bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study between the Effect of Addition of MgSO4 or Dexamethasone to Bupivacaine on the Prolongation of Ultrasound-Guided Quadratus Lumboram Block in Open Abdominal Surgeries
Authors: El Ella Sahar kamal Abo , Samir Ghada Mohamed , El Mawla Saleh Mohamed Abd , El Shabrawy Moussa El Sayed Moussa 
Published: August 2023

Abstract

Background
Operations rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using regional anethesia.

Aim of the Work
The aim of this study was to assess the analgesic effect of addition dexamethasone or magnesium with bupivacaine in ultrasound-guided QLB to prolong it’s duration in patients undergoing open abdominal surgeries in the early postoperative period regarding pain relief, provision of comfort, and improved respiratory functions.

Patients and Methods
After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients undergoing open abdominal surgeries were included in the study, and were divided into three groups (n = 22; each); group M, D and group C. In Group A, patients (n = 22) received 20 ml bupivacaine 0.25% plus 5 ml of 10% MgSO. In group B, patients (n = 22) received 20 ml bupivacaine 0.25% plus 8 mg dexamethasone (2 ml) plus 3 ml 0.9% NaCl. In group C (control), patients (n = 22) received 20 ml bupivacaine plus 5 ml 0.9% NaCl.

Results
The thesis proved that the addition of either magnesium sulfate or dexamethasone to bupivacaine 0.25% in ultrasound guided QLB for open abdominal surgeries hastened the onset, prolonged the duration of sensory block, increased post-operative analgesia and decreased rescue analgesia needed without increasing the risk of adverse effects, with Dexamethasone showed better results.

Conclusion
The addition of either 500 mg magnesium sulfate or 8 mg dexamethasone to 20 ml bupivacaine 0.25% in ultrasound guided quadratus lumborum block for open abdominal surgery prolonged the duration of analgesia significantly and decreased the postoperative analgesic requirement. Hence, this study suggests that either magnesium or dexamethasone may be a useful alternative as an adjuvant to long-acting local anesthetics for quadratus lumborum nerve block with Dexamethasone showed better results.
Use of Lactate Clearance as a Predictor of Mortality Rate after Initial Resuscitation in Patient with Severe Sepsis or Septic Shock
Authors: Sedky Karim A , Ghobrial Bassem B , Aboassal Noha M , Talaat Sahar M 
Published: August 2023

Abstract

Background
Early diagnosis of sepsis is the key for improving the survival. Culture is the diagnostic tool but the microbiological origin of infection is demonstrated in about 2/3rd of cases. Biomarkers have an important place in this process because they can indicate the presence or absence of sepsis and they are also important in evaluating the response to therapy and recovery from sepsis.

Aim of the Work
to find a correlation between the lactate clearance and mortality in patients with severe sepsis.

Patients and Methods
The study was conducted on 60 adult critically ill patients of both sexes with severe sepsis, who were admitted to the unit of Critical Care Unit in Ain Shams University Hospital. All participants were subjected to the following: detailed history, full laboratory and radiological investigations to diagnose sepsis including lactate level on presentation (0 hour), after 6 hours and after 24 hours, then lactate clearance is calculated and patients were divided to lactate clearance group and non-clearance group.

Results
The study showed that clearance patients significantly had lower mortality rate, SOFA score, vasopressor therapy duration, ventilation need and hospital stay days than the non-clearance patients.

Conclusion
Lactate is a good marker for predicting mortality and evaluating the initial resuscitation and management of severe sepsis and septic shock.
Effect of Epidural Dexmedetomidine vs Nalbuphine for Labor Analgesia: A Randomized Clinical Trial
Authors: EL Kabarity Reem Hamdy , El Fawal Sanaa Mohammed , Abd El Tawab Samar Mohammed , Ahmed Nourhan Tarek Fouad 
Published: August 2023

Abstract

Background
The addition of dexmedetomidine or nalbuphine to epidural bupivacaine was tested to reduce labor pain in women undergoing normal delivery.

