bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Accuracy of Lung Ultrasonography in Diagnosis of Pneumonia in Critically Ill Patient in Comparison with Computed Tomography of the Chest
Authors: Abd Elaziz Mohamed Saeed , Abd El Malek Fady Adib , Younes Abd Elhalim Abd Elhalim 
Published: November 2024

Abstract

Background
Chest X-ray (CXR) is the easiest approach in patients with suspected pneumonia, in search for a new infiltrate. However, studies clarified that it has low sensitivity for the diagnosis of pneumonia in comparison to chest computed tomography (CT). But the use of chest CT is not commonly used except for complex cases and cases with failure response to treatment. Lung ultrasonography (LUS), being a fast bedside technique, it has attracted many interests to preform studies to assess its ability to detect pleuropulmonary pathologies generally and pneumonia specifically.

Objective
To assess the diagnostic accuracy of ultrasonography (US) in the diagnosis of pneumonia when compared to computed tomography (CT).

Methods
This was a prospective comparative study where 30 patients completed the study in Ain Shams University Hospitals, with mean age of 61.03 ± 12.55 years and more males 23 (76.7%). After US assessment for the diagnosis of pneumonia, chest CT was done to confirm the diagnosis. Accordingly, they were divided into 2 groups. Twenty four patients (80%) were diagnosed with pneumonia “Positive CT group”. Six patient (20%) were not diagnosed with pneumonia “Negative CT group”.

Results
After plotting ROC curve for the data obtained from US in the diagnosis of pneumonia in comparison to the chest CT as a gold standard, US was considered a valuable tool to detect the diagnosis of pneumonia (p ˂0.042, accuracy 83%). It had extremely adequate results with sensitivity (100.0%) and specificity (16.7%). It showed excellent accuracy of 83%. The presence of one of the following four profiles in the ultrasound: (A + PLAPS, A/B, B’ or C profile) was used in the diagnosis. A + PLAPS profile showed 37.5% and 83.3%for sensitivity and specificity, respectively, A/B profile 20.8% and 100% B’ profile12.5% and 100 % and C profile:20.8% and 100%.

Conclusion
According to the results of this study, ultrasonography showed high sensitivity and specificity, so it is considered a bedside, reliable, rapid and non- invasive technique. The results suggest that it could have a significant role in the diagnostic workup of pneumonia in the ICU, alongside with the computed tomography.
Comparative Study between Ultrasound Guided Modified Pectoral Nerve Block (PECSΙΙ) versus Ultrasound Guided Serratus Anterior Muscle Plane Block for Analgesia Following Modified Radical Mastectomy
Authors: Mohammed Ibrahim Ahmed Saeed , Ibrahim Waleed Abdalla , Ahmed Mohamed Elshafeey Ahmed Elsayed , Rajab Sayed Owais Abdulrahman Sharara 
Published: November 2024

Abstract

Background
Modified pectoral nerve (PECSII) and serratus plane blocks have been recently used for analgesia in breast surgery, but evidence comparing their analgesic benefits is limited. This comparative study aims to examine the analgesic efficacy and safety profile of ultrasound-guided PECSII versus serratus block in patients undergoing modified radical mastectomy (MRM) for breast cancer.

Objective
To evaluate and compare the effect of both PECS II block versus and Serratus anterior block in patients undergoing modified radical mastectomy surgery.

Patients and Methods
The duration of analgesia and effect on hemodynamics parameters were evaluated. Moreover, undesirable side effects were studied. Thirty-six patients were randomly allocated into two equal groups (18 patients): group (A) and group (B). Group (A): received a PECSII block with 30 mL of bupivacaine 0.25%. Group (B): received a serratus anterior plane block (SAPB) using the same volume of 30 ml bupivacaine 0.25%. All patients were clinically assessed and routine preoperative investigations were done: CBC, Coagulation profile, liver function tests, kidney function tests, fasting blood sugar and ECG. The initial vital data were measured after applying the standard monitoring including pulse oximetry, non-invasive blood pressure and ECG.

