bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Dexmedetomidine Infusion Versus Magnesium Sulphate Infusion on Emergence Delirium in Pediatric Patients Undergoing Lower Abdominal Surgery
Authors: Mahmoud Esraa Alaa El-Dien , El Zahaby Hany Mohamed Mohamed , Moharram Assem Adel Moharram Ahmed , Asaad Anis Fikry Anis
Published: October 2021

Background

Emergence delirium (ED) is a clinical state during emergence from general anesthesia in which patients are awake but have an altered mental state. Its underlying cause remains unknown. Age, preoperative anxiety, anesthetic technique or agents, surgical procedure and pain are all suggested to play a role in its development. Several drugs were used to lower it's incidence in children.

Objective

Evaluating the incidence and intensity of emergence delirium in pediatric patients undergoing lower abdominal surgery after using either intravenous dexmedetomidine infusion or magnesium sulphate infusion intraoperatively.

Patients and Methods

100 patients were randomized to receive intraoperatively either dexmedetomidine loading dose (0.5 µg/kg) over 10 min. followed by infusion rate of (0.2 µg / kg / hr.) or magnesium sulphate loading dose (30 mg/kg) followed by infusion rate of (10 mg/kg/hr) after induction with sevoflurane, LMA application and administration of caudal block. PEAD score was used for assessing emergence delirium.

Results

Incidence of emergence delirium according to PAED scale ≥10 was significantly lower in dexmedetomidine group than magnesium sulphate group with Pvalue <0.001, <0.001, 0.031, 0.012, 0.012 at 0,5,10,15,20 min. respectively during PACU stay. This statistically significant vanishes after 20 min. stay in PACU. There were no significant differences as regard fentanyl top up doses, postoperative FLACC pain score, postoperative fentanyl requirements.

Conclusion

This study shows that intraoperative administration of dexmedetomidine infusion is more effective than magnesium sulphate infusion in lowering the incidence of emergence delirium during the first 20 minutes postoperatively. In preschool aged children undergoing lower abdominal surgeries.
Spinal Anesthesia Versus Popliteal and Adductor Canal Blocks for Ambulation After Pott's Fracture Surgery
Authors: Salama Madonna Mounir , El-Shafie Mohamed Anwar , Zaki Hany Victor , Hashim Reham Mustafa
Published: October 2021

Background

Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use.

Objective

To compare the effect of spinal anesthesia versus popliteal and adductor canal blocks for ambulation after pott's fracture surgery.

Patients and Methods

Type of Study: Randomized Clinical Trial. Study Setting: Ain Shams university hospitals. Study Period: 3 months from March to May 2019.

Results

On the other hand, the side effects of peripheral nerve block surgery limit the usefulness of the procedure. The common side effects are: incomplete block, direct nerve damage, localized hematoma and consequent ischemic damage, infection, and the risk of intravenous administration of local anesthetic. In our study we compared spinal anaesthia with nerve blocks for pott’s fracture and found that the time to perform spinal block was shorter than that needed to perform nerve blocks.

Conclusion

The adductor-popliteal canal provides longer duration of analgesic, better intraoperative hemodynamics, and decreased need for postoperative rescue analgesia in comparison with spinal anaesethia in patients with pot’s fracture ankle surgery.
The analgesic effects of combined pectoral nerve blocks versus combined serratus anterior plane block and pecto-intercostal fascial plane block in breast surgery
Authors: ElZahaby Hany Mohamed Mohamed , Talaat Sahar Mohamed , El FattahGhoneim Mohamed Mohamed Abd , Matared Manar Mohsen Ahmed
Published: October 2021

Background

Poorly controlled acute pain after breast surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and increased likelihood of chronic pain. The analgesic regimen used for postoperative pain control needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient.

Objective

The aim of this study is to compare the intra-operative and the post-operative analgesic effects of the thoracic interfascial plane blocks (serratus anterior plane block in combination with pecto-intercostal fascial plane block) and pectoral nerve blocks (PECS I and II)in patients undergoing non-reconstructive breast surgeries.

Patients and Methods

The study was conducted on 50 randomly chosen patients in Ain Shams University General Surgery Hospital after approval of the medical ethical committee. They were allocated in two groups of 25 patients each. The two groups were compared regarding analgesic outcome by using the visual analogue scaling system in the first 24 hours postoperative and the patients' satisfaction using verbal rating scale and this was the primary outcome of our study. The amount of fentanyl consumed intra-operative, time for first call for rescue analgesia and the frequency of using it were recorded and compared to achieve the secondary outcome of the study which included reducing opiods requirements and avoiding their side effects.

Results

The study found that the total amount of intra-operative fentanyl consumption was significantly higher in the SAPB and PIFB group than the Pecs group with the range of 100-150 versus 100-200 micg fentanyl respectively, and the VAS was significantly higher in the combination of serratus anterior plane block and pecto-intercostal fascial plane block compared to Pecs I and II at 8th, 12th and 24th hours post operatively with p value 0.018, 0.022 and 0.032 respectively, also the frequency of administration of rescue analgesia was higher in the SABP and PIFB group with the range of (2 to 3) times in PECS I and II group versus (2 to 5) in SABP/PIFB group. Besides, the first request of post-operative morphine was significantly delayed in the pectoral nerve blocks than the SABP and PIFB group with the p value (0.020).

