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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

Risk-Adapted, Combined-Modality Therapy for Unfavorable Pediatric Hodgkin Lymphom

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Journal of Cancer Therapy 2018年第7期9卷 545-558页

作者： Amany M. Ali Amira M. Mohamed Shimaa Ahmed Mohamed Abdallah Tarek M. Alsaba samar mansour Pediatric Oncology Department South Egypt Cancer Institute Assiut University Assiut Egypt Radiotherapy Department South Egypt Cancer Institute Assiut University Assiut Egypt Radiology Department South Egypt Cancer Institute Assiut University Assiut Egypt Pathology Department South Egypt Cancer Institute Assiut University Assiut Egypt Clinical Pathology Department South Egypt Cancer Institute Assiut University Assiut Egypt

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved-field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 - 103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 - 6 cycles) and (6 - 8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures;5 patients had progressive disease;and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable criteria with better assessment of early responders needed by PET-CT to identify patients at risk for relapse.

关键词： Risk-Adapted Combined-Modality Unfavourable Pediatric Hodgkin Lymphoma

Unique presentation of neonatal liver failure:A case report

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World Journal of Clinical Pediatrics 2024年第2期13卷 221-226页

作者： Eman Al Atrash Amer Azaz samar Said Mohammad Miqdady Department of Pediatrics Division of Pediatric GastroenterologySheikh Khalifa Medical CityAbu Dhabi 971United Arab Emirates Department of Pathology Mayo ClinicRochesterMN 55905United States

BACKGROUND Acute fulminant liver failure rarely occurs in the neonatal period.The etiologies include viral infection(15%),metabolic/genetic disease(10%),hematologic disorders(15%),and ischemic injury(5%).Gestational alloimmune liver disease usually manifests as severe neonatal liver failure,with extensive hepatic and extrahepatic iron overload,sparing the reticuloendothelial system.Empty liver failure is a rare cause of liver failure where a patient presents with liver failure in the neonatal period with no hepatocytes in liver biopsy.CASE SUMMARY A 5-week-old male presented with jaundice.Physical examination revealed an alert but deeply icteric infant.Laboratory data demonstrated direct hyperbilirubinemia,a severely deranged coagulation profile,normal transaminase,and normal ammonia.Magnetic resonance imaging of the abdomen was suggestive of perinatal hemochromatosis.Liver biopsy showed histiocytic infiltration with an absence of hepatocytes.No hemosiderin deposition was identified in a buccal mucosa biopsy.CONCLUSION Neonatal liver failure in the absence of hepatocellular regeneration potentially reflects an acquired or inborn defect in the regulation of hepatic regeneration.

关键词： Liver Hyperbilirubinemia Le foie vide Neonatal hemochromatosis Case report

Contrast Normalization Strategies in Brain Tumor Imaging:From Preprocessing to Classification

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Computer Modeling in Engineering & Sciences 2024年第8期140卷 1539-1562页

作者： samar M.Alqhtani Toufique A.Soomro Faisal Bin Ubaid Ahmed Ali Muhammad Irfan Abdullah A.Asiri Department of Information Systems College of Computer Science and Information SystemsNajran UniversityNajran61441Saudi Arabia Department of Electronic Engineering The University of LarkanoLarkanaSindh75660Pakistan Computer Science Department Sukkur IBA UniversitySukkurSindh65200Pakistan Eletrical Engineering Department Sukkur IBA UniversitySukkurSindh65200Pakistan Electrical Engineering Department College of EngineeringNajran UniversityNajran61441Saudi Arabia Radiological Sciences Department College of Applied Medical SciencesNajran UniversityNajran61441Saudi Arabia

Cancer-related to the nervous system and brain tumors is a leading cause of mortality in various countries.Magnetic resonance imaging(MRI)and computed tomography(CT)are utilized to capture brain images.MRI plays a crucial role in the diagnosis of brain tumors and the examination of other brain disorders.Typically,manual assessment of MRI images by radiologists or experts is performed to identify brain tumors and abnormalities in the early stages for timely intervention.However,early diagnosis of brain tumors is intricate,necessitating the use of computerized methods.This research introduces an innovative approach for the automated segmentation of brain tumors and a framework for classifying different regions of brain tumors.The proposed methods consist of a pipeline with several stages:preprocessing of brain images with noise removal based on Wiener Filtering,enhancing the brain using Principal Component Analysis(PCA)to obtain well-enhanced images,and then segmenting the region of interest using the Fuzzy C-Means(FCM)clustering technique in the third step.The final step involves classification using the Support Vector Machine(SVM)classifier.The classifier is applied to various types of brain tumors,such as meningioma and pituitary tumors,utilizing the Contrast-Enhanced Magnetic Resonance Imaging(CE-MRI)database.The proposed method demonstrates significantly improved contrast and validates the effectiveness of the classification framework,achieving an average sensitivity of 0.974,specificity of 0.976,accuracy of 0.979,and a Dice Score(DSC)of 0.957.Additionally,this method exhibits a shorter processing time of 0.44 s compared to existing approaches.The performance of this method emphasizes its significance when compared to state-of-the-art methods in terms of sensitivity,specificity,accuracy,and DSC.To enhance the method further in the future,it is feasible to standardize the approach by incorporating a set of classifiers to increase the robustness of the brain classification method.

