Evidence map›Paper›PMID 37848768›Full record

Trial reportIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2024

Pre-medication with simethicone and N-acetyl cysteine for improving mucosal visibility during upper gastrointestinal endoscopy: A randomized controlled trial.

Zaheer Nabi, Mohan Vamsi, Rajesh Goud, Mahiboob Sayyed, Jahangeer Basha, Palle Manohar Reddy, Rithesh Reddy, Praveen Reddy, Chaithanya Manchu, Santosh Darisetty and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05951712 (Pre-medication With N-acetylcysteine and Simethicone to Improve Mucosal Visibility During Gastroduodenoscopy), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05951712 nacompletednot on this map

Pre-medication With N-acetylcysteine and Simethicone to Improve Mucosal Visibility During Gastroduodenoscopy: A Double Blind, Randomized Controlled Trial.

TypeinterventionalSponsorAsian Institute of Gastroenterology, IndiaRan2022 to 2022Enrolled800ConditionsMucosal ErosionArmsSimethicone 150mg, N Acetyl cysteine 600mg, Simethicone 150mg plus N Acetyl cysteine 600 mg, Placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Early detection of gastrointestinal cancers in low- and middle-income countries: A risk-stratified framework and implementation roadmap.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Review
  2. Image-enhanced endoscopy in upper GI tract: State-of-the-art review.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Review
  3. Article
  4. Efficacy of water infusion combined with defoamers in colonoscopy.World journal of gastrointestinal surgery · 2025
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Zaheer NabiAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India. zaheernabi1978@gmail.com.ORCID 0000-0003-2713-4781
Mohan VamsiAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Rajesh GoudAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Mahiboob SayyedAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Jahangeer BashaAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Palle Manohar ReddyAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Rithesh ReddyAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Praveen ReddyAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Chaithanya ManchuAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Santosh DarisettyAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Rajesh GuptaAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Manu TandanAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Guduru Venkat RaoAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
D Nageshwar ReddyAsian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
Asian Institute of Gastroenterology · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimDiagnostic performance of esophagogastroduodenoscopy (EGD) may be compromized due to adherent mucus and foam. In this study, we aimed at assessing the impact of premedication on mucosal visibility during endoscopy.

methodsThis is a double-blinded (patient and investigator), randomized trial conducted at a tertiary care centre. Patients were randomized into four groups: A (water), B (simethicone [S]), C (N-acetyl cysteine [NAC]), D (S + NAC). Premedication solutions were administered 10-30 minutes before endoscopy and mucosal visibility graded from 1 (best) to 4 (worst) (1 best, 4 worst). Total mucosal visibility scores (TMVS) from six sites ranged from 6 (best) to 24 (worst) points. The primary outcome of study was comparison of TMVS between simethicone and combination (S + NAC) premedication groups. Secondary outcomes were adverse events and impact of endoscopy timing on TMVS.

resultsTotal 800 patients (39 years, 68.8% males) were randomized into four groups. Median TMVS were significantly lower in groups B (7 [6-8]) and D (8 [6-9]) as compared to A (11 [9-13]) and C (10 [8-12]). Proportion of cases with adequate gastric mucosal visibility (score < 7) was 26% in group A, 71% in group B, 36% in group C and 79% in group D. There was no difference in TMVS in groups A and C (p = 0.137). TMVS were significantly lower in late (> 20-30 minutes) vs. early (10-20 minutes) endoscopy sub-group (8 [7-11] vs, 9 ([7-11], p = 0.001). However, TMVS were similar between group B and group D in early endoscopy group (p = 0.451). There was no significant difference in the lesion detection rate among the different premedication drugs (p > 0.05).

conclusionsPremedication with simethicone or combination (simethicone and NAC) significantly improves mucosal visibility during EGD. If early endoscopy is indicated, simethicone provides similar mucosal visibility and may be an effective alternative to combined premedication.

trial registrationNCT05951712.

Indexed as

AcetylcysteinePremedicationSimethiconeAdultDouble-Blind MethodEndoscopy, Digestive SystemEndoscopy, GastrointestinalFemaleHumansMaleMiddle AgedAcetylcysteineSimethiconeEndoscopyMucosal visibilityN-acetyl cysteinePre-medicationQualitySimethicone

Identifiers

PMID37848768
OpenAlexW4387696862

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.