Comparison of efficacy of calcium channel blockers with angiotensin converting enzyme inhibitors in the treatment of essential hypertension in elderly men

To cornpare efficacy of calcium channel blockers [CCBs] with angiotensin converting enzyme inhibitors [ACEIs] in the treatment of elderly men [age more than 55 years] with essential hypertension. Randomized controlled trial. Military Hospital Rawalpindi, one year [From September 2005 to September 2006]. One hundred male patients with stage 2 hypertension, aged more than 55 years, meeting the inclusion and exclusion criteria were randomized in 2 groups by non-probability convenience sampling. One group received calcium channel blockers [CCBs], and the other group received angiotensin converting enzyme inhibitors [ACEIs] daily for duration of 6 months from the day of enrolment during the one year study period. Reductions in blood pressure means were observed in both groups after six months of therapy i.e. 28.52 mm Hg [with CCBs] and 26.4 mm Hg [with ACEIs] for systolic blood pressure and 16.32 mm Hg [with CCBs] and 13.4 mm Hg [with ACEIs] for diastolic blood pressure. The mean drop of systolic blood pressure in group 1 was 2.12 mm Hg more than group 2 and was significant [p value < 0.05]. The mean drop of diastolic blood pressure in group 1 was 2.92 mm Hg more than group 2 and was significant [p value < 0.05]. The study suggests that calcium channel blockers have a superior efficacy in controlling blood pressure; both systolic as well as diastolic, as compared to angiotensin converting enzyme inhibitors for stage 2 hypertension in elderly men

Chronic diarrhea; large gut causes

To determine the frequency of large bowel causes of chronic diarrhea in adult Pakistani patients. Cross sectional study. Medical unit 1 at Combined Military Hospital Lahore, Pakistan. Six months [from 01-11-2007 to 30-4-2008]. Fifty adult patients with chronic diarrhea, irrespective of their gender were selected by non probability convenient sampling. Patients already diagnosed with diseases known to cause diarrhea and those with toxic mega colon were excluded from the study. All patients were subjected to fiberoptic colonoscopy and findings were recorded. Biopsies were taken from suspected lesions or from normal looking mucosa. Diagnosis was made with colonoscopic and histopathologic findings. Thirty two [64%] patients had abnormal findings visible on colonoscopy. Histopathology was normal in 18 [36%]. Twenty [40%] patients had ulcerative colitis, seventeen [34%] had IBS, five [10%] had CA colon and three [6%] patients had crohn's disease. Other diagnoses included non specific colitis, tubulovillous adenoma and infection. Twenty three out of 24 patients [95%] who had blood in stools had a visible abnormality on colonoscopy whereas colonoscopy was positive in only 33% of patients who did not have blood in stools. Most causes of large gut chronic diarrhea can be identified by colonoscopy and biopsy. Colonoscopy has a very high yield in chronic diarrhea and should be recommended for its work up. Its yield is even higher in patients with bloody diarrhea