1 The hypokalaemic effect of salbutamol after more than 30 min of administration has been well described. A hyper-and-hypokalaemic effect for adrenaline has been reported, but no such hyperkalaemic effect for salbutamol. 2 The possible hyper-and-hypokalaemic effects of salbutamol with the concomitant potential for pro-arrhythmia were assessed in the baboon (Papio ursinus). 3 Male and femal baboons were anaesthetized with ketamine (15 mg kg-') and maintained with 6% pentobarbitone as spontaneously breathing animals. Six baboons in each group received either 10, 100 or 500 jg kg-' salbutamol i.v. Lead II of the ECG and femoral i.a. blood pressure were recorded continuously for 10 min. Arterial blood samples were collected at 0 min and then after 3 and 10 min of salbutamol administration. 4 All the animals developed sinus tachycardia (above 200 beatsmin-') within 30s of each dose of salbutamol administration and the high heart rate persisted throughout the experiment. All the animals were hyperkalaemic after 3 min and hypokalaemic after O min for each dose of salbutamol. Left ventricular conduction defects were seen in 3 animals during the hyperkalaemic phase. No arrhythmia was seen during the hypokalaemic phase. 5 Salbutamol has a transient hyperkalaemic and a more prolonged hypokalaemic effect in the baboon. The hypokalaemia could not be associated with arrhythmia although conduction defects were associated with the hyperkalaemia. 6 Since salbutamol is used as a bronchodilator in asthmatic patients and to treat acute hyperkalaemia, it is suggested that caution should be exercised when using salbutamol in high doses to treat acute asthma especially during the first few minutes of administration. The finding of hyperkalaemia with salbutamol questions its use in the treatment of hyperkalaemia.

Marijuana or the products from the plant Cannabis sativa have been used both as a recreational drug and for the treatment of various diseases for thousands of years. [1] In South Africa (SA) the local Khoisan used it before the arrival of European settlers. [2] This use continued until the law criminalised it in 1922. Recently the Constitutional Court overturned the law by declaring the products of cannabis legal for private use. [3] In spite of previous legislation, the South African Medical Research Council estimated that in the year 2008 there were ~3.2 million users of marijuana in SA. [4] At that stage the country was regarded as the fourth-biggest producer of marijuana in the world. [4] Not all users of cannabis products use them for recreational purposes -many are in fact self-medicating. The recent changes in legislation in SA have probably led to an increase in self-medication, but very little official information is available on the magnitude of this increase. Media interest indicates that it could be significant. Medical professionals are often not told that their patients are using these products, and they are not always aware of their possible benefits or adverse effects. Some patients may approach their doctor for assistance and information. Cannabis compounds are used for a variety of conditions, including pain, cancer, insomnia, inflammatory disease and epilepsy. [5] Although scientists have investigated the therapeutic value of cannabis in many of these conditions, the results are often inconclusive and more work is needed. In some conditions, such as epilepsy, there is evidence that patients can benefit from using cannabidiol (CBD) extracted from cannabis, and this information could assist general practitioners in advising patients on the efficacy of these compounds. ObjectivesThe objective of this review is to summarise the currently available information on the therapeutic effects of CBD, one of the main components of cannabis, in the treatment of epilepsy and to explore recent information on the mechanisms involved in these effects. MethodsSeveral searches were done on PubMed (https://www.ncbi.nlm.nih. gov/pubmed/) during the period June/July 2019. The key words 'epilepsy' , 'clinical studies' , 'therapeutic use' , 'adverse effects' and 'drug interactions' were used in combination with 'cannabis' , 'cannabinoids' and 'cannabidiol' . The abstracts were studied and the full text of articles of interest was acquired. Information from articles where it was not possible to get the full text was not included in the review. Literature reviewThe family Cannabaceae consists of three species, namely C. sativa, C. indica and C. ruderalis. [5,6] Owing to hybridisation, it is often difficult to distinguish between the different species. C. sativa is mostly known for its recreational use, whereas C. indica, commonly known as hemp, has been cultivated over the years for its fibres, which are used in the manufacturing of fabrics. [5][6][7] This plant family contains more than 460 different chemicals, of whic...

To date, there has been no study done investigating the relationship between the components of height and blood pressure (BP) in rural South African children. Therefore, the aim of this study was to investigate the relationship between height, sitting height (SH), leg length (LL), and SH-to-height ratio (SH/H) with BP in Ellisras rural children. All children underwent anthropometric and BP measurements using standard procedure. Linear regression was used to assess the relationship between height, SH, LL, SH/H, and BP. The regression showed a positive significant (p < 0.001) association between systolic BP (SBP) with height and SH (β ranged from 0.127 to 0.134 and 95% CI ranged from 0.082 to 0.415). Diastolic BP (DBP) also showed a positive significant (p < 0.001) association with height and SH (β ranged from 0.080 to 0.088 and 95% CI ranged from 0.042 to 0.259). After having been adjusted for age, gender, body mass index, and waist circumference, DBP showed a positive significant (p < 0.05) association with height. There was a positive significant association between DBP and SBP together with the components of height amongst Ellisras rural children.

