Dexamethasone

This research aims to analyze obstetric, endocrine, and metabolic follow-up data in women treated with dexamethasone (DEX) during pregnancy who are at risk of congenital adrenal hyperplasia. It seeks to understand the occurrence and impact of weight gain, insomnia, edema, stretch marks, arterial hypertension, and gestational diabetes. The study also evaluates pregnancy outcomes and assesses the corticotropic axis during and up to three months after pregnancy to improve management and prevent related health issues. The study includes women treated with DEX during pregnancy, focusing on those with a severe mutation of the CYP21A2 gene in both parents and carrying a female single fetus. Participants have started prenatal DEX treatment for at least 24 hours. This observational study collects retrospective and prospective data from this group to evaluate the effects and outcomes of the treatment. Participants will be monitored through follow-up data collection, including metabolic complications like hypertension and diabetes, adverse effects such as weight gain and insomnia, pregnancy complications, and hormone levels (cortisol and S-DHEA) during and after treatment. The primary outcome is the proportion of mothers developing hypertension and/or diabetes over an average of four years. The study aims to guide better clinical practices and recommendations for managing pregnant women treated with DEX.

This research aims to compare the effects of adding dexamethasone or magnesium sulfate to bupivacaine during bilateral erector spinae plane blocks for controlling pain after cesarean section under spinal anesthesia. The study focuses on women undergoing elective cesarean delivery and explores ways to improve postoperative pain management, which is important to support recovery and reduce complications like chronic pain and stress. Participants will be divided into three groups: one receiving 20 ml of 0.25% isobaric bupivacaine alone, another receiving 20 ml of the same bupivacaine plus 4 mg dexamethasone, and the third receiving 20 ml of bupivacaine with 200 mg magnesium sulfate. These treatments are delivered using ultrasound-guided erector spinae plane blocks during surgery. During the study, participants will be monitored for pain control, time to first need for additional pain relief, total morphine consumption, ability to move independently, and any complications within 24 hours after surgery. Researchers will assess pain levels, quality of recovery, and safety outcomes to evaluate the effects of the added medications. The study period includes immediate postoperative assessments and follow-up within the first day after cesarean delivery.

Postoperative nausea and vomiting (PONV) is a common consequence of ambulatory surgery, affecting up to 80% of high-risk patients and 20-30% overall.(1) Despite being widespread, a prior survey found that patients are more averse to PONV than pain and other significant postoperative problems.(2) Furthermore, even mild cases of PONV can have serious repercussions, such as postanesthesia care unit (PACU) workflow disruption, delayed discharges, higher medical costs, and lower patient satisfaction.(3)PONV following intraocular surgery can be unpleasant and may lead to serious complications including suprachoroidal hemorrhage (SCH).(4) SCH is a potentially serious condition that occurs when the posterior ciliary arteries or vortex veins burst, resulting in blood in the suprachoroidal region.(5) Several medications are proved to be effective for prevention of nausea and vomiting like steroids, dopamine antagonists and serotonin antagonists. PONV is best prevented and treated with selective serotonin receptor antagonists. Although serotonin receptor antagonists are more successful than metoclopramide and dexamethasone in preventing and treating PONV, their usage is restricted due to their expensive cost and limited availability in resource-poor facilities.(6) In an attempt to decrease the incidence of PONV in the ambulatory setting, several anti-emetics have been studied.(7) For decades, metoclopramide has been a popular antiemetic due to its dose-dependent activity on central dopaminergic D2 receptors, central and peripheral 5-HT3 receptors, and peripheral 5-HT4 receptors. Despite inconsistent results, it is nevertheless commonly used in clinical practice to prevent nausea and vomiting after surgery.(8) Dexamethasone was utilized as a standalone medication during surgery for both pediatric and adult patients.(9) Recently, there has been a suggestion that dexamethasone, which has been shown to be more effective in preventing nausea and is thought to lower 5-HT levels in the central nervous system, could lower the incidence of PONV.(10) The hypothesis is that dexamethasone will lower the incidence of PONV after cataract surgery when compared with metoclopramide. Aim of the work: The present study aims to test the efficacy of dexamethasone and metoclopramide in prevention of PONV in patients undergoing cataract surgery. Primary outcome: • Incidence of PONV Secondary outcomes: * Number of patients took antiemetic drug in 24h * Postoperative pain score Patients : Study settings: This study will be conducted in ophthalmology department, Alexandria university hospitals. Study design: Placebo-controlled, double blind, randomized, prospective study Sample size calculation: Study population: All patients will be randomized 1:1 using a sealed envelope method. Patients will be divided into three equal groups: Group P: patients will receive 0.9% normal saline Group M: patients will receive 10 mg metoclopramide Group D: patients will receive 8 mg dexamethasone Methods: Preoperative evaluation and preparation: During preoperative visit, evaluation of patients will be carried out through proper history taking, clinical examination and routine laboratory investigations including complete blood picture, coagulation profile, blood urea, serum creatinine, serum electrolytes and any other investigation needed. Pre-anesthetic preparation and premedication: * Informed written consent, from all individual participants who will be included in this study will be taken during preoperative visit. * Patients should be trained during preoperative visit on a visual analogue scale (VAS), with 0 corresponding to no pain and 10 to the worst pain imaginable On arrival to operative theatre, intravenous cannula will be inserted and standard monitoring will be established using multichannel monitor (Carescape Monitor B650, GE Healthcare Finland) to monitor the following in both groups: * Electrocardiogram (ECG) for heart rate and rhythm. (Beats/min). * Non-invasive measurement of arterial blood pressure. (Mean blood pressure in mmHg). * Pulse oxygen saturation. (SpO2%). Before sedation, patients will be randomly allocated to receive one of three drugs. Three 2-mL syringes containing either 8 mg dexamethasone,10 mg metoclopramide, or 0.9% saline per syringe will be prepared by an anesthetist who is not one of the observers. Syringes will be marked with a coded label. Patients in group P will receive 0.9% normal saline, group M will receive 10 mg metoclopramide and group D will receive 8 mg dexamethasone before sedation. All patients will be sedated with 0.025 mg /kg midazolam, 0.25 mg/kg ketamine and 0.05 mg/kg nalbuphine. Peribulbar block with 2 ml lidocaine 2% and 3 ml bupivacaine 0.5% will be given to all patients. The rescue antiemetic will be ondansetron 4 mg IV, which will be given for prolonged nausea (exceeding 10 min) or vomiting or at the patient's request and will be repeated if necessary. Pain will be assessed using VAS. Nausea will be assessed using a linear numerical scale of 0-3 (0=none, 1=mild, 2=moderate, 3=severe). The rescue analgesic will be intravenous ketorolac 30 mg if VAS \>3. Nausea refers to the unpleasant sensation of wanting to vomit, while vomiting is the forceful ejection of gastric contents from the mouth.

