bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrathecal Nalbuphine versus Intrathecal fentanyl as adjuvant to 0.5% bupivacaine for caesarian section surgery under subarachnoid block
Authors: Hameed Amr Essam El-Din Abdel , Hussien Noha Sayed , Mohamed Marwa Mamdouh , El Kenawy Abdelrahman Mostafa Mohamed
Published: October 2021

Background

One of the main objectives of anesthesia is to relieve the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for extended analgesia without any side effects to achieve this goal.

Aim of the Work

To compare the post-operative analgesic effect of intrathecal-nalbuphine and fentanyl as adjuvant to bupivacaine during cesarean delivery. The secondary aim is to compare side effects between using nalbuphine and fentanyl as adjuvants to bupivacaine.

Patients and Methods

After Approval is obtained from the research Medical Ethical Committee of Faculty of Medicine, Ain Shams University. The study was conducted on 60 patients that were randomly selected. Randomly divided into 2 groups 30 patients each. Group F which received fentanyl as adjuvant while group N received nalbuphine as adjuvant.

Results

The addition of a small dose of nalbuphine or fentanyl to bupivacaine in spinal anesthesia prolonged the time of postoperative analgesia. In this study, there was no significant difference regarding the age, height, weight, and duration of operation, maximum sensory level, and maximum motor blockade level. The duration of the postoperative analgesia was prolonged with Nalbuphine group in comparison to the fentanyl group, the results were highly significant.

Conclusion

We concluded that either intrathecal nalbuphine (0.8 mg) or intrathecal fentanyl (25 µg) combined with Bupivacaine improves intraoperative analgesia and prolongs early post-operative analgesia in cesarean section. There was no significant difference with regard to: Peak sensory block level, Maximum motor block level, systolic blood pressure, diastolic blood pressure, oxygen saturation, and heart rate.
Effect of phosphate level on the outcome of COPD patients in the Intensive Care Unit
Authors: Mohamed Gihan S , El Shebiny Ahmed A , Maarouf Mohammed M , Heikal Ahmed M
Published: October 2021

Background

Chronic Obstructive Pulmonary Disease (COPD) is a preventable ano treatable oisease with some sienificant extra pulmonary effects that may contribute to the severity in inoivioual patients. Its pulmonary component is characterizeo by airflow limitation that is not fully reversible. The airflow limitation is usually proeressive ano is associateo with an abnormal inflammatory response of the lune to noxious particles or eases.

Aim of the Work

to evaluate the effect of hypophosphatemia on patients with acute exacerbation of COPD reearoine severity of COPD exacerbation, neeo for ventilation, ouration of ventilation ano outcome.

Patients and Methods

This observational stuoy was performeo on 50 patients with acute exacerbation of COPD were aomitteo to intensive care oepartment of Ain Shams University. Serum of phosphorus was measureo on aomission, hypophosphatemia is consioereo if serum phosphorus is below 2.5me/ol. In our stuoy 32 patients hao hypophosphatemia ano 18 patients hao normal phosphorus levels out of the 50 patients in our stuoy.

Results

Severity of COPD exacerbation ano ventilation necessity increaseo in males with olo aee who were heavy smokers with lone ouration of smokine. Hieh levels of PaCO2 increaseo the neeo for ventilation. Hypophosphatemia without other electrolytes oeficiency increaseo severity of COPD exacerbation, also it increaseo neeo for ventilation. Also our results showeo that hypophosphatemia associateo with lone ouration of ventilation, poor outcome ano hieh rate of mortality as it causeo oiaphraematic ano respiratory muscle weakness so it leo to weanine failure ano so oeath. Combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation, ouration of ventilation ano poor outcome, while multiple electrolytes oeficiency without hypophosphatemia hao no effect on neeo for ventilation, ouration of ventilation ano outcome. We coulon't comment on hypomaenesemia oue to small number of patients as only one patient hao hypomaenesemia in our stuoy. Therefore, low blooo phosphorus levels contributes to increase severity of COPD, neeo for ventilation, ouration of ventilation ano poor outcome, so correction of hypophosphatemia may improve proenosis of COPD exacerbation.

Conclusion

Hypophosphatemia increases the severity of COPD exacerbation, neeo for ventilation, ouration of ventilation, weanine failure ano so increases the rate of mortality. Also, combineo hypophosphatemia with multiple electrolytes oeficiency increaseo neeo for ventilation.
Hypophosphatemia and weaning of Mechanically Ventilated patients with Chronic Obstructive Pulmonary Disease during acute exacerbations
Authors: Elkad Galal Adel Abdelrheem , Khalil Mustafa Mansour Hussien , Armanious Simone Halem , Adawy Ali Ragab Ahmed
Published: October 2021

Background

Chronic obstructive pulmonary disease (COPD) is a common pulmonary disease. It is currently the third leading cause of death in the United State and is predicted to be the third leading cause of death worldwide by 2020

Objectives

The aim of this study is to evaluate the predictive value of serum phosphorus level on weaning of mechanically ventilated chronic obstructive pulmonary disease (COPD) patients with acute exacerbation (AECOPD).

