bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound Guided Preoperative Assessment of Inferior Vena Cava Collapsibility Index in Prediction of Intraoperative Hypotension in Patients Undergoing Laparoscopic Cholecystectomy Surgery under General Anesthesia
Authors: Boles Ghobrial Bassem , Labib Heba Abdel Azim , Mohamed Mahmoud Saad , Sayed Yassen Amr Abd El-Razek 
Published: August 2023

Abstract

Background
Laparoscopic surgery aims to minimize trauma of the interventional process but still achieve a satisfactory therapeutic results. It is commonly performed because of various advantages such as reduced postoperative pain, faster recovery and more rapid return to normal activities, shorter hospital stay, and reduced postoperative pulmonary complications.

Aim of the Work
In this study we aim to evaluate effectiveness of preoperative IVC ultrasonography (IVC CI) in prediction of hypotension (mean arterial pressure &gt;60 mmHg) which develops following intraabdomenal gas insufflation, and in determining hypovolemia occurring in patients undergoing laparoscopic cholecystectomy surgery under general anesthesia.

Patients and Methods
This study was a prospective observational study conducted on 50 patients inside the operative theatre of El demerdash hospital after ethical committee approval.

Results
There was a statistically significant negative correlation between IVC CI and Change of MBP (mmHg) After induction from baseline with; while Change of MBP (mmHg) After insufflation of abdomen from baseline was of negative correlation but insignificant as there was no dehydrated patients among this study group preoperatively according to our measurements and for ethical purposes we considered that if there was any patient needed hydration preoperative according to preoperative assessment of IVC-CI should be managed before surgery in order not to have intraoperative hypotension which can affect his wellness intra and postoperative, also all the patients were ASA I/II with no critical illness affect volemic status and usage of deprevan, fentanyl and atracurium during induction which can cause hypotension post induction.

Conclusion
In this study there was a statistically significant negative correlation between IVC CI and Change of MBP (mmHg) After induction from baseline; while Change of MBP (mmHg) After insufflation of abdomen from baseline is of negative correlation but insignificant. We believe that IVC ultrasonography may be helpful in prediction of preoperative hypovolemia in patients who underwent laparoscopic cholecystectomy.
Change in Serum Chloride and Its Relation to Acute Kidney Injury in Septic Shock Patients
Authors: Abdel-Hameed Amr Essam , Hussein Noha Sayed , El Sayed Abo Shawaly Ayman El Shishtawy 
Published: August 2023

Abstract

Background
Septic shock is a dysregulated host response to infection resulting in potentially lifethreatening organ dysfunction. Acute kidney injury (AKI) id one of the most common and serious complications associated with septic shock patients especially in intensive care units.

Aim of the Work
To evaluate the predictive value of change in serum chloride and its relation to acute kidney injury in septic shock patients.

Patients and Methods
The study was included 65 septic patients who admitted to intensive care units of Ain Shams University Hospitals, Cairo, Egypt. All the included cases were subjected to full history taking and full general and local examination. Full laboratory investigations were taken from all the cases. The following were done; GCS, SOFA and APACHE II score. The initial serum chloride level and the highest level of chloride during stay was recorded with calculation the difference as the change of serum chloride level.

Results
In our study, diabetes was the most common comorbidity in the included cases (49 cases – 75.4%), followed by hypertension (40 cases – 61.5%), chest infection was the commonest source of sepsis in our study (33 cases – 50.8%), followed by UTI (23 cases – 35.4%). Other causes included intra-abdominal infections, skin and soft tissue infections and blood stream sepsis.

Conclusion
Acute kidney injury is a frequent complication in septic patients and optimization of fluid management is fundamental in order to limit the detrimental role of fluids on renal metabolism.
Prospective Randomized Study of the Post-Operative Analgesic Efficacy of Transversus Abdominis Plane Block versus Lumbar Epidural Analgesia after Total Abdominal Hystrectomy and Bilateral Salpingo-Oophorectomy
Authors: El Ghany Bassiouny Mohsen Abd , Khattab Salwa Omar El , Ismaeil Mohammad Abdulmohsen Abdulnaeim , Ali Doaa Ragab Ali Abu 
Published: August 2023

Abstract

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

Aim of the Work
To study the analgesic efficacy of bilateral ultrasound guided single shot Transversus Abdominis Plane (TAP) Block with bupivacaine compared to single shot lumbar epidural block with magnesium adjuvant to bupivacaine after total abdominal hysterectomy and bilateral salpingo-oophorectomy surgeries.

