Combined effect of captopril and thiazide diuretic on serum lipid profile in hypertensive women

BACKGROUND

Hypertension has long been recognized as the major risk factor for the development of coronary disease. It was found that the combination of thiazide diuretic and ACE inhibitor has favorable antihypertensive and metabolic effect i.e. the combination reduces the levels of lipid.

METHODS

40 women aged between 35-60 years having systolic blood pressure equal to or greater then 160 mmHg were included in the study. Captopril in a dose of 25-75 mg plus thiazide 25-50 mg orally per day was given in divided doses. Before starting therapy and then after 4th and 10th week of therapy, 5 ml of fasting blood was drawn to analyze lipid profile like serum triglyceride, cholesterol and lipoprotein (HDL and LDL-Cholesterol).

RESULTS

Study observed a marked decrease of blood pressure after taking captopril with diuretics. Level of triglyceride and of HDL and LDL-cholesterol were also significantly changed (P < 0.01) as compared to their controls.

CONCLUSION

It was observed that captopril in combination of thiazide diuretics not only decrease blood pressure but also a beneficial effect on lipid profile. Hence further research is needed on large number of patients of both sexes.

Pesticidal and receptor binding properties of Bacillus thuringiensis Cry1Ab and Cry1Ac delta-endotoxin mutants to Pectinophora gossypiella and Helicoverpa zea

Bacillus thuringiensis produces several larvicidal crystalline inclusions during sporulation. An understanding of their mechanisms of action is commercially important. In this study, two toxins, Cry1Ab and Cry1Ac, were compared that showed 98% amino acid identity in domain I and II, but differed significantly in domain III. Using site-directed mutagenesis techniques, two conserved loop 2 Arg's ((368)RR(369)) of Cry1Ab and Cry1Ac toxins were replaced with Ala ((368)AR(369), (368)RA(369), (368)AA(369)), Glu ((368)EE(369)), Phe ((368)FF(369)), His ((368)HH(369)), and Lys ((368)KK(369)). The effect of these mutants on structural stability, larvicidal potency, receptor binding, and ionic permeability towards two important cotton pests, pink bollworm (Pectinophora gossypiella) and bollworm (Helicoverpa zea) were analyzed. All seven mutants of Cry1Ab, excluding (368)AR(369), produced a stable protoxin, whereas for Cry1Ac all seven mutants yielded stable protoxin. Results showed that all the stable mutants behaved similarly to the wild type on incubation with trypsin and gut extract of both insect larvae. The Cry1Ab mutants, (368)AR(369), (368)AA(369), (368)FF(369), and (368)HH(369), lost toxicity; (368)EE(369) had reduced toxicity; whereas the more conserved change (368)KK(369) retained the toxicity similar to the wild type towards P. gossypiella. Double mutants of Cry1Ac, (368)AA(369) and (368)FF(369), abolished the toxicity. Double mutant (368)KK(369) of Cry1Ac retained its toxicity against P. gossypiella, whereas single mutants (368)AR(369), (368)RA(369), and (368)HH(369) retained only reduced toxicity. All the mutants of Cry1Ab lost their toxicity against H. zea except (368)KK(369). In Cry1Ac single mutants, (368)AR(369) and (368)RA(369), reduction in the toxicity was observed. A double mutant of Cry1Ac, (368)KK(369), also retained reduced toxicity. All the other double mutants lost their toxicity. Voltage clamping experiments on H. zea midguts provided an additional evidence about the insecticidal property and inhibition of I(sc) across the transepithelial membrane of the insect midgut.

