bluuebunny/crossref_metadata_2025_split huggingface dataset:
Greening Infection Prevention and Control: Multifaceted Approaches to a Sustainable Future
Authors: Lee Pamela S , Frantzis Irene , Abeles Shira R 
Published: July 2024

Abstract
Infection prevention and control, or IP&C, is a critical stakeholder in advancing environmental sustainability in health care. IP&C activities seek to ensure safety of processes in health care from an infection perspective, but how these are performed can drive substantial waste and pollution. There are certain IP&C measures that can, without compromising safety or efficiency, be adapted to more environmentally friendly practices and have a high impact benefit to sustainability without affecting patient outcomes. Moreover, IP&C practice stands to be significantly altered by climate change and pollution. Here, we describe the complex interdependence between sustainability, climate change, and IP&C, and opportunities for IP&C to be at the leading edge of optimizing healthcare's environmental footprint.
The Value of BLUE Protocol in the Diagnosis of Acute Onset of Respiratory Distress in Critically Ill Patient
Authors: Amin Koraa Alaa Eldin Abdelwahab , Elansary Adel Mohammed , Mohamed Hussen Mahmoud Hassan , Hussen Rania Maher , Elgamal Lobna Ahmed 
Published: July 2024

Abstract
To detect the value of BLUE protocol in the diagnosis of acute onset of respiratory distress in critically ill patients
This cross-sectional study conducted on 60 patients by performing ultrasonography on consecutive patients admitted to the ICU with acute onset of respiratory distress (dyspnea), comparing lung ultrasonography results on initial presentation with the final diagnosis with conventional method of diagnosis by the ICU team.
The BLUE protocol proved its importance, availability, easiness of application, accuracy and its ability to reach a final correct diagnosis in 90%of the patients. The lung U/S showed much better results than the CXR, but still the CT chest was more superior to the lung U/S as the sensitivity of the BLUE protocol in the diagnosis of pneumonia, pulmonary edema, pneumothorax, pleural effusion and COPD was 91.4%, 92.8%, 90%, 88.8% and 78.6 respectively.
The lung U/S (BLUE protocol) is a bedside, reliable, dynamic, rapid, and noninvasive technique, these results suggest it could have a significant role in the diagnostic workup of acute onset of respiratory distress in the ICU.
A Comparative Study of Erector Spinae Block versus Serratus Anterior Plane Block for Pain Management Following Video Assisted Thorocoscopic Surgery
Authors: Abd ELaziz Mai Mohsen , Saleh Mohamed Abd ELMawla , Elsaeidy Mohamed Ismail , Ibrahim Ghazy Dalia Mostafa 
Published: July 2024

Abstract

Background
Pain is an everyday challenge during all surgeries and it is a chief postoperative complication, so pain management is a corner stone in anesthetic practice. Minimally invasive thoracic surgery (MITS) has become more common over the past decade, with the proportion of lung resections performed using this technique increasing from 16% in 2005 to 47% in 2015. MITS includes both video-assisted and robotic-assisted techniques, with smaller skin incisions and chest wall trauma compared with open thoracotomy, Benefits include reduced postoperative pain, morbidity, and shorter hospital stay.

Objective
To compare efficacy between Serratus anterior block and Erector supinae block in Video assisted thoracoscopic surgery for minimally invasive thoracic surgery as regard post operative opioid consumption.

Patients and Methods
The study was conducted in Ain Shams University Hospitals after approval of the ethics committee and written patients‟ consent. It included a total of 40 adult patients aged 18-70 years, Scheduled for video assisted thoracoscopic surgeries. Patients were randomly divided into two equal groups, 20each, according to the inclusion and exclusion criteria.

Results
Intraoperative fentanyl consumption, postoperative opioid consumption and 1st rescue analgesic use were significantly lower in the ESPB group (P &lt; 0.05). NRS scores were significantly lower in the ESPB group (P &lt; 0.05) than SAPB from 2 to 8 hour only, mean arterial pressure and Heart rate was significantly lower from 2hour to 8hour in ESPB than SAPB but there were no significant difference in hemodynamics intraoperative.

