Pattern of use of anti-hypertensive drugs amongst hypertensive patients in a tertiary care hospital: a cross sectional, observational study

Background: Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases and is the single most important risk factor for stroke. Despite different guidelines for management of hypertension like Joint National Committee, British Hypertension Society, National Institute for Health and Care Excellence; there are still the clouds of controversy. The objective of the study was to evaluate the prescribing pattern of antihypertensive drugs among the patients attending medicine outpatient department of a tertiary care teaching hospitalMethods: A cross-sectional, observational study was conducted in our hospital over a period of six months. Relevant information was collected from medical records of 209 hypertensive patients fulfilling inclusion criteria. The collected data were sorted and analyzed.Results: Out of 209 patients, maximum were of age group of 45-65 years (55.02%). 115 (55.02%) were male and 94 (44.97%) were female. Diabetes mellitus (24.4%) was the most common associated disease with hypertension. Most of the patients had received single antihypertensive drugs (49.28%). Among the monotherapy category calcium channel blocker (82.78%) was the most commonly prescribed antihypertensive drug class followed by angiotensin receptor blocker (36.36%). Amlodipine (81.82%) was the most common among calcium channel blockers. The most frequent fixed drug combination prescribed consisted of amlodipine and atenolol. Most of the drugs were prescribed in generic name (90.9%).Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines

Blood pressure and its associated factors: a comparative study among rural and urban adolescents in Bangladesh

Background: Hypertension in adolescents may lead to irreversible damages in vital organs, such as heart, brain, kidney and may cause death if treatments are not given despite early diagnosis. The aim of this study is to identify the status of blood pressure and its associated factors among adolescents.Methods: It was a cross-sectional study. 810 adolescents of 8 schools and colleges in Chittagong district were collected by stratified cluster sampling technique. Ages of the respondents were 14 to 19. Status of Blood pressure and its associated factors in urban and rural area were the main outcome of interest.Results: The study found the significant difference in physical activities and overweight statistics between urban and rural adolescents (P<0.001). Obesity was found only in the urban area that was 1.2%. The mean systolic blood pressure (114.53 mmHg, 110.61 mmHg) and mean diastolic blood pressure (69.87 mmHg, 68.58 mmHg) of boys and girls in urban respondents were more than rural (109.79 mmHg, 68.97 mmHg and 105.02 mmHg, 67.941 mmHg respectively) and was statistically significant (P<0.001). The mean SBP and DBP were 126 mmHg and 79 mmHg respectively among obese. In the study prevalence of hypertension was 1.5% in urban adolescents and 0.2% in rural adolescents. Consumption of fast food, living area, physical activity, paternal hypertension and BMI were found significantly associated (p<0.05) with hypertension among urban adolescents.Conclusions: The results suggest that hypertension and pre-hypertension is an important public health problem among adolescents in urban than rural. The main associated factors are fast food consumption, living area, physical activity, paternal hypertension and BMI

The lifelong maintenance of mesencephalic dopaminergic neurons by Nurr1 and engrailed

Specific vulnerability and degeneration of the dopaminergic neurons in the substantia nigra pars compacta of the midbrain is the pathological hallmark of Parkinson’s disease. A number of transcription factors regulate the birth and development of this set of neurons and some remain constitutively expressed throughout life. These maintenance transcription factors are closely associated with essential neurophysiological functions and are required ultimately for the long-term survival of the midbrain dopaminergic neurons. The current review describes the role of two such factors, Nurr1 and engrailed, in differentiation, maturation, and in normal physiological functions including acquisition of neurotransmitter identity. The review will also elucidate the relationship of these factors with life, vulnerability, degeneration and death of mesencephalic dopaminergic neurons in the context of Parkinson’s disease

BMPRII deficiency impairs apoptosis via the BMPRII-ALK1-BclX-mediated pathway in pulmonary arterial hypertension (PAH)

YesPulmonary Arterial Hypertension (PAH) is a devastating cardiovascular disorder characterised by the remodelling of pre-capillary pulmonary arteries. The vascular remodelling observed in PAH patients results from excessive proliferation and apoptosis resistance of pulmonary arterial smooth muscle (PASMCs) and endothelial cells (PAECs). We have previously demonstrated that mutations in the type II receptor for bone morphogenetic protein (BMPRII) underlie the majority of the familial and inherited forms of the disease. We have further demonstrated that BMPRII deficiency promotes excessive proliferation and attenuates apoptosis in PASMCs, but the underlying mechanisms remain unclear. The major objective of this study is to investigate how BMPRII deficiency impairs apoptosis in PAH. Using multidisciplinary approaches, we demonstrate that deficiency in the expression of BMPRII impairs apoptosis by modulating the alternative splicing of the apoptotic regulator, Bcl-x (B-cell lymphoma X) transcripts: a finding observed in circulating leukocytes and lungs of PAH subjects, hypoxia-induced PAH rat lungs as well as in PASMCs and PAECs. BMPRII deficiency elicits cell specific effects: promoting the expression of Bcl-xL transcripts in PASMCs whilst inhibiting it in ECs, thus exerting differential apoptotic effects in these cells. The pro-survival effect of BMPRII receptor is mediated through the activin receptor like kinase 1 (ALK1) but not the ALK3 receptor. Finally, we show that BMPRII interacts with the ALK1 receptor and pathogenic mutations in the BMPR2 gene abolish this interaction. Taken together, dysfunctional BMPRII responsiveness impairs apoptosis via the BMPRII-ALK1-Bcl-xL pathway in PAH. We suggest Bcl-xL as a potential biomarker and druggable target.This work was supported by a fellowship (awarded to MTN) from the Department of Health via the NIHR Comprehensive Biomedical Research Centre award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London, Heptagon Life Science Proof of Concept Fund (grant KCL24 to MTN), the Great Britain Sasakawa Foundation (grant B70 to MTN), the Royal Society (grant 43049 to MTN), the Medical Research Council (grant G900865 to RCT, MTN and NWM) and the University of Bradford (grants 003200, 66006/001NAS and DH005 to MTN). NS and MYB were supported by scholarships from the Commonwealth Scholarship Commission, UK and Scientific and Technological Research Council of Turkey (TUBITAK), respectively

