New perspectives in the management of hypertension: role of herbal medicines

To compare the efficacy of coded herbal medicine [Hyprol] and losartan in hypertensive type II diabetic patients. Case control study. This study was carried out at the Out-patient Department of JPMC, Karachi and Herbal Clinics of Karachi from January 2014 to June 2014. This study is a case control prospective study to compare the effects of Losartan with herbal medicine [Hyprol] in type 2 diabetic hypertensive patients. 200 patients were enrolled and divided in two groups [A] [Control group] and [B] [Test group] treated with Losartan and Hyprol respectively. With ARB [Losartan] baseline to final change for SBP as well as DBP was significantly reduced i.e. 22.45% [p<0.001] and 16.84% [p<0.001] respectively and FBS was reduced by 21.85% [p<0.001] while Hyprol shows comparable results i.e. difference in SBP, DBP and FBS was 14% [p<0.001], 15.31% [p<0.001], 34.57% [p<0.001] respectively. ARBs are the first line drug of choice for hypertension since long time. Use of herbal medicine is an alternative mean of therapy to treat these patients and limit its cardiovascular and renal complications

Clinical evaluation of coded herbal medicine [hypoess] and angiotensin receptor blocker [candesartan] in essential hypertensive patients

The basic aim of this research study was to determine the comparative effect of herbal treatment in comparison with standard allopathic medicine in control and treatment of essential hypertensive patients. Prospective and comparative study. This study was carried out in Department of Pharmacology, HCM and D, FH and MS, Hamdard University, Karachi, from January 2014 to July 2014. A total of 200 patients were enrolled in study and were given Hypoess in one hundred patients while remaining one hundred patients received allopathic medicine Candesartan. In test group one hundred patients were treated with herbal drug [Hypoess] and it decreased mean systolic blood pressure of study patients with a decrease of 15.17% whereas, a reduction of 20.56% was found with allopathic medicine Candesartan Cilexetil. Similarly a decrease of 18.07% was found in mean diastolic blood pressure with herbal medicine in test group patients and a decrease of 21.65% was observed in case of allopathic drug in mean diastolic blood pressure of control group patients. The effects of herbal medicine were found statistically significant in controlling blood pressure and it has been found as an alternative option to treat essential hypertensive patients with its cost-effectiveness

Health care service quality: a comparison of public and private hospitals in karachi

The objective of the study was to compare the levels of patient satisfaction with the health service quality between the public and private hospitals in Karachi, so that their gaps, if any, may be identified and incorporated in future programs and policies. Cross sectional comparative study. This study was conducted in one public and one private hospitals in Karachi from May 2013 to July 2013. A random sample of 400 patients, 200 each from both public and private hospitals was drawn. Data was collected, on a pre-tested and pre coded questionnaire, and analyzed using SPSS version 16.0 level of satisfaction between patients in both the public and private health care settings were compared. The results of the study revealed that 75% of the patients availing health care services at the public hospital were not satisfied with the overall hygiene and cleanliness. 58.5% of the patients at public hospital were not involved in decision making regarding their own treatment. As for the patients availing services at the private hospital, 83.5% mentioned that they were provided with adequate privacy by their physician and hospital staff;however, 51% of the respondents replied that they had to pay huge medical bills which were beyond their affordability. Significant difference was found in the patients' satisfaction level with the quality of health care services provided in the private and public hospitals, with private hospitals performing better in most of the aspects of health care service delivery

Cardiovascular and renal protection in type 2 diabetic hypertensive patients. the role of calcium channel blockers

To study the effects of Calcium Channel Blocker [Amlodipine] as monotherapy in diagnosed hypertensive, non-insulin dependent diabetes mellitus [NIDDM] patients. Prospective study. This study was conducted at Jinnah post graduate medical centre [JPMC] Karachi, in collaboration with the department of medicine JPMC, Karachi from July 2010 to January 2011. This study is to examine the effects of Amlodipine in type 2 diabetic hypertensive patients with base line proteinuria. 20 normal subjects were also selected as a control group with CCB [Amlodipine] baseline to final change for SBP as well as DBP was significantly reduced i.e.24.70 % [p<0.001] and 16.20% [p<0.001] respectively. CCB showed 44% [p<0.001] reduction in FBS, creatinine clearance reduced by 8.10% [p<0.5], serum potassium reduced by 4.50%, non significant increase in serum urea i.e.3.70% and serum creatinine i.e. 3.8% was observed. Aim of treating hypertension is to control or limit its cardiovascular complications; CCB and are the drug of choice in controlling blood pressure and to prevent the progress of cardiovascular events in patients without diabetic nephropathy as well as reserves for add-on therapy in hypertensive patients complicated with diabetic nephropathy

observe the role of angiotension receptor blocker losartan in treating prehypertension

