bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propofol-dexmedetomidine Versus Propofol-ketamine for Anesthesia of Endoscopic Retrograde Cholangiopancreatography (ERCP)
Authors: Zaki Mohamed Sidky Mahmoud , Taha Sameh Salem Hanafy , Morkos Fady Adib Abd Elmalek , Salama Mohammed Ayman Abd El-Aziz 
Published: October 2021

Abstract

Background
The ideal method for anesthetic management during ERCP varied between deep sedation and general anesthesia with preference for general anesthesia over sedation.

Aim of the study
Primary aim: The aim of this study will to compare the effects of propofoldexmedetomidine and propofol-ketamine combinations for anesthesia in patients undergoing ERCP regarding the following outcome measures: Hemodynamic changes. Respiratory parameters changes. Propofol requirements. The recovery criteria. Post-operative pain. Secondary aim: To assess the rate of other anesthetic and procedural complications regarding the following outcome measures: Anesthetic complications: Post-procedural nausea and vomiting. Post-procedural cognitive dysfunction or hallucinations. Procedural complications: Bleeding: may occur by sphincterotomy. Duodenal perforation; it is a serious condition but it has a rare incidence and usually requires surgical intervention.

Material and methods
Patients ERCP, aged 20-50ys old, ASA І-II-III, were randomly allocated in two groups each of which was 25 by a probability method in the form of sequentially numbered, opaque, sealed envelopes (SNOSE) that will be divided in 2 groups (25 envelopes for each group) with random selection for each patient for an envelope. Group-I received dexmedetomidine loading 1µg/kg slow IV over 15min then infused at a rate of 0.5µg/kg/h by syringe pump. Group II received Ketamine 1mg/kg slow IV over 15min then infused at a rate of 0.5mg/kg/h by syringe pump. Both groups received propofol; 1-2mg/kg induction – then 5mg/kg/h IV infusion, 0.5mg/kg boluses guided by hemodynamic parameters, atracurium 0.5mg/kg intubating dose followed by 0.1mg/kg every 20min. Cuffed ETT was inserted and CMV. By the end of the procedure, patients turned supine and reversed by administration of neostigmine (0.05mg/kg) + atropine (0.01mg/kg). Extubation was performed after fulfillment of the criteria of extubation.

Conclusion
Dexmedetomidine-propofol combination was better than ketamine-propofol combination as regard; hemodynamic parameters (intra- and post-procedural), PONV, cognitive functions and recovery time. Incidence of pain had no clinical significant value between both groups. Total propofol consumption had no clinical significant difference between both groups.

Recommendation
Dexmedetomidine - propofol combination as TIVA technique for ERCP requires further studies with recommendation to include; different types of patients; geriatric, critically ill and increasing the sample size of patients.
Comparative study between intravenous versus perineural dexamethasone in prolonging the analgesic effect of supraclavicular plexus nerve block in hand surgeries
Authors: Abdelsattar Moustafa Mahmoud , Aly Naglaa Mohammad , mahran Mostafa Gamal eldin , Hamza Amr Hosny 
Published: October 2021

Abstract

Background
Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stays and an increased likelihood of chronic pain. Systemic analgesics (opioids and non-opioids) have long been used for postoperative pain, then neuroaxial or peripheral nerve blocks were employed. Local anesthetics alone were used, then various adjuvants were added to achieve quick, dense and prolonged block.

Objective
To study the effect of dexamethasone as an adjuvant to bupivacaine either intravenous or perineural in ultrasound guided supraclavicular brachial plexus block in hand surgeries regarding the onset of the block, the duration of the block, the effect on postoperative analgesic requirements as well as anticipated complications.

Patients and Methods
In our study, 50 patients were randomly divided into 2 equal groups. perineural group received bupivacaine (0.5%) concomitant with 8 mg dexamethasone and Systemic group in which 8 mg of dexamethasone were injected systemically. All patients received equal volumes of 20 milliliters.

Results
Our study showed that addition of a8 milligram of dexamethasone to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of sensory and motor blocks and significantly prolonged their durations. In addition, dexamethasone prolonged the duration of analgesia of the plexus block significantly, as proved by the time of request of first analgesia. Moreover, in perineural dexamethasone group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of dexamethasone perineural also did not affect the hemodynamics to a significant level. This makes perineural dexamethasone with bupivacaine more superior than the use of bupivacaine with addition of intravenous dexamethasone.

Conclusion
The use of ultrasonography in performing the supraclavicular nerve block, decreased significantly the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.
Comparative study of Prophylactic Intravenous Ondansetron in the Attenuation of Post Spinal Hypotension versus Dexamethasone in Parturient Undergoing Caesarean Delivery
Authors: Tewfeik Safie Ramez Tewfeik Abd El Moneim , El Hamid Hatem said Abd , Samir Ghada Mohamed 
Published: October 2021

Abstract

Background
Spinal anaesthesia (SA) is the preferred anaesthesia technique for Caesarean section. Hypotension and bradycardia are the most common side effects encountered and are more pronounced in pregnant patients, the incidence being as high as 52.6% and 2.5% in normal patients. The occurrence of hypotension can be dangerous as it compromises placental circulation and can have a detrimental effect on the foetus.