Patients and Methods
The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 25 patients each: Group TAP: 25 Patients of this group will receive bilateral ultrasound guided lateral approach TAP block at the end of surgery using 20 ml of 0.25% bupivacaine for each side with a maximum dose of (3 mg/kg). Group EA: 25 Patients of this group will receive epidural analgesia through catheter injection using a single dose of 15 ml of 0.25% bupivacaine and 100 mg MgSo4 (1 ml of 10% MgSo4) at the end of surgery for postperative pain relief.

Results
Revealed that Lumber epidural showed the best response as regard pain control post operatively in 1st 4 hour. Then TAB block shows more superior in analgesia starting from 6 hours postoperative than single shoot epidural with less overall rescue analgesia consumption and complications as hypotension and tachycardia.

Conclusion
Lumber epidural showed the best response as regard pain control post operatively in 1st 4 hour. Then TAB block shows more superior in analgesia starting from 6 hours postoperative than single shoot epidural with less overall rescue analgesia consumption and complications as hypotension and tachycardia.
Effect of Dexmedetomidine as an Adjuvant to Bupivacaine in Ultrasound Guided Transversus Abdominis Plane Block versus Caudal Block for Postoperative Analgesia in Children Undergoing Congenital Inguinal Hernia Repair
Authors: Ewais Bahaa Eldeen , Taeimah Mohamed , Kamal Mohamed Mohamed , Mohamed Elsayed Mohamed Ali 
Published: August 2023

Abstract

Background
Inguinal hernia is the most common lower abdominal surgery of childhood. It results from a small sac that comes through the inguinal ring that is normally open during fetal life and closes around the time of birth. For reasons we don't understand, it does not close in some infants. This sac then makes a pathway for abdominal organs to come through the inguinal ring into the groin. Analgesic techniques in pediatric patients having surgery are often delayed by the inherent difficulties of conducting a large randomized clinical trial in those patients. TAP block and caudal epidural block are two anesthetic techniques that are commonly used in pediatric age group for lower abdominal surgeries.

Aim of the Work
Compares the efficacy of Dexmedetomidine as an adjuvant to Bupivacaine in Ultrasound Guided Transversus Abdominis Plane Block versus Caudal Block for postoperative analgesia in children undergoing congenital inguinal hernia repair especially to provide prolonged post-operative analgesia and decrease opioid consumption.

Patients and Methods
We conducted a prospective, randomized, controlled and comparative study in Ain shams university hospitals in a period of 6 months including 50 patients divided on 2 groups; group A 25 of them received ultrasound guided transversus abdominis plane block with 0.3 ml/kg of 0.25% Bupivacaine with 1 µg/kg dexmedetomidine with age ranged from 2.5-8 years and they were 6 females (24%) and 19 were males (76.0%) and group B 25 patients received caudal epidural block with 0.6 ml/kg of 0.25% Bupivacaine with 1 µg/kg dexmedetomidine with age ranged from 3 – 9 years and they were also 4 females (16%) and 21 were males (84.0%).

Results
In the present study there was statistically significant increase in pain at 1 hr, 2 hrs and 4 hrs in caudal block group and increase in pain score at 12 hrs in tap block group but there was no statistically significant difference found between them at 6 hrs, 18 hrs and 24 hrs. There was statistically significant increase in rescue analgesia in caudal block group at 4 hr with p-value &lt;0.001; also there was statistically significant increase in rescue analgesia in tap block than caudal block at 12 hr with p-value = 0.009 while no statistically significant difference found between both groups at the other times of follow up.