The primary objective of the present study was to determine whether in patients with prehypertension six months of treatment with an angiotensin II, type I receptor antagonist [at a dose of 8mg once a day] reduces the incidence of hypertension in borderline patients Randomized, open-labeled, prospective study. This study was conducted in the department of pharmacology and therapeutics, Basic Medical Sciences institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC], Karachi, from July 2007 to January 2008. This study involved eighty untreated participants between 30 to 60 years of age of either sex with blood pressure on study entry in high-normal range i.e. systolic blood pressure of 130 to 139 mmHg and diastolic blood pressure of 85 to 89 mmHg, according to the classification developed by Joint National Committee on prevention, Detection, Evaluation, and Treatment of high blood pressure [JNC-VI]. All participants were randomized and enrolled in study after baseline investigations and informed written consent. All values have been expressed in standard error of mean [ +/- SEM]. Forty patients were treated with DRI and DR2 from day 0 to day 90[th] of study period respectively. InDRI group the mean systolic BY was decreased from 138 mmHg to 125.8 mmHg from day 0 to day 90[th] In DR2 group an increase was observed in systolic BY from 128 mmHg to 136 mmHg from day 0 to day 90[th]. An average percentage decrease of 8.21% in case of DR] while, 5.52% was increased in DR2 group. In same way a decrease of 11.82% in DR] group, while, an increase of 11.5% was observed in case of DR2 group in mean diastolic blood pressure respectively from day 0 to day 90[th] of study duration. Treatment of prehhypertension with an angiotension receptor antagonist May decreases incident hypertension. Additional studies will be needed to ascertain whether this or other strategies involving early pharmacological treatment of prehypertension would positively affect clinical outcomes

Prevalence of metabolic syndrome in patients present with unstable angina

The main objective of this study was to determine the frequencyof metabolic syndrome in patients presesnting with unstable angina at DUHS. Cross-sectional observational study. This study was carried out at all medical wards of a DUHS from January 2012 to July 2012. 81 patients with Unstable Angina [UA] presented in medical ward that fulfilled the inclusion and exclusion criteria and gave informed consent were enrolled for the study. Metabolic syndrome was defined according to ATPIII criteria. Patients were evaluated for obesity, diabetes, hypertension, hypertriglyceridemia and low HDL. Total 81 patients with unstable angina were included in this study Out of them 43 [53.1%] were male and 38 [46.9%] were female. Mean age was 60.23 +/- 8.7. Majority of patients [49.4%] were lying in 51 to 60 years age group. The frequency of metabolic syndrome was thirty nine [48.1%]. Among them twenty three [53.5%] were male and sixteen [42.1%] were females, hence it shows insignificant p value of 0.018. Metabolic syndrome is common with high frequency in our population. This study provides a quantitative estimate of the frequency of metabolic syndrome and suggests Diabetes, low HDL, hypertension, hypertriglyceridaemia and obesity strongly correlates with unstable angina

Sensitivity pattern of causative microorganisms in septicemia

The study was conducted to find out the various etiological organisms in septicemia and their sensitivity to different antimicrobial drugs. Observational study. This study was conducted in Medical units of Civil Hospital Karachi from January 2010 to December 2010. A total of 90 patients between the ages of 15 years to 80 years, irrespective of gender with septicemia were included in this study. Total number of patients was 90. There were 47 [52%] male and 43 [48%] were female. Staphylococcus aureus and Salmonella Typhi were the most common organisms isolates in 26% cases. Regarding the sensitivity pattern of bacteria to different antimicrobial drugs, the results showed that Staph. Aureus had good sensitivity to Augmentin, Imipenem and Tazobactum and marked resistance to Ciprofloxacin. No MRSA was isolated in the study. Salmonella Typhi showed good sensitivity to Quinolones and Ceftriaxone and marked resistance to Chloramphenicol, Co-trimaxazole and amoxicillin [Table 4]. Klebsiella showed good sensitivity to Amikacin, Ceftriaxone, Imepenem and marked resistance to Ampicillin and Carbencillin, Pseudomonas aeuroginosa had good sensitivity to Tazobactum, Amikacin and Ceftriaxone. Septicemia is a major cause of death worldwide and the random use of antibiotics has considerably increased the resistance to commonly used antibiotics. Blood culture should be sent immediately to know the spectrum of microorganisms, and their sensitivity pattern, however this may not delay the empirical use of antibiotics to hasten recovery

