Gastric Motility Following Ingestion of a Solid Meal in a Cohort of Adult Asthmatics

BACKGROUND/AIMS: Asthmatics have abnormal esophageal motility and increased prevalence of gastroesophageal reflux disease (GERD). The contribution of gastric motility is less studied. We studied gastric myoelectrical activity, gastric emptying (GE) and their association with GERD symptoms and vagal function in adult asthmatics. METHODS: Thirty mild, stable asthmatics and 30 healthy controls underwent real-time ultrasonography and 1 hour pre- and post-prandial cutaneous electrogastrography, following a test meal (480 kcal, 60% carbohydrate, 20% protein, 20% fat and 200 mL water). The percentage of normal slow waves and arrhythmias, dominant frequency and power, frequency of antral contractions, gastric emptying rate (GER) and antral motility index (MI) was calculated. Twenty-seven asthmatics underwent gastroscopy and in all subjects GERD symptoms were assessed by a validated questionnaire. Vagal function parameters were correlated with gastric motility parameters. RESULTS: The asthmatics (37% male; 34.8 +/- 8.4 years) and controls (50% male; 30.9 +/- 7.7 years) were comparable. None had endoscopic gastric pathological changes. Twenty asthmatics described GERD symptoms. Twenty-two (73.3%) asthmatics showed a hypervagal response. Compared to controls, asthmatics had delayed GER and lower MI, lower percentage of normal gastric slow waves, more gastric dysrythmias and failed to increase the post-prandial dominant power. There was no correlation of GE and cutaneous electrogastrography parameters with presence of GERD symptoms or with vagal function. CONCLUSIONS: Asthmatics showed abnormal gastric myoelectrical activity, delayed GE and antral hypomotility in response to a solid meal compared to controls. There was no association with vagal function or GERD symptom status.

Radiological changes of the spine in patients with chronic low backache

To determine the association between causes such as disc space narrowing, vertebral osteophytes and spondylolisthesis with chronic low backache among Sri Lankan adults. A case control study was done at the Teaching hospital Ragama and Rehabilitation hospital Ragama Sri Lanka. Postero- anterior and lateral radiographs of the lumbo- sacral spine of a hundred and thirty cases and a hundred and thirty three controls were studied. The cases and controls were matched for age and sex. All radiographs were read by two radiologists working independently for the presence of verebral osteophytes, spondylolisthesis and disc space narrowing. The results were analysed by applying chi squared test for bivariate associations and logistic regression for multivariate associations. The age range of the study subjects was 18-82 years. Mean [SD] age for cases was 49.3 years [15 years]; Mean [SD] age for controls was 51.4 years [17 years]. There were 81 [62.3%] females with low backache and 82 [61.7%] females without low backache. Disc space narrowing was present in 15% of cases and 2% of controls. A person with disc space narrowing had a 7 times greater chance of developing low backache compared to a person without disc space narrowing [OR = 6.8, P= 0.008]. Vertebral osteophytes were present in 72% of cases and 64% of controls. Spondylolisthesis was present in 8% of cases and 7% of controls. Vertebral osteophytes and spondylolisthesis did not have a significant association with low backache. Among the radiological features of the lumbar spine, disc space narrowing was the only feature with a significant association with low backache

Risk factors for chronich low backache in adult Sri Lanken females

To determine the risk factors for chronic low backache among adult Sri Lankan females. A case control study was done at Teaching Hospital Ragama and Rehabilitation Hospital Ragama. Three hundred and seven patients with chronic low backache [cases] and three hundred and twenty one people without backache [controls] were interviewed using a pretested structured interviewer administered questionnaire. The questionnaire had questions concerning demographic, social and risk factors for low backache. The cases and controls were matched for age. The age range of study subjects was 18-90 years. Mean [Standard Deviation [SD]] age for cases was 50.2 years [15.2 years]; Mean [SD] age for controls was 49.4 years [16.3 years]. Poor posture activities, five days a week [OR = 62], exercise < once a week [OR = 27], positive family history of low backache [OR = 14], education to less than sixth grade [OR = 4], Body Mass Index [BMI] >25 [OR = 2] and BMI <20 [OR =4] were significant independent risk factors for chronic low backache. Parity did not have a significant association with chronic low backache. In addition to the type of activity, the frequency of activities done for a week is also an important factor in the development of low backache. High BMI and low BMI are both risk factors for low backache. Participating in regular exercise, having a normal BMI and a higher level of education is important in preventing low backache