bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analgesic Effect of Intrathecal Nalbuphine versus Intrathecal Fentanyl as Adjuvant to 0.5% Bupivacaine for Cesarian Section under Spinal Anaesthesia
Authors: Marzouk Mervat Mohammad , Elsayed El Hennawy Ahmed Mohammad , Mohammad Kamal Mohammad , Abdnagho Abdelnour Tadrous Nabiel 
Published: July 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 extended analgesia without any side effects to achieve this goal. The use of opioids in intrathecal or epidural anesthesia has become common to increase postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use.

Objective
To assess the postoperative analgesic requirements and the spinally mediated analgesic effects of intrathecal nalbuphine as an adjuvant to intrathecal bupivacaine after cesarean section in comparison to intrathecal bupivacaine with fentanyl.

Methods
This randomized comparative clinical trial was conducted in Ain Shams University Hospitals’ operating rooms on 48 patients undergoing cesarean section within a period of six months after approval of ethical committee of Faculty of Medicine, Ain Shams University.

Results
This study showed that the addition of a small dose of nalbuphine or fentanyl to bupivacaine in spinal anesthesia prolonged the time of postoperative analgesia. In this study, there was no significant difference regarding the demographic data, duration of operation, maximum sensory level, and maximum motor blockade level. Adding to this, there was also no significant changes regarding the vital data of the patients. On the other hand, there was a significant difference regarding the duration of analgesia which was longer with nalbuphine. It was also noticed that with nalbuphine less patients required rescue analgesia in comparison to fentanyl. There was higher number of side effects recorded with fentanyl in comparison to nalbuphine.

Conclusion
Either intrathecal nalbuphine (0.8 mg) or intrathecal fentanyl (25 μg) combined with Bupivacaine improves intraoperative analgesia and prolongs post- operative analgesia in cesarean section. There was statistically significant difference between them, intrathecal nalbuphine had a prolonged duration of post-operative analgesia, lesser amount of rescue analgesia needed and fewer side effects than intrathecal fentanyl.
Peripheral Perfusion Index as a Predictor of Post-Spinal Hypotension in Patients Undergoing Lower Abdominopelvic Surgeries
Authors: Mohamed Sadek Sohair Abbas , Anis Saïd Sherif George , Adel Abdelhameed Gamal Eldin , Mohamed Ahmed Mohamed Khaled 
Published: July 2024

Abstract

Background
One of the main complications of spinal anesthesia is post spinal hypotension. And since noninvasive hemodynamic & blood pressure monitoring are the standards in most surgical procedures, ensuring best & safest monitoring standards has been of utmost importance. The use of plethysmography in anesthesia monitoring has become one of the essential tools in any anesthetic procedures. However, its varying interpretations & usages haven't been explored to the fullest.

Objective
To assess predictability of baseline peripheral perfusion index to Post spinal hypotension in patients undergoing elective lower abdomino-pelvic surgeries.

Methods
This Prospective Observational study was conducted in Ain Shams University Hospitals’ operating rooms. And was conducted over a period of 6 months after approval of ethical committee of Faculty of Medicine, Ain Shams University, All patients undergoing elective lower abdominopelvic surgeries at El-demerdash Hospital of Surgery during the study period. Surgeries include inguinal / inguinoscrotal hernia repair, paraumbilical hernia repair, lower laparotomies, transurethral resection of bladder tumor, simple gynecological procedures.

Results
This study showed that Perfusion index can be used as a predictor for hypotension in patients undergoing elective lower abdominopelvic surgeries under spinal anesthesia. Patients with baseline PI &gt; 0.9 are at greater risk of developing hypotension after spinal anesthesia when compared with those with baseline PI ≤ 0.9. Hence, peripheral perfusion index usage can be recommended in this regard.

