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Introduction: Post-operative sore throat is one of the most common complications following endotracheal intubation. Though considered minor complication, it may cause significant patient dis-satisfaction. Various non-pharmacological and pharmacological trials have been used with variable results. Objectives: To compare the efficacy of nebulised dexamethasone with that of nebulised magnesium sulphate in decreasing the incidence and severity of postoperative sore throat (POST). Materials and Methods:In this prospective double blind study 90 patients undergoing surgery under general anaesthesia with endotracheal intubation lasting <3hr were randomly assigned into two equal groups. Group D received dexamethasone 8mg (2ml) with 3ml saline nebulisation and group M received magnesium sulphate (50%W /V 2ml) with 3ml saline nebulisation 30 min before the induction of anaesthesia. Primary outcome assessed was incidence and severity of POST. Secondary outcome assessed were the incidence of post-operative hoarseness and cough. Results: Compared to group M, significantly lesser number of patients in group D had post-operative sore throat at 0hr (p= 0.0262), 4 th hr (p=0.00022), 8 th hr (p=0.00039) and 12hr (p=0.000657). None of the patients in group D had any hoarseness of voice at 0hr, 4 th hr, 8 th hr of assessment (p= <0.05). Except one patient in group M, none of our patients in either of the group had cough at any point of assessment. Conclusion: Preoperative dexamethasone nebulisation just before induction of anaesthesia is an effective method of reducing the incidence and severity of POST following endotracheal intubation. Dexamethasone nebulisation reduces the severity of sore throat more effectively than magnesium sulphate nebulisation.

Abstarct Haemophilia is the oldest known rare genetic bleeding disorder that disrupts the blood clotting process. Although the level of haemophilia care has improved substantially, the problems of management in developing countries are poor awareness, high costs of treatment, inadequate diagnostic and coagulation screening facilities and scarce factor concentrates for therapy. We present here the problems in the perioperative management of a case of haemophilia A in India. It portrays the current picture of haemophilia management in many developing countries around the world.

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