bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Sex Difference on the Analgesic Response of Nalbuphine after Major Orthopedic Surgery in One Egyptian Intensive Care
Authors: Alansary Amin M , Elewa Gamal M , Elsayed Elsayed M S , Said Sherif G A 
Published: August 2023

Abstract

Background
Several reviews on the topic of gender differences in pain mechanisms, control and treatments have been published in the last two decades. The increasing literature refers to a broad range of topics, including preclinical studies on mechanisms underlying male and female diffelences in nociception and its control, clinical lesearch on gender differences in pain perception and modulation, epidemiological investigations of sex differences in pain prevalence and a growing number of studies examining sex differences in responses to pain therapies.

Aim of the Work
To compare Egyptian male and female response to Nalbuphine as analgesia after major orthopedic surgery in the intensive care unit, as regards dose effectiveness and adverse effects, in the first postoperative 24 hours.
Patients and Method: This comparative prospective analytical study was performed at Ain Shams University Hospitals. The study enrolled 100 Egyptian postoperative patients admitted to ICU after major orthopedic surgery; including 50 females and 50 males.

Results
The mean age of the participants was 48.81 ± 8.99 years. Regarding the primary outcome, the current study showed that males required a higher dose of nalbuphine than females with a pvalue &lt; 0.001. There was no statistically significant in the VAS score of pain intensity between males and females at all times.

Conclusion
The results of this study suggest that postoperative nalbuphine requirements differ between Egyptian female and male patients undergoing major orthopedic surgeries. Males require a higher dose than females. But there was no statistically significant difference between females and males regarding postoperative analgesia complications. Nevertheless, funher studies on the ICIationship between the analgesic effect and other factors like comorbid mental disorders are required.
Continuous Infusion versus Intermittent Bolus Injections of Furosemide in Congestive Heart Failure
Authors: El Safty Omar Mohamed Taha , El Deek Abeer Mohamed Abdel Aziz Mohamed , El Far Marwa Mamdouh Mohamed , Wannas George Salah Farah 
Published: August 2023

Abstract

Background
Loop diuretic therapy (Furosemide) plays a pivotal role in the treatment of CHF. Despite the lack of mutual agreement about the best approach to use Furosemide in CHF, its demonstrated efficacy and the long clinical experience with it suggest that it will remain an integral part in management of the CHF. Ongoing investigation into the optimal strategy to administer furosemide is a must to maintain its efficacy and minimize its adverse effects.

Aim of the Work
To compare continuous infusion and bolus intermittent injection of Furosemide in patients admitted with congestive heart failure.

Patients and Methods
In our study we tried to distinguish the most useful method of Furosemide administration whether continuous infusion or intermittent bolus injections. 40 patients (31 males and 9 females) admitted with a diagnosis of CHF were randomized in 1:1 ratio into either continuous infusion or intermittent boluses of Furosemide. On patient admission, detailed history was taken including symptoms, risk factors and etiology. Clinical examination was performed to detect rales, other signs of pulmonary edema and peripheral edema. Body weight measurement was taken as a baseline. All patients were submitted to CXR, echocardiography and laboratory assessment of renal function and electrolytes.

Results
Patients were then compared daily regarding BWL, UOP and clinical improvement of pulmonary rales. They were monitored for electrolytes disturbance, renal function deterioration and hemodynamic instability for first 72 hours after admission. The length of ICU stay and mortality were observed as well. Our study revealed that Furosemide administered in continuous infusion group, in comparison with intermittent bolus group, was associated with more cumulative UOP (P value 0.002) and more total BWL in 3 days (P value 0.000). This was on the expense of more incidence of hypokalemia (P value 0.002), there was no significant difference between 2 routes regarding hemodynamic parameters, renal function, mortality or length of ICU stay.

Conclusion
Continuous infusion of Furosemide in patients with CHF appears to provide more efficient diuresis, together with more reduction of body weight when compared to intermittent bolus therapy. However, these obtained beneficial hemodynamic effects were not reflected on the clinical course and patient outcome. Moreover, they were associated with electrolyte disturbance.
Dexmedetomidine versus Dexamethasone as Adjuvant to Bupivacaine in Ultrasound Guided Transversus Abdomins Plane (TAP) Block for Analgesia in Patients Undergoing Laparoscopic Cholecystectomy Surgery
Authors: Gadallah Raouf R , Hefni Amira F , Khalil George M , AbdelTwab Mohamed Z 
Published: August 2023

Abstract

Background
Ultrasound-guided transversus abdominis plane (TAP) block became a common analgesic method after surgery involving the abdominal wall. Different adjuvants have been used to intensify the quality and the duration of local anesthetics.

