COVID-19 booster vaccination and dialysis patients
If you do not work in renal medicine you may not have realized that dialysis patients given the COVID-19 vaccine, demonstrate significantly lower antibody response compared to healthy controls. National strategies for Booster COVID-19 vaccines range from targeting vulnerable patient populations, to broadening out to healthcare workers or as in Israel, targeting the whole adult population. We welcome the Commentary piece by Dr Yen and colleagues from Chang Gung University in Taiwan who highlight the importance of dialysis patients receiving the booster vaccine. They summarize our current knowledge and draw our attention to ...
Source: QJM - November 5, 2021 Category: Internal Medicine Source Type: research

Corrigendum
In the originally published versions of the below listed manuscripts, author O M P Jolobe ’s corresponding address should read: “Oscar M P Jolobe MRCP(UK), Flat 6 Souchay Court, 1 Clothorn Road. Manchester, M20 6BR” instead of “From the Medical Division, Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL”. (Source: QJM)
Source: QJM - November 5, 2021 Category: Internal Medicine Source Type: research

Would Louis Pasteur be accepted for medical school entry today?
As a consequence of increasing pressures on our medical schools —has our entry selection processes become more rigid and formulaic with the significant risk that we fail to reward the lateral thinkers and those with an innovatory spirit? (Source: QJM)
Source: QJM - October 4, 2021 Category: Internal Medicine Source Type: research

Comparative Study between the Effect of Ultrasound Guided Pectoral Nerve Block (PEC 1) versus Serratus Anterior Plane Block (SAPB) For Postoperative Analgesia in Modified Radical Mastectomy
ConclusionSAPB 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. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Comparison between Nalbuphine and Ketamine as an adjuvant to Heavy Bupivacaine on Post Dural Puncture Headache
ConclusionAdding nalbuphine, and not ketamine, with hyperbaric bupivacaine in spinal anesthesia decreased incidence of post dural puncture headache, and prolonged the duration of sensory block. Both groups provided adequate anesthesia and analgesia with good hemodynamic stability. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

A Comparative Study between Intrathecal Fentanyl and Dexmedetomidine as Adjuvants to Hyperbaric Levobupivacaine 0.5% in Patients Undergoing Infra Umbilical Surgeries
ConclusionFrom the current study we can conclude that using intrathecal 5 µg dexmedetomidine seems to be a suitable alternative to 25 µg fentanyl as adjuvants to 0.5% hyperbaric levobupivacaine in spinal anaesthesia. Its associated with prolonged motor and sensory block and provides good quality of intraoperative analgesia and extended duration of post operative analges ia as compared to fentanyl. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Effects of Delayed Supine Positioning after Induction of Subarachnoid Block on Post-spinal Hemodynamic Changes Compared to Traditional Subarachnoid Block: prospective observational randomized controlled dose response clinical study
ConclusionUnder the conditions of this study delayed supine positioning after induction of SAB for 2.5  minutes is of great value in gaining an adequate level of anesthesia with more hemodynamic stability and less vasopressor need as a management of hypotension compared to the conventional SAB in Knee Arthroscope surgery. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Post Stroke Hyperglycemia as a marker of Stroke Severity and Prognosis: A cohort study
ConclusionFrom our study we can conclude that diabetes mellitus as a risk factor in cases of stroke leads to increase complications and worsens the outcome in cases of stroke whether hemorrhagic or ischemic.RecommendationsFrom our study we recommended strict control of diabetes mellitus when present in cases of stroke to avoid bad outcome and to prevent complications in these cases. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Evaluation of the effect of diastolic function on prognosis of patient with septic shock
ConclusionWe recommend assessment of patients admitted to the ICU with septic shock via echocardiography to determine the grade of diastolic dysfunction and using diastolic dysfunction as a predictive risk factor in various score assessment of ICU patients. Our study was limited by decreased sample size and we recommend further studies with increased sample size.. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Hypophosphatemia and weaning of Mechanically Ventilated patients with Chronic Obstructive Pulmonary Disease during acute exacerbations
