ABSTRACT
Germ cell tumors constitute approximately 20%- 30% of all ovarian tumors.Mature cystic teratomas account for 95% of germ cell tumors. Malignant transformation in a mature cystic teratoma of the ovary is a rare event, developing in 1 to 2 % of cases with squamous cell carcinoma being the most common malignant transformation(75%). We report a case of malignant transformation in mature cystic teratoma of the ovary in a 45 year old multiparous woman who had presented with pain abdomen for last two months. Pain was not releaved by symptomatic measures and therefore investigations were carried out, Radiological investigations revealed bilateral ovarian teratoma. During laprotomy a large cystic mass was seen arising from the left ovary that was adherant to the large gut. Right ovary was also found to be enlarged. Final histological diagnosis of bilateral cystic teratoma of ovaries with malignant squamous cell carcinoma arising in left ovarian teratoma was made.
ABSTRACT
Gabapentin is an anticonvulsant drug that has been shown useful in postoperative nausea and vomiting (PONV). AIM: We compared the effects of gabapentin on PONV with ondansetron, dexamethasone and placebo in patients undergoing laparoscopic cholecystectomy under general anesthesia. One-hundredtwenty patients undergoing elective laparoscopic cholecystectomy were randomly assigned to one of the following four groups: gabapentin group (G) received 600mg oral gabapentin capsule two hours before surgery +IV 2ml saline 10-15 minutes before surgery; ondansetron group (O) received an oral placebo two hours before surgery +IV 4mg ondansetron 10-15 minutes before surgery; dexamethasone group (D) received oral placebo two hours before surgery +IV 8mg dexamethasone 10-15 minutes before surgery and placebo group (P) received oral placebo two hours before surgery +IV 2ml saline 10-15 minutes before surgery. Granisetron IV 1mg was used as rescue medication for emesis. Nausea and vomiting were assessed by direct questioning of the patients at 1, 2, 6, 12 and 24 hours after surgery. RESULTS: We found that the incidence of PONV (by simple yes or no) in first 24 hours was significantly lower in gabapentin (40%) dexamethasone (30%) and ondansetron group (36.7%) as compared to placebo group (66.7%) (P<0.05). The number of patients requiring rescue antiemetics was significantly decreased in gabapentin (30%), dexamethasone (26.7%) and ondansetron (26.7%) group versus placebo group (60%) (P<0.05). Gabapentin is as effective as ondansetron and dexamethasone as an antiemetic in laparoscopic cholecystectomy patients.