bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Lung Ultrasound in the Diagnosis of Weaning-Induced Pulmonary Oedema in Mechanically Ventilated Patients
Authors: Akl Diaa Abd El-khalek , Hosny Mona Refaat , El-hak Ahmed Abd El-dayem Abd , Abd El-Gileel Mohammed Atef Mohammed 
Published: August 2023

Abstract

Background
Studies dealing with the use of lung ultrasound in the context of weaning have rather calculated lung ultrasound scores with aeration loss (without specifically addressing the issue of weaning induced pulmonary oedema “WIPO”) or assessed post-extubation distress. Our study specifically focuses on WIPO. Advantages of lung ultrasound for diagnosing WIPO are numerous. It provides a non-invasive and direct assessment of lung water accumulation by detecting lung interstitial syndrome (the first stage of haemodynamic pulmonary oedema), lung ultrasound is easier to learn and perform compared to Doppler echocardiography and the acquisition and analysis can be performed within 2 min.

Objective
To test the ideal profile (increase in the number of B-lines) for diagnosing WIPO using lung ultrasound to avoid the poor outcome of weaning failure.

Patients and Methods
This study was performed in intensive care units of Ain Shams University hospitals between October 2020 and March 2021. This study was carried out on 51 patients, the final outcome divided this group into three subgroups, successful group include 28 patients (54.9%), failed group without WIPO include 10 patients (19.6%) and failed group with WIPO include 13 patients (25.5%).

Results
The sensitivity of B-line in predict the successful weaning was 95.0, while the specificity was 90.0% and the accuracy was 92.0% at cut off value 5.0. The sensitivity of B-line in predict the WIPO was 90.0, while the specificity was 84.0% and the accuracy was 87.0% at cut off value 5.5.

Conclusion
From the results of this study it was concluded that an increase in the number of Blines ≥ 5 on four anterior points during SBT provided the best accuracy for diagnosing WIPO with lung ultrasound. We suggest calling this sign the WIPO profile. These encouraging results must be confirmed by larger series, so that LUCI may empower the non-invasive monitoring tools, including biochemical indices, for the diagnosis of this common problem.
The Predictive Value of Urinary Trypsinogen-2 Dipstick for Early Diagnosis of Acute Pancreatitis in Intensive Care
Authors: Zaki Mohamed S , Ali Rania M , EL-Naggar Dalia I , Ammar Mohamed M 
Published: August 2023

Abstract

Background
Acute pancreatitis is a sudden inflammation in the pancreas, with potential and variable involvement of adjacent organs or other organ systems.

Aim of the Work
to evaluate the rule of urinary trypsinogen-2 using dipstick test in the diagnosis of acute pancreatitis.

Patients and Methods
This cross-sectional study was carried out in surgical intensive care unit, Ain Shams University hospitals, during a period of 6 months. Forty five patients were included in our study, thirty patients were diagnosed as acute pancreatitis and fifteen patients weren’t diagnosed as acute pancreatitis through cross sectional study. All patients were subjected to full history taking, full clinical examination, laboratory investigations including serum levels of renal function tests, CBC, total and direct bilirubin, liver enzymes, alkaline phosphatase, INR, amylase and lipase. Urinary trypsinogen-2 dipstick test was done. Also, radiological examinations were done using ultrasonography of abdomen and pelvis, computed tomography of the abdomen.

Results
The most common cause of acute pancreatitis was gall stone obstructive pancreatitis (70%) and we found that serum amylase and lipase were elevated in (83.3% and 86.7% respectively) in acute pancreatitis patients. While the sensitivity of urinary trypsinogen-2 dipstick test was 93.3% in acute pancreatitis patients. The specificity of serum amylase, serum lipase was 73.3% for both of them, while the specificity of urinary trypsinogen-2 was 100% in diagnosis of acute pancreatitis.