Conclusion

The present study found that Pecs I and II group provided superior intra-operative and post-operative analgesic control compared to the serratus and PIFB group in patients undergoing non-reconstructive breast surgeries.
Effect of Adding Magnesium Sulphate to Epidural Bupivacaine Compared to Addition of Fentanyl in Patients undergoing Lower Limb Orthopedic Surgery under Combined Spinal Epidural Anathesia
Authors: Mohamed Mohamed Ibrahim El-Desoukey , Mahmoud Sahar Mohammed Kamal , Kamal Kareem Youssef
Published: October 2021

Background

The use of opioids in intrathecal or epidural anesthesia has become popular to optimize postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use.

Objectives

The purpose of this study was to assess the postoperative analgesic requirements and the analgesic effect of adding magnesium sulphate to epidural bupivacaine compared to addition of fentanyl in patients undergoing lower limb orthopedic surgery under combined spinal epidural anathesia.

Patients and Methods

After approval of ethical committee in our study and obtaining written informed consent from eligible patients the study was conducted on 60 patients classified to ASA I and II scheduled for lower limb orthopedic surgery. The study presents double armed randomized interventional prospective study including patients allocated into two equal groups each consists of 30 patients. Group (A): patients received magnesium sulphate added to bupivacaine in epidural, Group (B): patients received fentanyl added to bupivacaine in epidural

Results

The results of their study showed that the maximum level of sensory blockade was significantly higher in the combined fentanyl with magnesium group as compared with fentanyl group alone and magnesium sulphate group alone. The duration of sensory blockade of the combined fentanyl and magnesium group was significantly prolonged as compared to the other two groups as for the other two group the difference in the blockade duration was insignificant

Conclusion

We concluded that either magnesium sulfate (75 mg) combined with (10 ml) 0.25% Bupivacaine or fentanyl (1 µg/kg) combined with (10 ml) 0.25% Bupivacaine in combined spinal epidural improves intraoperative analgesia and prolongs early postoperative analgesia in lower limb orthopedic surgeries. The duration of analgesia was more prolonged in magnesium sulphate group than in the fentanyl group and this difference was statistically significant.
Comparison between Glucose Containing Solution D2.5% and Ringer Lactate as a Maintenance Fluid Management in Infants Undergoing Inguinal Hernia Repair
Authors: Mohamed Mohammed Hosny Hasan , Nasr Dalia Abd El Hameed Mohamad , Ansary Amin Mohamed El
Published: October 2021

Background

Infants and neonates are at particular risk of hypoglycemia when suffering from sepsis, asphyxia and hypothermia. A prospective study showed that up to 20% of preterm infants who were ready for discharge were still at risk of hypoglycemia when a feed was delayed. In contrast, surgery and critical illness may cause hyperglycemia.

Objectives

The aim of this study is to Assessment of glucose containing solutions 2.5 % as a maintenance fluid management intra operative in infants undergoing hernia repair as regard hyperglycemia and hypoglycemia.

Patients and Methods

The study was conducted on 100 randomly chosen patients aged from 28 days to 1 year, American Society of Anesthesiologists (ASA) class I scheduled for elective open inguinal hernia repair in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 50 patients each: Ringer lactate Group: patients received ringer lactate as maintenance fluid therapy according to body weight, glucose containing solution: patients received glucose containing solution 2.5% as maintenance fluid therapy according to body weight.

Results

The results of the study revealed that 12% of patients receiving glucose containing solution 2.5 % had simple hyperglycemia with no hypoglycemic patients recorded while the other group with ringer lactate 2% of patients had simple hyperglycemia and 4% of patients had hypoglycemia .

Conclusion

The usage of glucose containing solution 2.5% remained controversial, in this study we compared glucose 2.5 % in normal saline 0,9 % to ringer lactate and the results didn’t put a final decision to the usage of glucose containing solutions as The results of the study revealed that 12% of patients receiving glucose containing solution 2.5 % had simple hyperglycemia with no hypoglycemic patients recorded while the other group with ringer lactate 2% of patients had simple hyperglycemia and 4% of patients had hypoglycemia.
Comparative study between the effect of intrathecal bupivacaine versus bupivacaine dexmedetomidine combination in spinal anaeshtesia for lower abdominal surgeries
Authors: Marzouk Mervat M , Thabet Wael R , Ashoor Tarek M , Ahmed Ahmed Morsy
Published: October 2021

Study objectives

We compared effect of intrathecal bupivacaine versus bupivacaine

Design

This is a prospective, randomized, double-blinded study.

Setting

The setting is at an operating room in Ain Shams University Hospital. Patients: 50 patients scheduled for general anesthesia were randomly allocated to the following 2 groups in equal numbers.

