Objectives To determine whether preoperative dexamethasone reduces postoperative vomiting in patients undergoing elective bowel surgery and whether it is associated with other measurable benefits during recovery from surgery, including quicker return to oral diet and reduced length of stay. Design Pragmatic two arm parallel group randomised trial with blinded postoperative care and outcome assessment. Setting 45 UK hospitals. Participants 1350 patients aged 18 or over undergoing elective open or laparoscopic bowel surgery for malignant or benign pathology. Interventions Addition of a single dose of 8 mg intravenous dexamethasone at induction of anaesthesia compared with standard care. Main outcome measures Primary outcome: reported vomiting within 24 hours reported by patient or clinician. Secondary outcomes: vomiting with 72 and 120 hours reported by patient or clinician; use of antiemetics and postoperative nausea and vomiting at 24, 72, and 120 hours rated by patient; fatigue and quality of life at 120 hours or discharge and at 30 days; time to return to fluid and food intake; length of hospital stay; adverse events. Results 1350 participants were recruited and randomly allocated to additional dexamethasone (n=674) or standard care (n=676) at induction of anaesthesia. Vomiting within 24 hours of surgery occurred in 172 (25.5%) participants in the dexamethasone arm and 223 (33.0%) allocated standard care (number needed to treat (NNT) 13, 95% confidence interval 5 to 22; P=0.003). Additional postoperative antiemetics were given (on demand) to 265 (39.3%) participants allocated dexamethasone and 351 (51.9%) allocated standard care (NNT 8, 5 to 11; P<0.001). Reduction in on demand antiemetics remained up to 72 hours. There was no increase in complications. Conclusions Addition of a single dose of 8 mg intravenous dexamethasone at induction of anaesthesia significantly reduces both the incidence of postoperative nausea and vomiting at 24 hours and the need for rescue antiemetics for up to 72 hours in patients undergoing large and small bowel surgery, with no increase in adverse events. Trial registration EudraCT (2010-022894-32) and ISRCTN (ISRCTN21973627).

In clinical trials, sample size is usually lesser as compared to other epidemiological studies to make it more feasible and cost effective. Small sizes of such trials discourage the use of parametric test due to violation of the assumption under which they are applicable. Therefore, the use of nonparametric test is substantial in clinical trials to test two or more independent samples. The Kruskal-Wallis h test is an alternative to one-way ANOVA and can be used to identify significant differences among different populations. When we have several independent samples and assumed to be arranged orderly, Jonckheere Terpstra test is a best choice to compare population medians instead of means. For the application of Jonckheere Terpstra test the data from the study of cleaning methods for ultrasound probes are used. The Jonckheere Terpstra test is recommended over Kruskal-Wallis h test as it compares and provides significant difference between more than two population medians when they arranged in order. Therefore, the aim of this research paper was to explore the use and significance of Jonckheere-Terpstra test with the use of practical example.

FDI tends to increase the host country’s imports, because Multi-National Corporations (MNCs) often have a high tendency to import intermediate inputs, capital goods and services that are not readily available in the recipient countries as well as it also affect exports from the export supply side. We investigated the relationship between foreign direct investment (FDI) and imports demand as well as between foreign direct investment (FDI) and exports supply of Pakistan for the time span of 37 years range from 1973 to 2009. Our analysis emphasized on the existence of long run equilibrium relationship between FDI and imports demand & exports supply of Pakistan using econometric techniques (Co-integration Analysis and Error correction mechanism). The co-integration analysis of import demand showed stable long run equilibrium relation-ship between real import and FDI results of export expressed that FDI has positive relation with real exports in the long run, but the coefficient is statistically insignificant. It suggested that the inflow of FDI has largely been directed toward import-substitution industries or production for the domestic market while little has gone toward export-oriented industries. That is long run policies will be fruitful to be implemented. While the short term dynamics as analyzed by the error correction mechanism (ECM) revealed that the short term discrepancies were significant enough to not to converge toward equilibrium and will require a longer time to adjust back in both model. Unilateral causality was detected between real imports (RIM) and FDI which was established both by theoretic

Status epilepticus is a life threatening neurological medical emergency. It may cause serious damage to the brain and even death in many cases if not treated properly. There is limited choice of drugs for the short term and long term management of status epilepticus and the dugs recommended for status epilepticus possess various side effects. The present study was designed to investigate synergistic anticonvulsant effects of pregabalin with amlodipine on acute seizure model of epilepsy in mice. Pentylenetetrazole was used to induce acute seizures which mimic status epilepticus. Pregabalin and amlodipine were used in combination to evaluate synergistic anti-seizure effects on acute seizure model of epilepsy in mice. Diazepam and valproate were used as reference dugs. The acute anti-convulsive activity of pregabalin with amlodipine was evaluated in vivo by the chemical induced seizures and their anti-seizure effects were compared with pentylenetetrazole, reference drugs and to their individual effects. The anti-seizure effects of tested drugs were recorded in seconds on seizure characteristics such as latency of onset of threshold seizures, rearing and fallings and Hind limbs tonic extensions. The seizure protection and mortality to the animals exhibited by the drugs were recorded in percentage. Combination regimen of pregabalin with amlodipine exhibited dose dependent significant synergistic anticonvulsant effects on acute seizures which were superior to their individual effects and equivalent to reference drugs.

Bioequivalence data often do not follow the normality assumption on the linear (original) scale, therefore in that situation, the use of the logarithmic transformation is recommended. In the bioequivalence analysis, confusion arises about the use of geometric mean ratio when the logarithmic transformation is recommended by the regulatory authorities. The purpose of this research paper is to clear this confusion. Different average bioequivalence criteria are also reviewed in this paper.