Conclusion
This study concluded that Perfusion index can be used as a predictor for hypotension in patients undergoing elective lower abdominopelvic surgeries under spinal anesthesia. Patients with baseline PPI &gt;0.9 are at greater risk of developing hypotension after spinal anesthesia when compared with those with baseline PPI ≤0.9 .Hence, peripheral perfusion index usage can be recommended in this regard.
Effect of Calcium Ionophore on the Embryonic Outcome of the Intracytoplasmic Sperm Injection in Female Patients with Good & Bad Quality Oocytes: Histomorphometric Study
Authors: Baraka Aya Abdrabo , Hafez Kawther A , Elgamal Hatem H R , Desouky Ahmed M , Fetouh Marwa A 
Published: July 2024

Abstract

Introduction
Fertilization failure is the most common problem in assisted reproductive technology . In incident of ovum and/or spermatozoa correlated fertilization difficulties after intracytoplasmic sperm injection, approaches of modified ICSI techniques, which can be done using Ca 2+ ionophores. The objective of the research Effectiveness of Ca 2+ ionophores was studied on the embryonic outcome in female patients with bad quality oocytes while her partner has normal semen analysis.

Materials and Methods
Thirty-eight couples have undergone ICSI, with female age ranging between 40 to 45 years old. The retrieved oocytes were subdivided into 4 groups; good quality oocytes, good quality ovums with adding Ca 2+ ionophore treatment, bad quality ovums in addition, bad quality ovums with adding Ca 2+ ionophore treatment, all were inserted by the corresponding sperms. Examination of the embryos was done on day two after fertilization, cleavage stage, and blastulation stage.

Results
Treated good quality oocytes showed fertilization of (92%) of the oocytes compared to (68%) of the untreated good quality oocytes. Treated bad quality oocytes showed fertilization of (85%) of the oocytes compared to (65%) of the untreated bad quality oocytes. The quality of embryos was enhanced on day two after fertilization, day three (cleavage stage), and day five (blastulation stage) in both treated groups than in the untreated ones.

Conclusion
The activated oocytes resulted in better fertilization and embryonic development. Therefore, ICSI combined with artificial oocyte activation using Ca 2+ ionophore is useful in mid-age female patients with good and bad quality oocytes regardless the cause.
Effect of Consumption of Caffeinated Energy Drinks on the Myocardium of the Adult Male Albino Rat (A Histological and Morphometric Study)
Authors: Hakim Magdoline Helmy , Saleh Soheir Ibrahim , Amin Mariam Asaad , Helmi Abaas Maha Abbas 
Published: July 2024

Abstract

Background
Energy drinks are non-alcoholic beverages containing mainly caffeine. Chronic consumption of energy drinks may be associated with increased blood pressure, and cardiac work load, as well as, increased heart rate. Energy drinks consumption has been related to myocardial infarction in healthy young adult.

Aim of the Work
The aim of the present work was to study the harmful effect of energy drinks histologically and morphometrically, on the myocardium of the adult male albino rats.

Material and Methods
20 Adult male albino rats aging 4-6 moths were divided randomly into two groups; Group I (Control group) which consisted of 10 male albino rats with free access to food (rat chew) and water and Group II (Experimental group): 10 male albino rats which received 3.75 ml/kg body weight red bull through oral gavage daily for 4 weeks with free access to food (rat chew) and water. At the end of experiment, rats werescarificed, and cardiac muscle was extracted and processed into paraffin blocks for light microscopic examination. Morphometric study and statistical analysis were done.

Results
The present work demonstrated that Red Bull induced several histopathological changes of the cardiac muscle. The results showed the cardiac muscle of rats with irregularities in the arrangement of fibers and wide spaces in between. Some cardiomyocytes showed areas of pale stained sarcoplasm, partial loss of the cross striations and ill-defined intercalated discs. Localized areas of hyaline degeneration and areas of tissue disruption were also noticed with less frequently localized coalesced cytoplasmic vacuoles. The nuclei of the cardiomyocytes appeared small, darkly stained, and pyknotic. Others were flattened and deeply stained. Congested, and thick walled blood vessels were also observed, with mononuclear cellular infiltrations. In Masson’s Trichrome sections, relative increase in collagen deposition between the cardiac muscle fibers was observed which was associated with focal fibrous degeneration. Examination of the semithin sections showed partial disruption of the cardiomyocytes. The nuclei of the cardiomyocytes were small, darkly stained with perinuclear degeneration. Some nuclei were eccentric, or with an irregular outline, and peripheral chromatin condensation. The characteristic finding was the presence of longitudinal wavy cardiac muscle fibers with relatively wide spaces in between and localized areas of partially lost cross striations and intercalated discs. Dilated, thick walled blood vessels was noticed between the bundles of cardiac muscle. Mononuclear inflammatory cellular infiltrations were also detected.

