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Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit

World Journal of Cardiology 2024年第3期16卷 126-136页

作者： ayman el-menyar Bianca M Wahlen Department of Trauma and Vascular Surgery Clinical ResearchHamad Medical CorporationDoha 3050Qatar Department of Clinical Medicine Weill Cornell Medical CollegeDoha 24144Qatar Department of Anesthesiology Hamad Medical CorporationDoha 3050Qatar

The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)*** first description of post-resuscitation syndrome and stony heart was published over 50 years *** manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful *** do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was *** modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony *** awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term *** of these components before and early after the restoration of circulation will enhance the resuscitation *** review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation *** pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for *** restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and *** development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.

关键词： Cardiac arrest Out-of-hospital cardiac arrest In-hospital cardiac arrest Post-resuscitation Myocardial dysfunction Cardiopulmonary resuscitation Stony heart

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Rapid sequence induction(RSI) in trauma patients: Insights from healthcare providers

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World Journal of Emergency Medicine 2019年第1期10卷 19-26页

作者： Bianca M.Wahlen ayman el-menyar Mohammad Asim Hassan Al-Thani Department of Anesthesia Hamad General Hospital Clinical Research Trauma & Vascular Surgery Hamad General Hospital Clinical Medicine Weill Cornell Medical College Department of Surgery Trauma Surgery Hamad General Hospital

BACKGROUND: We aimed to describe the current practice of emergency physicians and anaesthesiologists in the selection of drugs for rapid-sequence induction(RSI) among trauma ***: A prospective survey audit was conducted based on a self-administered questionnaire among two intubating specialties. The preferred type and dose of hypnotics, opioids, and muscle relaxants used for RSI in trauma patients were sought in the questionnaire. Data were compared for the use of induction agent, opioid use and muscle relaxant among stable and unstable trauma patients by the intubating ***: A total of 102 participants were included; 47 were anaesthetists and 55 were emergency physicians. Propofol(74.5%) and Etomidate(50.0%) were the most frequently used induction agents. Significantly higher proportion of anesthesiologist used Propofol whereas, Etomidate was commonly used by emergency physicians in stable patients(P=0.001). Emergency physicians preferred Etomidate(63.6%) and Ketamine(20.0%) in unstable patients. The two groups were comparable for opioid use for stable patients. In unstable patients, use of opioid differed significantly by intubating specialties. The relation between rocuronium and suxamethonium use did change among the anaesthetists. Emergency physicians used more suxamethonium(55.6% vs. 27.7%, P=0.01) in stable as well as unstable(43.4 % vs. 27.7%, P=0.08) ***: There is variability in the use of drugs for RSI in trauma patients amongst emergency physicians and anaesthesiologists. There is a need to develop an RSI protocol using standardized types and dose of these agents to deliver an effective airway management for trauma patients.

关键词： Rapid-sequence induction Trauma Emergency physicians Anaesthetists Drugs

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Predisposing factors, clinical assessment, management and outcomes of agitation in the trauma intensive care unit

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World Journal of Emergency Medicine 2018年第2期9卷 105-112页

作者： Saeed Mahmood Omaima Mahmood ayman el-menyar Mohammad Asim Hassan Al-Thani Trauma Surgery Section Department of Surgery Hamad General Hospital (HGH) Doha Qatar College of Pharmacy Qatar University Doha Qatar Clinical Research Trauma Surgery Section Department of Surgery HGH Doha Qatar Clinical Medicine Weill Cornell Medical School Doha Qatar

BACKGROUND: Agitation occurs frequently among critically ill patients admitted to the intensive care unit(ICU). We aimed to evaluate the frequency, predisposing factors and outcomes of agitation in trauma ICU. METHODS: A retrospective analysis was conducted to include patients who were admitted to the trauma ICU between April 2014 and March 2015. Data included patient's demographics, initial vitals, associated injuries, Ramsey Sedation Scale, Glasgow Coma Scale, head injury lesions, use of sedatives and analgesics, head interventions, ventilator days, and ICU length of stay. Patients were divided into two groups based on the agitation ***: A total of 102 intubated patients were enrolled; of which 46(45%) experienced agitation. Patients in the agitation group were 7 years younger, had significantly lower GCS and sustained higher frequency of head injuries(Peloped agitation were more likely to be prescribed propofol alone or in combination with midazolam and to have frequent ICP catheter insertion, longer ventilatory days and higher incidence of pneumonia(Pelated to the type of sedation and poor outcomes in terms of prolonged mechanical ventilation and development of nosocomial pneumonia. Therefore, understanding the main predictors of agitation facilitates early risk-stratification and development of better therapeutic strategies in trauma patients.

