Background:Theoretically, angiotensin II receptor blockers (ARBs) have certain advantages over angiotensin-converting enzyme inhibitors, but the contribution of these advantages to the clinical effect of ARBs is not known.Objective:To compare the efficacy and tolerability of telmisartan with enalapril in patients of essential hypertension.Materials and Methods:Patients of mild to moderate hypertension were randomized to receive either 40 mg of telmisartan or enalapril 10 mg once a day orally for 12 weeks. At each visit, the systolic blood pressure (BP), diastolic BP and heart rate of each patient were recorded. Investigations such as hemogram hemoglobin, total leucocytes count (Hb, TLC), serum creatinine, serum glutamic oxaloacetic transaminase, serum glutamic pyruric transaminase (SGOT, SGPT) random blood sugar and urine examination were performed at baseline and after 12 weeks of the treatment period.Results:The mean reduction in systolic BP in the telmisartan/enalapril group was 26.38 ± 10.98/26.74 ± 8.24 mmHg while the mean reduction in diastolic BP in the telmisartan/enalapril group was 14 ± 2.98/9.71 ± 4.23 mmHg, respectively, at 12 weeks. When the reduction in systolic BP in the two groups was compared, there was no significant difference between the groups (P > 0.05). However, the mean reduction in diastolic BP achieved with telmisartan at 12 weeks was significantly higher (P < 0.001) than that achieved with enalapril after the corresponding period. The overall frequency of adverse-effects was similar. However, in the enalapril group, the incidence of dry cough was higher as compared to that in the telmisartan group (11.43% vs. 0%, respectively; P < 0.05).Conclusion:Telmisartan produces a greater reduction in diastolic BP than enalapril and is free from the adverse-effect of dry cough that is commonly encountered with enalapril.

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A structured close-ended questionnaire based on standard literature 5,6 was used. The questions were formulated to test the ability of nurses to (1) categorize commonly used medical and surgical devices (MSDs) as per modified Spaulding classification 5 (Table 1). (2) Categorize routinely available disinfectants (glutaraldehyde, hydrogen peroxide, ABSTRACT Background: Adequate disinfection and sterilization is crucial to prevent hospital acquired infections, this requires knowledge of various types of disinfectants and of the categories of medical and surgical devices. Nurses play a key role in supervising the use of disinfectants. Hence, they are an important target group for educational interventions for rationalization of disinfectant use. We conducted an educational intervention in nurses, related to rational use of disinfectants. The objective was to evaluate the immediate impact of this intervention on change in knowledge of nurses. Methods: This was a questionnaire-based pre-and post-test cross-sectional study. The questions were formulated to test nurses' ability to (1) categorize commonly used medical and surgical devices (MSDs) (2) categorize disinfectants as high, intermediate and low level disinfectants (3) to evaluate their knowledge about different aspects of disinfectant use. Results of pre and post-test were calculated as a percentage and Z test for difference between proportions was applied to test the statistical significance. Results: A total of 72 nurses filled the pre-test and 70 the post-test. Percentage of correct responders for classification of MSDs improved as follows-critical (77.77% pre-test to 95.71% post-test), semicritical (18.05-54.28%), noncritical (41.66-72.85%). Percentage of correct responders for classification of disinfectants improved from pre-to post-test glutaraldehyde (48.61-88.57%), Hydrogen peroxide (30.55-72.85%), benzalkonium (33.33-58.57%). Identification of chlorine concentration required for cleaning floors improved from 38.88% to 70%. There was a significant improvement seen post-test to items related to different aspects of disinfectant use. Conclusion: A positive immediate impact was observed, but there is a need for continuing education with interventions focused on various aspects of disinfectant use.

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