bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Ultrasound Guided Quadratus Lumborum Block as Postoperative Analgesia after Laparoscopic Cholecystectomy
Authors: Mina Marian Emil Riad , Hameed Hatem Saeed Abdel , Hashim Reham Mustafa , Fattah Mohamed Mohamed Abdel 
Published: August 2023

Abstract

Background
Poorly controlled acute pain after abdominal surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay and an increased likelihood of chronic pain.

Aim of the Work
The aim of this study was to assess the postoperative analgesic efficacy of quadratus lumborum block (QLB) compared to general anesthesia with multimodal routes of analgesia as paracetamol, ketorolac and morphine after laparoscopic cholecystectomy 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 60 randomly chosen patients aged 20 to 60 years, American Society of Anesthesiologists (ASA) class I or Il scheduled for elective laparoscopic cholecystectomy in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 30 patients each: Group A: (n = 30): patients received general anesthesia followed by QLB at the end of the operation and before emergence of GA, with rescue drug morphine 0.05 mg/kg IV, Group B: (n = 30): patients received general anesthesia only, with post-operative control of pain using multimodal routes of analgesia as paracetamol I gm IVI 16 hrs, ketorolac 30 mg in 100 ml normal saline solution every 12 hrs and rescue drug morphine 0.05 mg [kg IV.

Results
The results of the study revealed that the Patients receiving QLB had significantly lower pain scores at rest for the whole first 24 hrs while upon coughing there was no difference in the first 6 hrs between the two groups and lower pain in 12, 18, 24 hrs in QLB group postoperatively and decrease total need of analgesic in first 24 hrs postoperatively compared with patients who received multimodal routes of analgesia.

Conclusion
Bilateral QLB was effective in reducing postoperative pain scores at rest and upon coughing and lower total 24 hrs postoperative opioid and analgesic consumption after laparoscopic cholecystectomy under general anesthesia, compared to multimodal routes of analgesia, This technique can be a promising mode of postoperative analgesia. Use of adjuncts of continuous catheters might be used in the next studies for prolonging the duration of block.
Serum Procalcitonin, CRP, Lactate and Albumin as Predictors of Mortality in Critically Ill Cirrhotic Patients
Authors: Awad Hala Gomaa Salama , El Damarawy Mervat Mohamed , Ahmed Waleed Abdallah Ibrahim , Saleh Ashraf Nabil , El Azim Ibrahim Mohammed Abd , Ghonim May Elraey Abdelaziz Aly 
Published: August 2023

Abstract

Background
Cirrhosis is the last complication of chronic hepatic disease. Cirrhotic patients may be asymptomatic or have symptoms such as ascites, encephalopathy, variceal haemorrhage, and jaundice, which are all signs of liver malfunction or portal hypertension. Other problems, such as infection, hepatocellular carcinoma, or kidney failure, may have an influence on these individuals' survival. Patients' survival rates are significantly reduced as a result of these problems.

Aim of the Work
The aim of this study is to evaluate serum procalcitonin, CRP, lactate and albumin as predictors of mortality in critically ill cirrhotic patients.

Patients and Methods
This Prospective study was conducted at ICU of Theodor Bilharz Research Institute Hospital. This study included 60 Patients who were admitted to ICU of Theodor Bilharz Research Institute Hospital. The duration of the study was 6 months.

Results
The main results of this study were as following: The present study showed that as regard risk factors; There were 3 patients (5.0%) of them had “HTN”; 27 patients (45.0%) of them had “DM” and 17 patients (28.3%) of them had “Renal Imp.”, while there are no cases of IHD and stroke among risk factors. There was no statistically significant difference between the nonsurvivors’ group and survivors’ group as regard risk factors. The current study showed that according to vital data in the study group, was mean of SBP mmHg (96.17±13.42); mean of DBP mmHg (61.17±10.59); mean of HR (102.07±14.15); mean of RR (19.30±4.80); mean of Temperature (37.32±0.43) and mean of SPO2% (95.10±3.05). There was highly statistically significant difference between the non-survivors’ group and survivors’ group as regard vital signs.

