bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Preoperative Nebulization with Magnesium Sulfate and Ketamine in the Prevention of Postoperative Sore Throat during General Anesthesia with Endotracheal Intubation in Adults, a Randomized Double Blinded Clinical Trial
Authors: Mohamed Ahmed Mohamed Rizk , Moustafa Zakaria Abdelaziz , Kamal Karim Youssef , Salah Asmaa Mohamed 
Published: November 2024

Abstract

Background
Post operative sore throat (POST) is a common complication following general anesthesia requiring endotracheal intubation with incidence ranges from 21% to 65%, also it may consider a minor complication, but if left unresolved, it produces significant agony and annoyance to the patients, if it was severe, it may be associated with hoarseness of voice or change of voice.

Aim of the Work
In our study we compare between ketamine nebulization and magnesium sulphate nebulization to evaluate their efficacy in decreasing incidence and severity of POST and concluding which drug is better.

Patients and Methods
This study is a randomized double blinded clinical trial, after obtaining approval from the research ethical committee of Faculty of Medicine, Ain Shams University, this study was conducted in the operating theaters of Ain Shams University Maternity Hospital. Patients were randomly allocated by computer generated randomization into two groups (M, K) each group 20 patients: group Magnesium (M): patients received preoperative nebulization with 250 mg magnesium sulfate in 5ml saline, group Ketamine (K): patients received preoperative nebulization with 50 mg ketamine in 5ml saline.

Results
The result of the study showed that preoperative nebulization with ketamine 50mg is more effective than preoperative nebulization with magnesium sulfate 250mg in reducing incidence and severity of post operative sore throat especially early after operation.

Conclusion
We conclude that preoperative nebulization with ketamine 50mg is more effective than preoperative nebulization with magnesium sulfate 250mg in reducing incidence and severity of post operative sore throat especially early after operation.
Preoperative versus Postoperative Ultrasound-Guided Quadratus Lumborum Block for Postoperative Analgesia Following Radical Nephrectomy, A Comparative Study
Authors: Mohammad Ahmad Elewa Gamal Eldin , Maamoon Rania Maher Hussien , Wasfy Sanaa Farag Mahmoud , Abdelraouf Younis Mohammed Mahmoud 
Published: November 2024

Abstract

Background
The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L1 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers.

Objective
To compare the effectiveness of ultrasound-guided preoperative to postoperative QLB on the effectiveness and duration of postoperative analgesia represented as time of first analgesia requested by patients.

Patients and Methods
After approval of research ethical committee of Ain Shams University Hospitals, this prospective double blinded randomized clinical study was conducted between April 2023 till September 2023, written consent was taken from all participants after explaining the procedure. One hundred and eight patients were included. later on. eight patient were excluded due to bleeding, failed block, duration of surgery more than 180 minutes. Included patients were divided into 2 groups 50 each.

Results
The current study also calculated and compared the standard deviation for each of the two groups analyzed, as well as the postoperative NRS score, initial time to rescue analgesia, and total amount of opioids (Nalbuphine) administered in the first 24 h. When compared to the postoperative QLB group (Group B), preoperative QLB patients (Group A) showed higher values. Postoperative QLB was found to be more effective than preoperative QLB in this clinical trial. Group B was found to be superior to Group A in terms of analgesia (Nalbuphine), total Nalbuphine consumption, and NRS score. Group A had higher pain ratings and were the first to rescue analgesia. There are no many studies were done comparing preoperative versus postoperative plan block especially with QLB in postoperative pain management and that’s the gab of knowledge in our study.

Conclusion
Postoperative administration of QLB in nephrectomy provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to preoperative administration of QLB.
Ultrasound-Guided Quadratus Lumborum Block Using Bupivacaine versus Bupivacaine–Magnesium Sulfate as Postoperative Analgesia in Open Appendectomy in Middle Age Group
Authors: Elshafie Mohamed Anwar , Ammar Mona Ahmed Mohamed , Hamid Yasmine Magdy Abdel , Mohammed Mostafa Aly Abdelrahman 
Published: November 2024

Abstract

Background
The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L1 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers.

Objective
To assess the analgesic sparing effect of adding magnesium sulfate to Bupivacaine in Quadratus lumborum block in patients undergoing open appendectomy under general anesthesia.

Patients and Methods
After approval of the anaesthesiology department and scientific and ethical committees, this prospective single blind randomized clinical trial study was conducted in Ain Shams University Hospitals. Sixty patients scheduled for open appendectomy under general anaesthesia were included in this study. Patients were randomized using a random number table and the use of a closed envelopes technique to receive quadratus lumborum either magnesium sulphate and bupivacaine or bupivacaine only, each group constitutes of 30 patients.

