Fixed-dose combination therapy-based protocol compared with free pill combination protocol: Results of a cluster randomized trial

Fixed-dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster-randomized trial evaluates effectiveness and safety of a treatment protocol that used two-drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. Eligible patients were adults (≥18 years) with hypertension. The primary outcome was the odds of a patient being controlled at their last visit between baseline to 6-month follow-up in the FDC group compared to the free pill group. 4427 patients (mean [SD] age: 49.0 [12.4] years, 70.5% female) were registered with mean (SD) baseline systolic/diastolic blood pressure 155 (20.6)/96 (13.1) mm Hg. Baseline characteristics of groups were similar. After 6-months, hypertension control rate improved in the two treatment protocols, but there were no differences between the groups after adjustment (FDC = 53.9% versus free pill combination = 47.9%, cluster-adjusted p = .29). Adverse events were similarly low (<1%) in both groups. Both protocols improved hypertension control rates at 6-months in comparison to baseline, though no differences were observed between groups. Further work is needed to determine if upfront FDC therapy is more effective and efficient to improve hypertension control rates.     

Isolation of Salmonella from poultry droppings and other environmental sources in Awka, Nigeria.

OBJECTIVE: A survey of Salmonella contamination of poultry droppings used as manure, retail fresh beef, fresh beef retailers' aprons and fresh beef retail tables, was carried out. DESIGN: A total of 120 samples of poultry droppings collected from five poultry farms, 96 fresh beef samples, 96 beef retailers' aprons and 96 fresh beef retail tables were examined for the presence of Salmonella species. RESULTS: Different Salmonella serotypes were isolated from all the sources. Salmonella paratypi A had an isolation rate of 12.5% from poultry droppings, 4.2% from fresh beef, and 2.1% and 4.2% from meat retailers' aprons and tables respectively. Other serotypes isolated from the sources included S. typhimurium, S. enteritidis, S. gallinarum, S. pullorum, S. typhi and S. agama. Salmonella typhi was not isolated from poultry droppings throughout the survey. CONCLUSION: There is a need to create more environmental and personal hygiene awareness among the Nigerian populace, especially among food vendors.     

EFFECTS OF 5HT2 RECEPTOR ANTAGONISTS ON RESPONSES TO POTASSIUM DEPOLARIZATION IN RAT ISOLATED AORTA

1. In order to determine whether 5HT₂ receptor antagonists can modify Ca²⁺ uptake via voltage-operated Ca²⁺ channel (VOC) in arterial smooth muscle, a comparative study of the effects of selected Ca²⁺ uptake blockers and 5HT₂ receptor antagonists on K⁺-induced contractions of rat aortic strip was undertaken. 2. The antagonist drugs studied included the Ca²⁺ uptake blockers verapamil, nifedipine, felodipine, diltiazem and cin-narizine, the 5HT₂ receptor antagonists cyproheptadine, ritanserin, mianserin, and ketanserin and the α₁-adrenoceptor antagonist prazosin. 3. With the notable exception of prazosin, each of these compounds diminished K⁺-induced aortic responses. 4. The following order of potencies (mean IC₅₀ values in mol/L) was established: felodipine (7.0 × 10^-11) >nifedipine (4.8 × 10^-9) >verapamil (5.5 × 10^-8) >cyproheptadine (6.2 × 10^-8) > diltiazem (4.1 × 10^-7) >cinnarizine (1.3 × 10^-6) >ritanserin (1.8 × 10^-6) >ketanserin (9.0 × 10^-6) > mianserin (2.0 × 10^-5). 5. The results suggest that antagonists of 5HT₂ receptors can modulate Ca²⁺ uptake via VOC in rat aorta.     

Predominant usage of the proximal poly(A) site in alpha mRNAs is not intrinsic to the 3' termini

The maturation of IgM-expressing B cells to IgM-secreting plasma cells is associated with both an increase in mu mRNA and the ratio of secreted to membrane forms of mu mRNA. In contrast, previous studies demonstrated that in vitro the secreted form of alpha mRNA (alpha s mRNA) predominates regardless of the stage of B cell differentiation. The present study demonstrates that alpha s mRNA predominates in both B cells derived from the germinal centers of murine Peyer's patches and in the functional IgA memory population, suggesting that in vitro events accurately represent the generation of a secretory IgA response in vivo. Although the predominant usage of the alpha s poly(A) site is due to RNA processing, it does not depend on either the alpha s poly(A) site, the 3' splice site associated with the exon encoding the membrane exon of IgA (alphaM) or the alphaM poly(A) sites. Analysis of the sequence of the intron between the alpha s terminus and alphaM (alpha s- alphaM intron) demonstrates the existence of several potential regulatory elements. Furthermore, the effects of deletions within the alpha s-alphaM intron on 3' terminus usage demonstrate that the predominant usage of the proximal terminus is not strictly dependent on the length of the intron. Together with previous work, these observations support the idea that choice of 3' terminus for all Ig heavy chain genes is regulated by a similar mechanism, but specific sequences within a heavy chain gene can impinge upon that mechanism.