Toxicity and receptor binding properties of Bacillus thuringiensis delta-endotoxins to the midgut brush border membrane vesicles of the rice leaf folders, Cnaphalocrocis medinalis and Marasmia patnalis

Pesticidal activity and receptor-binding properties of Bacillus thuringiensis toxins to rice leaf folders, Cnaphalocrocis medinalis and Marasmia patnalis, were investigated. Saturation and competition binding experiments were done with iodine ((125)1)-labeled Bt proteins and brush border membrane vesicles prepared from the midgut of C. medinalis and M. patnalis. The results show saturable, specific, and high-affinity binding of all toxins except Cry2A toxin. Cry1Aa and Cry2A toxins were bound with low affinity but with high binding site concentration. Heterologous competition experiments showed that Cry1Aa, Cry1Ab, and Cry1Ac recognized or shared the same binding site that is different from the binding site for Cry2A toxin. Iodine ((125)I)-labeled Cry1Ac and Cry1Ab toxins were used in ligand blot experiments to detect specific binding proteins in brush border membrane vesicles of C. medinalis and M. patnalis. Cry1Ab toxin protein binds to 205-kDa and 200-kDa proteins respectively in case of C. medinalis and M. patnalis. The apparent molecular mass of the protein bound to labeled Cry1Ac toxins was identified as a 120-kDa protein in both C. medinalis and M. patnalis.

Bacillus thuringiensis delta-endotoxin proteins show a correlation in toxicity and short circuit current inhibition against Helicoverpa zea

Pesticidal activity of Bacillus thuringiensis delta-endotoxins, Cry1Aa, Cry1Ab, Cry1Ac, and Cry2A, was determined by using the force-feeding bioassay method to 4(th) instar larvae of Helicoverpa zea. H. zea was susceptible to Bt toxins in the order Cry1Ac > Cry1Ab > Cry1Aa > Cry2A with 63.60, 89.04, 159.65, and 375.78 ng/larvae respectively. The abilities of selected Bacillus thuringiensis toxins to inhibit short circuit current (I(SC)) in midgut epithelia of H. zea were also investigated by voltage clamp assay. The voltage-clamp studies were conducted on isolated midguts, measuring the inhibition of short circuit current (I(SC)) by activated toxin. A Cry1Aa toxin dilution of 33.3 and 500 ng/ml resulted in inhibition of I(SC) of -2.29 microA/min (lag time 15 min) and -4.48 microA/min (lag time, 2 min) respectively. The Cry1Ab dilution of 25 ng/ml inhibited I(SC) to -1.39 microA/min, a lag time of 14 min, and 333.3 ng/ml dilution resulted in decay of I(SC) -2.49 microA/min, lag time 1 min respectively. The Cry1Ac lower dilution 16.7 ng/ml inhibited I(SC) to -1.39 microA/min, lag time 4 min, and a high dilution 333.3 ng/ml decay I(SC) to -2.44 microA/min, lag time 1 min. The inhibition of I(SC) (-1.10 microA/min, lag time 25) at lower dilution (33.3 ng/ml) and high dilution (500 ng/ml), decay (-2.38 microA/min, lag time 5 min), showed a correlation between toxin concentration and inhibitory response with Cry2A toxin. The lag time decreased with increasing concentration of toxin applied, which is additional evidence of dose response besides direct correlation of toxicity assays and I(SC).

Regulatory role of prostaglandin E2 in induction of cyclo-oxygenase-2 by a thromboxane A2 analogue (U46619) and basic fibroblast growth factor in porcine aortic smooth-muscle cells

U46619, a thromboxane A2 analogue, and basic fibroblast growth factor (FGF-2) both induced the expression of the inducible cyclo-oxygenase (Cox)-2 in porcine aortic smooth-muscle cells. This induction was dose-dependent (submaximal at 300 nM for U46619 and 1 ng/ml for FGF-2) and time-dependent, with similar intensity and maximal expression at 2 h. Under these conditions, both inducers stimulated rapid activation of extracellular signal-regulated kinase (ERK2) at 5-10 min, a transient and lower intensity being induced by U46619 whereas that induced by FGF-2 was sustained (>1 h). PD98059, an inhibitor of the ERK pathway, inhibited the expression of Cox-2. In contrast, activation of Jun-N-terminal kinase (JNK1) was sustained with U46619 but poorly induced by FGF-2. Cox-2 expression induced by U46619 or FGF-2 was similarly reduced by prostaglandin (PGE2), forskolin or dibutyryl-cAMP, suggesting a regulatory effect of adenylate cyclase on Cox-2 expression. However, activation of ERK2 by FGF-2 was not affected by PGE2 whereas that of JNK1 by U46619 was inhibited, suggesting that inhibition of COX-2 expression by cAMP may be downstream of ERK2. The effects of PGE2 and forskolin on Cox-2 and phosphorylation of JNK1 were reversed with the protein kinase A inhibitor H89. In addition, endogenous PGE2 down-regulated the expression of Cox-2 by the two inducers, as stimulation of the cells in the presence of different Cox inhibitors increased the expression of the protein. Overall, these results suggest that exogenous and endogenous PGE2 exert negative inhibitory effects on Cox-2 expression mediated by stimulation of protein kinase A.

