HS was a more effective antihypertensive agent than HCTZ in mild to moderate hypertensive Nigerians and did not cause electrolyte imbalance. HS showed longer duration of action compared to HCTZ and reduction in serum Na+ may be another antihypertensive mechanism of action of HS.

Objectives:The present study investigated the effects of aqueous extract of Hibiscus sabdariffa (HS) on the three basic components of renin-angiotensin-aldosterone system: Plasma renin, serum angiotensin-converting enzyme (ACE), and plasma aldosterone (PA) in mild to moderate essential hypertensive Nigerians and compared with that of lisinopril, an ACE inhibitor.Materials and Methods:A double-blind controlled randomized clinical study was used. Seventy-eight newly diagnosed but untreated mild to moderate hypertensive subjects attending Medical Outpatients Clinic of Enugu State University Teaching Hospital, Enugu were recruited for the study. Those in Group A received placebo (150 mg/kg/day), Group B were given lisinopril (10 mg once daily) while those in Group C received aqueous extract of HS (150 mg/kg/day). After 4 weeks of treatment, the levels of plasma renin, serum ACE, and PA were determined.Results:HS and lisinopril significantly (P < 0.001) reduced PA compared to placebo by 32.06% and 30.01%, respectively. Their effects on serum ACE and plasma renin activity (PRA) were not significant compared to placebo; they reduced ACE by 6.63% and 5.67% but increased plasma PRA by 2.77% and 5.36%, respectively.Conclusion:HS reduced serum ACE and PA in mild to moderate hypertensive Nigerians with equal efficacy as lisinopril. These actions are possibly due to the presence of anthocyanins in the extract.

Background. Patient adherence with glaucoma medical therapy remains a global challenge. Objectives. To determine the prevalence of non-adherence and identify the determinants and deterrents to glaucoma medications in Enugu, southeast Nigeria. Material and methods. This study adopted a cross-sectional, descriptive, hospital-based survey involving 114 glaucoma patients on topical medications. They were recruited from the ophthalmic clinic of the University of Nigeria Teaching Hospital, Enugu. Information on their socio-demographic characteristics, clinical profile and issues of adherence with glaucoma medications were collected using a pre-tested, close-ended, interviewer-administered questionnaire. The data collected was analysed using SPSS version 21. Bivariate analysis was done to identify the associations of different factors of adherence with glaucoma medications. The level of significance was set at p < 0.05. Results. The participants were comprised of 58 males (50.9%) and 56 females (49.1%), with a mean age of 60.0 ± 14.8 years. Most were mainly on two or less glaucoma medications (92 (80.7%)) and were diagnosed with glaucoma for less than 5 years (73 (64.0%)). 42 (36.8%) participants were non-adherent with their glaucoma medications. Assisted administration of glaucoma medication was the most important determinant of non-adherence to medication. Gender, good/fair vision, distance from the pharmacy, knowledge of the disease and educational status also contributed. Cost was the major deterrent (59 (51.7%)) to adherence with glaucoma medications. Conclusions. The prevalence of non-adherence with medications among glaucoma patients in Enugu was high. Assisted drug administration was the most significant determinant, while the cost of drugs was a major deterrent to non-adherence with glaucoma medication.

Hibiscus sabdariffa (HS) has been traditionally used as a herbal medicine in Nigeria mainly because of its antihypertensive action. In view of the recent increase in the prevalence of renal failure, we have investigated the effect of HS consumption on renal function in Nigerians with mild to moderate hypertension. A total of 78 newly diagnosed but untreated subjects with mild to moderate hypertension attending the medical outpatients unit of Enugu State University Teaching Hospital (Enugu, Nigeria) were recruited for the study. These subjects were randomly divided into three equally sized groups that received HS or lisinopril (treatment groups) or placebo (control group), once daily for 4 weeks. Indices of renal function (urine volume and creatinine clearance) were measured at baseline and weekly throughout the study period. HS and lisinopril significantly increased (P < 0.001) urine volume compared to placebo, and HS significantly (P < 0.001) increased urine volume more than lisinopril. HS significantly increased (P < 0.001) creatinine clearance compared to placebo whereas lisinopril did not. These results indicate that HS consumption improved indices of renal function in our study population of Nigerians with mild to moderate hypertension.

