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Effect of Ketamine Instillation on Acute and Chronic Post Mastectomy Pain, a Dose Finding Clinical Study

Open Journal of Anesthesiology 2022年第4期12卷 146-159页

作者： fatma el sherif Hany elmorabaa Khaled Mohamed Fares Sahar Abdel-Baky Mohamed Nourhan M. elgalaly Khalid Rezk Moaaz Tohamy Department of Anesthesia ICU and Pain Management South Egypt Cancer Institute Assiut University Assiut Egypt Department of Anesthesia ICU and Pain Management Faculty of Medicine Assuit University Assiut Egypt

Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). Methods: Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses;1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. Results: Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P Conclusion: Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.

关键词： Acute Pain Breast Cancer Chronic Pain Ketamine Instillation Modified Radical Mastectomy

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The role of polymorphic cytochrome P450 gene(CYP2B6)in B-chronic lymphocytic leukemia(B-CLL)incidence and outcome among Egyptian patients

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Oncology Research 2024年第4期32卷 785-797页

作者： MENNA AL-ADL MAGDY MYOUSSEF AHMED el-SEBAIE sherif REFAAT AFAF el-SAID Division of Biochemistry Department of ChemistryFaculty of ScienceMansoura UniversityMansoura35511Egypt Hematology Unit Department of Clinical PathologyFaculty of MedicineMansoura UniversityMansoura35511Egypt Medical Oncology Unit Oncology Center Mansoura UniversityMansoura35511Egypt Department of Genetics Mansoura University Children’s HospitalMansoura35511Egypt

Cytochromes P450(CYPs)play a prominent role in catalyzing phase I xenobiotic biotransformation and account for about 75%of the total metabolism of commercially available drugs,including chemotherapeutics.The gene expression and enzyme activity of CYPs are variable between individuals,which subsequently leads to different patterns of susceptibility to carcinogenesis by genotoxic xenobiotics,as well as differences in the efficacy and toxicity of clinically used drugs.This research aimed to examine the presence of the CYP2B6*9 polymorphism and its possible association with the incidence of B-CLL in Egyptian patients,as well as the clinical outcome after receiving cyclophosphamide chemotherapy.DNA was isolated from whole blood samples of 100 de novo B-CLL cases and also from 100 sex-and age-matched healthy individuals.The presence of the CYP2B6*9(G516T)polymorphism was examined by PCR-based allele specific amplification(ASA).Patients were further indicated for receiving chemotherapy,and then they were followed up.The CYP2B6*9 variant indicated a statistically significant higher risk of B-CLL under different genetic models,comprising allelic(T-allele vs.G-allele,OR=4.8,pels.Following cyclophosphamide chemotherapy,we found that the patients with variant genotypes(GT+TT)were less likely to achieve remission compared to those with the wild-type genotype(GG),with a response percentage of(37.5%vs.83%,respectively).In conclusion,our findings showed that the CYP2B6*9(G516T)polymorphism is associated with B-CLL susceptibility among Egyptian patients.This variant greatly affected the clinical outcome and can serve as a good therapeutic marker in predicting response to cyclophosphamide treatment.

关键词： B-CLL Xenobiotics Cytochromes P450 CYP2B6

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Effect of Transcranial Direct Current Stimulation of Motor Cortex versus Insula Cortex on Chronic Post-Mastectomy Pain: Randomized Sham-Controlled Trial

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麻醉学期刊(英文) 2023年第10期13卷 197-211页

作者： Shereen Mamdouh Kamal Khaled Mohamed Fares Sahar Abdel-Baky Mohamed Mohanad Ahmed Mohamed fatma Adel el sherif Anaesthesia Intensive Care and Pain Management Department South Egypt Cancer Institute Assiut University Assiut Egypt