Conclusion
In-conclusion urinary trypsinogen-2 dipstick test is a promising low cost, bed side and easy test to be done in the diagnosis of acute pancreatitis.
Effect of Platelet Rich Plasma Therapy for Shoulder Osteoarthritis: Double Blinded Randomized Controlled Study
Authors: Elfatah Amr Mohammed Abd , Taeimah Mohamed Osman , Hasan Marwa Mostafa , Ismael Mohammed Salah Abd Allah 
Published: August 2023

Abstract

Background
Platelet-rich plasma (PRP) is widely used in musculoskeletal conditions and orthopaedic surgery ranging from clinic-based injections for tendinopathies to intra-operative application to augment soft-tissue healing. It has been used in knee osteoarthritis, rotator cuff tears, elbow epicondylitis, anterior cruciate ligament reconstruction, shoulder impingement syndrome and various tendinopathies to date, with an expanding list of indications. While available evidence supports the use of PRP in the management of lateral epicondylitis and knee osteoarthritis, there is limited clinically significant evidence for other indications

Aim of the Work
This study aims to evaluate the efficacy of platelet-rich plasma as a treatment for primary and secondary shoulder osteoarthritis pain.

Patients and Methods
A prospective, double-blinded randomized control study in Ain Shams University Hospitals from 3 to 6 months. The patients were divided into 2 groups using computerized generated randomization. The control group received 5 ml 0.9% saline injection in the intra-articular shoulder (between glenohumeral joint). The study group received 5 ml of PRP treatment.

Results
The study results showed: All demographic data (age, sex, weight and BMI) and chronic diseases were insignificantly different between both groups, all medical data (chronic diseases, type of osteoarthritis, severity of symptoms, time of symptoms, radiological finding and type of treatment) were insignificantly different between both groups, NRS was significantly lower in study group compared to control group at ―2nd evaluation post injection|| and was insignificantly different between both groups at ―1st evaluation post injection||. (P &lt; 0.05), range of movement was insignificantly different between both groups at 2nd evaluation post injection and injection related complications (inflammation and infection) were insignificantly different between both groups.

Conclusion
In general, efficacy was observed in treatment with PRP alone in shoulder osteoarthritis. However, patients receiving PRP treatment are less likely to experience post-injection pain and are more likely to recover faster when compared to patients receiving saline alone.
Ultrasound Guided Pectoral Nerve Block (PEC I) versus Serratus Anterior Plane block (SAPB) for Postoperative Analgesia in Modified Radical Mastectomy
Authors: Fawzy Hazem Mohamed , Shoukry Randa Ali , Elmaksoud Eman Shawky Abd , Mohamed Nada Ezzat Hussein 
Published: August 2023

Abstract

Background
Breast cancer is the most common cancer in women both in the developed and less developed world. In 2012, it represented about 12 percent of all new cancer cases and 25 percent of all cancers in women. A procedure called Modified radical mastectomy is now a standard surgical treatment for early stage breast cancers. These procedures cause significant acute pain and may progress to chronic pain states in 25–60% of cases. Though various risk factors have been suggested, inappropriate acute postoperative pain management has been associated with the development of chronic postmastectomy pain, a complex post-surgical pain syndrome that may occur following any type of breast surgery.

Objective
To evaluate the effectiveness of ultrasound guided pectoral nerve block (PEC1) versus Serratus Anterior plane block (SAPB) for postoperative Analgesia in modified radical mastectomy

Methods
This is Randomized controlled double blind clinical trial was conducted in the operating theatres of Ain Shams University Hospitals for 6 months after approval of ethical committee of faculty of medicine, Ain Shams Univeristy on 64 female patients undergoing Modified Radical Mastectomy divided randomly into two groups, each group consisted of 32 patients group I in which patients received PEC 1 and group II in which patients received Serratus Anterior Plane Block (SAPB).

Results
There was a statistically significant decrease mean of group II compared to group I according to postoperative systolic blood pressure (mmHg) from 1 hr. to 6 hrs. While there was no statistically significant difference between groups according to postoperative diastolic blood pressure (mmHg). However, a statistically significant decrease mean of group II compared to group I according to postoperative heart rate (beat/min) from 1 hr. to 6 hrs was found. A statistically significant decrease mean of group II compared to group I according to numeric rating score for pain from 1 hr to after 6 hrs also was found. The current study shows highly statistically significant difference between groups according to time of first analgesia (hour), number of patients who received postoperative Diclofenac 75 mg and total consumption of Diclofenac 75 mg.

