Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review

Background: Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure.Methods: We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane.Results: Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC.Conclusion: In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature

Pial arteriovenous fistula associated with vein of Galen dilatation in adult: A case report and MRI findings

Pial arteriovenous fistula (PAVF) is a rare intracranial vascular lesion where direct communication exists between one or more pial arteries and a cerebral vein, without an intervening nidus and located in the subpial meningeal space. When the drainage of PAVF involves a dilated, but already formed vein of Galen (VOG), it should be distinguished from other vascular lesions located in this area, because their angio-architecture, natural history and treatment options are different. A 33-year-old female was admitted to our hospital with a history of new-onset generalized tonic-clonic seizures. Clinical examination showed no neurological deficit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) depicted an arteriovenous fistula that was fed by the pial branches from left posterior cerebral artery and drained into the medial atrial vein before joining the VOG confluence and causing VOG dilatation. No nidus between the feeding arteries and draining vein, dural feeding arteries, or anatomical variations commonly seen with true vein of Galen aneurysmal malformations (VOGM) were found. These finding suggested a diagnosis of a PAVF associated with vein of Galen dilatation, which was confirmed by digital subtraction angiography. The patient was treated with transarterial glue embolization in 1 section, resulting in nearly complete occlusion of the fistula. Conventional MRI and MRA are noninvasive modalities that can provide valuable information regarding the anatomic localization of the fistula point, the feeding arteries, the venous sac, and their relationship with surrounding structures. These techniques are helpful for accurate diagnosis and treatment planning

Phytochemicals, Antioxidant and Antidiabetic Activities of Extracts from <i>Miliusa velutina</i> Flowers

The flowers of M. velutina were extracted with ethanol to obtain a crude extract that was consecutively extracted using n-hexane, dichloromethane, ethyl acetate and water. The crude extract and fractions were studied for the chemical composition and antioxidant and antidiabetic activities. The extracts had various phytoconstituents, namely steroids, flavonoids, tannins, saponins, alkaloids and glycosides. The aqueous extract had the highest total polyphenol (12.6 mg GAE/g extract) and total flavonoid (205.6 mg QE/g extract) content. The aqueous extract exhibited the strongest antioxidant activities in the ferric reducing antioxidant power assay (EC50 = 4.0 µg/mL), reducing power assay (EC50 = 78.1 µg/mL), 2,2-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid radical cation assay (EC50 = 48.2 µg/mL), total antioxidant capacity assay (EC50 = 8.7 µg/mL) and 1,1-diphenyl-2-picrylhydrazyl assay (EC50 = 9.3 µg/mL). The aqueous extract showed the strongest inhibitory effect on the activity of α-amylase (IC50 = 376.6 μg/mL) and α-glucosidase (IC50 = 69.7 μg/mL). The results showed that the aqueous extract of M. velutina flowers can be a promising candidate for the control of diabetes and oxidative stress. This is the first report about the chemical components and antioxidant and antidiabetic activities of M. velutina flower extracts

The protective effects of young pomelo fruits extract against acute hyperlipidemia and high-fat diet-induced obese mice

Introduction: Pomelo (柚 in Mandarin) (Citrus grandis L. Osbeck), a long-used fruit in Asia and China, is commonly used in traditional Chinese medicine. Pomelo is also a culturally significant fruit tree in Vietnam, renowned for its culinary and medicinal value. Young pomelo fruits possess high levels of flavonoids, but their research significance remains limited. Due to its relatively unknown potential, young pomelo is usually discarded during gardening maintenance leading to waste. This study aims to determine the naringin content and investigate the ameliorative effect on lipid profile of young pomelo extracts. Methods: Two mouse models of hyperlipidemia, specifically tyloxapol and a high-fat diet (HFD) model, were utilized to assess the effects of young pomelo extracts. Tyloxapol decreases the clearance of lipoprotein and leads to acute endogenous hyperlipidemia, while a high fat diet causes obesity among mice. The hypolipidemic effect of young pomelo extract was assessed through the level of serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), and high-density lipoprotein-cholesterol (HDL-c), while its ameliorative effect was assessed through physical changes of mice and histological changes of their livers. Results: In the tyloxapol model, the naringin-rich young pomelo extracts exhibited promising effects in the treatment of hyperlipidemia. Notably, they significantly reduced total cholesterol, triglycerides, and LDL-c levels while elevating HDL-c levels. In the HFD model, the young pomelo extracts demonstrated similar effects on the biochemical lipid profiles. Moreover, the young pomelo extracts possess a protective effect against HFD-induced hepatosteatosis and hepatic necroinflammation. These findings align with existing literature, highlighting the potential utilization of young pomelo fruits. Discussion: The findings have significant implications for the development of novel therapeutic approaches targeting obesity and related metabolic disorders. Furthermore, the study contributes to promoting sustainable agriculture practices by emphasizing the utilization of young pomelo fruits that would otherwise go to waste. Overall, this study provides valuable insights into establishing a high-fat diet-induced obesity model, tyloxapol-induced hyperlipidemia and demonstrates the potential of young pomelo as a rich source of naringin