Cyclooxygenase-1 and -2 of endothelial cells utilize exogenous or endogenous arachidonic acid for transcellular production of thromboxane

The presence of prostaglandin (PG) H2 in the supernatant of human umbilical vein endothelial cells (HUVEC) stimulated by thrombin restores the capacity of aspirin-treated platelets to generate thromboxane (TX) B2. Induction of cyclooxygenase-2 (Cox-2) by interleukin (IL)-1alpha or a phorbol ester increases this formation. HUVEC treated with aspirin lost their capacity to generate PGs but recovery occurred after 3- or 6-h induction of Cox-2 with phorbol ester or IL-1alpha. Enzyme activity of the newly synthesized Cox-2 in aspirin-treated cells, evaluated after immunoprecipitation, was similar to untreated cells but after 18 h of cell stimulation only 50-60% recovery of Cox-1 was observed. The use of SC58125, a selective Cox-2 inhibitor, confirmed these findings in intact cells. Cyclooxygenase activity was related to the amount of Cox proteins present in the cells, but after induction of Cox-2, contribution of the latter to PG production was 6-8-fold that of Cox-1. Aspirin-treated or untreated cells were incubated in the absence or presence of SC58125 and stimulated by thrombin, the ionophore A23187, or exogenous arachidonic acid. The production of endogenous (6-keto-PGF1alpha, PGE2, PGF2alpha) versus transcellular (TXB2) metabolites was independent of the inducer, the source of arachidonic acid and the Cox isozyme. However, in acetylsalicylic acid-treated cells, after 6-h stimulation with IL-1alpha, newly synthesized Cox-2 produced less TXB2 than 6-keto-PGF1alpha compared to untreated cells. At later times (>18 h), there was no metabolic difference between the cells. These studies suggest that in HUVEC, Cox compartmentalization occurring after short-term activation may selectively affect transcellular metabolism, but not constitutive production, of PGs.

Isolation, identification and sensitivity pattern of microorganisms isolated from the urine of pregnant women

The present studies were conducted to detect and identify the microorganism from the urine of pregnant women having urinary tract infection. The antibiotic susceptibility of these isolated microorganisms was also determined. The microorganisms found responsible for the infection were bacteria, fungi, yeast and protozoa. Among the bacteria two were identified as Gram-positive cocci i.e. Staphylococcus aureus and S. epidermidis, the remaining two were Gram-negative bacilli which were Escherichia coil and Pseudomonas aeruginosa. The fungus was identified as AspelEillus niger and the yeast like fungus Candida albican. The only protozoan found in some of the urine samples was Trichomonas vaginalis. These isolated and identified microorganisms were more susceptible to Norfloxacin, Velosef, Minocin, Nitrofurantoin, Malidixic acid and Metronidazole whereas antibiotics Penbritin and Cefaloridine were least effective against these microorganisms.

Isradipine in Asian patients with hypertension

Isradipine, a new calcium antagonist, was administered to 51 Pakistani patients with hypertension (36 women, 15 men; mean age 47 years) over an 8-week period. Mean sitting systolic, and sitting and standing diastolic blood pressure was significantly reduced, and mean standing systolic blood pressure tended to decrease. Laboratory values, and both sitting and standing heart rates were not significantly affected by isradipine treatment. At the end of 8 weeks, 41.2% of patients were receiving isradipine 1.25mg twice daily, and 58.8% were receiving 2.5mg twice daily. Isradipine was found to be effective and well tolerated in Pakistani patients with mild to moderate hypertension.

