Comparison between the world health organization (WHO) and international society of hypertension (ISH) guidelines for hypertension

The global burden of hypertension remains an unsolved problem, especially in low- and middle-income countries (LMICs). For this reason, clinical practice guidelines containing the latest evidence-based recommendations are crucial in the management of hypertension. It is noteworthy that guidelines simply translated from those of high-income countries (HICs) are not the solution to the problem of hypertension in LMICs. Among the numerous guidelines available, those of the World Health Organisation and the International Society of Hypertension are the latest to be published as of the writing of this article. In this review, we conducted both general and specific comparisons between the recommendations supplied by both guidelines. Differences in aspects of hypertension management such as the timing of antihypertensive initiation, assessment of comorbidities and cardiovascular risk factors, pharmacological therapy selection, and blood pressure target and reassessment are explored. Lastly, the implications of the differences found between the two guidelines in both LMICs and HICs are discussed.

Key messages

• Currently, with low treatment and control rates, hypertension remains a burden in low- and middle-income countries (LMICs).
• The lack of customised guidelines for LMICs cannot be solved simply by adopting guidelines from high-income countries.
• The World Health Organisation (WHO) recently published a clinical guideline for the pharmacological management of hypertension in LMICs. We compare select recommendations from the guidelines to those published by the International Society of Hypertension.

     

An Experimental Investigation of Static Properties of Bio-Oils and SAE40 Oil in Journal Bearing Applications

Considerable research has been conducted in the past decade and a half regarding the bio-lubricants potential to replace mineral-based lubricants as mainstream lubricants such as engine oil, hydraulic oil, compressor oil, and metalworking oil. This study studied several bio-lubricants (rapeseed oil, palm olein, and soybean oil) and a mineral-based lubricant, SAE40. The bio-lubricants have better physiochemical, tribological characteristics and environmental friendly nature, and are promising to replace mineral-based lubricants. In this study, a journal bearing test rig (JBTR) was developed in order to investigate the effect of journal speed on the temperature of oil film with time. Additionally, the load-carrying capacity of bio-oils was tested against the mineral-based lubricant SAE40 by adding a load on the journal. For all three speeds, i.e., 1000, 1500, and 2000 rpm, the bio-lubricants recorded minimum temperature. At 1000 rpm, rapeseed oil recorded a 9.2% lower temperature than SAE40. Similarly, at 2000 rpm, rapeseed oil recorded a minimum temperature that was 2.5% lower than SAE40; in comparison, at 1500 rpm, palm olein recorded a minimum temperature that was 1.8% less than SAE40. Overall, the results of this study revealed that bio-oils recorded a lower temperature rise than mineral oil. These results are very encouraging for further research in this area.     

Development of Therapeutic and Prophylactic Zinc Compositions for Use against COVID-19: A Glimpse of the Trends,Inventions, and Patents

Zinc is an essential nutrient for human health; it is involved in the catalytic, structural, and regulatory functions of the human cellular system. Different compositions of zinc, as well as its pharmaceutically acceptable salts, are available on the market. Recent studies have demonstrated the role of zinc in combating COVID-19. It has been determined that zinc prevents the entry of SARS-CoV-2 into cells by lowering the expression of ACE-2 receptors and inhibiting the RNA-dependent RNA polymerase of SARS-CoV-2. Zinc also prevents the cytokine storm that takes place after the entry of SARS-CoV-2 into the cell, via its anti-inflammatory activity. The authors believe that no study has yet been published that has reviewed the trends, inventions, and patent literature of zinc compositions to treat/prevent COVID-19. Accordingly, this review has been written in order to fill this gap in the literature. The information about the clinical studies and the published patents/patent applications was retrieved from different databases. This review covers patent literature on zinc compositions up to 31 January 2022. Many important patents/patent applications for zinc-based compositions filed by innovative universities and industries were identified. The patent literature revealed zinc compositions in combination with zinc ionophores, antioxidants, antivirals, antibiotics, hydroxychloroquine, heparin, ivermectin, and copper. Most of these studies were supported by clinical trials. The patent literature supports the potential of zinc and its pharmaceutical compositions as possible treatments for COVID-19. The authors believe that countless zinc-based compositions are still unexplored, and there is an immense opportunity to evaluate a considerable number of the zinc-based compositions for use against COVID-19.     

Biodiesel production from candlenut oil using a non-catalytic supercritical methanol transesterification process: optimization,kinetics, and thermodynamic studies

The present study was conducted to determine the feasibility of biodiesel production from candlenut oil using supercritical methanol (scMeOH) as a non-catalytic transesterification process. The influence of the scMeOH transesterification process was determined with varying pressure (85–145 bar), temperature (260–300 °C), methanol to oil (M : O) ratio (15 : 1–35 : 1), and reaction time (15–25 min). The experimental conditions of the scMeOH transesterification process were designed using central composite design (CCD) of experiments, and the process was optimized using response surface methodology (RSM). It was found that scMeOH temperature, pressure, M : O ratio, and reaction time substantially influenced the transesterification process. The maximum biodiesel yield of 96.35% was obtained at an optimized scMeOH transesterification process at the pressure of 115 bar, the temperature of 285 °C, M : O ratio of 30 : 1, and reaction time of 22 min. A second-order kinetics model and Eyring equations were utilized to determine the kinetics and thermodynamics of biodiesel production from candlenut oil. The activation energy value was determined to be 28.35 KJ mol⁻¹. Analyses of the thermodynamic properties of biodiesel revealed that the transesterification process was non-spontaneous and endothermic. The physicochemical properties of produced candlenut biodiesel via scMeOH complied with most of the biodiesel properties as per ASTM D6751 and EN14214, thereby referring to good quality biodiesel production. The findings of the present study reveal that the scMeOH is an effective non-catalytic transesterification process for biodiesel production from candlenut oil.

