was greater with cilnidipine groups as compared to losartan groups with statistically significant difference (group I 70.79±9.21 versus group II 79.42±8.25, p = 0.000 and group III 76.25±7.08 versus group IV 81±7.15, p = 0.010). Of 161 patients, only 1 patient experienced hot flushes from group I.Conclusions: The present study demonstrated that therapy with cilnidipine can be used safely and effectively in hypertensive patients with or without diabetes. Cilnidipine was equally efficacious in lowering BP, while it more effectively reduced HR as compared to losartan. Cilnidipine can, therefore, be recommended as an alternative especially when there is associated tachycardia.

2017 ◽  
Vol 41 (S1) ◽  
pp. S414-S414 ◽  
Author(s):  
A. Mermerelis ◽  
S.M. Kyvelou ◽  
V. Akke ◽  
C. Papageorgiou ◽  
C. Stefanadis ◽  
...  

IntroductionWhether anxiety and depression are associated with hypertension and to what extent is not clear.AimsThe aim of the present study was to assess any differences in the prevalence of anxiety and depression among different groups of hypertensive patients.MethodsThe study cohort comprised of 127 patients (75 male, mean age 54 ± 14) who underwent assessment of their blood pressure levels and were divided in four groups: group I (normotensives, n = 34), group II (stage 1 HTN, n = 33), group III (stage 2 HTN, n = 30) and group IV (stage 3 HTN, n = 30). The evaluation of anxiety disorder was made by means of Hospital Anxiety Depression Scale (HADS), while the evaluation of depression was made with the Beck Depression Inventory (BDI). Statistical analysis was done with SPSS for windows. P-value was set at 0.05 for differences to be considered significant.ResultsComparing the four groups of patients there was a significant difference both in BDI (8.6 ± 7.0 vs. 11.6 ± 10.4 vs. 27.1 ± 5.8 vs. 32.4 ± 3.9, P < 0.0001) and HADS (10.2 ± 7.2 vs. 9.7 ± 7.0 vs. 16 ± 4.7 vs. 27 ± 5.1, P < 0.0001). We proceeded to comparison among the 4 groups and there was a significant rise in the BDI and HADS in three of the four groups group II > group III > group IV, P < 0.0001.ConclusionThese data suggest that there is a clear burden of anxiety and depression as the levels of BP increase. This finding is of important clinical significance as it could contribute to a different approach of hypertensive patients. A larger cohort study could enlightened the mechanisms involved.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 28 (12) ◽  
pp. 1711-1717
Author(s):  
Nazish Waris ◽  
Samina Bano ◽  
Asher Fawwad ◽  
Abdul Basit

Objective: Association between alanine transaminase (ALT) and aspartate transaminase (AST) with newly diagnosed and known type 2 diabetes mellitus (DM) and to estimate association of liver enzymes with lipid profile in type 2 DM subjects. Study Design: Prospective Clinical study. Setting: Karachi University with Collaboration of Baqai Institute of Diabetology and Endocrinology. Period: November 2018 to May 2019. Material & Methods: Total 100 people were divided into four groups; Group I: 25 healthy controls with normal glucose tolerance, Group II: 25 newly diagnosed DM, Group III: 25 known DM type 2 with <5years duration and Group IV: 25 known DM type 2 between 5-10 years duration. Baseline data was collected on predesigned questionnaire. Blood samples for biochemical parameters were analyzed using standardized laboratory techniques. Results: Group I mean age (years) was 50.78±2.34, group II 50.56±1.96, group III 50.37±1.46 and group IV 56±1.36. In Group I, ALT and AST were significantly correlated to each other’s. In group II, ALT was significantly correlated with AST, triglycerides and HDL-C, while AST correlated with ALT and HDL-C. In group III, ALT was significantly correlated with AST, while AST correlated to ALT, triglycerides and HbA1c. However, in group IV, ALT was significantly correlated with AST, LDL-C and HDL-C, and, AST with ALT, total cholesterol, LDL-C and HDL-C. Conclusion: Elevated ALT and AST- the salient markers for disease of non-alcoholic fatty liver with deranged dyslipidemia were found in known type 2 DM as well as in newly diagnosed type 2 DM subjects.


