Drug prescription/blood pressure control in patients on monotherapy attending a tertiary hospital in Nigeria

Background: Current treatment guidelines for treatment of hypertension stipulate the use of diuretics or calcium channel blockers (CCBs) as first-line treatment. Although, many studies have been carried out to study prescription pattern and blood pressure (BP) control in this region none has independently compared the effect of different antihypertensive drug classes given as monotherapy on BP control. This study compares the BP lowering efficacy of different classes of antihypertensive drugs given as monotherapy in black hypertensive patients with or without complications.Methods: This prospective cross-sectional study evaluated the influence of antihypertensive prescription on BP controls among consecutive patients present on clinic days from November 2011 to April 2012. Patients were treated with either angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, CCB, centrally acting adrenergic drug or diuretic. The primary outcome was BP reading <140/90 mmHg in patients without complication or <130/80 mmHg in patients with complication.Results: Of 264 patients, 228 patients received one drug whereas 36 received no drug. More than half of those on non-pharmacological intervention had good BP control (n=21), patients on diuretic (28.8%) had a significantly higher BP control (p=0.014) than those on other classes of drugs. Only 58% of the patients had good BP control. Diastolic BP reduced with an increase in age.Conclusions: Inthis study, diuretics significantly reduced BP compared with other antihypertensive class. Although clinical trials also suggest the use of CCB as first‑line treatment, cost considerations are necessary

Antidiabetic and anti-oxidant activities of the methanol leaf extract of <i>Vernonia amygdalina</i> in alloxan-induced diabetes in Wistar rats

The methanolic leaf extract of Vernonia amygdalina (MLVA) was assessed to evaluate its antidiabetic potential in rats. Diabetes was induced in male Wistar rats by the administration of alloxan monohydrate at 100 mg/kg of body weight. After 48 h, rats with fasting blood glucose levels of 200 mg/dL and above were considered diabetic and used for the study. The experimental animals were grouped into five groups (A–E) of 10 animals each. Group A rats were non-diabetic normal control, Group B consisted of diabetic control rats that received no treatment, groups C, D and E rats were diabetic rats but treated with glibenclamide, 200 and 400 mg/kg doses of MLVA respectively. Blood samples were collected at days 14 and 28 after induction for haematological and serum biochemical indices such as triglycerides, LDL, cholesterols etc. The intestine was collected and intestinal homogenate was prepared for the antioxidant studies. The extract at 200 mg/kg and 400 mg/kg doses significantly (p < 0.05) reduced blood glucose levels in extract-treated diabetic rats and also significantly increased weight gain in these rats. Most haematological parameters in treated rats experienced, while platelets and neutrophils were decreased. Biochemical indices measured were reduced in MLVA-treated groups compared with diabetic control. Treatment with MLVA also produced significant (p < 0.05) decrease in markers of oxidative stress but increased levels of enzymic and non-enzymic antioxidant markers in intestinal homogenates of treated groups compared with diabetic control. This study showed that V. amygdalina has antihyperglycaemic and in vivo antioxidant effects

Cardioprotective effects and antioxidant status of Andrographis paniculata in isoproterenol-induced myocardial infarction in rats

Background: Myocardial infarction has been regarded as one of the fastest killer diseases of modern-day man. Aim: The protective effect of Andrographis paniculata on isoproterenol (ISO)-induced myocardial infarction in rats was investigated. Setting: The study was carried out in a laboratory setting. Methods: Animals were randomly divided into six groups of seven animals per group, and the treatment was as follows: normal control received normal saline for 9 days, isoproterenol group; three extract-treated groups in pre-treatment phase and an extract-treated group in post-treatment phase. The doses were given at 100, 200 and 400 mg/kg body weight for pre-treatment phase respectively while 200 mg/kg dose was given to the post-treatment phase group. Blood and heart tissues were collected for biochemical assays, haematological and histological analyses. Results: Myocardial infarction was recorded in ISO group but was corrected by the extracts in both pre-treatment and post-treatment phases. The ISO group experienced a significant decrease in antioxidant parameters, whereas the extract at all doses caused a significant increase in the activities of in these parameters. The extract caused a significant decrease in malondialdehyde content and hydrogen peroxide generation, whereas reverse was the case for the ISO group. Although no significant histopathological changes were recorded for the extract, the ISO group showed marked histopathological changes. ISO caused higher expressions of cardiac C-reactive protein (CRP) and CTnI and decreased the expressions of IL-10β; but this was the opposite for the extract. Conclusion: The ethanol leaf extract of A. paniculata significantly exhibits cardioprotective effects