Results
This study demonstrated that PECSII and serratus blocks have comparable analgesic properties in patients undergoing modified radical mastectomy. Both blocks were comparable in postoperative pain intensity, postoperative morphine consumption, and intraoperative fentanyl requirement. The two blocks were comparable in hemodynamics, and VAS score. The two blocks were associated with hemodynamic stability, and high satisfaction scores. The absence of major complications characterizes both blocks.

Conclusion
This study confirms that PECSII and serratus blocks provide similar adequate analgesia following modified radical mastectomy.
Comparative Study between the Analgesic Efficacy of Bupivacaine versus Bupivacaine and Nalbuphine in Ultrasound Guided Adductor Canal Block Post Knee Arthroscopy
Authors: Mohamed Salah El-Din Alaa Mohamed , El-Kabarity Reem Hamdy , Michael Hany Victor , El-Mawla Saleh Mohamed Abd 
Published: November 2024

Abstract

Background
Knee arthroscopy (KA) is associated with significant postoperative pain. The need for effective analgesia without compromising function is a priority. However, despite the effectiveness of this approach, the rehabilitation of limbs after a KA operation still faces critical challenges. Pain is the most difficult factor to control following KA; however, the development of an ultrasound- guided nerve block and multi- modal analgesia and motor- sparing regional anesthetic blocks has helped to reduce postoperative pain to a certain extent to help achieve early limb autonomous movement and facilitates early knee range of motion (ROM), speed up the rehabilitation process, reduces overall narcotic consumption, shorten hospital stays, and improve patient satisfaction.

Aim of the Work
to compare the analgesic effect of Bupivacaine and Bupivacaine/nalbuphine in adductor canal block in patients undergoing knee arthroscopy as regard post operative pain management.

Patients and Methods
This study is a Prospective, Randomized, Controlled study. After obtaining approval from Research Ethics Committee of Ain Shams University, the study was conducted on 50 patients in the operating theatres of Ain Shams University.

Results
The two groups were adequately monitored and assessed post-operatively for 24 hours and they were compared regarding NRS postoperative, by recording time for first for analgesic need and total consumption of opioid. Side effects were also monitored and compared. As for the comparison between effect of Adductor canal block with Bupivacaine alone and Bupivacaine with Nalbuphine as regard post-operative pain in knee arthroscopy, it showed that there is significance regarding the numeric rating score (NRS) that was used to assess postoperative pain and its intensity with range 1-3 for Adductor canal block with Bupivacaine and Nalbuphine and 2-4 for Adductor Canal block with Bupivacaine alone. These findings with our study primary and secondary outcomes showed that Adductor canal block with Nalbuphine has more analgesic effect regarding pain assessment and also with significant difference regarding the time of first analgesia postoperative and Total analgesics consumption (in mg.) over 24-hour period post-operative, but there was no significant difference regarding post operative complications such as hypotension, nausea and vomiting.

Conclusion
the comparison between effect of Adductor canal block with Bupivacaine alone and Bupivacaine with Nalbuphine as regard post-operative pain in knee arthroscopy, it showed that there is significance regarding the numeric rating score (NRS) that was used to assess postoperative pain and its intensity with range 1-3 for Adductor canal block with Bupivacaine and Nalbuphine and 2-4 for Adductor Canal block with Bupivacaine alone.
Comparative Study between the Effect of Intravenous versus Intrathecal Dexamethasone on Post Dural Puncture Headache in Cesarean Section Surgeries
Authors: Abdelaleem Azaa Atef , Elgendy Hanaa Abdallah , Abelghafour Mohamed Ahmed Saudy , Shahat Mohamed Asmaa Mohamed 
Published: November 2024

Abstract

Background
One of the main objectives of anesthesia is to alleviate the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for decreasing incidence of post operative side effect like PDPH.