Patients and Methods

After approval of the medical ethics committee of Faculty of medicine, Ain Shams University, informed consents were taken from the patient’s next of kin to include their data in this study.

Results

In this prospective cohort study, 116 patients were assessed for enrollment. 26 patients were excluded due to very early mortality at day 1, administration of total parentral nutrition containing phosphorous and very low phosphorus level (less than 1.5 mg/dL or who needs correction).

Conclusion

In the light of the previous results Hypophosphatemia (1.5 - 2.5 mg/dL) was associated with poor prognosis in terms of longer durations of mechanical ventilations and higher ICU mortality rates in mechanically ventilated patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), Hypophosphatemia should be included in initial assessment of such patients to stratify them.
Impact of dexamethasone added to intra-articular morphine and bupivaciane for post-operative analgesia after knee arthroscopy
Authors: Hammad Raafat Abdelazim , Abd El- Haq Ahmed Abd El-Daeem , El-Aziz Toulan HebaFouadAbd , Talaat Amr Mohammed
Published: October 2021

Background

Pain relief after knee arthroscopy is very important for early recovery and rehabilitation. Many drugs were used intra-articularly to prolong postoperative analgesia and diminish post-operative pain. The present study studies the effects of adding dexamethasone to intra-articular morphine and bupivacaine combination on postoperative pain after knee arthroscopy.

Aim of the Work

The aim of the study is to evaluate the effect of adding dexamethasone (8mg) to intra-articular morphine (10mg) and bupivacaine (25mg) injection on postoperative pain after knee arthroscopy.

Patients and Methods

A randomized double-blinded clinical trial was carried out on 40 patients undergoing knee arthroscopy. Patients were divided randomly into two equal groups. All drugs used were injected intra-articularly at the end of arthroscopy. In the control group, patients were administered 10mg morphine added to bupivacaine 25mg. In the study group, patients were administered 10mg morphine and 8mg dexamethasone added to bupivacaine 25mg. Visual analog score for pain at rest and movement, time to first analgesic request, total analgesic consumption, duration of analgesia and adverse effects were recorded.

Results

The study group showed lower visual analog score at rest and movement, prolonged postoperative analgesia, and decreased total analgesic consumption compared with the control group.

Conclusion

Adding dexamethasone to intra-articular combination of morphine and bupivacaine after knee arthroscopy prolongs the duration of analgesia, lowers pain scores, and decreases total analgesic consumption with no detected adverse effects.
Evaluation of the effect of diastolic function on prognosis of patient with septic shock
Authors: El zawawy Aya Abdel Khalek , Lateef Samia Abdel Mohsen Abdel , Hakim Karim Youssef Kamal , Refaat Sameh Ahmed
Published: October 2021

Background

Septic shock remains the leading cause of death in the intensive care unit (ICU), with an increasing incidence and a current mortality rate of approximately 30 %. Sepsis was defined by the presence of at least two criteria of systemic inflammatory response syndrome associated with a clinically or microbiologically documented, or a highly suspected infection. Severe sepsis was defined as a sepsis associated with at least one organ failure different from that responsible for the infection. Septic shock was defined as a severe sepsis associated with low blood pressure despite adequate vascular filling which required a vasopressor support. Cardiac dysfunction in sepsis is driven primarily by release of cytokines, mitochondrial dysfunction, and tissue hypoxia that leads to cardiac myocyte injury and death.

Aim of the Work

The aim of this study was to evaluate the effect of diastolic function on prognosis of septic shock in patients admitted to an intensive care unit (ICU).

Patient and Methods

This study was conducted on (50) patients with septic shock admitted to an intensive care unit (ICU) from November 2017 to November 2018.

Results

These patients was divided according to cardiac echocardiography findings into two groups:-Group 1:- 25 patients with preserved diastolic function and diastolic dysfunction grade I; 12 Male and 13 Female were included in the study, the average age was 43.44±13.69.Group 2:- Another 25 patients with diastolic dysfunction grade II and grade III; 11 Males and 14 Females were included in the study, the average age was 47.28±15.7.

Conclusion

We recommend assessment of patients admitted to the ICU with septic shock via echocardiography to determine the grade of diastolic dysfunction and using diastolic dysfunction as a predictive risk factor in various score assessment of ICU patients. Our study was limited by decreased sample size and we recommend further studies with increased sample size..
A Comparative Study between Ultrasound Guided Bilateral Transversus Abdominis Plane block Versus Opioids (Nalbuphine) Analgesia after Abdominoplasty
Authors: Elsafty Omar Mohammed Taha , Awad Hanan Mahmoud Farag , Mahran Mostafa Gamal Eldin , Sadek Haidy Atef Fekry
Published: October 2021

Background

Poorly controlled acute pain after abdominoplasty is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain.

