Comparison of Losartan And Enalapril Effects on Renal Function in Hypertensive Adults with Chronic Kidney Disease at a Kenyan Referral Hospital

Objective: The objective of this study was to compare renal function in diabetic hypertensive chronic kidney disease patients receiving enalapril or losartan.Design: This was a retrospective analytic cohort study.Setting: Kenyatta National Hospital, Nairobi, Kenya.Subjects: Two hundred adult patients with hypertension and diabetic nephropathy.Interventions: One hundred and sixteen participants received an enalapril regimen while 84 were on a losartan regimen.Main outcome measures: time to doubling of serum creatinine and  changes in the levels of proteinuria.Results: There was a higher risk of doubling of serum creatinine with losartan (Adjusted HR=1.572; [95% CI:1.015-2.434]; p=0.043) than enalapril. There was a significant difference in time to doubling between the two arms – losartan 18 months, enalapril 36 month (p=0.046). The changes in the levels of proteinuria between the two arms were not statistically significant for most of the follow up period except at the 15thmonth from treatment initiation (p=0.05).Conclusions: Enalapril was found to be more reno-protective compared to losartan. Where feasible, we suggest local use of enalapril as opposed to losartan for diabetic hypertensive chronic kidney disease patients

The Antimalarial and Antimicrobial Activity and Brine Shrimp Toxicity of Clematis Brachiata Extracts

The in vitro antimalarial activity of the root extract in partly supports the ethnobotanical use of the plant to manage malaria. Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders. Old stems and leaves are chewed for the management of toothaches and sore throats. Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity. The toxicity of the extracts was assessed using the brine shrimp lethality bioassay. The root extract gave the highest in vitro antimalarial activity against the mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity. The leaf, stem and root extracts had no bacterial or fungal inhibitory effects even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml, respectively. (E & C Afr Jnl Pharm Sci: 2002 5(1): 15-18

Anthelmintic and Antibacterial Activity of Hagenia abyssinica (Bruce) J.F. Gmel (Rosaceae)

Organic solvent extracts of the stem bark of Hagenia abyssinica Bruce J.F. Gmel (Rosaceae) were screened for anthelmintic and antibacterial activity. The methanol and dichloromethane/methanol extracts exhibited anthelmintic activity when tested using Panagrellus redivivus model. Further, the stem bark methanol extract showed significant but weaker activity than levamisole against Caenorhabditis elegans species. The petroleum ether and the dichloromethane/methanol extracts exhibited significant antibacterial activity against Staphylococcus aureus, Bacillus subtilis and Escherichia coli at a concentration of 50 mg/ml, but no antifungal activity.Key words: Hagenia abyssinica, anthelmintic, antibacteria