关键词： Trauma Intensive care unit Agitation Head injury Propofol Outcome

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Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 757-775页

作者： Husham Abdelrahman ayman el-menyar Ruben Peralta Hassan Al-Thani Trauma Surgery Hamad Medical CorporationDoha 3050Qatar Trauma and Vascular Surgery Hamad Medical CorporationDoha 3050Qatar

Background:Modern surgical medicine strives to manage trauma while improving outcomes using functional *** of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus *** anastomosis after traumarelated resection is associated with a high rate of *** ability of the surgeon’s bare eye to determine bowel viability remains limited,and the need for a more standardized objective assessment has not yet been ***,there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize traumaassociated *** green(ICG)coupled with fluorescence angiography is a potential solution for this *** is a fluorescent dye that responds to near-infrared ***:We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective ***:ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical ***,there is a paucity of information regarding the use of this technology to treat ***,angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions,leading to fewer cases of anastomotic *** has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient ***,there is no consensus on the ideal dose,time,and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical ***:There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical *** review will impro

关键词： Trauma Indocyanine green Fluorescence angiography Perfusion imaging Fluorescence guided surgery Acute care surgery

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Risk factors for ventilator-associated pneumonia in trauma patients:A descriptive analysis

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World Journal of Emergency Medicine 2018年第3期9卷 203-210页

作者： Suresh Kumar Arumugam Insolvisagan Mudali Gustav Strandvik ayman el-menyar Ammar Al-Hassani Hassan Al-Thani1 Trauma Surgery Section Department of SurgeryHamad General HospitalDohaQatar Clinical Research Trauma Surgery SectionHamad General HospitalDohaQatar Clinical Medicine Weill Cornell Medical CollegeDohaQatar

BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma ***:Data were retrospectively reviewed for adult trauma patients requiring intubation for>48 hours,admitted between 2010 and ***’demographics,clinical presentations and outcomes were compared according to intubation location(prehospital intubation[PHI]*** room[TRI])and presence *** of *** regression analysis was performed to identify predictors of ***:Of 471 intubated patients,332 patients met the inclusion criteria(124 had PHI and208 had TRI)with a mean age of 30.7±14.8 *** group had lower GCS(P=0.001),respiratory rate(P=0.001),and higher frequency of head(P=0.02)and chest injuries(P=0.04).The rate of VAP in PHI group was comparable to the TRI group(P=0.60).Patients who developed VAP were 6 years older,had significantly lower GCS and higher ISS,head AIS,and higher rates of *** overall mortality was 7.5%,and was not associated with intubation location or pneumonia *** the early-VAP group,gram-positive pathogens were more common,while gram-negative microorganisms were more frequently encountered in the late VAP *** regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the ***:In trauma,the risk of developing VAP is ***,the location of intubation and presence of chest injury could play an important role.

关键词： Ventilator-associated pneumonia Trauma Mechanical ventilation Intubation location Intensive care unit

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The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

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World Journal of Emergency Medicine 2023年第2期14卷 96-105页

作者： Ahmed Faidh Ramzee ayman el-menyar Mohammad Asim Ahad Kanbar Khalid Ahmed Bahaa Daoud Saji Mathradikkal Ahmad Kloub Hassan Al-Thani Sandro Rizoli Trauma Surgery Section Hamad General Hospital(HGH)Doha P.O Box 3050Qatar Clinical Research Trauma&Vascular Surgery SectionHGHDoha P.O Box 3050Qatar Clinical Medicine Weill Cornell Medical CollegeDoha P.O Box 3050Qatar

BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma ***: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital ***: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(el trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.

