1. Kennedy, Maureen Shawn MA, RN

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Ondansetron eases oral rehydration in children with gastroenteritis. Just one orally disintegrating tablet of ondansetron can reduce vomiting among children presenting with vomiting and mild dehydration in the pediatric ED, according to a study in the April 20 issue of the New England Journal of Medicine. The children who received ondansetron were significantly less likely to vomit than those who received placebo; if they did vomit, they were also less likely to vomit repeatedly. As a result, they were significantly less likely to need iv rehydration, they drank more oral rehydration fluid, and they had shorter ED stays. The only adverse effect was diarrhea.


Use of episiotomy should be restricted, based on clinical judgement of individual cases, say new guidelines from the American College of Obstetrics and Gynecology (ACOG). According to the report-"Episiotomy," published in the April 2006 issue of Obstetrics and Gynecology- episiotomy is performed often but studied little. The few studies available do not find maternal or fetal benefits in the routine prophylactic use of episiotomy. Risks include infection and maternal bleeding. The ACOG now recommends against its routine use, concluding also that mediolateral episiotomy may be safer than median episiotomy, if the clinician determines that episiotomy is needed. The report also finds no evidence to support the long-held assumption that episiotomy prevents pelvic floor damage leading to urinary incontinence.