Results
We found that the addition of magnesium sulfate to bupivacaine in QLB in open appendectomy in middle age group provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group.

Conclusion
The addition of magnesium sulfate to Bupivacaine in lateral QLB in open appendectomy surgery provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to bupivacaine alone group.
Comparative Study between Dexmedetomidine and Fentanyl as Adjuvants to Bupivacaine for Prevention of Post Spinal Shivering in Caesarean Sections
Authors: Kamal Abdel-Shafy Noura Abdel-Monem , Sedky Abdel- Rahman Kareem Ahmed , Saleh Zaki Gamal Fouad , Farag Awad Hanan M 
Published: November 2024

Abstract

Background
Shivering is a common complication in regional anesthesia during cesarean sections. It can impair monitoring and increase oxygen demand, CO2 production, and wound pain, healing, and discharge. Spinal anesthesia can increase vulnerability to hypothermia, leading to shivering. Dexmedetomidine and fentanyl have been shown to prevent post-spinal shivering.

Aim of the Work
This study aimed to compare the efficacy and safety of fentanyl and dexmedetomidine in preventing perioperative shivering and their effects on block intensity, hemodynamics, sedation, postoperative pain, and analgesic requirement.

Patients and Methods
150 obstetric patients were included and randomized into three equal groups: control, fentanyl, and dexmedetomidine group. Each group received 12.5 mg hyperbaric bupivacaine 0.5% intrathecally with different adjuvants.

Results
Both fentanyl and dexmedetomidine groups showed a decreased incidence and intensity of shivering compared to the control group. There was no statistically significant difference between the two groups in this regard (p-value &gt;0.05). The onset and duration of sensory and motor block were faster and prolonged in both fentanyl and dexmedetomidine groups compared to the control group, but dexmedetomidine showed faster onset and more prolonged duration than fentanyl. Dexmedetomidine also showed a statistically significant difference regarding hypotension (p-value &lt;0.05) but non-significant regarding bradycardia (p-value &gt;0.05) compared to other groups. There were no statistically significant differences in sedation intensity between the groups (p-value &gt;0.05). Fentanyl showed a higher incidence of nausea, vomiting, and pruritis compared to other study groups.

Conclusion
Both fentanyl and dexmedetomidine are safe to use with bupivacaine for prevention of perioperative shivering in cesarean sections. Both drugs decreased the incidence and intensity of shivering, and dexmedetomidine was more effective in terms of prolongation of sensory and motor block duration and reducing opioid requirements. Dexmedetomidine showed fewer side effects during the intra and postoperative period compared to fentanyl.
A Comparative Study between the Efficacy of Ultrasound Guided Erector Spinae versus Quadratus Lumborum Plane Blocks in Laparoscopic Appendectomy
Authors: Omran Yomna Abdelrahim , Maghawry Khaled Mohamed , Ismail Wafaa Elsayed , Shohdy Haidi Nashaat 
Published: November 2024

Abstract

Background
Laparoscopic appendectomy is more superior to open appendectomy in terms of wound site infections and pain intensity. Although the laparoscopic technique is minimally invasive, postoperative pain is inevitable, and it may affect the patients’ mobility and cause them to stay in the hospital for a more extended period.

Aim of the Work
to compare the effectiveness of erector spinae plane block and quadratus lumborum plane block as part of multimodal analgesia for reducing postoperative pain in patients undergoing laparoscopic appendectomy.

Patients and Methods
This prospective randomized controlled clinical trial was conducted at operative theatres, Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University Hospitals from April until September 2023.

Results
During this study, 54 patients undergoing laparoscopic appendectomy were enrolled and divided into two equal groups; group A subjected to erector spinae block and group B subjected to quadratus lumborum block. Intraoperative, Post Anaesthesia Care Unit and postoperative haemodynamic, postoperative NRS score, first time of postoperative analgesic request, total amount of postoperative analgesia and serum cortisol levels were measured. In this study there was a significant difference between the two groups regarding NRS scores and total amount of analgesia needed post operatively. In this study, no statistically significant difference was observed between the two groups in terms of serum cortisol levels. In this study, no significant difference was found between the two groups regarding heart rate and mean arterial pressure.

Conclusion
Both QLB and ESPB are effective as post-operative analgesia techniques for laparoscopic appendectomy. However, our study showed that US-guided ESPB may provide better pain control than QLB. These results allows healthcare providers and patients to choose the most suitable technique based on individual preferences and clinical considerations. However, further research with larger sample sizes and multicentric studies would be valuable to confirm these findings and explore potential variations in different patient populations or surgical settings.
The Effect of Tadalafil 5 mg on Outflow Obstruction due to Benign Prostatic Hyperplasia
Authors: Ghareeb Mohammed Esmat Abo , Azzazy Samir Sayed Mohammed , El-Labban Ahmed El-Husseiny Mohammed 
Published: November 2024

Abstract

Background
Tadalafil showed efficacy in treatment of LUTS due to BPH. In several clinical studies, it was found to have different mechanisms of actions on prostate through increasing blood supply and oxygenation, decreasing intrprostatic inflammation and relaxation of smooth muscle fibers.