Background: Transcranial direct current stimulation (tDCS) across cortical brain areas appears to improve various forms of pain, yet evidence of tDCS efficiency and ideal stimulation target is lacking. This study aimed to compare the add-on analgesic efficacy of concentric electrode transcranial direct current stimulation (CE-tDCS) stimulation over the primary motor cortex versus the insular cortex on the management of chronic postmastectomy pain. Method: Prospective randomized double-blind sham-controlled study enrolled eighty patients with chronic postmastectomy pain that were randomly assigned to four groups: active motor (AM), sham motor (SM), active insula (AI) and sham insula (SI) group, each received 5 sessions for 20-minute duration with 2 mA tDCS over the targeted area of the contralateral side of pain. Our primary outcome was VAS score, the secondary outcomes were VDS score, LANSS score and depression symptoms by HAM-D scores, assessment was done at 4 time points (prestimulation, after 5th session, 15th day and one month after the last session). Results: Both active tDCS groups (motor and insula) showed reduction of VAS (P Conclusion: Active tDCS stimulation either targeting the primary motor cortex or the insula cortex has add-on analgesic effect for controlling neuropathic chronic post mastectomy pain and the maximum effect was at 15 days after the last session.

关键词： Transcranial Direct Current Stimulation tDCS Postmastectomy Pain Motor Cortex Insular Cortex

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Comparative study between three carbonaceous nanoblades and nanodarts for antimicrobial applications

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Journal of Environmental Sciences 2024年第2期136卷 594-605页

作者： Mohamed S.Selim Ahmed M.Azzam Mohamed A.Shenashen Shimaa A.Higazy Bayaumy B.Mostafa sherif A.el-Safty National Institute for Materials Science(NIMS) 1-2-1 SengenTsukuba-ShiIbaraki-Ken 305-0047Japan Petroleum Application Department Egyptian Petroleum Research InstituteNasr City 11727Egypt Department of Environmental Research Theodor Bilharz Research InstituteGizaEgypt

The design of nanostructured materials occupies a privileged position in the development and management of affordable and effective technology in the antibacterial sector.Here,we discuss the antimicrobial properties of three carbonaceous nanoblades and nanodarts materials of graphene oxide(GO),reduced graphene oxide(RGO),and single-wall carbon nanotubes(SWCNTs)that have a mechano-bactericidal effect,and the ability to piercing or slicing bacterial membranes.To demonstrate the significance of size,morphology and composition on the antibacterial activity mechanism,the designed nanomaterials have been characterized.The minimum inhibitory concentration(MIC),standard agar well diffusion,and transmission electron microscopy were utilized to evaluate the antibacterial activity of GO,RGO,and SWCNTs.Based on the evidence obtained,the three carbonaceous materials exhibit activity against all microbial strains tested by completely encapsulating bacterial cells and causing morphological disruption by degrading the microbial cell membrane in the order of RGO>GO>SWCNTs.Because of the external cell wall structure and outer membrane proteins,the synthesized carbonaceous nanomaterials exhibited higher antibacterial activity against Gram-positive bacterial strains than Gram-negative and fungal microorganisms.RGO had the lowest MIC values(0.062,0.125,and 0.25 mg/mL against B.subtilis,S.aureus,and E.coli,respectively),as well as minimum fungal concentrations(0.5 mg/mL for both A.fumigatus and C.albicans).At 12 hr,the cell viability values against tested microbial strains were completely suppressed.Cell lysis and death occurred as a result of severe membrane damage caused by microorganisms perched on RGO nanoblades.Our work gives an insight into the design of effective graphene-based antimicrobial materials for water treatment and remediation.

