phenylephrine-hydrochloride and Gastritis

The optimal topical anesthesia regimen for unsedated transnasal endoscopy is unknown. The addition of a nasal decongestant, such as xylometazoline (X), to a topical anesthestic may improve patient comfort.. To determine the effectiveness of lidocaine (L) versus L plus X (LX) for anesthesia in unsedated transnasal endoscopy.. Consecutive participants of the Aklavik Helicobacter pylori project were prospectively randomly assigned to receive LX or L for unsedated transnasal 4.9 mm ultrathin endoscopy. The primary outcome was overall procedure discomfort on a validated 10-point visual analogue scale (1 = no discomfort, 10 = severe discomfort). Secondary outcomes included pain, endoscope insertion difficulty, gagging, adverse events and encounter times. Results were presented as mean +/- SD, difference in mean, 95% CI.. A total of 181 patients were randomly assigned to receive LX (n=94) and L (n=87). Baseline characteristics between the two groups were similar (mean age 40 years, 59% women). Overall, patient procedural discomfort with LX and L were 4.2+/-2.4 versus 3.9+/-2.1, respectively (0.29; 95% CI -0.39 to 0.96). Transnasal insertion difficulty was significantly lower with LX than with L (2.4+/-2.1 versus 3.2+/-2.8, respectively [-0.80; 95% CI -1.54 to -0.06]). Compared with L, the use of LX was associated with significantly less time needed to apply anesthesia (2.4+/-1.8 min versus 3.5+/-2.2 min, respectively [-1.10; 95% CI -1.71 min to -0.50 min]) and less time for insertion (3.2+/-1.8 min versus 3.9+/-2.2 min, respectively [-0.70 min; 95% CI -1.30 min to -0.10 min]). Epistaxis was rare but occurred less frequently with LX (1.1%) than with L (4.6%) (P=0.19).. LX did not improve patient comfort for transnasal endoscopy compared with L alone. However, LX was associated with less difficulty with endoscope transnasal insertion and reduced insertion time. Further studies on the optimal regimen and dosing of anesthesia are required.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Child; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Female; Follow-Up Studies; Gastritis; Helicobacter Infections; Humans; Imidazoles; Lidocaine; Male; Middle Aged; Nasal Decongestants; Nose; Pain Management; Pain Measurement; Retrospective Studies; Treatment Outcome; Young Adult

Swine-origin influenza A H1N1 (S-OIV) has not been systematically studied in Indian children.. To study the clinical characteristics, morbidity and mortality pattern in children with S-OIV infection.. This prospective study was conducted during the 'containment phase' of the pandemic in New Delhi from 10 June to 5 August 2009. All children suspected of being infected by S-OIV were admitted to the isolation wards and clinically evaluated according to WHO guidelines. Nasal and throat swabs were collected immediately for real-time reverse transcriptase polymerase chain reaction (RT-PCR). Haemoglobin, total leucocyte and platelet counts and chest radiography were undertaken in all patients. Those who tested positive for S-OIV infection were treated with oseltamivir for 5 days in isolation wards.. Thirty-seven children fulfilled the inclusion criteria. Twenty-one tested positive for S-OIV by RT-PCR and 16 tested negative. Comparison of the clinical characteristics of the two groups showed that duration of cough was longer in children with S-OIV (p<0.03). Total leucocyte and lymphocyte counts were significantly less in the S-OIV group (p<0.001 and , 0.02, respectively). Oseltamivir-related gastritis was seen in 38% of children. All improved and were discharged.. S-OIV infection in Indian children had features similar to those of seasonal influenza. Lymphopenia is an important feature of S-OIV.

Topics: Animals; Child; Child, Preschool; Female; Gastritis; Humans; India; Infant; Influenza A Virus, H1N1 Subtype; Influenza, Human; Leukocyte Count; Lymphopenia; Male; Nose; Oseltamivir; Pharynx; Radiography, Thoracic; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral

Topics: Adult; Biopsy; Chronic Disease; Esophagoscopy; Gastritis; Gastroesophageal Reflux; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Male; Nose; Polyps; Vocal Cords

Topics: Animals; Cattle; Female; Foreign Bodies; Gastritis; Intubation, Gastrointestinal; Nasal Bone; Nasal Cavity; Nose; Reticulum