Introduction: Coronavirus has spread rapidly in Pakistan. These patients were kept at quarantine facilities on suspicion, even before RT-PCR was done. We were able to collect clinical, laboratory, and management features from them.  Objective: To assess the features of Corona confirmed and unconfirmed patients, and compare them. It could help in deciding if confirmed and unconfirmed patients were correctly identified and managed appropriately. Material and Methods: Retrospective, Descriptive, Crossectional study between 8th April to 30th April 2020. Patient data was collected from different sites retrospectively, on a Performa. Clinical, Laboratory, and Management data as collected. It was analyzed on SPSS 23. All patients in quarantines and ICU were included, irrespective of their corona PCR status, if the treating physicians had a strong suspicion. Home quarantine and less than 15-year old patients were excluded. Results: Clinical features showed more preponderance for males and smokers. Chronic disease patients were also significantly involved. Fatigue, nasal congestion, runny nose, sickness, and vomiting were more common in confirmed patients. CURB 65 scores 3 and 4 were more in unconfirmed patients. CT involvement was more common in unconfirmed patients as was high white cells and neutrophils. More patients had mechanical ventilation in the unconfirmed group, and they also had more secondary infections and shock. Antibiotic use was more common in the confirmed group. Conclusion: Corona was more common in males and smokers. Though fever and cough were common, the presence of fatigue, runny nose, nasal congestion sickness, and vomiting discriminated confirmed patients. Antibiotics should be used irrespective of RT-PCR results, especially if CT showed an abnormality.

BACKGROUND & OBJECTIVE: Post operative nausea and vomiting (PONV) is an important concern in laparoscopic surgeries. Aim of this study is to identify the role of metoclopramide dexamethasone combination for prophylactic management of post laparoscopic cholecystectomy nausea and vomiting in comparison  to metoclopramide alone. METHODOLOGY: The study group comprised of 150 patients. These were the patients with symptomatic gallstones for whom elective laparoscopic cholecystectomy was planned. Study was conducted from 15-04-2018 to 15-07-2019. Non-probability consecutive sampling technique was used.Two groups were generated by simple random method.  Group M was given injection metoclopramide only, whereas patients in Group D+M were injected with both dexamethasone and metoclopramide, intravenously, before induction of anesthesia. Parameters observed for 24 hours during postoperative period included; nausea, episodes of vomiting, requirement for rescue antiemetic drugs and total duration of hospital stay after the surgical procedure. RESULTS:  In Group D+M (dexamethasone+metoclopramide), out of total 75 patients, 8% developed nausea while 5.33% had both nausea along with emesis. While in group M (metoclopramide), 16% out of the total 75 patients had nausea only but 18.7% patients had complaints of nausea and emesis. Three patients out of 75, that is 4% from group (D+M) had extended duration of in hospital admission (> 24 hours), while in groupM, this percentage was 13.33% (n=10) patients. CONCLUSION: A combination of metoclopramide with dexamethasone for prophylaxis against PONV in laparoscopic cholecystectomy patients is preferred to metoclopramide alone.

Objective: To compare analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy. Study Design: Randomized Control study. Setting: Aziz Fatimah Hospital, Faisalabad. Period: 01-03-2018 to 31-12-2018. Material & Methods: 80 patients were enrolled in the clinical study using non-probability consecutive sampling technique. They were divided into two groups, before start of surgery group BD received peritonsillar infiltration of bupivacaine and dexamethasone combination, whereas group B received local infiltration of bupivacaine only. Primary outcome measures were pain score recorded immediately after recovery of patient (0 hour) and at 2, 6, 12 and 24 hours after surgery and requirement for analgesia postoperatively. Other parameters recorded were time to first oral intake and sleep pattern over 24 hours. Results: Mean pain scores in group BD were 0.075, 0.225, 1.675, 0.75, 0.275 and in1 group B were 0.65, 0.975, 2.95, 1.5, 0.95 at 0, 2, 6, 12, 24 hours postoperatively respectively. 92.5% patients in group BD and & 57.5% in group B had good sleep whereas 7.5% in group BD and 42.5% in group B had disturbed sleep. 6 patients in BD group and 26 in B group required analgesia. Conclusion: Our study concluded that infiltration of tonsillar fossa with bupivacaine – dexamethasone prior to the start of surgery provides better postoperative analgesia, early start of oral intake, less rescue analgesic requirements and better sleep pattern.

Objectives: The laryngeal mask airway is used for provision of anesthesia for various surgical procedures as well as in emergency management of airway. It is a useful rescue tool in cases of failed intubation. Its insertion is associated with lesser complications. With advancement in medical equipment new versions of LMA with additional benefits are available. In this study evaluation of frequency of excellent LMA insertion conditions with use of ketofol or propofol as induction agent has to be evaluated. Purpose of the study is to identify which agent will provide favourable conditions for insertion, with least complications. Study Design: Randomized control trial. Setting: Departments of Anesthesia and Intensive Care Allied Hospital and Aziz Fatimah Hospital, Faisalabad. Period: From 01-01-2017 to 30-06-2018. Material & Methods: Approval from ethical review committee was obtained. 230 children presenting for elective surgery were enrolled into study using non-probability consecutive sampling. Two groups consisting of 115 each were generated by randomization. Group P received propofol and Group PK received 2:1 propofol ketamine mixture. Ease of LMA insertion was assessed on the basis of degree of muscle relaxation and adverse reactions to LMA insertion. Data was collected and analysed using SPSS version 18. Results: Results were presented in terms of frequency of excellent LMA insertion conditions. It showed that ketofol provides better LMA insertion as compared to propofol alone with p value of 0.007, which is significant. Conclusion: The study concluded that use of ketofol provides excellent insertion conditions for LMA insertion in children presenting for elective surgery.