[The effect of nifedipine and fentanyl on changes in the circulatory reaction to endotracheal intubation]

Recommendations for prevention of hypertension and tachycardia during the induction of anesthesia include the use of fentanyl and antihypertensive drugs and superficial anesthesia of the throat. Nifedipine has been used to treat acute hypertension and in many cases it has proved superior to other antihypertensive drugs. The present study was designed to find whether prophylactic injection of nifedipine alone or in combination with fentanyl can prevent cardiovascular responses during endotracheal intubation.

METHODS

A total of 140 female patients (ASA groups I or II) with no history of arterial hypertension were randomly allocated to 7 groups: group K was the control group, in which patients received only saline solution; patients in groups 0,1F; 0,2F; 0,3F received 0.1, 0.2 or 0.3 mg fentanyl, respectively; those in group 1,0N, 1 mg nifedipine; those in group 0,5N + 0,1F, 0.5 mg nifedipine, plus 0.1 mg fentanyl; and those in group 1,0N + 0,1F 1 mg nifedipine plus 0.1 mg fentanyl. Blood pressure and heart rate were measured at 1 min intervals. After estimation of control values the prophylactic drug or combination of drugs was injected. Anesthesia was induced in the conventional manner. Plasma concentrations of epinephrine and norepinephrine were analyzed before intubation and at 5, 30 and 60 min intervals after intubation. Side-effects, especially respiratory depression and arrhythmia, were carefully recorded.

RESULTS

In group K only systolic BP increased significantly after intubation. In the other groups the peak systolic blood pressure was not statistically different from the preinjection values. Diastolic BP increased significantly after intubation in all but two groups: in group 0,3F and in group 1,0N + 0,1F there was no significant difference in diastolic BP compared with the control values. The heart rate increased significantly in the control group after intubation as well as in groups 0,1F and 0,2F. In patients receiving 0.3 mg fentanyl there was no change in HR after intubation. Administration of 1 mg nifedipine alone (group 1,0N) or in combination with 0.1 mg fentanyl (group 1,0N + 0,1F) caused tachycardia even before intubation, whereas the combination of 0.5 mg nifedipine and 0.1 mg fentanyl did not result in a significant increase of HR following intubation. In all groups, epinephrine concentrations were significantly lower 5 min after intubation. A return to the control values was observed after 60 min in all groups except group 0,1F. Serum concentrations of norepinephrine were lower 5 min after intubation in all groups and were still low in groups 0,1F , 0,2F, 0,5N+0,1F and 1,0N+0,1F up to 60 min after intubation. Side-effects and adverse effects were checked for in the present study. An increase in heart rate was observed during induction in almost every group. More pronounced changes were recorded in groups 1,0N and 1,0N+ 0,1F receiving 1 mg nifedipine.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinicopathological profile of bronchogenic carcinoma in Bangladesh

This study reflects some of the basic facts and present status of bronchogenic carcinoma in Bangladesh. Of the total patients admitted in one surgical unit of IDCH during the period 1983 to 1986, 28.7 were clinically suspected to be suffering from bronchogenic carcinoma. Males largely dominated the females (82.4 percent as against 17.6 percent) giving a ratio of 4.6:1.0, and more than 90 percent of the victims were heavy smokers. All the suspected patients were then subjected to radiological examination of chest, bronchoscopic examination (73.0 percent), histopathological examination of the bronchial biopsy specimen and sputum cytological examination (63.2 percent) cases. Bronchoscopic examination revealed endobronchial tumor or suspicious lesion in 63.2 percent cases. The sputum cytological examination were positive for malignant cells in 35.6 percent cases. Histopathological gradation of the carcinoma in order of frequencies were squamous cell carcinoma (13.3 percent), large cell carcinoma (9.7 percent) and adenocarcinoma (4.2 percent) respectively. About one fourth of the cases (27.6 percent) were found to be clinically suitable for operation but on thoracotomy resectability was possible only in 20.6 percent cases. Inoperable cases were subsequently referred for radio or chemotherapy. Follow-up of the cases were rather difficult.