BACKGROUND Dexamethasone is an available and cheap drug and has low complications. There are not enough studies on antiemetic and analgesic effects of dexamethasone after laparoscopic cholecystectomy. The aim of this study was to assess the efficacy of single-dose of dexamethasone on Postoperative Pain (POP) and Nausea and Vomiting (PONV) in the patients undergoing laparoscopic cholecystectomy in northern Iran. MATERIALS AND METHODS This randomised controlled trial was conducted on 140 patients who were candidates for laparoscopic cholecystectomy. The subjects were randomly assigned into Group I (dexamethasone 8 mg) and Group II (normal saline 5 mL). Each group had 70 patients. The subjects were followed about POP and PONV every 4 hours for 12 hours after the operation using Nausea and Vomiting Scale (NVS) and Visual Analogue Scale (VAS) pain scores. RESULTS Seven patients (12.1%) were men and 123 (87.9%) were women. The mean age was 44.37 ± 8.69 years old. The mean NVS score was significantly different between the two groups in both periods 0-4 hours (Group I: 1.06 ± 0.85, Group II: 1.38 ± 1.00; p= 0.043) and 4-8 (Group I: 0.58 ± 0.24, Group II: 0.67 ± 0.29; p= 0.047) hours after the surgery. About VAS pain score, there were significant mean differences between the two groups in both periods 4-8 hours (Group I: 4.09 ± 1.01, Group II: 4.49 ± 1.24; p= 0.038) and 8-12 hours (Group I: 2.06 ± 0.81, Group II: 2.47 ± 1.16; p= 0.017) after the surgery. CONCLUSION According to the findings, single-dose of dexamethasone had a significant reducing effect on POP and PONV in the patients undergoing laparoscopic cholecystectomy.

Introduction: Short bowel syndrome can cause severe malnutrition. Parenteral nutrition and the prescription of water and electrolyte can increase the survival of these patients. This article introduces a patient, who received parenteral nutrition for nine months after gastric cancer surgery and chemotherapy because of the initiation of cutaneous fistula (short bowel syndrome). Case Presentation: The patient was a 33-year-old male, who had undergone total gastrectomy due to gastric adenocarcinoma. After chemotherapy, because of the peritonitis, laparotomy was performed; the abdomen was full of fecal and bile liquid, and the perforation area was not found due to the high adhesion in the abdomen. Considering the continued secretion from the right drain area of the abdomen, with the possibility of spontaneous closure, TPN was performed for nine months. Fistula repair surgery was done and postoperative total parenteral nutrition was terminated in nine days and oral feeding was started and the patient was discharged in good condition. Conclusions: Total home parenteral nutrition (HPN) in patients with short bowel syndrome increases the survival of patients without dangerous side effects. Home parenteral nutrition can be useful to prepare the patient for surgery.