Conclusion
TAP block was superior to caudal epidural anesthesia in terms of early postoperative pain, less need for rescue analgesia and need for less potent analgesia e.g. Paracetamol and NSAID. Addition of dexmedetomidine to conventional regional anesthetic protocol showed significant reduction of postoperative pain and the need for rescue analgesia.
Evaluation of Left Ventricular Diastolic Function Using a Tissue-Doppler Imaging Based Algorithm According to 2016 Ase/Eacvi Guidelines in Patients with Decompensated Liver Cirrhosis: A Prospective Observational Study
Authors: Shokeir Mohamed Hossam , Barakat Ashraf Abdelkhalek , Metwaly Amna Ahmed , Gendy Hanaa Abdallah El , Elsaid Mohamed Moien Mohamed , EL Moaz Basha Attallah Eslam Mohammed Maher Abd 
Published: August 2023

Abstract

Background
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The prevalence of cirrhosis has nearly doubled over the last decade, and the number of hospitalizations has similarly increased.

Aim of the Work
We aimed to correlate between the severity of liver cirrhosis using new MELD score and left ventricle diastolic dysfunction using tissue doppler imaging.

Patients and Methods
A prospective observational study in ICU of Theodor Bilharz Research Institute Hospital and Ain Shams University Hospitals for 6 months from June 2021 till end of November 2021 on hepatic patients who were admitted to ICU of Theodor Bilharz Research Institute Hospital and Ain Shams University Hospitals.

Results
In the studied group, the mean age was 53.13±9.44 years with males constituting more than half of them (57.8%). The mean MELD score was 24.08±6.01, and the mean left ventricular ejection fraction (LVEF %) was 60.43±5.49%. There were 5 patients (5.6%) with normal LV diastolic function and 85 patients (94.4%) with abnormal LV diastolic dysfunction. Out of the 90 patients, 5 patients were normal, 44 patients (48.9%) had a grade I LVDD, 28 patients (31.1%) had a grade II LVDD and 13 patients (14.4%) had a grade III LVDD. There was a highly statistically significant positive association between the grades of left ventricular diastolic dysfunction according to ALT, AST, T.Bilirubin, D.Bilirubin, INR and Creatinine. Additionally, there was a highly statistically significant negative association between grading of left ventricular diastolic dysfunction according to platelet count and sodium levels.

Conclusion
There was a statistically significant correlation found between the severity of liver cirrhosis represented by the new MELD score and the grade of left ventricular diastolic dysfunction. Therefore, in order to prepare the best post-procedural management of cirrhotic patients, echocardiography is required for all patients before any interventional procedure or liver transplantation regardless of the stage of cirrhosis. The mechanism of cardiac involvement in patients with cirrhosis seems to be complex and multifactorial.
Comparison of Three Different Doses of Dexamethasone Added to Midazolam for Prophylaxis against Nausea and Vomiting after Laparoscopic Cholecystectomy during Early Postoperative Period
Authors: Ebrahim Ahmed Saeed Mohamed , Elkhattab Salwa Omar , Mohamed Marwa Mamdoh , Abdelrahman Haytham Ahmed Maher 
Published: August 2023

Abstract

Background
General anesthesia using volatile anesthetics is associated with high incidence of postoperative nausea and vomiting ranging between 20% - 30% within 24 hours after surgery. Postoperative nausea and vomiting is thought to be of multifactorial etiology involving anesthetics, surgical and individual factors.

Objective
To compare between three different doses of Dexamethasone in conjunction with predetermined fixed dose of Midazolam which can provide effective prophylaxis against postoperative nausea and vomiting after laparoscopic cholecystectomy.

Patients and Methods
1ry outcome was to decrease nausea and vomiting after laparoscopic cholecystectomy and 2ry outcome was itching and dizziness. The present study was conducted in Ain shams University hospitals on 120 adult female patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled to an elective laparoscopic cholecystectomy. After obtaining approval from the research ethical committee of faculty of medicine of Ain Shams University, a written informed consent was obtained from every patient after explaining the procedure.