关键词： Brain tumor magnetic resonance imaging principal component analysis fuzzy c-clustering support vector machine

Neuroprotective effect of liraglutide and memantine in a rat model of Alzheimer’s disease

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Asian Pacific Journal of Tropical Biomedicine 2024年第5期14卷 207-214页

作者： Duaa M.Bakhshwin Foziya W.Alhalabi Mohamad Omar Barasheed Ahmed M.Bakhshwin Maha H.Jamal Mohammed A.Bazuhair Fatemah O.Kamel Rania M.Magadmi Zoheir A Damanhouri samar M.Alsaggaf Department of Clinical Pharmacology Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Hera General Hospital MakkahSaudi Arabia Department of Pathology Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Clinical Anatomy Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia

Objective:To assess the effect of memantine combined with liraglutide on aluminum chloride(AlCl_(3))and D-galactose(D-GAL)-induced neurotoxicity in rats.Methods:Male Wistar rats were divided into 5 groups of 5 animals each:the positive control,the negative control,the memantine-treated group,the liraglutide-treated group,and the combination group treated with memantine and liraglutide.AlCl_(3)and D-GAL were used to induce neurotoxicity.Behavioral tests,brain beta-amyloid protein,and oxidative stress biomarkers were evaluated.Results:The Morris water maze test indicated an enhanced memory in the combination group.Moreover,the combination treatment of liraglutide and memantine resulted in a remarkable reduction in the beta-amyloid protein level in the brain tissue.Neuronal inflammation and oxidative stress biomarkers were significantly reduced,and the levels of antioxidant parameters were enhanced.Conclusions:The combination of liraglutide and memantine exerts neuroprotective effects and enhances memory and cognitive functions in rats with Alzheimer’s disease.

关键词： Alzheimer’s disease Cognitive function Glucagonlike peptide-1 Liraglutide Memantine

A need for stratification of metastasis samples according to secondary site in gene expression studies

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BIOCELL 2022年第7期46卷 1747-1750页

作者： IVANA samarŽIJA Laboratory for Epigenomics Division of Molecular MedicineRuđer BoškovićInstituteZagreb10000Croatia Laboratory for Cell Biology and Signaling Division of Molecular BiologyRuđer BoškovićInstituteZagreb10000Croatia

Comparisons of gene expression profiles between primary tumors and metastasis have revealed genes that are implicated in metastasis formation.However,gene expression studies conducted on metastasis samples from the same primary site usually do not discriminate between different secondary sites.Although the change in the expression of number of genes is expected to be common to metastasis from the same primary but different secondary sites,herein the data that point to substantial differences are presented.Furthermore,the reciprocal communication between metastatic and host cells that is influencing these differences is outlined to emphasize the need for stratification of metastasis samples in gene expression studies.

关键词： Bone metastasis Brain metastasis Liver metastasis Lung metastases Gene expression

Comparing the efficacy of regen-cov,remdesivir,and favipiravir in reducing invasive mechanical ventilation need in hospitalized COVID-19 patients

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世界临床病例杂志 2023年第26期11卷 6105-6121页

作者： Sahar Kmal Hegazy samar Tharwat Ahmed Hosny Hassan Clinical Pharmacy Department Faculty of PharmacyTanta UniversityTanta 31511Egypt Rheumatology and Immunology Unit Internal Medicine DepartmentFaculty of MedicineMansoura universityMansoura 35511Egypt Clinical Pharmacy Department Mansoura University HospitalMansoura 35511Egypt