Aim of the Work
to compare dexmedetomidine versus dexamethasone added to bupivacaine as adjuvant to the local anesthetic bupivacaine during Ultrasoundguided transversus abdominis plane (TAP) block for postoperative analgesia in laparoscopic cholecystectomy, characteristics including duration of postoperative analgesia, post-operative pain score and sedation score.

Patients and Methods
The current study included 40 patients scheduled for elective laparoscopic cholecystectomy surgery were given Ultrasound-guided transversus abdominis plane (TAP) block after induction of general anesthesia. The patients were randomly allocated into two groups. Group (DM): patients received 22 ml of Bupivacaine 0.25 %in 20 ml + 1 ug/kg of dexmedetomidine in 2 ml on both sides. Group (DS): patients received 22 ml of Bupivacaine 0.25 % in 20 ml + 4 mg of dexamethasone in 2 ml on both sides.

Results
VAS pain score at rest especially 6, 12, 24, 48 hrs is significantly less in dexmedetomidine group than in dexamethasone group. VAS pain score at movement especially 6, 12, 24, 48 hrs is significantly less in dexmedetomidine group than in dexamethasone group. 1st rescue dose of analgesics was delayed up to (19.76±2.51 hrs), in dexmedetomidine group in comparison to (12.92±2.17 hrs) in dexamethasone group. The total dose of paracetamol required by patients in the dexmedetomidine group was (3.18±1.07 gm) compared to (5.33±1.16 gm) in dexamethasone group, indicating longer pain-free period and less requirement of analgesia in the dexmedetomidine group. Therefore, use of dexmedetomidine in TAP block has a beneficial effect in reducing the dose of systemic analgesic requirements.

Conclusion
co administration of 1 ug/kg of dexmedetomidine vs dexamethasone 4 mg to 0.25 % bupivacaine on both sides by US guided TAP block leaded to significant changes in the form of lower HR at 12, 24, 48 hrs, lower sedation score at 1, 6, 12, 24, 48 hrs and no significant changes in systolic blood pressure, diastolic blood pressure, oxygen saturation and respiratory rate.
The Efficacy of Fascia Iliaca Block for Pain Control after Total Hip Arthroplasty
Authors: Elella Sahar Kamal Mohamed Abo , Elagamy Ashraf Elsayed , Ahmed Ahmed Moneir , Abdo Mohamed Atef Elsayed 
Published: August 2023

Abstract

Background
Total hip arthroplasty (THA) are common surgical procedures for treatment of the degenerative disorders and traumatic diseases. However, a majority of patients often experience moderate to severe postoperative pain after THA. Postoperative pain control has a significant impact on earlier ambulation, initiation of physiotherapy, and better functional recovery. In addition, effective pain control would lower the length of hospital stay and the risk of thrombotic events which improves patients’ satisfaction.

Aim of the Study
To assess the efficacy and safety of FICB compared with standard multimodal analgesia in patients undergoing THA.

Patients and Methods
Ninety adult patients scheduled for total hip arthroplasty (THA), under spinal anesthesia were included in this study. The patients' age was ranging from 18 to 65 years and with the American Society of Anesthesiologists (ASA) Class II and III. Patients were included in the study, and were divided into two groups (n = 42; each); group FICB and control group.

Results
At PACU arrival there is no difference between two groups as two groups were recovering from anesthesia then facia illiaca block group showed the best response as regard as pain control post operatively for 12 hours postoperative then there is no statistical difference between two groups. There was statistically significant difference between groups as regard as visual analog score. As regard to total dose of morphine used in each group, facia illiaca block scientifically used less amount of morphine than control group (P &lt; 0.001).

