RESUMO
INTRODUCTION: There is a higher prevalence of non-dipping pattern in hypertensive chronic kidney disease (CKD) patients. Nocturnal hypertension has been shown to predict cardiovascular mortality and morbidity and is often superior to daytime blood pressure. We studied the effect of shifting or adding antihypertensive to night time on blood pressure profile of CKD III-IV patients. METHODS: In this single-center, prospective, randomized controlled trial, eligible participants were adults from eastern India aged 18-65 years with CKD stages 3 and 4, with a non-dipping pattern on ambulatory blood pressure monitor (ABPM). The intervention group received all the antihypertensives in the night time whereas the standard care group continued to take the medication in the morning. Both groups were followed up for 1 year. The primary outcome was the number of patients changed from non-dippers to dippers in the standard care group and intervention group. Secondary outcomes included a change in estimated glomerular filtration rate (eGFR) and change in the cardiac structure. RESULTS: 39 patients in the intervention group and 36 patients in the standard care group were analyzed. 10 patients (26%) reverted to dipping pattern in the intervention group as compared to none in the standard care group. Mean changes in eGFR were -2.55 and -0.18 mL/min/1.73 m2 in the standard care and intervention group at the end of the study, respectively. Between-group difference in eGFR was significant at 1 year (5.22 [95% CI, 4.3-6.1] ml/min/1.73 m2); (P = 0.03). The cardiac structure showed no significant changes in either group. CONCLUSIONS: Bedtime administration of antihypertensives reverted non-dippers to dippers and slowed the decline in eGFR in CKD stages 3 and 4 compared to morning administration of antihypertensives.
RESUMO
Okra production in eastern India at present is severely threatened by whitefly-mediated okra enation leaf curl disease (OELCuD). Identification of resistant genotype and understanding the genetic control and biochemical relationship of OELCuD resistance are prerequisite for developing an effective breeding strategy. This study was conducted employing six populations (P1, P2, F1, F2, BC1 and BC2) of two selected (resistant x susceptible (RxS)) crosses. Associationship between severity of OELCuD and biochemical parameters of parents and hybrids at preflowering and flowering stages was studied. Segregation pattern of the genotypes in F2 generation showing OELCuD reaction of two crosses suggested that two duplicate recessive genes was operative for resistance to OELCuD. Generation mean analysis revealed involvement of both additive and nonadditive effects in the inheritance of disease resistance. Hence, postponement of selection in later generations or intermating among the selected segregates followed by one or two generations of selfing to break the undesirable linkage and allow the accumulation of favourable alleles could be suggested for the development of stable resistant genotype against this disease. Higher peroxidase activity and total phenol content in leaf emerged as reliable biochemical markers for early selection of genotype resistant to OELCuD.
