First Al Faiyum

Researchers are evaluating how the combination of two drugs, statin and SGLT2i, affects patients with ischemic heart failure. The study aims to measure the levels of these drugs in the blood and assess their impact on cholesterol, triglycerides, LDL, and HDL levels, as well as observe any side effects. The study is prospective and will take place at the Department of Cardiology, Faculty of Medicine, Fayoum University, from April 1, 2024, to July 1, 2024. The trial will include 90 outpatients divided into three groups of 30 patients each: one group will receive statin (atorvastatin), another will receive SGLT2i (dapagliflozin), and the third will receive both medications together. Blood samples will be collected at the start and after three months to measure drug levels using high-performance liquid chromatography (HPLC). The study will monitor how each drug affects the other and track changes in laboratory tests related to heart health. Participants will provide written informed consent before joining the study. Their blood will be tested for cholesterol, triglycerides, LDL, and HDL at baseline and after three months. Researchers will also monitor for any adverse effects from the treatments. The main outcome is to evaluate the effect of the combination therapy over a three-month follow-up period, helping to understand the interaction and safety profile of these drugs in treating ischemic heart disease.

This research aims to compare the effectiveness of three glucocorticoid drugs—methylprednisolone, dexamethasone, and hydrocortisone—in treating patients with acute respiratory distress syndrome (ARDS). ARDS is a severe lung condition caused by various illnesses such as pneumonia and sepsis, leading to inflammation and breathing difficulties. The study explores how these medications impact the inflammatory processes triggered in ARDS, including the role of glucocorticoid receptors and critical illness-related corticosteroid insufficiency. Participants receive one of three treatments: methylprednisolone at 1 mg/kg/day (approximately 70 mg/day), dexamethasone at 13 mg/day, or hydrocortisone at 350 mg/day. The study compares these equivalent doses to evaluate their effects on ARDS. The treatments are given during the early phase of ARDS when inflammation is most active, as this is considered the critical period for glucocorticoid intervention. During the study, researchers monitor participants closely for 28 days to assess mortality after starting treatment. Participants must be receiving mechanical ventilation for hypoxemic respiratory failure and meet specific diagnostic criteria for ARDS. The study includes chest imaging, oxygen level monitoring, and assessments of respiratory symptoms. Researchers aim to understand which glucocorticoid provides the best response in reducing inflammation and improving survival in ARDS patients.

Researchers are evaluating whether Trinase, an enzyme-based anti-inflammatory medication containing trypsin, bromelain, and rutin, can reduce pain after root canal treatment in male patients with symptomatic irreversible pulpitis. This condition causes severe dental pain, and although root canal therapy removes inflamed tissue, many patients still experience pain in the first 24 to 48 hours after treatment. The study aims to compare Trinase to a placebo in reducing post-operative pain and the need for pain-relief medication, potentially improving patient comfort and pain management after endodontic care. The trial will include 182 systemically healthy male patients aged 18 to 50 years, each presenting with moderate to severe tooth pain and a restorable mandibular molar affected by irreversible pulpitis. Participants will be randomly assigned to receive either a single oral Trinase tablet or a placebo 30 minutes before a single-visit root canal procedure. The treatment involves standard endodontic techniques including local anesthesia, rubber-dam isolation, canal cleaning and shaping with rotary instruments, irrigation, obturation, and temporary restoration, all performed by one experienced operator to ensure consistency. Patients will record their pain levels using a Visual Analogue Scale (VAS) at baseline and at 6, 12, 24, and 48 hours after treatment, along with the number of pain-relief tablets taken during this 48-hour period. Pain will be analyzed using validated cutoff values, and researchers will compare pain intensity and analgesic use between the Trinase and placebo groups. The total participation time for each patient is approximately 48 hours, focusing on monitoring post-operative pain and medication use. The study has ethical approval and requires written informed consent from all participants.