Researchers are comparing the pain relief effects of three types of local injections—Dexmedetomidine, Ozone, and Dexamethasone—in people with carpal tunnel syndrome (CTS). CTS is caused by pressure on the median nerve at the wrist, leading to symptoms like numbness and pain. While corticosteroid injections are commonly used to reduce inflammation in mild to moderate CTS, there is no clear guideline on which steroid is best. This study aims to evaluate which injection offers better long-term pain relief and functional improvement in CTS patients. Participants receive one of three treatments: an injection of Dexmedetomidine (1 microgram/kg) combined with lidocaine near the median nerve; a single local injection of ozone gas mixed with lidocaine; or a single injection of dexamethasone with lidocaine. These injections are administered using similar techniques targeting the wrist area. The study follows a randomized, double-blind design to fairly compare these three treatment options. During the trial, patients will be assessed before treatment and then at 1 week, 4 weeks, 12 weeks, and 24 weeks after injection. Assessments include measuring pain levels and functional status, as well as nerve conduction studies to evaluate median nerve function. Researchers will also track pain medication use during the first 48 hours after injection. The study is sponsored by Tanta University and includes adults aged 20 to 60 with mild to moderate CTS confirmed by ultrasound and nerve studies.

This research focuses on children aged 4 to 15 years who experience asthma attacks, aiming to compare two different doses of the steroid dexamethasone given orally in emergency departments. The study evaluates which dose better reduces the need for repeat steroid prescriptions within two weeks after initial treatment. The study also examines how often children return to emergency care or their general practitioner and looks at how acceptable the treatments are to both parents and children. This pilot trial will help gather important information to plan a larger, more definitive study that addresses key concerns of families and healthcare professionals. Participants will receive one of two doses of dexamethasone, either 0.3 mg/kg or 0.6 mg/kg, as a single oral dose during their emergency department visit. The study is randomized and triple-blinded, meaning neither the participants, caregivers, nor researchers know which dose is given. The chosen doses reflect common clinical practices and aim to find the lowest effective dose to reduce side effects. This study period includes the initial emergency treatment and follow-up monitoring. Throughout the study, children will be monitored for the need for additional steroid treatment, hospital admissions, and how well they tolerate the medication. Researchers will track emergency department visits, general practitioner visits, and collect feedback from parents and children about the treatment experience. The primary outcome is participant recruitment over seven months, while secondary outcomes assess tolerability and hospital admissions. The study continues until August 2026, with careful safety monitoring by the research team.

Researchers are comparing the pain relief effects of two different nerve block techniques used during arthroscopic shoulder surgery. The study specifically evaluates the use of a combined suprascapular and supraclavicular nerve block with dexamethasone versus an interscalene brachial plexus block. The goal is to assess differences in postoperative pain levels, the need for additional pain medication, and diaphragm movement after surgery. Participants will receive one of two nerve block procedures before their shoulder arthroscopy under general anesthesia. One group will get the combined suprascapular and supraclavicular block with dexamethasone, while the other will receive the interscalene block. The study is randomized and single-blinded, meaning participants are randomly assigned and only one party is unaware of the group assignment. During the study, pain will be measured using a visual analog scale for 48 hours after surgery. Researchers will also assess diaphragm movement one hour after the operation. Other evaluations include monitoring the amount of additional pain medication participants use. The study will track participants closely to compare the effectiveness of the two nerve block methods in managing postoperative pain and side effects.