Objectives

The aim of this study is to assess the analgesic efficacy and hemodynamic effects of bilateral ultrasound guided single injection Transversus Abdominis Plane (TAP) Block compared with intravenous nalbuphine after abdominoplasty. Each of them combined with general anesthesia in patients undergoing abdominoplasty.

Patients and Methods

The study was conducted on 70 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 35 patients each: Group TAP: bilateral ultrasound guided TAP block was performed before extubation of patients using 20 ml of 0.25% bupivacaine in each side, Group N: received intravenous nalbuphine as post operative analgesia after abdominoplasty.

Results

The results of the study revealed that single injection tansversus abdominis plane block has more analgesic efficacy than intravenous nalbuphine. The first call for rescue analgesia (nalbuphine), total nalbuphine consumption and pain scores (visual analog score) indicated that the superiority of the analgesic technique (TAP Block) was attributed to their opioid sparing effect.

Conclusion

An ultrasound-guided TAP block technique allows for direct visualization of all anatomical structures, the needle, and the spread of local anesthetic, thereby increasing the safety margin, optimizing block qualities, decreasing systemic analgesia requirements and sparing its side effects.
Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension
Authors: Ibrahim Ahmed Saeed Mohamed , Hussien Rania Mahrous Aly , Ahmed Hazem Mohamed Sabry Abdel Aziz
Published: October 2021

Background

Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways.

Objectives

The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries.

Patients and Methods

Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia.

Results

There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively.

Conclusion

The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.
Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure
Authors: Al Shafi'i Mohammed N , El-din Doaa M. Kamal , Ismaiel Mohammed A. Abdulnaiem , Abotiba Hesham M
Published: October 2021

Background

Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU).

Aim of the Work

is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF).

Patients and Methods

This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV).

Results

Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV.

Conclusion

Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.
Epidural Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for Anesthesia in Knee Surgeries
Authors: Elela Sahar Kamal Mohamed Abo , Nasr Dalia Abd Elhamid , Elderh Maha Sadek , Elgawish Karim Mohamed Salah
Published: October 2021

Background

Epidural anesthesia is one of the preferred modes of regional anesthesia for lower limb orthopedic surgeries. This technique provides not only peri-operative anesthesia but also post-operative analgesia. Bupivacaine is commonly used local anesthetic in epidural anesthesia, many adjuvants added to local anesthetics to enhance the quality and duration of surgical anesthesia, among them are opioids, alpha 2 agonists. Opioids like fentanyl have been a popular choice, it offers faster onset and prolongs the duration of analgesia. Recently, alpha 2 agonists like clonidine and dexmedetomidine have been also used in prolonging the duration of epidural analgesia.

Aim of the Work

To compare the efficacy of using fentanyl and dexmedetomidine with bupivacaine in epidural block for knee surgeries, the time of onset of sensory, motor blockade and the duration of this blockade.

Patients and Methods

After obtaining approval from the Research Ethical Committee of Ain Shams University, this study was conducted in the operating theatres of Ain Shams University Hospital. It was a prospective double-blind randomized clinical study. Study period was 6 months.

Results

A total of 50 patients out of 71 consecutive patients met the inclusion criteria and consented for study. These 50 patients were randomized into two groups of 25 each. Out of the total patients, 33 were male and 17 were female.

Conclusion

Dexmedetomidine as an adjuvant to epidural bupivacaine is a better alternative to fentanyl as it shows faster onset of sensory and motor block, lesser time to attain maximum sensory level and prolonged duration of anesthesia.
Comparison between Adding Intravenous Neostigmine and Atropine versus Intravenous Hydrocortisone for Conservative Treatment of Postdural Puncture Headache After spinal Anaesthesia For Elective Caesarean Section
Authors: Ibrahim Sherif Farouk , Talaat Sahar Mohamed , AbdElrahman Tamer Nabil
Published: October 2021

Background

Postdural puncture headache (PDPH) lacks a standard evidence-based treat- ment. A patient treated with neostigmine for severe PDPH And anther patient treated with hydrocortisone prompted this study.

Objective

To assess and compare the efficacy of intravenous neostigmine and atropine versus intravenous hydrocortisone as an adjuvant to conservative treatment of PDPH after spinal anaesthesia for elective caesarean section.