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The influence of extraction methods: Cold aqueous (CA) hot aqueous (HA) and alcoholic extraction (AE) methods on the hepatotoxic effect of Azadirachta indica bark extract (ABC) was investigated using albino rats. A total of forty eight rats were divided into three groups of sixteen rats equally for the extraction methods. Each group was subdivided into four rats to represent control, low, medium and high doses of the extract. The control group received no extract while the other groups were administered the various concentrations (doses) intraperitoneally twice daily for seven (7) days before they were all sacrificed under light chloroform and used for the analysis. Parameters determined include glucose, cholesterol and triglycerol. Also alkaline phosphatase (ALP), Aspartate amino transferase (AST) and alanine amino transferase (ALP) activities were determined. The result shows that glucose levels decreased from 85.75+2.85 to 65.00+12.05 in high concentration of C.A. Similar decreases were obtained from HA and AE extraction methods. Cholesterol levels also decreased from 111,63+1.02 to 53.75+0.90 in the high concentration CA, and similarly decreased in HA and AE extraction methods. Also triglycerol levels decreased from 66.49+0.95 to 21.02+0.30 in the high concentration of CA, and also decreased respectively in both HA and AE extraction methods. Similarly, the activities of the enzymes decreased in all the extraction methods, and for the different concentrations over the control except for the activities of ALP which increased generally in CA method. This implies that ABE using HA and AE methods in non hepatotoxic while there is possibility of hepatotoxicity of the obstructive type if CA extraction method is used.

Background Amlodipine and hydrochlorothiazide (HCTZ) are commonly prescribed in Nigeria either as a monotherapy or in combination with other drugs. The present study was designed to investigate the antihypertensive efficacy of monotherapy with amlodipine or HCTZ and their effects on electrolyte profile in patients with mild to moderate hypertension. Methods A single-blind randomized clinical study was used; fifty patients newly diagnosed with mild to moderate hypertension (aged 33 to 60 years) were recruited and divided into two groups: amlodipine or hydrochlorothiazide each comprising of 25 subjects. The subjects received 5mg of amlodipine or 25mg of hydrochlorothiazide in their respective group once daily for 4 weeks. Blood pressure, serum and urine electrolytes were measured at baseline and weekly throughout the experiment. Results At the end of follow up, amlodipine reduced systolic and diastolic blood pressure significantly more (p<0.001) than HCTZ. At the end of follow up, blood pressure was reduced to normal in 80% of the subjects in amlodipine group compared to 50% in HCTZ. Amlodipine had no significant effect on electrolyte profile of subjects unlike HCTZ which significantly changed both their serum and urine electrolytes. Conclusions Monotherapy with amlodipine was more effective than HCTZ in black patients with mild to moderate hypertension and in addition maintained electrolyte balance.

Objectives: To identify causes of low vision among the patients in the Eye clinic of University of Nigeria Teaching Hospital (UNTH). Methods: This was a cross-sectional study of all new consecutive low vision patients seen at the eye clinic of University of Nigeria Teaching Hospital-(UNTH) Ituku-Ozalla. All patients with low vision were evaluated by the researcher and the findings entered on a research protocol. Data were analyzed using descriptive statistics to generate frequency and percentage distributions and analytical statistics to test for significance of observed inter-group differences. In all comparisons, statistical significance was indicated by p < 0.05. Results: A total of 197 patients were seen comprising of 120 males and 77 females (M:F = 1.6:1) aged 39.3 ± 22.9 SD years. The main causes of low vision in the study population were glaucoma (36.0%), followed by oculocutaneous albinism (14.7%). The mean presenting distant VA was logMAR 1.1 (95% CI), while the mean near VA is logMar 1.0 (6/60, 20/200). After refraction, the mean distant VA was logMar 1.0, using unpaired t-test, the difference between the distant presenting and refracted VA were not statistically significant. 57.9% had distant VA after optical low vision assessment of logMar 0.9-logMar-0.2 while the mean distant VA was logMar 0.8 which was statistically significant. Near vision after optical assessment improved with a mean of logMar 0.8, which was statistically significant. Conclusion: Glaucoma was the commonest cause of low vision in this study. Optical low vision aids improved the visual functions of majority of the patients in this study.