bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension
Authors: Ibrahim Ahmed Saeed Mohamed , Hussien Rania Mahrous Aly , Ahmed Hazem Mohamed Sabry Abdel Aziz 
Published: October 2021

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

Patients and Methods
The present prospective cohort study was conducted at Ain Shams University hospitals Intensive care units, from October 2019 to August 2020. After obtaining approval of the study protocol from the local ethical committee, as well as fully informed consents signed by the patient closet relative, 130 hepatic patients admitted at ICU with hepatic coma and patients classified according to platelet count on admission into two equal groups.
Group A: included 65 Patients with thrombocytopenia on admission (&lt;100,000/μL). Group B: included 65 Patients with normal platelet count on admission with persistently normal platelet count (≥100,000/μL).

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

Conclusion
MgSO4 as an adjuvant to Bupivacaine in Ultra-sounded guided TAP block reduces postoperative pain scores, prolong the duration of analgesia and decreases demand for rescue analgesics.