Patients and Methods

This study was carried out in Ain Shams University hospitals for six months (from February 2019 to August 2019) on 60 patients who presented with post dural puncture headache after elective caesarean section under spinal anaesthesia

Results

In this study, we compared the efficacy of hydrocortisone and neostigmine with conventional methods. All of the three groups (neostigmine, hydrocortisone and conventional methods) were effective in lowering VAS scores at 24, 48 and 72 h after headache's onset but neostigmine alleviated the pain more effectively and with rapid onset. The mean VAS score was significantly lower in neostigmine group compared with others 2, 6, 24, 48 and 72h after start of medications (p < 0.001 for all of them) and significantly lower in hydrocortisone group compared with Conventional group 6, 24, 48, and 72h (p < 0.001 for all of them).

Conclusion

neostigmine and hydrocortisone are both useful and safe in management of PDPH but neostigmine is more effective in this regard.
Effect of presence of severe thrombocytopenia on prognosis of hepatic patients in intensive care unit
Authors: Ahmed Ahmed Ali Fawaz , Elhenawy Ahmed Mohammed Elsayed , Abd-Alwahab Wael Abd-Almonem M , Salem Mahmoud Salem Elsayed
Published: October 2021

Background

Thrombocytopenia is defined as a platelet count below 150,000/μL.It is the most common hematological complication in patients with chronic liver disease (CLD).The prevalence of thrombocytopenia in chronic liver diseases ranges from 6 % among non-cirrhotic patients with chronic liver disease to 70 % among patients with liver cirrhosis.

Objective

To investigate the association between thrombocytopenia and the risk of higher mortality incidence in hepatic patients in intensive care unit.

Patients and Methods

The present prospective cohort study was conducted at Ain Shams University hospitals Intensive care units, from October 2019 to August 2020. After obtaining approval of the study protocol from the local ethical committee, as well as fully informed consents signed by the patient closet relative, 130 hepatic patients admitted at ICU with hepatic coma and patients classified according to platelet count on admission into two equal groups.

Group A: included 65 Patients with thrombocytopenia on admission (<100,000/μL). Group B: included 65 Patients with normal platelet count on admission with persistently normal platelet count (≥100,000/μL).

Results

Our study revealed that patients with lower platelet counts had significantly higher risk of death and ICU stay. In our study we showed that there are two independent risk factors affecting the outcome of hepatic patients in the ICU they were thrombocytopenia and high APACHE score. These observations highlight the potential importance of low platelets count in identifying a group of hepatic patients who are at risk for poorer prognosis.

Conclusion

Thrombocytopenia is a frequent laboratory finding among hepatic patients, which is generally correlated to the severity of illness. Thrombocytopenia is generally associated with higher APACHE II score when compared to normal platelet count indicating that it is associated with higher degree of morbidity and expected higher mortality rate.
Relation between Prolonged Cardiopulmonary Bypass Time in Cardiac Surgery in Adult Patients and Post-Operative Acute Kidney Injury
Authors: Mohamed Ali Mohamed Abd-El Khalek , Khalek Akl Diaa Abd-El , Salama Mohamed Samir Mohamed
Published: October 2021

Background

Cardiac-surgery associated acute kidney injury (CSA-AKI) remains an important and frequent complication in patients undergoing cardiac surgery and is associated with a poor short- and long-term prognosis. The incidence for CSA-AKI according to Acute Kidney Injury Network criteria (AKIN) varies between 3% and 50%. CSA-AKI requiring temporary renal replacement therapy (RRT) occurs in 5% to 20% of these patients and is associated with a high mortality rate.

Objective

To detect the relation between prolonged cardiopulmonary bypass time in cardiac surgery and the incidence of post-operative acute kidney injury.

Patients and Methods

This is an observational retrospective study conducted on (80) adult patients who underwent elective cardiac surgery at Aswan Heart Centre (Magdi Yacoub Foundation) after the approval of the Ethical Medical Committee of Aswan Heart Centre.

Results

Results of the statistical analysis of the present study showed that mean CPB duration was prolonged in the AKI group of patients (155 min) than the non-AKI group of patients (129 min).

Conclusion

Prolonged cardiopulmonary bypass duration may be an independent risk factor for acute kidney injury post cardiac surgery in adult patients.
Comparative Study between Ultrasound Guided Oblique Subcostal Transversus Abdominis Plane Block and Local Wound Infiltration as Postoperative Analgesia in Hepatectomy
Authors: El-Hanafy Mostafa Noshy Mohamed , Kamal Amr Mohamed El-said , Said Alfred Maurice , Kasem Amr Ahmed
Published: October 2021

Background

Poorly controlled acute pain after hepatectomy is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics. Appropriate pain treatment protocols to reduce postoperative morbidity, improve the results of the surgery and decrease hospital costs.

Objective

to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared local wound infiltration after hepatectomy regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received.

Patients and Methods

All patients were informed with the procedure US guided TAP block and were trained to use the visual analogue scale (VAS). The study was conducted on 60 randomly chosen patients aged 18 to 60 years, American Society of Anesthesiologists (ASA) class I ,II and III scheduled for hepatectomy in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 30 patients each:

Results

The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores for 12 h after operation and decrease total need of analgesic in first 24 h post operative compared with patients who received wound infiltration.