ConclusionIn the light of the previous results Hypophosphatemia (1.5 - 2.5  mg/dL) was associated with poor prognosis in terms of longer durations of mechanical ventilations and higher ICU mortality rates in mechanically ventilated patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), Hypophosphatemia should be included in initial assessmen t of such patients to stratify them. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Pleural Ultrasonography versus Chest Radiography for the Diagnosis of Pneumothorax
ConclusionsIn conclusion, US represent a good approach for the evaluation of PTX, with advantages of timeliness, high accuracy and high reliability. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Effect of Usage of the Proton Pump Inhibitor Omeprazole on the Structure of the Kidney of Male Albino Rats
ConclusionThe present study declared that long term use of omeprazole resulted in structural damage of rat renal tissue with associated deterioration of renal function in a time dependent manner.Extreme caution should be taken with clinical prescription of omeprazole and close monitoring of renal function is highly recommended. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Incidence and Association of Patient Safety Indicator 9 (Perioperative hemorrhage or hematoma) and clinical outcomes in Cardio-thoracic surgery hospital, Ain Shams University, Egypt
Conclusionhigh incidence rate of PSI9 and the incidence is higher in male gender and 60 years old and more patients. Those patients developed PSI9 were at high risk for readmission and death.Recommendationsthe hospital administration should consider strategies and policies to decrease the rate of PSI9 and subsequent unfavorable clinical outcomes. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Effect of Weight Loss Program on Anthropometric and Laboratory Measurements among Adult Obese Females: An Intervention Study
Conclusion and Recommendation: Prevention of obesity should be a high priority in public health, with particular emphasis on encouraging healthy lifestyles in all age groups, starting from early childhood. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Participation and Satisfaction with the National Campaign on Viral Hepatitis C and Non-Communicable Diseases among Administrative Workers of Ain Shams University, Cairo, Egypt
ConclusionsMost of the study group participated in the initiative 100 Million Seha and were satisfied with the service provided. Mass media played the most important role in awareness with the campaign. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Work Related Stress and its Effect on Mental Health among employees of Ain Shams University Hospitals
ConclusionThis study revealed a high level of workrelated stress among hospital employee who are not involved in patient ’s care with around fifth of them suffered severe levels of mental ill-health. Occupational stress resulted mainly from inadequate control over work duties and unpleasant or unsafe work conditions. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Awareness about the New Social Health Insurance System, among Physicians in Primary Health Care Centers in Cairo governorate, and Factors Affecting it
ConclusionThe study concluded that the level of awareness about the SHI among the studied sample of the PHCCs physicians at Cairo governorate was averaged. Recommendation: Efforts should be enhanced for reaching out to the physicians in PHCCs, including those working in governorates where implementation of SHI system hasn ’t commenced yet, especially to emphasize their understanding of the objectives and elements of the new system. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Assessment of Food Services Pre-requisite Program in a Tertiary Hospital in Egypt
ConclusionsThe present study showed that the necessary founding element of any food safety program, comprising the policies, operating procedures and similar organizing documents which was deficient in the studied hospital. Similarly, implementation of the basic required sanitation aspects in food handling was almost half applied. Reconsideration of basic underlying system for food services is mandated in our hospital. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Work Related Stress, Anxiety and Depression among School Teachers in general education
ConclusionDrawn from this study is that the degree of work related stress, anxiety and depression among teachers in governmental schools in kobri el koba district is considerably high. This indicates that we are in need to do Further studies on teachers for better assessment of the epidemiology of work related stress, anxiety and depression and the risk factors also Intervention studies are highly recommended as the prevelance of stress, anxiety and depression in the present study is almost 100% which is considered extremely high and in need to urgent intervention,Authorities should be informed about the results and should...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Reporting Medication Errors and Drug Therapy Problems Through the Egyptian National Electronic Reporting System in 56 Governmental Hospitals during 2019