Objectives
The purpose of this study is to assess the efficacy of ondansetron versus dexamethasone in decreasing incidence of spinal induced hypotension in parturient undergoing cesarean surgery.

Patients and Methods
This study was conducted at Ain Shams University Hospitals between March 2019 till September 2019. After approval is obtained from the research ethics committee of faculty of medicine, Ain Shams University & patients’ informed consents consent from each patient after full explanation of the procedure possible side effects and complications., 75 healthy parturient, (ASA)physical status I and II undergoing elective cesarean delivery under spinal anesthesia.

Results
8 mg ondansetron is more effective than 8 mg dexamethasone in the attenuation of post spinal hypotension. Also, that Dexamethasone 8 mg was as effective as ondansetron 8 mg in providing a simple, safe, cheap, and effective intra and postoperative nausea and emesis prevention method with the advantage of being cheaper decreasing the economic burden.

Conclusion
The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine and fentanyl as adjuvant for elective for cesarean section, prophylactic intravenous 8 mg ondansetron compared to dexamethasone significantly decreases hypotension, HR fluctuation, yet the need for rescue doses for ephedrine were significantly higher in ondansetron.
The effect of adding Magnesium sulfate to Bupivcaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries
Authors: Eid Samah Medhat , Aboul ella Sahar Kamal , El-ozairy Hala Salah El-Din , Naser Thabet Aziz 
Published: October 2021

Abstract

Background
Brachial plexus is a bundle of nerves that arises from the neck crossing through the axilla to supply the whole upper limb with motor and sensory supply. The aim in upper limb surgeries is to block this plexus using local anesthetics.

Objective
To study the effect of magnesium sulfate as an adjuvant to bupivacaine in supraclavicular brachial plexus block.

Patients and Methods
In our study 82 adult patients (age group 18-60, ASA I-II) were randomly and evenly divided into two equal groups (41 patients each), control group received only bupivacine 0.5 % and magnesium group received 2.5ml of 10% of magnesium in addition to bupivacine 0.5%. Patients were in semisitting position 45° the block was introduced US guided.

Results
Our study showed that addition of 250 mg of magnesium to bupivacine slightly delayed the onset time of both sensory and motor block (p value &gt;0.05) which was non significant.

Conclusion
The addition of 250 mg magnesium sulfate to bupivacaine 0.5 % solution in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade, the duration of postoperative analgesia and reduces the requirement of rescue analgesic without any detected side effects.
Effect of Gene Editing on Alzheimer's Disease
Authors: mohamed Noha nageh , sallam Maha mohammed , El-Khalek Marwa Ali Abd , Fouad Mohamed Mahmoud 
Published: October 2021

Abstract

Background
Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and, eventually, the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Current estimates suggest that 44 million people live with dementia worldwide at present. This is predicted to more than triple by 2050 as the population ages. Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people Treatment is currently targeted toward symptomatic therapy, although trials are underway that aim to reduce the production and overall burden of pathology within the brain. Recently, the Clustered Regular Interspaced Short Palindromic Repeats (CRISPR-cas9) has shown promise in certain neurological disorders, it provides a precise editing to human genome and reflect an efficient curative therapy.
We aimed to investigate the efficacy of knock-out of the APP gene “Amyloid precursor protein gene(APBA2)that consequently modify the expression of Amyloid protein in leucocytes cell line using CRISPR-cas9 technology.

Methods
The gene expression profile of Alzheimer's disease was downloaded from biological bioinformatics databases,and based on bioinformatics analysis, we figured out that APP gene was overexpressed in Alzheimer's disease in both brain and peripheral tissues such as plasma, fibroblast and PMNLs. We used PMNLs as the source of gene for edition in our study .We knocked out the APP gene in leucocytes cell lines using CRISPR-cas9 technology. Finally, the gene editing efficacy was evaluated by cell viability assay, the gene expression was measured by qPCR and the Amyloid protein expression was proved by Immunofluorescence.

Results
knockout of APP gene int Leucocytes Cell line resulted in reduction in cell viability that was associated with marked reduction in the amyloid protein and gene expressions.

Conclusion
knockout of APP(APBA2) gene represents a promising therapeutic strategy in Alzheimer's disease.
Effectiveness And Adherence To Hospital Infection Control Preventive Practice In Cardiac Implantable Electronic Devices
Authors: Kolta Michel Lotfy , Mohamed Khalifa Maha Mohamed , Ibrahmi Mazen Tawfik , khaled Said AbdElHaffez 
Published: October 2021

Abstract

Background
Cardiac implantable electronic device (CIED) have been increasingly used in the past years, There is arise in CIED related complications in the past years with the increase in the number of devices implanted, CIED associated infection is challenging in its management, including system removal (generator and leads ), antimicrobial therapy, replantation at another site.

