Comparative Efficacy and Safety of Amlodipine and Losartan Potassium in Essential Hypertension in a Tertiary Hospital of Bangladesh

Hypertension is a common disorder of major clinical, public health and economic importance. It affects men and women of all ages, and the prevalence is increasing in most countries. Maintenance of blood pressure below 140/90 mm of Hg is recommended by most of the guideline available around the world. Various classes of drugs are being used in the treatment of hypertension. Losartan potassium and amlodipine are two different antihypertensive agents belonging to two different groups used commonly around the world in treating essential hypertension. Losartan potassium is non-peptide Angiotensin-II receptor antagonist. Amlodipine which is the third generation dihydropyridine group of calcium channel blocker. The aim of the study was to compare the efficacy and safety of amlodipine and losartan for the treatment of essential hypertensive patients (18-75 years). A non-randomized comparative observational study was conducted in the Department of Pharmacology and Therapeutics in collaboration with Department of Medicine, Sylhet, MAG Osmani Medical College, Sylhet, Bangladesh from July 2021 to June 2022. In this study non-randomization was in two groups. Group A received amlodipine 5mg daily at morning and Group B received losartan potassium 50mg daily at night. The study parameters were systolic blood pressure (SBP), diastolic blood pressure (DBP), ankle oedema, serum K+ level. The result of treatment outcome was compared between two groups. After treatment the reduction of SBP was 5.19±2.93mm of Hg versus 3.27±1.34mm of Hg (p<0.001); reduction of DBP was 1.7±0.70 mm of Hg versus 0.68 mm of Hg (p<0.001) and serum K+ level 4.22±0.27mmol/L versus 4.21±0.16mmol/L (p<0.719) in amlodipine and losartan group respectively. Amlodipine is more effective than losartan potassium in respect to treatment of essential hypertension. Regarding adverse events losartan potassium causes angioedema, hyperkalemia, headache, dizziness etc. The study concluded that amlodipine is superior to losartan potassium in treating essential hypertension.

A Comparative Evaluation of Flexural and Impact Strength of Polymethyl Methacrylate (PMMA) Reinforced With Graphene and Multi-Walled Carbon Nanotubes: An In Vitro Study

Background and objective Low flexural strength (FS) and impact strength (IS) are major drawbacks in removable prostheses made from polymethyl methacrylate (PMMA). Attempts to enhance the strength and longevity of these prostheses have been of keen interest among researchers. Nanofillers are new and advanced reinforcements that can chemically modify PMMA. Graphene and multi-walled carbon nanotubes (MWCNTs) were used in this study to evaluate FS and IS when added to polymer and monomer individually. Method Four groups were created based on the addition of nanofillers: no nanofillers - control; 0.5% by weight of graphene; 0.5% by weight of MWCNT; and 0.25% by weight of both. These groups were further subdivided into two according to the nanofiller being added to polymer and monomer each. The samples were then subjected to a 3-point bending test to assess FS, and an Izod impact tester was used to test IS. Results Decreased FS and FS were seen in all groups with the addition of nanofillers in the polymer (p<0.001). With the addition of nanofillers in monomer, increased FS and IS were seen in groups with MWCNTs whereas a decrease was seen with the addition of graphene (p<0.001). Conclusion Nanofillers should be added to the monomer of heat-cure PMMA instead of polymer; 0.5% by weight of MWCNT has shown the highest FS and IS when added to the monomer.

Comparative Evaluation of Compressive and Diametral Tensile Strength in Die Stone Reinforced With Different Types of Nanoparticles: An In Vitro Study

AIM

To investigate the effect of different types of nanoparticles on the compressive strength (CS) and diametral tensile strength (DTS) of type IV dental stones.

MATERIALS AND METHODS

A total of 100 specimens were made from the mould for all five groups. Four commercially available nanoparticles (aluminium oxide (Al2O3), silicon dioxide (SiO2), zinc oxide (ZnO), and zirconium oxide (ZrO2)) were used in this study in a concentration of 10%. CS and DTS tests were performed in a universal test machine. The data were statistically analysed using ANOVA and Student's t-test.

RESULTS

The interaction between nanoparticles and the type of dental stone was found to be statistically significant (p < 0.05). CS and DTS values decreased by adding all four nanoparticles. The lowest CS and DTS were observed in 10% ZnO nanoparticles when added to type IV dental stone.

CONCLUSION

It was concluded that the addition of nanoparticles (Al2O3, SiO2, ZnO, and ZrO2) to die stone significantly decreased the CS and DTS for all groups. Among all groups, the incorporation of 10% ZrO2 nanoparticles (group E) to die stone showed significantly less decrease in CS and DTS compared to Al2O3, SiO2, and ZnO. Incorporation of ZnO nanoparticles, on the other hand, showed a significantly more amount of decrease in the CS and DTS compared to Al2O3, SiO2, and ZrO2.

Comparative Analysis of Three Different Impression Techniques for Impression Defects and Dimensional Accuracy Using a Digital Intraoral Scanner for Fixed Partial Dentures: An In Vivo Study

AIM

To evaluate the impression defects and compare the dimensional accuracy of three different impression techniques (single-step, two-step without spacer, two-step with spacer) for fixed partial dentures using a digital intraoral scanner in the anterior maxillary region.

MATERIALS AND METHODS

Thirty subjects, above the age of 18 years with maxillary central/lateral incisor requiring fixed prostheses were selected according to the inclusion and exclusion criteria. The impressions were rated and evaluated using Heine C2.3K Binocular loupes (Heine Ltd., Dover, NH, USA). An intraoral scanner and digital vernier calipers were used to study and compare the dimensional accuracy of all three impression techniques.  Results: Statistical analysis using the chi-square test revealed that the single-step double mix technique showed the least number of defects (40%), followed by the two-step without spacer (56.7%) and then the two-step with spacer (80%) impression techniques. Using Kruskal Wallis and Mann Whitney U test for dimensional accuracy, it was found that the two-step with spacer impression technique was closer to the control group (intraoral scanner) followed by the two-step without spacer and then the single-step double mix impression techniques.

CONCLUSION

All three impression techniques showed the presence of impression defects, mainly voids and bubbles. The single-step double mix and two-step without spacer techniques had more favourable outcomes compared to the two-step with spacer impression technique. The two-step with spacer impression technique was dimensionally more accurate compared to the two-step without spacer and single-step double mix techniques for fixed partial dentures.

Effect of head posture on tooth contacts in dentate and complete denture wearers using computerized occlusal analysis system

Purpose:

The purpose of the study was to assess and compare the occlusal contacts in dentate and edentulous patients wearing complete denture with varying head posture.

Materials and Methods:

Ad hoc sampling of 30 subjects (15 dentate and 15 edentulous) based on inclusion and exclusion criteria was done. Subjects were divided into two groups: dentate and edentulous. Each group was further divided into two subgroups based on two head postures-upright 90° and ventroflexed 30°. For recording of every posture, a new sensor was used, and the subject was asked to clench on the sensor in maximum intercuspation position at the two head postures.

Results:

Data were summarized as mean ± standard error and compared by Student's t-test using SPSS software (windows version 17.0 IBM corporation, New York, USA). A statistically significant correlation between head posture and contact area was found in dentate and denture wearers, i.e., tooth contact area varies with head posture.

Conclusion:

It was concluded that the occlusal contacts vary at different head posture in dentate as well as in denture wearers. With ventroflexion, the number of tooth contact decreased as compared to upright-erect position in both groups. Clinical implication - since the number of tooth contacts varies with varying head postures, it is recommended that the balancing of the contacts should be done at varying head postures.