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Observations: In 100 (100%) cases that were taken for the study 22 cases (22%) showed variations in the bifurcation and branching of the renal arteries was observed. There was an early bifurcation of the renal artery in 10 cases (45.45%). There was an accessory renal artery bilateral in 12 cases (54.54%). Conclusion: Identification of renal vascular variants is important, especially before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm. MDCT angiography is an excellent imaging investigation because it is a fast and non-invasive tool that provides highly accurate and detailed evaluation of normal renal vascular anatomy and variants. The number, size and course of the renal arteries and veins are easily identified by MDCT angiography.

The sympathetic nervous system (SNS) plays an important role in the regulation of blood pressure (BP) homeostasis and cardiac function. Elevated sympathetic activity not only plays a role in the induction of ischemia due to refl ex tachycardia and coronary vasoconstriction, but also correlates with hypertension, insulin resistance and coronary ABSTRACT Background: Increased resting heart rate (HR) has emerged as an independent risk factor in the general population and in patients with hypertension, coronary artery disease, and myocardial infarction. HR is strongly and directly associated with arterial rigidity in hypertensive patients. Nebivolol (N) and Ivabradine (I) were established HR lowering agents. In this study, we have evaluated Nebivolol and Ivabradine on HR and pulse wave velocity in hypertensive patients who were receiving Amlodipine. Methods: A total of 18 hypertensive patients on Amlodipine participated in our study. Nine received Nebivolol and others received Ivabradine. We measured HR, blood pressures (BPs) and carotid-femoral pulse wave velocity (cf PWV-an index of large artery stiffness) non-invasively at baseline and 2 hrs after administration of single oral dose of 5 mg N and 5 mg of I. Results: The mean change in HR (−21.7±7.1 vs. −13.89±7.4 beats/min p=0.03) and cf PWV (−0.27±0.58 vs. −2.31±2.1 m/s p=0.01) was statistically signifi cant after treatment in N and I groups respectively. However, there was no signifi cant change in systolic BP (−17.3±9.1 vs. −15.1±11.1 mmHg p=0.65) and diastolic BP (−3.5±5.0 vs. −8.0±6.4 mmHg p=0.11) after treatment in N and I groups, respectively. Conclusions: Nebivolol is an effective HR lowering agent compared to Ivabradine. However, signifi cant decrease in arterial stiffness was observed with Ivabradine.

The authors examined a 48-year-old man with a history of hypertension (6 years) and a history of erection and ejaculation during cold exposure and confrontation with fear (20 years). Exposing the foot to cold water induced ejaculation in 10 seconds. A variety of antihypertensive medications resulted in control of hypertension, without improvement in ejaculatory dysfunction. Similarly, prazosin controlled the blood pressure, but not the episodes of ejaculation. Treatment with reserpine resulted in gradual reduction in blood pressure and an improvement in ejaculatory dysfunction.

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