ConclusionMedication errors in drug dosing are prevalent in the hospitals included in this study. Also, drugs that are prescribed without need, while errors in antibiotics were very common in many hospitals either prescribed for no need or selected inappropriately. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Health Risks of Low Dose Of Ionizing Radiation Among Health Care Providers at ain Shams University Hospitals
ConclusionExposure to IR -even in small dose- may lead to significant health complains (adverse health effects), increase oxidative stress status and may affect general health status among exposed group compared to the non-exposed one.RecommendationsPersonal monitoring for ionizing radiation, periodic medical examination, and increasing level of protection for exposed workers are of utmost importance. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Comparative study between the effect of mesenchymal stem cells and/or platelet-rich plasma on bone parameters in ovariectomized mature rats
ConclusionBM-MSCs together with PRP can partially reverse OVX-induced bone loss and halt osteoporosis progression.AbbreviationsBM-MSCs: bone marrow derived mesenchymal stem cells, PRP: platelet-rich plasma, OVX: ovariectomized, ALK: alkaline phosphatase, CTX-1: cross linked c telopeptide of type 1 collagen, MDA: malondialdehyde, TNF- α: tumour necrosis factor-alpha. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Possible Protective Effects of Stem Cells Treatment on Ischemic/Reperfused Hearts in Hypertensive Rats Model
ConclusionSingle injection of BM-MScs exerted anti-hypertensive and anti-hypertrophic effects, reduced systolic and diastolic dysfunction after ischemia reperfusion injury and improved coronary flow in hypertensive rats, through homing into aortic tissues mitigating endothelial dysfunction and exerting angiogenic effects and homing into cardiac tissues exerting anti-oxidant, anti-inflammatory and anti-apoptotic effects. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

The Potential protective role of astaxanthin on doxorubicin-induced cardiac toxicity in rats
ConclusionDoxorubicin produces acute cardiotoxic effects and impairs systolic and diastolic cardiac functions, which is due to increased oxidative stress, mitochondrial instability and iron accumulation in the cardiac tissue. Astaxanthin exerts a major cardioprotective activities against DOXinduced cardiotoxicity, probably due to its major antioxidant and iron chelation properties. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

The Possible Protective Effect of Selenium on Liver Dysfunction in a Rat Model of Extrahepatic Cholestasis
ConclusionSelenium supplementation reduces liver injury and improves liver functions in experimental cholestasis probably by its antioxidant and anti-inflammatory activities, which further alleviate the liver fibrosis.AbbreviationsBDL: bile duct ligated group, BDL-Se: bile duct ligated-selenium group, MDA: malondialdehyde, TNF- α: tumour necrosis factor-alpha, TGF-β1: transforming growth factor- beta1, ROS: reactive oxygen species, mRNA: messenger RNA, IL-6: interleukin-6, BW: body weight, AST: aspartate aminotransferase, ALT: alanine aminotransferase, ALP: alkaline phosphatase, TP: total proteins, CCl4: carbon ...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Possible Cardio-protective Effect of Olive Oil in Experimentally Induced Hyperthyroidism in Rats
ConclusionOlive oil was able to impose partial improvement on cardiac systolic function at baseline condition, also, in response to the beta adrenergic agonist, isoproterenol, even though this improvement did not reach control levels. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Low level Laser Therapy versus Ultrasonic therapy for the Treatment of Shoulder Impingement Syndrome A Systematic Review of randomized controlled trials
AbstractBackgroundShoulder impingement syndrome is a common cause of shoulder pain in primary health care settings. Many physical modalities of treatment are available in clinical practice, however there is insufficient evidence on their relative effectiveness. This review compares the effectiveness of Low Level Laser Therapy (LLLT) with ultrasonic therapy.ObjectivesTo assess the effectiveness of LLLT vs. ultrasonic therapy in patients with subacromial impingement syndromeSearch methodsWe searched Cochrane Central Register of Controlled Trials (CENTRAL) on the Cochrane Library, MEDLINE (Pubmed), Embase, Scopus. We searched...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Evaluation of the efficacy and safety of different dilutions of Mesobotox in Mid and / or lower face rejuvenation: Interventional study
