bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic value of ultrasound in cases of pneumonia admitted at intensive care unit: A comparative study with chest x-ray
Authors: Ibrahim Sherif Farouk , Ibrahim Waleed Abdalla , Ahmed Hossam Mohamed Khalaf 
Published: October 2021

Abstract

Background
Pneumonia is consistently among the leading causes of morbidity and mortality worldwide. Defined as acute infection of the lung parenchyma, it is caused by a wide variety of microorganisms, including bacteria, viruses, and fungi. However, pneumonia is often misdiagnosed even now. Early and effective antibiotic treatment is important. An adequate treatment is thus reliant on an early diagnosis of pneumonia, yet the diagnosis is not always clear at presentation to the emergency department (ED). In a retrospective chart review of patients admitted with pneumonia, 22% of patients presented some reason for diagnostic uncertainty that could result in delayed antibiotics delivery.

Objective
The aim of the study was to evaluate the efficacy of LUS in the diagnosis of pneumonia.

Methods
This is a prospective observational study which was conducted on 36 consecutive patients with suspected pneumonia. All patients were admitted to the Hospital, in the period from May 2019 to January 2020.

Results
Chest x-ray diagnosed pneumonia in 66.7% of patients, while lung U/S diagnosed pneumonia in 75% of patients. Lung ultrasound was more sensitive and highly specific for diagnosis of pneumonia as sensitivity and specificity of lung ultrasound was 96.3% and 88.9% respectively while for chest xray was 81.5% and 77.8% respectively. Accuracy of lung ultrasound was 94.4% and that of chest x-ray was 80.6% in relation to CT chest the gold standard with accuracy 100%. Superiority of lung US findings over CXR findings could be explained by high sensitivity & specificity of lung US in diagnosing pneumonia in comparison with chest x ray as high resolution CT is a gold standred for the study.

Conclusion
LUS is a sensitive and highly specific diagnostic tool in pneumonia. Therefore, we hypothesize that Lung US may be considered as the first imaging test inpatients with suspicion of pneumonia. It should be noted, however, that the ability of LUS to detect lung consolidations located in peri-hilar regions is limited. A diagnostic algorithm of pneumonia which includes Lung US should be validated in prospective studies. Monitoring there solution of pneumonia can be another application of Lung US inpatients with pneumonia.
Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia
Authors: El-Khattab Salwa Omar , Taeimah Mohamed Osman , Seif Mahmoud Mohamed Elsayed 
Published: October 2021

Abstract

Background
Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers.

Objective
To evaluate the Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia.

Patients and Methods
After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 25 patients group I in which patients received general anesthesia followed by PECS BLOCK using only bupivacaine 0.25 % and group II in which patients received general anesthesia followed by PECS BLOCK using bupivacaine 0.25 % plus magnesium sulfate 50% (200mg).

Results
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed.

Conclusion
The addition of 200 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly reduce postoperative opioid consumption, prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia.
Norepinephrine versus Ephedrine Boluses To Treat Spinal-Induced Hypotension in Cesarean Deliveries
Authors: Abo Kamar Mohamed M , Shams Manal M , AbdelAziz Mai M , Selima Wessam Z 
Published: October 2021

Abstract

Corresponding Background
Cesarean sections normally require an anesthetic block at T4 level, so hypotension is reported to occur in up to 80% of spinal anesthesia cases. When maternal hypotension associated with spinal anesthesia for cesarean section is severe and sustained, it can lead to serious maternal complications as well as impairment of the uterine and placental blood flow with consecutive fetal hypoxia, acidosis, and neurological injury.

Aim of the Work
to compare the administration of intermittent i.v. boluses of norepinephrine and ephedrine to counterbalance the hypotensive effect of spinal anesthesia during cesarean delivery. The results of the study showed that compared with ephedrine, norepinephrine maintained maternal blood pressure and uterine artery blood flow. Further, it was associated with lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia during cesarean delivery. Furthermore, the numbers of boluses of vasopressors used during spinal anesthesia were lower in norepinephrine compared with the use of ephedrine.

Conclusion
Norepinephrine can be used as an alternative vasopressor to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, with no adverse effect on neonatal outcome.
Comparative Study between Bupivacaine-Dexmedetomidine versus Bupivacaine-Dexamethasone in Skin Infiltration as Post-Operative Analgesia for Patients undergoing Abdominoplasty Surgeries
Authors: Fawaz Ahmed Ali , Youssef Osama Ramzy , Ahmed Ahmed Mounir , Salama Mohamed Adel Abdelfattah 
Published: October 2021

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 postoperative 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.