This research evaluates the effects of two steroids, Dexamethasone and Betamethasone, on fetal heart activity in mothers at high risk of preterm birth. These steroids are given to speed up lung development in the baby before delivery, but they may affect the baby's heart rate differently as seen on fetal heart monitoring called cardiotocography (CTG). Participants will receive either Betamethasone or Dexamethasone through intramuscular injections. Betamethasone is given as 12 mg injections on two consecutive days, while Dexamethasone is given as two 12 mg doses spaced 24 hours apart. The study follows a randomized, double-blind design to compare these two treatment groups. During the study, fetal heart rate and its variations will be monitored before treatment and again at two and four days after treatment using CTG. Researchers will measure the number of heart rate accelerations and long-term heart rate variability to assess fetal well-being. The study will also monitor participants for any safety concerns related to the treatments.

Researchers are studying the effect of pre-medication with anti-inflammatory drugs, specifically ibuprofen and dexamethasone, on post-endodontic pain in patients with symptomatic irreversible pulpitis. This Phase 2 randomized and double-blind trial aims to compare these two drugs in managing pain after root canal treatment. The study will include adult patients aged 18 to 50 who have acutely inflamed pulp without swelling or draining sinus and are otherwise healthy. Participants will be divided into two groups, one receiving ibuprofen and the other dexamethasone as pre-medication 15 minutes before root canal treatment. The treatment involves local anesthesia, rubber dam isolation, working length determination, and instrumentation of the root canals using the ProTaper Next system with sodium hypochlorite irrigation. Calcium hydroxide will be used as an intra-canal medicament before temporary sealing. After instrumentation, patients will be recalled after one week for final obturation and restoration. During the study, patients will mark their pain intensity on a visual analogue scale at 24, 48, and 72 hours after the first visit. Severe pain will be managed with prescribed analgesics. Researchers will monitor the effect of pre-medication on post-endodontic pain at these time points. Patients must attend recall visits and provide written consent. The total study duration includes initial treatment and a one-week follow-up for final restoration.

Researchers are evaluating the safety and effectiveness of telitacicept in treating patients with primary IgA nephropathy who are at high risk of disease progression. IgA nephropathy is a kidney condition caused by abnormal IgA deposits, leading to diverse symptoms and uncertain causes. This study is a multicenter, randomized, controlled clinical trial aiming to build on earlier findings that telitacicept may reduce protein in the urine and slow disease progression. Participants will be randomly assigned to one of two groups: one group will receive telitacicept 240 mg once a week combined with a stable dose of angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II receptor blockers (ARB) for 40 weeks. The other group will receive glucocorticoids (prednisone or prednisolone starting at 0.5 mg/kg, up to 40 mg daily, with gradual dose reduction after 8 weeks) together with ACEI/ARB for 28 to 40 weeks. Both groups continue their ACEI/ARB treatment during the study. During the study, participants will have their 24-hour urine protein levels measured from the start until week 40, along with other kidney function tests such as estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio (PCR). Researchers will also monitor safety and record any changes in kidney function or disease progression. The study will last up to 40 weeks, with follow-up to assess the time until any serious kidney-related events occur.

Researchers are studying the effects of intravenous (IV) dexamethasone on spinal anesthesia in healthy women undergoing elective Cesarean delivery (CD). This randomized, double-blind, controlled trial aims to understand how IV dexamethasone influences the duration of motor and sensory blockade from spinal anesthesia, as well as its impact on pain, nausea, vomiting, and itching after surgery. The study compares dexamethasone to metoclopramide, another anti-nausea medication, within a multimodal antiemetic strategy as part of Enhanced Recovery After Surgery (ERAS) protocols. Participants receive a standardized spinal anesthesia with bupivacaine, fentanyl, and morphine. They are randomly assigned to receive either 10 mg of IV dexamethasone or 10 mg of IV metoclopramide immediately after spinal anesthesia. All participants also receive ondansetron as a second antiemetic. Additional anti-nausea medications may be given if needed. The study monitors motor and sensory block recovery times closely using specific assessments like the Bromage score and sensation testing at regular intervals. During the study, participants are assessed for pain, nausea, itching, and motor function recovery in the recovery room at scheduled times until full recovery of motor function is confirmed. Pain and nausea scores are recorded hourly until full motor function returns. Opioid use is tracked for 24 hours after surgery, along with any episodes of vomiting or itching. The main outcome is the time until complete resolution of motor block. The study plans to include 116 participants and is conducted with careful data collection and statistical analysis to compare the two treatment groups.