bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ringer Lactate Versus Voluven In Sepsis In Intensive Care Unit Patients
Authors: Abd-aziz M S , Abdallah M M K , Ali R E 
Published: May 2020

Abstract

Background
Sepsis, a syndrome of physiologic, pathologic, and biochemical abnormalities induced by infection, is a major public health concern. Sepsis should be defined as life-threatening organ dysfunction caused by a dys-regulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%.

Objective
To compare between ringer lactate and voluven in resuscitation of patient with sever sepsis in intensive care unit.

Patients and Methods
It is a prospective analytical study to compare ringer lactate versus voluven in resuscitation in sever sepsis. The required sample size has been estimated to be 30 patients for each group. A total number of 60 patients were treated for severe sepsis in our ICU during the study period. 30 patients assigned to ringer lactate and 30 patients assigned to HES 130/0.42, there was 40% of patients known to have HTN and 66.7% know to have DM.

Results
In comparison between the studied groups regarding the ABG data in first day, we found a PH improvement in Voluven group more than Ringer lactate group by P-value 0.020. Pao2 was worsened in Voluven group than Ringer lactate group by p-value 0.022. The laboratory data showed no specific significance between the two groups and C-Reactive protein results were not in the two study groups.

Conclusion
There’s no significant difference in Patients with severe sepsis assigned to fluid resuscitation with Voluven compared to those receiving Ringer’s lactate in SOFA score results as well as mortality index.
Comparison between the Effects of Thiopental Sodium and Propofol on Maternal Hemodynamics during Cesarean Section Under General Anesthesia and Apgar score of the newborns
Authors: Elshaer E , Omar H , Elshaer A , Youssif T , Abdelmoneim W 
Published: May 2020

Abstract

Background
Cesarean delivery is one of the most current surgeries in women and one of the most significant challenges of anesthesiologists in this kind of surgery is the fetuses' exposure to anesthetic drugs. Regional anesthesia is generally preferred during cesarean section, but general anesthesia may be the only option under certain circumstances such as patient preference, back deformities. The most common drugs which are used in cesarean section to induce general anesthesia are thiopental sodium and propofol.

Aim
compare the effect of sodium thiopental induction versus propofol induction on hemodynamics of mothers undergoing elective cesarean section under general anesthesia and their effect on Apgar score of their newborns.

Materials and Methods
A total 260 healthy patients were included in an open randomized study, among whom 130 patients received Thiopentone and 130 received Propofol. These patients were premedicated with granisetron and ranitidine, after induction dose the maintenance was similar for both groups. APGAR scoring and umbilical cord venous gas analysis were among the parameters used for determining the general well-being of newborns. There were no significant difference between the two groups regarding Apgar scoring in 1st, 2nd and 5th minutes. Umbilical cord blood gas values were similar . There was no metabolic acidosis in newborns of mothers receiving thiopental or propofol as anesthetic agents during cesarean section.

Results
Group (T) received general anesthesia with thiopental at a dose of ( 4-6 mg/kg) while patients in group (P) received general anesthesia with propofol at a dose of (2mg/kg). As regards hemodynamic changes, there were no significant difference in maternal heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure during their measurement throughout the procedure-preoperatively, after delivery of the baby,15 minutes after delivery, after extubation and in recovery room- but after intubation, there were significantly lower in propofol group which suppressed hemodynamic response to intubation .

Conclusion
Thiopental and propofol can be safely used in cesarean sections, but the use of propofol is more advantageous than thiopental because it provides adequate anesthetic suppression of pressor response of intubation without any depressive effect on newborns.
Comparison Between Volume Controlled Ventilation And Pressure Controlled Ventilation In Morbidly Obese Patients Undergoing Laparoscopic Gastric sleeve Surgery
Authors: Elshafie M A , Elfawy D M A , Abdelhak A A , Abdelalim Y N 
Published: May 2020

Abstract

Background
Although numerous studies conducted in the past years, there is no superior guideline that indicates the best ventilation mode during laparoscopic anesthesia inobese patients. There are numerous studies with dissimilar controversial points. The management of oxygenation in a morbid obese patient undergoing laparoscopic procedures presents many challenging aspects to the anesthetist.

Objective
The aim of this study was to equate the effect of pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on respiratory, oxygenation parameters and post operative complications.

Patients and Methods
This study was conducted on 80 patients who underwent laparoscopic gastric sleeve surgery in Ain Shams University Hospitals. Post induction of Anesthesia, Patients were divided into two groups. The first group mechanical ventilation setting was volume controlled ventilation and the second group mechanical ventilation setting was pressure controlled ventilation.