Conclusion
The present study demonstrated the degenerative and cardiotoxic effects of Red Bull as an example of energy drinks on the histological structure of the cardiac muscle.
The Utility of Serum Procalcitonin Level as an Early Diagnostic Biomarker For COVID in Patients Presenting with ST-Elevation Myocardial Infarction Post Primary Percutaneous Coronary Intervention
Authors: Abdelhamid Yara Mostafa Mohamed , Ibrahim Mostafa Ibrahim , Taher Mohamed Awad , Abdelrahman Mohamed Ahmed 
Published: July 2024

Abstract

Aim and Objectives
The aim of the study was to detect if serum procalcitonin could be used as an early diagnostic marker for COVID in asymptomatic patients presenting with ST-segment elevation Myocardial infarction and if procalcitonin is related to the extent of myocardial injury after the infarction.

Patients and Methods
The study was carried out on 150 patients (age 53.39 ± 13.16) presenting to Ain shams university hospitals with ST-segment elevation Myocardial Infarction and received the standard of care management which is Primary PCI. The patients were assessed regarding the demographic data, presence of any symptoms and signs of infection, risk factors, echocardiography and laboratory measures. COVID PCR and Procalcitonin were withdrawn from all patients.

Results
Out of all the asymptomatic patients presenting with STEMI whose COVID PCR turned out to be positive, the procalcitonin was positive 24 and 48 hours post presentation with P value 0.000. Procalcitonin had no statistical significance with any demographical data, risk factors and comorbidities for cardiovascular disease, extent of myocardial injury and most laboratory findings. There was high statistical significance between positive procalcitonin and TLC count where there was a drop from a median of 11/mm3 with range (4.5– 19) /mm3 in negative procalcitonin to a median of 3.7 /mm3 with range (1.4 –12) /mm3 in procalcitonin positive patients. There was high statistical significance between positive procalcitonin and rise of CRP value where there was a rise from CRP median value from 12 mg/dL range (2– 40) mg/dL in negative procalcitonin patients to 47 mg/dL range (14– 163) mg/dL in positive procalcitonin patients.

Conclusion
Procalcitonin as an inflammatory marker has no relationship to myocardial infarction nor extent of myocardial injury. There was a strong relationship between procalcitonin and COVID infection in asymptomatic patients thus procalcitonin can be used as an early diagnostic biomarker for covid infection in patients presenting with myocardial infarction.
Pilot study: Measurement of first phase ejection fraction in a sample of Egyptian people
Authors: Takla Andrew , Soud Mona Aboul , William Viola , Abdeltawab Adham 
Published: July 2024

Abstract

Background
Left ventricular dysfunction (LVD) constitutes the final common pathway for a number of cardiac disorders. Ischemic heart disease (IHD) is the dominant cause of heart failure (HF). The remaining etiologies include cardiomyopathy, hypertension (HTN), valvular heart diseases (VHD) and myocarditis. Data from the Framingham heart study shows that it develops in approximately 16% of men and 18% of women who had diabetes; 12% of men and 8% of women who had HTN; and 30% of both sexes who had myocardial infarction (MI).

Aim of the Work
to measure the first phase ejection fraction (EF1) in a sample of Egyptian population and to determine its normal value and to assess its reliability in assessment of systolic function.

Patients and Methods
This study is a prospective and observational clinical that was conducted at El- Mokattam health insurance & Ain Shams University hospitals from October 2019 to March 2022.

Results
we found that mean EF1 was 35.41 ± 4.16 %, its minimal value was 26.9% and its maximal value was 43.4%. We found that EF1 was reliable and reproducible as there was no statistically significant intra observer nor inter observer variabilities (p-value was 0.547 & 0.602 respectively). We found that there was no significant statistical correlation between EF1 and gender or heart rate or other demographic or clinical data.

