Awake P6 stimulation for post-operative nausea and vomiting using Japanese acupuncture needle among children 5-18 years old at Philippine Children's Medical Center

@#<p><strong>OBJECTIVE:</strong> To compare the effectiveness of preoperative Japanese acupuncture for prevention of post-operative nausea and vomiting (PONV) in non-sedated children for surgery under general anesthesia.</p><p><strong>METHODS:</strong> This is an RCT studying the effectiveness of press-tack Japanese needles in P6 prior to any sedatives in children age 5-18 years old for surgery under general anesthesia (n=66). Patients were randomized to receive either press-tack needle (n=33) or an identical press-tack without the metal component (n=33). Incidence of PONV was reported using BARF scale. Children, parents, anesthesiologists, and nurses were blinded to group assignment.</p><p><strong>RESULTS:</strong> Eight of 33 (22%) in the intervention group while 17 of 33 (51.52%) in the placebo group experienced PONV (RR = 0.47, 95% CI [0.24-0.94], p-value 0.0224). One case reported an adverse event of worsening of nausea and vomiting.</p><p><strong>CONCLUSIONS:</strong> Japanese acupuncture at P6 prior to sedation using press-tack needle significantly reduced the incidence of PONV in children after general anesthesia. KEYWORDS: PONV, POV, P6, PC6, Japanese acupuncture, Acupuncture, RCT</p>

[ importance of pediculous latissimus dorsi flap in reconstructive surgery about 44 cases]

The authors present a series of 44 cases of pediculous latissimus flaps operated these last ten years at Sahloul Hospital Sousse. They insist on the vascular reliability of this flap and on the importance of its rotation arch for covering the lost of cutaneous substances of the cervico-thoraco-brachial area

[Disarticulation of the shoulder due to a high voltage electrical burn about 2 cases]

The high-voltage electrical bums cause an exceedingly high rate of morbidity resulting from the massive necrosis of deeper structures often necessitating major limb amputations. The authors report two rare cases of high-voltage electrical burns occurring accidentally, with a 49 and 19-year-old men, after an indirect contact with a high-voltage line. These high-voltage electrical burus caused massive necrosis and extended necrosis in the upper limb requiring the recourse to a disarticulation the shoulder. The indications and the operative techniques used are discussed