Results
The results of our study shows that despite some valuable effects regarding plateau and mean airway pressure with PCV, there is no momentous clinical difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) in obese patients undergoing laparoscopic gastric sleeve surgery. However, pressure controlled ventilation shows slightly more favorable results regarding post extubation oxygen saturation and the decrease of post operative basal atelectasis. It appears that using dual modes would be an epitome approach with lower complications and similar outcomes.
Comparitive Study Between Ultrasound Guided Rectus Sheath Block versus Local Wound Infiltration for Post-Operative Analgesia in Patients Undergoing Midline Exploratory Surgeries
Authors: Mahmoud H O , Elhennawy A M , Ali M M M M , Abdelhalim A A A 
Published: May 2020

Abstract

Background
Poorly controlled acute pain after abdominal surgery 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 Rectus Sheath Block (RSB) compared local wound infiltration after midline incision 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 RSB block and were trained to use the visual analogue scale (VAS). The study was conducted on 50 randomly chosen patients aged 20 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective midline exploratory surgery. In Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 25 patients each: RSB block Group: received general anaesthesia and 20 ml of 0.25% bupivacaine on each side under ultrasound guidance. Local wound infiltration: received general anaesthesia and with 0.25% bupivacaine 20 ml at surgical site.

Results
The results of the study revealed that there is Patients receiving RSB block had significantly lower pain scores at rest for 12 h and on mobilization for 6 h after operation and decrease total need of analgesic in first 24 h post-operative compared with patients who received wound infiltration of local aneasthetic.

Conclusion
U/S-guided rectus sheath block is as effective analgesic technique as local infiltration of the surgical wound, with longer duration of action and pethidine -sparing effect during the postoperative period after midline exploratory surgeries.
Effect of Sleep Deprivation on the Hippocampus of Adult and Senile Male Albino Rat: A Histological and Histochemical Study
Authors: Elkilany S S I , Zakaria M M A , Tash R F , Mostafa A Y , Abdelmalik S W , Nadim H S 
Published: May 2020

Abstract

Background
The importance of sleep and the impact of its deprivation on development of brain pathology became a recent subject of interest in medicine. The restorative effect of sleep on the brain and the harmful effects of insomnia have been recently revealed through the discovery of the glymphatic system and its association with sleep.

Aim of work
Specific objectives are: To detect histological and apoptotic changes in the neurons and dendrites of the cornu Amonis and the dentate gyrus in sleep deprived rats in comparison to rats with undisturbed sleep pattern (control). To detect deposition of neurotoxic metabolites in comu Amonis and dentate gyrus in sleep deprived rats in comparison to controls.

Methods
Twenty four adult male Albino rats were used in the present experiment. randomly categorized into four equal groups; Group A1 served as the control group, Group .A2 one day sleep deprivation, Group A3 three days sleep deprivation and Group A4 seven days sleep deprivation. They were deprived of sleep using grid over water method where the animals placed over a grid suspended above tank filled with water with free access to food (rat chew) and water. Hippocampai specimens were collected, processed for paraffin blocks and examined by light microscopy.

Results
there were neurodegenerative signs appeared from day one sleep deprivation, increased by day three and prevailed by day seven. It was confirmed by apoptotic changes detected by caspase 3 immunohistochemical staining. Furthermore, deposition of beta amyloid appeared in rats deprived of sleep and confirmed by congo red stain.

Conclusion
Adequate sleep is essential for integrity of the newly discovered glymphatic system responsible for clearance of the brain from waste products including the area most involved in learning and memory function; the hippocampus. Correction of SD could be a viable therapeutic strategy to prevent the onset or slow the progression of AD.

Recommendations
Further characterization of the glymphatic system in humans are required, it may lead to new therapies and methods of prevention of neurodegenerative diseases. Correction of SD could be a viable therapeutic strategy to prevent the onset or slow the progression of AD.
Correlation between QRS duration and cardiac output measured by left ventricular outflow tract velocity in patient with cardiac resynchronization therapy
Authors: Elshikh A S A E , Khalifa M M , Shehata H , Murtada A 
Published: May 2020

Abstract

Background
Cardiac resynchronization therapy (CRT) is proved as an effective treatment for moderate to severe heart failure. It reduces all-cause mortality in patients with advanced heart failure. There is strong evidence that CRT reduces mortality and hospitalization, improves cardiac function and structure in symptomatic chronic heart failure patients with optimal medical treatment, severely depressed LVEF (i.e. &lt;35%) and complete LBBB. However 30% of patients may show negative response to CRT therapy. Therefore, optimization of CRT therapy in patients with heart failure seems to be a main subject for study in our researches. Methods of optimization includes optimization of medical therapy, control of risk factors and comorbidities, and optimization of device implantation and programming. Overall, studying the correlation between QRS duration and cardiac output will improve CRT programming optimization techniques.