Objective
To compare the efficacy of intrathecal dexamethasone with intravenous dexamethasone in the prevention of post dural puncture headache in spinal anesthesia in cesarean section surgeries.

Patients and Methods
We performed our study on 75 patients divided into 3groups (control group, IT group, IV group) respectively the first group25 patients had classic spinal, the second group 25 patients had classic spinal and 2ml (8mg) dexamethasone intravenously and the third group had spinal anesthesia with 0.5ml (2mg) dexamethasone intrathecally. All patients observed for 48hrs for occurrence of headache (PDPH) after excluded other types of headache. The incidence, severity, onset and duration of the headache assessed.

Results
The results revealed that there was significantly difference between the groups in incidence, Severity, onset and duration of PDPH. There was a statistically significant higher frequency of headache in control group was 10 patients (40%), followed by IV group was 7 patients (28%), then IT group was 3 patients (12%). As well as a statistically significant higher frequency of severe headache in control group, while there is no severe headache in IT group and IV group,). The results shows a statistically significant higher mean value of duration “hrs.” of headache in control group was 22.29±11.87, followed by IV group and IT group was (12.00±0.00 and 12.86±8.07) respectively.

Conclusion
This study showed that use of dexamethasone decrease the incidence and duration of PDPH. As There was a statistically significant higher frequency of headache in control group, followed by IV group then IT group. As well as a statistically significant higher frequency of severe headache in control group, while there was no severe headache in IT group and IV group, The results showed that duration of headache in control group was higher, followed by IV group and IT group respectively.
Ultrasound Guided Ilioinguinal/Iliohypogastric Nerve Block versus Transversus Abdominis Plane Block in Pain Management Following Unilateral Inguinal Hernia Repair
Authors: Mohamed Elsebaiee Basel Magdy , Din Abdel Hamid Amr Essam El , Mohamed El Fawal Sanaa Mohamed , Mahmoud Bayoumy Aya Ali 
Published: November 2024

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 and prolonged hospital stay.

Aim of the Work
The aim of this study was to assess the postoperative analgesic efficacy of TAP block compared to IIN+IHN nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received.

Patients and Methods
The study was conducted on 64 randomly chosen patients American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups.

Results
The study revealed that patients received IIN+IHN block had significantly lower pain scores after operation, delayed time for rescue analgesia and decreased total need of analgesic in the first 24hrs post- operative compared to patients who received TAP nerves block.

Conclusion
IIN+IHN block was effective in reducing postoperative pain scores, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to TAP nerves block.
Intranasal Dexmedetomidine versus Intranasal Ketamine as Pre-Anaesthetic Medication in Paediatric Age Group Undergoing Surgery
Authors: Mohammed Dalia Abd El-hamid , Ghaly Safaa Ishak , Mohammad Douaa Galal , Diaa El-din Doaa Ahmed 
Published: November 2024

Abstract

Background
The immediate pre-operative period is a very stressful time for most of the individuals undergoing surgery especially the paediatric patients. So, relieving their pre- operative anxiety becomes an important concern for an anaesthesiologist. Many anaesthetic pre-medications are used to relieve this stress response. Of these pre-medications, ketamine and dexmedetomidine are effectively used as sedatives. The present study is planned to compare sedative effect of intranasal dexmedetomidine vs intranasal ketamine as a pre- anaesthetic medication in children.

Aim of the Work
To compare the sedative effects, successful child–parental separation and haemodynamic parameters of intranasal dexmedetomidine versus ketamine as a premedication in children undergoing surgery.

Patients and Methods
After Ethical Committee approval and written informed parents’ consent, this Prospective randomized controlled clinical trial was performed in Ain Shams University Hospitals, Cairo, Egypt. Ninety children were scheduled to undergo elective surgeries.