Conclusion
Clinicians could develop a preference for either ESPB or SAPB for pain control after VATS based on their clinical experiences and personal choices. However, our study showed that US-guided ESPB may provide better pain control than SAPB.
Comparison of Volume-Controlled Ventilation (VCV) Mode and Pressure-Controlled Ventilation (PCV) Mode in Patients Undergoing Lumbar Spine Surgery in the Prone Position
Authors: Abd El Aziz Mohamed Saeed , Hassan Kachef Nevine Ahmed , Nasr Thabet Aziz , Ibrahim Ali Ismael Ibrahim 
Published: July 2024

Abstract

Background
The prone position is commonly required to enable surgical access during lumbar spine surgery. When a patient moves into the prone position, inferior vena cava obstruction causes reduced venous return and increase thoracic pressure results in reduced left ventricular compliance, leading to a decreased cardiac index (CI).

Aim of the Work
The aim of this study, we will compare the effects of the VCV and PCV on peak airway pressure (P peak), ETCO2 as a primary outcome ABG, SPO2, and hemodynamics as MAP, HR and as a secondary outcome in the prone position.

Patients and Methods
This prospective, single blinded study included 60 patients who assigned randomly into two equal groups: group A: patients on volume-controlled ventilation mode VCV and group B: patients on pressure-controlled ventilation mode PCV.

Results
Baseline characteristics (age, sex, BMI, ASA physical status, duration of anesthesia and surgery) were insignificantly different between both groups. Heart rate and MAP at supine and prone positions at all time measurements were insignificantly different between both groups. P peak and SpO2 at supine and prone positions at all time measurements were insignificantly different between both groups. Respiratory rate and ETCO2 at supine and prone positions at all time measurements were insignificantly different between both groups.

Conclusion
No significant difference between two modes of ventilation VCV and PCV in patients undergoing lumbar spine surgery in the prone position as regard P peak, ETCO2, SPO2, and hemodynamics.
Study of Effects of Preoperative Oral Domperidone on Gastric Residual Volume after Clear Fluid Ingestion in Patients Scheduled for Elective Surgeries
Authors: Mahmoud Deabes Ahmed Abdelhamid Mahmoud , Ahmad Elewa Gamal Eldin Mohammad , Ali Sultan Sherif Sayed , Alansary Amin Mohammed 
Published: July 2024

Abstract

Background
Oral Dopmeridone is a prokinetic drug that enhance gastric emtptying, which has a positive effect in decreasing the gastric residual volume, subsequently decreasing the risk of pulmonary aspiration

Aim of the Work
This study to aimed to assess the effect of oral Domperidone preoperatively on gastric residual volume by ultrasound for patients undergoing elective surgeries under general anesthesia as a primary outcome and postoperative nausea and vomiting as a secondary outcome.

Patients and Methods
We applied our study on 40 patients were divided into two equal groups: Group A (study group): The patients received 400 ml of apple juice as a clear fluid, two hours preoperatively, and oral Domperidone tab (Motilium 10mg/tab, Janssen comp.) & Group B (control group): The patients received 400 ml of apple juice as a clear fluid two hours preoperatively with a placebo (Folic acid 500 mcg, dietary supplement), with the same inclusion and exclusion criteria.

Results
There was statistically significant decrease mean in group A compared to group B according to Ultrasound Measurements in the right lateral position after 2 hrs has been demonstrated about D1 right lateral position; D2 right lateral position; CSA right lateral position and calculated gastric volume right lateral position (ml). In addition to a statistically significant decrease mean in after 2hrs. compared to after 1hr. according to Ultrasound Measurements in the right lateral position about D1 right lateral position; D2 right lateral position; CSA right lateral position and Calculated gastric volume right lateral position (mL) in group A. There is also a statistically significant decrease mean in after 2hrs. compared to after 1hr. according to Ultrasound Measurements in the right lateral position about D1 semi-sitting; D2 right lateral; CSA right lateral position and Calculated gastric volume right lateral position (mL) in group B. At last, there has been a statistically significant higher change (after 2hrs.-1hr.) in group A compared to group B according to Ultrasound Measurements in the right lateral position about D1 right lateral position; D2 right lateral position; CSA right lateral position and Calculated gastric volume right lateral position (mL), with p-value (p &lt; 0.05 significant).

Conclusion
Preoperative oral Domperidone intake was able to decrease the GRV measured by ultrasound, more than the decrease of GRV by applying placebo.
Prognostic Value of Prolonged QT Interval in Patients with Acute Ischemic Stroke
Authors: Said El Fayomy Mohamed Kamal , Moustafa Zakaria Abdelaziz , Eldin ElSerwi Heba Bahaa 
Published: July 2024

Abstract

Background
Early predictors of mortality and poor functional outcome are crucial for planning the level of care and optimizing resource utilization. Nonetheless, rapid and noninvasive methods for assessing the prognosis of patients with acute hemorrhagic stroke in the emergency department (ED) are currently lacking.