2020 ◽  
Vol 5 (1) ◽  
pp. 153-155
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta

Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5681-5681
Author(s):  
Mei Xie ◽  
Weihong Chen ◽  
Qiaoxia Zhang ◽  
Xin Du

Abstract Objective: To study the feasibility of using cyclophosphamide alone without total body irradiation (TBI) as conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and establish a graft-versus-host disease (GVHD) mouse model. Methods: Single cell suspension of spleen and bone marrow were prepared from donor C57/BL/6 mice (B6 mice) . The recipient B6D2F1 mice (F1 mice) were signed into 4 groups with 12 mice per each group. Groups I~III mice were conditioned with peritoneal injection of cyclophosphamide (300 mg/m 2/d) on day -5, -4 and -3 of allo-HSCT, and group IV mice were used as control with saline injection. On day 0, group I mice were injected through tail vein with a mixture of 2×107 spleen cells, 5×106 bone marrow cells and 1×104 P815 cells; group II with 5×106 bone marrow cells and 1×104 P815 cells; group III with 1×104 P815 cells and group IV with RPMI1640 culture medium. The blood leukocyte counts were analyzed, GVHD score and the pathological leukemia infiltration of skin, liver and colon were evaluated and compared on day 30 after allo-HSCT. Results: (1) The GVHD scores of group I mice were 2 to 4 on day 14 post allo-HSCT, and mice started to die on day 15, eight (8) mice survived and the GVHD scores of them were 1 to 6 with a survival rate of 66.7% on day 30. Group II mice began to die on day 6 and only one survived on day 30 with a survival rate of 8.3%. All of group III mice died on day 18. Group IV mice survived (Figure 1). (2) The leukocyte counts in group I and group II were significantly increased on day 7 post allo-HSCT(p<0.05). There was also a significant difference in total leukocyte counts between groups I/II and group IV (p<0.05). The leukocyte counts in mice of groups I~III were significantly decreased, and there were a significant difference between group I and groups II/III/IV respectively (p<0.05) on day 14 post allo-HSCT. On day 21 after allo-HSCT, the leukocyte count of Group I and II mice were ≥1×109/L, which means that allo-HSCT were successful. The leukocyte counts in group I mice were again increased on day 28 post allo-HSCT. There was no significant difference between Group I and Group IV (p>0.05). (3) Pathological observation: The cell atrophy and necrosis in the hepatic portal area and slight infiltration of the leukemia cells in central vein were observed in group I recipient mice. The number of hepatocytes of the mice decreased, and the infiltration of the leukemia cells in the liver sinus were observed in group II. The liver was heavily infiltrated by leukemic cells in group III mice. The mouse livers were normal in group IV mice. Conclusion: It is feasible to establish GVHD model of the leukemia mice with cyclophosphamide conditioning regimen of allo-HSCT, and simple to operate. This is less harmful to people, animals and the environment. Discussion: The traditional animal model of GVHD is based on TBI conditioning regimen prior to allo-HSCT. However, the process can lead to systemic adverse reactions such as myelosuppression, radiation gastroenteritis, endocrine disorders and systemic function disorders, etc. in both the operators and animals. Therefore, the radiotherapy doses have to be low. At the same time, it is difficult to establish animal models of GVHD due to the uneven distribution of the doses. Cyclophosphamide was selected for the conditioning regimen of allo-HSCT in the study. Cyclophosphamide had the effect direct on killing tumor cells, induced recipients to tolerate the immune of donors, enabled to implant donor cells into recipients smoothly. The stable chimeras were obtained. There are a large number of T and B lymphocytes in donor's spleen cells. By injecting donor spleen cells and active immune cells derived from proliferation and differentiation of hematopoietic stem cells, the effects of graft-anti-leukemia are availably activated in recipients. Acknowledgments We thank Dr Zhifu Xiang very much for his great helpful revisions. Disclosures No relevant conflicts of interest to declare.


2017 ◽  
Vol 1 (1) ◽  
pp. 20-25
Author(s):  
Pooja Kabra

ABSTRACT Aim The purpose of this study was to evaluate the fracture strength of roots instrumented with the self-adjusting file (SAF; ReDent-Nova, Ra'anana, Israel) and the Reciproc reciprocating file and that were and were not obturated using the warm vertical lateral compaction technique. Materials and methods In total, 75 mandibular premolar teeth were sectioned at or below the cementoenamel junction to obtain roots 13 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameters and weight. They were distributed into four experimental groups and one control group (n = 15): No instrumentation (group I), instrumentation with SAF files but no obturation (group II), instrumentation with SAF files and obturated with warm vertical lateral compaction (group III), instrumentation with Reciproc File but no obturation (group IV), and instrumentation with Reciproc File and obturated with warm vertical lateral compaction (group V). AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) was used along with gutta-percha points. One week later, a vertical load was applied to the specimen's canal until fracture occurred. Data were statistically analyzed using one-way analysis of variance (p = 0.05). Results The mean fracture load was 312.83 N for group I, 297.35 N for group II, 359.15 N for group III, 231.51 N for group IV, and 275.81 N for group V. Conclusion The fracture resistances exhibited a statistically significant difference between all the groups. Teeth instrumented by SAF exhibited a better fracture resistance. How to cite this article Tyagi S, Choudhary E, Kabra P, Chauhan R. An in vitro comparative Evaluation of Fracture Strength of Roots Instrumentated with Self-adjusting File and Reciproc Reciprocating File, with and without Obturation. Int J Clin Dent Res 2017;1(1):20-25.