关键词： Antimicrobial properties Nanoblades Mechano-bactericidal effect RGO nanosheets Gram-positive bacteria Cell viability

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Effect of Local Wound Infiltration with Ketamine versus Dexmedetomidine Added to Bupivacaine on Inflammatory Cytokines, a Randomized Clinical Trial

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Open Journal of Anesthesiology 2022年第8期12卷 261-277页

作者： fatma A. el sherif Moaaz Tohamy Mohamed A. M. Mostafa Suzanne de la Adlan Sahar Abdel-Baky Mohamed Samar Mansour Mahmoud M. Mohammed Ahmad M. Abd el-Rahman Anethesia ICU and Pain Management South Egypt Cancer Institute Assiut University Assiut Egypt Anesthesia ICU and Pain Management National Cancer Institute Cairo University Cairo Egypt Clinical Pathology South Egypt Cancer Institute Assiut University Assiut Egypt Surgical Oncology South Egypt Cancer Institute Assiut University Assiut Egypt

Background: Ketamine or dexmedetomidine as an adjuvant to bupivacaine in local wound infiltration attenuated postoperative stress response, especially with ketamine in patients undergoing total abdominal hysterectomy. Objectives: Compare effect of local wound infiltration with ketamine or dexmedetomidine added to bupivacaine to bupivacaine alone on inflammatory cytokine response after total abdominal hysterectomy. Methods: Sixty female patients with endometrial carcinoma underwent total abdominal hysterectomy and scheduled to receive local wound infiltration before wound closure either with one of three;40 ml of 0.25% bupivacaine alone (C Group) or with the addition of 2 mg/kg ketamine (K Group) or 2 μg/kg dexmedetomidine (D Group). After extubation, they were followed up for postoperative interleukin 6 (IL6), IL1β, IL10, and TNF-α levels were assessed at baseline, pre-infiltration, 6, and 24 h by blood samples obtained from each patient, hemodynamic variables, analgesic profile and side effects. Results: Inflammatory cytokines response was attenuated in K and D groups, evidenced by decreased mean pro-inflammatory cytokines IL6, TNF-α, and increased anti-inflammatory IL10 at 6 and 24 h postoperatively compared to pre-infiltration levels (p ≤ 0.01) with preservation of IL1β at its preoperative level (p > 0.05). Attenuation was more in K and D groups than in the C group and was highest in the K group with decreased 1st request, total morphine consumption without serious side effect. Conclusion: Local wound infiltration with ketamine or dexmedetomidine added to bupivacaine has a good postoperative analgesic profile and attenuated cytokines inflammatory response more than bupivacaine alone after total abdominal hysterectomy, with highest attenuation in ketamine group.

关键词： Ketamine Dexmedetomidine Local Infiltration Cytokines Hysterectomy

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A Hybrid Cybersecurity Algorithm for Digital Image Transmission over Advanced Communication Channel Models

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Computers, Materials & Continua 2024年第4期79卷 201-241页

作者： Naglaa F.Soliman fatma E.Fadl-Allah Walid el-Shafai Mahmoud I.Aly Maali Alabdulhafith Fathi E.Abd el-Samie Department of Information Technology College of Computer and Information SciencesPrincess Nourah bint Abdulrahman UniversityP.O.Box 84428Riyadh11671Saudi Arabia Department of electronics and Communications Faculty of EngineeringZagazig UniversityZagazig44519Egypt Security Engineering Lab Computer Science DepartmentPrince Sultan UniversityRiyadh11586Saudi Arabia Department of electronics and electrical Communications Engineering Faculty of Electronic EngineeringMenoufia UniversityMenouf32952Egypt