Interventions

Spinal anaesthesia will be performed in the sitting position at L3-L4 or L4-L5 level using a 25-gauge Quincke spinal needle by the most competent experts. The sensory block level will be assessed along the mid-clavicular line bilaterally. The motor block will be assessed according to Bromage scale

Measurements

Post operative (VAS) score and Time to first requested analgesia.(primary outcome), Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate will be recorded every 5 minutes for 20 minutes then every 15 minutes till the end of surgery, Nausea and/ or vomiting as yes/no, Level of highest sensory block, Bromage score ≥3, Onset of sensory block and Two segment regression time (secondary outcomes) were recorded..

Main results

Results of this study showed that the addition of dexmedetomidine to bupivacaine in spinal anaesthesia significantly prolonged both sensory and motor blockades duration compared with bupivacaine alone. They also prolonged the time of postoperative analgesia as evidenced by significantly longer time to first rescue analgesia and lower NRS scores with minimal adverse effects and haemodynamic stability.

Conclusions

We concluded that intrathecal dexmedetomidine increases the duration of analgesia and reduces postoperative pain without changes in the hemodynamic parameters and adverse side effects. It can be considered as an appropriate adjuvant to intrathecal local anesthetics for lower abdominal surgeries.
COMPARISON BETWEEN PERINEURAL DEXAMETHASONE AND INTRAVENOUS MAGNESIUM SULPHATE AS ADJUVANT IN SUPRACLAVICULAR BLOCK
Authors: El-Shaer Ahmed Nagah , Ali Ahmed Kamal Mohamed , El-Aziz Farouk Kamal Eldeen Abd , El-Sayed Mostafa Samir
Published: October 2021

Background: Upper extremity surgeries are commonly performed under regional anaesthesia. Regional anaesthesia of the upper extremity has several advantages over general anaesthesia such as improved postoperative pain management, decreased postoperative narcotic consumption, and reduced recovery time.

Objectives: The aim of the study was to compare between dexamethasone and magnesium sulphate as adjuvants in supraclavicular brachial plexus block as regards the onset and duration of sensory and motor block as well as side effects.

Patients and Methods: This prospective double-blinded comparative study was carried out in Faculty of Medicine, Ain-Shams University Hospital on 120 adult patients between 21-50 years of both sexes with ASA classification 1&2 who were scheduled for elective upper limb orthopaedic surgeries. A written informed consent was obtained from all patients. Every patient received an explanation about the purpose of the study. Procedures had been approved by the institutional and the regional ethical committee. Total 120 patients are enrolled in the study and divided into 3 groups A and B and C (40 for each one).

Results

From aspect of increasing the duration of sensory &motor block magnesium sulphate group (group A) showed higher prolongation of sensory & motor block with recovery of pin prick sensation in median time 313 mins ± when compared with group B &C even with longer time taken for patient to request rescue analgesia after 5 hours. In group (B) by adding dexamethasone with bupivacaine the blood pressure rate are increased after 20 min of injection and return normal after 240 min, heart rate are normal, but in case of sensory and motor block about 77.5% of study patient in this group have full motor and sensory block, in case of increasing time of motor and sensory block the dexamethasone success increasing time for motor and sensory block to reach 278 min sensory and 314 min in motor block, first call of Analgesic are after 4 hr.

Conclusion: Group A (Magnesium sulphate with bupivacaine) were more effective and increasing affected time in motor and sensory block than Group B (Dexamethasone with Bupivacaine) and Group C (Control).
Study of Effects of Soaking Oro-Pharyngeal Pack with Triamcinolone Acetonide in Or-Base Form on Postoperative Throat Discomfort in Patients Undergoing Functional Endoscopic Sinus Surgeries
Authors: Fahmy Nouran Mohsen Ahmed , Ali Sultan Sherif Sayed , Emam Dalia Fahmy , Hasan Mohamed Ibrahim
Published: October 2021

Background

Post-operative throat complaints frequently arise after general anesthesia in the first 2 postoperative days, but they are of limited intensity and duration and often regard it as a relatively minor complication.

Objectives

The aim of this study was to determine the effect of adding triamcinolone acetonide to Oropharyngeal packs on decreasing the postoperative throat discomfort.

Patients and Methods

After obtaining approval from the Research Ethical Committee, Faculty of Medicine, Ain Shams University No. FWA 000017585 at 10th of April 2019, this study was conducted in the operating theaters of Otorhinolaryngology department, Ain Shams University Hospitals, Cairo, Egypt. Prospective, interventional double – blinded, randomized, controlled trial. Study Period: From 10th of April 2019 to 10th of September 2019.

Results

Post was followed up in the studied patients in 30 minutes postoperative, and at the duration of 2 to 6 hours postoperative and 24 hours postoperative and the median was calculated. The median IQR of patients who developed sore throat after use of oral packs in our study from 2 to 6 hours postoperative in control group was 4 with range (3 -5), median IQR in study group during the same period was 3 with range (4 -5) with test value 2.194 using Mann-Whitney test with P-value 0.028 with significant result.

