Efficacy, Safety and Tolerability of Valsartan and Hydrochlorothiazide Compared to Valsartan and Amlodipine in Stage 2 Hypertension

Background: Hypertension is a growing medical and public health issue. The United States and European treatment guidelines have been issued to attain smooth control of hypertension in various categories of patients. It is a need of time to unveil safe combination therapies in various populations. Objectives: (i) To determine the efficacy of valsartan and hydrochlorothiazide versus valsartan and amlodipine (ii) To determine the safety and tolerability of both combinations. Materials & Methods: This experimental study was conducted at Shalamar Hospital Lahore. 126 patients with stage 2 hypertension were recruited from the medical outdoor of Shalamar Hospital Lahore after getting informed consent. In group A, 63 patients were given valsartan and hydrochlorothiazide. In group B, 63 patients were given valsartan and amlodipine. Blood pressure (BP) of both study groups was recorded on day zero, 2nd, 4th, and 8th weeks and the readings were entered on a Proforma. The efficacy of drug combinations was accessed in both groups by recording the change in mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP). The safety and tolerability of the drug combinations were assessed in terms of side effects and laboratory findings. Results: In group A, there was a 39±7mmzHg and 18±1mmHg decrease in MSBP and MDBP, respectively, from baseline BP. In group B, there was a 26.7±4mmHg and 14±2 mmHg decrease in MSBP and MDBP, respectively, from baseline BP. Both combinations were safe, and no significant difference in the efficacy of both combinations was observed after 8-week of treatment. Conclusion: Both combinations are effective for control of BP, but the valsartan and hydrochlorothiazide combination (group A) appears to have better tolerability and greater effect in decreasing BP as compared to the combination of valsartan and amlodipine (group B), although this difference is not statistically significant.  

Biodiversity of Wasps Hymenoptera: Vespidae from Multan Division, Punjab, Pakistan.

To explore the wasp’s fauna and its biodiversity from Multan division, extensive surveys were carried out in selected localities of four districts of Multan division during 2013-2016. Result yielded 24 species under 14 genera of three sub- families i.e., Eumeninae, Vespinae and Polistinae as per following details: subfamily Eumeninae with 18 species under 11 genera, among them, five species are new records for Pakistan; subfamily Polistinae represented five species under two genera, whereas subfamily Vespinae with one species under one genus. Out of 24 identified species, 21 species are recorded first time for Multan division from which five species, i.e., Antepipona ceylonica, Delta campaniforme campaniforme, Odynerus reniformis, Stenodynerus punjabensis Qasim, Carpenter et Rafi, sp. nov. and Subancistrocerus pakistanensis Qasim, Carpenter et Rafique, sp. nov are new records for Pakistan included two species, Stenodynerus punjabensis Qasim, Carpenter et Rafi, sp. nov. and Subancistrocerus pakistanensis Qasim, Carpenter et Rafique, sp. nov. which are new to science. Two genera Odynerus and Subancistrocerus are reported first time from Pakistan. Diversity was calculated using Shannon-Wiener’s diversity index and Simpson’s index. Richness was calculated by using Menhinck index and Marglef’s index and the evenness or equitability was calculated with Nakamura’s index and Shannon’s equitability index. Result of diversity indices and richness from four districts showed that the Vespidae are normally distributed without any significant difference. Results of Shannon equitability and Nakamura indices showed Vespidae are evenly distributed. However, diversity and richness was low in some localities of Multan division due to geographical and hard climatic conditions.