First Al Faiyum

This research investigates the relationship between serum levels of statins and SGLT2 inhibitors SGLT2i when used together in patients with ischemic heart failure. The study aims to understand how these drugs affect cholesterol, LDL, HDL, and triglyceride levels over time. Conducted by Fayoum Universitys Department of Cardiology, this prospective study involves 90 outpatient participants diagnosed with ischemic heart disease. Participants are divided into three groups of 30 each one group takes statins, another takes SGLT2i, and the third group takes both medications. Blood samples are collected at the start and after three months to measure serum statin and plasma SGLT2i levels using high-performance liquid chromatography HPLC. Researchers monitor the impact of each drug on the other and track changes in lipid profiles and any adverse effects. During the study, patients provide informed consent and attend scheduled visits for blood sampling and laboratory tests. The main outcome is to evaluate the combined effect of statin and SGLT2i therapy on ischemic heart disease after three months. Safety and side effects are also observed. The study spans from April to July 2024, ensuring detailed monitoring of participants responses to the treatments.

Researchers are evaluating the effectiveness of three glucocorticoid drugsmethylprednisolone, dexamethasone, and hydrocortisonein patients with acute respiratory distress syndrome ARDS. ARDS is a serious condition caused by severe inflammation in the lungs, often following pneumonia or sepsis, leading to breathing difficulties. The study aims to compare these drugs at equivalent doses to understand their impact on inflammation and lung function in ARDS patients. The study involves three groups of 100 patients each, receiving either methylprednisolone at 1 mgkgday, dexamethasone at 13 mgday, or hydrocortisone at 350 mgday. These drugs are given during the early phase of ARDS, when inflammation is most active. The study is randomized and does not use masking. Participants receive treatment and are monitored closely during a 28-day period. Participants will be assessed for outcomes such as 28-day mortality, need for invasive mechanical ventilation, number of ventilator-free days, length of ICU stay, hospitalization duration, and occurrence of serious side effects like infections and high blood sugar. The study includes chest imaging and oxygen level monitoring to confirm ARDS diagnosis and track progress. The total participation period for each patient is 28 days from enrollment.

This research aims to evaluate whether Trinase, an enzyme-based anti-inflammatory medication containing trypsin, bromelain, and rutin, can reduce pain after root canal treatment in male patients diagnosed with symptomatic irreversible pulpitis. The study focuses on 182 healthy male adults aged 18 to 50 years who experience moderate to severe tooth pain. It is designed as a randomized, double-blind, placebo-controlled clinical trial to assess post-operative pain relief and analgesic use following treatment. Participants are randomly assigned to receive either a single oral Trinase tablet or a matching placebo 30 minutes before undergoing a standard single-visit root canal treatment. The procedure involves local anesthesia, rubber dam isolation, mechanical canal cleaning with rotary instruments, irrigation, and canal obturation using a modified technique. All treatments are performed by the same experienced operator to ensure consistency. Both groups follow the same clinical protocol, with only the premedication differing. Patients will record pain intensity on a Visual Analogue Scale VAS at baseline and then at 6, 12, 24, and 48 hours after root canal treatment. They will also document the number of pain-relief tablets taken during this 48-hour period. The study will analyze differences in pain scores and analgesic consumption between the Trinase and placebo groups. The total active participation duration for each participant is about 48 hours post-treatment, with no additional invasive procedures beyond standard care.

Researchers are studying adult patients undergoing elective Coronary Artery Bypass Grafting CABG surgery to compare the effects of adding lidocaine to the Custodiol cardioplegia solution versus using standard Custodiol alone. The trial aims to evaluate whether the addition of lidocaine reduces the incidence of ventricular fibrillation after removal of the aortic cross clamp during heart surgery. This phase 4, randomized, double-blinded clinical trial addresses ongoing debate about the best cardioplegic solutions for myocardial protection and arrhythmia prevention during surgery. Participants are randomly assigned to receive either the standard Custodiol solution or Custodiol mixed with lidocaine. The cardioplegia solution is given as a single dose of 20 mLkg over 6-8 minutes at a temperature of 5-8C, with an additional half dose if the surgery exceeds three hours. Lidocaine is added at 6.5 ml of 2% per liter of Custodiol in the experimental group. The solution is delivered via an antegrade approach during cardiopulmonary bypass, with anesthesia and surgical procedures following standard protocols. Defibrillation and medications such as amiodarone are used if ventricular fibrillation occurs after cross clamp removal. Participants undergo preoperative assessments including blood tests, imaging, and heart function evaluations. During surgery, monitoring includes ECG, blood pressure, and blood gas analysis. Researchers track the incidence of ventricular fibrillation, number of defibrillator shocks, heart enzyme levels, cardiac function, and recovery indicators such as ventilation time and hospital stay length. The study lasts through surgery and up to one month postoperatively to assess safety and outcomes. Data are analyzed to compare the two solutions effects on heart rhythm and recovery.