Aim of the Work
The aim of this work is to assess and evaluate the QT- prolongation in patients with acute stroke without known cardiac disease and to correlate between prolonged QT interval and different neurological outcomes.

Patients and Methods
This was a case control study. Data from patients with acute ischemic stroke (stroke patients) who were admitted to the neurological intensive care unit were collected for the period from June 2021 to December 2021 at the First Affiliated Ahmad Maher teaching hospital, and patients in other departments were enrolled as controls.

Results
This study had several limitations. First, the study was performed in a single center, which may reduce its generalizability. In addition, we were unable to determine non-fatal long-term outcomes, such as major adverse cerebro-cardiovascular events (MACCE). Second, the mechanism underlying QTc interval prolongation remains tentative because ECG was performed at single time points, not overtime. Furthermore, major cardiac and non-cardiac comorbidities were defined as the previous history and/or ECG results at admission, thus possibly underestimating subclinical conditions. In addition, the contribution of each cardiac and non-cardiac condition to QTc interval prolongation is not equally the same. We also could not absolutely exclude patients with coronary artery disease who shared similar risk factors because we did not conduct echocardiography or coronary angiography, and this may have affected the QTc interval changes in ECG.

Conclusion
Prolonged QTc interval was associated with the increased risk of long-term mortality, in parallel with the increasing trend of the prevalence of cardiovascular risk profiles and stroke severity, across sex differences, such as different distributions of age, comorbidities, morality, and QTc intervals in AIS patients. Acute ischemic stroke patients may have a longer QT interval and a higher incidence of electrocardiogram abnormalities. In clinical practice, careful attention should be paid to acute ischemic stroke patients to prevent malignant arrhythmia.
Comparative Study between Rocuronium And Magnesium Sulfate as Adjutants to Regional Anesthesia for Ophthalmic Surgeries using Peribulbar Block
Authors: Nagy Mohamed , El-Ella Sahar Abo , El-Shafey Mohamed , Ragaey Melad , Helal Amr 
Published: July 2024

Abstract

Background
Peribulbar anesthesia is frequently used in cataract surgeries. Compared to retrobulbar anesthesia, this approach is associated with less significant consequences. However, it has the disadvantages of a slower onset of orbital akinesia and the frequent requirement for block supplementation.

Aim of the Work
To evaluate the effect of addition of magnesium sulfate and rocuronium to standard local anesthetics mixture on the time of onset of globe and lid akinesia and corneal anesthesia for peribulbar block in ophthalmic surgeries.

Patients and Methods
This Prospective Double-blinded Randomized Study was carried out in the ophthalmic surgery unit, Ain Shams university hospital from January 2019 to April 2020. After institutional Ethical Board approval and obtaining written informed patients’ consents, 75 patients from both sexes, ASA physical status I-III, aged 40-80 years and having an Axial globe length less than or equals 26 mm scheduled for cataract surgery under peribulbar block were included in the study.

Results
Our study found statistically significant more rapid onset of action (mean time to start surgery) in rocuronium group (7.00±1.22) than control group and magnesium sulfate group (9.00±1.47 and 9.00±1.15) respectively, (p &lt; 0.001); Moreover, no statistically significant difference was reported between control group and magnesium sulfate group. In addition, no significant difference was reported regarding duration of surgery between groups

Conclusion
Adding Rocuronium to local anesthetic mixture in peribulbar block during cataract surgery enhances ocular akinesia and corneal anesthesia and reduces the need for supplementary injections with no side effects and that was significantly better than Magnesium sulfate in term of rapid onset and time needed to achieve adequate condition to begin surgery. However, adding Magnesium sulfate showing good results regarding akinesia, corneal anesthesia and need for supplementary injections but it did not significantly fasten the onset of block and hence the time to start surgery.
Impact of Sub-Anesthetic Dose of Ketamine on Post Spinal Hypotension in Cesarean Delivery
Authors: Mahmoud El-Gamal Ahmed Adel , Abdel Hamid Amr Essam El Din , Abd Elsamie Hoda Shokri , Abdel-Tawab Samar Mohamed 
Published: July 2024

Abstract

Background
Spinal anesthesia is the commonest technique used in Cesarean Section (CS) and most frequently associated with maternal hypotension, for whicha lot of techniques have been described to prevent but an effective method is yet to be found.

