Background and objectives: Postoperative nausea and vomiting (PONV) are still one of the most common and unpleasant side effects following surgeries under general anesthesia, especially in patients receiving opioids. The primary purpose of this study was to compare Zofran and oxycodone versus Zofran and morphine for the prevention of postoperative nausea and vomiting.
Subjects and methods: A prospective, monocentric clinical trial study was conducted at Mount Lebanon Hospital (MLH) between November 2018 and November 2021. After getting approval from the ethical committee, 237 patients were enrolled on a ratio of 1 to 2 in two groups: the first receiving Oxycodone 5 mg IVP with Zofran 4 mg IVD and the second receiving Morphine 5 mg IVP with Zofran 4mg IVD. Pearson’s Chi-square test and Fisher’s exact test were used to checking for the groups’ differences.
Results: Morphine and Oxycodone had a similar analgesic effect. The use of Zofran lowered PONV incidence rates in both groups. A statistically significant (p-value = 0.047) lower nausea and vomiting incidence in the Morphine group (2.5%) was noted compared to the Oxycodone group (8.8\% incidence). Only 10% of Oxycodone group patients and 8.9% of Morphine group patients had moderate nausea and vomiting, and none of the group’s patients had severe nausea and vomiting. Surgery duration, gender, age, smoking, BMI, pain level, and treatment group were not statistically associated with the severity of NV.
Conclusion: With the same analgesic effect, Zofran injection seemed to lower PONV incidence in both groups, even though the Morphine group had a lower incidence. Zofran seemed effective in lowering the NV severity as well. Therefore, recommending the systematic administration of antiemetic agents in patients receiving Oxycodone or Morphine could enhance patient satisfaction.
Aim: To assess histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding.
Methodology: One hundred eight females with the complaint of abnormal uterine bleeding were enrolled. A gynecological examination was done. Dilatation and curettage were carried out. Specimens thus obtained were stored in 10\% formalin. The slides were examined under a microscope, and the various histopathological patterns were assessed.
Results: The age group 20-30 years had 48, 30-40 years had 50, and 40-50 years had ten females. A significant difference was observed. Inflammatory lesions were 28, such as acute endometritis in 12, chronic endometritis in 11, and chorioamnionitis in 5. Proliferative non-neoplastic lesions were 42, such as atypical hyperplasia in 18, typical hyperplasia in 12, and endometrial polyp in 12. Neoplastic lesions in 20 include leiomyoma in 8, a partial mole in 7, the complete mole in 2, and endometroid carcinoma in 3. Normal endometrium in 18, such as proliferative phase in 12 and secretory phase endometrium in 6. A significant difference was observed (P< 0.05).
Conclusion: The most common endometrial biopsy revealed proliferative non-neoplastic lesions such as atypical hyperplasia, typical hyperplasia, and endometrial polyp.
For timely prediction of the development of AHI syndrome in patients with closed abdominal trauma, it is necessary to monitor the IAP level. IBH syndrome develops in patients with concomitant abdominal trauma and is characterized by relatively high mortality rates. A statistically significant correlation was established between the level of AHI, APD, the frequency of development of a picture of multiple organ failure, and the severity of the patient’s condition according to the SOFA and APACHE II scales (p <0.05). A sudden increase and persistence of a high IAP level for a long time in patients with closed abdominal trauma indicate the use of active surgical tactics to perform decompression. The decision to decompress the abdominal cavity is based on IAP monitoring, considering the clinical picture of developing multiple organ failure.
Aim: To assess traumatic axial cervical spine injuries in 84 patients.
Methodology: Eighty-four patients with traumatic axial cervical spine injuries of either gender were enrolled. Magnetic imaging resonance (MRI) was performed in all. Conservative treatment was given to those with minimal no bony injuries with or without spinal cord contusion, and decompression and fixation were performed in moderate to severe bony injuries with spinal cord compression. In addition, patients were treated for anterior fixation, i.e., corpectomy with either autologous bone graft or titanium cage and plate fixation and with corpectomy with tricorticate graft.
Results: Out of 84 patients, males comprised 54 (64.2\%), and females had 30 (35.8\%). Aetiology in the present found to be assault in 9, road traffic accident in 48, sports injury in 17, and workplace injury in 10 cases. Body fracture was evident in 24 and ligamentous injury in 60 patients. The type of body fractures was C3 in 3, C4 in 2, C5 in 12, C6 in 3, and C7 in 4 patients. Management performed was corpectomy with tricorticate graft in 26 cases and a corpectomy with fixation with a titanium cage and plate/screws in 58 cases.
Conclusion: Discoligamentous was a major type of injury, and road traffic accident was the main cause of injury among patients with subaxial cervical spine injuries.
The article presents the results of studying the modern literature on diagnosing and treating severe concomitant abdominal trauma and their prediction. In addition, the authors provide the primary literature data of domestic and foreign authors in recent years.