Aim
To study the correlation between QRS duration and cardiac output measured by left ventricular outflow tract (LVOT) VTI in patients with CRT implantation.

Methods
Study included 100 CRT already implanted patients, they are requested to do a simple electrocardiographic and echocardiographic study. The relation between post implant QRS and cardiac output are studied among the patients.

Results
There was negative significant correlation between QRS duration and LVOT VTI and SVi. The optimal cut off values for optimal response to CRT using ROC curves were 130msec for post implant QRS duration and 17.1 cm for LVOT VTI.

Conclusion
CRT response is more in female patients with lower BSA, and without previous history of IHD or smoking. There is a significant negative correlation between QRS duration and LVOT VTI. Post implantation cut off value of QRS duration (&lt;130) predict higher LVOT VTI and also the post implantation benefit for the patient with CRT implanted.
Predictors of No-Reflow Phenomenon in ST-Elevation Myocardial Infarction in Patients undergoing Primary Percutaneous Coronary Intervention
Authors: Abdelaziz H S , Zahran M E , Othman K S , Wafa S S 
Published: May 2020

Abstract

Background
Functional single ventricle (FSV) is a spectrum of severe congenital heart disease, with multiple anatomic variations but similar surgical treatment strategies. FSV patients are living longer into adulthood compared to two or three decades ago, and they are more frequently undergoing imaging to assist in clinical and surgical management.

Objective
To assess the relation between admission eGFR, HDL, Monocytes, CRP & albumin levels in patients presenting with acute STEMI and angiographic no-reflow after primary PCI.

Material and Methods
From October 2018 to February 2019, 60 patients with STEMI who underwent primary PCI in Ain-Shams University hospitals. All patients subjected to history, clinical examination, ECG pre and post pPCI, pre-pPCI eGFR, monocytes, HDL, CRP and albumin, echocardiography. Patients were divided into two groups based on post-pPCI Thrombolysis in Myocardial Infarction (TIMI) flow grade. No reflow was defined as TIMI flow grades ≤ 2, and normal reflow was defined as TIMI 3 flow grade. All the laboratory parameters were measured on admission before pPCI.

Results
The study population was divided into 2 groups: reflow (n = 31) and no-reflow (NR) (n = 29) groups. CRP over albumin ration “CAR” (7.9 [4.41-16.18] vs 1.74 [1.54-2.35] (P &lt;.001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. However, eGFR and Monocytes over HDL ratio “MHR” didn’t show any statistical differences between the two groups.

Conclusion
No-reflow can be predicted by systemic inflammation markers including monocytes, CRP, albumin and HDL. CAR has the highest positive predictive value for no-reflow.
Predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization due to stable angina or acute coronary syndromes
Authors: Ayman R , Shehata H , AL-Fikki E , Gomaa Y 
Published: May 2020

Abstract

Background
Introduction of coronary stents in the field of interventional cardiology has significantly improved short- and long-term results of the percutaneous coronary interventions but in the same time they became responsible for development of a new entity called neo-intimal hyperplasia (NIH). If overexpressed, NIH can lead to so-called in-stent restenosis (ISR).

Objective
To assess the predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization in Proximal Left Anterior Descending(LAD) Artery using Drug Eluting Stents (DES) due to stable angina and acute coronary syndrome.

Material and Methods
This study was conducted over 113 pateints to assess the predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization in Proximal Left Anterior Descending (LAD) Artery using Drug Eluting Stents (DES).

Results
From the study population collected(n = 113), 18.4% of which were females (n = 21), statistically significant relation was found between DES-ISR and CHADSVasc score (p value =0.033). A significant relationship existed between ISR and CHADVasc score 3 or more, and each of: Age(p value= 0.022), DM(p value=0.029), SBP during the procedure(p value = 0.036), time since the PCI was done(p value =0.001), stent length(p value=0.028), pattern of the lesion and management of the lesions as individual variables (p value less than0.001). However, non-significant relationship could be concluded between ISR and each of gender(p value= 0.987), CHF(p value=0.163), HTN(p value=0.446), vascular diseases (p value=0.662), CAD type (SCAD or ACS)(p value=0.616), DBP during the procedure(p value=0.167), creatinine clearance (p value=0.69), HBA1c(p value=0.091), use of DAPT(p value=0.198), the duration of DAPT use(p value=0.873), type of P2Y12 inhibitor used(p value=0.083), use of statins(p value=0.402), beta blockers or nitrates (p values= 1 & 0.836, respectively) and stent diameter used (p value=0.615)