Objectives
The aim was to study the effect of using a sub-anesthetic dose of ketamine to prevent post-spinal hypotension in CS delivery.

Methods
This double-blinded randomized controlled study was conducted on 60 participating parturients who were ASA І, П term pregnant. All the parturients received spinal anesthesia. The parturients were then randomly divided into two equal groups (n = 30 in each); ketamine group received a sub- anesthetic dose of ketamine of 0.5 mg/kg IV bolus in 3 ml saline and control group received the same volume of normal saline IV bolus. Heart Rate (HR) and Mean Arterial blood Pressure (MAP) were recorded at baseline (5 minutes prior to the intrathecal injection), at 5, 10, 15 and 20 minutes after the injection and then every 15 minutes till the end of the operation. Incidences of hypotension and severe hypotension were recorded. The total dose of ephedrine was recorded. Modified Ramsay sedation score was recorded at baseline then 5, 10, 15, 30, 45 minutes after injection and then at the end of the operation.

Results
The study revealed that ketamine didn’t prevent hypotension, it only delayed it for 10 min compared to control group 5 min. Also, observed that total ephidren dose significantly decreased in ketamine group compared to control group. And sedation scores in the first 30 min were higher in ketamine group. HR wasn’t affected. No changes in APGAR score were noticed between the two groups. No side effects from ketamine except for nystagmus.

Conclusion
This study concluded that the use of intravenous ketamine in low dose (0.5mg/kg) doesn’t prevent postspinal hypotension but it only decreases ephidren requirements.
Ultrasound Guided Erector Spinae Block Using Bupivacaine – Magnesium Sulphate versus Bupivacaine – Dexmedetomidine for Postoperative Analgesia in Lumbar Spine Surgeries
Authors: Soliman Hussien Ehab Hussien , Abdelmageed Waleed Mohamed , Alwedeny Hadeel Magdy , Refaat Sameh Ahmed , Fouly Mohammed Abdelmoneim 
Published: July 2024

Abstract

Purpose
Lumbar spine surgeries are associated with significant postoperative pain. Erector Spinae Plain Block (ESPB) is a new ultra-sound guided block technique for such surgeries . We aimed to explore the analgesic effect of adding dexmedetomidine and magnesium sulfate as adjuvants to bupivacaine in ESP.

Patients and Methods
Fifty two patients scheduled for lumbar spine surgery were randomly allocated into two groups to receive an ESP block., A total volume of 25 ml, [10 mL 0.5% bupivacaine diluted in normal saline (NS) and 2 mg/kg MgSO4 in group (MG group) and 10 mL 0.5% bupivacaine in NS with 2 μg/kg dexmedetomidine in group (DEX group)] were injected. The block was administered preoperatively before anesthesia induction. Postoperatively, hemodynamics, visual analog scale scores, the first request for analgesia, total analgesic consumption, and side effects were observed for 12 hours.

Results
The demographic data including age, gender, height, weight and BMI showed no difference between both groups, also, ASA classification and duration of surgeries done showed no difference between the studied groups (P &gt; 0.05). There were no recorded complications in both groups (P &gt; 0.05). There was no significant difference among both groups regarding basal, and follow up period at 15 min values of heart rate, and basal value of mean arterial pressure (P &gt; 0.05), but for the intraoperative hemodynamic parameters including MAP and HR, both parameters decreased significantly in the group which received dexmedetomidine in comparison to the other group except follow up values at 180 and 210 min, as no significant differences were recorded among both groups (P &gt; 0.05). Regarding postoperative pain, the visual analogue score (VAS) was used to record it postoperatively every 2 hours while we found a statistically significant difference regarding the VAS from 4 to 6 hours postoperatively as P &lt; 0.005, but, we found no difference regarding the postoperative total consumption of nalbuphine (P &lt; 0.005) . As for patient satisfaction in the studied groups, an anaesthesia satisfaction questionnaire was developed, validated (Kappa coefficient). Dexmedetomidine group was associated with a significant increase in satisfaction compared to MG group (P &lt; 0.05).