Results
Over 24 h, the incidence of nausea, vomiting and rescue antiemtic use reduced significantly in Group ІІ and Group ІІІ when compared to group І. As with incidence, the severity of nausea was even significantly reduced in the group ІІ and group ІІІ group (P 0.043 and 0.009) respectively compared to group І in 24 hours postoperative. Postoperative pain was assessed for initial 6 h. Group ІІ and group ІІІ had significant reduction in severity of pain (P &lt; 0.016 and 0.006) respectively when compared to group І while there was no significant difference between group ІІ and group ІІІ. Moreover, the incidence of use of rescue analgesia significantly reduced from 82.5% in group І to 52.5% and 45% in group ІІ and group ІІІ, respectively. However, dose of rescue analgesia used in 6 h was significantly reduced in Group ІІІ only (P = 0.013).

Conclusion
The minimum effective dose for prevention of postoperative nausea is 4 mg of Dexamethasone in combination with Midazolam in female patients undergoing Laparoscopic cholecystectomy with additional advantage of analgesia in the early postoperative period. Further reduction in incidence and severity of PONV can be achieved with a dose of 8 mg dexamethasone.
The Effect of Adding Magnesium Sulphate to Epidural Bupivacaine Compared to the Addition of Fentanyl to Epidural Bupivacaine in Patients Undergoing Lower Limb and Pelvic Orthopedic Surgery under Combined Spinal Epidural Anesthesia
Authors: El Ghafar Hazem M Abd , Aziz Mohamed S Abdel , Yossif Osama R , Mohamed Wael A 
Published: August 2023

Abstract

Background
Epidural anesthesia is safe and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief. Research continues concerning different techniques and drugs that could provide better surgical anesthesia and postoperative pain relief.

Aim of the Work
to investigate how the addition of magnesium sulphate to 0.5% bupivacaine affects duration, quality, complications and dermatome spread of anesthesia in comparison to fentanyl.

Patients and Methods
The current study included 50 patients who had been scheduled to undergo lower limb or pelvic orthopedic surgery under combined spinal - epidural anesthesia. The study had been done after approval of the local ethics committee and after obtaining written informed consent from all patients enrolled in the study; which had been held at Ain Shams Hospital, Faculty of Medicine.

Results
Pain assessment using VAS showed no statistically significant difference between the two studied groups in the first and second hours postoperative. Starting from the third hour statistical significant differences were observed between the two groups, VAS was higher in groups (M) than in group (F); (1.82 ±0.6 vs. 1.42 ±0.4 in both groups respectively. At the fourth hour; VAS was higher in groups (M) than in group (F); (2.80±0.8 vs. 1.76 ± 0.6 in both groups respectively. The incidence of complications was significantly lower among group (M) where 52% of patients had no complications at all.

Conclusion
the use of both magnesium and fentanyl as adjuvants to local anesthetics in epidural anesthesia is safe and effective. No significant differences regarding quality of motor block and hemodynamics. But the study shows that fentanyl is significantly a better adjuvant regarding postoperative analgesia and time for first analgesic dose. While magnesium is a significantly better adjuvant regarding complications such as nausea, vomiting and pruritis.
Mean Platelet Volume as a Prognostic Marker in Sepsis in ICU
Authors: Awad Hossam Magdy , El Shantory Sherif Farouk Ibrahim , El Fawal Sanaa Mohamed Mohamed , Ezzat Ahmed Wagih 
Published: August 2023

Abstract

Background
Sepsis is defined as a systemic inflammatory response to confirmed or suspected infection. It is a major cause of morbidity and mortality, and the incidence is rising, probably due to the growing elderly population, antibiotic resistance, immunosuppressive medication and, invasive surgery. Pneumonia is the most common infection leading to sepsis, followed by urinary tract infections and abdominal infections. These infections are usually localized and controlled by the immune system, but they can sometimes spread and cause sepsis.

Objective
To correlate between the mean platelet volume in patients with sepsis with C-reactive protein as a prognostic markers.

Patients and Methods
This is a prospective study conducted on 80 adult critically ill patients of both sexes with sepsis and sever sepsis who admitted to the units of Critical Care Medicine Ain Shams University Hospitals. The samples were collected during the period from 1st October 2019 to 31st March 2020, MPV results were correlated to CRP, SOFA score and APACHE score.

