Zagazig 2

Researchers are evaluating the effectiveness of the infraspinatus-teres minor (ITM) block in improving pain relief before surgery, reducing the need for opioid pain medications, and enhancing overall pain control in patients undergoing shoulder surgeries. This study compares the ITM block to a control group receiving general anesthesia, focusing on various pain and recovery outcomes. Participants in the ITM block group will receive a single ultrasound-guided injection of local anesthetics, including bupivacaine, dexmedetomidine, and dexamethasone, before general anesthesia is started. The control group will receive general anesthesia alone. The study measures include the total amount of rescue analgesics used in the first 24 hours after surgery, intraoperative fentanyl use, pain scores at rest and during shoulder movement, time to leave the post-anesthesia care unit, side effects from opioids, and patient satisfaction with pain control. During the study, participants will be monitored for pain levels using a numerical rating scale and assessed for side effects such as constipation, itching, dizziness, nausea, and vomiting. Researchers will also track recovery times and overall satisfaction with pain management. The main outcomes include the total opioid use within 24 hours and during surgery, with safety and efficacy followed carefully throughout the study period.

Approximately 1.66 million hip fractures occur each year worldwide, mostly in individuals over 60 years old. Total hip arthroplasty (THA) is a common surgical treatment for hip fractures and degenerative hip changes in the elderly, but it often causes moderate to severe postoperative pain. Effective pain management is critical for recovery, reducing complications like immobility-related thromboembolism, and enabling earlier rehabilitation and discharge. Various regional anesthesia techniques have been used after THA, but each has limitations, and no previous study has compared the supra-iliac anterior quadratus lumborum (QL) block with the anterior iliopsoas muscle space block as pre-emptive analgesia. This study compares two ultrasound-guided nerve block techniques given before general anesthesia in patients undergoing elective THA. One group will receive the anterior iliopsoas muscle space (IPS) block with 30 ml of bupivacaine 0.25%, while the other group will receive the supra-iliac anterior QL block with the same dose. The control group will undergo general anesthesia without these blocks. Both blocks target nerves supplying the hip joint to provide pain relief during and after surgery. Participants aged 50 to 80 undergoing elective THA will be monitored for changes in pain intensity using a visual analogue scale measured at multiple time points up to 24 hours after surgery. Researchers will evaluate pain control effectiveness, safety, and recovery progress. The study includes assessments of nerve block effects, anesthesia, and postoperative outcomes to determine which block better helps manage pain and supports recovery after hip replacement surgery.

This research aims to evaluate the effectiveness and safety of Candida antigen and bivalent HPV vaccine in treating multiple common warts. It compares the use of each treatment alone or in combination, focusing on how these agents work through different immune responses. The study is a Phase 2 trial that follows patients with common warts, including those that are resistant or have distant lesions. Participants are divided into three groups: one receiving Candida antigen injections, another receiving bivalent HPV vaccine injections, and a third receiving both treatments combined. Injections are given directly into the largest wart using an insulin syringe every two weeks, continuing until the warts clear completely or up to a maximum of five treatment sessions. During the study, researchers will monitor how well the treatments work by measuring complete, partial, or no response within three months. They will also track safety and recurrence rates. Patients will be followed throughout the treatment period to assess the outcomes and any side effects, ensuring careful evaluation of both therapies' effects on warts.

Hip fractures are a major health concern worldwide, especially in elderly patients aged 65 years and older, with high mortality rates and significant impacts on independence and quality of life. This research compares two regional anesthetic techniques—circum-psoas blocks and combined lumbar and sacral plexus blocks—to evaluate their effectiveness in managing postoperative pain for patients undergoing hip fracture surgery under general anesthesia. Effective pain control is critical for recovery and early mobilization after surgery, which can reduce complications and hospital stay. Participants receive standard general anesthesia followed by one of the two ultrasound-guided nerve block techniques. The lumbar and sacral plexus blocks involve injecting 40 ml of bupivacaine 0.25% to block multiple nerves supplying the hip and lower limb. The circum-psoas block is a newer technique targeting similar nerve areas with local anesthetic injections near the psoas muscle. Both approaches aim to provide effective sensory blockade and postoperative pain relief. During the study, researchers assess pain levels using a Visual Analogue Scale at multiple time points up to 24 hours after surgery. Participants undergo hip fracture surgery within 24-72 hours of admission and are monitored closely for pain relief and recovery progress. The study also observes safety and any complications from the nerve block procedures, with the goal to identify the best analgesic method to improve postoperative outcomes in elderly hip fracture patients.

Researchers are evaluating the clinical performance of two types of laryngeal mask airways, LarySeal Clear and Ambu Aura40, in preschool children undergoing surgery. These children have unique anatomical and physiological features requiring careful airway management. The study aims to compare these supraglottic airway devices, which provide continuous oxygenation and ventilation with less stress and fewer complications during anesthesia. The study will randomly assign children to one of two groups: one using the LarySeal Clear laryngeal mask airway and the other using the Ambu Aura40. Device size is chosen based on the child's weight, and each device is lubricated before insertion following manufacturer guidelines. The LarySeal Clear is inserted with the child's head in a sniffing position using a finger technique, while the Ambu Aura40 is inserted with the head in a neutral position using a midline approach. Both devices will have their cuffs inflated to recommended volumes. Anesthesia is induced with medications and maintained with sevoflurane, and ventilation is controlled during the procedure. Participants will be closely monitored before, during, and after surgery. Assessments include vital signs, airway placement success, and complications such as coughing or airway obstruction. The main outcome measured is the oropharyngeal leak pressure after device insertion and 10 minutes later. Recovery observations will track potential side effects like dysphonia or cough. The total study duration is within 12 months, with careful follow-up to ensure safety and effectiveness of the airway devices.