Conclusion

The use of oral packs with triamcinolone acetonide showed lower proportion of patients who developed dysphagia and hoarseness of voice in patients group compared to control group, while no one of the studied patients showed postoperative nausea and vomiting as complication of use of oral packs.
Dexmedetomidine versus Ketamine-Propofol for Sedation of Obese Patients Undergoing Upper Gastrointestinal Endoscopy
Authors: Zaher Ola Nasser Hussain , El Kabarity Reem Hamdy , Ali Rania Magdy Mohamed , Mohamed Mohamed Moien
Published: October 2021

Background

Gastrointestinal endoscopy is an uncomfortable and stressful procedure for most patients. Conscious sedation is a common strategy for improving patient comfort during this procedure. Benzodiazepines (gamma-aminobutyric acid (GABA) agonists) such as midazolam have been used for sedation of patients undergoing gastrointestinal endoscopy. The effective dose ranges of such agents differ considerably among patients, making it difficult to achieve stable sedation. Also obesity is a significant health problem that has assumed epidemic proportions. As a result, the number of obese patients requiring endoscopy is increasing. It is relatively unknown how safe the current practices of sedation for endoscopic procedures are in bariatric patients. Therefore, special consideration should be given to these patients

Aim of the Work

To compare the sedative properties and haemodynamic and respiratory effects of Dexmedetomidine and a Ketamine-Propofol combination (ketofol) in obese patients undergoing Upper GI Endoscopy.

Patients and Methods

This study was conducted in the endoscopy unit of Ain Shams

University Hospital after obtaining approval from the Research Ethical Committee of Ain Shams University. A prospective, randomized controlled clinical trial was found to be the most suitable design in order to achieve the study objectives. Cases were divided into 2 groups using computer generated random list of numbers in sealed opaque envelopes.

Results

We found that ketamine-propofol infusion (1:3) is a better sedation regimen for upper gastrointestinal endoscopy compared to dexmedetomidine as lesser time is taken to achieve optimal sedation, with no hemodynamic unstability or postprocedure complications.

Conclusion

In this study, we compared a group of 40 upper GIT endoscopy obese patients (BMI 30-40) who received procedural sedation with either Dexmedetomidine or propofolketamine combination, we found that ketamine-propofol infusion (1:3) is a better sedation regimen for upper gastrointestinal endoscopy compared to dexmedetomidine as lesser time is taken to achieve optimal sedation, with no hemodynamic unstability or post procedure complications.
Effect of Growth Hormone on Outcome of Pediatric Burn Patients
Authors: Mohamed Gihan Seif El Nasr , Amin Salwa Omar ElKhattab , Kamal Mohamed Mohamed , Loka Sherif Hany Adly
Published: October 2021

Background

A burn is a thermal injury caused by biological, chemical, electrical and physical agents with local and systemic repercussions. There are several ways of classifying burns: Classification by mechanism or cause, Classification by the degree and depth of a burn, Classification by extent of burn the extent of burn.

Objectives

The objective of this study was to determine the safety and efficacy of using recombinant human growth hormone (rhGH) in the treatment of pediatric burn victims and their ICU length of stay, mortality and morbidity.

Patients and Methods

This study was an Interventional randomized controlled Double Blind Study in which Patients subdivided randomly into 2 groups: Group A received somatotropine hormone after their 3 days of resuscitation besides their conventional treatment during their stay in the Burn ICU. Group B received the conventional treatment only in the Burn ICU.

Results

The comparison between the GH group and the control group showed that the mean ICU stay in days in GH group was 10.88 while in the control group 13.59 with P value 0.018 as a significant result as the GH group showed a less ICU stay time than the control group with approximately 20%. Mortality in the GH group was 6.2% from the total number of the group while in control group 18.8% from the total number of the group with P value 0.033 as a significant result yet the mortality may also depend on other factors as the degree of burn and the area of burn and the associated events like inhalational injury or delay post burn or any other co-morbidity. Morbidity results seen was 0% in control group and 4.7% in GH group with P value 0.080 as a non-significant result, morbidity was in the form of hyperglycemia.

Conclusion

The use of recombinant Growth hormone with a dose of 0.2 mg/Kg SQ 2 days per week with 3 days time interval in pediatric burn patients after their primary resuscitation from the burn injury, shows a marvelous improvement concerning the ICU stay time as the patient received the growth hormone showed an approximately 20% time less ICU stay than the control group this may be accounted for the faster wound healing and readiness for grafting and even faster graft healing, also a decreased mortality in a significant way, although mortality may depend on many factors in burn patients like degree of burn and the area of burn and the associated events like inhalational injury or any other co-morbidity.
Comparison between Ultrasound Guided Transversus Abdominis Plane Block versus Ultrasound Guided IlioInguinal/Iliohypogastric Nerves Block for Postoperative Analgesia in Patients Undergoing Unilateral Oblique Inguinal Hernia Repair Under General Anesthesia
Authors: Faramawy Shrouk Ayman Mohamed Soliman , Abdel-Latif Samia Abdel-Mohsen , Abdel-Atte Mohamed Abdel-Salam Menshawe , Ahmed Ibrahim Mohammed El Sayed
Published: October 2021

Background

Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain.