The efficient transmission of images,which plays a large role inwireless communication systems,poses a significant challenge in the growth of multimedia technology.High-quality images require well-tuned communication standards.The Single Carrier Frequency Division Multiple Access(SC-FDMA)is adopted for broadband wireless communications,because of its low sensitivity to carrier frequency offsets and low Peak-to-Average Power Ratio(PAPR).Data transmission through open-channel networks requires much concentration on security,reliability,and integrity.The data need a space away fromunauthorized access,modification,or deletion.These requirements are to be fulfilled by digital image watermarking and encryption.This paper ismainly concerned with secure image communication over the wireless SC-FDMA systemas an adopted communication standard.It introduces a robust image communication framework over SC-FDMA that comprises digital image watermarking and encryption to improve image security,while maintaining a high-quality reconstruction of images at the receiver side.The proposed framework allows image watermarking based on the Discrete Cosine Transform(DCT)merged with the Singular Value Decomposition(SVD)in the so-called DCT-SVD watermarking.In addition,image encryption is implemented based on chaos and DNA encoding.The encrypted watermarked images are then transmitted through the wireless SC-FDMA system.The linearMinimumMean Square Error(MMSE)equalizer is investigated in this paper to mitigate the effect of channel fading and noise on the transmitted images.Two subcarrier mapping schemes,namely localized and interleaved schemes,are compared in this paper.The study depends on different channelmodels,namely PedestrianAandVehicularA,with a modulation technique namedQuadratureAmplitude Modulation(QAM).Extensive simulation experiments are conducted and introduced in this paper for efficient transmission of encrypted watermarked images.In addition,different variants of SC-FDMA based on the Discrete Wavelet Transform(DWT),Discre

关键词： Cybersecurity applications image transmission channel models modulation techniques watermarking and encryption

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Strain engineering in electrocatalysis:Strategies,characterization,and insights

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Nano Research 2024年第5期17卷 3603-3621页

作者： Qibo Deng Peng Xu Hassanien Gomaa Mohamed A.Shenashen sherif A.el-Safty Cuihua An Li-Hua Shao Ning Hu School of Mechanical Engineering Hebei University of TechnologyTianjin 300401China Department of Chemistry Faculty of ScienceAl-Azhar University71524AssiutEgypt Department of Petrochemical Egyptian Petroleum Research Institute(EPRI)Nasr City11727CairoEgypt Center for Functional Materials National Institute for Materials Science(NIMS)1-2-1 SengenTsukubaIbaraki-ken305-0047Japan State Key Laboratory of Reliability and Intelligence electrical Equipment Key Laboratory of Advanced Intelligent Protective Equipment TechnologyMinistry of Educationand School of Mechanical EngineeringHebei University of TechnologyTianjin 300401China National Key Laboratory of Strength and Structural Integrity Institute of Solid MechanicsSchool of Aeronautic Science and EngineeringBeihang UniversityBeijing100191China Advanced Equipment Research Institute Co. Ltd.of HEBUTTianjin 300401China

Strain engineering,as a cutting-edge method for modulating the electronic structure of catalysts,plays a crucial role in regulating the interaction between the catalytic surface and the adsorbed molecules.The electrocatalytic performance is influenced by the electronic structure,which can be achieved by introducing the external forces or stresses to adjust interatomic spacing between surface atoms.The challenges in strain engineering research lie in accurately understanding the mechanical impact of strain on performance.This paper first introduces the basic strategy for generating the strain,summarizes the different strain generation forms and their advantages and disadvantages.The progress in researching the characterization means for the lattice strains and their applications in the field of electrocatalysis is also emphasized.Finally,the challenges of strain engineering are introduced,and an outlook on the future research directions is provided.

关键词： strain electrocatalysis characterization chemical reaction kinetics lattice mismatch

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Effects of Moringa oleifera aqueous extract on the growth performance,blood characteristics,and histological features of gills and livers in Nile tilapia

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Aquaculture and Fisheries 2024年第1期9卷 85-92页

作者： Mahamoud A.Emam Ramy M.Shourbela Waleed N.el-Hawarry Seham Y.Abo-Kora fatma Abdel-Monem Gad Ashraf M.Abd el-latif Mahmoud A.O.Dawood Histology Department Faculty of Veterinary MedicineBenha UniversityBenha13511Egypt Department of Animal Husbandry and Animal Wealth Development Faculty of Veterinary MedicineAlexandria UniversityAlexandria22758Egypt Pharmacology Department Faculty of Veterinary MedicineBenha UniversityBenha13511Egypt Clinical Pathology Department Faculty of Veterinary MedicineBenha UniversityBenha13511Egypt Department of Aquatic Animal Diseases and Management Faculty of Veterinary MedicineBenha UniversityBenha13511Egypt Animal Production Department Faculty of AgricultureKafrelsheikh UniversityKafr El-Sheikh33511Egypt The Center for Applied Research on the Environment and Sustainability The American University in CairoCairo11835Egypt

