ABSTRACT
Chest discomfort is a common challenge to clinicians; conditions vary from benign to life threatening. The differential diagnosis includes and overlaps cardiovascular, respiratory, gastrointestinal, neuromusculoskeletal & psychiatric problems, all requiring careful history and thorough investigations. However, a significant number of cases remain undiagnosed despite meticulous investigations and thus require empirical therapy (Fagring et al, 2005; Thomas, 2012). The present study was aimed to find the effect of one of the Proton-pump inhibitors (PPIs; Rabeprazole) on patients having non-traumatic, non severe chest discomfort, diagnosis of which could not be confirmed. Forty eight eligible patients were divided into 2 groups: PPI group and placebo group. Before and after 4 weeks of therapy, they were studied with visual analog scale for pain and its frequency, duration and intensity. Rabeprazole treated patients responded much better than the placebo group. Seventy five percent were pain free or had appreciable relief in pain intensity after 4 weeks. In contrast to Rabeprazole group, in placebo group none became pain free; 45 % had marginal relief while 55 % derived no benefit. Proton-pump inhibitors are of value in the treatment of non specific chest discomfort.
ABSTRACT
Accidental Potassium bromate poisoning is uncommon in adults, can have varied manifestations in different patients and can sometimes be deceiving. Potassium bromate white powder and oxidizing agent is used predominantly in bakeries as a maturing agent for flour and as a dough conditioner. It is also occasionally used as a neutralizer in hair kits. This paper deals with nine cases of accidental potassium bromate poisoning working in a bakery. Almost all the patients present with pain abdomen, vomiting and diarrhea. Severe gastritis leading to hematemesis is one of the dreaded complications. Acute renal failure can ensue after 24-48 hours of intake and thus patient must be investigated in this line. All of them ingested potassium bromate powder considering it to be milk powder. Potassium bromate poisoning must be considered as a possibility in every case presenting as acute gastroenteritis like symptoms after intake of bakery products. Strict legislation is required to decrease the risk of such incidents.