Various clinical presentations of falciparum malaria and outcome: a study of 100 patients

Various clinical presentations of falciparum malaria and outcome. Malaria is an important disease worldwide, result in estimated 300-500 million new cases and 1.5-2.7 million deaths per year. Most deaths occur due to Plasmodium Falciparum infection. Falciparum malaria is a major community problem in our country. Presentation of falciparum malaria with paroxysms of fever chills and rigors are easy to diagnose and treat. Case series study. This study was conducted at DUHS from January 2011 to December 2011. 100 patients above 12 years of age with any gender, presenting with high grade fever and diagnosed as a case of Falciparum malaria on thick and thin film are included in this study. Among 100 patients 69 were male and 31 females. Clinically all patients presents with fever, while 69 with headache, 39 with vomiting and 28 with altered level of consciousness. The most common sign was anemia i.e. in 40 patients, splenomegaly in 37, and jaundice was found in 35 patients. 7 patients were expired during the study. Falciparum malaria is a notorious for various presentations which may mimic like upper and lower respiratory tract infection, acute gastroenteritis and bacterial meningitis. The treating physician should be aware of the various presentations because early detection and treatment may reduce the morbidity and mortality associated with falciparum malaria

Comparison of hemodynamic responses of intrathecally placed hyperbaric 0.75% bupivacaine hydrochloride in different height groups of patients undergoing caesarean section

To compare the Hemodynamic response of intrathecally placed 1.5 ml of 0.75% hyperbaric bupivacaine hydrochloric in different height groups of patients undergoing caesarean section in spinal anesthesia. Quasi experimental study. This study was carried out in the Department of Anesthesia, Sindh Govt, Lyari General Hospital, Dow Medical College, Dow University of Health Sciences from July 2009 to December 2009. In this study patients enrolled for elective caesarean section, were divided into two groups. In Group-A the height of the patients was equal or less than 60 inches [5 feet] and the height of the patients of Group-B was between 60 -66 inches [5 - 5.5 feet]. Hypotension was observed in 67 patients. 46 patients belonged to Group-A and 21 patients from Group-B. The study showed that height of the patients influenced the hemodynamic response of local Anesthetics given during spinal anesthesia

Radiographic patterns in HIV associated pulmonary tuberculosis

To evaluate Radiographic patterns in HIV associated PULMONARY TUBERCULOSIS. Observational, retrospective, descriptive study. This study was conducted in the Department of Infectious Diseases, Civil Hospital, Karachi between July 2008 to April 2009. This study is conducted by reviewing the admission records of 54 HIV diagnosed patients. A total of 30 patients presented with pulmonary symptoms were evaluated by sputum smear for acid fast bacilli [AFB] and chest radiographs. Out of 30 HIV seropositive patients, 29 were male and 1 was female of mean age +/- SD 33.9 +/- 95 years. Sputum staining for acid-fast bacilli was positive in 10 patients [33.3%]. Frequent radiographic patterns were 12 [40%] normal, 5 [16.6%] apical infiltrate, cavitatory lesion was observed in 1 patient. Dominant symptoms were weight loss 29 [93.3%], fever 24 [80%]. Majority of HIV seropositive patients with pulmonary tuberculosis were male, common radiographic patterns were normal radiograph, apical infiltrates atypical radiographic presentation is particularly related in advance stages of immunosuppressant. Cavitatory lesions and pleural effusion were rare findings

To compare the efficacy of rocuronium bromide and succinylcholine in elective surgery for endotracheal tube

