QJM : monthly journal of the Association of Physicians
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Randomized Controlled Trial Clinical Trial
Divalproex sodium in the management of post-herpetic neuralgia: a randomized double-blind placebo-controlled study.
Post-herpetic neuralgia is difficult to treat. Divalproex sodium (valproic acid and sodium valproate in molar ratio 1:1) has been used successfully in the management of various painful neuropathies. ⋯ Divalproex sodium provides significant pain relief in patients of post-herpetic neuralgia, with very little incidence of adverse reactions. These data provide a basis for longer trials in a larger group of patients.
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Randomized Controlled Trial Clinical Trial
Management of tuberculous constrictive pericarditis and tuberculous pericardial effusion in Transkei: results at 10 years follow-up.
Tuberculous pericarditis is common in Transkei (Eastern Cape). Two randomized trials showed benefits at two years for prednisolone in patients with constrictive pericarditis, and open drainage plus prednisolone in patients with pericardial effusion. ⋯ In the absence of a clear contraindication, a corticosteroid should be used in addition to antituberculosis chemotherapy in the management of patients with tuberculous pericarditis.
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Randomized Controlled Trial Clinical Trial
Sodium valproate for painful diabetic neuropathy: a randomized double-blind placebo-controlled study.
Various drugs are effective in the management of painful diabetic neuropathy, but none is completely satisfactory. We previously found sodium valproate to be effective and safe in a short-term study. ⋯ Sodium valproate is well-tolerated, and provides significant subjective improvement in painful diabetic neuropathy.
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Randomized Controlled Trial Clinical Trial
Clinical predictors of acute coronary syndromes in patients with undifferentiated chest pain.
Patients with acute, undifferentiated chest pain present a frequent diagnostic challenge to clinicians. Clinical features are often used to determine which patients may have acute coronary syndrome (ACS). ⋯ In addition to previously recognized predictors of ACS, it appears that indigestion or burning type pain predicts ACS in patients attending the emergency department with acute, undifferentiated chest pain. Diagnosis of acute 'gastro-oesophageal' chest pain should be avoided in this setting.
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Randomized Controlled Trial Clinical Trial
A pilot study of N-acetylcysteine as adjunctive therapy for severe malaria.
The case fatality rate of severe malaria remains unacceptably high. N-acetylcysteine (NAC) is a safe compound that inhibits tumour necrosis factor (TNF) and impedes cytoadherence, both of which have been implicated in the pathogenesis of malaria complications. ⋯ NAC's mechanism of action in malaria is unclear, since it did not markedly alter plasma cytokine profiles. Trials of NAC adjunctive therapy for complicated malaria, with mortality as an endpoint, appear to be warranted.