Conclusion
EF1 is a simple and reproducible measurement of LV systolic function that is easily measured by transthoracic echocardiography and is considered comparable to other indices that measure LV systolic function.
Correlation analysis of central venous pressure and Intra-thoracic pressures in Acute Respiratory Distress Syndrome mechanical ventilated patients, a pilot Study
Authors: Taha Ebtihal Abdelhakim , Elrahman Gamal Abd , Al Maraghy Ashraf 
Published: July 2024

Abstract

Background
Positive end expiratory pressure can affect measurement of central venous pressure through increased intrathoracic pressure. However, when positive end expiratory pressure (PEEP) is applied, central venous pressure and pleural pressure often increases more than right atrial pressure, so that transmural right atrial pressure (true filling pressure) decreases.

Aim of the study
Primary end point was to recognizing correlation coefficient between mean CVP and intra- thoracic pressures on volume-controlled mode and spontaneous modes on same population of mechanically ventilated ARDS patients. The secondary end point is to compare the correlation coefficient R during both modes with parameters of ventilatory settings.

Patient and Methods
A cohort observational prospective study was done enrolling single group of patients with acute respiratory distress syndrome, who necessitate mechanical ventilation more than two days after connection to ventilators, the study was performed with demonstration of central venous pressure in cmH2O upon application of needed PEEP. Central venous catheter inserted for measuring CVP were processed in accordance with the standard guidelines.

Results
There were statistically significant differences between control and support group regarding the PEEP, Plateau pressure, mean CVP and mean airway pressure MAP. The data were higher in control than support group with p-value &lt;0.001, 0.002 and 0.004, respectively. There was statistically significant positive correlation between R and CVP in the control group with p &lt; 0.001 and r = 0.918. There was statistically significant positive correlation between R and ΔPIT in support group with p 0.001 and r = 0.926. The correlation between CVP and R among the control group was R = 0.028 + 0.032 * CVP with p-value &lt;0.001, whereas the correlation between ΔPIT and R among the support group was R = 0.465 + 0.020 * ΔPIT with p-value = 0.022

Conclusion
The relation between hemodynamics change of central venous pressures and intrathoracic pressure is new independent marker for evaluating ARDS mechanically ventilated patients. Values of R correlation are different in controlled mode relative to spontaneous mode during ARDS ventilated patients.
Cardiac Magnetic Resonance Imaging for the Evaluation of Pulmonary Hypertension
Authors: Mohamed Shaimaa Saeed , El Korashy Reem Ibrahim , Ahmed Mona Mansour , Mohamed Ali Tamer , Osman Ahmed Mohamed , Abd Elkader Maryam Aly , Kamel Khalil Sameh Nabil 
Published: July 2024

Abstract

Purpose
Evaluate the utility of cardiac magnetic resonance imaging for noninvasive estimation of the key hemodynamic parameters that are measured by the right heart catheterization i.e. mean pulmonary artery pressure, pulmonary artery wedge pressure and pulmonary vascular resistance through cardiac magnetic resonance based numerical models.

Materials and Methods
29 pulmonary hypertension patients, fitting the inclusion criteria were randomly selected and included in the study. CMR Imaging and right- sided heart catheterization (RHC) were performed within 1 month. 3 Cardiac MRI based models in literature that showed high accuracy were tested. Two equations for mPAP calculation; mPAP= - 231.423 + loge inter-ventricular septal angle X 53.8 + log10 ventricular mass index (right ventricular mass/left ventricular mass) X 8.708 + diastolic pulmonary artery area X 0.009 and mPAP = –4.6 + (interventricular septal angle × 0.23) + (ventricular mass index × 16.3). One equation for PAWP; PAWP = 6.43 + LA volume index x 0.22.