To compare the efficacy of rocuronium bromide and Succinylcholine in elective surgery for endotracheal tube. Randomized, double blind study. This study was conducted in the Department of Anesthesia and Surgical ICU, Civil Hospital Karachi over a period of six months i.e. January 2009 to August 2009. This study was conducted on sixty patients. They were aged between 20-60 years. Patients were divided into two groups following inclusion i.e. Group A and Group B. Patients in Group A were given inj. Rocuronium 0.9mg / kg and group B received inj. Succinylcholine 1.5mg / kg. In group A which was received rocuronium bromide 0.9mg / kg, showed excellent intubating conditions in 83.33% of patients as compared to group B which was given Succinylcholine 1.5mg / kg, showed 96.66%. The intubating conditions were significantly better in group B which received inj. Succinylcholine 1.5mg / kg as compare to group A was given inj. Rocuronium 0.9mg / kg

Comparison of haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade

The aim of the study was to compare the haemodynamic responses between atropine and glycopyrrolate used with neostigmine during reversal of neuromuscular blockade. The experimental study was conducted in the Department of Anesthesia, Sindh Govt Lyari General Hospital over a period of 6 months from February 2009 to July 2009. In this study we included total sixty patients undergoing elective surgeries. These patients were allocated into two equal groups. The patients in group I received inj Neostigmine 0.04 mg/kg with inj atropine 0.4 mg/1 mg neostigmine and the patients in group II were given inj neostigmine 0.04 mg/kg with inj. Glycopyrrolate 0.2mg/1 mg neostigmine at the end of the surgery. In both the groups heart rate and blood pressures were recorded as a base line value prior to administration of reversal agents and then after 1, 5, and 10 minutes interval after giving the reversal agents. The comparison was made between groups I and group II. Out of 60 patients 37 [61.66%] were males and 23 [3 8.33%] were females with 1.6:1 male to female ratio. The base line mean heart rate, systolic and diastolic blood pressure readings in group I were 75.13 +/- 5.23, 130.18 +/- 7.1 and 75.22 +/- 4.37 respectively while in group II these readings were 71.19 +/- 4.21, 121.12 +/- 11.52 and 75.77 +/- 3.61 respectively. Mean heart rate and systolic blood pressure readings between groups at 1, 5 and 10 minutes were statistically significant while diastolic blood pressure readings between groups were significant only at 5 minutes. Glycopyrrolate, in comparison to atropine, is more effective in providing cardiovascular stability in antagonizing the muscarinic cardiovascular effects of neostigmine

Comparison of propofol and sevoflurane for laryngeal mask airway insertion [LMA] in adults

To compare the effects of Porpofol and Sevoflurane in Laryngeal Mask Airway insertion. This study was quasi experimental was carried out in the Department of Anesthesiology, Surgical Intensive Care and Pain Management, Dow Medical College and Civil Hospital Karachi, Dow University of Health Sciences. The duration of the study was six months. In this study 60 patients schedule for elective surgery were enrolled which were divided into two groups. The average age of the patients was 25.1 +/- 10.6 years [95% CI; 23.7-29.0]. Out of 60 patients, 28 [46.6%] were males and 32 [53.3%] were females with 1:0.8 male to female ratio. Gender difference was not statistically significant between the groups [Chi-Square= 0.601; P=0.44]. The average age, weight and LMA insertion time were not statistically significant between groups. Induction time was significant between groups. Induction time was significantly higher in porpofol group [B] than in the sevoflurane group [A]. Condition of LMA insertion of 24 [80%] patients were excellent [score = 18] and 6 [20%] patients were satisfactory [Score between 16 to 17] in group A while condition of LMA insertion of 28 [93.3%] were excellent and 2 [6.7%] were satisfactory in group B. This study concludes that porpofol is a better anesthetic agent for insertion of LMA as compared to sevoflurane by using loss of eye lash reflex as the end point for induction

