The cardiovascular and central nervous system effects of the kappa opioid receptor agonist U-62066E were investigated in ten normal male subjects who received U-62066E or placebo with low or high dose naloxone in a randomized, double blind study. Blood pressure and heart rate in the supine and standing position, plasma adrenaline and noradrenaline, regional Doppler blood velocity indices and psychometric assessments were recorded for 1.25 h before and 6 h following injection. U-62066E caused sedation and dysphoria but no euphoria. Plasma noradrenaline was increased by U62066E when compared with basal levels. This action of U62066E was prevented by high but not low dose naloxone. U-62066E had no significant effect on blood pressure, heart rate or regional blood flow indices in the vessels studied and no effect on plasma adrenaline levels. Since U62066E at a dose known to have marked kappa effects was not found to influence cardiovascular indices our results do not support a major role for kappa opioids in the control of the circulation. However, U62066E may influence noradrenaline release or clearance and cause sedation and psychotomimetic effects.

No abstract

Reproducibility of Doppler blood velocity waveform measurements in external and internal carotid, middle cerebral, and brachial arteries and ascending aorta was determined in 8 normal male volunteers twice daily on three occasions each separated by two or more weeks. Measurements were made in supine and standing positions at rest and after taking glyceryl trinitrate and in the supine position after performing a standardized exercise test. The Doppler blood flow waveform indices showed a between days coefficient of variation of less than 15% both for baseline measurements and during haemodynamic change induced by exercise or glyceryl trinitrate. We conclude that Doppler blood velocity waveform measurement in different vascular beds is reproducible at baseline and when the cardiovascular system is interrupted pharmacologically or physiologically.

Objectives: To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania. Methods: In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns in the hospitals through observation and checking the treatment files. Results: Forty nine percent were males while 50.5% were females. Most of the children (54.9%) were aged between 1-2 years. 78.4 % had scalds while 21.6 % had flame burns. No children were found to have burns caused by chemicals or electricity. Most of the burns (97.5%) occurred accidentally, although some (2.5%) were intentional. 68.6 % of these burn injuries occurred in the kitchen. Immediately after burn 87.3% of the children had first aid applied on their wounds while 12.7% didn't apply anything. Of the agents used, honey was the most used (32.8%) followed by cold water (16.7%). The source of knowledge on these agents was from relatives and friends (72.5%), schools (7%), media (6%) and medical personnel (14%). The study further revealed that analgesics, intravenous fluids, antiseptics and antibiotics were the drugs used for treatment of burns in the hospital and that there was no specialized unit for burns in the hospitals. Conclusions: Causes of childhood burns are largely preventable requiring active social/medical education and public enlighten campaigns on the various methods of prevention. The government to see to it that hospitals have specialized units for managing burn cases and also the socio-economic status of its people be improved.

Antihypertensive agents are used to prevent morbidity and mortality related to hypertension. Prescribing patterns and the cost of some antihypertensive were studied for 600 patients attending medical clinics in four private hospitals in Dar es Salaam using the WHO drug use indicator forms. The average number of drugs per prescription ranged from 1.9 to 4.2 while that of antihypertensives varied from 1.3 to 2.1. About 50 % of the prescriptions contained 2 to 3 drugs. The most frequently prescribed antihypertensives were diuretics (41 %), β-blockers (28.5 %), calcium channel blockers (19.8 %), hydralazine/losartan (18.5 %) and angiotensin converting enzyme inhibitors (11.5 %). Antihypertensives prescribed as monotherapy included atenolol (23.2 %), bendrofluazide (22 %), frusemide (19 %), hydralazine (11.2 %), nifedipine (9.8 %), amlodipine (9.5 %) and enalapril (9.3 %). Among the combination therapy drugs were angiotensin converting enzyme inhibitor+diuretic (7 %), β-blocker+diuretic (4 %), calcium channel blocker+losartan (2.3 %), β-blocker+angiotensin converting enzyme inhibitor (2.2 %), calcium channel blocker+angiotensin converting enzyme inhibitor (1.8 %) and diuretic+hydralazine (1.7 %). The cost of nifedipine, bendrofluazide and frusemide was about five to six times higher in the private hospitals than at the government owned medical stores department. This study reveals a need for continuing education and standard treatment guidelines for rational prescribing of antihypertensive drugs.