Conclusion

oblique subcostal TAP block was effective in reducing postoperative pain scores at rest and movement for 12-24 hours and lower total 24-h postoperative opioid and analgesic consumption after hepatectomy under general anesthesia, compared to local wound infiltration.
A COMPARISON BETWEEN INSTILLATION OF INTRAPERITIONEAL BUPIVACAINE & MORPHINE vs. BUPIVACAINE ALONE IN ANALGESIA AFTER LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Aly Omar Hany , Mostafa Zakaria Abdelaziz , El Salam Ehab Hamed Abd , Mekki Yehia Mamdouh Hassan
Published: October 2021

Background

Pain after laparoscopic cholecystectomy remains a challenging issue to this relatively less invasive surgery, In this study we try to tackle this problem through intraperitoneal injection of drugs particularly morphine and bupivicaine to reduce post-operative pain.

Objectives

The Aim of this study is to assess postoperative pain in laparoscopic cholecystectomy by comparing between administering intraperitoneal bupivacaine alone versus intraperitoneal bupivacaine with intravenous morphine; Using the VAS scale and measuring time for rescue analgesic administration.

Methods and material

This prospective double blinded randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent laparoscopic cholecystectomy were included in the study their ages range between 18 and 60 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization into two groups 30 patients in each (n = 30), Group BM received 30 ml of mixture of bupivacaine and 2 mg morphine while group BO received bupivacaine only

Results

This study showed that Morphine bupivacaine admixture had made dramatic decline in shoulder and abdominal pain VAS scores specifically at the 18th and24th hour; 15 patients in the BM group had either VAS score zero or 1 when compared to BO group whom their scores at the 18th and 24th hour was between 4 and 8. Also, there was more decrease in postoperative analgesic consumption in BM group.

Conclusions

We conclude that intraperitoneal instillation of 2 mg to bupivacaine 0.5% in elective LC significantly reduced post-operative shoulder pain and analgesic requirement when compared to bupivacaine 0.5% alone.
A Comparative Study between Ultrasound Guided Trans-muscular Quadratus Lumborum Block Versus Ultrasound Guided Transversus Abdominis Plane Block as postoperative analgesia in Laparoscopic Bariatric Surgery
Authors: Youwakiem Peter N , Reyad Moustafa K , Abo Zeid Abd El Aziz A , Basta Mariam K
Published: October 2021

Background

A variety of unwanted post-operative consequences, including patient suffering, respiratory distress complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain are due to poorly controlled acute pain after laparoscopic abdominal surgery.

Aim of the Work

is to compare the analgesic efficacy of ultrasound-guided TQL with TAP block during laparoscopic bariatric surgery and to improve the outcome of the patients undergoing laparoscopic bariatric surgery under general anesthesia who suffer from postoperative pain and also in the early postoperative period regarding pain relief, decreasing postoperative opioid requirements, provision of comfort, early mobilization and improved respiratory functions.

Patients and Methods

The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each: Group TQL (n = 20): received combined general anesthesia with TQL block. Group TAP (n = 20): received combined general anesthesia with TAP block.

Results

TQL block has more analgesic efficacy than TAP block. The first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block.

Conclusion

TQL with general anesthesia was more effective technique in providing analgesia after laparoscopic bariatric surgery without associated hemodynamic instability in comparison to TAP block with general anesthesia and also the first call for rescue analgesia (Meperidine), total meperidine consumption and pain scores (visual analog score at rest and movement) indicated the superiority of the analgesic technique TQL block.
Addition of intrathecal atropine for prevention of postoperative nausea and vomiting in patients received intrathecal bupivacaine / morphine in lower limb surgeries
Authors: Ramadan Ibrahim Abd Elghani , Elagamy Ashraf Elsayed , Elgharabawy Wael Sayed Ahmed Abd Elghaffar , Elkady Ramez Mohamed Kamel Amin
Published: October 2021

Background

Intrathecal opioids administration is an attractive analgesic technique since the opioids is injected directly into the cerebrospinal fluid providing safe and effective postoperative analgesia for up to 24 hours. The most common adverse effects after intrathecal morphine are postoperative nausea, vomiting and pruritus. We evaluated the effect of intrathecal atropine on prevention of postoperative nausea and vomiting in patients receiving intrathecal hyperbaric bupivacaine and morphine in lower limb surgeries and on its effect on duration of postoperative analgesia.

Methods

80 patients undergoing lower limb surgeries under spinal anesthesia were randomized into two groups.

BM group

Received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + Normal saline (0.1ml).

BMA group

received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + 100 mcg preservative-free atropine sulphate (0.1ml). Follow-up of both nausea and vomiting episodes was done during the first 24 hours postoperatively.

