Postoperative nausea and vomiting (PONV) has been variously described as the “big little problem” the “nal therapeutic challenge” for anaesthesiology. The commonest cause of morbidity after anaesthesia and surgery are pain and postoperative nausea vomiting 1. To compare the incidences of PONV following laparoscopic cholecyetectomy in different groups of patients receiving ondansetron, palonosetron and Granisetron. 2. To identify the better strategy for prevention of PONV. This is a prospective randomized double blinded clinical study. Both patient and observer were blinded to the group allocation. Allocations to three groups were strictly condential and concealed. One and half year (18 months). Patients undergoing elective laparoscopic cholecystectomy under General Anaesthesia at General Surgery operation theatres of Bankura Sammilani Medical College and Hospital, Bankura The effects of palonosetron, granisetron and ondansetron in preventing PONV (postoperative nausea vomiting) were compared in patients undergoing laparoscopic cholecystectomy and it was found that palonosetron was best and granisetron better in comparison with ondansetron in preventing postoperative nausea and vomiting. Palonosetron provides more effective prophylaxis of early PON (postoperative nausea), late PON (postoperative nausea), and late POV (postoperative vomiting) compared with granisetron and ondansetron. Palonosetron could provide effective prophylactic antiemetic control to prevent PONVafter laparoscopic cholecystectomy surgery under general anesthesia.

Brain tumours may cause disturbances of cerebral auto-regulation & the blood brain barrier (BBB). These effects could possibly have an unfavourable influence on brain condition. To compare the effects of the application of a bolus hypertonic saline with those of mannitol on intraoperative brain relaxation. Ninety patients of ASA grade II and III in the age group >18 years with supratentorial brain tumours posted for elective brain tumour surgery were studied in the current study. They were randomly allocated into two groups. Each group enrolled with 45 patients- Group HTS : receiving 160 ml of 3% hypertonic saline. Group M : receiving 150 ml of 20% mannitol. Patients from both groups were induced with injection fentanyl, propofol & rocuronium. Maintained with N2O: O2 in a ratio of 2:1 combined with isoflurane, fentanyl and vecuronium. End tidal Co2 pressure were maintained between 35-40 mm Hg. Arterial blood pressure were kept within baseline value ± 20. Hence application of hypertonic saline is a more effective method for brain relaxation in patients posted for elective supratentorial brain tumours surgery and can be a great value in routine practice.

: Pre-eclampsia is a severe life threatening complications of pregnancy and it is characterized by hypertension and significant amount of protein in urine usually occurring during the second half of pregnancy which is mostly after 20 weeks of pregnancy. A systemic meta analysis was planned to analyze and study the recorded pre-eclampsia cases and their fundus changes associated during pregnancy. This systemic self-study have reviewed the facts which were published earlier to determine the current scenario by vast study of statistics and derivation of facts. Vast meta-analysis were conducted with proper examination of data were made to evaluate with final conclusion.Based on our meta-analysis & systematic evaluation on pre-eclampsia and ocular fundus manifestation during pregnancy we observed, studied and derived into several facts and results. We also inferred that ocular examination in patients with pregnancy induced hypertension should be considered as an important tool of clinical evaluation to asses, predict and diagnose the safety of fetal outcomes and the complication and future risk of mother’s life.We conclude that well-being of both mother and fetus is very crucial during pregnancy. This well-being mostly depends upon the placental circulation. Ophthalmic examination of mother’s fundus could be very important tool to assess the health and well-being of both mother and fetus which might indicate to similar microcirculatory changes in placenta and indirectly to fetal well-being.