Prophylactic administration of ondansetron in emergency intraabdominal operations

Efficiency of Ondansetron, a selective 5- HT [3] receptor antagonist, in prevention of postoperative nausea and vomiting in 40 ASA I - II patients to undergo emergency intraabdominal operations is studied in a randomized, double-blind and placebo controlled study. Patients of no premedication are administered 4 mg I.V. ondansetron or placebo [saline] before induction. Thiopental [4 mg/kg] was used for induction, succinylcholine [2 mg/kg] for muscular relaxation, and 50% nitrous oxide in oxygen and isoflurane [0.8 - 1.5%] for the maintenance, and fentanyl and norcuron were administered when necessary. Vital findings were closely monitored and recorded during anesthesia and during early postoperative period. Study was carried out during postoperative 0 - 1 h, 1 - 2 h and 2 - 24 h periods. Nausea scores and emesis attacks of the patients were recorded during 0 - 1 and 1 - 2 h periods Ondansetron was found significantly more effective than placebo [p < 0.05 and p < 0.05]. Although it was effective during 2 - 24 h period, the difference was not statistically significant [p > 0.05]. No significant difference was observed between the groups in terms of vital findings, laboratory findings and side effects [p > 0.05]. Therefore, it is concluded that administration of prophylactic I.V. Ondansetron to patients undergoing emergency intraabdominal operations is effective in prevention of nausea and vomiting without any significant side effect

Clinical and laboratory profile of episodes of diabetic ketoacidosis in Madina Al-Munawarah, Saudi Arabia

Although the precipitating factors and mortality has been previously studied, there is no report of clinical and biochemical profile of patients with Diabetic Ketoacidosis in Saudi Arabia. To study the clinical and laboratory profile of patients with diabetic ketoacidosis in Madinah Al-Munawarah, Saudi Arabia. King Abdul Aziz and Fahad Hospital Madinah-Al-Munawarah Saudi Arabia. May 1991 to April 1992. 85 consecutive admissions among adults =/>age 12 years. Criteria for diagnosis of diabetic ketoacidosis was arterial pH>7.3, serum bicarbonate <15 m mol/l, hyperglycaemia with blood sugar >12.1 m mol/l. Other causes of metabolic acidosis excluded. Clinical features and results of laboratory profile were noted at the time of hospital admission. Laboratory profile included: blood sugar, arterial pH, arterial bicarbonate, serum urea, serum Na+and K+ with calculated serum osmolality. Commonest clinical features included, nausea and vomiting [48%], polyuria and polydipsia[46%], abdominal pain[33%] and dizziness [21%]. Unconsciousness [11%] was a rare presentation. Mean laboratory profile of these cases included, blood sugar 33.9 m. mol/l, arterial pH 7.10, bicarbonate 6.8 m.mol/l, serum urea 9.2, serum Na+ 132 m.mol/l, serum K+ 4.4 m.mol/l and calculated serum osmolality of 317 m.Osmol/l, Our study indicates that nausea, vomiting and abdominal pain are more common in diabetic ketoacidosis patients in Saudi Arabia while the laboratory profile is generally in agreement with other studies in Asia

Nausea and vomiting as predictors of presence, location and size of acute myocardial infarction

In a trial to assess the value of nausea and/or vomiting in prediction presence, location and/or size of acute myocardial infarction [AMI] in patients presenting with acute chest pain and electrocardiographic [ECG], changes suggestive of coronary heart disease [CHD], 220 patients were included in the present work. They classified into AMI group [G1], [which was further classified into anterior Q-wave infarction [G[1a]], inferior Q-wave infarction [G[1b]] and non-Q-wave infarction [G[1c]] and noninfarction group [G[11]]. Nausea and/or vomiting were good predictors of AMI [85% positive predictive value]. They had no relation to infract site [67% in anterior infarction group VS. 65% in inferior infarction group with insignificant difference between them]. Using peak serum creatine kinase [CK] level, as an index of infect size, nausea and/or vomiting were good predictors of larger infarction [nausea and/or vomiting were present in 54%, 70%, 79% and 86% in patients with peak serum CK level < 1.000 IU/liter, > 1000 IU/liter, > 1.500 IU/liter, and > 2.000 IU/liter, respectively]. Thus, nausea and/or vomiting are important predictors in diagnosing AMI and are associated with larger myocardial infarctions but do not suggest infarctions in a particular location