Moringa oleifera is well known as a highly nutritious plant and a water purifier in fish culture.Tilapia fish has many impressive qualities making them very suitable for aquaculture.Therefore,this study aimed to evaluate the effect of supplementation of Moringa oleifera aqueous extract(MOAE)at varying concentrations(0,100,200,and 400 mg/kg diet for 90 days)on growth performance,hematological,and some biochemical parameters of Nile tilapia.Additionally,histological changes and immunohistochemical expression of caspase 3 in gills and livers were evaluated.Significant enhancements(Pells,hemoglobin,packed cell volume,white blood cells,and total serum protein were observed in fish fed 200 mg MOAE/kg diet compared with other groups.However,a significant reduction(Pells indicating severe apoptotic features.Accordingly,a dietary MOAE at 200 mg/kg diet is recommended to improve the growth performance,hematological parameters,liver and kidney functions in Nile tilapia.Meanwhile,caution must be considered when using MOAE at a concentration over 200 mg/kg diet.

关键词： Growth performance Liver Gills Moringa oleifera Nile tilapia

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Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study

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Journal of Intensive Medicine 2024年第1期4卷 94-100页

作者： Hakan Erdem Jaffar AAl-Tawfiq Maha Abid Wissal Ben Yahia George Akafity Manar Ezzelarab Ramadan fatma Amer Amani el-Kholy Atousa Hakamifard Bilal Ahmad Rahimi Farouq Dayyab Hulya Caskurlu Reham Khedr Muhammad Tahir Lysien Zambrano Mumtaz Ali Khan Aun Raza Nagwa Mostafa el-Sayed Magdalena Baymakova Aysun Yalci Yasemin Cag Umran elbahr Aamer Ikram Department of Infectious Diseases&Clinical Microbiology Gulhane School of MedicineTurkish Health Sciences UniversityAnkaraTurkey Specialty Internal Medicine and Quality and Patient Safety Department Johns Hopkins Aramco HealthcareDhahranSaudi Arabia Division of Infectious Diseases Indiana University School of MedicineIndianapolisINUSA Department of Infectious Diseases Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Internal Medicine Department Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Cape Coast Teaching Hospital Cape CoastGhana Medical Parasitology Faculty of MedicineSuez UniversitySuezEgypt Department of Medical Microbiology and Immunology Faculty of MedicineZagazig UniversityZagazigEgypt Department of Clinical Pathology Faculty of MedicineCairo UniversityGizaEgypt Department of Infectious Diseases School of MedicineIsfahan University of Medical SciencesIsfahanIran Department of Infectious Diseases Kandahar University Medical FacultyTeaching HospitalKandaharAfghanistan Department of Infectious Diseases Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac CenterAwaliBahrain Department of Infectious Diseases and Clinical Microbiology Faculty of MedicineIstanbul Medeniyet UniversityIstanbulTurkey Department of Pediatric Oncology National Cancer Institute–Cairo UniversityChildren Cancer Hospital EgyptCairoEgypt Department of Medicine Federal General HospitalIslamabadPakistan Institute for Research in Medical Sciences and Right to Health(ICIMEDES) Scientific Research Unit(UIC)Faculty of Medical Sciences(FCM)National Autonomous University of Honduras(UNAH)TegucigalpaHonduras National Institute of Health IslamabadPakistan Shaukat Khanum Memorial Cancer Hospital and Research Center LahorePakistan Medical Parasitology Department Research Institute of OphthalmologyGizaEgypt Department of Infectious Diseases Military Medical AcademySofiaBulgaria Department of Infecti