Patients and Methods
64 patients were randomly allocated into two groups of 32 parturients each with conscent from parturients. Groups A and B received a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) through the epidural catheter and then a top up dose of 6 ml volume consisting of 5 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) were given when VAS score becomes 4 or more and a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 10 mg nalbuphine (1 ml volume) through the epidural catheter and then a top up dose of 5 ml of 0.25% bupivacaine and 2 mg nalbuphine (1 ml volume) respectively. Assessments included VAS score for pain, vital data monitoring, recording of duration of stages of labor, neonatal APGAR score and adverse effects.

Results
Parturients in both groups had satisfactory labor analgesia, but those in the dexmedetomidine group had lower pain scores than those in the nalbuphine group. Taking into consideration that dexmedetomidine had a faster onset than nalbuphine.

Conclusion
Epidural dexmedetomidine seems to offer some advantages over epidural nalbuphine.
Thus, it can be used effectively and safely as an adjuvant to epidural bupivacaine in labor analgesia.
Low Dose Caudal vs Dorsal Penile Nerve Block for Postoperative Analgesia after Circumcision
Authors: Zaki Mohamed Sidky Mahmoud , Sersi Mayar Hassan El , Mahrose Ramy Ahmed , Elnaggar Samar Sobhi 
Published: August 2023

Abstract

Background
Circumcision is a painful surgery that is mostly performed under general anesthesia in order to eliminate fear and anxiety. Regional techniques are more effective than systemic opioids, non steroidal anti-inflammatory drugs, and acetaminophen for postoperative analgesia in circumcision, The most preferred techniques are dorsal penile nerve block and caudal block.

Objective
To investigate the effectiveness of post operative analgesia and complications among dorsal penile nerve block, caudal block and the combination of both.

Patients and Methods
Our study was carried out to compare the effectiveness, duration of postoperative analgesia, and the complications among dorsal penile nerve block (DPNB), caudal nerve block (CNB) and the combination of both. This study was carried out on 81 male patients, aged from 3-12 years old & undergoing circumcision. The patients were divided into 3 groups, each is composed of 27 patients; group 1 including DPNB patients, group 2 including CNB patients and group 3 for combined block. This study compared between the three groups regarding the intraoperative vital data (HR,BP), post-operative VAS scores and the complications (nausea, vomiting, urinary retention, itching, constipation & CNS depression).

Results
The demographic data (age, weight & height) does not differ between the three groups of the study. There is difference in the VAS score post operatively, being significantly less in the CNB group. There was no significant difference in the percentage of complications between the groups, except for urinary retention being slightly increased in the CNB group.

Conclusion
Our results showed that, CNB is superior to DPNB in intraoperative and postoperative analgesia after circumcision as regarding pain control. However CNB is associated with more complications compared to the DPNB. Also, the results showed that there‟s no need to combine both blocks as it gave the same results as with the CNB alone.
Ultrasound Guided Fascia Iliaca Compartment Block versus Three in One Block for Post Operative Analgesia in Patients Undergoing Hip and Knee Replacement Surgeries
Authors: Hosny El-Sayed Shereen , Ismail El-Seady Mohammed , Khalil George Mikhaiel , Tawab Samar Mohammed Abdel 
Published: August 2023

Abstract

Background
Patients undergoing total hip and knee arthroplasty experience substantial and sustained postoperative pain. Inadequate analgesia may impede physical therapy and rehabilitative efforts and delay hospital dismissal. Peripheral nerve blockade of the lumbosacral plexus has emerged as an analgesic approach. In several studies, unilateral peripheral block provided quality of analgesia and functional outcomes similar to those of continuous epidural analgesia and superior to those of systemic analgesia, but with fewer side effects because of their opioid-sparing properties. Peripheral nerve block techniques may be the optimal analgesic method following total joint arthroplasty.

Aim of the Work
To compare postoperative analgesia between ultrasound-guided FICB and three in one nerve block.

Study design
a prospective randomized double-blinded study.

Patients and Methods
The study was conducted on 80 randomly chosen patients from 21 to 65 years old in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 40 patients group I and group II. After preoperative assessment and obtaining baseline vital data, all patients received spinal anesthesia. Patients in the group I received FICB (35-40 ml of 0.25% bupivacaine). Patients in group II received three in one bock (35-40 mL of bupivacaine 0.25%).

