[ value of intraopepvative use of topical bupivacaine combined with rectal diclofenac on post tonsillectomy pain and oral intake in children]

To evaluate the efficacy of intraoperative topical bupivacaine combined with rectal diclofenac in reducing postoperative pain and facilitating early oral intake. Between 1 January 2005 and 1 January 2008 one hundred fifty patients aged 5-13 years underwent elective tonsillectomy with adenoidectomy in Prince Rashed Ben Al-Hassan hospital and Prince Zaid Ben Al-Hussein hospital, Jordan. Patients were randomized into two groups; group [1]: 75 patients received 0.5% bupivacaine 2 mg/kg soaked swabs [2x2] inch tightly packed in their tonsillar fossa for five minutes after complete and good hemostasis. Group [2]; 75 patients had soaked swab with normal saline for five minutes also. Three patients excluded for failure to complete the postoperative data and another two patients for postoperative bleeding from the adenoid site. Data from 145 patients were analyzed as five patients were excluded. When comparing the two groups for postoperative pain, less pain was noted in the bupivacaine group, the difference was statistically significant for the first 8 hours and also after 24 hours among treatment group who did not complain of pain postoperatively. The mean time difference of first drink and eat between the two groups was statistically significant. No major complications such as airway obstruction, dehydration or local anesthetic toxicity developed. We concluded that topical bupivacaine combined with rectal diclofenac is safe and easy to administer. Topical bupivacaine use combined with diclofenac reduces postoperative pain and facilitate early oral intake in children

Prevalence of visual deficits among young men in Jordan

To report the pattern of various causes of decreased visual acuity [VA], within the age group of young [18-25 years] healthy adults in Jordan. We carried out this retrospective study on the records of 16550 candidates examined from June 2004 to June 2005 by the Medical Committee of Employment, Royal Medical Services in Amman, Jordan. All candidates received an ophthalmic examination as well as medical and ENT examination. We divided the candidates with visual acuity of less than 6/12 in either eye into 3 groups. The most important cause of decreased VA in the 18-25 years age group was refractive errors followed by amblyopia, which represents the major ophthalmic cause of employment rejection in a wide range of occupations in adult life. This study emphasize the need for early visual screening for refractive errors and anisometropic amblyopia in early primary schools, and every effort must be made to achieve the best possible acuity in young patients with amblyopia