Background:Fever of unknown origin(FUO)in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO.Methods:A multi-center study for infectious causes of FUO in lower middle-income countries(LMIC)and lowincome countries(LIC)was conducted between January 1,2018 and January 1,2023.In total,15 participating centers from seven different countries provided the data,which were collected through the Infectious DiseasesInternational Research Initiative platform.Only adult patients with confirmed infection as the cause of FUO were included in the study.The severity parameters were quick Sequential Organ Failure Assessment(qSOFA)≥2,intensive care unit(ICU)admission,vasopressor use,and invasive mechanical ventilation(IMV).Results:A total of 160 patients with infectious FUO were included in the study.Overall,148(92.5%)patients had community-acquired infections and 12(7.5%)had hospital-acquired infections.The most common infectious syndromes were tuberculosis(TB)(n=27,16.9%),infective endocarditis(n=25,15.6%),malaria(n=21,13.1%),brucellosis(n=15,9.4%),and typhoid fever(n=9,5.6%).Plasmodium falciparum,Mycobacterium tuberculosis,Brucellae,Staphylococcus aureus,Salmonella typhi,and Rickettsiae were the leading infectious agents in this study.A total of 56(35.0%)cases had invasive procedures for diagnosis.The mean qSOFA score was 0.76±0.94{median(interquartile range[IQR]):0(0–1)}.ICU admission(n=26,16.2%),vasopressor use(n=14,8.8%),and IMV(n=10,6.3%)were not rare.Overall,38(23.8%)patients had at least one of the severity parameters.The mortality rate was 15(9.4%),and the mortality was attributable to the infection causing FUO in 12(7.5%)patients.Conclusions:In LMIC and LIC,tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.

关键词： Developing countries Fever of unknown origin Infection

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Epidemiological and histopathological characteristics of thyroid carcinoma in a Tunisian health care center

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 37-42页

作者： Maissa Ben Thayer fatma Khanchel Imen Helal Dorra Chiboub Hedhli Raoueh Ehsen Ben Brahim Raja Jouini Aschraf Chadli-Debbiche Faculty of Medicine of Tunis Tunis El Manar UniversityTunisTunisia Depatment of Pathology Habib Thameur's HospitalTunisTunisia Department of Otorhinolaryngology-Head and Neck surgery Habib Thameur's HospitalTunisTunisia

Background:Thyroid carcinoma(TC)accounts for almost 0.5%–1%of total malignancies.Its incidence is increasing rapidly worldwide.Several studies have drawn up the epidemiological profile of TC and its clinical and pathological features.However,to date,no similar studies have been conducted in Tunisia.Aims:To establish an epidemiological profile of TC in a Tunisian health care institute and to analyze its clinical and histopathological characteristics in our institute.Materials and Methods:We present a retrospective study reviewing the cases of TC diagnosed in our institution in a 4-year period.Results:We collected a sample of 192 cases of TC.It consisted of 31 males and 161 females(83.8%)with a sex-ratio M/F of 0.19.The mean age was 46.4 years.Papillary thyroid carcinoma was the most frequent histological subtype.The multifocality rate was 33.8%.The mean size of TC was 2.2±1.9 cm.60.9%of TC were staged pT1 and 20.3%had nodal involvement.Papillary thyroid microcarcinomas were noted in 37.5%of cases.Conclusion:Our results were consistent with those of the literature.A high proportion of pT1 and pN0 tumors were noted in our series,suggesting that TC's diagnosis and management was performed at an early stage of the disease in our institution.In addition,our study enabled us to notice the impact of the Coronavirus disease 19 crisis on the management of TC in our institution.Further studies are needed to establish the epidemiological profile of TC in Tunisia and to assess its clinical and pathological features.

关键词： coronavirus disease 19 epidemiology papillary thyroid carcinoma papillary thyroid microcarcinoma pathology thyroid carcinoma

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