bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Value of Platelet-To-Lymphocyte Ratios among Critically Ill Patients with Acute Kidney Injury
Authors: Nour-Eldin Basel Mohammed Essam , Abd-Elsalam Ihab Hamed , Nasr Thabet Aziz , Karim Michael Safwat 
Published: August 2023

Abstract

Background
Kidney is one of the most affected organs by sepsis causing acute kidney injury (AKI). Sepsis is a major cause of morbidity and mortality worldwide, and it results from a dysregulation of the systemic inflammatory response to infection. Despite significant advances in the pathophysiology and therapeutic strategies for sepsis, the mortality remains high, at 300 deaths per 100 000 people.

Aim of the Work
It is reasonable to speculate the presence of a potential relationship between PLR and mortality for sepsis. However, no investigation has been conducted. Therefore, in this study, we aimed to investigate the prognostic value of PLR for sepsis.

Patients and Methods
Logistic regression was used to explore the association between PLR and hospital mortality. Subgroup analyses were performed based on acute kidney injury (AKI) and a Sequential Organ Failure Assessment (SOFA) score &gt;10.

Results
In our study, the overall mortality was 43.5% (87 out of 200 patients). There were 78 cases death (78%) of PLR &lt;90, also were 9 cases death (9%) of PLR &gt;90 regarding prognosis with (p-value = &lt;0.001 highly significant).

Conclusion
This study confirmed that the platelet-to-lymphocyte ratio (PLR) has significant prognostic value for sepsis with acute kidney injury. PLR appears to be additive biomarker used in detection high-risk patients and this can add to early diagnosis of such patients with better management strategies.
Dynamic of Glycemic State as a Prognostic Marker in Acute Ischemic Stroke: A Prospective Controlled Cohort Observational Study
Authors: Said Amr Mohamed El , Sayed Hussien Noha , Negm Mohamed Atef 
Published: August 2023

Abstract

Background
Hyperglycemia is encountered in 20% to 40% of acute stroke patients, with or without a pre-morbid diagnosis of diabetes mellitus. Hyperglycemia is a risk factor for infarct expansion and poor outcome through the first 72 hours of hospitalization in both diabetics and nondiabetics. Major and minor studies of stroke patients suggested that ‘Stress Hyperglycemia’ (raised blood glucose levels without a previous diagnosis of diabetes) was associated with a poorer outcome.

Aim of the Work
The aim of the work was to study the glycemic status after acute ischemic stroke and to assess the influence of glycemic status in the stroke outcome.

Patients and Methods
This study was a prospective cohort study conducted in Ain shams University Hospitals during the period from October 2019 to March 2020. The study included a total of 105 patients presented with acute ischemic stroke within 24 hours from onset of symptoms. The study population were predominantly males (60.95%), with a mean age of 61.66 ± 10.38 years (range from 40 to 85 years).

Results
Our study revealed that: Hyperglycemia is a good predictor of mortality outcome after acute ischemic stroke (65.7% vs. 5.7%), stress hyperglycemia had the worst mortality outcome compared with diabetic group and control group (85.7% vs. 45.7% vs. 5.7%; respectively), hyperglycemia is a good marker of stroke severity assessed by NIHSS score (14.60 ± 5.80 vs. 7.60 ± 3.38), hyperglycemia has significant association with longer ICU and hospital stay (12.26 ± 8.92 vs. 2.89 ± 4.07 days), NIHSS score is a significant predictor of mortality outcome after acute stroke (18.20 ± 3.43 vs. 7.30 ± 1.86), hyperglycemia has significant association with posterior circulation strokes (20% vs. 0.0%) and patients with hyperglycemia had higher incidence of intracerebral complications, namely hemorrhagic transformation (17.1%) and brain edema (10%).

Conclusion
This study revealed that there is an association between admission hyperglycemia and poor outcome after acute ischemic stroke. Admission hyperglycemia worsens the outcome and functional disability during the phase of ischemic stroke. Hyperglycemia at stroke onset, without prior history of DM have particularly poor prognosis, than those with hyperglycemia in known diabetes.
Comparison of Adding Magnesium Sulphate to Bupivacaine with Plain Bupivacaine in Ultrasound Guided Pectoral Nerve Block for Postoperative Analgesia in Modified Radical Mastectomy
Authors: Mageed Azza Mohammed Shafik Abd El , Emam Dalia Fahmy , Nasr Thabet Aziz , Mohamed Mohamed Sabry Bayoumi 
Published: August 2023

Abstract

Background
Breast cancer is the most common malignancy in women, and its incidence continues to increase. Modified radical mastectomy (MRM) is one of the standard treatments for multi-centric disease or tumors with extensive coexistent ductal carcinoma in situ.

