Effectiveness of oral and intravenous PPI for peptic ulcer re-bleeding and management after endoscopic therapy.

To explain the effectiveness of different oral and intravenous (IV) Proton Pump Inhibitors (PPI) used in the management of peptic ulcer re-bleeding after successful endoscopic intervention. This article offers the summarization of various articles on PPI which are published in a well-known journals. All the articles used the same method in the management of peptic ulcer re-bleeding. Rockall risk scoring system were used for grading the rate of the bleeding. Pubmed and Embase was used to identify the related articles that assessed the efficacy of PPI and found Six articles matched our criteria. All the results where P <0.05 where considered significant for writing this review article. Neither any alterations or modifications nor any softwares were used in this article. All the results and conclusions were briefed and summarized carefully after a through discussion of the articles included in our review.

Efficacy and safety of Duloxetine compared with placebo for diabetic neuropathy pain: meta-analysis.

Background: Duloxetine is relatively considered as a treatment for diabetic neuropathy pain due it is balanced and potent reuptake inhibitor of both serotonin and nor epinephrine where these neurotransmitters play a great in pain inhibition. Materials and Methods: We searched DLX related articles in Pubmed, Cochrane and Embase from 2005 to 2010. 158 articles were found after through search out of which 68 articles were case reports, reviews and meta-analysis, 40 studies were clinical trials but not efficient data was available, 45 studies were RCTs but not related to our topic. Only 5 RCTs included after exclusion. We then performed the meta-analysis of the studies which met our eligibility criteria we performed fixed effect model network meta-analysis to analyze the efficacy of DLX compare to placebo. We chose diabetic neuropathy duration, diabetes mellitus duration, types of diabetes and DLX with regard to MNSI scale. Results: 5 published RCTs were included in this meta-analysis no significant difference observed for DLX and DND [(SD mean difference 0.22 (95%CI -0.16 to 0.60); P=0.25)] , on diabetes mellitus duration for HbA1c and fasting blood glucose (FBG) [(SD mean difference -0.00 (95%CI-0.087 to 0.87); P=1.00)] and on types of diabetes[(COR 1.00 (95% CI 0.73 to 1.38; P=0.98)] and [(OR 1.00 (95% CI 0.72 to 1.37); P=0.98)] .DLX shown to have significant efficacious compared to placebo for MNSI (95% CI -0.37 to – 0.03); P=0.02)]. Conclusion: In the fixed effect model analyses of DLX, showed similar efficacy to placebo for efficacy parameters, except on MNSI scale but not clinically relevant.