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Journal of the Medical Research Institute Journal of the Medical Research
Number of Followers: 12  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1110-0133 - ISSN (Online) 2682-2547
Published by Alexandria University Homepage  [2 journals]
  • Analgesic Requirements and Incidence of Neuropathic Pain after Erector
           Spinae Plane Block in ...

    • Abstract: Background: Multimodal analgesia that includes pharmacotherapy and regional anesthetic techniques such as erector spinae plane block (ESPB), is recommended for the management of post-mastectomy pain Methods: A retrospective analysis of 75 patients’ records who had modified unilateral radical mastectomy where the initial anesthetic plan was ESPB with general anesthesia were reviewed. According to the patient's position during the ESPB, they were assigned into three groups: Group I (sitting position), Group II (lateral decubitus), and Group III (prone position). The endpoints were the dermatomal sensory block, visual analog scale (VAS) for pain, the time to the first request for postoperative analgesia, opioid consumption, neuropathic pain & complications, and anesthesiologist satisfaction. Results: More sensory block coverage was detected in the mid-axillary and mid-clavicular lines in group I compared with groups II and III (p-value < 0.001). The VAS for pain did not differ significantly among the studied groups over 16 hours postoperatively. However, it decreased significantly in group I compared to the other groups at 20 and 24 hours postoperatively. The percentage of patients who requested morphine analgesia, the time for the first request of rescue opioid, and the total dose of analgesic requirements were comparable. There was insignificant variation regarding the anesthesiologist's satisfaction with the ease of the block and the incidence of neuropathic pain. Conclusion: ESPB in the sitting position resulted in more dermatomal sensory block and prolonged analgesia. However, compared to the prone or lateral positions, it did not significantly reduce analgesic requirement or the development of neuropathic pain.
      PubDate: Sat, 29 Jun 2024 21:00:00 +010
       
  • Analgesic Effect of Three Different Adjuvants to Bupivacaine in
           Transversus Abdominis Plane ...

    • Abstract: • Background: A vital component of enhanced recovery programs is optimal pain management after cesarean section (CS). Transversus abdominis plane block (TAPB) is recommended to reduce post-CS pain. • Methods: The study evaluated three different adjuvants to bupivacaine in TAPB after CS. The primary endpoint was the time to first rescue analgesia. The secondary endpoints were the visual analog scale (VAS) for pain, the total opioid consumption, the post-operative vital signs, and patient satisfaction with analgesia. The patients were assigned to four groups regarding the additives to bupivacaine (dexamethasone, Dexmedetomidine (DEX), tramadol, and control groups). The study included 240 patients planned for elective lower-segment CS underneath spinal anesthesia. After surgery, a bilateral posterior ultrasound-guided TAPB was performed. • Results: The first request for analgesia in dexamethasone group was delayed significantly compared to control group (p-value = 0.041). Still, it was statistically insignificant compared to the DEX and Tramadol groups. The opioid analgesic requirement in the dexamethasone group was reduced substantially in comparison to control group (p-value = 0.006). However, it was statistically insignificant compared to the DEX and Tramadol groups. The dexamethasone group had significantly lower VAS ratings from 8 to 24 hours than the other additives. However, VAS scores between 30 minutes and 4 hours and patient satisfaction with analgesia were comparable among groups. • Conclusion: adding dexamethasone, dexmedetomidine, or tramadol to TAPB improved postoperative analgesia without inciting severe adverse effects after CS. The dexamethasone significantly reduced the opioid analgesic requirements and prolonged analgesia for up to 24 hours.
      PubDate: Sat, 29 Jun 2024 21:00:00 +010
       
  • Effective Management of Acute Aluminum Phosphide Poisoning in Pregnancy: A
           Case Study of Dual ...

    • Abstract: Aluminum phosphide (AlP) poisoning is a significant public health concern, particularly in developing countries where it is easily accessible. This case report discusses the successful management of acute AlP poisoning in a pregnant woman at 28 weeks gestation. Initially presenting with vomiting and abdominal pain and discomfort, the patient remained stable throughout. Metabolic acidosis, identified through arterial blood gas analysis, prompted bicarbonate administration. The application of dual therapy with N-acetylcysteine (NAC) and Coenzyme Q10 (CoQ10) effectively countered oxidative stress, contributing to the patient's stabilization. Collaborative interdisciplinary care played a crucial role in ensuring the well-being of both the mother and fetus, ultimately resulting in a favorable outcome upon discharge. This case highlights the effectiveness of therapeutic interventions and underscores the pivotal importance of interdisciplinary cooperation in managing acute AlP poisoning. Such instances reinforce the significance of a rapid and coordinated response to mitigate the potentially fatal consequences of poisoning incidents.
      PubDate: Fri, 31 May 2024 21:00:00 +010
       
  • The possible association between Helicobacter Pylori Infection and the
           severity of rheumatoid ...

    • Abstract: The possible association between Helicobacter Pylori Infection and the severity of rheumatoid arthritis in Egyptian patients Abstract Background: The etiology of the autoimmune diseases is not clear, but some contributing elements may activate its evolution in hereditary susceptible person, like some viral or bacterial infection or chemical exposure. Helicobacter pylori is a Gram-negative organism that affects mostly people in developing countries (80%) and a percentage of people in developed countries (50 %). This organism as a chronic infection can induce a state of chronic inflammation that may trigger the appearance of autoimmune diseases or aggravates their clinical course. One of the most common autoimmune disorders is rheumatoid arthritis that is thought to be initiated or aggravated by chronic infection. In the present study, the relation between rheumatoid arthritis and Helicobacter pylori infection will be examined. Aim: Compare the progression of rheumatoid arthritis in patients with and without infection with Helicobacter pylori. Patients &Methods: 50 rheumatoid arthritis patients were confirmed to have positive serum IgG antibodies to Helicobacter pylori, provided that no past history of previous infection or previous treatment of Helicobacter pylori. All patients were assessed for the severity of rheumatoid arthritis through the estimation of their ESR and CRP levels and by using the DAS 28/ESR score. Results: No significant effect of infection with H pylori on ESR, CRP, or DAS28/ESR. Conclusion: Assessment parameters of rheumatoid arthritis activity and severity were not affected by the existence of H pylori infection. Keywords: Autoimmunity, Rheumatoid arthritis, Inflammation, Helicobacter pylori, infection.
      PubDate: Fri, 31 May 2024 21:00:00 +010
       
 
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