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A comparative study between small dose dexamethasone, tropisteron, metoclopramide and normal saline in reducing nausea and vomiting after laparoscopic cholecystectomy
دراسة مقارنة بين جرعة صغيرة من الديكساميثازون ، التروبيستيرون ، الميتوكلوبراميد والمحلول الملحي الطبيعي في الحد من الغثيان والقيء بعد استئصال المرارة بالمنظار

Authors: Tayeb S. Kareem --- Aman Abdulmawjood Taha
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 1 Pages: 317-321
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Nausea and vomiting are among the most common distressing complications encountered by patients postoperatively. The aim of this study is to evaluate the prophylactic effect of small dose of dexamethasone (5 mg) on postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC). Methods: A prospective double blind placebo controlled study of 160 patients who underwent elective LC at Rizgary Teaching and Hawler Private Hospitals in Erbil, Kurdistan in a period between Jan 2009 and Dec 2009. Preoperatively the patients were allocated randomly to one of the four groups (n = 40 each). 1. The dexamethasone group received dexamethasone 5mg. 2. The metoclopramide group received metoclopramide 10mg. 3. The tropisetron group received tropisetron 2mg. 4. The placebo group received normal saline 2ml. Results: Both the dexamethasone and tropisetron groups were significantly different from the placebo group in the incidence of nausea and vomiting. The differences between the dexamethasone and tropisetron groups were not significant (P = 0.799). Conclusion: : prophylactic IV dexamethasone 5 mg significantly reduces the incidence of PONV in patients undergoing LC.


Article
Accuracy of Modified Alvarado Scoring System in Early Diagnosis of Acute Appendicitis
دقة تعديل نظام تسجيل Alvarado في التشخيص المبكر لالتهاب الزائدة الدودية الحاد

Authors: Star S. Hussein --- Nadya Y. Ahmed --- Tayeb S. Kareem
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 2 Pages: 8-13
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objectives: Appendicitis is a common surgical emergency. The patients with equivocal signs can present a diagnostic challenge. Early diagnosis and intervention is mandatory for prevention of complications. On the other hand negative appendicectomy should be avoided as much as possible. The aim is to evaluate the role of the modified Alvarado scoring system in early diagnosis of acute appendicitis.Methods: During a period of 6 months from 1st February to 31st July 2008; 250 patients with right iliac fossa pain were admitted and observed in Emergency Hospital in Erbil. The age of the patients was ranged between 13-70 years (mean 22 years ). The male to female ratio was 3:2. They were prospectively evaluated on admission using modified Alvarado scoring system to determine whether or not they had acute appendicitis. The results were correlated with the operative and histopathological findings.Results: After first scoring; 179 (72%) patients were admitted and 71 (28%) patients were discharged. Rescoring by modified Alvarado scoring system was done after 6 hours from admission, only 162 (91%) patients were operated on , and the rest 17 (9%) patients were discharged. During operation we found that 142 cases (87.5%) had really acute appendicitis. Overall the modified Alvarado scoring system showed sensitivity of (93%) for [8-9] scores and (39%) for [1-7] scores. .Conclusions: The modified Alvarado scoring system is accurate in early diagnosis of acute appendicitis . Patients with 8-9 scores should be operated on immediately without hesitation. Patients with score 5-7 must be admitted and scored frequently. Score 1-4 can be discharged unless otherwise indicated.

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