Climate change in Viet Nam, impacts and adaptation : a COP26 assessment report of the GEMMES Viet Nam project

On the occasion of COP26, this report is proposing an assessment of the socio-economic impacts of climate change in Viet Nam by 2050, based on the intermediary results of the GEMMES Viet Nam research project. MONRE and AFD have undertaken this ambitious collaboration around the GEMMES Viet Nam project with the general objective to support Viet Nam in the implementation of the Paris Climate Agreement. Financed by the Facility 2050, in collaboration with IRD and IMHEN, this report materializes our common wish to develop a long-term vision of the economic, social and territorial issues of a resilient development strategy for Viet Nam

Climate change in Viet Nam, impacts and adaptation : a COP26 assessment report of the GEMMES Viet Nam project

On the occasion of COP26, this report is proposing an assessment of the socio-economic impacts of climate change in Viet Nam by 2050, based on the intermediary results of the GEMMES Viet Nam research project. MONRE and AFD have undertaken this ambitious collaboration around the GEMMES Viet Nam project with the general objective to support Viet Nam in the implementation of the Paris Climate Agreement. Financed by the Facility 2050, in collaboration with IRD and IMHEN, this report materializes our common wish to develop a long-term vision of the economic, social and territorial issues of a resilient development strategy for Viet Nam

Climate change in Viet Nam, impacts and adaptation : a COP26 assessment report of the GEMMES Viet Nam project

On the occasion of COP26, this report is proposing an assessment of the socio-economic impacts of climate change in Viet Nam by 2050, based on the intermediary results of the GEMMES Viet Nam research project. MONRE and AFD have undertaken this ambitious collaboration around the GEMMES Viet Nam project with the general objective to support Viet Nam in the implementation of the Paris Climate Agreement. Financed by the Facility 2050, in collaboration with IRD and IMHEN, this report materializes our common wish to develop a long-term vision of the economic, social and territorial issues of a resilient development strategy for Viet Nam

2D-quantitative structure–activity relationships model using PLS method for anti-malarial activities of anti-haemozoin compounds

Background: Emergence of cross-resistance to current anti-malarial drugs has led to an urgent need for identification of potential compounds with novel modes of action and anti-malarial activity against the resistant strains. One of the most promising therapeutic targets of anti-malarial agents related to food vacuole of malaria parasite is haemozoin, a product formed by the parasite through haemoglobin degradation.Methods: With this in mind, this study developed two-dimensional-quantitative structure–activity relationships (QSAR) models of a series of 21 haemozoin inhibitors to explore the useful physicochemical parameters of the active compounds for estimation of anti-malarial activities. The 2D-QSAR model with good statistical quality using partial least square method was generated after removing the outliers.Results: Five two-dimensional descriptors of the training set were selected: atom count (a_ICM); adjacency and distance matrix descriptor (GCUT_SLOGP_2: the third GCUT descriptor using atomic contribution to logP); average total charge sum (h_pavgQ) in pKa prediction (pH = 7); a very low negative partial charge, including aromatic carbons which have a heteroatom-substitution in “ortho” position (PEOE_VSA-0) and molecular descriptor (rsynth: estimating the synthesizability of molecules as the fraction of heavy atoms that can be traced back to starting material fragments resulting from retrosynthetic rules), respectively. The model suggests that the anti-malarial activity of haemozoin inhibitors increases with molecules that have higher average total charge sum in pKa prediction (pH = 7). QSAR model also highlights that the descriptor using atomic contribution to logP or the distance matrix descriptor (GCUT_SLOGP_2), and structural component of the molecules, including topological descriptors does make for better anti-malarial activity.Conclusions: The model is capable of predicting the anti-malarial activities of anti-haemozoin compounds. In addition, the selected molecular descriptors in this QSAR model are helpful in designing more efficient compounds against the P. falciparum 3D7A strain

Table1_Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review.docx

Background: Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure.Methods: We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane.Results: Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC.Conclusion: In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature.</p