role of verapamil in long-term management of opioid dependence

To determine the effectiveness of calcium channel blocker, verapamil in long-term management of patients with chronic dependence on opioids. Patients were admitted for 10 days in hospital. No treatment was given during first three days of admission after abrupt termination of opioid to observe the acute opioid withdrawal signs and symptoms. Then the verapamil was given orally to each patient in a dose 40 mg twice daily from day 4 to day 10 of admission. Then patients were discharged on the same treatment and advised to attend OPD weekly for further 12 weeks. The treatment was continued till the 8[th] week and then the dose of verapamil was gradually tapered off during next two weeks that is weeks 9 and 10. During last two weeks that is week 11 and 12 patients were assessed without given any treatment. The intensity of signs and symptoms were recorded by using objective opiate withdrawal scale and modified subjective opiate withdrawal scale respectively. The physiological parameters were also recorded throughout the study. Urine analysis for opioids was done on day 1 and day 10 of admission and then on 4[th], 8[th] and 12[th] weeks of follow up. Verapamil significantly decreased the intensity of signs and symptoms of protracted opioid withdrawal from day 4 to week 12. There were no undesirable variations in physiological parameters. Urine analysis for opioids was positive on day 1 while zero on day 10, weeks 4, 8 and 12. Verapamil significantly decreased the intensity of signs and symptoms of protracted opioid withdrawal during long-term management of opioid dependence

Comparing the effects of verapamil and moxonidine in treatment of acute opioid abstinence syndrome

To compare the effectiveness of calcium channel blocker, verapamil and alpha two agonist, moxonidine in treatment of acute opioid withdrawal syndrome in patients with chronic dependence on opioids. Patients were divided into two groups. Group 1 had 27 patients, treated with verapamil 40 mg BID. Group 2 had 19 patients, treated with moxonidine 0.2 mg OD. All Patients were admitted for 10 days in hospital. Placebo was given during first three days of admission after abrupt termination of opioid to observed the acute opioid withdrawal signs and symptoms. Then the treatment was given to each patient daily from day 4 to day 10 of admission. The intensity of signs and symptoms were recorded by using objective opiate withdrawal scale and modified subjective opiate withdrawal scale respectively. The physiological parameters were also recorded daily throughout the patients stay in hospital. Urine analysis for opioids was done on day I and day 10 of admission. Verapamil and moxonidine both significantly decreased the intensity of signs and symptoms of acute opioid withdrawal from day 4 to day 10 of admission without any significant side effect but verapamil was found to be more efficacious than moxonidine. There was no undesirable variation in physiological parameters. Urine analysis for opioids was positive on day 1 while zero on day 10. Verapamil was found to be more effective than moxonidine for the treatment of acute opioid abstinence syndrome in indoor patients

Comparative effect of candesartan cilexetil and atenolol on glucose metabolism in essential hypertensive patients

To compare the changes on Glucose metabolism in essential hypertensive patients. Randomized, open-labeled, prospective comparative study. The study was carried out in the department of pharmacology and therapeutics, Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC], Karachi, from January 2007 to December 2008. In this study [80] newly diagnosed essential hypertensive patients were enrolled and divided into two groups [DR1] and [DR2] respectively. DRI patients received Candesartan 16 mg once a day and DR2 patients received Atenolol 50mg once a day for 3 months duration. At the end of study period the parameters examined were fasting and random blood glucose levels. The results have been expressed as mean +/- SEM [Standard error of Mean]. The mean fasting blood glucose level was decreased [from 90.22+ 1.34 mg/dl to 89.20 +/- 1.70 mg/dl; for DR1] versus DR2 in which mean fasting blood glucose level was increased [from 91.82 +/- 1.34 mg/dl to 97.91 +/- 1.22 mg/dl; p<0.001]. A reduction of 1.13% in case of DR1 and an increase of 6.63% were observed in case of DR2 group. The mean random blood glucose level was decreased for DRI group [from 151.12 +/- 0.99 mg/dl to 149.36 +/- 0.80 mg/dl] versus DR2 in which mean random blood glucose level was increased from [155.47 to +/- 0.96 mg /dl to 168.83 +/- 0.81 mg/dl; p<0.001]. A reduction of 1.16% was observed in case of DR1 group while and increase of 8.59% was observed in case of DR2 group, respectively. Candesartan cilexetil is a newer and safer alternative for the treatment of diabetic hypertensive patients in comparison to Atenolol treatment

