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

Pathological study of benign and malignant salivary gland tumors

To carry out a retrospective analysis of all benign and malignant tumors of major and minor salivary glands which were diagnosed at King Hussein Medical Center during the years between 2000 and 2006. A total of 127 patients diagnosed to have salivary gland tumors were retrieved from our histopathology data records between 2000 and 2006. Most patients were originally treated at King Hussein Medical Center, and some at one of the peripheral military hospitals. All cases were analyzed according to their sex and age distribution as well as the frequency of various histopathological types and their anatomical sites. Of the 127 cases 84.3% of tumors were benign and 15.7% were malignant. The mean age of the benign neoplasms was 43.3 years, and most of these tumors were seen between the fourth and sixth decade of life. The mean age for the malignant neoplasms was 51.1 years, and most cases were in the sixth decade of life. There was a male predominance in both benign and malignant salivary gland neoplasms. Among the benign salivary gland tumors, the most frequent histological type was pleomorphic adenoma [57.9%] followed by Warthin's tumor [35.5%]. Adenoid cystic carcinoma and mucoepidermoid carcinoma were the most frequently encountered malignant tumors accounting for 90% of all malignant tumors. The most commonly involved salivary gland for benign and malignant tumors was the parotid gland. Of the minor salivary gland tumors, the most frequently affected site was the palate [65%], and the most frequent tumor encountered was pleomorphic adenoma [55%]. Salivary gland tumor is a subject of considerable interest because of its not uncommon occurrence and varied histological pattern. This study describes the pathological features of salivary gland tumors in Jordan. The findings are in agreement with results of most previously published research studies