Conclusion
Fascia iliaca compartment block is effective for pain relief during the early post-operative period after total hip arthroplasty. Meanwhile, it can reduce the cumulative morphine consumption and the risk of opioid-related adverse effects.
The Effect of Nitroglycerine on Myocardial Injury Induced by Ischemia/Reperfusion in Adult Male Albino Rats
Authors: Thabet Moubarak Hemdan , Habib Eman Kamal Mohammed , Sawy Marwa Mohamed El , Mohamed Reham Hussein , Mamdouh EL-Sabban Radwa 
Published: August 2023

Abstract

Background
Despite, early reperfusion is the current optimal way to rescue the heart and salvage of greater amount myocardium, the process of reperfusion could induce myocardial injury and cardiomyocyte death, that result in heart failure and death. Several therapeutic medications such as nitroglycerine is currently under investigation for preventing myocardial reperfusion injury which has the potential to improve clinical outcomes in patients with acute myocardial infarction treated

Aim of the Work
To investigate the effect of nitroglycerin on myocardial ischemic reperfusion injury as regard histopathological changes.

Materials and methods
30 Male adult albino rats were randomly divided into four groups (10 rats for each); Group I (2 subgroups: group 1A (control group) & group 1B (sham group)). Group II (ischemia/reperfusion animal model). Group III (nitroglycerine 0.5 mg/kg BW 15 min before I/R). Tissue samples of heart ventricles of all animals were collected and processed for light microscopic examination.

Results
The ischemia /reperfusion group showed massive disruption of the normal histological cardiac muscle picture, interstitial hemorrhage, inflammatory cells infiltration, pyknotic changes in the nuclei and dark acidophilic contraction bands. Nitroglycerine treated group revealed disruption of cardiac muscle fibers and with minimal improvement in the histological appearance.

Conclusion
Nitroglycerine injection attributed to potential improvement for myocardial ischemia reperfusion injury which. Therefore, it might be assumed that nitroglycerine could be used as a safe drug before induction of reperfusion.
Effect of Contrast Agent on Renal Functions in Patients with Renal Impairment Undergoing Percutaneous Coronary Intervention
Authors: El Mawardy Ramzy Hamed , Helmy Haytham Galal Mohamed , Azab Eslam Adel Mohamed 
Published: August 2023

Abstract

Background
Contrast induced nephropathy is one of the most important clinical complications associated with IV administration of radio-contrast media. This prospective study evaluating incidence and predictors of contrast induced nephropathy after administration of contrast agent in patients with renal impairment undergoing percutaneous coronary intervention.

Objective
To predict the effect of contrast agents on renal functions in patients with renal impairment undergoing percutaneous coronary intervention.

Patients and Methods
A prospective study that included 120 patients who underwent percutanous coronary intervention with glomerular filtration rate below 90 ml/min. All patients were subjected to full history, examination and investigation. Results were recorded using serum creatinine and glomerluar filtration rate before and 72 hours after procedure.

Results
CIN had occurred in 26.67% of studied group where these was high incidence of occurrence of CIN with elderly (p = 0.009), obese patients (p = 0.039), hypertensive (p = 0.004), Diabetics (p = 0.000) and amount of dye received (p = 0.000). 50% of patients who developed CIN where males and 50% where females which was non significant with p = 0.165.

Conclusion
CIN in patients with preexisting renal damage or risk factors for the development of kidney dysfunction is a potentially serious complication after PCI with increased short and longterm morbidity and mortality. Appropriate management of patients at risk is crucial for the prevention of CIN. Although a specific treatment for CIN is not available removal of modifiable risk factors and implementation of periprocedural measures such as CM reduction and intravenous hydration can significantly lower the risk of CIN in selected patients.
Impact of Different Right Ventricular Lead Positions on QRS Complex Duration Post Cardiac Resynchronization Therapy Device Implantation
Authors: Hesham T , Shehata H , Reda A , Badran H 
Published: August 2023

Abstract

Aim and objectives
The aim of the study was to evaluate the effect of different RV lead positions on QRS complex duration post CRT device implantation in patients indicated for CRT as a treatment of chronic heart failure based on the recommendations of ESC guidelines for diagnosis and treatment of acute and chronic heart failure published in 2016 and to assess the effect of change of QRS complex duration and morphology according to different RV lead positions on clinical response.