Aim of the Work
To compare skin infiltration with bupivacaine-dexmedetomidine mixture versus bupivacaine-dexamethasone mixture for analgesia in abdominoplasty under general anesthesia.

Patients and Methods
A prospective randomized clinical trial study was conducted in Ain Shams university hospital on 40 adult patients undergoing Abdominoplasty surgeries. The patients were randomly divided into two groups using their computer-generated random numbers will be enrolled in group I for bupivacaine-dexmedetomidine and group II for bupivacaine-dexamethasone.

Results
This study demonstrated that the addition of dexmedetomidine to wound infiltration with local anesthetics improves postoperative pain and reduces the need for analgesics.

Conclusion
Wound infiltration with bupivacaine -dexmedetomidine mixture provides prolonged local anesthetic effect, decreases the need for rescue analgesics, and provides better sedation than bupivacaine–dexamethasone mixture in patients undergoing Abdominoplasty surgeries.
Clinical and Laboratory Prognosis of Patients at Risk for Traumatic ARDS
Authors: Eshohady Mohamed Ahmed Mohamed , El Kady Galal Adel , Zakry Milad Ragaey 
Published: October 2021

Abstract

Background
Trauma victims who survive their initial injuries to hospitalization in the intensive care unit (ICU) face the possibility of life-threatening complications such as multiple organ failure (MOF), the leading cause of death in these patients. Acute respiratory distress syndrome (ARDS) is the most frequent manifestation of MOF after trauma.

Objective
Diagnosis of traumatic patients who are at risk of developing ARDS based on clinical and laboratory findings and their proper management.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2020.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Identifying potentially causal and modifiable factors that could lead to the development and testing of preventative ARDS therapies has been slow in part because of an incomplete understanding of which patients are likely to develop ARDS after major trauma. There are several ARDS predictors including an injury severity score (ISS), Acute Physiology and Chronic Health Evaluation (APACHE) II Score and others which try to identify trauma patients at greatest risk for ARDS. However, despite the intense research, only few effective therapies for ARDS have been postulated, including the lung protection strategies.
Comparative Study between Automatic Tube Compensation (ATC) and Pressure Support Ventilation (PSV) as a Mode of Weaning from Mechanical Ventilation in Patients with Respiratory Failure
Authors: Elshaer Ahmed N , Elshebiny Ahmed A , Habib Mariam K , Abdelrasol Mohammed G 
Published: October 2021

Abstract

Background
Weaning covers the entire process of liberating the patient from mechanical support and from the endotracheal tube (ETT). Weaning from mechanical ventilation (MV) is a challenge. Its prolongation is related to increased mortality.

Aim of the Work
is to assess the value of ATC in predicting successful weaning and hastening the weaning process. This study will compare the benefits and effects of ATC versus PSV as weaning modes on spontaneous breathing trials and work of breathing.

Patients and Mehtods
This prospective non randomized was done on 50 adult patients admitted to the Critical Care Medicine Department in Ain shams University Hospital presenting with ARF and mechanically ventilated for at least 24 hours. They were divided into two groups:

Group I
“ATC group” Each underwent a 1-hour spontaneous breathing trial, using ATC mode and

Group II
“PSV group” PSV mode was used.

Results
In the present study we have found that the use of ATC during a spontaneous breathing trial was as effective as PSV in predicting the ability of patients to maintain spontaneous, unassisted breathing for more than 48 hours after removal of the endotracheal tube. In our study, there was no significant difference in the number of patients who tolerated the spontaneous breathing trial and then extubated between ATC and PSV groups (60 % vs. 56% respectively, p &gt; 0.05). Both modes had comparable sensitivity, and +ve predictive value. Sensitivity was 80.0% versus 75.0% and the positive predictive value was 88.0%, versus 87.0% for ATC versus PSV respectively. The specificity was comparable (76.8% versus 80.0 % in ATC versus PSV respectively). ATC group had higher negative predictive than PSV group (82.0% versus 70.1%, respectively). In our study, criteria for successful extubation were met in 56.0%. In ATC group 60.0% met the criteria for successful extubation vs. 60% in PSV group. In the present study it was found that male patients were the most predominant in both groups (72.0% in ATC group and 68% in PSV group). This is expected as cigarette smoking is prevalent among males and is the single most important and most prevalent risk factor for the development of COPD. In our study, about one third of patients had COPD exacerbation as a cause for ARF.