Researchers are evaluating the addition of lidocaine to the Custodiol cardioplegia solution to reduce the incidence of ventricular fibrillation (VF) in adults undergoing elective Coronary Artery Bypass Grafting (CABG) surgery. Custodiol has been widely used since 1970 as a single-dose myocardial protection during open-heart surgery, but it may be associated with higher rates of ventricular arrhythmias compared to other solutions containing lidocaine, which helps stabilize heart membranes and prevent arrhythmias. In this Phase 4 randomized, double-blinded clinical trial, patients are assigned to receive either the standard Custodiol solution or Custodiol modified by adding 6.5 ml of 2% lidocaine per liter. The cardioplegia is given as a single dose of 20 mL/kg over 6-8 minutes at a cold temperature, with an additional half dose if surgery exceeds 180 minutes. The procedure includes comprehensive anesthesia and heart protection protocols, with monitoring and treatment of any VF after aortic cross-clamp removal. Participants will be carefully monitored through blood tests, imaging, and heart rhythm assessments before, during, and after surgery. The study measures the rate of ventricular fibrillation perioperatively and includes safety monitoring and standard postoperative care. The total number of participants is planned as 70 adults, and data will be analyzed statistically to compare outcomes between the groups.

Researchers are evaluating the effectiveness of microneedling combined with topical silymarin application for treating gingival hyperpigmentation. This study compares this method to the traditional scalpel technique and diode laser treatment to see which provides better clinical and aesthetic results. It also aims to identify any medical problems participants might experience when using topical silymarin. Participants will be divided into three groups. One group will receive gingival depigmentation using a conventional scalpel blade. Another group will have the pigment removed using a diode laser device. The third group will undergo repetitive microneedling punctures with a specialized device, followed by topical application of silymarin for ten minutes. All procedures are performed under aseptic conditions and local anesthesia. Throughout the study, participants will be monitored for recurrence of gingival pigmentation from enrollment up to six months. Researchers will assess clinical outcomes and aesthetic improvements. Safety will also be observed with attention to any adverse effects related to silymarin use. This trial includes adults of both genders who meet eligibility criteria and agree to participate.

Effective management of pain after open nephrectomy is challenging but important to prevent complications such as poor breathing, delayed movement, longer hospital stays, and increased opioid use. This study compares two ultrasound-guided nerve block techniques, the serratus intercostal plane block (SIPB) and the erector spinae plane (ESP) block, to evaluate their effectiveness in controlling postoperative pain for patients undergoing open nephrectomy. These blocks offer alternatives to traditional methods like systemic opioids and epidural analgesia, aiming to improve pain relief while reducing opioid side effects. Patients will be randomly assigned to receive either the serratus intercostal plane block or the erector spinae plane block after general anesthesia is induced. The SIPB is performed with the patient lying on their back, targeting nerves near the serratus anterior muscle, while the ESP block is done with the patient on their side, targeting nerves near the erector spinae muscle. Both blocks use 25 mL of 0.25% bupivacaine injected under ultrasound guidance by an experienced anesthesiologist. Standard general anesthesia and postoperative care are provided to all patients. Participants will be monitored closely before, during, and after surgery with physical exams, blood tests, heart monitoring, and pain assessments using the Visual Analogue Scale (VAS). The main outcome is the pain level at rest 12 hours after surgery. Additional monitoring includes rescue opioid use, sensory testing for block success, and safety measures to manage any complications. The study involves 132 patients aged 18 to 65 with planned open nephrectomy and follows strict protocols to ensure accurate and safe evaluation of pain control methods.

Researchers are evaluating whether a single bolus dose or a continuous infusion of dexmedetomidine before extubation is more effective in reducing emergence agitation in obese adults undergoing nasal surgery. Emergence agitation after general anesthesia can cause serious complications such as self-injury, aspiration, bleeding, and arrhythmias, especially in adults with certain risk factors like ear, nose, and throat surgery, obesity, and sevoflurane anesthesia. Dexmedetomidine, a selective alpha-2 sympatholytic, is studied for its anxiolytic, sedative, and pain-modulating effects without causing respiratory depression. However, optimal dosing and timing remain unclear due to risks of oversedation and delayed recovery. The study compares two dexmedetomidine dosing methods: a continuous infusion given throughout the surgery and a single dose administered 15 minutes before the end of surgery. All patients receive standard general anesthesia with medications including fentanyl, propofol, and atracurium, and maintenance with isoflurane. At the end of surgery, muscle relaxants are reversed, and patients are extubated when able to breathe spontaneously and respond to commands. Patients are then transferred to the post-anesthesia care unit (PACU) until recovery criteria are met. Participants will be monitored during and after surgery with standard anesthesia monitoring, including electrocardiogram, pulse oximetry, blood pressure, and capnography. The main outcome measured is the degree of emergence agitation five minutes after surgery using the Richmond Agitation Sedation Scale. The study involves careful observation of sedation, vital signs, and recovery times to evaluate the safety and effectiveness of the dexmedetomidine dosing methods for preventing agitation after nasal surgery.