Objectives

The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received.

Patients and Methods

The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee.

Results

The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block.

Conclusion

TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.
Role of Ultrasound-Guided Tru-cut Biopsy in the Diagnosis of Peripheral Lung and Pleural Lesions
Authors: Wagih Khaled Mohamed , Osman Nehad Mohammed , Heta walid , Abdellatif Fatma El-Zahraa
Published: October 2021

Background

Transthoracic needle biopsy is a well-established technique for diagnosing pulmonary lesions. Computed tomography (CT) is usually used as guidance. Ultrasound (US)-guided biopsy is a relatively affordable modality for diagnosis of peripheral lung lesions (PLLs; also known as peripheral pulmonary lesions [PPLs]) and peripheral pleural lesions.

Objectives

The purpose of this study was to study the diagnostic yield of US guidance sampling a consecutive series of peripheral lung and pleural lesions and potential factors influencing the diagnostic yield with recording the occurrence of any complications.

Patients and Methods

This was a prospective study that was conducted at Ain Shams University Hospitals upon a population of 60 patients, during the period from September 2018 to August 2019. A special puncture transducer is used to perform US-guided biopsy with visualization of the biopsy needle and the lesion; facilitating the sampling procedure.

Results

The use of US-guided transthoracic needle biopsies across 60 patients was shown to have a yield of 75% which found the occurrence of 45 conclusive and 15 non-conclusive results From this study population, 70% (n = 42/45) were found to have malignant manifestations, of which 26 were undifferentiated high grade adenocarcinoma, and 9 were moderately differentiated adenocarcinoma. As for complications arising from the biopsy procedure, twenty percent 20% (n = 12) of patients suffered from complications in the form of hemoptysis in 8 which was controlled by hemostatic measures and 4 patients acquired pneumothorax, three (¾) of them received high flow oxygen and conservative treatment and only one (1/4) patient had intercostal tube placement. Diagnostic yield was significantly increased with the presence of Wedge shaped hypoechoic lesions(p < 0.001), hard Mass consistency was significantly highly associated with conclusive results (p < 0.001), as well as a significant link between the longitudinal diameter of masses that had a mean length of 45.05mm ±12.93mm (#x0003D; 0.029).It also showed that more biopsies taken were highly significant correlation with conclusive outcomes (p < 0.001).

Conclusion

US-guided biopsy is a robust and accurate procedure to effectively diagnose peripheral lung lesions, with a low incidence of complications and gradually improving results with the mastery of the procedure.
Study of long non-coding RNA and mitochondrial dysfunction in diabetic rats
Authors: Kamal Haytham K , Moustafa Amr S , Elayat Wael M , Lasheen Noha N , AbouGhalia Azza H
Published: October 2021

Diabetes mellitus (DM) is a worldwide health problem. Many factors participate in the pathogenesis of DM, including genetic, autoimmune, metabolic, dietary and environmental factors. Intact mitochondrial function is essential for prompt cellular metabolism and energy balance. Malfunctioning mitochondria lead to disturbed glucose metabolism and therefore evolving of DM. Epigenetics plays a role in the control of geneencoded proteins of mitochondrial function and dynamics. One of the primary epigenetic effectors is a family of long non-coding RNAs. The role of lncRNA, H19 in the regulation of mitochondrial dynamics has been recently investigated.

The Aim of the work

This study aims to evaluate the possible functional role of lncRNA, H19 and its relation to mitofusin-2 (MFN2) expression in diabetic rats.

Subjects and methods

This study was performed on adult male albino rats divided into diabetic and control groups. Induction of type 1 DM was conducted through single intraperitoneal injection of streptozotocin. Serum measurement of glucose, lipid profile, urea, creatinine, and creatine kinase were performed. Blood pressure measurement, ECG recording, and echocardiography were also performed. Histological examination of cardiac and renal tissues was also performed. In addition, quantitative expression of cardiac and renal tissue MFN2 and lncRNA H19 was determined using qPCR.

Results

Serum CK-MB and lipid profile levels were markedly elevated in diabetic group compared to controls. Also, kidney functions (serum creatinine, creatinine clearance and albumin creatinine ratio) were markedly elevated in diabetic group compared to controls. Histological examination revealed necrotic changes and intercellular micro hemorrhages in both cardiac and renal tissues of diabetic rats. Expression level of MFN2 gene was lower in diabetic heart and significantly lower in diabetic kidney, as compared to control. Expression of lncRNA H19 was higher in diabetic heart and diabetic kidney as compared to control but without statistical significance.