Results

Nausea and vomiting were noticed in 17 patients (42.5%) in group BM and 7 patients (17.5%) in group BMA, with significant differences (p = 0.015). As regards postoperative analgesia, there was no significant differences between BM and BMA group.

Conclusions

Intrathecal atropine has antiemetic effect after spinal anesthesia using bupivacaine and morphine for lower limb surgeries without affecting postoperative analgesia.
The Prognostic Value of Hypophosphatemia in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Elalim Azza A. Abd , Wahba Ramy M , Shabana Tarek S , Dabbour Sarah T.S
Published: October 2021

Background

Phosphorus (P) is an important electrolyte that plays a significant role in different physiological processes especially muscle contraction and adenosine triphosphate high energy bonds. Low phosphorus level in blood may increase the exacerbation of chronic obstructive pulmonary disease, need, and duration of mechanical ventilation.

Objective

To examine the prognostic effects of hypophosphatemia in COPD patients and evaluate the correlation between phosphorus levels and severity of attacks, need for mechanical ventilation, duration of The ICU stays and mortality.

Methods

This study was performed on 72 patients with acute exacerbation of COPD admitted in chest department and respiratory ICU in Ain Shams University Hospital in the period between June 2019 & March 2020.

Results

The study showed Low blood phosphorus levels contribute to an increase in: COPD flare-up with high statistically significant value (p < 0.001), also the need for ventilation, duration of ventilation, duration of hospitalization, days in intensive care units and finally increased rate of mortality were statistically significant value p-value (0.002, 0.024, 0.021 & 0.001) respectively.

Conclusion

Close monitoring and careful adjustment of disorders correlated to electrolyte such as phosphorus, are crucial and may improve prognosis and also increase the survival rate of patients with COPD.
Postoperative Analgesic Efficiency of Transversus Abdominis Plane Block with and without Magnesium Sulphate after Surgical Repair of Moderate Size Umbilical Hernia
Authors: Shokeir Mohamed Hossam El Din Hamdy , El Henawy Ahmed Mohamed El Sayed , Armanios Simon Halim , Morgan Shaimaa Mansour Abd Elkader
Published: October 2021

Background

The transversus abdominis plane (TAP) block is a known approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. Different adjuvants have been used to intensify the quality and the duration of local anesthetics.

Aim of the Work

The aim of this study is to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing surgical repair of moderate sized umilical hernia under general anathesia. As regard postoperative pain and opioid consumption using Visual Analogue scale VAS.

Patients and Methods

the study was carried out on 40 patients who was undergo surgical hernial repair, after ethical approval of Ain Shams University Hospital and informed consent from patients ,patients assigned in two group ,each group include 20 patients, Group 1: receive TAP block with Bupivacaine 0.25% 20 ml per side. Group 2: receive TAP block with Bupivacaine 0.25% 18 mL+2 ml magnesium sulphate.

Results

By the end of our study we found that VAS pain score was less in group II than in group I at 0,1,2 and 24 hours postoperatively and most significant at 4,6 and 12 hours the VAS score less in group II than group I (p value <0.05).And the mean time for first rescue analgesic dose was delayed in group II (872.87±265.25mins) compared to group I(466.54±118.29mins) (p value <0.001).

Conclusion

MgSO4 as an adjuvant to Bupivacaine in Ultra-sounded guided TAP block reduces postoperative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.
Registry of Primary Lung Tumours in Ain Shams Hospitals
Authors: Mohamed Yasser Moustafa , Ali Tamer Mohamed , EzzEldin Mai Mohamed Ali , Soliman Fatma Emad
Published: October 2021

Background

Bronchogenic carcinoma is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. This growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body. Most cancers that start in the lung, known as primary lung cancers, are carcinomas, The two main types are small-cell lung carcinoma (SCLC) and non- small-cell lung carcinoma (NSCLC).

Aim of the Study

Register cases of primary lung tumors presented to Ain shams university hospital during period from June 2018 to June 2019 and to follow up their response to different lines of treatment and to assess delay time between diagnosis and start of treatment.

Patients and Methods

This study is an observational, analytical and retrospective study, conducted upon 95 cases of primary lung tumor cases presented to Ain Shams University Hospital _oncology chest clinic.