Objectives
The aim of the study is to evaluate the adherence to the steps of infection control protocol in cardiac device implantation related infection .

Patients and Methods
One hundred patients referred for cardiac device implantation was enrolled in the study and prospectively evaluated regarding applying of infection control measures and followed up for six months to study effect of adherence to these measures in prevention of postoperative device related infection.

Results
analysis of all factors of infection control protocol revealed significant correlation between postoperative device related infection and the following factors, Age ( p value = 0.010) , DM ( p value = 0.024) and number of Operators≥4.0 ( p = 0.001) as well as duration of sterilization ( p = 0.001), wearing double gloves (p = &lt;0.001).

Conclusion
Our results proved certain factors as significant risk factors for device related infection, they are either patient related factors including and diabetes mellitus or device related factors reflecting higher incidence with CRT devices (p = 0.025), others related to applying anti septic measures namely double glove technique and duration of skin disinfect prior to the procedure.

Abbreviation list;
CIED (cardiac implantable electronic devices), DRI (device related infection), CKD (chronic kidney disease), DM (diabetes mellitus), HTN (hypertension), CRT (cardiac resynchronization therapy), DDD (dual chamber device), VVI (ventricular demand pacing), ICD (implantable cardioverter defibrillator).
Comparison Between the Incidence of Coronary No-Reflow in Patients with Acute ST-Elevation Myocardial Infarction receiving ticagrelor versus clopidogrel loading doses
Authors: Elewa Mohamad Gamaleldin , Eletriby Shehab Adel , Elserafy Ahmed Shawky 
Published: October 2021

Abstract

Background
Primary PCI is the preferred reperfusion strategy for ST segment elevation myocardial infarction (STEMI); because it offers prompt and complete recanalization of an occluded infarct-related artery. However, inspite of successfully restored (Thrombolysis in Myocardial Infarction [TIMI] grade 3) epicardial blood flow, myocardial reperfusion is not regained in some patients. This phenomenon is referred to as coronary no reflow. Such patients with no reflow have higher incidence of resting segmental wall motion abnormalities (SWMA), myocardial free wall rupture, and death.

Objective
To compare the effect of 180 mg ticagrelor versus 600 mg clopidogrel loading doses, on the incidence of no-reflow in acute ST segment elevation myocardial infarction (STEMI) patients.

Material and Methods
This study was carried out on 100 patients, presented with acute STEMI to Ain Shams university hospitals, in the period between November 2018 and February 2019 who underwent primary percutaneous coronary intervention (PCI). All patients were subjected to history, clinical examination, ECG recording before and after primary PCI, blood samples before primary PCI for (creatinine, CKTotal, CKMB in addition to routine laboratory investigations), and echocardiography after primary PCI. Patients were divided into two groups, where 50 patients received a 600 mg loading dose of clopidogrel and the other 50 received a 180 mg loading dose of ticagrelor prior to primary PCI. The primary endpoint was the occurrence of no reflow defined as TIMI flow grades ≤ 2 and or MBG of 0 or 1. The secondary endpoint was the occurrence of major adverse cardiac events during hospital stay.

Results
The primary endpoint of no reflow occurred in 17 (34%) patients in the clopidogrel group versus 12 (24%) patients in the ticagrelor group. This difference was not statistically significant (P-value 0.271). There was no significant statistical difference in the occurrence of major adverse cardiac events either.

Conclusion
The incidence of no reflow does not seem to be affected by the type of P2Y12 inhibitor loading received in the setting of STEMI. Further large-scale multi-center studies are required to prove or disprove the current evidence on the superiority of ticagrelor over clopidogrel in STEMI patients.
Evaluation of High-Sensitive C Reactive Protein Serum Level in Patients with Chronic Plaque Psoriasis before and After Treatment with Narrow Band Ultraviolet B Therapy or Methotrexate Comparative Study
Authors: Eldahshan Lobna Ebrahim , ElShiemy Saleh Mohammed , El Husseiny Rania Mahmoud , Saudy Wael Mohammed 
Published: October 2021

Abstract

Background
Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life.Highly sensitive c reactive protein ( hsCRP) could be useful as biomarker for assessing the psoriasis severity(1).

Objectives
Assess the changes in high-sensitive C-reactive protein serum level in patients with chronic plaque psoriasis before and after treatment with narrow band ultraviolet B therapy and Methotrexate.

