Effects of ondansetron, metoclopramide and granisetron on perioperative nausea and vomiting in patients undergone bariatric surgery: a randomized clinical trial.

INTRODUCTION: Post-operative nausea and vomiting (PONV) is a common problem after sleeve gastrectomy. In recent years, following the increase in the number of such operations, special attention has been paid to preventing PONV. Additionally, several prophylaxis methods have been developed, including enhanced recovery after surgery (ERAS) and preventive antiemetics. Nevertheless, PONV has not been completely eliminated, and the clinicians are trying to reduce the incidence of PONV yet. METHODS: After successful ERAS implementation, patients were divided into five groups, including control and experimental groups. Metoclopramide (MA), ondansetron (OA), granisetron (GA), and a combination of metoclopramide and ondansetron (MO) were used as antiemetics for each group. The frequency of PONV during the first and second days of admission was recorded using a subjective PONV scale. RESULTS: A total of 130 patients were enrolled in this study. The MO group showed a lower incidence of PONV (46.1%) compared to the control group (53.8%) and other groups. Furthermore, the MO group did not require rescue antiemetics, however, one-third of control cases used rescue antiemetics (0 vs. 34%). CONCLUSION: Using the combination of metoclopramide and ondansetron is recommended as the antiemetic regimen for the reduction of PONV after sleeve gastrectomy. This combination is more helpful when implemented alongside ERAS protocols.

A swallowed denture leading to misdiagnosis with esophageal neoplasm: a case report.

Introduction: Foreign body ingestion can lead to esophageal complications, including perforation and impaction, in up to 20% of cases, making it a critical situation. Misdiagnosis or delayed diagnosis can cause severe complications. Case presentation: We present the case of a 78-year-old female who swallowed an acrylic partial denture leading to progressive dysphagia and a vegetative ulcerative lesion on endoscopy. The lesion was initially misdiagnosed as a neoplasm of the esophagus. CT scan and a repeat endoscopy revealed the presence of a denture in the esophagus. The denture was successfully removed with a rigid esophagoscope, and no evidence of complications was reported in follow-up visits. Discussion: Diagnosis of esophageal foreign bodies involves imaging studies and endoscopy, which is the gold standard for diagnosis and management. CT scans also have an important role in diagnosing controversial cases. Treatment depends on the size, shape, and location of the object.