Results
Both FICB and three in one block provided good quality of postoperative analgesia and patient satisfaction as evidenced by low VAS and low postoperative rescue analgesic requirements. Both techniques provided equal sensory blockage of femoral nerve, obturator nerve, and genitofemoral nerve, but sensory blockage of LFC nerve was demonstrated in 92.5% patients in FICB and 62.5% of patients in three in one block, which was significantly lower (p-value &lt;0.001 HS). VAS at 12 hours after surgery during movement of 3.68 ± 2.77 in the FICB group and 4.90 ±0.18 in the 3 in 1 group were statistically significant (P value = 0.007).

Conclusion
The FICB provides a high degree of sensory blockade of the LFC nerve and improves analgesia when continuous passive motion is initiated in the early postoperative period; also, it is easy to perform, reliable and does not threaten any vital organ. Thus, FICB can be recommended as an alternative to three in one block for the treatment of pain after hip and knee arthroplasty.
Comparison of Bilateral Ultrasound-Guided Intermediate Cervical Plexus Block vs Local Wound Infiltration for Postoperative Analgesia in Patients Undergoing Total Thyroidectomy
Authors: Sultan Sherif Sayed Ali , Nofal Walid Hamed , El Naeim Ismaiel Mohamed Abd El Mohsen Abd , Allah Shrouk Mohamed Abd 
Published: August 2023

Abstract

Background
The thyroid gland surgery is a common and painful procedure demanding analgesia. Bilateral intermediate cervical plexus block (BSCPB) could be beneficial for analgesia in thyroid surgery. In this study we will evaluate the analgesic efficacy of ultrasound guided intermediate cervical plexus block vs local wound infiltration in patients undergoing elective thyroidectomy under general anaesthesia.

Objective
To evaluate the analgesic efficacy and possible side effects of ultrasound guided intermediate cervical plexus block vs local wound infiltration in patients undergoing elective thyroidectomy under general anaesthesia as a primary outcome. The secondary outcome is the assessment of the safety of ICPB and the total dose of meperidine used for 24 hours postoperatively.

Patients and Methods
40 patients were divided into two equal groups: Group A: The patients received intermediate cervical plexus block with 10 ml of 0.25% bupivacaine. The same will be repeated on the contralateral side. Group B: Patient will receive local wound infiltration with 20 ml bupivacaine 0.25% under the skin immediately before extubation by the surgeon for pain control.

Results
ICPB group showed significant lower median score compared with LWI group at time 2 hrs, 4 hrs, 6 hrs, 12 hrs The time for first dose meperidine was significantly longer in ICPB group (17.2 ± 3.02 vs 10.15 ± 1.84) while Total 24 h meperidine consumption was significantly less in ICPB (26.25 ± 17.16 vs 36.25 ± 12.76)

Conclusion
Intermediate cervical plexus block provides another safe alternative analgesia compared to superficial blocks and local wound infiltration with better analgesic efficacy.
Analgesic Sparing Effect of Dexamethasone with Levobupivacaine in Quadratus Lumborum Block in Patients Undergoing Unilateral Inguinal Hernia Repair
Authors: Wahba Sherif Samir , Khalaf Khaled Mostafa , Hafez Amr Fouad , Ahmed El Shahawy Yasmin Tarek Ali 
Published: August 2023

Abstract

Background
The QLB is an effective analgesic technique for various abdominal wall incisinos. The QLB covers T7 to L2 dermatomes. Levobupivacaine is a long-acting LA agent, commonly used for peripheral nerve block due to its better safety profile than that of bupivacaine. Dexamethasone as an adjuvant to LA has been shown to prolong the duration of pain-free period, less requirement for rescue opioids consumption, more patient satisfaction and lesser incidence of nausea and vomiting.

Objective
To assess the analgesic sparing effect of adding dexamethasone to levobupivacaine in quadratus lumborum block in patients undergoing unilateral inguinal hernia repair under general anesthesia.

Patients and Methods
After approval of the anesthesiology department and scientific and ethical committees, this prospective double blind randomized clinical trial study was conducted in Ain Shams University Hospitals. Sixty patients scheduled for elective ingunial surgeries under general anesthesia were included in this study.