AbstractAs life expectancy has prolonged nowadays, interest has increased to change patterns of life, which include improving the consequences of skin ageing through slowing the ageing process. There are two main processes of skin ageing either intrinsic or extrinsic. Intrinsic ageing reflects genetic background in which skin appears thin with exaggerated expression lines. However, extrinsic ageing is caused by external factors such as smoking, excessive use of alcohol, poor nutrition and sun exposure. Extrinsically aged skin appears predominantly not only by wrinkles, but also by pigmented lesions such as freckles, lentig...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Epidemiological and Biochemical Factors (Serum Ferritin and Vitamin D) Associated with Premature Graying Of Hair
AbstractBackgroundPremature graying of hair (PHG) is defined as graying of hair before the age of 20 years in Caucasians and before 30 years in Blacks. Several factors contribute to development of hair graying as genetics, environmental factors, life style and stressful events. Also, many biological markers were associated with development of hair graying as vitamin D, ferritin, vitamin B12 and many other electrolytes as calcium and magnesium.Aim of the studyassess various epidemiological factors and biochemical variables (serum ferritin and vitamin D) associated with premature graying of hair.Patients and methodsThe curre...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Evaluation of Serum Fetuin A in Psoriatic Patients and Its Correlation to Coronary Artery Disease
AbstractBackgroundPsoriasis is a chronic, immune-mediated, inflammatory disease of the skin. It is a multifactorial disease with genetic background triggered by environmental factors and immunological mediators. Fetuin A is considered as a marker to detect cardiac risk.Aim of the workto evaluate Fetuin A level in psoriatic patients and its correlation to coronary artery calcification and cardiovascular risks.MethodsThis is a case control comparative study was conducted at Dermatology outpatient clinic, during the period from January 2019 to November 2019. The Forty eight patients who were recruited in this study were class...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Diagnostic Value of Video-Dermatoscopy in Patients with Systemic Sclerosis and Dermatomyositis with its relation to Serum Vascular Endothelial Growth Factor (S.VEGF)
ConclusionMicrovascular abnormalities are the earliest features of SSc and DM with elevation of serum VEGF level indicating its role in disease pathogenesis and disturbance of microvessls. Videodermoscopy and measurement of serum VEGF are effective tools in diagnosis, prognosis and grading of autoimmune connective tissue diseases as SSc and DM. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Identification of Malassezia Species in Seborrheic Dermatitis Patients by CHROM Agar-Medium
ConclusionThe distribution of Malassezia spp. on healthy and diseased skin shows significant variation and differences, although our knowledge of Malassezia yeasts has increased tremendously during the last two decades, their pathological roles remain ambiguous, and there is currently no conclusive evidence that any given species is responsible for a specific disease. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Prevalence of Metabolic Syndrome in Men with Erectile Dysfunction
ConclusionAmong the 200 patients, 96 (48%) patients had MetS. Incidence of moderate to severe ED was higher among patients with MetS versus those without. There was a negative significant correlation between IIEF scores and age, systolic BP, and diastolic BP. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Fractional carbon dioxide laser, platelet –rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (A prospective randomized comparative trial)
This study aimed to evaluate and compare the efficacy and safety of Fr: CO2 laser, PRP, combined Fr: CO2 laser and PRP, combined Fr: CO2 laser and NB-UVB, combined Fr: CO2 laser, PRP and NB-UVB in the treatment of vitiligo as well as reporting the side effects.Patients and methodsThis study included 20 vitiligo patients with at least 6 patches of stable vitiligo (120 patches), the patches were divided into six groups according to the treatment modality. Assessment of treatment response was done through patient satisfaction score and Vitiligo analysis by computer-assisted grid (VACAG).ResultsRegarding surface area reduction...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Efficacy and Tolerability of N-Acetyl-Cysteine for Treatment of The Early-onset Androgenetic Alopecia in Men
