Efficacy of balanced antiemesis for prophylaxsis againt post operative nausea and vomiting [PONV]: comparative study of ondansetron and dexamethasone versus ondansetron alone

A randomized placebo controlled cohort comparative blind study was conducted at department of Anesthesia and Intensive Care from September 2003 to December 2003, to find out the efficacy of balanced antiemesis with combination of ondansetron and dexamethasone versus ondansetron alone. Patients undergoing elective caesarean section under general anaesthesia were randomly given intravenous ondansetron 4mg with dexamethasone 8mg, or ondansetron [4mg] alone or N/S [placebo], for the prevention of PONV at the time of induction of anaesthesia. The incidence of N and V were recorded over first 24 hours after extubation. The severity of N and V was assessed using a modified standard four-point ordinal scale based on a visual analogue scale [none, mild, moderate, severe]. Total 120 patients were recruited in this study, 40 in each group. As many as 5%, 22.5% and 52.5% of patients in combination group, ondansetron alone group and placebo group respectively required rescue ant emetics. The study revealed that balanced antiemesis with ondansetron and dexamethasone is more effective way in the prevention of PONV with minimal side effects

Use of sub clinical dose of nalbuphine in cataract surgery

This study was conducted at Eye department Military Hospital Rawalpindi. One hundred cases were randomly selected and grouped into two namely A and B. Group A received 1 mg of nalbuphine and in Group B surgery was performed without any intravenous sedative or analgesic. Visual Analog Scale was used to measure the pain intensity. Our study has shown that forty patients in Group A had no pain following injection of Nalbuphine as compared to zero patients in Group B [p<0.001]. Similarly ten patients in Group A had mild pain following injection of Nalbuphine as compared with 27 patients in Group B [p<0.005]. According to this study it was found that 1 mg of nalbuphine provides adequate pain relief

Operative management of splenic trauma

A case series report of eleven splenic injuries is presented with a view to etiological factors, surgical treatment, prospects of splenic conservation and follow up. Eight cases sustained blunt abdominal trauma while the other three had fire arm injury. Splenorraphy was carried out successfully in two of the cases. Another four cases could possibly have splenic salvage. Two cases developed delayed postoperative serious infection, while one of the patients developed deep vein thrombosis

Peritoneal lavage, its role in improving diagnostic accuracy of intra-abdominal trauma

Out of forty cases admitted with abdominal injuries eleven were subjected to diagnostic peritoneal lavage due to inconclusive clinical findings, Ten out of eleven cases gave true positive or negative findings giving high index of reliability, no untoward effects of the procedure were recorded

Simple ligation versus stump invagination during appendicectomy: a prospective trial

A prospective, randomized trial on 416 consecutive cases of appendicectomies was carried out in which half of the cases had simple ligation of the stump and the rest had invagination of the stump in addition. The two groups were matched for age, sex, state of personal hygiene and nutrition. The incidence of wound infection, and early and late post-operative complications remained comparable between the two groups. However, the mean operating time was significantly less in case of simple ligation. Barium enema in suspected cases of caecal neoplasm in post-operative cases did not reveal any ceacal deformity in the group of simple ligation thus avoiding confusion of mistaking deformed caecum due to the invaginated stumps as neoplasm. Simple ligation of the appendiceal stump is therefore advocated during appendicectomy

Survey of major surgical operations in Hazara division

All the hospitals of Hazara Division with facilities for major surgical procedures were surveyed from 1981 to 1986 and their work load was assessed. 10205 cases collected in this survey were categorised. Male to female ratio was calculated to 3.5:1 and age group of 16-30 was predominantly represented [44%]. Crude rate for work load was calculated which shows an increasing rise of four fold in six years [1981-1986]

Xanthogranulomatous pyelonephritis

A case of xanthogranulomatous pyelonephritis is presented. It is an uncommon but well recognised entity of chronic bacterial pyelonephritis which may easily be mistaken for renal cell carcinoma, renal carbuncle or tuberculosis

Intracranial hydatidosis

Four cases of intracranial Echniococcosis presenting to the Department of Neurosurgery, Jinnah Postgraduate Medical centre, Karachi over the period of years are reported along with their follow-up to date. Special aspects of pathogenesis and treatment of the disease is discussed in order to establish early diagnosis and proper management of disease