Objective
to assess the effect of tadalafil on uroflowmetry and IPSS in patients with BPH/LUTS.

Patients and Methods
This study is prospective, non-randomized; single-arm study that was conducted on patients obtained from outpatient urology clinics of Ain Shams University Hospital & El-Sahel Teaching Hospital in the study period between September 2021 and May 2022. It was conducted on 55 patients with BPH/LUTS who received tadalafil 5 mg daily, IPSS was assessed before starting treatment and after 12 weeks, Uroflowmtery was done before starting treatment, after 4 weeks and 12 weeks of treatment.

Results
Our study showed that Qmax increased from baseline 10.8±2.0 to 11.5±2.4 in week-4, then to 12.7±2.2 in week-12. The change from baseline to week-4 was 0.6±0.5, the elevation was statistically significant (p &lt; 0.001). The change from baseline to week-12 was 1.9±0.3, the elevation was statistically significant (p &lt; 0.001). The change from week-4 to week-12 was 1.3±0.4, the elevation was statistically significant (p &lt; 0.001).

Conclusion
In patients with BPH/ LUTS, tadalafil 5 mg once daily resulted in statistically significant improvement in IPSS and Qmax and it was well tolerated.
The Efficacy and Safety of Adjunctive Alpha-Blocker Therapy before Flexible Ureteroscopy in the Management of Upper Ureteric Stones in Pediatrics Group
Authors: Abo Ghareeb Mohamed Esmat , Mohamed Mohamed Hasan , Ibrahim Ahmed Hamdy 
Published: November 2024

Abstract

Background
The incidence of pediatric urolithiasis has risen dramatically over the past few decades, with a reported rate of 4% per year. A unique aspect of children is the smaller ureteral diameter, which often results in failure to access the ureter during an initial URS (either Flexible or Rigid) attempt to be able to perform the intended procedure.

Aim of the Work
To evaluate efficacy adjunctive alpha-blocker therapy before Flexible ureteroscopy in the management of Upper ureteric stones (ranging from 5:10 mm) in children as regard facilitating ureteric orifice navigation and ureteral dilatation.

Patients and Methods
This was a prospective randomized control study that was conducted at Urology Department, Faculty of Medicine, Ain Shams University on 80 patients they were divided into 2 groups. Group A (random): 40 Children received Tamsulosin 0.4 mg capsule for 5 days prior to Flexible ureteroscopy. Group B (random): 40 Children didn’t receive Tamsulosin 0.4 mg capsule prior to Flexible ureteroscopy.

Results
There were 60 child were male and 20 were female and their ages ranged from 5 to 18 years (mean 10.66 years). There was no statistically significant difference between Group A and Group B regarding age (Years), gender, Body mass index (kg/m2) and Side. Successful stone access occurred in 34 of 40 patients (85%) who had received tamsulosin and 30 of 40 (75%) who had not (p = 0.264). There was no statistically significant difference between Group A and Group B regarding stone burden (mm2), successful access and stone free rate. There was no statistically significant difference between Group A and Group B regarding complication (P &lt; 0.05).

Conclusion
Adjunctive alpha-blocker therapy (Tamsulosin) before flexible ureteroscopy in the management of upper ureteric stone in school age children failed to show a statistically significant difference for successful ureteral orifice navigation, ureteral dilatation, stone free rete and complication.
Predictive Value of E-Cadherin, β-Catenin and SOX4 in Recurrence and/or Progression of Non-Muscle Invasive Urinary Bladder Transitional Cell Carcinoma. A Retrospective Study
Authors: Safaan Ahmed Mohamed , Amin Aly Roshdy Mamdouh Mohamed , El-lithy Tarek Ramzy , Alsaid Mohamed Hassan , Hammam Olfat Ali Ibrahim , Mohamed Mousa Ahmed Kadry Salama 
Published: November 2024

Abstract

Background
Bladder cancer (BC) is one of the most common genitourinary cancers worldwide, the pathophysiology and etiology of BC are complicated, including both internal genetic and environmental factors. Currently, some studies suggest that the abnormal function of intercellular adhesion molecules is highly correlated with the invasion of surrounding tissues and distant organ metastasis of BC.

Objective
To develop a correlation between these markers and NMIBC and to help predict the recurrence and/or progression.

