RESUMEN
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.
RESUMEN
Fenofibrate is one of the commonest drug to treat hyperlipidemia in adults (Marshall et al, 2011). However, apart from its hypolipidemic action, it also has the ability to induce bilirubin conjugation. The present study was aimed to find its effect on uncomplicated neonatal hyperbilirubinemia. The study was conducted on 40 normal term newborns who were admitted for uncomplicated jaundice at R.D. Gardi Medical College & Hospital, Ujjain from March 2010 to October 2010. The data included: age, sex, weight, serum bilirubin level, and duration of hospitalization. All newborns enrolled in this study, received phototherapy. The cases were divided into two groups viz. Fenofibrate group (B) consisting of 14 boys (70%) and 6 girls (30%) and a control group (A) with 11boys (55%) and 9 girls (45%). There were no statistical overt differences between the two groups regarding sex distribution, age, weight and total serum bilirubin level at the time of admission. Mean values for total serum bilirubin in Fenofibrate group at 12, 24, 36, and 48 hours after starting of phototherapy were significantly lower than those for control group (p<0.00l). The mean time needed for phototherapy was also shorter in Group B than Group A. Fenofibrate appears to be an effective drug for neonatal hyperbilirubinemia. This decreases the duration of phototherapy and thus reduces the length of hospital stay.