Results
The results of the present study revealed: 55.8 % were male and 44.2 % were females. Sex did not affect mortality, no statistical significance found. In this study, MPV was a significant parameter in septic patients. The cut off value for MPV was 10.5 fl which was found to be significant and of a magnitude considered to be clinically useful, with sensitivity 57.1%, specificity 80.8%, p value (0.003) and accuracy 72.5% in predicting mortality. A correlation was found between high MPV, CRP, SOFA and APACHE scores. Therefore, MPV may be used as an auxiliary test in the prognosis of sepsis.

Conclusion
Initial values of MPV were significantly correlated with CRP, APACHE and SOFA scores and with the estimated rate of mortality.
Midodrine as Adjunction Support for Weaning off Norepinephrine in Septic Shock
Authors: Hafez Hussien Gamal Mohammed , Nashed Sherif Wadie , El Malek Morkos Fady Adib Abd , El Wahab Wael Abd El_Moneim Mohamed Abd 
Published: August 2023

Abstract

Background
Septic shock is the most severe form of sepsis, in which profound underlying abnormalities in circulatory and cellular/metabolic parameters lead to substantially increased mortality.

Objective
To evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV norepinephrine and allow earlier discharge from ICU compared to control patients.

Patients and Methods
This was a Prospective comparative study. The population of the study included 60 patients whom were admitted to adult ICU department with septic shock. This study was included 60 critically ill patients who was fulfilled the diagnostic criteria for septic shock were randomly assigned to one of two group each one was included 30 patients.

Results
Concerning the effect of midodrine on the outcome of septic patients, our study showed that there was highly significant effect on the ICU length of stay and ICU mortality. (The ICU length of stay (days) in midodrine group = 6.2 VS 8.3 in control group (p = less than 0.001) and the ICU survival in midodrine group = 96.7%VS 60% in control group (p = 0.001). A number of confounding factors may have influenced this endpoint, including the provider confidence in patient stability, bed availability on floor or step-down units or continued need for ICU monitoring for other reasons.

Conclusion
Use of midodrine significantly reduces duration of IV vasopressor infusion during the recovery phase of septic shock. Use of midodrine has great impact on overall survival, length of ICU stay and ICU survival. Administration of midodrine improved MAP & serum lactate in midodrine group.
Fascia Iliaca Block versus Intra-Venous Analgesia for Positioning of Neck Femur Fracture in Patient Undergoing Spinal Anathesia
Authors: Abdelaziz Mohamed Saeed , Hakim Karim Youssef Kamal , Ibraheem Peter Naiem Abdelmassiah , Mohamed Mahmoud Abdelaziz 
Published: August 2023

Abstract

Background
Fracture of the femur is a well-known reason for surgical repair in patients of all ages. Locations include the neck, intertrochanteric, shaft, and distal fractures. Spinal anesthesia is the commonly used, preferred method for surgery and is associated with lower odds of mortality compared to general anesthesia. Spinal anesthesia is administered in either a sitting or lateral decubitus position. Positioning patients with a fractured femur for spinal anesthesia is challenging since minimal movement of the overriding fracture ends can cause extreme pain.

Objective
To elaborate the efficacy and safety of FICB with intravenous analgesic (IVA) on the quality for positioning before spinal anesthesia in participants with a femur fracture.

Methods
After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n = 25; each); group FICB and control group.

Results
The study results show that there was no statistically significant difference found between FICB group and FENT group regarding demographic data and characteristics of the studied patients. While there was statistically significant increase in the quality of patient positioning in FICB group than FENT group with p-value = 0.021; also there was statistically significant increase in the patient satisfaction in FICB group than FENT group with p-value =0.021. And a statistically significant increase was found in the time to first rescue analgesic postoperative in FICB group than FENT group with p-value &lt; 0.001.

Conclusion
Fascia Iliaca Compartment Block is more efficacious than intravenous fentanyl for positioning during spinal anaesthesia in surgery for fracture femur. Fascia Iliaca Compartment Block provides superior analgesia, better quality of patient positioning, greater patient satisfaction thereby reducing the time taken to perform spinal anaesthesia in sitting position compared to i.v. fentanyl in fracture femur surgery.