Conclusion
SAPB was effective in reducing postoperative pain scores for 6 -12 hours and lower total 24-h postoperative opioid and analgesic consumption after modified radical mastectomy under general anesthesia, compared to PEC 1 block.
Dexmedetomidine versus Fentanyl as Adjuvant to Propofol Total Intravenous Anesthesia during Endoscopic Retrograde Cholangial-Pancreatography Procedure
Authors: Reyad Mostafa Kamel , Anis Sherif George , Mahran Mostafa Gamaledin , Aguer Nyanriak Thon 
Published: August 2023

Abstract

Background
Various types of sedation and analgesia technique have been used during endoscopy procedures. Providing an adequate regimen of sedation/analgesia might be considered an art, influencing several aspects of endoscopic procedures: the quality of examination, the patient’s cooperation and the patient and physician’s satisfaction with sedation

Objective
To compare the effects of Dexmedetomidine/Propofol and Fentanyl/Propofol combination for conscious sedation in patients undergoing ERCP regarding hemodynamic changes, patients and endoscopists satisfaction.

Patients and Methods
Ninety four (94) ages 18-70 ASA ı-ıı were enrolled in this study. Patients were allocated randomly into two equal groups D/P and F/P groups. Patients received either Fentanyl 1 µg/kg or Dexmedetomidine 1 µg/kg for 10 min, followed by maintenance dose 0.2 µg to 0.5 µg/kg/min. combined with propofol 1 mg/kg IV and maintenance 3 mg/kg/h regimen. With requiring additional dose if sedation level did not reached. Conduct open airway technique was used while applying o through nasal cannula 3 L/min. (MAP, HR and SPO) were recorded before and after sedation procedures then every 10 min. till the end of procedure, recovery time, postoperative complications, patients and endoscopists were recorded.

Results
the intra procedure HR, and BP showed statistical significant differences between both groups throughout the procedure with lower value in group D/P (p = 0.042) while there were no statistical significance differences regarding MAP and SPO. During postoperative procedure BP and MAP was statistical significant lower in D/P group (p = 0.015). Post procedure recovery time was shorter in group D/P (p = 0.049), regarding PONV was higher in D/P compared to F/P (p = 0.03), both group were statistical significant satisfied.

Conclusion
In our study we concluded that Dexmedetomidine/ Propofol combination provided adequate sedation with hemodynamic and respiratory stability with accepted few side effects and a good satisfication scores for patients and endoscopists. It was a good competitive to standard sedative as Fentanyl/Propofol in moderate sedation during ERCP.
A Comparison between Intravenous Ketamine and Magnesium Sulphate for Prevention of Intraoperative Shivering in Patients Undergoing Spinal Anesthesia
Authors: Kamaly Ayman Mokhtar , Wahba Rami Mounir , Fathy Galal Reham , Mahomud Omar Ahmed Sameh 
Published: August 2023

Abstract

Background
Post-anesthetic shivering is a frequent complication of spinal and epidural anesthesia causing many complications intra and post operatively. This randomized controlled study aimed to compare Ketamine versus Magnesium sulphate in prevention of intraoperative shivering after spinal anesthesia.

Aim of Work
To compare the efficacy and safety of low doses of ketamine versus magnesium sulphate as preventive agents of shivering in patients undergoing spinal anesthesia for surgery.

Patients and Methods
The current randomized double-blinded clinical trial was conducted in Ain Shams university hospitals. It included 75 patients who underwent diabetic foot debridement surgeries under spinal anesthesia and met the selection criteria. After intrathecal injection, the patients were classified into three groups: Group K who received ketamine 0,5 mg/kg. diluted in a 100 ml of normal saline and given over 15 minutes, prophylactically. Group M received Magnesium sulphate 30 mg/kg. diluted in a 100 ml of normal saline and given over 15 minutes prophylactically. Group P received a 100 ml bolus of physiological solution given over 15 minutes.