Conclusion

In diabetic rats, hyperglycemia had inverse relationship with mitofusin expression and direct proportional relationship with H19 expression. We concluded that hyperglycemia has effect on mitochondrial dynamics suppressing fusion in favor of fission and mitophagy, while H19 expression serve to counterpart the effect of hyperglycemia. In the future, MFN and H19 could serve as potential therapeutic target to reverse effects of hyperglycemia and its complications in DM.
Transcriptome Spectral Analysis using Hyperspectral Imaging for Hepatocellular Carcinoma Detection
Authors: Aboughaleb Ibrahim H , Matboli M , Shawky Sherif M , Aref Mohamed Hisham , El-Sharkawy Yasser H
Published: October 2021

Hepatocellular carcinoma (HCC) is a noteworthy health problem with a poor diagnosis due to limited detection techniques. Transcriptome studies can be used to classify cancer further away from anatomical location and histopathology. Recent studies demonstrated the novelty of numerous types of specific RNA biomarkers that differentially expressed both the normal liver and the HCC tissues, but those specific types overlapped with the detection of other types of cancers. In this study, total RNA was used to ensure the existence of differences between different cancer types. A multispectral light source (340-1000 nm) interacted with the sample. Multi-wavelengths images were captured using a hyperspectral camera (wavelength 380-1000 nm). The optimum wavelength to discriminate between the normal and HCC samples was selected by calculating the optical properties (transmission, absorption and scattered light). Results showed specific spectral signatures for total RNA within the red-band (633-700 nm) that discriminate HCC from control. The amount of light scattering, transmission and absorption relatively changed due to the variations of size, shape, and concentration of total RNA. The spectral RNA signature that is dependent on the shape and size of total RNA may be utilized as the gold standard for HCC detection.
The effect of nutri-epigenomic agent “pterostilbene” on the expression of ADAR enzyme(s) in HCC animal model
Authors: Desoky Islam A , Zaki Kamelia Ahmed , Mohamad Magda I , Kassim Samar Kamal
Published: October 2021

Background

A-to-I RNA editing represents a new player in the pathogenesis of cancer. However, the knowledge of RNA editing process in cancer is still limited and represents only the tip of the iceberg. The ADAR gene family regulate the dynamic landscape of RNA editing. Aberrant RNA editing status played a vital role in the pathogenesis of hepatocellular carcinoma (HCC). The nutri-epigenomic agent- pterostilbene- exhibits anti-inflammatory, antioxidative and antiproliferative activities. However, the effect of pterostilbene on ADAR(s) expression in HCC was not studied before.

Aim of the work

to evaluate the potential effect of pterostilbene administration on Adar(s) expression in HCC rats.

Materials and methods

Twenty four adult male rats were randomly divided into 4 groups: the control group, untreated HCC group received diethylnitrosamine (DENA) for 14 weeks, HCC group take received pterostilbene and DENA for 14 weeks, and non-HCC rats were given pterostilbene for 14 weeks. These groups were subjected to histological examination of liver tissues, laboratory measures (serum albumin, ALT, AST, and α fetoprotein), and Adar(s) expression by real time-PCR.

Results

liver enzymes (ALT, AST) and α fetoprotein levels in treated HCC group were significantly lower than untreated HCC group (p<0.05). Serum albumin levels were significantly higher in treated HCC rats than untreated HCC group (P<0.05). Adar1 was highly expressed in untreated HCC rats in comparison to the control group (p<0.05). Meanwhile, treated HCC group had lower expression levels of Adar1 in comparison to untreated HCC rats.

Conclusions

pterostilbene had a beneficial effect on HCC and it may alleviate the aberrant expression of Adar1 in HCC rats.

Key words

HCC, ADARs, pterostilbene, RNA editing enzymes.

Acknowledgments: No finical support was present

Conflict of interest: the authors declared that no conflicts of interest concerning the article.

Authors’ contributions: The authors contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript
The effect of Surgical Technique, Age and Trisomy 21 on early outcome of Surgical Management of Complete Atrioventricular Canal Defect
Authors: Azzab Sherief , Samy Ahmed , Singab Hamdy , Ghanam Mohamed EL , Tarek Ahmed
Published: October 2021

Background

The optimal timing, surgical technique and the influence of Down syndrome on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remains uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome.

Methods

A prospective study included 70 patients who underwent repair of CAVC at Ain Shams university hospitals, academy of cardiothoracic surgery during the period from July 2016 to October 2019. Age at surgery (less than 6 months old versus later), surgical technique used [(modified single patch versus double patch technique), (use of posterior annuloplasty for repair of left AV valve or not)] and association of Down syndrome were evaluated for their impact on the outcome of surgical repair using multivariate analysis. Patients were followed up for 6 months; primary end point was mortality and secondary end point was reappearance of LAVV regurgitation.