Results
Our study did not have any complications associated with the use of dexamethasone with levobupivacaine in QLB. Type 1 QLB failed to provide postoperative analgesia in surgeries involving dissection in the retroperitoneal area as there were high chances of damaging the thoracolumbar fascia.

Conclusion
The addition of dexamethasone to levobupivacaine in QLB in unilateral inguinal hernia repair surgery provides a prolonged duration of postoperative analgesia, with reduced analgesic requirements, a better quality of analgesia in terms of NRS compared to levobupivacaine alone group.
The Effect of Low Dose Nalbuphine or Ketamine in the Prevention of Emergence Agitation after Sevoflurane Anesthesia in Children Undergoing Tonsillectomy with or without Adenoidectomy
Authors: Ahmed Tarek M Ashor , Mostafa Zakaria Abdelaziz , Ismail Yasser Alaa , Haiba Diaaeldein Mahmoud 
Published: August 2023

Abstract

Background
Emergence agitation (EA) in children is increased after sevoflurane anesthesia. Nalbuphine and midazolam have been used for prophylactic treatment with controversial results.

Patients and Methods
Totally, 90 children between 4 and 10 years of age and of American Society of Anesthesiologists I-II undergoing adenotonsillectomy under sevoflurane-based anesthesia were enrolled in the study. Children were randomly allocated to one of the three groups: group N received nalbuphine 0.1 mg/kg, group K received ketamine 0.25 mg /kg and group S received the equivalent volume saline. The study medications will be given after discontinuation of sevoflurane by the end of surgery. In the post anesthesia care unit EA was assessed with emergence agitation scale upon admission (T0), after 5 min (T5), 10 min (T10), 15 min (T15), 20 min (T20), 25 min (T25) and 30 min (T30).

Results
In the PACU, the incidence of EA (emergence agitation scale) were significantly lower in the N Group (6.6%) and K Group (16.6%) compared to S group (33%) with (p = 0.044), the duration in PACU was significantly prolonged in S group compared to K group and N group (p- value 0.011), more patients experienced postoperative pain (mCHEOPS) in S group compared to N group and K group ( p-value 0.001).

Conclusion
Nalbuphine 0.1 mg/kg or ketamine 0.25 mg/kg are effective in preventing emergence agitation following sevoflurane-anesthetized adenotonsillectomy paediatric patients.
Effect of Kefir Extract against Sodium Hydroxide Induced Corrosive Esophageal Injury in Adult Male Albino Rats
Authors: Mahmoud Nesma Kamal , El Hamied Hemmat Abd El Kader Abd , Aal Youssef Shoukry Abdel , Gaber Noha Mohamed 
Published: August 2023

Abstract

Background
Ingestion of corrosive substances and its long-term effect on the gastrointestinal system especially the esophagus is considered as an important public health issue in spite of the multiple efforts to educate the public. Mucosal injury begins within minutes of caustic ingestion. Kefir extract is fermented milk, produced from grains that comprise a specific and complex mixture of bacteria and yeasts that live in a symbiotic association, this symbiotic culture of bacteria and yeast forms “grains” that resemble cauliflower. The grains are soft, gelatinous white biological mass, compromised of proteins, lipids and soluble polysaccharide that surround bacteria and yeast. It is prepared by inoculating cow, goat, or sheep milk with kefir grains for about 24 hours at room temperature.

Aim of the Work
The aim of the present work was to investigate the possible curative role of kefir on the structure of esophageal mucosa when injured after corrosive agent.

Material and Methods
Thirty adult male albino rats were used in this study. The rats were randomized into four groups: The control group was further subdivided into two subgroups (I a served as a negative control, I b received one ml of kefir once daily orally), the corrosive esophagitis group (rats received one ml of 5% NaOH orally and sacrificed on the same day), spontaneous healing group (rats received one ml of 5% NaOH orally and left for seven days) and the kefir treated group (rats received one ml of 5% NaOH orally and then received one ml of kefir once daily orally for seven days). At the end of experiment, rats were euthanized, and esophageal specimens were processed into paraffin blocks for light microscopic examination and other specimens were processed into scanning electron microscopic examination.