Aim of the Study
To elaborate the analgesic efficiency and safety of pectoral nerve block by adding magnesium sulphate to bupivacaine as an adjuvant versus bupivacaine as a sole agent in cases of modified radical mastectomy (MRM).

Patients and Methods
This is a Prospective double – blinded randomized controlled study was conducted in the operating theatres of Ain Shams University Hospitals. It included Female patients undergoing Modified Radical Mastectomy. Twenty-four patients were enrolled in the study divided into 12 patients in each group.

Results
There was a statistically significant difference between 2 groups according to post-operative visual analogue scale. It was lower in consumption in group B than in group A. Also a statistically significant difference between group A and group B according to first time of rescue morphine consumption was found, it was longer time to need postoperative morphine consumption in group B than in group A And we found the addition of 300 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia.

Conclusion
The addition of 300 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia
Using of Oral Midodrine in Weaning of Intravenous Vasopressors in Patients with Septic Shock Admitted to ICU
Authors: Basiouny Mohsen Abd El-Ghany , Samir Ghada Mohamed , Ibrahim Ahmed Farouk , Mahmoud Mohammed Ali Mohammed 
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. Diagnosis of septic shock is based on presence of certain symtoms, signs & there is also many Biomarkers which are essential for Diagnosis and Prognosis of Sepsis patients like CRP, Prolactin & BNP.

Objective
To assess whether the use of adjunctive oral midodrine in patients with vasopressordependent hypotension reduces the time to cessation of intravenous vasopressor.

Patients and Methods
In order to achieve this aim, we included a total of 140 patients admitted to the ICU unit at Ain Shams University Hospitals who developed septic shock and required IV vasopressors. Patients were divided into 2 groups: Group (A): consists of 70 patients who will receive IV vasopressors only (control group). Group (B): consists of 70 patients who will receive IV vasopressors with adjunctive oral midodrine (midodrine group) or (case group).

Results
In our study there were no significant differences among patient’s demographics, clinical and hemodynamic parameters suggesting so that the observed results were not secondary to baseline group characteristics. Our results indicate that use of oral midodrine during recovery from septic shock has no effect on the duration and weaning of IV vasopressor infusions. Although the previous parameters were lower in the IV vasopressor with midodrine group compared with the IV vasopressor only group, but the differences weren't significant. The IV vasopressor duration in hours was (139.65 ± 46.21 VS 141.30 ± 79.00) and the IV vasopressor weaning duration in hours was (65.37 ± 13.94 VS 73.20 ± 35.78). These insignificant results may be attributed to the absence of special protocol for vasopressor weaning in the unit, in addition to the obligatory and temporary stoppage of vasopressor weaning when hemodynamic instability occurs (MAP ≤65 mmHg or SBP &lt; 90 mmHg, low urine output &lt; 0.5 ml/kg/h). Our results are inconsistent with most of studies that have demonstrated that midodrine use was associated with a rapid and effective wean from IV vasopressors.

Conclusion
Use of midodrine doesn't reduce duration of IV vasopressor infusion and weaning during the recovery phase of septic shock. Use of midodrine has no impact on overall survival, length of ICU stay and ICU mortality. Administration of midodrine improved MAP in midodrine group.
Ultrasound Guided Fascia Iliaca Block versus Femoral Nerve Block for Post Operative Analgesia for Patient Undergoing Total Knee Arthroplasty
Authors: Gadalla Raouf Ramzy , Daniel Reham Fathy Galal Samuel Habachi , Ahmed Nermeen Shawky 
Published: August 2023

Abstract

Background
Total knee arthroplasty (TKA) is commonly performed in patients with end-stage osteoarthritis or rheumatic arthritis of the knee to relieve joint pain, increase mobility, and improve quality of life. Multimodal techniques featuring peripheral nerve blocks have demonstrated a significant advantage in perioperative pain relief for TKA patients. Peripheral nerve blocks have gained more attention because of the discovery of new and more trustworthy anesthesia medications and developments in technology and anesthesia. Peripheral nerve blocks can also be used for anesthesia of the operation area and are commonly used for postoperative analgesia being with general anesthesia.

Aim of the Study
To compare the effect of Fascia iliaca versus femoral nerve block on postoperative anaelgesia in patients undergoing TKA.

Patients and Methods
This is a prospective randomized clinical trial study was conducted in Ain Shams University Hospitals within a period of 6 months. Seventy adult patients scheduled for total hip arthroplasty (THA), under spinal anesthesia were included in this study and randomly assigned into one of the following groups using computer generated codes and opaque sealed envelopes: Group I (FICB group) received ultrasound guided Fascia iliaca compartment block (FICB) and Group II (FNB group) received ultrasound guided femoral nerve block.

