Comparison of single-dose nalbuphine versus tramadol for postoperative pain management in children: a randomized, controlled trial / 대한마취과학회지

BACKGROUND: Acute postoperative pain control in children is an essential component of postoperative care, particularly in daycare procedures. Giving patients continuous narcotic analgesics can be risky; however, a single dose may be sufficient. METHODS: This study used a prospective, randomized controlled design and was conducted at the Pediatric Surgery Unit, Services Hospital, Lahore. In total, 150 patients who underwent inguinal herniotomy (age range: 1–12 years) were randomly assigned to two groups: group A (nalbuphine) and group B (tramadol). Patients were given a single dose of either nalbuphine (0.2 mg/kg) or tramadol (2 mg/kg) immediately after surgery and pain was measured at 0, 1, 2, 4, and 8 h. RESULTS: The demographic characteristics were similar between the two groups. The mean pain score was lower in group A than in group B at 0 and 1 h (P < 0.05). However, at 4 h and 8 h, the pain scores in group A were still lower, but not significantly. In all, 9 patients (12.0%) required rescue analgesics in group A compared to 16 patients (21.3%) in group B (P = 0.051). The mean time for requirement of rescue analgesics was 6.5 ± 0.5 h in group A and 5.3 ± 1.7 h in group B (P = 0.06). CONCLUSIONS: A single dose of nalbuphine is sufficient, and superior to tramadol, for postoperative pain management in children who have undergone daycare procedures.

Duplication cyst presenting as hydrocoele in a child

Enteric duplication cyst can occur anywhere in Gastrointestinal Tract [GIT], from oropharynx to rectum. Their presentation depends upon the portion of GIT involved. The most common site of GIT involved is small intestine, in 50% of cases. Small intestinal duplication cyst usually present with abdominal pain or mass and rarely as intussusception, volvulus or small bowel obstruction. It may also present very rarely as inguinal hernia of which only 2 cases have been reported yet. We report a 3 years child presenting as hydrocoele of the cord which turned to be duplication cyst which is very rare presentation

Alveolar clefts reconstruction: a comparison of autogenous bone graft versus autogenous combined with alloplasts

Alveolar cleft reconstruction is a major challenge in cleft lip and/or palate [CLP] patients and golden standard protocol is to perform bone grafting [BG] before canine eruption and subsequent orthodontic closure. Objective of this study was to compare the post operative morbidity of two procedures in terms of complications i.e. the average operation time, intra-operative blood loss, postoperative pain and to demonstrate the surgical procedure and clinical outcome in terms of preservation of the grafted alveoli. This was a prospective comparative study conducted at the Department of Oral and Maxillofacial Surgery, Children Hospital, Lahore on twenty patients with residual alveolar clefts. The patients were randomly divided into two groups A and B. In group A, the cancellous bone graft was harvested from the anterior iliac crest while in group B, the cancellous bone was harvested from the anterior iliac crest and mixed with Synthetic bone substitutes in 1:1 by volume. The patients in group B recovered from walking uncomfortably statistically faster than those in group A. The duration of the hospital stay was significantly shorter in group B than in group A. The average bone graft densities of both groups significantly reduced within 6 months after grafting then seemed to be stable until month 24. The bone graft heights gradually decreased with time, in both groups by 24 months postoperatively. It was concluded that efficacy of hydroxylapatite is comparable with that of autogenous bone alone in terms of bone remodeling and tooth eruption, either spontaneous or orthodontically assisted

Incidence of homicide by sharp edged weapon at Lahore

To find out the most frequently targeted site of the body in sharp force homicidal injuries, defence wounds, age, associated weapon use, gender incidence and cause of death. Department of Forensic Medicine and Toxicology, King Edward Medical University, Lahore. 2002, 2003 and 2004. Proforma was designed for retrospective study, relevant information was gleaned from the available record .A three year period was selected, spreading over 2002, 2003 and 2004, was scrutinised for 232 cases autopsied at this facility. Male to female ratio was 2.26: 1. Maximum number of victims belonged to the 20-29 years age group. Single injuries were present in 18.54% of the cases and multiple were present in 81.46% cases. The commonest associated weapon used was blunt. Death was caused by haemorrhage in 46.5% cases and damage to vital organs proved to be the cause of death in 53.5% cases. Defence injuries were seen in 26.7% cases. The commonest infliction site was the neck in females while the area most targeted in male victims was the chest. The most targeted site is neck. Approximately one in four victims had defence injuries. Most injuries are on trunk [chest and abdomen]. Commonest regions for males was chest and in females. Damage to vital organs was the major cause of death. Amongst females teenager are more vulnerable, as this group had the maximum number of victims

Hair tourniquet strangulation of penis

Strangulation of the penis by coil of hair is very uncommon. Left as such it can produce varying grades of injury to skin, urethra.and glans. Simple removal of hair coil at early stage can prevent the dreadful complication. The author describes a series of 9 boys who presented with hair coil strangulation of penis. Four boys had superficial skin injury. The rest five presented with urethral fistula at the corona glandis. One stage repair was done in all cases with good results for repair of fistula. Overview of the literature and surgical technique is discussed