Conclusion
In ICU population, ATC was safe, reliable, and can be reasonably used for weaning trials. ATC confers a potential benefit in weaning duration, weaning category, number of Ss, failure of first SBT extubation outcome, ICU length of stay, complication, and mortality rate. In addition, ATC improves the predictive value of RR/TV and IWI in predicting weaning success.
A comparison of intranasal dexmeditomidine versus intranasal midazolam as a pre anesthetic medication in children undergoing adenotonsillectomy
Authors: El Zoghby Nourhan M , Mohammed Ahmed S , El Hennawy Ahmed M , Wahba Ramy M 
Published: October 2021

Abstract

Background
Adenotonsillectomy is one of the most common surgical procedures performed on pediatric patients. Relieving pre- and post-operative anxiety is an important concern for the pediatric anesthesiologist. Aim of the Work: to compare dexmedetomidine with midazolam effect on preoperative sedation, the ease of children parent separation, the mask tolerance, intraoperative hemodynamics stability, emergence of anesthesia and postoperative analgesia.

Patients and Methods
A Prospective, randomized and double blind controlled clinical trial was done after approval of institutional ethics committee in Ain Shams university Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include fifty pediatric patients, aged 5 to 10 years old of both genders, with physical status ASA Ι.

Results
statistically significant increase mean of Dexmedetomidine compared to midazolam according to sedation score after 15min. to after 45min.

Conclusion
Premedication with intranasal dexmedetomidine 1 μg/kg attained significant and satisfactory sedation with better parent separation and lower anxiety levels without any adverse effects as compared with intranasal midazolam 0.2 mg/kg in children undergoing adenotonsillectomy.
Optimum End Tidal Sevoflurane Concentration Required for Intravenous Cannulation in Children
Authors: Noureldin Bassel Mohamed Essam , Seif Eman Mohamed Kamal Abo , Eltawansy Omar Mohamed Mohamed , Ghoneim Mohamed Mohamed Abdel Fattah 
Published: October 2021

Abstract

Background
Inhalation mask induction is a cornerstone of pediatric anesthesia. Because of their natural aversion to needles, healthy children are usually anesthetized by mask prior to intravenous insertion. The early insertion of an intravenous access provides a means for administering fluids and drugs if an untoward event occurs during inhalational induction. Sevoflurane is the inhalation agent most commonly used for mask inductions in pediatric anesthesia, having largely replaced halothane for this purpose.

Objectives
The aim of the study was to evaluate the optimum end tidal concentration of Sevoflurane at which an intravenous cannulation can be successfully attempted without movement in pediatric patients.

Patients and Methods
In this clinical trial, pediatric subjects of either sex aged 2-5 years, weighing 10-20 kg were included.

Results
Showed that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation without movement in children.

Conclusion
We conclude that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation in un- premedicated children aged between 2 and 5 years.
Incidence Of Post-Operative Delirium In Geriatric Patients Undergoing Hip Replacement Surgery Using Pre-Operative Haloperidol
Authors: Eskander Fahmy Saad Latif , Hakim Karim Youssef Kamal , Ibrahim Dalia Ahmed , El-Mallah Wael Safwat 
Published: October 2021

Abstract

Background
Delirium is acute onset & fluctuating disturbance in mental state that causes patient appear confused, disoriented or with difficulty to focus and with decline in cognitive function (memory, orientation, speech), circadian disturbance and behavior of patient either agitated or sleepy,in other words sudden confusion. Delirium, also known as acute confusional state, is an organically-caused decline from a previously baseline level of mental function that develops over a short period of time (hours to days). Delirium is not a disease itself, but a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, like psychomotor disturbances (e.g. hyperactive, hypoactive, or mixed), impaired sleepwake cycle, emotional disturbances, and perceptual disturbances (e.g. hallucinations and delusions).

Objective
To determine incidence of post-operative delirium in geriatric patients undergoing hip replacement surgery using pre-operative haloperidol.

Patients and Methods
This study is conducted through geriatric patients undergoing orthopedic surgery and the incidence of pre.& post-operative delirium. This randomized, double-blind, placebo-controlled trial was conducted post-operative surgical ICU in Demerdash hospital which was closed unit and had the same well-established pain, sedation and delirium assessment practices. A delirium was monitored through CAM score in their stay in ICU (max. for &7 days from admission post-operative).