Results
The Pearson correlation test correlation between invasively quantified and CMR-estimated mPAP had good correlation with r = 0.594 and r = 0.599 (p &lt; 0.001) for CMR based mPAP model 1 and 2, respectively. While, Altman and Bland test showed that The mean bias between the RHC-derived and CMR-estimated mPAP was 7.9 (agreement interval -24.8 to 40.6 mmHg) and mean bias -3 (agreement interval -34.8 to 28.2 mmHg) for CMR based mPAP model 1 and 2, respectively. There was no correlation between invasively quantified and CMR-estimated PAWP with (p = 0.092) for CMR based PAWP model. The mean bias between the RHC- derived and CMR-estimated PAWP was 2.4 (agreement interval –13.5 to 18.2 mmHg). The correlation between invasively calculated and CMR-estimated PVR had good correlation with r = 0.703 and r = 0.704 (p &lt; 0.001) for CMR based PVR model 1 and 2, respectively. The mean bias between the RHC-derived and CMR- estimated mPAP was 0.6 (agreement interval -11.6 to 12.8 mmHg) and mean bias -1.3 (agreement interval -12.1 to 9.5 mmHg) for CMR based mPAP model 1 and 2, respectively.

Conclusion
our results showed good correlations between CMR findings and RHC as regard mPAP and PVR. Thus Non-invasive estimation of mPAP, PAWP and PVR using CMR is feasible but needs further studies to improve accuracy.
Serum Glial Fibrillary Acidic Protein as a Blood Biomarker in Relapsing Remitting Multiple Sclerosis Egyptian Patients
Authors: Zeitoun Yasser Ahmed , El-Kabarity Rania Hamdy , Ahmed Walid Abdelhady , Aboustate Alaa Mohamed , Rashad Salma 
Published: July 2024

Abstract

Background
Multiple sclerosis (MS) is a neurodegenerative disease with various clinical subtypes. Glial fibrillary acidic protein (GFAP) is significantly elevated in the cerebrospinal fluid (CSF) of MS patients compared with that of healthy controls and serum concentrations have been shown to reflect CSF levels.

Objectives
The aim of this study was to evaluate serum levels of GFAP in relation to disease activity in relapsing-remitting MS patients and to compare them with those of healthy controls.

Subjects and Methods
This case-control study involved 45 RRMS patients; 21 in relapse and 24 in remission, and 45 healthy individuals as age- and sex-matched controls. Blood samples were taken from the patients at inpatient ward and outpatient clinic of Neurology Department of Ain Shams University hospitals and the serum levels of GFAP were determined using the enzyme-linked immunosorbent assay (ELISA) technique.

Results
Patients in relapse showed higher serum concentration of GFAP than that of patients in remission and this result was highly significantly different (p = 0.000). ROC curve of serum GFAP demonstrated at cut off point &gt;200 pg/ml, it yielded a sensitivity of 76% being in relapse and specificity of 82%.

Conclusion
GFAP biomarker is an indicator of disease activity in RRMS patients and its serum level may correlate with the state of disease activity.
Fractional Carbon Dioxide Laser versus Cryotherapy in the Treatment of Alopecia Areata: A Pilot Comparative Study
Authors: Ojaimi Mays Qays , Elfattah Afify Ahmed Abd , Shaheen Maha Adel 
Published: July 2024

Abstract

Alopecia areata, one or more round bald patches appear suddenly, most often on the scalp. It can affect males and females at any age. The exact mechanism is not yet understood and there is not yet any reliable cure for alopecia areata. Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Superficial cryotheray is introduced as a possible treatment for Alopecia Areata with minimal side effects and being less painful. In addition, fractional CO2 laser is introduced as a effective option in AA treatment.

Aim of the Study
the current study aimed to assess the efficacy and safety of FCO2 laser in comparison to cryotherapy in the treatment of AA.

Patients and Methods
this study included 22 patients (with patchy AA (at least three patches) of both sexes. Patients were subjected to full history taking, complete general and dermatological examination then digital photography and dermoscopic examination were performed. The three patches in each patient were divided according to therapy used; one patch was treated with Fractional CO2 laser, second one was treated with superficial cryotherapy and the third was left without treatment as control.

Results
Regarding FCO2 laser treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. In addition, SVHs count showed significant increase after treatment compared to before treatment. Concerning cryotherapy treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. Also, there was as increase in the TH and SVHs count after treatment in comparison to before treatment, but the results were statistically insignificant.

Conclusion
Both cryotherapy and fractional CO2 laser therapy are safe and effective modalities in the treatment of AA with superiority for FCO2 laser.