2015 ◽  
Vol 09 (02) ◽  
pp. 224-227 ◽  
Author(s):  
Shenbagakuttalam Anand ◽  
Ambrose Vedamanickam Rajesh Ebenezar ◽  
Nirupa Anand ◽  
Kothandaraman Rajkumar ◽  
Sekar Mahalaxmi ◽  
...  

ABSTRACT Objectives: To comparatively assess the micro shear bond strength (MSBS) of dentin bonded surface pre-treated zirconia ceramics. Materials and Methods: Zirconia blocks were sectioned into 50 cubical blocks. The blocks were further categorized into five groups (n = 10 each). Group I: No treatment was performed on zirconia samples; Group II: The zirconia samples were sand-blasted; Group III: Group II + etched with 9.8% of hydrofluoric (HF) acid for 60 s; Group IV: The sandblasted zirconia samples were selectively infiltrated with low fusing porcelain; and Group V: Group IV + etched using 9.8% HF acid gel. The zirconia specimens were then bonded to dentin samples, and the samples were tested for MSBS evaluation using universal testing machine. Results: The MSBS of all the four experimental groups shows greater value than group I. Among the experimental groups, group V and group IV do not show any statistical significant difference, whereas the mean MSBS of groups IV and V were statistically greater than group III and group II. However, groups I, II, and III do not show any statistical significant difference in mean MSBS values between them. Conclusion: Selective infiltration etching of zirconia ceramics provides the highest bond strength with resin cement.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Amer ◽  
K M Makboul ◽  
B M Mostafa ◽  
C A Girgis ◽  
Y A Mohammed

Abstract Background Type 2 diabetes mellitus (T2DM) has reached global epidemic proportions, with more than 382 million people affected according to 2013 estimate. By 2035, its prevalence is expected to reach 471 million, meaning that 10% of the world’s population will have diabetes. Patients with diabetes often suffer from metabolic abnormalities, poor glycemic control, oxidative stress, insulin resistance, and low-grade inflammation. These conditions trigger vascular dysfunction, which predisposes them to atherothrombosis Objective The present study aimed to study the mean platelet volume (MPV) as a potential risk factor for ischemic heart disease and cerebrovascular stroke in type 2 diabetes. Methods The study was conducted on 150 subjects there ages ranged from 40 to 60 years old. They were divided into 4 groups: Group 1: included30 type 2 diabetic overweight or obese patients without previous history of myocardial infarction or cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 1a) 15 diabetic non hypertensive patients. 1b) 15 diabetic hypertensive patients. Group 2: included A) 30 type 2 diabetic overweight or obese patients with recent cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 2Aa) 15 diabetic non hypertensive patients. 2Ab) 15 diabetic hypertensive patients. B) 30 type 2 diabetic overweight or obese patients with acute myocardial infarction. Then, they were subdivided into 2 subgroups: 2Ba) 15 diabetic non hypertensive patients. 2Bb) 15 diabetic hypertensive patients. Group 3: 30 overweight or obese non-diabetic patients with acute myocardial infarction or recent cerebrovascular stroke. Then, they were subdivided into 3a) 15 patients with acute myocardial infarction. 3b) 15 patients with recent cerebrovascular stroke. Group 4: 30 Healthy control with matching age and sex and were subdivided into 2 subgroups: Control a) 15 lean subjects. Control b) 15 overweight or obese subjects. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, Two hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile (Total cholesterol-LDL-HDL-Triglycerides), Mean platelet volume and Liver and kidney function test. The following radiological investigation were done: Carotid ultrasonography for estimation of intima-media thickness and abdominal ultrasonography. Results As regards MPV, there was a high statistical significant difference between the studied groups (p-value&lt;0.01), being the highest in group II (mean 11.93 ± 0.37 fl) followed by group III (10.77±1.69 fl), group I (10.67±1.98 fl) and group IV (8.83±0.98 fl). On comparing between every other groups there was a high statistical significant difference between group (I) & (II) being higher in group II, (I) & (IV) being higher in group I, (II) & (III) being higher in group II, (II) & (IV) being higher in group II and (III) & (IV) being higher in group III (P value&lt;0.01). However, there was a non-statistical significant difference between group (I) & (III) regarding the MPV (P value&gt;0.05). On comparing between hypertensive and non-hypertensive patients in each group as regard MPV, there were non-significant statistical difference. Conclusion MPV was higher in type 2 diabetic patients than healthy control. Moreover, MPV was significantly higher in type 2 diabetic patients with macrovascular complications. There was no significant difference between hypertensive and non hypertensive patients as regard MPV. There was no significant difference between obese and lean subjects as regard MPV. There was a positive significant correlation between MPV and markers of glycemic control in T2DM.