Patients and Methods
This study included 100 patients (age 60.02 ± 7.18) post CRT device implantation presented for follow up at electrophysiology clinics of the cardiology department of Ain Shams university hospitals at least 3 months post CRT device implantation, during the period form from December 2020 till May 2021. The patients were divided into 2 groups according to the site of RV lead implantation after confirmation of the RV lead position by fluoroscope in Right anterior oblique (RAO) and left anterior oblique (LAO) views, 54 patients had the RV lead implanted in the RV Apex (RVA n = 54) and 46 patients had the RV lead implanted in the RV Septum (RVS n = 46).

Results
OF the total 100 patients that enrolled in our study the rate of non-responders was 19% of the patients showed no clinical improvement, no improvement of NYHA class by at least one grade, 30% of the patients were non-Echocardiographic responders, no improvement of LVEF (Δ EF) by at least 5% with no decrease of LVES diameter by at least 15%, and 15% of the patient were nonECG responders, delta QRS (ΔQRS) didn`t increase by at least 20%. There was no significant difference between the two groups regarding clinical response (NYHA class) (P-value = 0.583), LVEF (Δ EF 6.26 ± 1.64 in RVS group vs. 6.07 ± 1.67 in RVA group, P-value = 0.575) LVES diameter (47.70 ± 8.03 in RVS group vs. 45.39 ± 7.48 in RVA group, P-value = 0.141) or QRS complex narrowing (ΔQRS 60.93 ± 24.68 in RVS group vs. 54.07 ± 26.12 in RVA group, P-value = 0.182). There was no significant difference in the rate of non-responders between the two groups (clinical non responders in RVS group n = 8 vs. RVA group n = 11, P value = 0.547) (Echo non responders in RVS group n = 13 vs. RVA group n = 17, P value = 0.726) (ECG non responders in RVS group n = 6 vs. RVA group n = 9, P value = 0.613), There was an inverse relationship between ΔQRS and clinical response (NYHA) class post CRT device implantation in both RVS and RVA groups (P value 0.016 in RVS group, P value 0.007 in RVA group).

Conclusion
The study demonstrates that septal RV pacing in CRT is non-inferior to apical RV pacing regarding the primary objective of the study regarding clinical outcome, narrowing of QRS complex (ΔQRS) or LV reverse remodeling, thus no recommendation for optimal RV lead position can hence be drawn from this study.
Also, delta QRS complex duration may be used as indicator for electric remodeling and CRT response.
Pattern of Chronic Obstructive Pulmonary Disease Patients
Authors: Sayed Ahmed Abd El-Aal , Ahmed Mona Mansour , Salah Haitham 
Published: August 2023

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is a widespread chronic respiratory disease with rising morbidity and death, resulting in enormous societal and economic costs. COPD is a widespread, avoidable, and curable condition characterised by usual symptoms such as dyspnea, coughing, and/or sputum production. The goal of this study was to use a COPD questionnaire to analyse clinical, demographic, and available prescription pattern for chronic obstructive pulmonary disease.

Results
Our findings suggest that patients' early knowledge of COPD risk factors and symptoms, as well as assistance in early illness detection and the provision of patient-centered treatment based on patients' unique requirements in disease management, are all necessary.

Conclusion
The major objective of COPD management is to control symptoms and limit the risk of exacerbation in order to enhance the quality of life of patients. In addition to pharmaceutical management, achieving these goals necessitates the adoption of a healthy lifestyle and the avoidance of risk factors.
The Effect of Thrombocytopenia in COVID-19 Patient in Comparison with Patient with Normal Platelets Count
Authors: Elasal Gehan Mohmed , Mahmoud Mahmoud Mohsen , Aly Dina Essam 
Published: August 2023

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a novel coronavirus disease 2019 (COVID-19), which spreads rapidly around the world17.Changes in platelet count are common in COVID-19 patients. The platelet count is a sensitive indicator of illness severity that is of great clinical utility to monitor a quickly changing health condition of patients affected by aggressive viral infections.18

Aim of the Work
study thrombocytopenia as a prognostic factor in covid 19 patient and it’s relation with length of hospital stay and prognosis

Patients and Methods
A total of 60 COVID-19 patients were involved in the prospective study during the period from June 2020 to December 2020 who were admitted isolation hospital, Ain Sham University Hospitals. then for each patient, CBC at admission was done, repeated at day 7 from the start of symptoms, day 14 and day 21. all patient didnot recieve anticoagulation. patients were followed regarding length of hospital stay and Mortality.

