ABSTRACT
INTRODUCTION: Average annual incidence of snakebite worldwide is between 5.5 to 1.2 million, and at least 125,000 of them are fatal. In Iran, around 4,500-11,000 snakebites occur annually, and a small number of them are fatal. Snake bites can cause intoxity and immediate death in patients, and the aim of this study was to investigate the epidemiological study of snakebites in Ardabil Province. METHODS: This study was a cross-sectional that has been done on 67 snakebite patients who were admitted to the Imam Khomeini Hospital of Ardabil during 2008-2013. Information included: age and sex of victims, region of incidence, site of bite, hospitalized duration and symptoms. Data analyzed by descriptive statistical methods using SPSS version 19. RESULTS: There was significant difference between the two sexes (p=0.001). There was no significant difference between the mean age of male and female victims (p=0.68). Most of the victims were in the age group of 20-29 years (34.3%). All snakebites happened in rural areas. There was no significant relation between gender of victims and the residential location of victims (p=0.32). Most snakebites happened during 11 a.m. to 4 p.m. (32.8%). Most of the snakebites occurred in spring and summer seasons. Results showed that most of the bites in yearly months was seen in the summer season and the difference between seasons is significant. (p=0001). Most snakebites, with 38 cases (56.7%), were observed on lower limbs and among them right limbs with 20 cases (52.6%) had the greatest number. There was significant difference between organs of bites in victims because the most organs were in the right lower limb (p=0.002). Of all cases, 66 (98.5%) were injured by a species of viper snake. All patients, showed symptoms of pain, swelling, erythema and ecchymosis bite. Twenty-seven (40.3%) of all cases, suffered fainting. Nausea and vomiting were two other common symptoms. The antidote used in patients was 5.1±1.3 vials. The mean incidence rate of snakebite was an estimated 4.1 per 100000. CONCLUSIONS: Possible risk factors include male gender and young age. It was also found that the stings reach peak in the morning and noon. These reports are all in rural areas, and mostly occurred in the warm months. Snakebites in rural parts around Ardebil were prevalent. Severe side effects were rare, but the incidence of other complications was common among the victims.
ABSTRACT
Postoperative nausea and vomiting (PONV) are one of the most common complications of anesthesia and without prophylactic intervention occurs by about one-third of patients under general anesthesia. The aim of this study was to compare the efficacy of ondansetron and metoclopramide in reducing PONV after laparoscopic cholecystectomy. In this study, 60 patients undergoing laparoscopic cholecystectomy were randomly allocated into two equal groups (n=30), and in the first group 10 mg metoclopramide and in the second group 4 mg ondansetron preoperatively were injected. Nausea and vomiting and the need for rescue antiemetic treatment in recovery and 6 hr. and 6-24 hrs. After surgery were evaluated. Data were analyzed by SPSS software with chi-square test and analysis of variance (ANOVA). The incidence of nausea in metoclopramide was 43.3 % and in ondansetron was 33.3 %. The difference between two groups was not significant (P=0.6). The incidence of vomiting in metoclopramide was 20% and in ondansetron was 26.7%, and there was not any significant difference between intervention groups (P=0.12). For prevention of PONV after laparoscopic cholecystectomy, both metoclopramide and ondansetron are effective, and in preventing of nausea, ondansetron is more effective than metoclopramide, whereas there was not any significant difference between two drugs in preventing of vomiting.
