A comparative study to determine the clinical efficacy of Ramipril versus combination of Ramipril and Telmisartan in reducing microalbuminuria associated with grade 2 hypertension

Inhibition of the renin-angiotensin system causes a reduction in urinary protein excretion. It is uncertain whether Angiotensin receptor blockers (ARBs) are equally effective antiproteinuric agents as Angiotensin converting Enzyme (ACE) inhibitors, or whether the combination of ACE inhibitors with ARBs is preferable to ACE inhibitor alone? Microalbuminuria is a prognostic marker for cardiovascular and renal risk. The objective of the study was to compare the clinical efficacy of Ramipril alone versus combination of Ramipril and Telmisartan by assessing the fall in B.P. and the improvement in the degree of microalbuminuria in stage II hypertensive patients. 60 patients of stage II hypertension without having any other cause of microalbuminuria were selected as subjects for the present study and were randomly distributed in to 2 groups- Group A included 30 patients who were given Ramipril 5 mg/ day and Group B included the same number of patients who were given a combination of Ramipril 5 mg/day and Telmisartan 40 mg/day. Baseline parameters included were measurement of Systolic, diastolic blood pressure and mean arterial pressure; microalbuminuria, blood urea, serum creatinine and serum potassium estimations. The drugs under trial were given for 20 weeks. Microalbuminuria was determined at 0 and 20 weeks. The mean percentage fall in microalbuminuria and mean arterial pressure were statistically highly significant (p<0.0001) with combination of Ramipril and Telmisartan (Group B) in comparison to Ramipril (Group A) alone. A highly significant (p‹ 0.0001) mean percentage increase in potassium level was observed in group B at the end of 20 weeks. The side effects were less observed in the combination group. Thus to conclude the combination of Ramipril and Telmisartan provides superior blood pressure (BP) lowering and target organ protection than Ramipril alone, hence the combination of Ramipril and Telmisartan is a better choice to treat and to prevent the progression of the disease.Keywords: Hypertension; Microalbuminuria; Ramipril; Telmisarta

Elemental analysis of chamber organic aerosol using an Aerodyne high-resolution aerosol mass spectrometer

The elemental composition of laboratory chamber secondary organic aerosol (SOA) from glyoxal uptake, α-pinene ozonolysis, isoprene photooxidation, single-ring aromatic photooxidation, and naphthalene photooxidation is evaluated using Aerodyne high-resolution time-of-flight mass spectrometer data. SOA O/C ratios range from 1.13 for glyoxal uptake experiments to 0.30–0.43 for α-pinene ozonolysis. The elemental composition of α-pinene and naphthalene SOA is also confirmed by offline mass spectrometry. The fraction of organic signal at m/z 44 is generally a good measure of SOA oxygenation for α-pinene/O3, isoprene/high-NO_x, and naphthalene SOA systems. The agreement between measured and estimated O/C ratios tends to get closer as the fraction of organic signal at m/z 44 increases. This is in contrast to the glyoxal uptake system, in which m/z 44 substantially underpredicts O/C. Although chamber SOA has generally been considered less oxygenated than ambient SOA, single-ring aromatic- and naphthalene-derived SOA can reach O/C ratios upward of 0.7, well within the range of ambient PMF component OOA, though still not as high as some ambient measurements. The spectra of aromatic and isoprene-high-NO_x SOA resemble that of OOA, but the spectrum of glyoxal uptake does not resemble that of any ambient organic aerosol PMF component

Ammonia-oxidizing microbial community dynamics under different mineral and fertilization management

Non-Peer Reviewe