Pathophysiology and appropriate management of acute asthma

To study pathophysiology and guidelines for the diagnosis and management of acute asthma. Prospective study of management of known cases of acute asthma for a period of 3 months. Department of Chest Medicine, Jinnah Post Graduate Medical Centre, Karachi. 300 cases of known acute asthma were included. Management was initiated with saturated oxygen and Salbutamol nebulizer. Subsequent treatment was added if sign and symptom did not regress. Hydrocortisone [after 15 minutes], Ipratropium [after 30 minutes] and Aminophylline [after 1 hour]. 190/250 [76%] males and 40/50 [80%] females, total 210/300 [70%] patients became stable after initial treatment. 3 0/60 [50%] males and 10/10 [100%] female, total 40/70 [57%] were stable after Hydrocortisone was added. 20/30 [66%] male patient became asymptomatic after treatment with Ipratropium. 10 patients became asymptomatic after 1 hour of treatment with Arninophylline. No adverse effects were observed. Acute asthma is highly variable clinical condition therefore the level of control must be monitored on a periodic basis to determine whether therapy should be maintained or adjusted. It includes symptomatic relief as well as arrest of pathophysiolgical mechanism of asthma

Anti hypertensive efficacy of cardioselective beta-blocker atenolol and amlodipine in essential hypertensive patients

High blood pressure increases the risk of cardiovascular disease for millions of people worldwide and there is evidence that the problem is only getting worse. In the past decade, age adjusted rates of strokes incidence have risen. The incidence of end stage renal disease and the prevalence of heart failure have also increased. A major contributor to these trends is inadequate control of blood pressure in the population. The variety of treatments has been established with the passage of time from older to newer class. Researchers with passage of time proved on one side beneficiary drugs but also contraindicated in various types of patients. Keeping in view the necessity of treatment of hypertension at its initial stages in essential hypertensive patients to prevent cardiovascular complications in essential hypertensive patients. In present study the objective was to compare blood pressure lowering effects of cardio selective beta blocker Atenolol with calcium channel blocker Amlodipine in essential hypertensive patients

Comparison of Losartan and Amlodipine in hypertensive type-II diabetic patients

The present study assesses whether Losartan and Amlodipine, alone or in combination, prevent microalbuminuria in hypertensive type II diabetic patients. Department of pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Centre, Karachi from June 2006 to January 2007. In this study 60 hypertensive diabetic patients were divided into 3 groups having 20 each. Group 'N' patients were kept as control, group 'A' patients were treated with Losartan, 50 mg once daily, group 'B' with Amlodipine 10 mg once daily and Group 'C' patients were given a combination of both the drugs i.e. tab losartan and tab amlodipine. Tablet Glibenclamide 5 mg was given according to the glicemic control. Although all the three groups showed a comparable effect in lowering both the systolic and diastolic blood pressure but the effect on proteinuria was variable. Losartan treated patients in Group 'A' shows marked reduction of proteinuria but non-significant change in creatinine clearance. In Group 'B' the patients who were treated with Amlodipine showed significant reduction in creatinine clearance, but non-significant change in proteinuria and Group 'C' patients showed countable reduction in proteinuria but a non-significant increase was observed in creatinine clearance. The results suggest that in hypertensive type II diabetic patients Losartan is worthwhile reducing both systolic and diastolic blood pressure and proteinuria significantly

Proteinuria a target for reno-protection in hypertensive patients with type 2 diabetic nephropathy

To study the response of angiotensin II [ATI] receptor antagonist ARE [Losartan] as monotherapy in diagnosed hypertensive, non-insulin dependent diabetes mellitus [NIDDM] patients with nephropathy [albuminuria]. Department of pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC], Karachi. This study is a randomized trial used to examine the effects of ARB [Losartan] on the renal outcome of 20 diagnosed cases of hypertensive noninsulin dependent diabetes [NIDDM] with base line proteinuria. 20 normal subjects were also selected as control group. Baseline albuminuria is almost linearly related to renal outcome, and is the strongest predictor among all measured well-known baseline risk parameters. The changes in albuminuria in the first 3 months of therapy are roughly linearly related to the degree of long-term renal protection. ARB [Losartan] showed 58% [P<0.001] reduction in proteinuria, 4.7% reduction in serum urea, 7.06% [P<0.01] reduction in serum creatinine, creatinine clearance by 4.72%, serum potassium increases by 5.07% [P<0.01] and FBS reduced by 33.29% I [P<0.001]. Baseline to final change for SBP as well as for, DBP was significantly reduced i.e.19.20% [P<0.001] and 16.16%[p<0.001] respectively. In conclusion, albuminuria should be considered a risk marker for progressive loss of renal function in hypertensive type 2 diabetic patients with nephropathy, as well as a target for therapy. Reduction of residual albuminuria to the lowest achievable level should be viewed as a goal for future renoprotective treatments