Objectives: Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery. Materials and Methods: A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated. Results: The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient's sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery. Conclusion: Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.

Our results confirm that conventional TBNA is a sensitive and useful technique but it is relatively expensive and the protocols should be adapted to allow appropriate material to be collected for ancillary diagnostic tests.

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HighlightsYolk sac germ cell tumours are rare in post-menopausal patients.Most involve mixed yolk sac tumoursConsider diagnosis in patients with a pelvic–abdominal mass and raised AFP

Background and Objective: Surgical knots though provides an anchoring function on suture line, but also present a potential source of infection. Knotless barbed sutures were designed to prevent knot-related complications. The aim of this study was to determine the safety, effectivity and longevity of unidirectional barbed sutures in intraoral wound closure. Materials and method: A non-randomised study involving 13 patients who required intraoral incisions for open reduction and internal fixation of mandibular fractures and alveoloplasty. Following the surgical procedures, wound closure was done by unidirectional barbed sutures. Outcome parameters that were measured were type of healing, erythema, wound discharge, wound dehiscence, necrosis and pus on 3rd and 7th post-operative day and 2nd and 4th post-operative week. Results: Statistically significant change in healing and erythema status was observed in the group (P value < 0.001) across the timeline. No statistical significance was found for other parameters. Dehiscence of sutured wound was observed on the same day of the procedure in one patient. Suture extrusion was also noticed in one patient after 1st postoperative week. Conclusion: Knotless barbed sutures can be used without harm in wound approximation of intraoral incisions with no potentially harmful major or minor complications.