Current medical research and opinion
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Randomized Controlled Trial Multicenter Study Clinical Trial
The efficacy and tolerability of controlled-release dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hips.
A double-blind, parallel group study was undertaken in general practice to compare the efficacy of and tolerability to controlled-release (CR) dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hip(s). Eighty-six patients were randomly allocated to receive either CR dihydrocodeine (60 mg) tablets (1 tablet twice daily to 2 tablets daily) or combination dextropropoxyphene (32.5 mg)/paracetamol (325 mg) tablets (2 tablets 3-times daily to 2 tablets 4-times daily) for a period of 2 weeks. Patients recorded in a diary card 4 times a day the severity of their pain and each morning whether or not they woke during the night due to pain in their hip(s). ⋯ Tolerance in terms of withdrawals or side-effect profile did not appear to the dosage of each preparation administered. It is concluded that after 2-weeks' treatment CR dihydrocodeine provided superior analgesia to dextropropoxyphene/paracetamol with no difference in side-effects. Furthermore, CR dihydrocodeine has the advantage of twice rather than 3 or 4-times daily dosing.
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Randomized Controlled Trial Clinical Trial
The efficacy of pre-operative controlled-release indomethacin in the treatment of post-operative pain.
A double-blind, placebo-controlled study in patients undergoing lumbar laminectomy was carried out to assess the morphine-sparing effect of a controlled-release indomethacin formulation ('Flexin Continus' tablets, 75 mg). Thirty patients were randomly allocated to receive 1 tablet of active or placebo study medication pre-operatively and their pain scores on visual analogue scale (VAS) and their morphine consumption, delivered by Patient Controlled Analgesia (PCA), were recorded over the 24-hour post-operative period. ⋯ At the 12-hour time point, the difference in morphine consumption approached statistical significance (p = 0.074). It is concluded that the pre-operative administration of controlled-release indomethacin reduces post-operative morphine requirements and significantly reduces VAS pain scores on recovery.
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Randomized Controlled Trial Comparative Study Clinical Trial
A single-blind, randomized study to compare the efficacy of two ear drop preparations ('Audax' and 'Cerumol') in the softening of ear wax.
A parallel group, single-blind, randomized study was carried out in a general practice to compare the effectiveness and tolerability of two ear drop preparations ('Audax' and 'Cerumol') in the softening of ear wax in 50 adult patients with impacted or hardened ear wax. Assessments were made on entry of the amount, colour and consistency of the ear wax, symptoms, and objective hearing. Patients were then allocated at random to receive one or other preparation and instructed to use the drops, morning and evening, for 4 days after which they were reassessed. ⋯ Both treatments were shown to be effective in the softening of ear wax and were well tolerated, there being no significant difference between the two groups in these parameters. However, patients who had abnormal hearing before treatment had a significantly greater improvement in objective hearing after treatment with 'Audax' ear drops compared to those patients treated with 'Cerumol' ear drops. There were no between-treatment differences in either either the physician's or patient's overall assessments of effectiveness.
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Nine patients with Type I diabetes mellitus, diastolic blood pressure of 90 to 100 mmHg and persistent microalbuminuria of greater than or equal to 30 micrograms/min were treated with 50 to 100 mg atenolol daily for 3 years in an uncontrolled pilot study to assess the effect of long-term reduction of blood pressure on microalbuminuria. Treatment with atenolol prevented progression of microalbuminuria with a median (range) urinary albumin excretion rate before treatment of 74 (33 to 196) micrograms/min and 50 (5 to 123) micrograms/min after 3 years of therapy (p less than 0.05). ⋯ Measurements of renal function and diabetic control remained unchanged throughout the study period. These results suggest that early and prolonged use of antihypertensive therapy is beneficial in slowing down progression of microalbuminuria.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of a single occasion treatment of head louse infestation with phenothrin liquid shampoo or a carbaryl lotion.
Fifty subjects with head louse infestation were recruited into a controlled trial to compare a phenothrin liquid shampoo with a carbaryl lotion. Twenty-seven subjects were treated with phenothrin and 23 with carbaryl, each formulation being applied only on a single occasion. Subjects were inspected for evidence of live lice and eggs at 24 hours and 3 to 4 weeks after application of treatment. ⋯ No statistically significant difference in treatment efficacy was observed between the two groups. Fewer side-effects, however, were observed with the phenothrin liquid shampoo than with the carbaryl lotion. These results indicate that, when applied as a single treatment, a phenothrin liquid shampoo was as effective as a carbaryl lotion in eradicating head lice and eggs.