Hypertension continues to be an important public health concern because of its associated morbidity, mortality and economic impact on the society. It is a significant risk factor for cardiovascular, cerebrovascular and renal complications. It has been estimated that by 2025, 1.56 billion individuals will have hypertension. The increasing prevalence of hypertension and the continually increasing expense of its treatment influence the prescribing patterns among physicians and compliance to the treatment by the patients. A number of national and international guidelines for the management of hypertension have been published. Since many years ago, diuretics were considered as the first-line drugs for treatment of hypertension therapy; however, the recent guidelines by the Joint National Commission (JNC8 guidelines) recommend both calcium channel blockers as well as angiotensin-converting enzyme inhibitors as first-line drugs, in addition to diuretics. Antihypertensive drug combinations are generally used for effective long-term management and to treat comorbid conditions. This review focuses on the antihypertensive medication utilization, their cost factors, adherence to treatment by patients, and physicians’ adherence to guidelines in prescribing medications in different settings including Indian scenario. The antihypertensive medication prescribing pattern studies help in monitoring, evaluation and necessary modifications to the prescribing habits to achieve rational and cost-effective treatment. Additionally, periodic updating of recommended guidelines and innovative drug formulations, and prescription monitoring studies help in rational use of antihypertensive drugs, which can be tailored to suit the patients' requirements, including those in the developing countries.

Epicardial fat is independently and linearly associated with CAD and its severity.

Mosquitoes have always been a human health threat; the major global health problems caused by them are malaria, dengue fever, yellow fever, and Zika as well as several other vector-borne outbreaks. The major problems in controlling these vectors borne diseases are related to resistance to eradication measures. Different classes of insecticides used for controlling public health have raised the concern of resistant problems with mosquitoes and environmental pollution caused by the control measures. Thus, a search for alternative natural compounds is necessary for solving the insecticidal resistance problem using pesticides in the larval stage of vector development as well as creating a chemical-free environment for a healthy society. Hence, the major focus of this study is to identify the larvicidal mechanisms, metabolite, antioxidants, and chemical compounds and elucidate their structures from C. ternatea flower and to test their efficacies against early 4th instar larvae of Aedes aegypti and Aedes albopictus. Clitoria ternatea flowers were collected from the garden of the Faculty of Medicine in International Quest University, Ipoh, Perak, and thence used for crude extraction. Further on, the metabolite test, antioxidant test, and chromatography techniques were conducted to identify the chemical composition of extracts and their chemical structures were identified using GCMS-QP2010 Ultra (Shimadzu). Next, the extracts were evaluated against the early 4th instar larvae of Aedes mosquito vectors following the WHO procedures for larval bioassays. The larvicidal activity of Clitoria ternatea flower extracts evidently affected the early 4th instar larvae of Aedes mosquito vectors. The highest larvicidal activity was observed against the early 4th instar larvae of Aedes aegypti with the LC50 and LC95 values of 1056 and 2491 mg/L, respectively. Meanwhile, the larvae bioassay test for Aedes albopictus recorded the LC50 and LC95 values of 1425 and 2753 mg/L. Moreover, the results for nontarget organism test on guppy fish, Poecilia reticulata, showed no mortalities with flower extracts at 2500 mg/L, hence posing no toxic effects on fish. In this study, we have found a total of 16 chemical compounds and 6 chemical compounds have been reported to possess direct insecticidal, larvicidal, and pupicidal effects. Six chemicals with insecticidal properties were found to be glycerin, 2-hydroxy-gamma-butyrolactone, neophytadiene, n-hexadecanoic acid, cis-vaccenic acid, and octadecanoic acid with a total of 28.7% efficacy. Clitoria ternatea flower extracts also showed different types of phenols such as anthocyanins, flavonoids, and tannins. Our findings showed that the crude extract of Clitoria ternatea flower bioactive molecules is effective and may be developed as biolarvicide for Aedes mosquito vector control. Furthermore, this study also provided a baseline understanding for future research work in the field of applications of Clitoria ternatea flower extracts for their long-term effects on human health such as a food additive, antioxidant, and cosmetic.

Background: Piperine is isolated from Piper nigrum popularly known as black pepper. Previous studies have demonstrated the beneficial effects of piperine in various health conditions. Additionally, it is a powerful bioenhancer for many drugs. Piperine extract is believed to potentiate the effect of drugs by several folds. The present study is focused on its individual effect on liver function. Materials and methods: A total of 30 CF-1 albino mice obtained from the animal house of faculty of Medicine, Benghazi University, Benghazi, Libya were included in the study. These mice were fed with high cholesterol diet and divided into 2 groups. Twenty mice were administered piperine at a dose of 5mg/kg body weight. Piperine was isolated in Department of Pharmacognosy, Faculty of Pharmacy, Benghazi University, Benghazi and 10 mice were not administered piperine but fed with high fat diet. These mice were anesthetized with ketamine and halothane and blood was drawn from each mouse before the study and after three weeks by cardiocentesis. Serum transaminases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), alkaline phosphatase and total protein were measured by authenticated methods. Results: Serum alanine amino transferase was significantly elevated (p=0.0002) in group A mice after the administration of Piperine extract for three weeks compared to those of group B mice. Serum aspartate amino transferase was elevated significantly (p=0.046) and alkaline phosphatase (p= 0.0001) also was significantly increased after the administration of piperine. Serum total protein (p= 0.011) values were significantly decreased after the use of piperine for three weeks in group A mice. Conclusion: This study showed that there might have been a considerable damage to liver with piperine extract. Further research may be required to prove this damage to liver function.

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