Globus pharyngeus is a common benign condition with controversial management. Patients with globus pharyngeus are usually investigated to exclude the possibility of upper aerodiagestive malignancies. There is a great debate about the role of barium swallow in the management of this condition. Review of 1,145 barium swallow repourts of patients presented with globus pharyngeus between 1999 and 2004 has failed to diagnose any patient with pharyngeal or oesophageal cancer. We conclude that barium swallow should not be requested systematically as part of management of globus pharyngeus patients. This approach will reduce the cost and radiation effect of unnecessary investigations.
The operation of septoplasty is often given to junior surgeons to perform and dismissed as a simple procedure. This can lead to unsatisfactory results with unnecessary morbidity for the patient and disillusionment for the surgeon. Trainee surgeons feel that the operation of septoplasty is poorly taught. Some common problems encountered during septal surgery are described and a variety of surgical solutions are offered.
Key words: Nasal Septum; Surgical Procedures, Operative IntroductionThe septoplasty technique is on the curriculum to be taught and undertaken in the UK in the rst year as a specialist registrar in otolaryngology and it is often dismissed as a simple procedure. According to trainees septoplasty is poorly taught and should not be considered as a simple procedure in which one operation ts all.1 The competent septal surgeon should have a range of techniques at their disposal to get the best operative result.Previous authors have described their operative technique 2-5 inferring that only one approach is necessary for all septal deviations. Others have tried to classify all septal deviations and suggest operative strategies to apply to these cases.
Calcium influx into sickle cells, with consequential activation of the Ca2(+)-activated K+ efflux (Gardos) channel, is a potential cause of cellular dehydration and loss of deformability. Bepridil, a recently described inhibitor of the Gardos channel, was found at pharmacological concentration (1 mumol/l) to inhibit significantly (P less than 0.01) the loss of deformability when sickle cells were subjected to cycles of oxygenation-deoxygenation for 15 h at 37 degrees C. Bepridil also inhibited significantly (P less than 0.005) the formation of irreversibly sickled cells. Drugs that preserve the K+ and therefore water content of erythrocytes are of potential value for hydrotherapy of sickle cell disease.
We report on a case of unilateral tinnitus after a short course of low-dose amitriptyline for neuralgic foot pain. This has been described in the literature previously at much higher doses and is associated with prolonged administration; we present our case with a review of the current literature in-order to raise awareness of this possible complication of anti-depressant therapy. We also propose a novel hypothesis for the pharmacological basis of amitriptyline-induced tinnitus.
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