Results
The general cellular morphology of the esophageal mucosa after NAOH administration was greatly affected. Erosions of the epithelial covering with shedding of the epithelial cells in the lumen, loss of keratin layer, and massive lymphocyte infiltration were noticed in the lamina propria. Kefir treated group for seven days showed histopathological findings mostly normalized compared with corrosive esophagitis group; normal appearance of the surface mucosa was detected with restoration of keratin layer and reduced inflammatory cell infiltrate and vascular congestion were observed.

Conclusion
NAOH is capable of producing injury to esophageal mucosa. The present study showed a novel and favorable effect of kefir on the structure and function of the esophageal mucosa.
The Potential Link between Obesity, Synbiotics Intake and Inflammasomes in an Animal Model
Authors: Medhat Christeen , Mohamad Magda I , Sallam Reem M 
Published: August 2023

Abstract

Background
Obesity is one of the major public health problems worldwide, being considered a global epidemic. A growing body of evidence highlights the relevance of inflammasomes as a consequence of metabolic disorders and obesity. NLRP3 is the most studied component of the inflammasomes. Gut microbes contribute to the subclinical systemic inflammation that ultimately leads to the development of pathologies such as obesity, insulin resistance. Therefore, the use of intestinal microbiota modulators (e.g probitoics, prebiotics, or both as synbiotics) may improve several metabolic and immune functions. Recently, the link between these modulators and NLRP3 in obesity is less investigated.

Aim of the Work
to study the potential involvement of inflammasomes as an indicator for the efficacy of synbiotics in alleviating diet-induced obesity.

Materials and Methods
Thirty adult male Wistar rats were randomly divided into four groups (7 rats /group): normal control group (receiving normal diet), HFD (high fat diet) group, normal group receiving synbiotics, and HFD rats receiving synbiotics. After eight weeks, all rats were sacrificed then WAT (visceral, subcutaneous), brown adipose tissue, and liver were obtained. The body weight of each rat was measured weekly. The expression of NLRP3 was performed by real-time PCR.

Results
HFD induced a significant weight gain compared to normal diet (p &lt; 0.05). However, synbiotics administration could not affect such weight gain in rats receiving HFD with synbiotics (p &gt; 0.05). The expression of NLRP3, pre-inflammatory marker, is elevated in adipose and liver tissues in HFD group compared to normal diet group (p &lt; 0.05). However, synbiotics successfully reduced the expression of NLRP3 in all previous tissues (p &lt; 0.05).

Conclusion
the intake of synbiotics could disrupt the inflammatory consequences of obesity through targeting the expression of NLRP3. Thereby, synbiotics might be a promising potential therapeutic agent in treatment of obesity.
Comparison between Myocardial Glycogen Storage in CABG after Using Blood Cardioplegia versus HTK Solution
Authors: Ammar Ashraf El Sebaei Ayman Mahmoud , Hikal Tamer Shahat , Elnaggar Abdelrahman Ahmed Abdelrahman Mousa 
Published: August 2023

Abstract

Background
Inadequate myocardial protection in long ischaemic periods followed by reperfusion is an issue of concern in cardiac surgery. Cardioplegic solutions improve the tolerance to ischaemia and reperfusion by preserving myocardial energy reserves, preventing osmotic and electrolyte imbalances and buffering acidosis.

Objective
This somewhat surprising given the high number of procedures performed worldwide with this cardioplegic solution. As such, the purpose of this study was to assess the safety of the HTK solution when compared with our standard blood cardioplegia in coronary artery bypass graft operations via assessment of myocardial glycogen storage.

Patients and Methods
This was a retrospective, convenient, non- randomized study conducted on 40 consecutive patients who underwent isolated elective CABG at department of cardiothoracic surgery at Ain Shams University Hospitals. The aim of the study was to compare early outcomes of Custodiol versus blood cardioplegia in coronary artery bypass graft surgery via assessment of glycogen storage in myocarduim via assessment of myocardial glycogen storage. at Ain Shams University Hospitals.

Results
There was no statistically significant difference between the two groups of myocardial glycogen storage post-operative.

Conclusion
There was statistically significant difference between the pre and post-operative in both custodial and blood cardioplegia. There was no statistically significant difference between the two groups of myocardial protection in mortality and morbidity. Custodiol cardioplegia is an easy technique and simple without need of preparation or repeated administration.