Patients and Methods
Our Prospective clinical study included 40 patients of both sex, aged 20-60 years old with psoriasis vulgaris recruited from dermatology outpatient clinic of Ain Shams University Hospital from January 2018 to December 2018. The study was approved by Ain Shams University ethical committee. Informed consents were taken from each Patient after full description of the study aims and procedures

Results
Both methotrexate and nb-uvb showed significant decrease in serum level hscrp ,PASI score and DLQI after 12 weeks of treatment ,although there were statistically significant lower PASI , DLQI scores and serum level hscrp after 12 weeks of treatment in methotrexate group of patient compared to nb-uvb group of patients

Conclusion
Highly sensitive C reactive protein(hscrp) is a promising inflammatory marker for monitoring psoriasis severity and efficacy of treatment respectively .Methotrexate treatment showed significant effect on psoriasis severity regarding lowering hscrp serum level ,PASI and DLQI in compared to Nb_UVB therapy .
Evaluation of Serum Fetuin A in Psoriatic Patients and Its Correlation to Coronary Artery Disease
Authors: Saleh Hanan M , Hassen Samah I , Sheha Aliaa S , Eskander Nardeen N 
Published: October 2021

Abstract

Background
Psoriasis is a chronic, immune-mediated, inflammatory disease of the skin. It is a multifactorial disease with genetic background triggered by environmental factors and immunological mediators. Fetuin A is considered as a marker to detect cardiac risk.

Aim of the work
to evaluate Fetuin A level in psoriatic patients and its correlation to coronary artery calcification and cardiovascular risks.

Methods
This is a case control comparative study was conducted at Dermatology outpatient clinic, during the period from January 2019 to November 2019. The Forty eight patients who were recruited in this study were classified to two groups, Group A (cases group): included twenty four patients presented clinically with chronic generalized psoriasis randomly selected from Dermatology outpatient clinics of Ain Shams University Hospital. Group B (control group): included twenty four age and sex matched healthy volunteers who were nonsmokers, non-alcoholics and don’t suffer any systemic or organic illness.

Results
Our results showed no significant correlation between levels of Fetuin A and age, sex, BMI or serum levels of TG or total cholesterol among psoriatic patients. In addition, negative correlation was found between Fetuin A and calcium scoring CT scan where the median serum plasma level of Fetuin A was found to be significantly decreased in cases with plaque psoriasis with increasing calcium score, with p-value &lt; 0.001 and r = -0.928. Also, there is no significant correlation was found between levels of calcium scoring and age, sex, BMI or serum levels of TG or total cholesterol nor PASI scoring among psoriatic patients.

Conclusion
Fetuin A and Ca scoring CT scan appear to be a useful, simple, and noninvasive examination to investigate the presence of subclinical calcification in coronary blood vessel even in psoriatic patients who seem to be otherwise healthy.
Ionic Anti-Viral Intralesional Therapy in Plantar Warts
Authors: Mohammed Ghada Fathy , Afify Ahmed Abd-Elfattah , Abdel Latif Wessam Moustafa Abo Elmagd 
Published: October 2021

Abstract

Background
Warts (verrucas) are an extremely common, benign, and usually self-limited skin disease. Their size ranges from a few millimetres to several centimetres. The normal skin lines are interrupted by skin coloured to brownish-grey proliferations, the diagnosis is established clinically; no supplementary histologic or virologic investigations are needed.

Objective
The aim of this two armed double blinded randomized clinical trial was to evaluate the clinical efficacy of intralesional combined digoxin and furosemide in the treatment of multiple planter warts.

Methods
This study included 40 patients with plantar warts, they were divided into 2 groups, 20 patients per group, the first group received intralesional normal saline, one injection session every week for maximum 5 injection sessions. The second group received intralesional combined digoxin and furosemide, one injection session every week for maximum 5 injection sessions. All the patients were recruited from the Dermatology outpatient clinic at Ain-Shams University Hospital and Shobra General Hospital during the period From July 2018 to July 2019.

Results
There was no statistically significant difference between the 2 studied groups as regard size of wart before treatment. While there was statistically significant difference between the 2 studied groups as regard size of wart after the 5th session. Also there was a steady increase in the response to treatment in group 2 showing an earlier response to treatment and most of patients with excellent and very good response to treatment after the 5th session. There was no statistically significant difference between the 2 studied groups as regard the number of warts before treatment. While there was statistically significant difference between the 2 studied groups as regard the number of warts after the 5th session. There was no statistically significant correlation between age, sex, disease duration and response to treatment (as regard reduction in number of warts) after the 5th session in group 2. While in group 1 there was no reduction in number of warts after the 5th session. There was a statistically significant difference between the number of warts before and after receiving the active treatment in group 1, in group 2 and for both groups together (all patients).

Conclusion
We concluded from this study that intralesional injection of combined digoxin and furosemide offers effective alternative form of treatment for plantar warts in adults. It is inexpensive and safe to treat plantar warts.