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Latar Belakang: Perdarahan perioperatif sering dijumpai dalam setiap operasi. Penggunaan obat anestesi induksi (etomidat dan pentotal) berpengaruh dalam menghambat agregasi trombosit.Tujuan: untuk mengetahui perbedaan pengaruh etomidat dan pentotal terhadap agregasi trombosit.Metode: Penelitian ini merupakan penelitian eksperimental pada 43 pasien yang mendapat anestesi umum. Subjek selanjutnya dibagi menjadi dua kelompok, dengan kelompok I mendapatkan etomidat dosis 0,3mg/kgBB intravena, sedang kelompok II (n=20) mendapatkan penthothal dosis 5mg/kgBB intravena. Sampel darah pasien pada kedua kelompok diambil 5 menit sebelum dan 5 menit sesudah induksi. Semua spesimen dibawa ke Laboratorium Patologi Klinik untuk dilakukan pemeriksaan Tes Agregasi Trombosit dengan ADP 10, 5, dan 2 µM sebagai induktor. Uji statistik menggunakan paired t-test dan independent t-test (dengan p< 0,05 dianggap signifikan).Hasil: ADP 10 µM merupakan induktor yang paling sensitif dalam mendeteksi hipoagregasi. Pada penggunaan ADP 10 µM sebagai induktor didapatkan perbedaan persentase agregasi maksimal trombosit yang bermakna antara sebelum dan sesudah pemberian etomidat maupun pentotal dengan nilai p masing-masing 0,000. Persentase agregasi trombosit pasca perlakuan pada kelompok I (66,0±8,9) berbeda bermakna dengan kelompok II (77,9±6,8), dengan nilai p 0,000. Selisih persentase agregasi trombosit sebelum dan sesudah perlakuan pada kelompok I (14,7±3,9) juga berbeda bermakna dengan kelompok II (3,6±3,2), dengan nilai p 0,000. Hipoagregasi ditemukan pada 14 dari 23 pasien pada kelompok I, dan 1 dari 20 pasien pada kelompok II.Kesimpulan: Etomidat 0,3mg/kgBB intravena dan pentotal 5mg/kgBB intravena menyebabkan penurunan agregasi trombosit yang bermakna, namun penurunan agregasi trombosit pada kelompok etomidat lebih rendah secara bermakna dibandingkan pentotal, selain itu lebih banyak pasien dari kelompok etomidat yang mengalami hipoagregasi.

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common problem during cancer treatment and its proper management is essential. The primary objective of this study was to compare the efficacy of a single dose palonosetron in the control of chemotherapy-induced nausea and vomiting (CINV) to that of oral aprepitant and ondansetron.  The secondary objective is to determine age, gender, morning sickness, motion sickness, as well as chemotherapy protocols as risk factors in increasing chemotherapy-induced nausea and vomiting (CINV). Methods: This is a prospective cohort study carried out at Al-Andalus Private Hospital for Cancer Patients in Baghdad, Iraq. The study included 296 patients, diagnosed with cancer, and receiving high emetogenic chemotherapy protocol. Patients were divided into 3 arms according to the antiemetic received. Arm 1 received aprepitant and ondansetron, arm 2 received ondansetron, and arm 3 received palonosetron. The primary endpoint was the response rate defined as the percentage of patients without nausea or vomiting episodes during the chemotherapy treatment cycles. Other secondary endpoints such as age, gender, morning sickness, motion sickness, as well as chemotherapy protocols, were measured as risk factors in increasing chemotherapy-induced nausea and vomiting (CINV). Results: A total of 296 patients, diagnosed with cancer, and receiving high emetogenic chemotherapy protocol were evaluated. There was no significant association between age or gender and CINV. The incidence of nausea and vomiting with ondansetron was more than the incidence of nausea and vomiting with aprepitant, and the incidence of nausea and vomiting with palonosetron was less than the incidence of nausea and vomiting with aprepitant. There was no significant association between morning sickness and nausea or vomiting. On the other hand, there was a significant association between motion sickness and nausea or vomiting. The most common cycle reported in nausea and vomiting was cycle 3. Regarding suffering from nausea and vomiting with some chemotherapy drugs, the most common drugs were adriamycin cyclophosphamide (AC) and carboplatin. Conclusion: The results of the present study confirm the previous reports on the superiority of palonosetron over ondansetron and its aprepitant in reducing the incidence of CINV. Regarding risk factors, motion sickness, chemotherapy cycle 3, as well as adriamycin cyclophosphamide (AC) and carboplatin were risk factors inducing CINV in high emetogenic chemotherapy protocols.

Introduction:The primary objective of this study was to identify the percentage of oxaliplatin-induced vascular pain during administration in Iraqi patients. The secondary objective was to identify the risk factors for vascular pain. Methods: This is a cross-sectional observational study carried out at the Al-Andalus private hospital for cancer patients, Baghdad, Iraq. The study included 101 patients, diagnosed with one of the following cancers: colon, pancreatic, stomach, and rectal cancer, ranging from 18 to 80 years, and receiving oxaliplatin peripheral venous infusion. Data collected included: age, gender, diagnosis, history of chronic disease, treatment protocol, degree of pain severity, cancer stage, history of previous vascular pain, number of cycles, the incidence of vascular pain, oxaliplatin dose. Results: Sixty-two patients out of 101 patients had experienced vascular pain during oxaliplatin peripheral venous infusion, representing about (61.4 %). History of diabetes mellitus was significantly associated with vascular pain induction (OR=1.59, [CI: 1.07 -2.39]). The age group from 40-60 years old was significantly associated with 59 % higher odds of vascular pain (OR=1.59, CI: 1.07 -2.39) than other age groups. Female patients were significantly associated with 59 % higher odds of vascular pain (OR=1.59, CI: 1.07 -2.39) than males. Conclusion:The results of this study indicate that history of diabetes mellitus, the age group from 40-60 years old, and female gender are risk factors for oxaliplatin-induced vascular pain in patients with GI malignancy. These findings could be useful to assess the risk of vascular pain in clinical settings.