Researchers are evaluating the effects of two drugs, dexmedetomidine and magnesium sulfate, on reducing post-operative cognitive dysfunction (POCD) in elderly patients aged 60 to 80 undergoing general anesthesia for open abdominal surgery. POCD is a decline in thinking and mental functions after surgery, which is common and concerning in older adults due to changes in their sensitivity to anesthetic drugs and brain chemistry. The study also aims to assess how these drugs affect serum levels of C-reactive protein (CRP), a marker linked to neuronal damage. Participants will receive either dexmedetomidine or magnesium sulfate during surgery. Dexmedetomidine is given as a 20 mg/kg loading dose over 10 minutes before anesthesia induction, followed by a maintenance dose of 5 mg/kg/hour until skin closure. Magnesium sulfate, known for its neuroprotective properties, is being studied for its ability to prevent excitotoxicity and reduce POCD. The study compares these two treatments to understand their protective effects on brain function during and after surgery. Throughout the study, researchers will monitor the incidence of POCD 24 hours after surgery. They will also measure blood markers like CRP and S100β protein, which indicate brain injury and inflammation. Patient cognitive function will be assessed, and safety will be monitored during and after the procedure. The study focuses on elderly patients with specific physical health statuses and surgical conditions to ensure accurate evaluation of the treatments' effects.

This research evaluates the effect of adding dexmedetomidine to ropivacaine for bilateral Pectoral nerve (PECS) block in patients undergoing cardiac surgery via midline sternotomy. The study aims to see if this combination can prolong anesthesia duration and improve postoperative pain relief compared to using ropivacaine alone. PECS block is a regional analgesic technique used for chest wall surgeries and has been adopted for various procedures since its description in 2012. The study is a double-blind randomized controlled trial conducted at FAYOUM University Hospital. Eligible patients will be randomly assigned to one of three groups: a control group receiving only intravenous fentanyl, a group receiving bilateral PECS block with plain ropivacaine, and a group receiving bilateral PECS block with ropivacaine plus dexmedetomidine. The PECS block involves ultrasound-guided injection of anesthetic between specific chest muscles on both sides. Anesthesia during surgery is managed with continuous infusions of fentanyl, midazolam, and rocuronium. Participants will be monitored for pain using the Visual Analog Scale during the first 24 hours after surgery, opioid consumption, duration of mechanical ventilation, ICU stay, and any complications. Pain assessments occur at extubation and at multiple intervals up to 24 hours. Patient satisfaction will also be measured. The study includes 90 patients aged 20 to 65 years undergoing elective isolated CABG or valve surgery with adequate heart function.

Researchers are investigating how different low flow rates of oxygen affect the buildup of carbon dioxide in anesthetized children during a 3-minute apnea period. This study focuses on children aged 1 to 6 years undergoing general anesthesia, a time when they are at higher risk for low oxygen levels. Apneic oxygenation, providing oxygen without breathing or mechanical ventilation, has been shown to reduce the risk of low oxygen and extend safe apnea time in children. During the study, children will receive standard anesthesia care including premedication and induction with medications like midazolam, propofol, fentanyl, and atracurium. After intubation and stabilization, apneic oxygenation will be started using a nasal cannula delivering oxygen at a low flow rate for 3 minutes. Ventilation settings and vital signs will be closely monitored throughout. Participants will have various assessments including blood counts, vital signs, and oxygen and carbon dioxide levels. The primary outcome measured is the rise in arterial carbon dioxide pressure between 60 and 180 seconds of apnea. Postoperative side effects such as nausea, coughing, or breathing issues will also be recorded. The study uses detailed monitoring and statistical analysis to evaluate the effects of different oxygen flow rates during apnea in children.