Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Abstract Introduction: Postoperative nausea and vomiting (PONV) is a common complication after cataract surgery, potentially affecting patient comfort and recovery. Traditional fasting protocols (nil per os, NPO) aim to reduce aspiration risk but may cause discomfort, especially in elderly patients. This study evaluates the impact of preoperative fasting duration on PONV incidence in cataract surgery patients.

Materials and Methods: This randomized, double-blind clinical trial included 100 patients undergoing elective cataract surgery, divided into two groups (n=50 each): one following strict fasting (8 hours) and the other allowed clear fluids up to 2 hours before surgery. All procedures were performed without local anesthesia, and PONV incidence was assessed in the recovery unit by blinded nurses. Statistical analysis was conducted to compare PONV severity between groups.

Results: There was no significant difference in the mean severity of PONV between the intervention (6.01 ± 1.14) and control groups (8.88 ± 1.14). Nine patients in the intervention group and ten in the control group required metoclopramide for severe PONV.

Conclusion: Preoperative fasting duration does not significantly impact PONV incidence in cataract surgery. Permitting clear fluids up to two hours preoperatively can enhance patient comfort without increasing aspiration risk.

Abstract Post-traumatic stress disorder is a mental health condition that is triggered by a traumatic event. Symptoms can include nightmares and intense anxiety, as well as uncontrollable thoughts about the event. Examples of events that can trigger the disorder include war, crime, fire, accident, death of a loved one, or sexual abuse. According to statistics, between 7 and 8 percent of the world's population suffers from post-traumatic stress disorder (PTSD), and it affects women more than men. Although most PTSD symptoms begin within a month of exposure to the traumatic event, sometimes they do not appear for years. These symptoms cause significant problems in social or work situations and in the sufferer's relationships. They can also interfere with your ability to perform normal daily tasks. Post-traumatic stress disorder (PTSD) is a debilitating disorder that is associated with behavioral disturbances, physical problems, and some mental health disorders such as depression, with a high risk of suicide.

Abstract Introduction: Postoperative delirium is a common yet underrecognized complication following total hip arthroplasty in elderly patients, associated with increased morbidity, mortality, and healthcare burden. This study aimed to identify the contributing risk factors for delirium in patients aged 65 and older undergoing hip replacement surgery.

Materials and Methods: A prospective cohort study was conducted at Tabriz University of Medical Sciences involving 75 patients aged ≥65 years undergoing elective total hip arthroplasty. Data on demographic characteristics, comorbidities, cognitive status (MMSE), perioperative variables, and postoperative outcomes were collected. Delirium was assessed using DSM-5 criteria and the Confusion Assessment Method (CAM). Statistical analyses included multivariate logistic regression.

Results: Delirium occurred in 26.8% of patients. Significant predictors included older age (OR: 1.14), lower MMSE scores (OR: 1.26), general anesthesia (OR: 2.89), ICU admission (OR: 3.92), and postoperative opioid use (OR: 1.11). Delirium was associated with prolonged hospitalization, higher ICU admission rates, and increased need for mechanical ventilation.

Conclusion: Postoperative delirium in elderly hip arthroplasty patients is influenced by both modifiable and non-modifiable factors. Early identification and preventive strategies targeting high-risk individuals are essential to improve outcomes.

Abstract Introduction: Postoperative pain following lumbar laminectomy can be intense and challenging to manage. Intravenous dexamethasone is commonly used as part of multimodal analgesia, but optimal dosing remains unclear. This study aimed to compare the effects of low-dose and standard-dose dexamethasone on acute pain, opioid use, and postoperative nausea and vomiting (PONV) in the early postoperative period.

Materials and Methods: In this double-blind randomized controlled trial conducted at Tabriz University of Medical Sciences, 70 patients undergoing elective single-level lumbar laminectomy were randomized to receive either 4 mg (low-dose) or 8 mg (standard-dose) of intravenous dexamethasone before incision. Pain intensity (VAS), morphine consumption, and PONV incidence were assessed during the first six hours postoperatively. Blood glucose levels and adverse effects were also monitored.

Results: Patients in the standard-dose group had significantly lower VAS scores at all time points (p < 0.01) and reduced morphine use (p = 0.003). PONV incidence was also lower (p = 0.048). Blood glucose levels were slightly higher in the standard-dose group (p = 0.021), but remained within safe limits.

Conclusion: Standard-dose dexamethasone (8 mg) is more effective than low-dose (4 mg) for early postoperative pain control and PONV reduction, with acceptable short-term safety.