Postoperative nausea and vomiting [PONV]: an experience with and without metoclopramide with opioid use for control of pain

Objective: To evaluate postoperative nausea and vomiting [PONV] with and without metoclopramide with opioid use for control of pain

Study Design: Interventional comparative study

Place and Duration of Study: This study was carried out at KAH, Bisha, Saudi Arabia for period of 3 months 18th July 2014 to 17th October 2014

Patients and Methods: Fifty patients were included and divided into Group A and B. Group A was given inj. Fentanyl 1.5mg/kg intra-operatively and Inj. Pethidine 1.5mg/kg post-operatively to control pain. Group B was given inj. Metoclopramide 0.15 mg/kg intra-operatively and same dose postoperatively in addition to Inj. Fentanyl andPethidine

Results: In Group A, 10 [40%] female patients and 02 [8%] male patients developed PONV while in Group B only one [4%] female patient developed PONV

Conclusion: PONV is reduced when anti-emetics are used along with opioids for pain control. Inj. Metoclopramide, an anti-dopaminergic prokinetic, was found to give better results as its antiemetic action is considered

Endoscopic evalution of acute dysphagia due to mechanical obstruction

To find out the common causes of mechanical dysphagia in South Punjab and determine the endoscopic features of benign and malignant stricture to decide for either therapeutic intervention [endoscopic dilatation/stunting] or biopsy. This descriptive study was conducted in Medical Unit-1, Gastroenterlogy Nishtar Hospital Multan Pakistan during the period from September 2004 to December 2005. A total 50 patients were included in the study. Foreign body in esophagus, was seen in 3 patients [6%] 2 female and one male. Two patients [4%] had esophageal web, both patients were female and upper part of oesophagus was involved in both of them. Benign stricture was the commonest abnormality. Lower third of oesophagus was the commonest site of involvement [62.5%], middle one third was involved in 31.25% of cases while upper third was involved in only 1 patient [6.25%]. Carcinoma oesophagus was predominantly found in males and lower one third was the commonest site [71.4%]. No patient had involvement of upper third while middle third was involved in 28.6%. Mean age of the patients was 42; age range was 14 to 63. Duration of dysphagia ranged from one day to 35 days; mean duration was 18 days. Upper gastrointestinal endoscopy is a safe and valuable procedure in individuals of all age groups with dysphagia and often leads to positive therapeutic intervention even in quite frail subjects. Benign esophageal stricture, esophagitis and esophageal carcinoma, are the commonest causes of dysphagia in South Punjab

Clinical laboratory and tomographic evaluation of patients presenting with cerebrovasular accidents

The purpose of study was to describe important differences in clinical picture, morbidity and outcome between patients presenting with hemorrhagic and non-hemorrhagic strokes. It was a descriptive study. Medical Unit-I of Nishtar Hospital Multan. One hundred consecutive patients presenting with neurological deficit were evaluated. Sample was collected on the basis of convenience. The variables studied were the state of conscious level, severity of hemiplegia, duration of hospital stay, complications, in-hospital mortality and functional outcome at the time of discharge in both hemorrhagic and non-hemorrhagic stroke groups. On computed tomography, 22 patients [23.4%] were found to have hemorrhagic stroke while 72 patients [76.6%] suffered from cerebral infarction. Eight hemorrhagic stroke patients [36%] and 5 ischemic stroke patients [7%] expired during their hospital stay. Unconsciousness was the most common mode of presentation in both hemorrhagic [45.4%] and ischemic stroke patients [33.3%]. Ischemic stroke was found to be more common than hemorrhagic stroke. Hypertension was the most common risk factor in both groups. The history of hypertension was largely unknown and control and monitoring was poor. The incidence of death was higher in hemorrhagic stroke group

Clinical outcome of patients presenting with acute oliguria after an acute gastroenteritis episode

The purpose of the study was to describe important characteristics of acute oliguria, developing after an episode of acute gastroenteritis. This study was carried out mainly in the Medical Unit I of Nishtar Hospital Multan. December 1999 to June 2001. The sample of study was randomized to two groups. Group A was administered low dose [renal dose] Dopamine infusion along with fluid replacement and other modalities of treatment, group B was given conventional treatment. 50 patients among the above study were randomized to the group A and were administered low dose dopamine along with other modalities of treatment. The average duration of diarrhea in this group was 3.04 +/- 0.9 days. Mean creatinine level among this group was 6.7 +/- 2.9 at presentation. Hyperkalemia occurred in 10 patients [20%] in this group all of them required treatment for hyperkalemic episodes either in form of drugs or hemodialysis. 2 patients in this group developed chronic renal failure 50 patients among the above study were randomized to the group B and were not administered low dose dopamine. Mean creatinine level among this group was 6.5 +/- 3.3 at presentation. The average duration of diarrhea in this group was 3.12 +/- 0.98 days. Hyperkalemia occurred in 6 patients. No patient developed chronic renal failure in this group. Infectious food was the main cause of gastroenteritis in this study. More patients in the group A [given dopamine] developed chronic renal failure

Clinical laboratory and tomographic evaluation of patients presenting with cerebrovasular accidents

The purpose of study was to describe important differences in clinical picture, morbidity and outcome between patients presenting with hemorrhagic and non-hemorrhagic strokes. It was a descriptive study. Medical Unit-I of Nishtar Hospital Multan. One hundred consecutive patients presenting with neurological deficit were evaluated. Sample was collected on the basis of convenience. The variables studied. were the state of conscious level, severity of hemiplegia, duration of hospital slay, complications, in-hospital mortality and functional outcome at the time of discharge in both hemorrhagic and non-hemorrhagic stroke groups. On computed tomography, 22 patients [23.4%] were found to have hemorrhagic stroke while 72 patients [76.6%] suffered from cerebral infarction. Eight hemorrhagic stroke patients [36%] and 5 ischemic stroke patients [7%] expired during their hospital stay. Unconsciousness was the most common mode of presentation in both hemorrhagic [45.4%] and ischemic stroke patients [33.3%]. Ischemic stroke was found to be more common than hemorrhagic stroke. Hypertension was the most common risk factor in both groups. The history of hypertension was largely unknown and control and monitoring was poor. The incidence of death was higher in hemorrhagic stroke group