Researchers are evaluating the effectiveness of the microneedling technique combined with topical silymarin application in treating gingival hyperpigmentation. This study compares this method with conventional scalpel and diode laser treatments to determine any clinical or aesthetic advantages. It also aims to identify any medical issues participants may experience when using topical silymarin. Participants will be divided into three groups one receiving scalpel de-epithelization, another treated with a diode laser device, and the third undergoing microneedling with the Dr.Pen ULTIMA - A6 needle tip, followed by topical application of silymarin for ten minutes. The laser uses a wavelength of 980 nm with a 320-micron tip, while microneedling involves repetitive punctures at various speeds and needle arrangements. During the study, researchers will monitor gingival pigmentation recurrence over six months and record post-operative pain on days 1, 3, 5, and 7 after treatment. The study includes assessments of clinical and aesthetic outcomes to evaluate the treatments. Participants will be observed for any adverse effects, especially related to silymarin use, throughout the follow-up period.

Effective management of pain after open nephrectomy, a surgery to remove a kidney, is challenging because poor pain control can cause breathing problems, delayed movement, longer hospital stays, increased opioid use, and more complications. This research compares two types of ultrasound-guided nerve blocks, the serratus intercostal plane SIPB block and the erector spinae plane ESP block, to see which provides better pain relief after this surgery. Participants are randomly assigned to one of two groups one receives the SIPB and the other the ESP block. Both blocks are performed by an experienced anesthesiologist after the patient is under general anesthesia. The SIPB targets nerves in the lateral chest wall, while the ESP block targets nerves near the spine. Each block uses 25 mL of 0.25% bupivacaine injected under ultrasound guidance. Standardized general anesthesia is given to all patients, and the blocks are done before surgery begins. Throughout the study, patients will be monitored for pain using the Visual Analogue Scale VAS at multiple time points up to 12 hours after surgery. Additional assessments include the success of the nerve block, opioid use in 24 hours, time to first pain medication request, side effects, and hospital stay length. Patients undergo preoperative evaluations including blood tests and heart monitoring. Safety measures are in place to manage any adverse reactions during the procedure. The study plans to enroll 132 adults aged 18 to 65 undergoing open nephrectomy, with close monitoring during and after surgery.

Researchers are evaluating the use of dexmedetomidine to reduce emergence agitation in obese adults undergoing nasal surgery. Emergence agitation is a serious condition that can occur when waking from general anesthesia, leading to risks like self-injury, aspiration, and other complications. This study compares a single bolus dose given before extubation with a continuous infusion to find the most effective way to reduce agitation. The trial is a prospective randomized study sponsored by Fayoum University Hospital and focuses on adults aged 18 to 50 years with a body mass index below 30 undergoing elective nasal surgery. Participants receive either a single dose of dexmedetomidine at 0.5 gkg in saline over 10 minutes starting 15 minutes before the end of surgery or a continuous infusion of dexmedetomidine at 0.5 gkghour during the operation without a loading dose. Standard anesthesia monitoring is used, including electrocardiogram, pulse oximetry, and non-invasive blood pressure. Anesthesia is maintained with isoflurane, and muscle relaxation is reversed before extubation. Patients are then transferred to the postanesthesia care unit PACU once awake, calm, and sedated. Various rescue drugs and supportive care are provided as needed. During the study, participants are closely monitored for heart rate, blood pressure, agitation level using the Richmond Agitation Sedation Scale five minutes after surgery, and other outcomes like extubation time, PACU time, analgesic use, and incidence of side effects. Follow-up occurs up to 24 hours after surgery to assess pain, nausea, vomiting, and surgical field quality. The total participation includes the surgery and post-operative care until discharge from PACU. Statistical analysis will compare the two dexmedetomidine dosing methods to determine their effects on emergence agitation and related outcomes.