Results
There was a statistically significant mean in FNB group compared to FIB group according to VAS score after 6 hrs postoperative and shows significant higher mean in FNB group after 12 hrs and 24 hrs postoperative. Also, a statistically significant increase mean/hrs in FIB group compared to FNB group was found according to first time to ask analgesia and also shows statistically significant higher mean in FNB group compared to FIB group according to total pethidine given (mg).
At PACU arrival there is no difference between two groups as two groups were recovering from anesthesia then fascia 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
The fascia iliaca block and femoral nerve block provide the same analgesic effect during early post operative period; however after 6 hrs, fascia iliaca block provides a more efficient pain control and less morphine consumption.
Ultrasound Guided Oblique Subcostal Tranversus Abdominis Plane Block (TAP) versus both Subcostal and Posterior TAP Block as Postoperative Analgesia in Hepatectomy
Authors: Lateef Fahmy Saad , Hosny Mona Refaat , Ezzat Ahmed Wagih , Abdelhalim Rana Ayman Mohamed 
Published: August 2023

Abstract

Background
Poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics.

Aim of the Work
The aim of this study is to determine the postoperative analgesic effect of ultrasound guided TAP block via oblique subcostal and posterior approaches in hepatectomy.

Patients and Methods
The study was conducted on 40 randomly chosen patients aged 40 to 60 years old, American Society of Anesthesiologists (ASA) class II and III scheduled for hepatectomy in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each: Subcostal TAP block Group: received general anesthesia and 30 ml (10 ml bupivacaine 0.25%, 10 ml lidocaine, 1 gm magnesium and 4 mg dexamethasone) by oblique subcostal approach under ultrasound guidance. Subcostal- posterior TAP block Group: received general anesthesia and with injection of same solution as in the first group in both approaches divided equally between them “ without exceeding the toxic dose “ with total volume 60 ml.

Results
The results of the study revealed that the Patients who received only subcostal TAP block had significantly lower pain scores for 24 h after operation and decreased total need of analgesic in first 24 h post operative compared with patients who received combination of subcostal and posterior TAP.

Conclusion
Combination of Oblique Subcostal TAP block with posterior TAP block was more effective in reducing postoperative pain and analgesic consumption after hepatectomy under general anesthesia, compared to subcostal TAP block only.
A Comparative Study between Non-Invasive Continuous Positive Airway Pressure Ventilation and High Flow Nasal Cannula Oxygenation among COVID-19 Patients with Acute Hypoxemic Respiratory Failure
Authors: Shehab-eldin Sara Osama Tawfik , Zaki Mohamed Sidky Mahmoud , Mahmoud Noura Mohamed Youssri Ahmed , Mohamed Ahmed Moustafa Mohamed 
Published: August 2023

Abstract

Background
Both non-invasive continuous positive airway pressure ventilation (NIV CPAP) and high flow nasal cannula oxygenation (HFNC) are beneficial in patients with acute hypoxemic respiratory failure. COVID-19 is a pandemic infectious disease caused by the coronavirus with a variable clinical picture. This study compares NIV CPAP and HFNC oxygenation in maintaining adequate ventilation, oxygenation and prevention or delaying endotracheal intubation and invasive mechanical ventilation in COVID-19 patients with acute hypoxemic respiratory failure.

Objective
To study the effect of NIV CPAP versus HFNC oxygenation among COVID-19 patients with acute hypoxemic respiratory failure in maintaining adequate ventilation, oxygenation and prevention or delaying endotracheal intubation when conventional oxygen therapy (COT) fails to maintain adequate oxygenation.

Patients and Methods
Our study compares the effect of NIV CPAP versus HFNC oxygenation among COVID-19 patients with acute hypoxemic respiratory failure in maintaining adequate ventilation, oxygenation and prevention or delaying endotracheal intubation when conventional oxygen therapy (COT) fails to maintain adequate oxygenation.

Results
Results showed a significant improvement in most of patients whether using NIV or HFNC and delaying intubation, with superiority of NIV over HFNC specially as regard oxygenation in terms of PaO2/FiO2. As regard invasive ventilation free days NIV-CPAP use yielded a mean invasive ventilation free days of statistically significant longer duration than HFNC group. While comparison between both groups showed that there was no significant difference as regard ICU stay days or mortality rate.

