Randomized Controlled Clinical Trial on Value of Domperidone in Functional Abdominal Pain in Children.

OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs). METHODS: One hundred children (aged 5-12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment. Primary outcomes defined were cure and patient-reported general improvement. Secondary outcomes were reduction in the severity of abdominal pain and increase in gastric motility. Patients were followed up for 6 months. RESULTS: Eighty-nine (42 in placebo group, 47 in domperidone group) completed the trial at 8 weeks. Seventy-nine completed the 6-month follow-up. When primary outcomes were assessed at 8 weeks, 37 (74%) in the domperidone group and 25 (50%) in the placebo group showed patient-reported general improvement (P = 0.013), whereas no significant difference was observed in cure (22 [44%] vs 14 [28%] P = 0.09). At 6-month follow-up 30 (60%) in the domperidone group and 19 (38%) in the placebo group reported cure (P = 0.028), whereas 44 (88%) in the domperidone group and 33 (66%) in the placebo group showed patient-reported general improvement (P = 0.009). When assessing secondary outcomes at 8 weeks, the domperidone group reported significant reduction in the severity of abdominal pain (54.1% vs 24.7%, P = 0.008) and an increase in the antral motility index (27.5% vs 7.2%, P = 0.029). None of the patients reported intervention-related adverse effects. CONCLUSIONS: Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.

Evaluation of physiology lectures conducted by students: comparison between evaluation by staff and students.

As a peer-assisted learning process, minilectures on physiology were conducted by students. During this process, students lecture to their colleagues in the presence of faculty staff members. These lectures were evaluated by faculty staff and students simultaneously. The aim of this study was to compare feedback from faculty members and students on 66 minilectures conducted by students. Their perception of different qualities of lecture was assessed using a questionnaire. There were significant correlations between students and faculty members for many qualities of the lecture, including the speed of the lecture, retaining attention, clear introduction, and the overall quality of the lecture. However, ratings for gesture, eye contact, language usage, illustration usage, audiovisuals, voice usage, and important points stressed were significantly different between students and faculty members. Multiple regression analysis was performed to assess the degree of effect of different aspects of a lecture on its overall quality. Aspects such as gesture, eye contact, and language usage showed very low ß-values, suggesting a poor contribution of these factors to the overall quality of the lecture for both students and faculty members. The speed of the lecture, retaining attention, and clear introduction were qualities that faculty members and students rated equally, and these were the main contributors to the overall quality of the lecture. Awareness about the possible discrepancy between ratings given by faculty members and students may be important when interpreting the evaluation results of formal lectures by these two groups.

Autonomic functions and gastric motility in children with functional abdominal pain disorders.

BACKGROUND: Abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood. AIM: To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs. METHODS: One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques. RESULTS: The main gastric motility parameters assessed (gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4], and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs (P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain (P < 0.05). Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities (P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone (maladaptive parasympathetic tone) (P < 0.05). CONCLUSION: Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.

IT-based activity in physiology education: an experience from a developing country.

Information technology (IT)-based components are included as active learning activities in medical curricula that have been shown to be more effective than most passive learning activities. In developing countries, these activities are not popular compared with developed countries. In this study, an IT-based assignment was carried out in physiology for undergraduates in Sri Lanka. We assessed certain basic IT capabilities before the assignment and found that the capability of using MS Word, e-mail, and the internet was limited to 68.3%, 62.0%, and 49.2% of students, respectively, with 40.8% of students having some other IT capabilities. We found a considerable variation in IT capabilities among the students, which depended on IT learning at schools and the geographical locations where students came from. The main source of IT knowledge for students was an introductory IT course given in the medical school with the second source being private IT learning centers. Response to the IT-based assignment was very poor. The reasons for poor participation included a lack of time due to parallel subjects, poor IT knowledge, and poor IT resource availability. However, students were willing to have optional IT-based components and were aware that IT knowledge is important for medical students as well as doctors. This study shows the importance of improving IT knowledge in students and the need of improving IT resources in medical schools. With these improvements, physiology education can be enriched with more interactive IT-based learning activities, which help students to acquire knowledge more efficiently and effectively in developing countries like Sri Lanka.

Influence of age, gender, and sidedness on ulnar nerve conduction.

Anatomic variation and susceptibility for injuries depending on gender were described for the ulnar nerve. The aim of this study was to investigate the association between gender and ulnar never motor conductance and the influence of sidedness for this association. Study was conducted as a retrospective study using nerve conduction study data of ulnar nerve of 2,526 patients. Influences of age, gender, and sidedness on ulnar never motor conduction velocity (UMV) were investigated. Regression analysis was conducted to compare the relationship between UMV and age. Regression was significantly higher in males (-0.253 vs. -0.113), suggesting higher influence of age on UMV in males than in females. When analyzing right and left sides separately, influence of age on UMV is higher in males (-0.286 vs. -0.109) only in right side. Multiple regression analysis was done comparing the influence of age, gender, and sidedness on UMV, and it found that the order of influence is gender, age, and sidedness (Beta values 0.153, -0.140, and 0.029). Ulnar nerve motor conductance depends on gender, age, and sidedness. Males are having lower UMV than females. Age-dependant change of UMV is more prominent in males than in females and is more prominent in right hand than in left hand in males.