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Home > A Randomised Comparative Clinical Trial of Prokinetic Agents and Proton Pump Inhibitors in H. Pylori Negative Non-Ulcer Dyspepsia

A Randomised Comparative Clinical Trial of Prokinetic Agents and Proton Pump Inhibitors in H. Pylori Negative Non-Ulcer Dyspepsia

Thesis Info

Author

Ngunga, Mzee

Department

Internal Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2008

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728032305

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Aim: To compare the efficacy of prokinetic agents and proton pump inhibitors in symptom relief of patients with non-ulcer dyspepsia. Design: Comparative prospective single blind clinical trial. Patients and setting: Fifty four cases of non-ulcer dyspepsia in whom H. pylori has been eradicated were seen in the specialist gastroenterology clinic of a tertiary care hospital. Methodology: Patients with dyspepsia and negative endoscopy for peptic ulcer disease, gastro-oesophageal reflux disease, hiatus hernia and upper gastrointestinal malignancy in whom H pylori has been eradicated but still had dyspepsia were assessed and scored using the modified Glasgow dyspepsia severity score (GDSS) at baseline. They were then randomized to receive domperidone or oesomeprazole for three months and the GDSS evaluated monthly over a three month period. Results: Twenty eight patients were randomized to receive domperidone and 27 patients received oesomeprazole. All the patients were evaluated in the first month, 96% in the second month and 87% in third month. The mean GDSS at baseline was 4.68±1.49 for domperidone and 5.0±2.06 for oesomeprazole p=0.59. The rank of the scores at baseline was 5 for domperidone and 5 for oesomeprazole. There were no significant differences between the scores for domperidone and oesomeprazole using Mann Whitney analysis. The percentage of patients who scored less than 1 on the modified GDSS at one month was 29.2% for domperidone and 33% for oesomeprazole, p=0.741; at two months 43.5% for domperidone and 30.8% for oesomeprazole, p=0.357; and at three months 54.5% for domperidone and 40.9% for oesomeprazole, p=0.365. The odds of improving while on domperidone as compared to oesomeprazole was 0.824, 95% CI 0.251-2.700 in the first month, 1.731, 95% CI 0.536-5.587 in the second month and 1.733 95% CI 0.525-5.723 in the third month. Conclusion: Domperidone and oesomeprazole are equiefficacious in relieving dyspepsia symptoms amongst H. pylori negative non-ulcer dyspepsia patients when given continuously for three months.
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کلرکوں کا غیر منصفانہ رویہ

کلرکوں کا غیر منصفانہ رویہ

                مصنف نے ناول میں ایسے کلرکوں کا ذکر کیا ہے جو سالہاسال سیٹ پر براجمان رہتے ہیں اور کام بھی کوئی نہیں کرتے۔ ولیم ایسے کلرکوں کو سخت ناپسند کرتا تھا اور بات پہ بات وہ اپنے کلرک نجیب شاہ کو اس کے حلیہ کے بارے میں آگاہ کرتا رہتاتھا۔ مگر نجیب شاہ پہ اس کا کوئی اثر نہ تھا۔ولیم کا خیال تھا کہ شاید پندرہ سال کے بعد تمام کلرک ایک جیسے ہی دکھنے لگتے ہیں۔مصنف نے دونوں کرداروں کے ذریعے کلرکوں کا طریقہ کار بتایا ہے۔ ان کا رہن ،سہن آدھے سر سے گنجے پیٹ ضرورت سے زیادہ باہر جو مسلسل بیٹھے رہنے کی وجہ سے باہر نکل آیا ہوا تھا، عینک کے شیشے موٹے موٹے جو کہ کبھی صاف بھی نہیں کرتے  یا پھر سر کا تیل عینک کے شیشوں کا دھندلائے رکھتا ہے۔یاکچھ اس طرح سے مصنف بات کو رخ دیتے ہیں کہ کلرک چاہتا ہے کہ عینک صاف نہ ہونا ہی بہتر ہے۔ بے رونق چہرہ ایک تو ایماندار نہ ہونا اور دوسرا چہرہ مسلسل استرے کے استعمال سے اس قدر سخت کہ کراہت کا احساس ہوتا ہے اور سب سے زیادہ کراہت کا احساس تب ہوتا ہے جب ناک کے بال بھی نتھوں سے باہر جھانک رہے ہوتے ہیں۔کلرک دیہی علاقوں میں یہ عہدہ سرکاری ملازمین کی نچلی سطح  پر ہوتا ہے۔اگر برطانوی حکومت کی بات کی جائے تو انھیں  ولیج افسر کہا جاتا تھااور یہ انتہائی با اثر ہوتے تھے کہ تاریخ میں یہ لوگ حکومت کے لیے کان اور آنکھ کا کام کرتے تھے۔دیہات میں زمینی کاروائی اور دیکھ بھال والا ہوتا ہے۔ماضی میں بھی یہ لوگ اتنے با اثر رہے ہیں ،موجودہ صورتحال میں بھی انہیں زیادہ اثرورسوخ مل گیا ہے اور یہ لوگوں کا ایسے فائدہ اٹھاتے...