The present study was conducted to determine the feasibility of biodiesel production from candlenut oil using supercritical methanol (scMeOH) as a non-catalytic transesterification process.     

Combined effect of smear layer characteristics and hydrostatic pulpal pressure on dentine bond strength of HEMA-free and HEMA-containing adhesives

Objective

This study evaluated the combined effect of smear layer characteristics with hydrostatic pulpal pressure (PP) on bond strength and nanoleakage expression of HEMA-free and -containing self-etch adhesives.

Methods

Flat dentine surfaces were obtained from extracted human molars. Smear layers were created by grinding with #180- or #600-SiC paper. Three HEMA-free adhesives (Xeno V, G Bond Plus, Beautibond Multi) and two HEMA-containing adhesives (Bond Force, Tri-S Bond) were applied to the dentine surfaces under hydrostatic PP or none. Dentine bond strengths were determined using the microtensile bond test (μTBS). Data were statistically analyzed using three- and two-way ANOVA with Tukey post hoc comparison test. Nanoleakage evaluation was carried out under a scanning electron microscope (SEM).

Results

Coarse smear layer preparation and hydrostatic PP negatively affected the μTBS of HEMA-free and -containing adhesives, but there were no significant differences. The combined experimental condition significantly reduced μTBS of the HEMA-free adhesives, while the HEMA-containing adhesives exhibited no significant differences. Two-way ANOVA indicated that for HEMA-free adhesives, there were significant interactions in μTBS between smear layer characteristics and pulpal pressure, while for HEMA-containing adhesives, there were no significant interactions between them. Nanoleakage formation within the adhesive layers of both adhesive systems distinctly increased in the combined experimental group.

Conclusion

The combined effect of coarse smear layer preparation with hydrostatic PP significantly reduced the μTBS of HEMA-free adhesives, while in HEMA-containing adhesives, these effects were not obvious.

Clinical significance

Smear layer characteristics and hydrostatic PP would additively compromise dentine bonding of self-etch adhesives, especially HEMA-free adhesives.     

Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report

The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.     

Molecular Characterization of β-Thalassemia Mutations Via the Amplification Refractory Mutation System-Polymerase Chain Reaction Method at the North Waziristan Agency,Pakistan

β-Thalassemia (β-thal) is a monogenic disease characterized by mutations on the HBB gene, affecting the production of globin that results in hypochromic and microcytic anemia. The aim of this study was to determine the prevalence of six common β-thal mutations, and their frequency and inheritance pattern in affected populations of North Waziristan Agency, Pakistan. In this study, 130 blood samples from 37 unrelated β-thalassemic families having a minimum of one transfusion-dependent child with β-thal major (β-TM), were retrieved either from the Thalassaemia Centre for Women and Children Hospital Bannu or their home towns situated in Noth Waziristan Agency. All samples were analyzed by the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) using six allele-specific primers for the presence of the six β-thal mutations common in the Pakistani population. Of the six common mutations, our study demonstrated five HBB mutations comprising HBB: c.27_28insG, HBB: c.92+5G>C, HBB: c.126_129delCTTT, HBB: c.92+1G>T and HBB: c.17_18delCT from the families studied, while mutation HBB: c.47G>A [codon 15 (G>A)] was not detected in any of the studied families. Furthermore, the HBB: c.27_28insG and HBB: c.92+5G>C were noted to be the most common with frequencies of 42.85 and 31.42%, respectively. The findings of the present study may be useful in launching carrier screening and prenatal diagnosis (PND) programs by screening analyzed and other unanalyzed affected families for the possible presence of common mutations through the ARMS-PCR technique that will help to control the disease.     

Infections by multidrug-resistant Gram-negative Bacteria: What's new in our arsenal and what's in the pipeline?

The spread of multidrug-resistant bacteria is an ever-growing concern, particularly among Gram-negative bacteria because of their intrinsic resistance and how quickly they acquire and spread new resistance mechanisms. Treating infections caused by Gram-negative bacteria is a challenge for medical practitioners and increases patient mortality and cost of care globally. This vulnerability, along with strategies to tackle antimicrobial resistance development, prompts the development of new antibiotic agents and exploration of alternative treatment options. This article summarises the new antibiotics that have recently been approved for Gram-negative bacterial infections, looks down the pipeline at promising agents currently in phase I, II, or III clinical trials, and introduces new alternative avenues that show potential in combating multidrug-resistant Gram-negative bacteria.