Results
Several trials stated that the usage of Haloperidol pre-operative decrease the duration and the severity of Delirium rather than the incidence of delirium. In our trial we will detect the incidence of delirium with using prophylactic haloperidol in geriatric patients undergoing Hip replacement surgery. In our study revealed that using prophylactic pre-operative haloperidol decrease the incidence of delirium among geriatric patient as well as decreasing both the duration and the severity of delirium among the study group.

Conclusion
Our study and results revealed that Haloperidol as antipsychotic drug have beneficial effect on reduction of incidence of delirium in post-operative geriatric patients, also it showed effect on duration of delirium and severity of the disease as well as ICU stay.
Role of Capnograghy during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease
Authors: Ali Ramy Karem Ali , Mostafa Yasser Mosafa Mohammed , Ali Tamer Mohammed 
Published: October 2021

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation associated with an enhanced chronic inflammatory response in the airway, acute exacerbations of COPD can lead to progressive respiratory failure necessitating mechanical ventilation. Weaning of these patients may prove difficult and a spontaneous breath trial should be provided before the decision of extubation.

Aim
To evaluate the role of capnograghy in COPD patients during weaning from mechanical ventilation.

Subject and methods
This was a cross sectional prospective study conducted on 50 patients who were admitted at the Respiratory Intensive Care Unit of Abbassia Chest hospital and diagnosed as COPD and on mechanical ventilation. During the weaning trial, the role of capnography device evaluated considering the ability of Pet CO2 parameter in predicting hypercapnia and subsequently weaning outcome

Results
The changes in ABG reading before and after the SBT, PaCO2 and Pet CO2 showed significant elevation at the end of SBT,P=0.001 for both, while O2 saturation was significantly decrease at the end of SBT, P0.001.

Conclusion
The study found that Pa CO2 and PetCO2 are correlated to each other before, during and after SBT. Most of the studies that was found reported that PetCO2 is highly correlated with Paco2 and that PetCO2 may be a rapid and reliable predictor of arterial PaCO2 in respiratory distress.
Modulation of Autophagy Signal Pathway in Type 2 Diabetes Mellitus Rat Model Using Phytochemical Extracts
Authors: Mohamed Sanaa Eissa , Mohamed Amany Helmy , Bekhit Meram Mohamed , Sayed Maha Saad Zenhom 
Published: October 2021

Abstract

Background
Type 2 DM is a chronic metabolic disease characterized by insulin resistance and beta cell dysfunction. It is an extremely heterogeneous disease in which the insulin resistance and beta cell dysfunction resulted from environmental and genetic factor. Type 2 diabetes is the most prevalent form of diabetes worldwide and account for 90% of cases globally. It represents a major public health threat and considered as a principal cause of morbidity and mortality affecting almost 6% of the world’s population. Patients with type 2 diabetes usually have insulin resistance and relative insulin deficiency and are often associated with a strong genetic predisposition.

Objective
To retrieve potential miRNA-associated ceRNAs Linked to autophagy, insulin resistance and type 2 DM from Public microarray databases followed by validation of the chosen network in animal model. To evaluate the efficacy of Isorhamentin as a potential therapeutic strategy to modulate the autophagy pathway and IR in type 2 DM.

Patients and Methods
This study was done at Medical Biochemistry Department, Faculty of Medicine, Ain Shams University during the period from December 2019 – June 2020 and included 50 wistar male rats. 50 Male Wistar rats weighed (140-150g), age nearly two months, were purchased from the Holding Company for Biological Products and Vaccines. They were acclimatized to laboratory environment for at least one week with free access to water and food before induction of diabetes. Experiment for eight weeks duration was planned after a pilot study was performed for determination of the most effective and least toxic STZ dose.

Results
Our study demonstrated that “Isorhamentin” can be potential treatment in type 2 diabetes mellitus through modulation of Autophagy signaling pathway related genes and ceRNA network. Isorhamentin down-regulates the expression of m-tor mRNA and it up-regulates the expression of miR-1.

Conclusion
The results of our study Support our previous hypothesis that miR-1 miRNA and mTOR mRNA act as ceRNA network and might play an important role in the pathogenesis of autophagy and insulin resistance and T2DM.And could be potential therapeutic target by isorhamentin to modulate the expression of the deregulated network in type 2 DM.