Conclusion
Non-survivors of critically sick cirrhotic patients had greater CRP, PCT, and lactate levels than survivors while, albumin was higher in survivors than non survivors. PCT and CRP are the most significant predictor of poor outcome and increased mortality, followed by Lactate and albumin.
Accuracy of Initial Chest Computed Tomography Scan for Diagnosis of COVID-19: A Systematic Review
Authors: Fahmy Sameh Michel Hakim , Nofal Waleed Hamed Abdelmenaem , Ibrahim Peter Naiem Abdelmassiah , Armanious Michael Nabil Botros 
Published: August 2023

Abstract

Background
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus (SARS- COVID-19) with recent outbreak occurred on 11 March 2020. A computerized tomography (CT) scan for chest was proved to be a helpful tool for diagnosis of COVID-19 pneumonia. But little is known about its diagnostic accuracy.

Aim of the Work
This systematic review aims at determining current evidence regarding accuracy of initial chest CT scan for detection of COVID-19 infection.

Patients and Methods
We conducted an electronic search through different databases; PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL). We included clinical trials whether randomized or nonrandomized prospective or retrospective cohorts, case control, cross sectional studies and case series larger than 10 cases). All studies that reported data about the diagnostic accuracy of initial chest CT for diagnosis of COVID-19 infection were enrolled. We evaluated the methodological quality for included studies using QUADAS-2 Risk of Bias tool.

Results
From a total 4617 screened citations, 40 studies met our inclusion criteria. We divided the identified studies into two groups: studies that reported both sensitivity and specificity (6 studies, n = 1431) and studies that included only positive COVID-19 cases from which we could estimate only sensitivity (34 studies, n = 3515). Among six studies that evaluated accuracy of CT chest, there was high sensitivity ranged from to 93% to 100% but CT chest specificity was low ranged from to 10% to 56%. Rest of 34 studies had a wide range of sensitivity between 61% and 100% with few studies reported sensitivity below 80%.

Conclusion
Our results suggest that CT chest is a great screening tool for COVID-19 with high sensitivity but it had low specificity. However, interpretation of CT chest along with other laboratory could enhance its diagnostic accuracy.
Comparitive Study between Dexamethasone versus Fentanyl as Adjuvant to Local Anesthesia in Supraclavicular Nerve Block in Upper Limb Surgery
Authors: Mostafa Zakaria Abdelaziz , Said Alfred Maurice , Abdelhaq Ahmed Abdeldayem , Abdelsatar Mohamed Abdelmaabod 
Published: August 2023

Abstract

Background
Peripheral nerve block as an anesthetic technique plays an important role in modern regional anesthesia. Upper limb surgeries are mostly performed under peripheral blocks such as the brachial plexus block. Peripheral nerve blocks not only provide intra-operative anesthesia, but also extend analgesia in the post-operative period without major systemic side-effects by minimizing stress response and using minimal anesthetic drugs.

Objective
To evaluate the effects of adding dexamethasone and fentanyl to bupivacaine in ultrasound guided supraclavicular brachial plexus block for upper limb surgery versus bupivacaine alone.

Patients and Methods
After obtaining approval from the medical ethical committee in Al-Matareya Teaching Hospital, this study was conducted in Al-Matareya Teaching Hospital in cooperation with Ain Shams University. It was include patients undergoing elective upper limb surgery. A written informed consent was obtained from every patient after explaining the procedure. A randomized double-blinded controlled study is thought to be the most suitable design to achieve the study objectives.

Results
The present study showed that addition of dexamethasone and fentanyl to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of both sensory and motor blocks and significantly prolonged their duration compared to bupivacaine olny.