Results
Both Ketamine and Magnesium sulphate showed better results in the control of shivering than the control group (p = 0.035), reduced requirement of pethidine (p = 0.022) and both showed significant effect in delaying the onset of shivering (p = 0.001). The ketamine group had less incidence of shivering, more delayed onset and lesser dose of pethidine required than the Magnesium group but not enough to be statistically significant.
Ketamine also showed less incidence of hypotension following spinal anesthesia (p = 0.03) but much more incidence of heavy sedation and hallucinations (p = 0.000)

Conclusion
Both ketamine and Magnesium sulphate are effective agents in controlling shivering after spinal anesthesia. They reduce the incidence of shivering, delay the onset of shivering if it occurs and reduces the required dose of pethidine to resolve shivering with minimal side effects. Ketamine has a probable protective effect against hypotension after spinal anesthesia.
A Comparative Study between Dexmedetomidine and Dexamethasone as Adjuvants to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block in Upper Limb Surgeries
Authors: shoqier Mohamed Hossam , El Agamy Ashraf El Sayed , Selima Wessam Zaher , Mohamed Omar Medhat 
Published: August 2023

Abstract

Background
Brachial plexus blocks are among the most commonly performed peripheral nerve blocks for upper extremity surgeries in clinical practice. It offers many advantages over general anaesthesia for upper limb surgeries such as sympathetic block, better postoperative analgesia, high success rate and fewer side effects.

Objective
To compare the efficacy of bupivacaine plus dexamethasone versus bupivacaine plus dexmedetomidine as adjuvants on the block characteristics including: onset and duration of sensory and motor blockade, duration of postoperative analgesia, the first analgesic request time, adverse effect and hemodynamic parameters of patients.

Patients and Methods
After obtaining approval from the medical ethical committee in El Demerdash Ain Shams University Hospital, this study was conducted in El Demerdash Ain Shams University Hospital. It included patients scheduled for elective upper limb orthopedic and plastic surgery. A written informed consent was obtained from every patient after explaining the procedure.

Results
Regarding demographic data and operative characteristics there were no statistically significant difference between the two groups. The current study showed that the addition of dexmedetomidine to bupivacaine for supraclavicular brachial plexus block leads to prolongation of motor and sensory block duration, prolongation of duration of analgesia and decrease in total 24 hrs analgesia in comparative to dexamethasone.

Conclusion
Regarding comparison between dexmedetomidine and dexamethasone as an additive to bupivacaine in ultrasound guided supraclavicular block, it could be concluded that the addition of dexmedetomidine to bupivacaine shortened the onset times of both sensory and motor blocks, significantly prolonged their durations and prolonged the analgesia of brachial plexus block with subsequent consumption of less amounts of postoperative analgesics. Also the use of ultrasound guided technique decreased the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.
The Efficacy of Ultrasound Guided Bilateral Pectoralis Nerve Block for Postoperative Pain Control in Cardiac Surgery, Randomized Control Trial
Authors: Elshaer Ahmed Nagah , ElMalek Fady Adib Abd , Taher Islam Abdel-Aal Abdel-Mouty , Elhelaly Omar Ragaie Mohamed 
Published: August 2023

Abstract

Background
Cardiothoracic surgeries are associated with significant pain. Optimal analgesia is a vital part of enhanced recovery after surgery strategies intended to improve patients' perioperative experience and outcomes. Traditionally, analgesia in these types of surgeries has depended on large doses of I.V. opioids. This is particularly pertinent given the current focus on removing needless perioperative opioid administration, and thereby decreasing the potential for opioid side effects.

Aim of the Work
The aim of the study was to evaluate the effect of postoperative bilateral US guided Pecs block on postoperative pain control in patients undergoing cardiac surgery through mid-line sternotomy compared to systemic analgesia.

Patients and Methods
Approval was obtained from the research ethics committee of Faculty of Medicine; Ain Shams University and a written informed consent was taken from each patient to participate in the study, patients were randomly allocated into two groups with 15 patients in each group. Group 1 (control group) received systemic analgesics, whereas Group 2 (study group) received pecs block.

Results
Our study showed that when compared to general anesthesia with systemic opioids, PECs block is associated with significantly better postoperative pain control.