Conclusion
This study was able to show a significant relationship between ISR and each of CHADVasc score, Age, DM, SBP during the procedure, time since the PCI was done, stent length used, pattern of the lesion and management of the lesions
Big endothelin-1 level as a predictive marker for the presence of isolated coronary artery ectasia in patients presented with chest pain
Authors: Bishay B , Elhammady W , Elkashlan Y , Zarif J 
Published: May 2020

Abstract

Background
Coronary artery ectasia (CAE) is a common finding of coronary angiography, therefore, to find a biomarker to discriminate isolated coronary artery ectasia ICAE from obstructive coronary artery disease CAD may be important for clinical implication.

Objectives
The aim is to study the relationship between big ET-1 level and isolated CAE in patients presented with chest pain, undergoing coronary angiogram.

Methods
This study was conducted on 55 patients. They were presented by cardiac symptoms (chest pain, dyspnea, unstable and stable angina). They were subjected to coronary angiography. According to its findings, patients were classified into four different groups (ICAE; n = 15), (CAE & CAD; n = 15), (CAD; n = 15), and (Normal; n = 10). The level of big ET-1 was found to be significantly higher in the patients with ICAE compared with the other three groups (ICAE; 261±176 ng/ml, CAD + CAE; 132±29 ng/ml, CAD; 107±16 ng/ml and Normal; 109±17 ng/ml, p &lt; 0.001, respectively). Also we found that the percentage of hypertension was significantly higher in patients with CAD group compared with ICAE group and normal coronary angiography group.

Conclusion
In conclusion, in our study, our data suggested that the big ET-1 level was higher in isolated CAE patients and was an independent predictor for isolated CAE. Recognizing big ET-1 as an independent predictor of isolated CAE requires multivariate analysis which was not done in our study.
Safety and outcome of cryoballoon ablation versus radiofrequency catheter ablation of the pulmonary veins in patients with paroxysmal atrial fibrillation
Authors: Riad O H M A , Wong T , Ali A N , Ibrahim M T , Abdelhamid M A , Nabih M A 
Published: May 2020

Abstract

Background
Pulmonary vein isolation (PVI) has become the mainstay of catheter ablation of atrial fibrillation (AF). There are two commonly used methods to isolate the pulmonary veins, either point-by-point delivery of circumferential lesion sets around ipsilateral pulmonary veins using radiofrequency energy, or the application of the cryoballoon to the pulmonary vein antrum with occlusion of the vein ostium. The cryoballoon has proven to be a reliable alternative to radiofrequency ablation in acute and long-term freedom from AF. We describe our results using both modalities.

Aim and Objectives
to compare the safety and efficacy of cryoballoon (CB) ablation and radiofrequency (RF) ablation in treatment of paroxysmal atrial fibrillation.

Patients and Methods
Forty-four consecutive patients having paroxysmal AF underwent PVI using the second generation cryoballoon were compared to a retrospective cohort of 69 patients who had radiofrequency induced PVI, either by conventional RF catheter (n = 32), or a contact-force sensing-catheter (n = 37). The study took place at Ain Shams university hospitals and Royal Brompton & Harefield NHS trust. Patient data, procedural data and follow up data- at 3, 6 and 12 months- were collected and analysed. Recurrence was defined as documented AF or atrial arrhythmias with duration exceeding 30 seconds, either by 12 lead ECG or an ambulatory monitoring device.

Results
A total of 113 patients were studied. The mean age was 53.84 ± 15.01 for the CB group and 55.78 ± 14.84 for the RF group and females representing 40.9% vs 34.8% respectively. The mean procedural times in minutes were significantly less in the CB group (94.37 ± 39.32 vs 184.57 ± 88.19, p &lt; 0.0001), while the median fluoroscopy times were similar [30 (11.04 - 40) vs 37.25 (14.2 - 70), p = 0.172]. Procedural complications were comparable between the two groups (p = 0.06) with 1 patient (2.3%) having long term phrenic nerve paresis. At 1 year follow up, after an initial 90-day blanking period, recurrence rate of CB was similar to RF (27.3% vs 30.4% respectively, p = 0.719), the Kaplan Meier estimates of AF- free survival for a period of 1 year were comparable between both groups (log rank test, p = 0.606).

Conclusion
Cryoballoon is a feasible method for pulmonary vein isolation with similar success rates to radiofrequency ablation. Cryoballoon ablation is safe with shorter duration of the procedure.