Conclusion
In the current study, the addition of dexamethasone or fentanyl to bupivacaine for supraclavicular brachial plexus block make the onset of sensory & motor block faster and prolongation of motor and sensory block duration and prolongation of duration of analgesia more than using bupivacaine only. But onset of motor and sensory block was shorter in fentanyl group than dexamethasone group and duration of sensory and motor block more in dexamethasone rather than fentanyl.
Role of Therapeutic Bronchoscopy in Comparison to Standards of Care in Critically Ill Patients with Acute Respiratory Failure
Authors: Noureldin Bassel Essam , Abdellatif Ayman Ahmed , Mahmoud Noura Mohammed Youssri Ahmed , Hassan Mohamed Atef Elbasiony 
Published: August 2023

Abstract

Background
Acute respiratory failure (ARF) is a sudden failure of oxygenation, carbon dioxide clearance or both, Hypoxic ARF is most commonly caused by pneumonia, cardiogenic or noncardiogenic pulmonary edema, or pulmonary haemorrhage, while the underlying causes of hypercapnic ARF include drug overdose, neuromuscular disease, chest wall abnormalities and severe obstructive airway disorders. Treatment for respiratory failure includes clearing the airways by suction, use of bronchodilators, tracheostomy and endotracheal tube with ventilator support. Additionally, the treatment regimen includes antibiotics for infections, anticoagulants for pulmonary thromboembolism, and electrolyte replacement for fluid imbalance.

Objective
To evaluate difference between use of therapeutic bronchoscope to standards of care, including open and closed suctioning (no bronchoscopy) regarding patient outcome.

Patients and Methods
Study included 80 patients who were divided by alternation into two groups: Group A: 40 patients were subjected to traditional standards of care including chest percussion, closed and open suctioning. Group B: 40 patients were subjected to therapeutic bronchoscope (fibreoptic bronchoscopy) with endobronchial washing and suctioning in addition to traditional standards of care.

Results
Regarding ABG significant improvements were observed, (in terms of PaCO2, PaO2 and PaO2/FiO2 ratio) in group B (fibreoptic bronchoscopy) in comparison with group A (traditional standards of care) at all follow up periods (P &lt; 0.05). Regarding the radiological improvement, in this study we observed significant improvement after 3 days, after 8 days and total improvement were observed in group B (fibreoptic bronchoscopy) compared to group A (traditional standards of care) (P &lt; 0.05). Regarding the patient’s ICU length of stay, both groups demonstrated insignificant differences (8.24±3.06 in group A versus 6.78±4.09 in group B) (P &gt; 0.05).

Conclusion
The current study revealed that fibreoptic bronchoscopy was associated with significant improvement compared to traditional standards of care, in ARF cases in terms of ABG parameters as well as radiological findings. However, ICU length of stay and duration of mechanical ventilation seemed to be comparable.
Role of Arterial versus Venous Lactate and Base Deficit in Assessing Prognosis of Septic Patients
Authors: Kamel Amr Mohamed Al-Saeed , Thabet Wael Reda Hussein , Fouad Mohamed Emad Eldeen Mohamed 
Published: August 2023

Abstract

Background
Septic shock is a syndrome of pathologic, physiologic, and biochemical disturbances caused by infection, and it is a major public health concern worldwide. Many techniques have been developed for the early detection of septic shock and prompt resuscitation. Lactate-guided resuscitation decreased mortality in patients with septic shock compared to that of resuscitation without lactate monitoring. In 2016, the international consensus launched a new sepsis definition (Sepsis-3), which is composed of the sepsis condition, the need for a vasopressor to maintain a mean arterial pressure of ≥ 65 mmHg and a serum lactate level rising to be ≥ 2 mmol/L in the absence of hypovolemia.

Aim of the Work
The aims of the study are to determine if lactate and standard base deficit can be used interchangeably in patients with septic shock in the emergency setting and to demonstrate whether venous blood gases could act as a surrogate for arterial blood gases in patients with sepsis syndrome.

Patients and Methods
This prospective observational study was conducted on 35 patients admitted to the ICU with a diagnosis of sepsis or septic shock in the Intensive Care Units at Ain Shams University Hospitals through 6 months.

Results
Our study found a significant correlation and high levels of agreement between arterial lactate and peripheral venous lactate in patients admitted to ICU with sepsis indicating the possibility of their interchangeable use. Our data also demonstrated strong correlations across lactate and base excess but not between lactate and anion gap in patients with septic syndrome. The results of our study indicate that base deficit is superior to lactate level as a predictor of mortality. Only, the 2nd arterial and venous base deficit at 24-hours revealed highly significant differences between both survivors and non-survivors.