ConclusionOn the basis of the findings of current study we can conclude that, the role of trichoscopy in increasing the accuracy for diagnosing hair disorders as well as to detect response or failure to treatment, N-acetylcysteine (NAC) improved significantly most of the trichoscopic features of AGA and it was was generally tolerable and the side effects encountered did not necessitate stoppage of the treatment course. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

The Role of Cardiac Magnetic Resonance in Assessment of Myocardial Contractile Function After Exercise Training Based Cardiac Rehabilitation Program in Anterior ST-Elevated Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention
AbstractBack groundRegular exercise training program has been shown to reduce mortality, improve functional capacity and control risk factors in myocardial infarcted patients. Wall motion score index (WMSI) is a strong independent mortality predicator in patient with previous MIAIMThe main objective of this study was to investigate the impact of exercise training on regional left ventricular systolic function, in patients post anterior myocardial infarction. using cardiac magnetic resonance imagingMethodsWe recruited twenty-six adult patients on optimal medical therapy one month after an anterior myocardial infarction unde...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Assessment of Longitudinal Left Ventricular Function in Patients with Coronary Artery Ectasia by 2D Speckle Tracking Echocardiography
ConclusionIn our study, we have concluded that global peak longitudinal strain was significantly impaired in patients with coronary artery ectasia without significant coronary artery lesion denoting subclinical LV systolic dysfunction .LV diastolic dysfunction was more prevalent in coronary artery ectasia patients compared to control subjects. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Role of Colchicine in Prevention of Contrast Induced Nephropathy in Patient Undergoing Primary Percutaneous Coronary Intervention
ConclusionThere was a trend towards lower incidence of CIN in patients undergoing primary PCI receiving colchicine, although not statistically significant. However, this trend became significant when studied in diabetic subgroup. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Serum Leptin In Ischemic Heart Disease Patients With And Without Significant Diastolic Dysfunction In Lean And Obese Patients; Cross Sectional Study
AbstractBackgroundCardiovascular diseases represent the leading cause of mortality worldwide. Ischemic heart disease is one of the main causes of diastolic heart failure and its presence predicts a poor prognosis in ischemic heart patients. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as overweight and obesity. Leptin –also known as satiety hormone- helps in inhibiting hunger and regulate energy balance(1).Objectiveto correlate leptin level with ischemic heart disease with or without diastolic dysfunction by comparing it in lean and obese patients.Material and Methodsfrom J...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Prevalence of Left Ventricular Diastolic Dysfunction by Tissue Doppler Imaging in Patients with End Stage Renal Disease undergoing Regular Dialysis with Preserved Systolic Function
AbstractBackgroundLeft ventricular hypertrophy (LVH) is the principal myocardial alteration in patients with ESRD due to multiple preload and afterload factors related to hemodialysis leading to left ventricular diastolic dysfunction manifested by signs and symptoms of heart failure with preserved ejection fraction (HFpEF). The use of echocardiography and tissue Doppler imaging is essential to detect diastolic dysfunction in ESRD patients undergoing hemodialysis as the prevalence of diagnosing HFpEF in ESRD patients is under-estimated.ObjectiveTo evaluate the possible impact of renal replacement therapy in the form of regu...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

The Added Value of ST-Elevation in Lead aVR to Clinical TIMI Score in Predicting the Angiographic Severity of Coronary Artery Disease in Patients with Non ST-Elevation Myocardial Infarction
ConclusionST-segment elevation (STE) in lead avR had an adding predicting value in NSTEACS patients especially those with low to intermediate TIMI score. Adding the value of STE in lead aVR to TIMI risk score may improve the early stratification& management of those patients at high risk coronary artery disease, with subsequent impact on morbidity& mortality. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Sternotomy versus Mini-Sternotomy in Pediatric Patients undergoing Modified Blalock-Taussig Shunt
