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Postoperative sore throat (POST) is a common complication with incidence of 30-90% when intubation was done using conventional Macintosh laryngoscope. Although POST is usually self-limiting and with no long-term morbidity, it can lead to patient's discomfort and dissatisfaction in the postoperative period. The objective of this study was to compare the incidence of POST following intubation using Macintosh laryngoscope and C-MAC® videolaryngoscope (VL) at various time intervals post anaesthesia. This prospective randomised controlled study comprised of 128 patients with American Society of Anesthesiologists (ASA) I and II status who underwent elective surgery under general anaesthesia in Universiti Kebangsaan Malaysia Medical Centre. All recruited patients have normal airway and divided randomly into Group 1 and Group 2 that used Macintosh laryngoscope and C-MAC® VL during intubation, respectively. Patients were evaluated for sore throat, hoarseness of voice, dysphagia and coughing at recovery, 6 hours, 12 hours and 24 hours after intubation. Severity of POST was assessed using numerical rating scale (NRS). Incidence of POST was found to be higher in the Macintosh laryngoscope group (61.9%) compared to C-MAC® VL group (47.9%) although the difference was not statistically significant (p=0.107). Median pain score was used to assess the severity of POST, showing low and comparable in both groups at all time intervals. There were also no significant differences seen in hoarseness of voice, coughing and dysphagia for both groups during postoperation. Incidence of POST following intubation using C-MAC® VL and conventional Macintosh laryngoscope were comparable. This study revealed that severity of POST was generally low in both groups. [ABSTRACT FROM AUTHOR]

SUMMARY Sequential hepatobiliary scintigraphy using Tc-99m-diethyI-IDA of an omphalopagus conjoined twins indicated the anatomic size, contour and position of fusion of the livers pre-operatively. There was absence of significant cross-circulation between the twins. It demonstrated separate gall bladders and biliary ducts which emptied into separate proximal duo-denas. In addition, fusion of the proximal midgut from which separate ilea arose was shown. Separate kidneys and bladders were also demonstrated. This case illustrates a significant advantage of this non-invasive technique over other methods in the evaluation of the anatomy and function of the liver and biliary system of omphalopagus conjoined twins. [ABSTRACT FROM AUTHOR]

The combination of continuous intravenous infusion of diazepam (20--40 mg/kg per day) and intragastric phenobarbitone (10--15 mg/kg per day in 4 divided doses) was used to treat 19 cases of neonatal tetanus. Mortality was 2/19 (11%). This regimen was considered to have reduced the mortality and the need for artificial ventilation. The main side effects encountered were severe drowsiness, coma, and apnoeic episodes which were reversible when the level of diazepam was reduced. [ABSTRACT FROM AUTHOR]

SUMMARY Radionuclide angiocardiographic features of aneurysm of the main pulmonary artery is described. Both dynamic and static radionuclide examination demonstrated the aneurysm well. Radionuclide angiocardiography is a simple, safe, rapid and non-invasive procedure in the differentiation of pulmonary artery aneurysms from other mediastinal masses. [ABSTRACT FROM AUTHOR]

The relationships between total and free serum concentrations of phenytoin and the clinical control of seizures were investigated retrospectively in 114 patients. Total phenytoin levels were measured by enzyme-modified immunoassay (EMIT), and the free fraction by ultrafiltration at 37 degrees C using 14C-labelled phenytoin as a tracer. The median free fraction in 188 serum samples was 13.7% (range 8.9-27.0%). The free fraction was greater than 18% in 34 (18.1%) of the serum samples. In all but 5 samples, a likely reason for the elevated free fraction could be determined. The identifiable reasons were commonly hypoalbuminaemia and the presence of liver or renal disease. There was a significant negative correlation between serum albumin level and free fraction of phenytoin (n = 90, r = -0.68, p less than 0.001). The free phenytoin concentration was strongly correlated with the total phenytoin concentration in serum (n = 188, r = 0.94, p less than 0.001). The total phenytoin concentration provided as good an indication of clinical response as the free concentration in 91 patients (85.8% of the patients for whom response could be reliably determined). In the other 15 (14.2%) patients, free phenytoin concentrations were better related to clinical effect. These patients generally had significant reductions in the serum protein binding of phenytoin. The relationship between phenytoin toxicity and free serum concentrations was particularly strong--in 14 patients with toxicity, the total serum concentration of phenytoin was greater than 80 mumol/L in only 42.9% of cases, while the free phenytoin concentration was greater than 8 mumol/L in 85.7% of the cases (p less than 0.05 by chi-square test).(ABSTRACT TRUNCATED AT 250 WORDS)