Rabbits and sheep were exposed to low- and high-protein diets and subsequently infested three times with adults of Rhipicephalus appendiculatus and Rhipicephalus evertsi evertsi. The mean weight of R.e. evertsi females which dropped from rabbits maintained on a high-protein diet decreased from 515.0 +/- 24.9 mg (naive) to 381.5 +/- 25.0 (second infestation) to 340.3 +/- 23.3 mg (third infestation) while the weight of ticks fed on animals which were exposed to a low-protein diet did not change significantly (2.7%). The mean weight of engorged females of R. appendiculatus which completed their blood meal on rabbits (high protein) decreased from 520.9 +/- 31.8 (naive) to 369.3 +/- 39 mg (3rd infestation), a significant decrease of 29.1% compared to a 12.3% decrease in weight between the 1st and 3rd infestation of females fed on animals on a low-protein diet. Rhipicephalus e. evertsi fed on sheep exhibited the same phenomenon. The mean decrease in weight of 4rd-infestation ticks which dropped from sheep fed lucerne was 26.2% compared to 16.6% for ticks from sheep which were fed on grass. Hosts maintained on a low-protein diet failed to acquire resistance to ticks, lost weight and developed anaemia while those on a high-protein diet developed resistance, maintained weight and did not develop anaemia. The nutritional stress of the hosts and its application in South Africa are discussed.

The stability of cardiodynamic and some blood parameters during a slow, continuous infusion of a combination of ketamine and diazepam is reported. Contractility (dP/dt), myocardial relaxation (Tln), left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), arterial blood pressure and certain blood parameters were assessed in 3 male and 3 female juvenile baboons (<em>Papio ursinus</em>). Anaesthesia was induced with 15 mg/kg ketamine IM and maintained with a continuous IV infusion (40-60 mℓ/h) of ketamine and diazepam. The mixture consisted of 2 mℓ ketamine (100 mg/mℓ), 2 mℓ diazepam (5 mg/mℓ) and 50 mℓ saline. A period of 75 + 10 min was allowed for preparation of the animals, after which lead II of the ECG, femoral artery blood pressure and left ventricular pressure were recorded at 15-min intervals for a period of 2 h: the total duration of anaesthesia was 195 min. Arterial blood samples were analysed at 30-min intervals for blood gases, electrolytes, glucose and insulin. Left ventricular parameters were derived from the left ventricular pressure curve. Tln, LVSP and LVEDP showed small fluctuations. Contractility decreased (p &lt; 0.037) at the 195-min interval. No arrhythmias or ECG changes were seen, while blood pressure decreased gradually. Serum calcium concentration decreased and blood glucose levels increased gradually over time. Anaesthesia and analgesia were sufficient and no other drugs were necessary. The animals appeared sedated and dazed 60-80 min after the procedure. A continuous infusion of a combination of ketamine and diazepam for a duration of 150 min can provide stable anaesthesia for cardiodynamic measurements

The aim of this cross-sectional study was to investigate the association between birth weight, underweight, and blood pressure (BP) among Ellisras rural children aged between 5 and 15 years. Data were collected from 528 respondents who participated in the Ellisras Longitudinal Study (ELS) and had their birth weight recorded on their health clinic card. Standard procedure was used to measure the anthropometric measurements and BP. Linear regression was used to assess BP, underweight variables, and birth weight. Logistic regression was used to assess the association of hypertension risks, low birth weight, and underweight. The association between birth weight and BP was not statistically significant. There was a significant (p < 0.05) association between mean BP and the sum of four skinfolds (β = 0.26, 95% CI 0.15–0.23) even after adjusting for age (β = 0.18, 95% CI 0.01–0.22). Hypertension was significantly associated with weight for age z-scores (OR = 5.13, 95% CI 1.89–13.92) even after adjusting for age and sex (OR = 5.26, 95% CI 1.93–14.34). BP was significantly associated with the sum of four skinfolds, but not birth weight. Hypertension was significantly associated with underweight. Longitudinal studies should confirm whether the changes in body weight we found can influence the risk of cardiovascular diseases.

Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis &gt;50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

Previous studies have shown that crude extracts from Pavetta harborii as well as dried plant material have cardiotoxic effects on rats and sheep that can lead to heart failure. The active component has since been isolated and identified. This substance has been named pavetamine. The aim of this study was to determine whether pavetamine has cardiotoxic effects similar to those seen in previous reports, when administered to rats intraperitoneally. Sprague Dawley rats received two doses, initially 4 mg / kg and then 3 mg / kg pavetamine respectively and were monitored for 35 days before cardiodynamic parameters were measured by inserting a fluid-filled catheter into the left ventricle via the right carotid artery. These values were compared to those of control rats that had received only saline. Pavetamine significantly reduced systolic function and body mass in the treated rats, which indicates that it has the potential to induce heart failure in this animal model.