Conclusion
Our study demonstrated a high level of agreement in the lactate levels as measured on venous samples and arterial samples in patients with septic syndrome; we also demonstrated that lactate and base excess showed a strong correlation with each other, but not with anion gap. Thus, these biomarkers can be used interchangeably to help in the early determination of septic shock, and also venous lactate levels are reliable in the resuscitation of patients with sepsis. A larger multicenter study may be required to confirm the generalizability of our results.
Adductor Canal Block versus Intravenous Patient Controlled Analgesia for Postoperative Pain Control for Primary Total Knee Arthroplasty
Authors: Elsinsar Mohamed Hamza Elsaid , Korraa Alaa Eldin Abd Elwahab Amin , Sharaf Amr Gaber Sayed , Taha Sahar Mohamed Talaat 
Published: August 2023

Abstract

Background
Uncontrolled postoperative pain has an adverse sequel of delayed resumption of normal pulmonary function, restriction of mobility, nausea and vomiting, increase in the systemic vascular resistance, cardiac work, and myocardial oxygen consumption through an increase in the catecholamine release induced by the stress response.

Aim of the Work
to compare efficacy, hemodynamic effects, opiate consumption and side effects of Adductor canal block and intravenous patient-controlled analgesia (PCA) in terms of postoperative primary total knee arthroplasty analgesia.

Patients and Methods
The study was performed upon 60 patients, randomly distributed into two equal groups: Group I: Patients of this group underwent ultrasound guided single shot adductor canal block after the end of surgery and before extubation with 20 ml of bupivacaine 0.5% and Group II: Patients of this group received intravenous patientcontrolled analgesia (PCA) with Nalbuphine after the end of surgery and before extubation. For each patient, the following data were collected: age, sex, weight, height, ASA, hemodynamic changes, VAS, Nalbuphine extradoses consumption, Side effects such as nausea, vomiting, pruritus, urinary retention and hypotension were recorded. Orthopedic rehabilitation indices were assessed by physiotherapy staff.

Results
ACB provided more effective analgesia for the first 6 hours but PCA with nalbuphine was superior after and for the rest of 24 postoperative hours.

Conclusions
Adductor canal block had good control of pain for the first 6 postoperative hours. However, the conventional use of intravenous PCA containing opioids was more effective for the rest of the first 24 postoperative hours.
A Comparison between Sub-Sartorial Canal Block and Femoral Nerve Block for Postoperative Analgesia after Arthroscopic Knee Surgery
Authors: Aboelela Sahar Kamal Mohammed , Alansary Amin Mohammed , Abdou Khaled Mohammed Ahmed Mohammed , Helmy Elsayed Mohamed 
Published: August 2023

Abstract

Background
Knee arthroscopy is a common orthopedic procedure worldwide, despite its minimally invasive nature compared to the traditional knee surgery, post-arthroscopic pain may be severe, and the patients generally require a significant amount of opioid-based analgesics after such procedures.

Aim of the Work
The aim of the study is to compare the analgesic efficacy and functional recovery of ACB and FNB in patients who have undergone knee arthroscopy.

Patients and Methods
In the period from April 2021 to October 2021 sixty patients who underwent Arthroscopic knee surgery were randomly allocated to one of two groups and comparative study was done. Group I (group FNB): (no. 30): Patients received Femoral Nerve Block (FNB) after spinal anaesthesia. Group II (group ACB): (no. 30): Patients received Sub-sartorial canal block (Adductor Canal Block) (ACB) after spinal anaesthesia.

