Treatment of Diastolic Heart Failure in Hypertensive Diabetic Patients : between Illusion and Achievements : Review

Hypertension is the most prevalent cardiovascular disease in the world. Because of associated morbidity and mortality; it is in one of the most important public health problems. Hypertension is the most important cause of heart failure with low or preserved ejection fraction. If hypertension develops concomitantly with diabetes mellitus; treatment of the two diseases becomes more complex. It is known that beta-blockers may induce type 2 diabetes; but new generation drugs such as nebivolol do not have this effect.There are many drugs with proven efficacy in lowering blood pressure; but the optimal treatment to prevent progression to heart failure is uncertain. Beta-blockers are a class of drugs with benefits for both hypertension and heart failure. Drugs in this class have different pharmacological properties in terms haemodynamic and cardiovascular effects. Nebivolol is a beta-blocker that causes vasodilatation mediated by nitric oxide release. This medicine lowers blood pressure; prevents endothelial dysfunction and improves coronary flow reserve and diastolic function independent of ventricular geometry changes. The action of nebivolol is superior to classic beta-blockers due to reversibility of subclinical changes in the left ventricle before the onset of heart failure.In the early stages of heart failure with preserved ejection fraction management is not yet established. Therefore it is important to know that in these situations nebivolol has beneficial effects

Comparison of parasite lactate dehydrogenase based immunochromatographic antigen detection assay (optimal) with microscopy for detection of malaria parasites.

This study was done to compare the ability of a newly developed rapid malaria test OPtiMAL, an immunochromatographic antigen detection assay for the diagnosis of malaria using parasite lactate dehydrogenase, against standard microscopy. Blood samples were obtained from 232 patients suspected of having malaria. A total of 122 samples (52.5%) were positive by blood films while 118 (50.8%) were positive by OPtiMAL test. The blood film indicated that 21.4% (26 of 122) of the patients were positive for P. falciparum and 78.6% (96 of 122) were infected with P. vivax. OPtiMAL test showed that 21.2% (25 of 118) were positive for P.falciparum and 78.8% (93 of 118) were infected with P. vivax. This assay had sensitivities of 88.4% and 96.8% compared to traditional blood films for detection of P.falciparum and P.vivax malaria respectively. Thus OPtiMAL test can be used with or without traditional blood film examination for detection of both P. vivax and P. falciparum malaria and can be effectively used for the rapid diagnosis of malaria.