Alopecia areata (AA) is an autoimmune condition causing sudden, patchy hair loss on areas like the scalp, eyebrows, and beard. It involves immune cells attacking hair follicles, leading to hair loss. Treatments include corticosteroids and other topical or systemic therapies, but this study explores combining microneedling with substances like lactic acid, vitamin D3, or triamcinolone acetonide to improve hair regrowth. Participants are divided into four groups, each receiving microneedling with a different topical treatment: 1% lactic acid solution, vitamin D3 solution, triamcinolone acetonide injection, or normal saline as a control. Microneedling is performed using a dermapen with needles 1.5 to 2 mm long, applied repeatedly until pinpoint bleeding occurs. Treatments are given every two weeks for up to six sessions, and photographs document progress. During the study, patients will be monitored for hair regrowth using the SALT score and percentage of hair growth at three months. Assessments include photographic records taken before, during, and after treatment. Participants must meet eligibility requirements and will be followed closely to measure treatment effects and safety over the course of the study.

Researchers are developing and validating a machine learning model that combines chest X-ray results with arterial blood gas (ABG) analysis to predict whether critically ill adult patients need mechanical ventilation. This study takes place at Zagazig University Hospitals and aims to improve clinical decision-making by using artificial intelligence to integrate radiological and biochemical information, addressing limitations of current separate assessments. About 2,160 critically ill adults will be enrolled over six months. Data collected include patient demographics, clinical details, ABG parameters like pH and oxygen levels, and chest X-ray features such as infiltrates and consolidation. Patients will be grouped based on whether they require mechanical ventilation. The machine learning model will be trained on 70% of the data and tested on the remaining 30%, with its accuracy and prediction quality evaluated using statistical measures. Participants will undergo chest X-rays and ABG tests at the time of evaluation. Researchers will monitor and compare the model's predictions with actual clinical decisions on mechanical ventilation. The main outcome measured is the accuracy of the model in predicting the need for ventilation within 24 hours of patient presentation. The study follows ethical guidelines and has IRB approval from Zagazig University's Faculty of Medicine.

Researchers are evaluating the use of ultrasound-guided regional anesthesia compared to traditional general anesthesia in patients undergoing awake tympanoplasty surgery. The study aims to assess the effectiveness and safety of these anesthesia methods, focusing on factors such as discharge time from the post anesthesia care unit, intraoperative hemodynamic stability, surgical field quality, and block success rate. It also examines postoperative pain, analgesia needs, opioid use, patient and surgeon satisfaction, and any complications related to the block or surgery, such as nerve injury or nausea. Participants are divided into two groups: one receiving ultrasound-guided regional anesthesia targeting specific nerves around the ear with real-time ultrasound to guide needle placement, and the other receiving general anesthesia as a control. The regional anesthesia involves blocking nerves like the great auricular, auriculotemporal, and lesser occipital nerves to perform the surgery while awake. Both approaches are compared to evaluate their outcomes and safety. During the study, participants are monitored for discharge timing from the post anesthesia care unit two hours after surgery. Researchers will track intraoperative conditions, pain scores, the time until first analgesic request, opioid consumption, and satisfaction levels. Safety is closely observed, including any complications from the anesthesia or surgery. Eligible patients aged 21 to 65 scheduled for elective unilateral tympanoplasty and meeting specific health criteria will be included, with the total study duration depending on individual surgery and recovery timelines.

Researchers are evaluating the effectiveness of two techniques, CT-guided and fluoroscopic-guided genicular nerve ablation, in reducing knee pain and improving function in adults with knee osteoarthritis who have not responded to conservative treatments. This randomized controlled trial aims to determine which method offers better pain relief, functional improvement, safety, and patient satisfaction. Knee osteoarthritis is a chronic condition characterized by joint cartilage loss, inflammation, and persistent pain, which can significantly affect quality of life. Participants will undergo one of the two nerve ablation procedures. The CT-guided ablation uses computed tomography imaging to precisely locate and target the genicular nerves responsible for knee pain. The fluoroscopic-guided ablation uses real-time X-ray imaging to guide needle placement for nerve ablation. Both procedures are minimally invasive and performed under local anesthesia. The study includes scheduled follow-up visits to monitor pain, knee function, and any adverse events. During the study, participants will complete questionnaires assessing pain relief, knee function using the WOMAC index, and overall satisfaction with the procedure. Follow-up visits occur at 1 week, 1 month, 3 months, and 6 months after treatment. The main outcome measured is the reduction in knee pain three months after the procedure. Safety and adverse events are closely monitored throughout the study to compare the two methods and provide insights to improve treatment for knee osteoarthritis.

Researchers are evaluating the effectiveness and safety of two treatments for adults with Trigeminal Neuralgia, a chronic condition causing severe facial pain. The study compares Pulsed Radiofrequency (PRF) alone with a combination of Pulsed and Thermal Radiofrequency (PRF + TRF) to determine which provides better long-term pain relief and reduces the need for pain medication. This randomized controlled trial focuses on adult patients experiencing significant facial pain that has not improved with medication. Participants will be randomly assigned to receive either PRF treatment, which uses electrical pulses to modulate nerve function without causing heat damage, or a combined PRF and Thermal Radiofrequency treatment that adds controlled heat to create a lesion on the trigeminal nerve. Both procedures are performed under sterile conditions with anesthesia, targeting the nerve responsible for the pain. The treatments aim to compare the pain relief and safety profiles of the two methods. During the 12-week follow-up, participants will have their pain levels assessed at baseline, 1 week, 4 weeks, and 12 weeks after the procedure using pain scales such as the Numeric Rating Scale and Visual Analog Scale. Researchers will also monitor changes in medication use and any adverse events related to the procedures. Participants will attend scheduled follow-up visits to support these assessments and ensure safety throughout the study period.