Results
During our study, it was found that ACB is equally effective with FNB in patient satisfaction for post operative analgesia (NRS at 4 hrs, 8 hrs, 12 hrs, 16 hrs, 20 hrs and 24 hrs was non-significant as P value was 0.3, 0.29, 0.1, 0.5, 0.35, 0.87 respectively) but ACB is more effective than FNB in post operative ambulation and rehabilitation after arthroscopic knee surgery (ACB ambulated after 180.7 ± 23.6 mins in ACB and 241.2 ± 29.12 mins in FNB with pvalue &lt;0.001). When compared to our study, it revealed that the group received FNB suffered from quadriceps weakness which interfered with postoperative rehabilitation and early ambulation although postoperative analgesia was equally effective in comparison to the group received ACB.

Conclusion
Our study concluded that Adductor Canal Block is more effective than Femoral Nerve Block in post operative ambulation and equally effective with femoral nerve block in patient satisfaction for post operative analgesia after arthroscopic knee surgery.
Erector Spinae Plane Block for Post-Operative Analgesia in Lumbar Spine Surgeries
Authors: Ibrahim Ahmed Saeed Mohamed , Ibrahim Waleed Abdalla , Mekky Yahia Mamdouh Hassan , Ezz el dien Mohamed Islam 
Published: August 2023

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. Lumbar spine surgeries are usually associated with acute postoperative pain and restricted mobility. Ultrasound guided nerve block is considered a recent technique for pain management. It provides better visualization of the nerves and reduces the risk for complications e.g. unintended injury to adjacent structures.

Aim of the Work
The present study was designed to assess the analgesic efficacy and safety of ultrasound guided ESPB done at lumbar transverse process level in patients undergoing lumbar spine surgeries for postoperative analgesia.

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 70 adult patients aged 21-50 years, Scheduled for lumbar spine surgeries.

Results
The main finding in this study was that ultrasound guided ESPB at level of lumbar process provides a good analgesic effect in patients undergoing lumbar spine surgery as following: Reduced the total amount of postoperative morphine consumption in comparison to controlled group, prolonged the time to first request of analgesia (duration of analgesia), provided early mobilization, increase patient satisfaction in 1st 24 hour, decease incidence of nausea and vomiting due to decrease opioids Intake.

Conclusion
Ultrasound-guided bilateral erector spinae plane block reduced postoperative morphine consumption, alleviated postoperative pain scores and improved patients’ satisfaction in the first 24 hours after lumbar spine surgeries, without any associated adverse effects or complications.
Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Intravenous Patient Controlled Analgesia for Post Operative Analgesia in Parturients Undergoing Cesarean Delivery under General Anesthesia
Authors: Hussein Mohamed Tarek , Marzouk Mervat Mohamed , Ahmed Dalia Mahmoud , El-Aziz Heba Fouad Abd 
Published: August 2023

Abstract

Background
Cesarean delivery rates are rising, and efficient postoperative pain management is a key priority of women undergoing cesarean delivery. Inadequate pain management in the acute postoperative period is associated with persistent pain, greater opioid use, delayed functional recovery, and increased postpartum depression. In addition to pain relief, optimal management of patients after cesarean delivery should address the goals of unrestricted maternal mobility, minimal maternal and neonatal side effects, rapid recovery to baseline functionality, and early discharge home.

Aim of the Work
The Primary aim is to compare the efficacy of TAP block versus PCA with IV morphine to Provide Prolonged Post-operative analgesia. Secondary objective is to identify the side effects of both techniques as post operative analgesia.

Patients and Methods
74 patients were randomly allocated to one of 2 groups (n=37; each); group A received general anesthesia followed by US-guided TAB block at the end of the operation before extubation using 20 ml bupivacaine 0.25% bilaterally. Group B: received general anesthesia followed by PCA at the end of operation after extubation via dedicated 20 G canula woth disposable PCA pump of 100 ml volume, through continuous infusion of 2 ml/hr & bolus application of 1 ml with 15 min lock time using 50 mg morphine, 60 mg ketorolac, 2 mg granisetrone & filled with 0.9% normal saline.

Conclusion
when TAP block is given in the volume of 20 mL bilaterally, it is as effective as intravenous Morphine PCA in pain treatment. Compared with intravenous PCA, TAP block can be considered as a more preferable method because it can avoid the systemic actions of morphine used for PCA, and its analgesic effect begins earlier.