Results
Out of 60 patients, 19 patients (31.7%) were thrombocytopenic.The length of hospital stay was significantly higher in thrombocytopenic group. There was high statistical significant difference between normal platelets count group and thrombocytopenic groups regarding outcome (P value &lt;0.001).in thrombocytopenic patients, 5 (50%) showed deterioration, 4 (40%) patients died and one patient in this group showed complete recovery.

Conclusion
Thrombocytopenia is associated with increase length of hospital stay and poor prognosis in patients with COVID-19.
Detection of NCF-2 Gene Expression in Egyptian Children with Chronic Granulomatous Disease
Authors: Bakr Salwa Ibrahim , Samaha Dalia , Owaidy Rasha El , Samir Nancy , Ahmed Gehad 
Published: August 2023

Abstract

Background
Chronic granulomatous disease (CGD) is a rare inherited primary immunodeficiency disorder (PID) which is characterized by enhanced susceptibility to severe bacterial and fungal infections. It results from defects in one of the five polypeptide subunits of the nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) complex; CYBB (gp91-phox), NCF-1 (p47phox), CYBA (p22-phox), NCF-2 (p67-phox), or NCF-4 (p40-phox) with a resulting failure of the phagocytes in generating a variety of microbicidal reactive oxygen radicals during respiratory burst.

Objectives
This work intended to diagnose autosomal recessive (AR)-type of CGD by detection of NCF-2 gene expression using real time RT-PCR as a cheaper diagnostic method for CGD subtypes categorization among CGD children.

Subjects and methods
This case-control study was conducted on 15 children provisionally diagnosed as CGD patients by the use of dihydrorhodamine (DHR) stimulation index (Group I) in addition to 12 mothers and 8 fathers of the studied patients (Group IIa and IIb respectively) to detect the genetic mutations in carriers, if any, and 14 apparently healthy children as a control group (Group III). In the present study, cases with a fold change of NCF-2 gene expression less than 0.67 were considered defective for NCF-2 gene expression. At this cut-off value, from our molecularly studied subjects, 2 CGD cases and one mother showed underexpression of NCF-2 gene. In conclusion, defect in the NCF-2 gene, which encodes gp67-phox of the oxidase enzyme could be done by RT-PCR as a cheaper diagnostic method for CGD without the need to use complex and expensive methodologies such as northern blot, or genomic DNA sequencing.
Quantitative Stool Culture of Candida in Autism Spectrum Disorder Patients
Authors: Amer Malaka Z , El Halim Rania M Abd , El Hussieny Reham M , Salem Ghada Elsayed 
Published: August 2023

Abstract

Background
Autism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by social and communication impairment and restricted or repetitive behaviors.

Aim of the Work
to estimate the quantity of Candida in autism spectrum disorder (ASD) patients compared to normal children and to find the association between Candida colony count and severity of ASD.

Patients and Methods
The study was carried out on 40 children, diagnosed as autism and 40 normal children as control group recruited from Pediatrics and adolescent Psychiatric Clinic at Ain Shams University Pediatrics Hospitals and Main Microbiology lab in Clinical Pathology Department of Ain Shams University. The study was conducted on a wide age group ranging from 3 to 14 years, (mean age of 6.30±2.40 years), Stool sample was collected from each patient in a sterile container, cultured on Sabouraud Dextrose Agar (SDA) and colony count was determined. Identification of isolated Candida species was done using chromogenic media.

Results
The study revealed statistically significant difference in Candida isolation rate among patient and control group with p-value (p = 0.006). Candida species were isolated from 23 patients (57.5%) and from 10 child in control group (25%), But detected that stool count was nonsignificant in severe autistic group compared to mild to moderate autistic group with p-value more than 0.05 NS. There were 14 patients (60.9%) with C. Albicans; 2 patients (8.7%) C. Glabrata; 6 patients (26.1%) C.Krusie and one patient (4.3%) C. Utilis, among candida species.

Conclusion
ASD is more common among male than female; ratio about 4:1. The high rate of intestinal colonization by Candida species in ASD children may represent a part of syndrome related to immune system disorders that may play a role in the pathogenesis of ASD. C. albicans was the predominant isolate than other non-Candida albicans species in ASD. The degree of candida colonization represented as quantitative colony count is not related to the severity of CARS among ASD patients.