关键词： Emergency department Length of stay Trauma Management Outcomes Trauma activation criteria

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Multiple Organ Dysfunction Syndrome (MODS): Is It Preventable or Inevitable?

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International Journal of Clinical Medicine 2012年第7期3卷 722-730页

作者： ayman el-menyar Hassan Al Thani el Rasheid Zakaria Ahmad Zarour Mazin Tuma Husham AbdulRahman Ashok Parchani Ruben Peralta Rifat Latifi Clinical Medicine Weill Cornell Medical School Doha Qatar Medical Research Center Hamad Medical Corporation (HMC) Doha Qatar The Clinical Research Trauma Surgery Hamad Medical Corporation (HMC) Doha Qatar Trauma surgery Hamad Medical Corporation (HMC) Doha Qatar

Multiple organ dysfunction syndrome (MODS) is a systemic, dysfunctional inflammatory response that requires long intensive care unit (ICU) stay. It is characterized with high mortality rate depending on the number of organs involved. It has been recognized that organ failure does not occur as an all-or-none rule, but rather a range of organ dysfunction exists resulting in clinical organ failure. In the absence of a gold standard scoring or tool for early diagnosis or prediction of MODS, a novel bio-clinical scoring is mandatory. Moreover, understanding the pathophysiology of MODS in medical, surgical and trauma, ICUs should take a priority to achieve a favorable outcome. Herein we reviewed the literatures published in English language through the research engines (MEDLINE, Scopus, and EBASE) from 1982 to 2011 using key words: “multiorgan dysfunction”, “organ failure”, “intensive care units” to highlight the definition, mechanism, diagnosis and prediction of MODS particularly at its earliest stages. Bring up new bio-clinical scoring to a stage where it is ready for field trials will pave the way for implementing new risk-stratification strategy in the intensive care to reduce the morbidity and mortality and save resources. Prospective studies are needed to answer our question and to shift MODS from an inevitable to a preventable disorder.

关键词： Multiorgan Dysfunction Failure Intensive Care Units

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Arrhythmia Detection by Using Chaos Theory with Machine Learning Algorithms

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Computers, Materials & Continua 2024年第6期79卷 3855-3875页

作者： Maie Aboghazalah Passent el-kafrawy Abdelmoty M.Ahmed Rasha elnemr Belgacem Bouallegue ayman el-sayed Math and Computer Science Department Faculty of ScienceMenoufia UniversityShebin El-komEgypt College of Engineering Computer Science DepartmentEffat UniversityJeddahKingdom of Saudi Arabia Department of Computer Engineering College of Computer ScienceKing Khalid UniversityAbha61421Saudi Arabia Computer Science and Engineering Department Faculty of Electronic EngineeringMenoufia UniversityShebin El-komEgypt Climate Change Information Center and Expert Systems Agriculture Research CenterGizaEgypt

Heart monitoring improves life ***(ECGs or EKGs)detect heart *** learning algorithms can create a few ECG diagnosis processing *** first method uses raw ECG and time-series *** second method classifies the ECG by patient *** third technique translates ECG impulses into Q waves,R waves and S waves(QRS)features using richer *** ECG signals vary naturally between humans and activities,we will combine the three feature selection methods to improve classification accuracy and *** using all three approaches have not been examined till *** researchers found that Machine Learning(ML)techniques can improve ECG *** study will compare popular machine learning techniques to evaluate ECG *** algorithms—Support Vector Machine(SVM),Decision Tree,Naive Bayes,and Neural Network—compare categorization *** plus prior knowledge has the highest accuracy(99%)of the four ML *** characteristics failed to identify signals without chaos *** 99.8%classification accuracy,the Decision Tree technique outperformed all previous experiments.

