Prescription pattern and rationality of antihypertensive drugs in patients of type 2 diabetes with hypertension: a pilot study

Background: As presence of hypertension (HTN) in type 2 diabetes significantly increases risk of morbidity and mortality, its control with rational use of antihypertensives is essential. Authors performed this study to understand the current prescribing pattern of antihypertensives in patients of type 2 diabetes and their assess the rationality to recommendations of JNC-8 guidelines.Methods: Authors performed a cross sectional survey of prescription of diagnosed patients of diabetes with HTN at a tertiary care hospital. Prescription of patients attending medicine OPD were scanned. Data was collected over 2 month and analyzed with descriptive statistics.Results: In 76 patients analysed, mean age was 54.9±9.3 years and 51.3% were females. Insulin and oral antidiabetic agents were prescribed in 16 (21.1%) and 73 (96.1%) patients respectively. One, two, three and four antihypertensive drugs were prescribed in 44 (57.9%), 28 (36.8%), 3 (3.9%) and 1 (1.3%) patients respectively and 24 (31.6%) of them were fixed dose combinations. Among antihypertensives, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), thiazide diuretics, beta blockers (BBs) and calcium channel blockers (CCBs) were present in 29 (38.2%), 26 (34.2%), 22 (28.9%), 21 (27.6%) and 14 (18.4%) respectively. In individual drugs, ramipril (28.9%) was most common followed by telmisartan (26.3%), hydrochlorothiazide (26.3%), atenolol (16, 21.1%) and amlodipine (17.1%) were frequently prescribed. In adjuvant drugs, antiplatelet (52.6%) and statins (56.6%) were common. This pattern of prescription was as per the recommendations of recent JNC-8 guidelines for treatment of hypertension.Conclusions: ACEIs/ARB are the most preferred for HTN treatment in type 2 diabetes mellitus. Prescription of antihypertensives in our set up was rational as per JNC-8 recommendations

Treatment of synthetic textile wastewater containing dye mixtures with microcosms

The aim was to assess the ability of microcosms (laboratory-scale shallow ponds) as a post polishing stage for the remediation of artificial textile wastewater comprising two commercial dyes (basic red 46 (BR46) and reactive blue 198 (RB198)) as a mixture. The objectives were to evaluate the impact of Lemna minor L. (common duckweed) on the water quality outflows; the elimination of dye mixtures, organic matter, and nutrients; and the impact of synthetic textile wastewater comprising dye mixtures on the L. minor plant growth. Three mixtures were prepared providing a total dye concentration of 10 mg/l. Findings showed that the planted simulated ponds possess a significant (p < 0.05) potential for improving the outflow characteristics and eliminate dyes, ammonium-nitrogen (NH4-N), and nitrate-nitrogen (NO3-N) in all mixtures compared with the corresponding unplanted ponds. The removal of mixed dyes in planted ponds was mainly due to phyto-transformation and adsorption of BR46 with complete aromatic amine mineralisation. For ponds containing 2 mg/l of RB198 and 8 mg/l of BR46, removals were around 53%, which was significantly higher than those for other mixtures: 5 mg/l of RB198 and 5 mg/l of BR46 and 8 mg/l of RB198 and 2 mg/l of BR46 achieved only 41 and 26% removals, respectively. Dye mixtures stopped the growth of L. minor, and the presence of artificial wastewater reduced their development