Bob Gustwell, scheduling manager I am happy with the idea of formal project management, but I do see some problems implementing it. Some people around here like the way we do things now. It is a natural reaction for employees to fight against any changes in management style. But don't worry about the scheduling department. My people will like the change to formal project management. I see this form of management as a way to minimize, of not eliminate, schedule changes. Better planning on the part of both department and project managers will be required, and the priorities will be set at corporate level. You can count on our support because I'm tired of being caught between production and sales.

21 Does the combination of aluminium and magnesium hydroxide, given as an antacid, decrease the absorption of omeprazole if these are co-administered to help relieve heartburn quickly?

22 Should proton pump inhibitors be used with caution in patients with renal impairment?

23 Has cisapride been withdrawn from the market because of the danger of ventricular fibrillation?

24 In peptic ulcer disease: 1. What are the indications for an upper gastrointestinal endoscopy? 2. As this is an invasive procedure, is an oesophagogastroduodenoscopy (OGD) or barium meal X-ray preferable?

25 Is telithromycin as, or more, effective than clarithromycin in the treatment of Helicobacter pylori? If so, what is the recommended dosage and how long should treatment be continued?

26 Currently favoured regimens for eradication of Helicobacter pylori are triple therapy with a proton pump inhibitor along with two antibiotics for 1 week. For example: Omeprazole 20 mg metronidazole 400 mg and clarithromycin 500 mg (all twice daily). Omeprazole 20 mg clarithromycin 500 mg and amoxicillin 1 g (all twice daily). Resistance to amoxicillin has not yet been demonstrated. Previously, regimens such as omeprazole, metronidazole, amoxicillin and clarithromycin were recommended; are these regimens no longer used? The reason behind this question is the 'sky-high' cost of clarithromycin in Pakistan, which is inversely proportional to patient compliance (that is, low-cost regimens tend to have a higher rate of compliance).

27 What is the difference between the management of a gastric and of a duodenal ulcer?

28 How does omeprazole suppress Helicobacter pylori?

29 Does omeprazole cause rebound hyperacidity? Does this also apply to H2-blockers?

30 On (K&C 7e, p. 249), you state that the postsynaptic neurotransmitter that inhibits the relaxation of lower oesophageal sphincter (LOS) is nitric oxide (NO). I have understood NO to promote relaxation of LOS by acting on the non-adrenergic, non-cholinergic (NANC) inhibitory neurones, which inhibits the action of cholinergic excitatory neurones. Could you please explain this paradox?