In this study we compare post-operative short term outcomes of sternotomy versus mini-sternotomy approaches in pediatric patients undergoing Modified Blalock Taussig Shunt.Patients and MethodsA prospective randomized study was conducted on 90 patients who were schedueled for MBT shunt due to a group of cyanotic heart disease. They comprised 2 groups G1: sternotomy group (n  = 45) and G2: ministernotomy group (n = 45).ResultsMean age was 11 ± 3.39 months and mean weight was 6.75±1.96 kg in the sternotomy group, while for ministernotomy group the mean age was 10.55± 4.6...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Deep Wound Infection in Pediatrics after Open Cardiac Surgery
AbstractSurgical site infection (SSI) is a serious complication requiring prolonged hospitalization, intravenous antibiotics, wound care and dressings resulting in increased cost and resistant bacteria. In pediatric cardiac surgery, Median sternotomy is the most frequently used incision for the correction of congenital anomalies. Sternal wound infections (SWIs) are well described complications of cardiac surgery and can occur in 3% to 8% of children. Furthermore, the mortality rate can increase 2-fold after SSIs. Also, SSIs are associated with an increased length of hospital stay, readmissions, and higher health care expen...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Acomparative Study between Epidural Analgesia of Levobupivacaine with Fentanyl versus Dexmedetomidine for knee replacement surgeries
ConclusionEpidural levobupivacaine with dexmedetomidine provided better sedation, adequate surgical anesthesia with prolonged postoperative analgesia for lower limb surgeries. Both adjuvants reduced the epidural dose of levobupivacaine and potentiated its efficacy. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Dexmedetomidine versus Ketamine-Propofol for Sedation of Obese Patients Undergoing Upper Gastrointestinal Endoscopy
ConclusionIn this study, we compared a group of 40 upper GIT endoscopy obese patients (BMI 30-40) who received procedural sedation with either Dexmedetomidine or propofolketamine combination, we found that ketamine-propofol infusion (1:3) is a better sedation regimen for upper gastrointestinal endoscopy compared to dexmedetomidine as lesser time is taken to achieve optimal sedation, with no hemodynamic unstability or post procedure complications. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

A comparison of intranasal dexmeditomidine versus intranasal midazolam as a pre anesthetic medication in children undergoing adenotonsillectomy
ConclusionPremedication with intranasal dexmedetomidine 1  μg/kg attained significant and satisfactory sedation with better parent separation and lower anxiety levels without any adverse effects as compared with intranasal midazolam 0.2 mg/kg in children undergoing adenotonsillectomy. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Study of Effects of Soaking Oro-Pharyngeal Pack with Triamcinolone Acetonide in Or-Base Form on Postoperative Throat Discomfort in Patients Undergoing Functional Endoscopic Sinus Surgeries
ConclusionThe use of oral packs with triamcinolone acetonide showed lower proportion of patients who developed dysphagia and hoarseness of voice in patients group compared to control group, while no one of the studied patients showed postoperative nausea and vomiting as complication of use of oral packs. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

New Onset of Atrial Fibrillation" as an Outcome Predictor in Critically Ill Patients with Sepsis: A Systemic Review
ConclusionNOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Our Meta-analysis suggests that it is independently associated with poor outcome. In view of these findings there is a need for better quality observational studies, because reliable identification of patients with sepsis who are prone for the development of AF may allow for early pharmacological interventions to prevent this complication. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Relation between Prolonged Cardiopulmonary Bypass Time in Cardiac Surgery in Adult Patients and Post-Operative Acute Kidney Injury
ConclusionProlonged cardiopulmonary bypass duration may be an independent risk factor for acute kidney injury post cardiac surgery in adult patients. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia
ConclusionThe addition of 200  mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly reduce postoperative opioid consumption, prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia. (Source: QJM)
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research