Disturbance of consciousness caused by dyclonine hydrochloride mucilage: a case report.

BACKGROUND: Dyclonine hydrochloride mucilage is a topical anaesthetic formulated for mucosal surfaces. It is employed frequently for topical anaesthesia of the pharynx prior to endoscopic examinations such as electronic gastroscopy, and few adverse reactions have been reported. This article describes a patient who experienced a transient but severe disturbance of consciousness following oral dyclonine hydrochloride mucilage administration. CASE PRESENTATION: A 75-year-old female presenting with gastrointestinal bleeding was examined by electronic gastroscopy. Six minutes after oral dyclonine hydrochloride mucilage administration, the patient entered a comatose-like state accompanied by loss of limb muscle tone and profuse perspiration. This response was not accompanied by changes in cardiac rhythm, blood pressure, or respiration rate, suggesting an effect on higher brain centres. After ten minutes, the patient's symptoms were alleviated. CONCLUSION: We suggest that sites of dyclonine hydrochloride mucilage use be equipped with appropriate rescue devices for these rare events.

Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan's Gross National Happiness Study, 2015.

OBJECTIVE: Common mental disorders (CMDs) are a major cause of the global burden of disease. Bhutan was the first country in the world to focus on happiness as a state policy; however, little is known about the prevalence and risk factors of CMDs in this setting. We aim to identify socioeconomic, religious, spiritual and health factors associated with symptoms of CMDs. DESIGN AND SETTING: We used data from Bhutan's 2015 Gross National Happiness (GNH) Survey, a multistage, cross-sectional nationwide household survey. Data were analysed using a hierarchical analytical framework and generalised estimating equations. PARTICIPANTS: The GNH Survey included 7041 male and female respondents aged 15 years and above. MEASURES: The 12-item General Health Questionnaire was used to measure symptoms of CMDs. We estimated the prevalence of CMDs using a threshold score of ≥12. RESULTS: The prevalence of CMDs was 29.3% (95% CI 26.8% to 31.8%). Factors associated with symptoms of CMDs were: older age (65+) (ß=1.29, 95% CI 0.57 to 2.00), being female (ß=0.70, 95% CI 0.45 to 0.95), being divorced or widowed (ß=1.55, 95% CI 1.08 to 2.02), illiteracy (ß=0.48, 95% CI 0.21 to 0.74), low income (ß=0.37, 95% CI 0.15 to 0.59), being moderately spiritual (ß=0.61, 95% CI 0.34 to 0.88) or somewhat or not spiritual (ß=0.76, 95% CI 0.28 to 1.23), occasionally considering karma in daily life (ß=0.53, 95% CI 0.29 to 0.77) or never considering karma (ß=0.80, 95% CI 0.26 to 1.34), having poor self-reported health (ß=2.59, 95% CI 2.13 to 3.06) and having a disability (ß=1.01, 95% CI 0.63 to 1.40). CONCLUSIONS: CMDs affect a substantial proportion of the Bhutanese population. Our findings confirm the importance of established socioeconomic risk factors for CMDs, and suggest a potential link between spiritualism and mental health in this setting.

Promoting active transport in a workplace setting: evaluation of a pilot study in Australia.

Promoting active transport is an increasingly important focus of recent health promotion initiatives addressing the major public health concerns of car dependence, decreased levels of physical activity and environmental health. Using active transport that relies less on the use of private cars and more on alternatives such as walking, cycling and public transport has the potential to increase population levels of physical activity and to improve the environment. Over 12 months, a combined social and individualized marketing campaign was delivered to a cohort of randomly selected health service employees (n = 68) working at a health care facility in inner-city Sydney, Australia. Pre- and post-intervention surveys measured changes in mode of transport, awareness of active transport and attitudes towards mode of transport. Following the intervention, we found there was a reduction in the proportion of participants who drove to work 5 days per week and a decrease in trips travelled by car on weekends. In addition, there was high awareness of the intervention amongst participants and their understanding of the concept of active transport improved from 17.6% at baseline to 94.1% at the follow-up survey (p < 0.01). There was also a significant shift in attitudes, which suggested increased positive regard for active transport. Our findings suggest that a combined social and individualized marketing campaign in the workplace setting can increase the use of active transport for the journey to work and trips on weekends. However, before these findings are widely applied, the intervention needs to be tested in a controlled study with a larger sample size.