Evaluation of antihypertensive efficacy of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension: a randomized controlled trial

Background: Cardiovascular disease (CVD) is the most common contributor of morbidity and mortality in underdeveloped and developing countries including the South Asian countries (including India and Pakistan). Amongst the cluster group of CVDs, Hypertension (HTN) represents the most common cardiovascular risk factor. The aim of this trial was to evaluate of antihypertensive efficacy and effect on biochemical parameters of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension with a randomized controlled trial.Methods: This was a prospective, randomized controlled trial of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension. The primary endpoint on treatment was analysis of antihypertensive efficacy of these drug combinations. The variables were compared at different time points- baseline, 3 and 6 months.Results: In the present study, 76 patients were enrolled with 38 patients each allocated to each treatment groups. The effect of Losartan 50mg + Hydrochlorthiazide 12.5mg OD was found to be significant on SBP and DBP in both supine as well as sitting position than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group at 3 and 6 months.Conclusions: The results on anti- hypertensive efficacy was far better in Losartan 50mg + Hydrochlorthiazide 12.5mg OD group than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Highly Uncertain Times: An Analysis of the Executive Branch\u27s Decision to Not Investigate or Prosecute Individuals in Compliance with State Medical Marijuana Laws

This Comment analyzes the constitutionality and impact of the Executive Branch\u27s decision to not investigate or prosecute individuals in compliance with state medical marijuana laws. As detailed in this Comment, the Executive Branch\u27s decision to not investigate or prosecute individuals in compliance with state medical marijuana laws is a questionable use of prosecutorial discretion and provides individuals with a false sense of security in relying upon compliance with such laws. In conclusion, the author urges Congress to pass and President Obama to sign into law legislation consistent with the Executive Branch\u27s revised enforcement policy regarding medical marijuana in order to ensure the constitutionality of such enforcement policy, and urges states that have enacted medical marijuana laws in the meantime to highlight the risks to individuals of relying upon compliance with such laws despite the change in the Executive Branch\u27s enforcement policy regarding medical marijuana

Can the Rich Fend for Themselves?: Inconsistent Treatment of Wealthy Investors Under the Private Fund Investment Advisers Registration Act of 2010

In this comment, the author analyzes the inconsistent regulation of wealthy investors under the federal securities laws in light of the passage of the Private Fund Investment Advisers Registration Act of 2010. After summarizing the exemptions in the federal securities laws for wealthy investors and providing an overview of private equity and hedge funds, the author summarizes the regulation of private equity and hedge funds under the Private Fund Registration Act of 2010 and analyzes this regulation in light of the exemptions in the federal securities laws for wealthy investors. The author concludes with policy recommendations to eliminate the inconsistent regulation of wealthy investors under the federal securities laws

Maintaining the Legitimacy of the High Court:Understanding the "25 Years" in Grutter v. Bollinger

The Supreme Court's decisions in Grutter/Gratz v. Bollinger were among the most anticipated rulings in recent history. Legal scholars, media commentators, and laypeople alike eagerly awaited the release of the Court's decision on whether the use of race in the admissions processes of institutions of higher education would be held constitutional under the Fourteenth Amendment. Given the divided opinion of the American public on the issue of affirmative action in higher education, it was expected that the Court's rulings would ignite fervor amongst individuals on either side of the debate, whichever way the decisions came outaffirmative action, use of race, college admission,

Enhanced Recovery After Surgery (ERAS) in gynecologic oncology: an international survey of peri-operative practice

Introduction Enhanced Recovery After Surgery (ERAS) programs have been shown to improve clinical outcomes in gynecologic oncology, with the majority of published reports originating from a small number of specialized centers. It is unclear to what degree ERAS is implemented in hospitals globally. This international survey investigated the status of ERAS protocol implementation in open gynecologic oncology surgery to provide a worldwide perspective on peri-operative practice patterns. Methods Requests to participate in an online survey of ERAS practices were distributed via social media (WhatsApp, Twitter, and Social Link). The survey was active between January 15 and March 15, 2020. Additionally, four national gynecologic oncology societies agreed to distribute the study among their members. Respondents were requested to answer a 17-item questionnaire about their ERAS practice preferences in the pre-, intra-, and post-operative periods. Results Data from 454 respondents representing 62 countries were analyzed. Overall, 37% reported that ERAS was implemented at their institution. The regional distribution was: Europe 38%, Americas 33%, Asia 19%, and Africa 10%. ERAS gynecologic oncology guidelines were well adhered to (>80%) in the domains of deep vein thrombosis prophylaxis, early removal of urinary catheter after surgery, and early introduction of ambulation. Areas with poor adherence to the guidelines included the use of bowel preparation, adoption of modern fasting guidelines, carbohydrate loading, use of nasogastric tubes and peritoneal drains, intra-operative temperature monitoring, and early feeding. Conclusion This international survey of ERAS in open gynecologic oncology surgery shows that, while some practices are consistent with guideline recommendations, many practices contradict the established evidence. Efforts are required to decrease the variation in peri-operative care that exists in order to improve clinical outcomes for patients with gynecologic cancer globally