RESUMO
OBJECTIVES OF THE STUDY: The aim of the study was to compare the efficacy and tolerability of different classes of antihypertensive drugs in diabetic and nondiabetic patients (NDPs) with essential hypertension. MATERIAL AND METHODS: The study was conducted in Mayo Hospital, Punjab Institute of Cardiology, and National Defence Hospital, Lahore, Pakistan, on 200 hypertensive patients with diabetes and 230 hypertensive patients without (Three hospitals) diabetes. Both male and female patients of age between 30 and 80 years with systolic blood pressure (SBP) above 130 mmHg and diastolic blood pressure (DBP) above 80 mmHg were enrolled in the study. Angiotensin converting enzyme inhibitors (ACEI), beta-blocker (ßB), calcium-channel blocker (CCB), diuretics (D), angiotensin receptor blocker (ARB) as well as α-blocker classes of antihypertensive drugs were used. These drugs were used as monotherapy as well as combination therapy. The study was conducted for 4 months (July-October). After 4 months, patients were assessed for efficacy by monitoring blood pressure (BP) and tolerability by assessing safety profile on renal function, liver function as well as lipid profile. RESULTS: Significant control in mean BP by all drug groups was observed in "both groups that is patients with diabetes and without diabetes." The efficacy and tolerability data revealed that in diabetic patients with hypertension, the highest decrease in SBP and DBP was observed using monotherapy with ACEI, two-drug combination therapy with ACEI plus diuretic, ARBs plus diuretic, ACEI plus CCBs, three-drug combination therapy with ACEI plus CCBs plus diuretic, and four drug combination therapy with ACEI plus CCBs plus diuretic plus ßBs, ARB's plus CCBs plus diuretic plus ßBs while in NDPs, monotherapy with diuretic, two-drug combination therapy with ACEI plus CCBs, ACEI plus ßBs, three-drug combination therapy with ßBs plus ACEI plus D was found more effective in controlling SBP as well as DBP. Adverse effects observed were dry cough, pedal edema, dizziness, muscular cramps, constipation, palpitations, sweating, vertigo, tinnitus, paresthesia, and sexual dysfunction. CONCLUSION: All classes of antihypertensives were found to control blood pressure significantly in both groups of patients that is diabetic patients with hypertesion and non-diabetic patients with hypertension.
RESUMO
OBJECTIVES: To discover the most effective mode of teaching from the perspective of medical students and to analyse their preferences for various pedagogical aids. METHODS: The qualitative, descriptive survey designed as a cross-sectional study was conducted at the King Edward Medical University, Lahore, from April to June 2011. A 25-item questionnaire regarding perceptions towards teaching aids was handed out to 500 undergraduate medical students and the answers were analysed using SPSS 17. RESULTS: Of the 500 questionnaires, 8 (1.6%) were left out for being incomplete.The study sample size, as such, was 492 with a response rate of 98.4%. Out of the 492 students, 325 (66%) disagreed that the whole lecture should be delivered via PowerPoint slides.To understand complex concepts, 246 (50%) approved of animation based learning. For retaining and recalling facts, the combination of PowerPoint slides and animations was considered by 157 (32%) as most effective, while transparencies were considered to be the least effective (n=5; 1%). Regarding their attention span 357 (76%) students said they experienced the lowest attention span during Overhead Projector lectures. Irrespective of the method used, 225 (46%) students responded that visual aids of any sort increased their concentration 'a lot'. For small groups, 283 (58%) students considered blackboards optimal, while for a large group, 243 (49%) students considered animations to be optimal. As far as combinations went, 291 (59%) preferred blackboard plus animations, 148 (30%) preferred blackboard plus PowerPoint. CONCLUSION: The combination of animations alongside blackboard was preferred over other combinations. The subjects wanted animations to be incorporated frequently into medical pedagogy, while overhead projectors were clearly disliked by them.