关键词： ECG extraction ECG leads time series prior knowledge and arrhythmia chaos theory QRS complex analysis machine learning ECG classification

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Robust Malicious Executable Detection Using Host-Based Machine Learning Classifier

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Computers, Materials & Continua 2024年第4期79卷 1419-1439页

作者： Khaled Soliman Mohamed Sobh ayman M.Bahaa-eldin Department of Computer and Systems Engineering Ain Shams UniversityCairo11517Egypt Department of Computer Engineering Technology ElSewedy University of TechnologyCairo44629Egypt

The continuous development of cyberattacks is threatening digital transformation endeavors worldwide and leadsto wide losses for various organizations. These dangers have proven that signature-based approaches are insufficientto prevent emerging and polymorphic attacks. Therefore, this paper is proposing a Robust Malicious ExecutableDetection (RMED) using Host-based Machine Learning Classifier to discover malicious Portable Executable (PE)files in hosts using Windows operating systems through collecting PE headers and applying machine learningmechanisms to detect unknown infected files. The authors have collected a novel reliable dataset containing 116,031benign files and 179,071 malware samples from diverse sources to ensure the efficiency of RMED *** most effective PE headers that can highly differentiate between benign and malware files were selected totrain the model on 15 PE features to speed up the classification process and achieve real-time detection formalicious executables. The evaluation results showed that RMED succeeded in shrinking the classification timeto 91 milliseconds for each file while reaching an accuracy of 98.42% with a false positive rate equal to 1.58. Inconclusion, this paper contributes to the field of cybersecurity by presenting a comprehensive framework thatleverages Artificial Intelligence (AI) methods to proactively detect and prevent cyber-attacks.

关键词： Portable executable malware intrusion detection cybersecurity zero-day threats Host IntrusionDetection System(HIDS) machine learning Anomaly-based Intrusion Detection System(AIDS) deep learning

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Enhancing Canola Yield and Photosynthesis under Water Stress with Hydrogel Polymers

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Phyton-International Journal of Experimental Botany 2024年第7期93卷 1623-1645页

作者： elham A.Badr Gehan Sh.Bakhoum Mervat Sh.Sadak Ibrahim Al-Ashkar Mohammad Sohidul Islam ayman el Sabagh Magdi T.Abdelhamid Field Crops Research Department National Research CentreCairo12622Egypt Botany Department National Research CentreCairo12622Egypt Plant Production Department College of Food and Agriculture SciencesKing Saud UniversityRiyadh12271Saudi Arabia Department of Agronomy Hajee Mohammad Danesh Science and Technology UniversityDinajpur5200Bangladesh Department of Field Crops Faculty of AgricultureSiirt UniversitySiirt56100Turkey Department of Agronomy Faculty of AgricultureKafrelsheikh UniversityKafrelsheikh33516Egypt Department of Research Centers Montana State UniversityBozemanMT 59717USA

While Egypt’s canola production per unit area has recently grown,productivity remains low,necessitating increased *** are water-absorbent polymer compounds that can optimize irrigation schedules by increasing the soil’s ability to retain ***,twoﬁeld experiments were conducted to examine hydrogel application to sandy soil on canola growth,biochemical aspects,yield,yield traits,and nutritional quality of yielded seeds grown under water deﬁcit stress *** experiments were conducted by arranging a split-plot layout in a randomized complete block design(RCBD)with three times replications of each *** water stress at 75%or 50%of crop evapotranspiration(ETc)lowered chlorophyll a,chlorophyll b,caro-tenoids,and total pigments content,indole-3-acetic acid,plant development,seed yield,and oil and total carbo-hydrates of seed yield,hydrogel treatment enhanced all of the traits mentioned ***,hydrogel enhanced to gather compatible solutes(proline,amino acids,total soluble sugars),phenolics content in leaves,seed protein,and crop water productivity,which increased while the plants were under water *** results revealed that the full irrigation(100%ETc)along with hydrogel compared to water-stressed(50%ETc)led to enhanced seed yield(kg ha^(-1)),Oil(%),and Total carbohydrates(%)of rapeseed by 57.1%,11.1%and 15.7%,***,under water-stressed plots with hydrogel exhibited enhancement by 10.0%,3.2%and 5.1%in seed yield(kg ha^(-1)),oil(%),and total carbohydrates(%)of rapeseed by 57.1%,11.1%and 15.7%,respec-tively compared to *** a result,the use of hydrogel polymer will be a viable and practical solution for increasing agricultural output under water deﬁcit stress situations.

关键词： Hydrogel oil osmolytes rapeseed yield water stress

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