2021 ◽  
Vol 6 (4) ◽  
pp. 217-221
Author(s):  
Ashish Choudhary ◽  
Sukhbir Kour ◽  
Azhar Malik

IIrrigation solutions used and time of use has a definite effect on the micro hardness & other physical properties of dentin which in turn have direct consequence on the longevity functional performance of root canal treated teeth. To evaluate the effect of different irrigation solutions on micro hardness of root dentin.Forty extracted single rooted lower premolars were used. After instrumentation all the root halves were randomly assigned into 4groups (n=10) and brought in contact with one of the following irrigants for 5 minutes. Group I: 10 ml of 5% Sodium Hypochlorite (NaOCl).Group II: 10 ml of 17% ethylene diamine tetra-acetic acid (EDTA) followed by 10 ml of 5% NaOCl.Group III: 10 ml of 5% NaOCl followed by 10 ml of 2% chlorhexidine digluconate (CHX).Group IV: 10 ml of 5% NaOCL followed by flush of 10 ml distilled water then by 10ml of 2% CHX. Dentin micro hardness was measured at baseline and after treatment to determine the change in micro hardness, using Vickers tester.Data was analyzed using following parametric tests t-test, ANOVA test and Post Hoc test. Group II ie final irrigation with EDTA showed the highest percentage decrease in micro hardness values, followed by group III, then group IV and the lowest was group I. All groups showed a significant difference between each other (P &#60; 0.05), except group III and IV. The coronal third showed the highest percentage decrease with significant difference between apical and middle thirds (P &#60; 0.05).EDTA with NaOCl causes greatest changes in dentine micro hardness, an intermediate flush with normal saline should be given for prevention of precipitation with NaOCl & CHX.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 670
Author(s):  
Erwin Mulyawan ◽  
Muhammad Ramli Ahmad ◽  
Andi Asadul Islam ◽  
Muh. Nasrum Massi ◽  
Mochammad Hatta ◽  
...  

Background: Valeriana officinalis has often been used to treat sleep disorders as a traditional medicine for 2000 years. The sedative effect of valerian extract is facilitated by the GABAA receptor β3 subunit. The aim of this study is to determine the effect of valerian extract on GABRB3 gene mRNA expression and sedative effect in BALB/c mice. Methods: This is an experimental preclinical study using a posttest-only control group design. A total of 20 BALB/c mice were randomly allocated into four groups consisting of five mice each. Group I was given 5 ml of Aqua Dest (distilled water), group II was given 0.025 mg/10 g of diazepam, group III was given 2.5 mg/10 g of valerian extract, and group IV was given 5 mg/10 g of valerian extract. The drugs were administrated for seven days through a gastric gavage. The rotarod test was performed on the seventh day. A blood sample was taken on the first day before drug administration and after the rotarod test on the seventh day to be analyzed using quantitative real-time PCR. Results: GABRB3 gene mRNA expression showed a significant increase in groups II, III, and IV (p <0.0001). There was significant difference between group III and IV. The examination of motor coordination (rotarod test) showed a significant difference (p <0.05) between group I and group II, between group I and group III, and between group I and group IV. There was no significant difference between group II and both groups III and IV. Conclusions: GABRB3 gene mRNA expression was significantly increased after the administration of valerian extract. Based on the rotarod test, valerian extract and diazepam had a clinically similar sedation effect. A higher dose of valerian extract does not yield a higher level of GABRB3 gene mRNA expression nor sedative effects.


1992 ◽  
Vol 29 (3) ◽  
pp. 210-219 ◽  
Author(s):  
Karl Glander ◽  
George J. Cisneros

The craniofacial characteristics of two syndromes commonly associated with Robin sequence were compared for 49 subjects. Lateral cephalograms were analyzed for four groupings: Group I—Stickler syndrome with versus without Robin, Group II—velocardlofacial (VCF) syndrome with versus without Robin, Group III—Stickler without Robin compared to VCF without Robin, and Group IV—Stickler with Robin compared to VCF with Robin. Thirty-two skeletal and 18 soft tissue measurements were compared. In Group I, three skeletal measurements were significantly different (SNA, SNB, and SNPg). In Group II, no significant difference was found for any of the 50 measurements. In Group III, a significant difference was demonstrated for seven parameters (one skeletal, six pharyngeal and airway). In Group IV, two skeletal and eight airway measures were significantly different. The findings Indicate that the relative maxillary and mandibular retrognathia observed in Stickler/Robin patients may predispose them to the Robin sequence and vice versa; the Robin features In VCF may be caused by hypotonia rather than any craniofacial or physical obstruction of the airway; Stickler and VCF are similar in craniofacial morphology but show marked differences in pharyngeal and airway morphology; and cephalometrics should not be the sole prognosticator of the Robin sequence and Its association with Stickler and VCF.


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