BACKGROUND Coronavirus disease 2019(COVID-19)pandemic stimulates research works to find a solution to this crisis from starting 2020 year up to now.With ending of the 2021-year,various advances in pharmacotherapy against COVID-19 have emerged.Regarding antiviral therapy,casirivimab and imdevimab antibody combination is a type of new immunotherapy against COVID-19.Standard antiviral therapy against COVID-19 includes Remdesivir and Favipiravir.AIM To evaluate the efficacy of antibodies cocktail(casirivimab and imdevimab)compared to standard antiviral therapy in reducing the need for invasive mechanical ventilation(IMV).METHODS 265 COVID-19 polymerase chain reaction confirmed patients with indication for antiviral therapy were included in this study and were divided into 3 groups(1:2:2):Group A:REGN3048-3051 antibodies cocktail(casirivimab and imdevimab),group B:Remdesivir,group C:Favipiravir.The study design is a single-blind nonrandomized controlled trial mansoura University Hospital owns the study’s drugs.The duration of the study was about 6 mo after ethical approval.RESULTS Casirivimab and imdevimab achieve less need for O2 therapy and IMV,with less duration of this need than remdesivir and favipiravir.CONCLUSION Group A(casirivimab and imdevimab)achieve better clinical outcomes than groups B(remdesivir)and C(favipiravir)intervention groups.

关键词： Antivirals Casirivimab and imdevimab Coronavirus disease 2019 Favipiravir Remdesivir

Molecular mechanisms targeting drug-resistance and metastasis in colorectal cancer:Updates and beyond

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World Journal of Gastroenterology 2023年第9期29卷 1395-1426页

作者： samar Al Bitar Marwan El-Sabban Samer Doughan Wassim Abou-Kheir Department of Anatomy Cell Biology and Physiological SciencesAmerican University of BeirutBeirut 1107-2020Lebanon Department of Surgery American University of Beirut Medical CenterBeirut 1107-2020Lebanon

Colorectal cancer(CRC)is the third most diagnosed malignancy and a major leading cause of cancer-related deaths worldwide.Despite advances in therapeutic regimens,the number of patients presenting with metastatic CRC(mCRC)is increasing due to resistance to therapy,conferred by a small population of cancer cells,known as cancer stem cells.Targeted therapies have been highly successful in prolonging the overall survival of patients with mCRC.Agents are being developed to target key molecules involved in drug-resistance and metastasis of CRC,and these include vascular endothelial growth factor,epidermal growth factor receptor,human epidermal growth factor receptor-2,mitogen-activated extracellular signal-regulated kinase,in addition to immune checkpoints.Currently,there are several ongoing clinical trials of newly developed targeted agents,which have shown considerable clinical efficacy and have improved the prognosis of patients who do not benefit from conventional chemotherapy.In this review,we highlight recent developments in the use of existing and novel targeted agents against drug-resistant CRC and mCRC.Furthermore,we discuss limitations and challenges associated with targeted therapy and strategies to combat intrinsic and acquired resistance to these therapies,in addition to the importance of implementing better preclinical models and the application of personalized therapy based on predictive biomarkers for treatment selection.

关键词： Colorectal cancer Metastatic colorectal cancer Targeted therapy Drugresistance Personalized medicine

A Hybrid Model for Reliability Aware and Energy-Efficiency in Multicore Systems

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Computers, Materials & Continua 2022年第3期70卷 4447-4466页

作者： samar Nour Sameh A.Salem Shahira M.Habashy Department of Computer and Systems Engineering Faculty of EngineeringHelwan UniversityCairo11792Egypt Egyptian Computer Emergency Readiness Team(EG-CERT) National Telecom Regulatory Authority(NTRA)Cairo12577Egypt

Recently,Multicore systems use Dynamic Voltage/Frequency Scaling(DV/FS)technology to allow the cores to operate with various voltage and/or frequencies than other cores to save power and enhance the performance.In this paper,an effective and reliable hybridmodel to reduce the energy and makespan in multicore systems is proposed.The proposed hybrid model enhances and integrates the greedy approach with dynamic programming to achieve optimal Voltage/Frequency(Vmin/F)levels.Then,the allocation process is applied based on the availableworkloads.The hybrid model consists of three stages.The first stage gets the optimum safe voltage while the second stage sets the level of energy efficiency,and finally,the third is the allocation stage.Experimental results on various benchmarks show that the proposed model can generate optimal solutions to save energy while minimizing the makespan penalty.Comparisons with other competitive algorithms show that the proposed model provides on average 48%improvements in energy-saving and achieves an 18%reduction in computation time while ensuring a high degree of system reliability.

关键词： Energy-efficiency safe voltage multicore processors core utilization dynamic voltage/frequency scaling makespan