Results
ninety children, aged between 2-8 years of either sex, belonging to ASA I-II, scheduled for elective surgery were enrolled in this prospective, randomized and comparative clinical study. The children were divided into two groups of 45 each. thirty minutes before induction, Group-D (n = 45) received intranasal Dexmedetomidine 1mcg/kg and Group K (n = 45) received intranasal ketamine 2mg/kg. Our study showed that there was no statistically significant difference between the two groups as regarding the HR and the blood pressure at 10 and 20 min after intranasal drug instillation. There was a statistically significant decrease in the dexmedetomidine group regarding the heart rate and the BP at 30 min, preoperative and during the intraoperative period. There was no significant difference in oxygen saturation between both groups. The MOAA/S scores were comparable in both groups, It was significantly lower in the ketamine group at 10 and 20 min after the administration of the drug. However, at 30min there was a statistically significant decrease in sedation score in the D group compared with group K.

Conclusion
Revealed that both drugs produce effective and favorable sedation level with superiority to dexmedetomidine in sedation scores and slight delay in onset of sedation, and there was little decrease in heart rate and MAP which is favorable during surgeries. Also, there was accepted parental separation scores denoting that there was smooth and easy separation from guardians. Thus, it can be concluded that intranasal dexmedetomidine can be used effectively and safely as a preanesthetic medication in children undergoing any surgical procedures under general anesthesia.
Ultrasound Measurement of Optic Nerve Sheath Diameter as Non-Invasive Detector of Raised Intracranial Pressure in Adult Traumatic and Non-Traumatic Neurocritical Patients in ICU
Authors: Abdelaziz Mohammed S , Abd Elmegid Khaled M , Tawadros Safaa I , Ahmed Ibrahim M , Elmalakhany Kareem E 
Published: November 2024

Abstract

Background
Measurement of intracranial pressure (ICP) is crucial in the management of many neurological conditions. However, due to the invasiveness, high cost, and required expertise of available ICP monitoring techniques, many patients who could benefit from ICP monitoring do not receive it. As a result, there has been a substantial effort to explore and develop novel non-invasive ICP monitoring techniques to improve the overall clinical care of patients who may be suffering from ICP disorders.

Objective
Assessment of the role of ultrasound as a non-invasive method (bedside) to measure the raising of intracranial pressure by measuring the optic nerve sheath diameter in traumatic and nontraumatic neurocritical patients.

Patients
and Methods: A total of 100 patients of both sexes above 18 years old diagnosed with traumatic & non-traumatic brain injury with high intracranial pressure (ICP) which suspected by the initial CT brain and Marshall Classification were enrolled. Patients were divided into control group that included 50 patients with no evidence of any intracranial abnormality or severe head injury. Mean ONSD in the control group was considered to be normal. Study group subjects included 50 patients aged above 18 years old who sustained a severe traumatic or non-traumatic brain injury (GCS &lt;8) All patients had a non-contrast CT head b efore any surgical or non-surgical i ntervention. The CT head was used to determine the Marshall score.

Results
Optic nerve sheath diameter was statistically significant higher in all periods 0-24 hours among cases with high intracranial tension compared with control ones with statistically significant positive correlations between it and age at 6hrs. and 24hrs and Marshal score at Ohr. and 24hrs and negative correlation between it and GCS score at Ohr. and 24hrs. The best cut off value for detector of raised intracranial pressure was 4.9 with sensitivity 94.7%, specificity 83.3%, positive predictive value 94.7% and negative predictive value 83.3%.

Conclusion
The evaluation of the optic nerve sheath diameter is a simple non-invasive procedure, which is a potentially useful tool in the assessment and monitoring of traumatic and nontraumatic neurocritical patients suspected of having raised intracranial pressure.
Atropine Prophylaxis before Spinal Anesthesia in Young and Middle Age Males Undergoing Inguinal Hernia Repair
Authors: Abdelrahman Mohamed Mahmoud Mohamed , Mahmoud El- Azazi Hesham Mohamed , El sayed Abdellatif Ayman Ahmed , Fawaz Mariam Momtaz 
Published: November 2024

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. One of the most common complications associated with spinal anesthesia is hypotension with or without bradycardia that can increase risk of perioperative cerebral and cardiovascular events.

