Comparative study of orogastric suction and dexamethasone to reduce vomiting after pediatric tonsillectomy

To compare the effect of gastric emptying with an orogastric tube and the effect of a single dose of dexamethasone on the incidence of postoperative vomiting in children undergoing tonsillectomy. Two hundred and ten patients of both genders, aged 1.5-14 years, who were scheduled to undergo tonsillectomy with or without adenoidectomy were studied prospectively. Patients were randomized into three groups. Group I included patients who underwent gastric aspiration with an orogastric tube prior to extubation following surgery [n = 70]. Group II included patients who received dexamethasone 0.5 mg/kg intravenously [maximum dose 8 mg] after the induction of anesthesia and before surgery [n = 70]. Group III included patients who neither received dexamethasone nor underwent gastric aspiration [n = 70]. Data on the number of episodes of vomiting, total volume of emesis, administration of rescue prophylactic antiemetics were recorded. The incidence of early postoperative vomiting [before discharge from recovery room] was not significantly different between the three groups. The incidence of vomiting during stay on the ward [late vomiting] was more frequent in group I and III. The mean number of episodes of vomiting in the three groups was 2.42.2 and 2.3 respectively. The mean volume of emesis for the patients who experienced postoperative vomiting was similar in the three groups [183 ml, 176 ml and 180 ml respectively]. Prophylactic antiemetic rescues were required in 13% of group I, 4% in group II and 10% in group III. The time to the first oral intake and duration of intravenous hydration was significantly shorter in the dexamethasone group than in the other two groups. Prophylactic intra operative single dose of dexamethasone decreases the incidence of postoperative vomiting, and accelerates the return to normal diet in children undergoing tonsillectomy. Aspiration of gastric contents with an orogastric tube does not decrease postoperative vomiting, mean number of vomiting episodes and the volume of emesis. Routine use of orogastric tube placement for gastric aspiration following pediatric tonsillectomy is not advisable

Fine needle aspiration cytology in the diagnosis of salivary gland tumors: experience at Queen Allia military hospital

To evaluate the diagnostic accuracy of fine needle aspiration cytology in the examination of salivary gland tumors at Queen Alia Hospital and to compare our experience with the international literature. This retrospective study was conducted between January 2000 and December 2004. Seventy two patients with salivary gland masses were evaluated using fine needle aspiration cytology. Those patients were further subjected to surgery and tissue was subjected to histopathological examination. The preoperative cytologic findings were analyzed and compared with the postoperative corresponding histopathologic diagnoses. The relationship between the fine needle aspiration cytology and the histopathology was investigated statistically using the Chi-square test. Out of the 72 cases with pre-operative cytology subjected to surgery, the histopathological findings included sixty benign and six malignant tumors which were accurately diagnosed with in addition to two false positive and four false negative cases giving a diagnostic accuracy of 91.66%. There is a significant statistical association between the fine needle aspiration cytology and the histopathology [p<0.05]. Our study revealed 66.7% accuracy in diagnosing malignant disease, and 96.7% accuracy in diagnosing benign disease. Fine needle aspiration cytology is an important and useful diagnostic tool with high accuracy in the pre-operative assessment of patients with both benign and malignant salivary gland masses. It should be however noted that the presence of false negative and false positive results using fine needle aspiration cytology indicates the need for caution

Clinical profile of patients with allergic rhinitis

To find out the allergic symptoms of patients who presented to otorhinolaryngology clinic. Two hundred and fifteen patients of either sex and above the age of sixteen years who presented to otorhinolaryngology clinic suffering from allergic rhinitis were involved in the study. History of rhinorrhea, sneezing, nasal obstruction, nasal itching, epistaxis, nasal dryness and conjunctival symptoms which are generally the chief symptoms of allergic rhinitis in addition to family history of bronchial asthma and other allergies were recorded. Physical clues to allergic rhinitis were boggy, pale, or [bluish] nasal turbinates, rhinorrhea, allergic salute and allergic shiners. The commonest complaint was rhinorrhea seen in 96% of cases followed by sneezing [88%], nasal obstruction [80%], nasal itching [55%], epistaxis [17%], nasal dryness [14%] and conjunctival symptoms [12%]. Pale and hypertrophied boggy turbinates were seen in 97% of cases, allergic salute in 4% and allergic shiners in 13% of cases. In 7% of cases, the patients had mild bronchial allergy manifested by dyspnea, cough and wheezes during the attack. Positive family history of allergy was found in 25% of patients. Allergic rhinitis is a common medical condition characterized by rhinorrhea, sneezing and nasal obstruction as chief symptoms. The diagnosis rests mainly on a classic clinical picture