Conclusion
Pecs block is technically simple, safe and very effective technique and can be used as a part of multimodal analgesia in postoperative cardiac surgical patients for better patient comfort and satisfaction and also helps in superior pulmonary rehabilitation, thus assisting in better outcome and less unwanted side effects of systemic analgesics.
Evaluation of Ain Shams University Hospitals Clinical Pathway for Pulmonary Artery Banding
Authors: Samir Khaled Mohamed , Kamel Waleed Ismail , Abdelfattah Mohamed Adel , Salem Ahmed Hussein Afifi 
Published: August 2023

Abstract

Background
Pulmonary artery banding (PAB) remains a useful surgical palliation for small neonates and early infants with excessive pulmonary blood flow who are unable or difficult to withstand an open heart surgery using cardiopulmonary bypass or in developing countries where the facilities not suitable for primary corrective surgery in those infants.

Objectives
In our current study we aimed to study clinical pathway of cases underwent PAB at ASU hospital pediatric cardiac surgery department with discussion of different causes of mortality and morbidity.

Patients and Methods
Study done by data collection retrospectively of 50 patients underwent pulmonary artery banding in the period from January 2018 to December 2019 who fulfilling the inclusion criteria with evaluation of different clinical pathways for the outcome mainly morbidities and mortality.

Results
We found that the major risk factors of mortality in cases underwent PAB in ASU hospitals includes patients diagnosed with TGA, low preoperative so2 ≤85, ventilation is high risk factor for mortality so it is recommended to extubate those patients on table or shortly after discharge to ICU as soon as possible, duration of intubation: the longer the duration of intubation, the higher the mortality, postoperative PG across band ≤45.that indicator for a loose band with still persistent pulmonary overflow, re-intubation, post operative morbidities are highly associated with mortality, 11 out of 12 mortality cases suffered from postoperative complications (91.7 % of mortality cases) that includes poor chest condition, stroke, postoperative convulsions and pulmonary hemorrhage. These morbidities result in prolonged intubation and prolonged ICU stay.

Conclusion
Pulmonary artery banding is palliative procedure done in infants with pulmonary artery overflow with unprotected pulmonary circulation in variable congenital cardiac diseases (VSD, single ventricle, TGA) as a primary stage for total repair when the infant gain weight and get older, the suitable age for banding is &lt; 6 months.
Correlation of Serum Uric Acid Levels with Coronary Flow in Patients with STsegment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention
Authors: Sharafeldin Abdelrahman Ahmed Abdelrahman , Sallam Walid Mohamed , Hammady Walid Abdel Azim El 
Published: August 2023

Abstract

Background
Worldwide, ischemic heart disease is the single most common cause of death and its frequency is increasing. STEMI is a significant cause of morbidity and mortality in patients with coronary heart disease.

Aim of the Work
Our study aimed to assess the impact of Uric acid level prior to primary PCI in patients presenting with acute STEMI on myocardial perfusion.

Patients and Methods
This is an interventional randomized controlled clinical trial conducted the coronary care units and coronary catheterization lab unit of the cardiology department and ER in Ain Shams University Hospitals between January 2021 and June 2021. The study was conducted in Ain Shams University hospitals on 80 patients presented from 2020 till the end of June 2021 with ST segment elevation myocardial infarction and underwent primary PCI. They were divided into two groups. The first group was hyperuricemic while the second group had normal uric acid blood level. Both groups received the standard care for acute STEMI patients which is the primary percutaneous intervention in addition to medications.

Results
Results for age, gender, hypertension, smoking, family history dyslipidemia, and diabetes did not show any statistical significance of value between the cases and control groups. In the control group, there were 19 patients with TIMI flow less than III and MBG less than III. Meanwhile, in the cases group, there were 8 patients with TIMI flow less than III and 7 patients MBG less than III. This difference was statistically significant with a P-value of 0.010 regarding TIMI flow score while a highly significant statistical difference of P-value 0.003 regarding MBG.

Conclusion
Our study concluded that normal uric acid level before primary PCI is associated with improved post-procedural TIMI flow and MBG.