Results

The main age of our studied population ranging from 17 to 66 years old in cases diagnosed as small cell lung cancer (SCLC), from 30 to 81 years old in cases diagnosed as non small cell lung cancer(NSCLC), eight out of nine cases diagnosed as SCLC were males, sixty six out of 86 NSCLC cases were males, about 66.7% of SCLC cases & 57% of NSCLC were smokers, forty four percent of SCLC presented with performance score 2, while 48.8% of NSCLC presented with performance score 1, Out of 86 cases of non small cell lung cancer 54 were adenocarcinoma, 27 were squamous cell carcinoma, 4 cases were large cell lung cancer and 1 case was mucoepidermoid carcinoma. Dyspnea was the main symptom in SCLC cases (6 cases out of 8). Fibreoptic bronchoscopy was the diagnostic tool in 33.3% of SCLC cases, 29.1% of NSCLC cases. In non small cell lung cancer, US guided biopsy took the second hand after fibreoptic bronchoscopy by 25.6%, Most of cases were stage 4, 77.8% in small cell carcinoma, 80.2% in non small cell lung cancer. SCLC received Gemcitabine/carboplatin in 33.3% of cases, 22.2% of cases received palliative radiotherapy as first line treatment.11.1% of them received definitive radiotherapy as second line treatment.In NSCLC, 25.6% of cases treated with Gemcitabine/carboplatin, 17.4% received palliative radiotherapy.In NSCLC 36% of cases presented with dyspnea then chest pain 22%.The relation between delay time and prognosis as regard disease progression is non significant similar to the relation between delay time from definitive diagnosis to start of treatment)and stage at time of diagnosis. Unlikely, the inverse relation between delay time and ECOG(Eastern Cooperative Oncology Group Performance status) in both small and non small cell lung cancer.

Conclusion

The relation between delay time and prognosis is non significant similar to the relation between delay time and stage at time of diagnosis. Unlikely, the inverse relation between delay time and ECOG in both small and non small cell lung cancer.
The effect of Epitranscriptomic writer (METTL3) silencing on Hepatocellular carcinoma cell line
Authors: El-sherbeni Afaf R , Ghattas Maivel H , Shehata Hanan H , Mohamad Magda I
Published: October 2021

Worldwide, HCC is the sixth most common malignancy and the third most common cause of cancer-related death. RNA epigenetics becomes a hot topic in recent years. Among more than a hundred different RNA modifications, m6A is the most abundant modification. m6A is involved in regulating mRNA stability, splicing, and translation. However, the implications of m6A modification in human carcinogenesis remain poorly understood. METTL3 is a major RNA methyltransferase implicated in mRNA biogenesis, decay, and translation control through m6A modification. We aimed to target METTL3 in HepG2 cell lines by siRNA (small interfering RNA), and then evaluated the effect of this interference on viability and proliferative activity of HepG2 cells.

Material and methods

Using HepG2 cell lines, METTL3 was targeted using siRNA. The viability of HepG2 was conducted by Trypan blue exclusion test. The cell proliferation was tested by CellTiter 96® AQueous One Solution Cell Proliferation Assay.

Results

viable cell number and viability percent were significantly reduced in HepG2 cells transfected with siMETTL3 compared to mock cell lines (treated with transfection reagent only) (p<0.05). The active proliferative cell count was lower in cells transfected with siMETTL3 than mock cells (p<0.05).

Conclusions

Knockdown of METTL3 in HepG2 cell lines successively reduced cell viability and active proliferative cell count. METTL3 may be involved in liver tumorigenesis and its targeting may be of therapeutic benefit.
Evaluation of the Consequence of CTNNB1 & RAB1A Targeting on Hepatocellular Carcinoma Cell Line
Authors: Ismail Amira Salah , Kassim Samar Kamal , Shehata Hanan H , Mohamad Magda I , Roushdy Marian Maher Salib
Published: October 2021

Background

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults and the most common cause of death in people with chronic liver diseases. In Egypt, liver cancer forms 11.75% of the malignancies of all digestive organs and 1.68% of the total malignancies. HCC constitutes 70.48% of all liver tumors among Egyptians. In the past few years, early diagnosis and advances in therapeutic measures have greatly improved the outcome of HCC patients. However, the prognosis is still poor with overall survival rates of 3-5%. The alterations in cancer driver genes and associated pathways are the major triggers for HCC. So, the identification and targeting of these genes are beneficial to understand HCC and to develop a new therapy.

Aim of the work

We aimed to target CTNNB1 and RAB1A oncogenes in HepG2 cell lines by RNAi then evaluate the effect of their targeting on the viability and proliferative activity of HepG2 cells.

Materials and methods

Using HepG2 cell lines, CTNNB1 & RAB1A oncogenes were targeted using two different siRNAs (small interfering RNA) for each gene. The viability of HepG2 was conducted by Trypan blue test. The cell proliferation was tested by CellTiter 96® AQueous One Solution Cell Proliferation Assay.

Results

There was significant reduction in the cells’ viability detected by trypan blue test in transfected cells with siRNA targeting either CTNNB1 or RAB1A compared to Mock HepG2 cell lines (p <0.05). In addition, the proliferative activity was significantly lower in both HepG2 cell lines transfected with siRNA targeting the previous genes compared to mock cells (p < 0.05). Furthermore, HepG2 cells transfected with siRNA targeting RAB1A were more proliferative compared to those transfected with siRNA targeting CTNNB1 (p <0.05).