Results

No significant difference between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Down patients showed significant difference in the occurrence of postoperative compared to non-Down patients (LAVVR grade 2 + = 8.9% vs 24%, P value =0.005) respectively. Surgical repair by Modified single patch technique showed significant reduction in cross clamp time (mean = 47.6 ± 9.227 min vs 73.55 ± 21.087 min, P value 0.00), shorter bypass time (mean = 71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.00) and shorter duration of ICU stay (mean =3.2 ± 1.657 days vs 5.3 ± 2.761 days, P value=0.01) as compared to double patch technique. Posterior annuloplasty used for repair of LAVV compared to closure of cleft only resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVVR 2+ 43% vs 7%, P value=0.03) and at 6 months of follow up. (LAVVR 2+ 35.4% vs 0%, P value=0.01) respectively.

Conclusion

early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair, Down syndrome was not found to be a risk factor for early intervention. Modified single patch and double patch techniques for repair, can be used both with comparable results even in large VSD component (8mm and larger), finally, repair of common AV valve by cleft closure with posterior LAV annulplasty showed better results with significant decrease in postoperative LAV regurgitation and early mortality in comparison to closure of cleft only.
Post operative echocardiographic follow up after mitral valve replacement by different types of biological valves
Authors: sayed Gamal samy , Ismael Ihab Abdel razek , Shahin Khalid Mohamed , Hanna Angelo Emad
Published: October 2021

Objectives

This retrospective study compares porcine with bovine bioprosthesis in mitral position with regard to valvular degeneration.

Methods

Between 2005 and 2019, 15 patients underwent mitral valve replacement with porcine Epic biological valve (St-Jude) and 15 patients underwent mitral valve replacement by bovine Carpentier –Edwards Perimount biological valve and follow up ecocardiogarphy was done to evaluate valvular degeneration of both types

Results

Bovine type showed longer durability than porcine and less valvular degeneration within 14 years of follow up regardless age of patient, cause of valve replacement, or lesion of valve Coclusion: Bovine bioprothesis are better than porcine regarding durability
Effect of Iron deficiency on health-related quality of life in chronic heart failure patients regardless of anaemia status
Authors: Fawzy Ahmed Alaa Eldin , Keddas Viola William , Elkelany Wael Mahmoud
Published: October 2021

Background

Chronic Heart Failure (CHF) patients have marked functional limitations causing a significant impact on Health Related Quality of Life (HRQoL) in these patients. Iron Defeciency is very common in Heart Failure patients & it is suggested that it affects HRQoL in CHF patients regardless of the Anemia status .

Objective

To evaluate the impact of iron deficiency (ID) on health-related quality of life (HRQoL) in chronic heart failure (CHF) patients using Minnesota Living with Heart Failure questionnaire (MLHFQ) in patients with normal hemoglobin levels .

Methods

From October 2018 to August 2019 ,100 patients with CHF from out- patient clinics in ASU university hospitals were subjected to history taking , examination , Echocardiography , measurement of Iron status using serum ferritin, Assessment of Health

Related Quality of Life (HRQoL) using Minnesota Living with Heart Failure Questionnaire (MLHFQ) . Patients then were divided into 2 equal groups depending on their serum ferritin level & comparison of MLHFQ score between the 2 groups was done .

Results

The study population was divided into 2 groups: Iron Defecient (ID) (n = 50)

& non Iron Defecient (non ID) (n = 50) , 61 patients were males & 39 were females. The MLHFQ scores were 66.9 ± 9.1 among ID patients vs 46.9 ± 7.3 in non ID patients (p value < 0.001) indicating worse HRQoL in ID group . The physical domain (p value < 0.001) was markedly affected than the emotional domain (p value 0.006) of the MLHFQ score .

Conclusion

In CHF patients , HRQoL was markedly affected among ID patients than non ID patients with physical factors more affected than the emotional factors .
Assessment of right ventricular function in patients presenting with inferior ST segment elevation myocardial infarction and right ventricular infarction undergoing primary percutaneous intervention by different echocardiographic modalities in correlation with angiographic findings
Authors: Lotfy Ahmed , Eldesoky Ahmed I , Thabet . Sameh S
Published: October 2021

Background

Patients with inferior wall myocardial infarction who have right ventricular (RV) involvement appear to have a worse prognosis than those without RV involvement; infarcted RV tissue fails to offer a sufficient preload which is essential for adequate LV performance. Thus, assessment of RV function is an important step in dealing with patients presenting with inferior wall myocardial infarction that will help in adopting a proper management plan.

Objective

To assess the correlation between RV function and angiographic findings in patients presenting with inferior wall myocardial infarction associated with RV infarction undergoing primary percutaneous coronary intervention.

Patients and Methods

Study included 60 patients who presented to Ain shams university hospitals by inferior wall ST segment elevation myocardial infarction associated with RV infarction during the period from February 2019 to August 2019.All patients were subjected to history taking, clinical examination, ECG recording then primary percutaneous coronary intervention. Echocardiographic assessment was done to all patients within 48 hours of admission.