Patients and Methods
It is a retrospective cohort (observational) study assessing a correlation regarding the alternation in the expression of E-cadherin, β-catenin and SOX4 in determining the recurrence and/or progression and their prognostic value in NMIBC TCC. Patients Diagnosed with NMIBC TCC and their follow ups data were evaluated at the urology department in Theodor Bilharz Research Institute (TBRI) and Ain Shams University from January 2019 – till July 2022.

Results
Loss of normal expression of E-cadherin and β-catenin, upregulation of SOX4 is significantly correlated with BC and tumorigenesis, yet no clear relation between E-cadherin, β- catenin and SOX4 in progression or recurrence of NMIBC, regarding It’s staining intensity, percentage of positive cells and immunoreactive score (IRS).

Conclusion
bases on our current study, E-cadherin, β-catenin and SOX4 showed highly significance difference between normal urothelium and TCC NMIBC indicating it may have a role in diagnosis, although its value changes with follow up of the patients but of non-significant difference to predict prognosis, recurrence and/or progression among TCC NMIBC.
Effect of Preoperative Silodosin on Ureteric Dilatation in Retrograde Intrarenal Surgery
Authors: Radwan Ahmed Ibrahim , Ghani Ahmed Ramadan Mohamed Abdel , Gamil Ahmed Maher 
Published: November 2024

Abstract

Background
Selective alpha blockers have been used for treatment for ureteric stones as medical expulsive therapy (MET). Recently they have been successfully used in passive ureteric dilatation before semirigid ureteroscopy.

Objective
This study enables us to know the role of silodosin in ureteric dilatation to facilitate ureteral access sheath placement in Retrograde Intrarenal Surgery (RIRS) with flexible ureteroscopy (F-URS).

Patients and Methods
A total of 120 patients with renal or upper ureteric stone of 2 cm or less were enrolled, after consenting each of them and divided into two groups; group A (study group) that included 60 patients who underwent flexible ureteroscopy using Ho-YAG laser for stone disintegration. These patients received silodosin ‘one tablet 8 mg per day’ for three days preoperatively and group B (control group) included 60 patients who underwent non-stent ureteroscopy using Ho- YAG laser for stone disintegration. These patients received placebo for three days. All patients were blind to the medication received. Our primary outcome was to assess success of ureteric access sheath placement as follows: spontaneous passage of ureteral access sheath without dilatation or passage of UAS after dilatation or failure of the ureteral access sheath insertion. All cases were classified accordingly.

Results
Successful placement and spontaneous uretroscopy passage without dilatation were statistically significant higher with less frequency of failed dilatation in silodosin group. Also, operative time, frequency of stone residual, hospital stay and total cost were statistically significant lower. Finally, postoperative complications as pain, hematuria and mucosal injuries were statistically significant lower.

Conclusion
Preoperative use of silodosin increases the success rate of UAS insertion while decreasing the risk of ureteral wall injury in intrarenal endoscopic procedures.
Comparison between Flexible Ureteroscopy by Using Uretral Access Sheath and Flexible Ureterosopy without Using Ureteral Access Sheath in Cases of Upper Ureteric and Pelvic Stones
Authors: ahmed Hussein Ibraheem , Shaker Hassan Sayed , El-Moazen Mohamed Ibrahim 
Published: November 2024

Abstract

Background
Ureteral access sheath use has been widely accepted by urologists since older ureteroscopes were difficult to insert into the ureter due to their stiffness, width and limited deflection angles. However, with advancing technology and design improvement, new generation ureteroscopes are thinner and built with lighter and more flexible materials than their older counterparts. This in turn has produced devices that are easier to maneuver, meaning that procedures can be performed without needing UAS thus the actual benefit of UAS was under question.

Aim of the Work
to compare the usage of UAS versus not using the UAS during FURS regard operative time, intra operative, postoperative complications and patient satisfaction.

Patients and Methods
This randomized controlled clinical trial was conducted in Urology Department, Ain Shams, University Hospitals and included 50 upper ureteric stone disease patients. They were divided into 2 comparative groups (each group 25 patients) by closed envelop method. One of these groups underwent FURS with ureteral access sheath and the second group underwent FURS without ureteral access sheath.

Results
there was no significant difference between the 2 groups regarding demographic or clinical data. Moreover, no significant difference was detected between the 2 groups regarding intra or post-operative complications, stone free rate or duration of hospital stay. However, statistically significant longer operative time was recorded in UAS group compared to no UAS group.

Conclusion
our study showed that flexible ureterenoscopy without ureteral access sheath Seems to be safe as flexible ureterenoscopy with ureteral access sheath regards intraoperative, post- operative complications, patient satisfaction, stone free rate and duration of hospital stay, an additional advantage is shorter operative time without using of ureteral access sheath