Conclusion

Targeting CTNNB1or RAB1A in HepG2 cell lines decreased the cell viability and proliferative activity. Moreover, targeting CTNNB1 was effective in decreasing cell proliferative activity compared to targeting RAB1A in HepG2 cell lines. So, targeting CTNNB1 may have a potential therapeutic effect in treatment of HCC.
Diet, Serum Short Chain Fatty Acids, and Potential Molecular Associations in Obesity
Authors: Nabil Helmy Lobna Mohammad , Ahmed Sallam Reem Mohamed , Sallam Maha Mohamed , Abdelsalam Hala M , Mohamed Dalia Abdel-Wahab , Salib Marian Maher
Published: October 2021

Gut microbiota-derived short-chain fatty acids (SCFAs) have been reported to result in a wide range of health benefits including improvements in body composition and reduced body weight. However, excess production of colonic SCFAs has been implicated in the promotion of obesity. In this study, we aimed to explore the interrelation between diet, SCFAs production and obesity. This study included 31 subjects divided into a lean group and an obese group. Their dietary habits were assessed by means of food-frequency questionnaire and 24-hour recall then blood samples were collected from all of them. Analysis of short-chain fatty acids (i.e., acetate, propionate, and butyrate) in serum was performed using gas chromatography-mass spectrometry (GC-MS). Dietary assessment revealed that obese subjects had a significantly higher intake of carbohydrate, fat and sodium while lean subjects had a significantly higher intake of dietary fiber. Serum levels of propionate were higher in lean subjects compared to obese subjects (P < 0.05). Serum propionate level showed a positive significant correlation with fiber intake (P < 0.05). Our study suggests that healthy dietary choices and increasing daily fiber intake may be associated with positive health outcomes modulated by increasing short chain fatty acids.
Evaluation of Galectin1 gene, miRNA22 and LncRNA MEG3 in type2 diabetic patients
Authors: Ahmed Manar Fouad , Ali-Labib Randa , Zaki Walid Said , Abd El Hameid Marwa Mahmoud , Makboul Khaled Mahmoud
Published: October 2021

Background

Diabetes mellitus is considered the ninth major cause of death, biomarkers have been investigated in DM research field to understand the pathophysiology of DM, help in diagnosis and find new therapeutics. This study evaluated the role of Galectin 1, LncRNA MEG3, miR22 in T2DM.

Aim of the work

we aimed to evaluate the role of galectin 1 expression in type 2 DM and to explore the epigenetic regulatory effect of miRNA22 and LncRNA, MEG3 on gelatin 1 expression in type 2 DM

Materials and methods

The study included two groups: Fifteen type 2 diabetes mellitus patients and fifteen normal healthy individuals. Blood samples were collected from every participant and serum was separated. Expressions of Gal-1, LncRNA MEG3, miR22 were assessed in each serum sample by quantitative real time polymerase chain reaction (qRT-PCR).

Results

The study revealed higher levels of gal-1, miR22 and lower levels of MEG3 in serum samples of T2DM Patients compared to normal healthy individuals with statistical significance difference (p < 0.05).

Conclusion

Gal-1, MEG3, miR22 may play a role in the pathophysiology of T2DM. Studies with larger sample sizes are required to further confirm their role in early detection and diagnosis of T2DM.
Evaluation of MACF1-regulatory non-coding RNA as a potential therapeutic target in Colorectal Cancer
Authors: Aboushahba Rowaida Mohammed Reda M. M , Motaleb Fayda Ibrahim Abdel , Abou-Zeid Ahmed Abdel Aziz , Nabil Enas Samir , Mohamed Dalia Abdel-Wahab , Mohamed Shaimaa Mohamed
Published: October 2021

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths world-wide. There is an increasing need for the identification of novel biomarkers/targets for early diagnosis and for the development of novel chemopreventive and therapeutic agents for CRC. Recently, MACF1 gene has emerged as a potential therapeutic target in cancer as it involved in processes critical for tumor cell proliferation, invasion and metastasis. It is suggested that MACF1 may function in cancers through Wnt signaling. MiR-34a is a well-known tumor suppressor miRNA.miR-34a targets MACF1 gene as a part of the wnt signaling pathway. In this study, 40 colonic tissues were collected from CRC patients (20) and control subjects (20). miR-34a-5p was assessed by real time PCR in all study groups. The results showed highly significant decrease (P < 0.01) in miR-34a relative expression in the CRC group (median RQ 0.13) when compared to the benign group (median RQ 5.3) and the healthy control group (median RQ 19.63). miR-34a mimic and inhibitor were transfected in CaCo-2 cell line and proliferation was assessed. The transfection of the cell line with miR-34a mimic decreased cell proliferation. Our study suggests that miR-34a-5p targets MACF1 gene as a part of the wnt signaling pathway leading to the involvement in the molecular mechanisms of CRC development and progression.