Aim of the Work
to find out the effectiveness of prophylactic administration of intravenous atropine for attenuation of spinal anesthesia induced hypotension in inguinal hernia repair surgeries.

Patients and Methods
Therefore, A randomized controlled clinical trial was found to be the most suitable design in order to achieve the study objectives. A total of 40 patients males included in the study, aged 15-60 years, and were divided equally into two groups: Group 1 received intravenous injection of 0.01 mg /kg atropine sulphate one minute before spinal anesthesia and fluid preloading 500 ml Ringer solution. Group 2 received the same volume of normal saline intravenous bolus.

Results
Prophylactic intravenous atropine sulphate 0.01 mg /kg intravenous one minute prior to spinal anesthesia in inguinal hernia repair surgeries was effective in reducing spinal anesthesia induced hypotension, incidence of hypotension was lower in atropine exposed group compared to placebo group. The incidence of ephedrine use and number of boluses of fluids were lower in atropine exposed group compared to placebo group.

Conclusion
among patients who received spinal anesthesia with bupivacaine for elective inguinal hernia repair, prophylactic intravenous atropine sulphate 0.01 mg /kg prior to spinal anesthesia reduced spinal anesthesia induced hypotension and reduced ephedrine use.
A Comparative Study between C-MAC Video-Laryngoscope and Fiberoptic Laryngoscope in Anticipated Difficult Intubation
Authors: Salama Nahed Effat Yousef , Abdelatif Ayman Ahmed El-Sayed , Soliman Madkour Mohamed Emad , Toulan Heba F 
Published: November 2024

Abstract

Background
Numerous indirect laryngoscopes have been introduced into clinical practice and compared with the Macintosh laryngoscope. Most studies have described a significantly better glottic view and a higher success rate in difficult tracheal intubations for the indirect laryngoscopes. Some case reports also describe the successful use of these tools under sedation with preserved spontaneous breathing.

Objective
To compare the C-MAC® D-Blade video laryngoscope and the flexible fiberoptic scope for intubation of patients with anticipated difficult intubation. The primary endpoint was the time to achieve successful tracheal intubation. Secondary endpoints included glottic view at intubation and the number of intubation attempts. The study was conducted on 60 patients at the operating theatres of Ain Shams University Hospitals.

Patients and Methods
After obtaining approval from the Research Ethical Committee, Faculty of Medicine, Ain Shams University and informed consents from patients, 60 American Society of Anaesthesiologists I-II adult patients with El-Ganzouri risk index score (EGRI) ≥ 4 (age range, 21- 60 years) undergoing elective surgeries requiring tracheal intubation were enrolled in this prospective study at the operating theaters of Ain Shams University Hospitals from March 2022 to October 2022.

Results
Our results showed Duration of intubation (s) among the study groups. Duration of intubation (s) in Video laryngoscope Group ranged from 22 to 34 seconds with mean ± SD = 27.87 ± 3.74 while in Fiberoptic Group the Duration of intubation (s) ranged from 60 to 75 seconds with mean ± SD = 66.77 ± 4.24 with highly statistically significant difference (p = &lt;.001) between the two groups and showed POGO score among the study groups. Regarding POGO score, there was a significant difference between the two studied groups (p = 0.019). C-MAC video laryngoscope had become a good alternative and was associated with visualization of laryngeal structures in shorter time as compared to traditional flexible fiberoptic laryngoscopy.

Conclusion
This randomized, prospective study demonstrated that the C-MAC may offer an advantage over the fiberoptic laryngoscope with respect to the time required to obtain a clear glottic view and successful placement of the tracheal tube. However, the Flexible Fiberoptic Scope offered a better visualization of the glottic opening compared to the C-MAC video laryngoscope. The use of C-MAC as a usual tool was limited as it is expensive device, and the use of fiberoptic bronchoscope needs more experience and training.