Objective: To compare the frequency of post-operative infection rate between single dose versus multiple dose antibiotic therapy in patients undergoing laparoscopic cholecystectomy. Study Design: Comparative prospective study. Place and Duration of Study: Surgical Department, Combined Military Hospital, Lahore Pakistan from Oct 2017 to Feb 2020. Methodology: Patients of both genders undergoing laparoscopic cholecystectomy for simple cholelithiasis were included. Group-A patients underwent laparoscopic cholecystectomy using single-dose prophylactic antibiotic therapy with 2-gram 3rd generation cephalosporin at the time of induction of anaesthesia. In contrast, Group-B patients underwent laparoscopic cholecystectomy using 2-grams of 3rd generation Cephalosporin intravenously at the time of induction of anaesthesia followed by intravenous 1-gram Ceftriaxone two doses 12 hours apart. All patients were followed up on the first postoperative day, and then 1-week and 2-week follow up were done for any surgical site infection. Results: Patients in Group-A had a mean age of 37.12±6.53 years, while patients in Group-B had a mean age of 37.74±6.40 years. The post-operative infection rate in Group-A (single dose antibiotic therapy) was seen in 08 (4.28%), while in Group-B (multiple dose antibiotic therapies) was seen in 18 (9.63%) patients (p-value = 0.042). Conclusion: This study concluded that the single-dose prophylactic antibiotic is as good as multiple-dose antibiotic therapy used as prophylaxis for the prevention of post-operative infection rate among patients with cholecystectomy done via the laparoscopic method.

Objectives: To compare the effects of Nalbuphine with Tramadol on cardiovascular response (change in heart rate and blood pressure) to tracheal intubation in patients undergoing emergency appendectomy. Material and methods: This randomized controlled trial was conducted at the Department of Anaesthesiology, CMH Mardan from January 1, 2022, to June 30, 2022. A total of 100 patients who were undergoing emergency appendectomy under general anaesthesia, with ASA grade I, aged between 30-50 years, and weighing between 50-80 kg were selected. Patients were either male or female and had normal blood pressure. They were divided into two groups: the Nalbuphine group and the Tramadol group. The study focused on analyzing the cardiovascular response (changes in heart rate and blood pressure) to tracheal intubation in both groups. Results: Most of the patients in both Group A and Group B were females, with a female to male ratio of 3.54:1 and 2.57:1, respectively. The mean age of patients in Group A was 37.90±5.41, while in Group B it was 40.10±6.39. After laryngoscopy and tracheal intubation, patients in Group A had a significantly less increase in heart rate and blood pressure as compared to those in Group B. Conclusion: The Nalbuphine is better than Tramadol in attenuating the cardiovascular response to laryngoscopy and tracheal intubation. Keywords: Nalbuphine, Tramadol, Cardiovascular Response, Tracheal Intubation, Laryngoscopy, Heart Rate and Blood Pressure.