Performance of Mansabdari System under the Successors of Emperor Jalal-Ud-Din Muhammad Akbar

The aim of this paper is to analyze the performance of mansabdari system under the successors of Emperor Jalaluddin Muhammad Akbar. The paper is focused on the mansabdari system which was developed and strengthened during the reign of Akbar. It can be argued that the mansabdari was an integrated system of efficient and loyal servants on the disposal of Akbar for the large expansion of his empire. The successors of Akbar tried to capture the spirit of Akbar’s age and reign in all respects but without much success. The system remained intact with central authority during Akbar’s days. The paper indicates that after the death of Akbar, the mansabdars started defying the authority of governors as well as the successors of Akbar. In this research attempt the performance of mansabdari system under the successors of Akbar i.e. Jahangir, Shah Jahan and Aurangzeb will be analyzed.

اصول فقھ میں مسالک فقپیھ کے مشترکات: تقابلی جائز ھ ادلھ اجتہاد کے تناظر میں

The purpose of this study is to investigate how different Islamic schools of thought interpret and derive basic principles in Islamic jurisprudence. It is believed that the Muslims set the principles of Islamic jurisprudence soon after the demise of the Prophet (s.a.w.w) of Islam. This branch of knowledge is actually a superb fusion of reasoning and imitation. It is the study of the arguments through which Islamic Sharia is interpreted and Islamic legislation is achieved. Most often, the debates involve doctrinal arguments, and all the existing Islamic schools of thought agree on the basic principles through which certain laws are derived from those debates. All the Islamic schools of thought agree that Qur’an is the final authority, and it is the Qur’an that provides the initial argument whenever some issue arises. Thus the Qur’an is the first and foremost source to provide an answer to any issue. However, the Hambli scholars ascribe authority to the Qura’an and the Sunnah, without making a clear distinction in order or rank between the two. The Sunnah is the second source for deriving doctrinal principles. All Islamic schools of thought agree that the Sunnah is an important and basic source for deriving the Sharia principles. The Sharia can be divided into two kinds: the first deals with the steady and gradual reporting which, according to every school of thought, adds to argumentative knowledge, and hence stands for authority in Islamic jurisprudence. The second kind involves personal reporting which depends on personal character for determining its truth-value. However, every school of thought takes it as authority once its truth-value is verified. For Hanfi school of thought, certain other conditions besides personal character are required in order to accept the personal reporting. The third most important source for deriving principles in Islamic jurisprudence is the community consensus. Every school of thought accepts the authority of the general consensus. Although most of the schools of thought agree on the authority of absolute consensus, the Malkis also take community consensus as an authority, i.e., if the community in Madina arrive at a consensus on some issue, it would be accepted as the authority. On the other hand, according to the Ja’fri school of thought, every consensus has attained authority with a ma’soom’s opinion in its favor. For the majority Ummah, reasoning is also regarded as authority for the derivation of the Sharia principles. According to Imam Ibne Hazam, logical reasoning is possible, but it is not recognized by the Sharia. On the other hand, the Ja’fri school of thought accepts the authority of both the mansoosul-illat reasoning and the awaliyat reasoning. As for the authority of istashab, all the Muslim states accept and set it as a precedence to implement the state laws. The Hanfis believe that only an accepted right can be explored and verified through istashab, and not a new one. All these are the basic principles that serve as authority in the Islamic jurisprudence. Every Islamic school of thought employs them for the interpretation and implementation of the Sharia. Assessment is an integral part of the education system everywhere in the world whereas education in Pakistan is provincial subject according to the constitution. There are certain organizations responsible for the assessment of the student's achievement like Board of Intermediate and Secondary Education (BISE) and National testing Service in Pakistan (NTS). The comparative study of these organizations was carried out keeping in view the different objectives as: a.) To analyze the evaluation system of Boards of Intermediate and Secondary Education and National Testing Service with reference to content validity. b.) To evaluate the Boards of Intermediate and Secondary Education and National Testing Service with reference to construct validity. c.) To determine the relevance with reference to chronology and psychological considerations. d.) To analyze the subjective type of evaluation. e.) To analyze the objective type of evaluation. f.) To evaluate the efficiency in the area of control and conduct. g.) To analyze the system of the practical examination. h.) To explore the area feedback and research. Two questionnaires were prepared using the techniques of comparative assessment and both the systems were assessed through the respondents with same criterion applied at the same time. The sample of 500 students was randomly selected with 100 teachers from BISE Rawalpindi. All the students who appeared in NTS and Board of Intermediate and Secondary Education Examination at the F-Sc level constituted the population of the study with teachers of the respective area. The findings gave a clear insight about the efficiency and the areas of improvements in the systems. NTS was responded as more reliable system as compare to Board of Intermediate and Secondary Education with considerable improvements necessary for the future.