Conclusion
Magnesium sulphate and dexmedetomidine seem to be both effective adjuvants to bupivacaine in ESP blocks for postoperative analgesia in patients undergoing lumbar spine surgeries, with slightly better analgesia provided by dexmedetomidine.
Predictive Value of Ultrasonic Diaphragm Thickening Fraction on Successful Weaning in Postoperative Cardiothoracic Surgery Patients with Chronic Obstructive Pulmonary Disease (COPD)
Authors: Zaki Gamal Fouad , Elkomos Samaan Paula Micheel , Jacoup Mina Samy , Kassem Amr Ahmed 
Published: July 2024

Abstract

Background
The diaphragm is the most important muscle of respiration and is largely responsible for the change in the intra thoracic pressure. In mechanically ventilated patients, the diaphragm can develop atrophy and weakness leading to prolonged duration of mechanical ventilation. Many studies reported a high prevalence of diaphragm dysfunction during weaning, and it was found to be associated with poorer clinical outcomes.

Objective
To assess the predictive value of diaphragm thickening fraction (DTF) by bedside ultrasound on successful weaning in postoperative cardiothoracic surgery patients with COPD.

Subjects and Methods
This prospective study was conducted on 40 subjects at cardiothoracic ICU unit at Elmaadi Military hospital during the period from (September,2021) to (July,2022) after approval of the research Ethical committee at faculty of medicine, Ain shams university.

Results
Regarding the relation between the two studied groups and diaphragmatic thickness, the thickness was decreased in the failed group than the successful group during inspiration, expiration and thickness fraction %, with significant difference between two groups as p-Value was &lt;0.05. There was an increase in the duration of ICU stay & mechanical ventilation in the failed group compared to the successful group, with significant difference between two groups as p-Value was &lt;0.05. Regarding the correlation between ICU stay & mechanical ventilation and diaphragmatic thickness, there were negative correlation between ICU stay & MV duration and all parameters of the diaphragmatic thickness, with significant difference as p-Value was &lt;0.05.

Conclusion
Weaning success in mechanically ventilated postoperative cardiothoracic surgery patients with COPD can be predicted by ultrasonography-based evaluation of diaphragm function by analyzing diaphragmatic thickness fraction. It is a practical, feasible, non-invasive technique that may be used at the bedside to rule out diaphragmatic dysfunction.
Comparative Study between Pectoral Nerve Block Type-II (PECS II) and Serratus Anterior Plane Block (SAPB) in Postoperative Analgesic Efficacy in Modified Radical Mastectomy
Authors: Riad Moustafa Kamel , El Moneim Fouly Mohamed Abd , Awad Taeimah Mohamed Osman , Ahmed Ahmed Alaa Mohamed 
Published: July 2024

Abstract

Background
Breast cancer is the most common cancer in women both in the developed and less developed world. In 2012, it represented about 12 percent of all new cancer cases and 25 percent of all cancers in women.

Aim of the Work
The aim of this work is to evaluate the efficacy of ultrasound guided pectoral nerve block type two versus Serratus Anterior plane block regarding postoperative pain control in patients undergoing modified radical mastectomy.

Patients and Methods
After obtaining approval from the medical ethical committee in Ain Shams University, this study was conducted in the operating theatres of Ain Shams University Hospitals. It included 70 female patients undergoing modified radical mastectomy were divided randomly into two groups, each group consisted of 35 patients; Group I patients received pectoral nerve block type two (PECS II), Group II patients received Serratus Anterior Plane Block (SAPB).

Results
The results of our study showed that there was no statistically significant difference between groups regarding demographic data. There was a statistically significant decrease in Mean blood pressure (mmHg) in Group I compared with Group II from hour-4 to hour-16 postoperative. However, a statistically significant decrease in group I compared to group II regarding postoperative heart rate (beat/min) from hour-4 to hour-16. A statistically significant decrease in group I compared to group II regarding visual analogue score for pain from minute-30 to after 12 hrs also was found. The current study shows highly statistically significant difference between groups as regard the need to intraoperative fentanyl incremental doses, time of first rescue analgesia, number of patients who received postoperative pethidine and total dose of opioids during the first 24 hrs.

Conclusion
Our findings suggest that PECS II block is more effective regarding postoperative pain control in patients undergoing modified radical mastectomy under general anesthesia compared to SAPB especially in the first 16 hours postoperative. Also patients underwent PECS II block show less need to intraoperative fentanyl incremental doses, less need to postoperative opioids and longer duration for time of rescue analgesia compared to patients underwent SAPB.