Effects of Anacardium occidentale stem bark extract on in vivo inflammatory models.

The methanol extract of Anacardium occidentale stem bark was evaluated for activities against the lipopolysaccharide (LPS)-induced septic shock, as well as LPS-induced microvascular permeability in mice. Pre-treatment with Anacardium occidentale extract (25-200 mg/kg) caused a dose-dependent and significant (p < 0.05) reduction in the elevated levels of alanine and aspartate aminotransferases in the sera of D-galactosamine-primed mice injected with LPS. The highest dose of the extract studied (200 mg/kg) produced a 100% protection against death from sepsis. Pentoxifylline (100 mg/kg) and L-NAME (5 mg/kg) offered 100% protection against LPS-induced septic shock, and produced marked reduction in elevated levels of transferases. A dose-related inhibition of LPS-induced microvascular permability in mice was also produced by pentoxifylline, L-NAME and the extract

Efficacy and safety of pyronaridine–artesunate versus artemether–lumefantrine in the treatment of acute uncomplicated malaria in children in South-West Nigeria: an open-labelled randomized controlled trial

Abstract Background In Nigeria, declining responsiveness to artemether–lumefantrine (AL), the artemisinin-based combination therapy (ACT) of choice since 2005, has been reported. Pyronaridine–artesunate (PA) is a newer fixed-dose ACT recently prequalified by the WHO for the treatment of uncomplicated falciparum malaria. However, PA data from the Nigerian pediatric population is scarce. Therefore, the efficacy and safety of PA and AL using the WHO 28-day anti-malarial therapeutic efficacy study protocol in Ibadan, southwest Nigeria, were compared. Methods In an open-labelled, randomized, controlled clinical trial, 172 children aged 3–144 months with a history of fever and microscopically confirmed uncomplicated Plasmodium falciparum malaria were enrolled in southwest Nigeria. Enrollees were randomly assigned to receive PA or AL at standard dosages according to body weight for 3 days. Venous blood was obtained for hematology, blood chemistry, and liver function tests on days 0, 3, 7, and 28 as part of the safety evaluation. Results 165 (95.9%) of the enrolled individuals completed the study. About half (52.3%; 90/172) of enrollees were male. Eighty-seven (50.6%) received AL, while 85 (49.4%) received PA. Day 28, adequate clinical and parasitological response for PA was 92.7% [(76/82) 95% CI 83.1, 95.9] and 71.1% [(59/83) 95% CI 60.4, 79.9] for AL (0.001). Fever and parasite clearance were similar in both groups. Two of six and eight of 24 parasite recurrences were observed among PA- and AL-treated children, respectively. PCR-corrected Day-28 cure rates for PA were 97.4% (76/78) and 88.1% (59/67) for AL (= 0.04) in the per-protocol population after new infections were censored. Hematological recovery at day 28 was significantly better among PA-treated patients (34.9% 2.8) compared to those treated with AL (33.1% 3.0) (0.002). Adverse events in both treatment arms were mild and similar to the symptoms of malaria infection. Blood chemistry and liver function tests were mostly within normal limits, with an occasional marginal rise. Conclusion PA and AL were well-tolerated. PA was significantly more efficacious than AL in both the PCR-uncorrected and PCR-corrected per-protocol populations during this study. The results of this study support the inclusion of PA in the anti-malarial treatment guidelines in Nigeria. Retrospective trial registration Clinicaltrials.gov: NCT05192265