Researchers are studying the effects of dexmedetomidine and magnesium sulfate on postoperative cognitive dysfunction POCD in elderly patients aged 60 to 80 undergoing open abdominal surgery under general anesthesia. POCD is a condition causing changes in thinking and mental functions after surgery, with a higher risk in older adults due to increased sensitivity to anesthetic drugs and other physiological changes. This study also examines the impact of these drugs on serum levels of C-reactive protein CRP, a marker linked to neuronal degeneration and inflammation. Participants will be randomly assigned to receive either dexmedetomidine or magnesium sulfate during their surgery. The dexmedetomidine group will receive a bolus dose of 0.5 micrograms per kilogram over 10 minutes before anesthesia induction, followed by an infusion at 0.3 micrograms per kilogram per hour until the skin closure. The magnesium sulfate group will receive a loading dose of 20 milligrams per kilogram over 10 minutes before induction, followed by a maintenance dose of 5 milligrams per kilogram per hour until skin closure. During the study, researchers will monitor participants for the incidence of POCD 24 hours after surgery and measure CRP levels to explore their correlation with cognitive changes. Participants will be assessed through clinical evaluations before and after surgery. The study includes careful monitoring of inflammatory markers and neuronal injury proteins to understand the neuroprotective effects of the treatments. Total participation involves the perioperative period with follow-up at 24 hours post-operation.

Researchers are evaluating the use of dexmedetomidine added to ropivacaine in bilateral Pectoral nerve PECS block to improve anesthesia duration and postoperative pain relief for patients undergoing cardiac surgery through midline sternotomy. This phase 4, double-blind randomized controlled study aims to compare the effects of this combination with plain ropivacaine and a control group receiving only fentanyl. The PECS block is a less invasive regional analgesic technique that has been successfully applied in various chest wall surgeries. The study involves three groups of 30 patients each one group receives bilateral PECS block with 30 ml of 0.25% ropivacaine plus dexmedetomidine 0.5 mcgkg per side the second group receives 30 ml of 0.25% plain ropivacaine per side and the control group receives no regional anesthesia but continuous intravenous fentanyl at 1 mcgkghr. All patients receive standard anesthesia, including total intravenous anesthesia with fentanyl, midazolam, and rocuronium, followed by paracetamol infusion after surgery. The PECS block is guided by ultrasound and performed in a supine position, with local anesthetic injected between specific muscle layers. Participants will be monitored through pain assessments using the Visual Analog Scale at multiple intervals during the first 24 hours after extubation, duration of mechanical ventilation, total fentanyl consumption, incidence of complications, length of ICU stay, and patient satisfaction measured by a five-item Likert scale. The study includes assessments of hemodynamic stability, blood gases, coagulation time, and drain output before performing the block. The trial will continue until January 2025, with close monitoring post-surgery in the surgical ICU until patients are fully awake and extubated.

Researchers are studying how different low flow oxygen rates affect carbon dioxide buildup during apnea in children aged 1 to 6 years under general anesthesia. The study aims to compare the effects of low flow apneic oxygenation at rates of 2, 4, and 8 liters per minute on the rate of carbon dioxide accumulation, which has not been previously explored in pediatrics. This is important because children, especially infants and younger ones, are more prone to low oxygen during apnea, which can increase health risks. Children undergoing elective surgery will receive general anesthesia with muscle relaxants, and apneic oxygenation will be given using a nasal cannula at different low flow oxygen rates for 3 minutes during apnea after induction. Before this, patients are preoxygenated and monitored with vital signs including pulse oximetry and end-tidal carbon dioxide. After intubation, mechanical ventilation and anesthesia maintenance will be provided, and an arterial line will be placed for blood gas monitoring. Participants will be closely observed during the apnea period to measure carbon dioxide and oxygen levels, heart rate, and blood pressure. Researchers will record the rise in arterial carbon dioxide between 60 and 180 seconds of apnea, along with secondary outcomes such as time to oxygen desaturation, oxygen pressure differences, and postoperative side effects like sore throat or coughing. Parents will be asked about any side effects after surgery, and the total participation includes preoperative assessments, anesthesia, and post-anesthesia recovery monitoring.