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

Clinical profile of patients with allergic rhinitis

To find out the allergic symptoms of patients who presented to otorhinolaryngology clinic. Two hundred and fifteen patients of either sex and above the age of sixteen years who presented to otorhinolaryngology clinic suffering from allergic rhinitis were involved in the study. History of rhinorrhea, sneezing, nasal obstruction, nasal itching, epistaxis, nasal dryness and conjunctival symptoms which are generally the chief symptoms of allergic rhinitis in addition to family history of bronchial asthma and other allergies were recorded. Physical clues to allergic rhinitis were boggy, pale, or [bluish] nasal turbinates, rhinorrhea, allergic salute and allergic shiners. The commonest complaint was rhinorrhea seen in 96% of cases followed by sneezing [88%], nasal obstruction [80%], nasal itching [55%], epistaxis [17%], nasal dryness [14%] and conjunctival symptoms [12%]. Pale and hypertrophied boggy turbinates were seen in 97% of cases, allergic salute in 4% and allergic shiners in 13% of cases. In 7% of cases, the patients had mild bronchial allergy manifested by dyspnea, cough and wheezes during the attack. Positive family history of allergy was found in 25% of patients. Allergic rhinitis is a common medical condition characterized by rhinorrhea, sneezing and nasal obstruction as chief symptoms. The diagnosis rests mainly on a classic clinical picture

Comparative study of local infiltration of bupivacaine and parenteral administration of diclofenac sodium for post tonsillectomy pain in adults

To compare the efficacy of pre-operative local infiltration of local anesthetic [bupivacaine] with the conventional parenteral administration of an NSAID, diclofenac sodium on postoperative pain in adults undergoing tonsillectomy using a st and ardized anesthetic technique. 120 patients of either sex, age 20 to 40 years posted for tonsillectomy were enrolled and randomly assigned into 2 groups: Group A: Received diclofenac sodium 1.5 mg/kg intramuscular, 30 min. before surgery [60 patients]. Group B: Received bilateral pre-incisional infiltration of 3 ml of 0.25% bupivacaine in the peritonsillar fossa [60 patients]. Pain intensity after surgery was assessed by asking patients to express there pain on visual analogue scale 0- 100 mm scale [0 mm: no pain; 100 mm: maximum imaginable pain] and estimated at 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after surgery. There was no statistically significant difference between group A and B at all time intervals [p < 0.01]. Preincisional infiltration of local anesthetic [bupivacaine] and pre-operative parenteral administration of an N SAID, diclofenac sodium were found to be equally effective methods for treating post tonsillectomy pain