Results

Study included 60 patients, 43 males (71.7%) and 17 females (28.3%), with mean age of 56.73 ± 9.94 years. Commonest Infarction related Artery (IRA) associated with impaired RV function was proximal RCA (p-value: 0.003). In 23 patients (38.3%) heavy thrombus burden was found while in the other 37 patients (61.7%) there was no evidence of heavy thrombus burden. Regarding post procedural TIMI flow grade: 1 patient (1.7%) had final TIMI I flow, 9 patients (15.0%) had final TIMI II flow and 50 patients (83.3%) had final TIMI III flow. There was statistically significant relationship between RV function assessed through measuring RV free wall strain and both of thrombus burden and final TIMI flow grade. Abnormal RV function was more commonly associated with heavy thrombus burden (p-value:0.023) and less than TIMI III flow after angioplasty (p-value:0.011).RV free wall systolic strain assessment had highest accuracy (75%) in detection of proximal RCA occlusion compared to other parameters including TAPSE, S’ and FAC.

Conclusion

Impaired RV function in patients presenting with RV infarction can be predicted by different angiographic findings. Proximal RCA total occlusion being commonest IRA associated with impaired RV function. Also, presence of heavy thrombus burden and less than TIMI III flow after angioplasty are associated with increased risk of impaired RV function. RV free wall strain measured by 2D-speckle tracking echocardiography has highest accuracy in detection of proximal RCA occlusion compared to other echocardiographic indices including TAPSE, S’ and FAC.
Intravascular ultrasound guidance to minimize the use of contrast in percutaneous coronary interventions in diabetic patients with chronic stable angina
Authors: Marey Mohamed Abdelfattah , Mohamed Hisham Ammar , Moneim Rezq Ahmed Abdol , Elias Ramy Raymond
Published: October 2021

Objective

To evaluate the impact of Intravascular ultrasound guidance on the final volume of contrast agent utilized in diabetic patients undergoing PCI for chronic stable angina.

Background

To date, few approaches have been described to reduce the final dose of contrast agent in percutaneous coronary interventions (PCI). We hypothesized that intravascular ultrasound (IVUS) might serve as an adjuctive imaging tool in many steps during PCI, thereby reducing the use of iodine contrast.

Methods

A total of 100 Diabeic Egyptian patients were selected to angiography-guided PCI or IVUSguided PCI from June 2019 to January 2020 .The study type was case control and non consecutive . Both groups were treated according to a pre-defined meticulous procedural strategy. A written informed consent was taken from all patients.The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 6 months.

Results

The median total volume of contrast was 111.65 ml (interquartile range [IQR] 170.40 ± 52.91ml , range from 100 ml to 300 ml) in angiography-guided group vs. 56.99 ml (IQR 94.70 ± 19.28ml , range from 70 ml to 180 ml) in IVUS-guided group (p < 0.001).similary, the median total volume of contrast was 111.65 ml (interquartile range [IQR] 170.40 ± 52.91ml , range from 100 ml to 300 ml) in angiographyguided group vs. 56.99 ml (IQR 94.70 ± 19.28ml , range from 70 ml to 180 ml) in IVUS-guided group (p < 0.001).In-hospital and 6 month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI according to : Death, Acute myocardial infarction, Unplanned revascularization, Stent thrombosis.

Conclusions

Thoughtful and extensive utilization of IVUS as the primary imaging tool to guide PCI is safe, and markedly reduces the volume of iodine contrast, compared to angiography alone guidance.
Myocardial bridge analysis by multidetector computed tomography and its association with coronary atherosclerosis
Authors: Mousa Mohamed Ismail Ahmed Abd El Ati , Mohamed Yasser Gomaa , Onsy Ahmed Mohamed
Published: October 2021

Background

Myocardial Bridging an inborn coronary abnormality, is defined as a segment of a major epicardial coronary artery, the tunneled artery, that goes intramurally through the myocardium beneath the muscle bridge.

Objective

To evaluate noninvasively the presence and distribution of atherosclerotic plaques in relation to myocardial bridge coronary segments and to determine the prevalence of myocardial bridges and their location and morphology by using MDCT.

Patients and Methods

The study population consisted of 55 patients presented with chest pain, referred for MDCT coronary angiography and found to have myocardial bridge at during the period from April 2018 and August 2019. 23 patients was found having Myocardial Bridge and coronary artery atherosclerotic plaques included in Group (A), 29 persons found having Myocardial Bridge without CAD included in Group (B). All patients were subjected to detailed history taking, clinical evaluation, ECG analysis and MSCT coronary angiography.

Results

In the present study, patients with atherosclerotic plaque (group A) (n = 29), mean age was 52.41 ± 10.55 years ranged from 35.0 to 73.0 years, 41.4% were males, while in Myocardial bridge without atherosclerotic lesion group (group B) (n = 26), mean age was 51.65 ± 7.58 ranged from 38.0 to 65.0 years., 30.8% were males.

Conclusion

Our study showed that diabetes mellitus and dyslipidemia are a significant risk factor for developing atherosclerotic plaque in the segment proximal to myocardial bridge. Myocardial bridge were usually located over the Mid segment of the left anterior descending coronary artery