Carbamazepine and the QTc interval: any association?

Objective: To determine whether carbamazepine monotherapy in epilepsy patients is or is not associated with prolongation of the QTc interval. Methods: This case-control study enrolled 100 consecutive patients with generalized tonic-clonic seizures. Fifty patients were already taking carbamazepine for a variable time, and the rest (n=50) were not on any antiepileptic drug. The QTc interval was calculated after doing a resting 12-lead ECG examination on a single occasion. Results: Of the 50 patients who had received carbamazepine, 11 patients displayed prolongation of their QTc interval, while 8 patients out of the 50 in the control group had QTc interval prolongation after correction for gender; p value =0.49, OR 1.36, 95% CI 0.54-3.29. Conclusion: This study demonstrated no statistically signifi cant association between carbamazepine monotherapy and prolongation of the QTc interval. Carbamazepine does not seem to prolong the QT interval when used as monotherapy for epilepsy. The presence of prolonged QTc interval in such patients should prompt a search for co-factors that prolong this interval, such as multiple medications, electrolytes disturbances, structural heart disease, and congenital long QT interval syndromes.

Time trends of gastro-esophageal reflux disease [GERD] and peptic ulcer disease [PUD] in Iran

Epidemiology of diseases changes over time with changes in socio-economic status, culture and health care systems. Gastroesophageal reflux disease [GERD] and peptic ulcer disease [PUD] are among the diseases whose epidemiology has changed over the past few decades in the west. Studies addressing the trend of GERD and PUD occurrence in Iran are lacking. We aimed to look at the time trends of GERD and PUD in a referral endoscopy clinic in Tehran, Iran. All patients with dyspeptic symptoms who underwent upper GI endoscopy from 1993 to 2005 [inclusive] in a tertiary outpatient GI referral center in Tehran were enrolled. Erosive esophagitis [EE, used as a proxy for GERD as a whole], PUD, rapid urease test [RUT] status and demographic characteristics were recorded from the endoscopy reports according to the year the endoscopy was performed. Over a period of 13 years, 8,029 endoscopic examinations were performed. The most common endoscopic diagnosis was EE that occurred in 4,808 patients [59.8%] followed by duodenal ulcer in 2,188 [27.3%] and gastric ulcer in 88 [1.1%]. Over 13 years [1995-2005], the proportion of EE increased from 14.1% in 1993 to 75.1% in 2005 among dyspeptic patients in this referral clinic. The proportion of each grade of GERD according to the Los Angeles classification was as follows: GERD-A 76.0%, GERD-B 20.9%, GERD-C 2.8% and GERD-D 0.3%. RUT positivity decreased from 71.4% to 9.5% during the study period. This study shows a remarkable increase in EE with a concomitant decrease in PUD and RUT positivity among dyspeptic patients in Tehran over a decade. This change in trend is important for future health care planning

[ survey on the effects of Benzydamine HCL following periodontal surgeries]

Background and aim: periodontal diseases are of the most common problems in oral cavity which frequently require surgery. Some of the patients because of their impossibility to take conventional analgesics due to systemic problems and post-surgical pain and also intolerance toward periodontal pack for one week, refuse surgery. Therefore, it seems advantage use to perform surgery free from such complications. The aim of this study was to investigate the effects of Benzydamine HCL for post-surgical periodontal patients

Materials and Methods: for thirty patients with similar periodontal problems on contralateral sides of the mouth full thickness flap was performed at an interval of SLY weeks. No periodontal pack was used following surgery. Patients were given Benzydamine HCL or a placebo randomly and asked to rinse mouth for a 7-day period every four hours. During this period, a questionnaire on pain was filled by each patient. Plaque and bleeding indices were also evaluated at 0, 1, 3 and 7 days post-surgery. Six weeks later the second surgical procedure was carried out on contralateral part of the mouth and if patients received Benzydamine HCL, now used a placebo and vice versa. Data were analyzed statistically using t-test and variance analysis test

Results: the results from 30 regions which were randomly divided into Benzydamine HCL and placebo groups [n=15] showed that all Benzydamine samples suffered from a mild pain on first day and were without pain from the 2nd to 7th day. However, all placebo samples suffered from a moderate pain on first day and a mild pain from the 2nd to 7th day. Bleeding index, in Benzydamine group, on 3rd and 7th days were 0.73 +/- 0.08 and 0.62 +/- 0.09, respectively which were less than that of placebo group [2.4+/-0.2]. t.test statistical analysis revealed significant difference between two groups [P<0.001]. Plaque index, in Benzydamine group, on 3rd and 7th days were. 1.43 +/- 0.12 and 1.3 +/- 0.18, respectively and those of placebo were 2.06 +/- 0.1 and 2.2 +/- 0.28 that statistically significant differences were found on both days between two groups by t-test [P<0.001]

Conclusion: according to the findings of this research, using Benzydamine HCL mouth rinse 15% post periodontal surgeries can be effective on pain reduction, gingival bleeding and plaque control and may be substituted for periodontal pack and analgesics such as asprine, acetaminophene and Ibuoprophene