Human papillomavirus genotype distribution among colposcopy diagnosed cervical precancerous lesions

Background: Cervical cancer (CC) is one of the primary causes of gynaecological cancer death. Cervical cancer is the fourth most frequent cancer worldwide, and it is the second most common cancer in Bangladesh. The stage of cervical cancer at diagnosis has a significant impact on survival. Cervical cancer mortality is high in Bangladesh due to late detection and limited management facilities. The aim of the study was to determine the pattern of human papillomavirus (HPV) genotype among colposcopy diagnosed cervical precancerous lesions. Methods: This cross-sectional study was conducted in the department of gynecological oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. Total of 142 women attending the colposcopy clinic of BSMMU. Results: The mean age was found 38.7±7.3 years with a range from 30 to 60 years. 10 (7.0%) patients were found HPV 16 positive followed by 1 (0.7%) HPV 18, another hr-HPV 3 (2.1%), HPV 16 and other hr-HPV 3 (2.1%) and HPV 16, HPV 18 and other hr-HPV 1 (0.7%). Regarding colposcopy reports 99 (69.7%) patients had CIN I, 33 (23.7%) had CIN II and 10 (7.0%) had CIN III identification by colposcopy reports. 61 (43.0%) patients had CIN I followed by 15 (10.6%) had CIN II, 11 (7.7%) had CIN III, 7 (4.9%) had CIS, and 48 (33.8%) had normal or squamous metaplasia by histopathological reports. Conclusions: It can be concluded that among all the 14 hr-HPV genotype HPV 16 is more prevalent while HPV18 prevalence was very low in colposcopy diagnosed cervical precancer cases. The study revealed HPV16 was more common among high grade lesions

Temperature Effects in the Composition of Metal Halide Perovskite thin Films

Metal halide perovskites have shown to be a structure with great promise as an efficient photovoltaic, but at the same time it is affected by instability problems that degrade their performance. Degradation mechanisms vary with temperature, moisture, oxidation, and energy conversion during light exposure. We study performance loss due to temperature by probing diffusion of elemental composition across the thickness of films produced by spin coating and for temperatures ranging from 20 to 200°C. X-ray reflectivity was used to identify the electron density, composition, and quality of the films, aided with X-ray fluorescence and X-ray photoelectron spectroscopy studies to obtain information about degradation of the organic phase of the films

Caracterización del aceite de Leucaena (Leucaena leucocephala) por análisis directo en tiempo real (DART) y cromatografía de gases

For the first time, we report the characterization of triacylglycerols and fatty acids in Leucaena (Leucaena leucephala) oil [LUCO], an unexplored nontraditional non-medicinal plant belonging to the family Fabaceae. LUCO was converted to fatty acid methyl esters (FAMEs). We analyzed the triacylglycerols (TAGs) of pure LUCO and their FAMEs by time-of-flight mass spectrometry (TOF-MS) followed by multivariate analysis for discrimination among the FAMEs. Our investigations for the analysis of LUCO samples represent noble features of glycerides. A new type of ion source, coupled with high-resolution TOF-MS was applied for the comprehensive analysis of triacylglycerols. The composition of fatty acid based LUCO oil was studied using Gas Chromatography (GC-FID). The major fatty acid components of LUCO oil are linoleic acid (52.08%) oleic acid (21.26%), palmitic acid (7.91%) and stearic acid (6.01%). A metal analysis in LUCO was done by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The structural elucidation and thermal stability of LUCO were studied by FT-IR, 1H NMR, 13C NMR spectroscopic techniques and TGA-DSC, respectively. We also measured the cytotoxicity of LUCO.Se presenta por primera vez la caracterización de triacilgliceroles y ácidos grasos del aceite de Leucaena (Leucaena leucephala) [LUCO], una planta no medicinal, no tradicional y no explorada, perteneciente a la familia Fabaceae. Se analizaron triacilgliceroles (TAGs) de LUCO y sus FAMEs por espectrometría de masas de tiempo de vuelo (TOF-MS) seguido de análisis multivariante para discriminación entre los FAME. Nuestras investigaciones para el análisis de muestras de LUCO presentaron características propias de los glicéridos. Un nuevo tipo de fuente de iones, junto con alta resolución TOF-MS se aplicó para el análisis exhaustivo de triacilgliceroles. La composición de aceite de LUCO basado en ácidos grasos se estudió usando Cromatografía de Gas (GC-FID). Los principales componentes de ácidos grasos del aceite LUCO fueron, linoleico (52,08%), oleico (21,26%), palmítico (7,91%) y esteárico 6,01%. El análisis de metales se realizó mediante Espectrometría de Plasma Acoplado Inductivamente a Masas (ICP-MS). La elucidación estructural y la estabilidad térmica de LUCO se estudiaron mediante FT-IR, 1H NMR, técnicas espectroscópicas de 13C NMR y TGA-DSC, respectivamente. También se midió la citotoxicidad de LUCO