Conclusion
We concluded that both NI-CPAP and HFNC therapy are effective measures in respiratory support and management of acute hypoxemic respiratory failure caused by COVID-19. This is proved by improvement in oxygenation and ventilation after treatment with both NI-CPAP and HFNC which is evident by increase in both peripheral oxygen saturation (SpaO2) and PaO2/FiO2 ratio with lower both respiratory rates and PaCO2. This makes them as an excellent alternative to prevent or postpone invasive mechanical ventilation as a standalone therapy and as a bridge for respiratory recovery. This is especially important in limited resources in face of worldwide outbreak.
Efficacy of Dexamethasone in Attenuation of Postinduction Hypotension in Geriatric Patients Undergoing General Anesthesia: A Randomized Controlled Trial
Authors: Fawaz Ahmed Ali , Esmat Ibrahim Mamdouh , Hasseb Ahmad Mahmoud , Ashoor Tarek Mohamed , Labib Shenouda Nabih 
Published: August 2023

Abstract

Background
Postinduction hypotension is a common problem that faces anesthesiologists on a daily basis, with incidence ranging from 25% to 67.5% when propofol is used as an induction agent. Post-induction Hypotension is even more common in the elder population because increase in age is an independent predictor of intraoperative hypotension as a result of the diminished cardiovascular reserves.

Aim of the Work
This study assessed the efficacy of dexamethasone to alleviate the drop in blood pressure after induction of anesthesia. All patients were informed of their participation in the study and written consents were taken. They were assessed preoperatively by careful history taking, full physical examination, and laboratory evaluation.

Patients and Methods
A Prospective randomized clinical study in Ain-Shams University hospitals, Cairo, Egypt form June 15, 2021 to October 15, 2021 on 100 randomly chosen patients aged ≥ 60 years, American Society of Anesthesiologists (ASA) class I or II who were scheduled for elective surgery in Ain Shams University Hospitals, after approval of the medical ethical committee. They were allocated in two groups of 50 patients each.

Results
The results of the study revealed that the Patients who received preoperative dexamethasone had a significantly less incidence of hypotension, nausea, vomiting and shivering. Accordingly, ephedrine and IV fluid boluses were less frequently needed.

Conclusion
A single 8 mg IV dexamethasone given two hours preoperatively was able to decrease the incidence of postinduction hypotension in geriatric patients undergoing general anesthesia, leading to decreased use of ephedrine and IV fluid boluses. In addition, a significantly fewer percentage of patients developed nausea, vomiting and shivering after surgery than those who didn’t receive the drug.
Preoperative Ultrasound Assessment of Residual Gastric Volume in Patients with Delayed Gastric Emptying Undergoing Elective Surgeries
Authors: Bekheet Verina F Z , A Elewa Gamal M , Abdelaal Wail A M , Abdel Hamid Faisal S 
Published: August 2023

Abstract

Background
One of the main problems facing anesthesiologists during anesthesia is delayed gastric emptying which may contribute to pulmonary aspiration. Perioperative aspiration of gastric contents is a rare but serious complication of anesthesia. Pulmonary aspiration is involved in up to 9% of all anesthesia-related deaths. One of the main risk factors for aspiration is the presence of residual gastric fluid at the time of anesthetic induction. It was demonstrated that bedside utrasonography can provide reliable qualitative and quantitative information about the nature (fluid or solid) and volume of gastric content.

Aim of the Work
To provide a qualitative description of the sonographic appearance of the gastric antrum in fasted patients with delayed gastric emptying undergoing elective surgery by proposing a grading system of the gastric antrum based exclusively on qualitative findings and correlation with the quantitative predicted gastric volume by the known formula prescribed for persons without delayed gastric emptying.

Patients and Method
This cross-sectional study was conducted at Ain Shams University Hospitals. Using ultrasonography, gastric contents was evaluated in 85 patients, with delayed gastric emptying, scheduled for elective surgeries before induction of anesthesia.

Results
Our study involved 85 patients, with age ranging from 25-66 years old, 49 of them were females and 36 were males, with BMI ranging from 28-35 Kg/m2.The most common surgeries involved were general surgeries especially laparoscopic cholecystectomy, with associated comorbidities such as diabetes, hypertension, smoking, hypothyroid, chronic kidney disease, rheumatoid arthritis. Ultrasonography showed that 46 of patients were Grade 0 with stomach empty in both supine and right lateral decubitus (RLD) and 36 were Grade 1 with stomach empty in supine but contains fluid in RLD and 3 patients in Grade 2 were stomach contains fluid in both supine and RLD or contains solid content.

Conclusion
Bedside ultrasound is of a good value in estimating the gastric volume and content in patients with delayed gastric emptying.