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Objective: i) To compare the efficacy of mebeverine, mefenamic acid and placebo in relieving the symptoms of primary dysmenorrhoea. ii) To compare the incidence of concurrent effects during treatment with mebeverine, mefenamic acid and placebo., Design: Double-blind, prospectively randomised, three-way crossover study of mebeverine, mefenamic acid and placebo during three consecutive menstrual cycles., Setting: University health centres in the UK., Patients: Sixty-four females suffering from primary dysmenorrhoea who experienced pain during every menstrual cycle., Intervention: Dosage was two capsules, three times daily, of mebeverine, mefenamic acid or placebo. Each mebeverine capsule contained 135 mg mebeverine hydrochloride, and each mefenamic acid capsule contained 250 mg mefenamic acid. Paracetamol (up to 2 x 500 mg) was permitted, if required, as rescue analgesia., Measurements and Results: Details of pain severity, nausea, abdominal bloating and disruption to daily activities were recorded by means of clinician assessments and patient diaries. Patients indicated their treatment preference after three cycles. Mebeverine and mefenamic acid were superior to placebo in reducing pain severity (p less than 0.01 and p less than 0.02 respectively), and mefenamic acid reduced the level of disruption to normal activities (p less than 0.01). The number of concurrent effects reported was five during treatment with mefenamic acid and one each during treatment with placebo and mebeverine., Conclusions: Mebeverine and mefenamic acid are effective in relieving symptoms of dysmenorrhoea.

In a double-blind study the analgesic efficacy and acceptability of meptazinol 200 mg was compared with placebo in patients suffering from acute or chronic pain. Patients were randomly allocated to receive either 200 mg of meptazinol or one tablet of placebo 4 to 6 hourly over a 14-day period. Clinical evaluations were made by the physician at baseline and again at the end of the study. The patients made daily recordings of pain using a visual analogue scale. The results showed that meptazinol was a more effective and acceptable analgesic than placebo. There was no significant difference in the incidence of adverse effects reported by patients in either treatment group.

A preliminary report is given on the first 500 patients entered in an on-going open study in general practice of a combination of 10 mg timolol maleate and 2.5 mg bendrofluazide used to treat mild to moderate essential hypertension. After a 2-week placebo period, dose titration was conducted at weekly intervals, with a final assessment 8 weeks after the diastolic blood pressure was controlled. Data for 472 patients out of 492 commencing active therapy were evaluated. Four-hundred and thirty-seven (93%) became normotensive (less than or equal to mmHg diastolic) on a mean dose of 1.9 tablets taken as a single daily dose. Control was maintained over the follow-up period in all but 13 (2.6%) patients who required a dosage reduction and 2 (0.4%) who required a dosage increase. The incidence of side-effects was low, 22 (4.4%) patients stopping treatment due to adverse events. Biochemical parameters all stayed within normal values. The rapidity of dosage titration, patient acceptability, compliance with regard to the once daily dosage and the low incidence of side-effects suggest that the timolol/bendrofluazide combination approaches optimum therapy for mild to moderate hypertension.

Groups of volunteers were immunized with one of three influenza virus vaccines, and the resistance to challenge infection with attenuated influenza A (H1N1) virus was measured 8 months later. The vaccines were aqueous subunit influenza A/USSR/77 (H1N1) vaccine, aqueous subunit influenza B/Hong Kong/73 vaccine, or attenuated influenza virus A (H1N1) vaccine. The B virus vaccine was included as a control to assess the incidence of natural A virus infection during the study period. A proportion of the B virus vaccinees had pre-existing A (H1N1) virus antibody and were used to study the immunity conferred by natural infection to the live virus challenge. The serum antibody responses were measured at 1 and 8 months after immunization. The results showed that all the vaccines induced serum HI antibody in a proportion of the volunteers; however, after 1 month, higher titres of serum antibody were found in volunteers given inactivated A vaccine than in those given live attenuated A virus vaccine. Eight months post-immunization the titres of serum antibody in volunteers given inactivated vaccine had declined significantly, but there were no changes in the antibody titres of those given live virus vaccine. The incidence of infection by the challenge virus at 8 months post-immunization was directly related to the serum antibody titres 1 month post-immunization; no evidence was obtained to suggest that those given live virus vaccine had a more solid immunity than those given inactivated vaccine.

Groups of volunteers were immunized subcutaneously with one of three inactivated influenza virus A/USSR/77 (H1N1) vaccine preparations; a whole virus vaccine, a surface-antigen subunit adsorbed vaccine, or an aqueous surface-antigen subunit vaccine. The reactions to immunization were recorded, and the antibody response was measured 1 month later. A fourth group of volunteers were inoculated intranasally with live attentuated A/USSR/77 (H1N1) influenza virus; the reactions and antibody response of these volunteers were also measured. One month after immunization, the incidence of infection by challenge with homologous live attentuated virus was determined for all groups of volunteers. The results showed that all four vaccines used were relatively non-reactogenic, and that inactivated vaccines induced higher titres of serum antibody than the live attenuated vaccine. All the vaccines induced significant protection against challenge virus infection which was directly related to the level of serum HI antibody response.