BM Group Research Articles

Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia during Cesarean Section: A Double-Blind Randomized Clinical Trial Study.

Background Comparing bupivacaine's adjuvants in spinal anesthesia, we assessed the specific blocking characteristics and adverse effects of bupivacaine alone and in combination with dexmedetomidine or meperidine in spinal anesthesia during cesarean section. Methods In this double-blind randomized clinical trial study, ninety pregnant women were divided into groups to receive 10 mg bupivacaine (group B), 10 mg bupivacaine with 5 μg dexmedetomidine (group BD), or 10 mg bupivacaine with 10 mg meperidine (group BM) intrathecal. Patients were assessed for the quality of analgesia during operations. Durations of sensory and motor blocks and anesthesia-related complications were analyzed using SPSS 21, and p values <0.05 were considered statistically significant. Results The onset of sensory and motor blocks was essentially the same in all treated groups. Block regression time was significantly prolonged in the BD group compared to the B and BM groups (p < 0.001). The duration of analgesia was significantly longer in the BD and BM groups than in the B group (p < 0.001). The level of sedation in the BD group was higher than in the B group. Shivering occurred in 40% of patients in the B group, which was significantly more than that of the BD (16.6%) and BM (33.3%) groups. Itching happened in 33.3% of women in the BM group which was statistically more than that of the B (3.33%) and BD (0) groups. The incidence of adverse effects was the same in all groups. Conclusion The combination of bupivacaine with dexmedetomidine significantly prolonged sensory and motor regression time and duration of analgesia.

Early Structural and Vascular Changes after Within-24 Hours Vitrectomy for Recent Onset Rhegmatogenous Retinal Detachment Treatment: A Pilot Study Comparing Bisected Macula and Not Bisected Macula.

Background: In this study we aimed at investigating macular perfusion/anatomical changes in eyes with early onset rhegmatogenous retinal detachment (RRD) after prompt surgery within 24 hours, comparing a bisected macula and not bisected macula RRD. Methods: In this prospective observational study, 14 eyes of 14 patients who underwent within-24 hours vitreoretinal surgery for early onset RRD were enrolled. Patients were further divided into two subgroups: the not bisected macula group (NBM group) and the bisected macula group (BM group). At baseline and 3-month follow up, macular architecture and vessel analysis were assessed using optical coherence tomography angiography (OCTA) imaging. In detail, quantitative and qualitative analyses of the macular area were performed to quantify topographical retinal perfusion changes after surgery, calculating the foveal avascular zone (FAZ), vessel density (VD) and vessel length density (VLD) at the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results: Most cases (43%) were superotemporal RRD. Primary retinal reattachment was obtained in all cases, without recurrences within 3-month follow up. After surgery, a significant FAZ enlargement was observed at both the SCP and DCP level (p < 0.001; p < 0.05), with a significant effect of time noted between the two time points in the NBM and BM subanalysis (F = 3.68; p < 0.017). An excellent functional outcome was maintained for the whole follow-up. On the other hand, after surgery, perfusion parameters did not change significantly apart from the vessel density of the inferior macular sector at the DCP level (p = 0.03). Conclusions: Our findings suggest that the macular perfusion of eyes with RRD is still preserved if the surgery is performed really promptly, thus highlighting the great importance of a correct timing for surgery. OCTA analysis allows for a better understanding of the pathophysiological mechanisms underneath early vascular microarchitecture modifications of the posterior pole in retinal detachment, differentiating the two types of RRD not completely involving the fovea (BM and NBM).

Effects of black soldier fly (Hermetia illucens) pre-pupae meal on the growth, stress, and immune responses of juvenile rainbow trout (Oncorhynchus mykiss) reared at different stocking densities

The present study investigated the effects of black soldier fly (Hermetia illucens) pre-pupae meal (BM) as a feed ingredient on the growth performance and health status (stress and immune response) of rainbow trout (Oncorhynchus mykiss) reared at different stocking densities. BM was used to replace 5 % of soybean meal in the control diet (CON). Juvenile rainbow trout (4.9 ± 0.2 g) were acclimated and placed in experimental tanks, at stocking densities of 4.9 (low density, LD) and 9.8 (high density, HD) kg/m3. Trout were assigned to four treatments (CON/LD, CON/HD, BM/LD, and BM/HD) in triplicates and reared for 6 weeks. After the feeding trial, fish reared in low-density tanks showed significantly higher weight gain regardless of diet (P < 0.05). In HD groups (CON/HD and BM/HD), however, fish fed the BM diet showed a significantly higher weight gain than those fed the CON diet. The lauric acid (12:0) content of BM groups (BM/LD and BM/HD), in the whole-body, was closely correlated with diets and significantly higher than that of the CON groups (P < 0.05). Fish from the BM/LD group showed significantly higher expression of interleukin 1β (IL-1β), interleukin 8 (IL-8), and immunoglobulin M (IgM) genes compared to the CON groups (P < 0.05). Although no statistical difference was detected, the overall response patterns of liver tissue in antioxidant and immune parameters, including superoxide dismutase (SOD), lysozyme activity (Lyz), IL-1β, and IgM, followed the expression of immune-related genes in response to the different diets and stocking density. In a challenge test with Aeromonas salmonicida for 10 days, fish fed the BM diet showed a significantly higher cumulative survival rate than those fed the CON diet (P < 0.05). These results suggest that BM could be a beneficial feed ingredient for juvenile rainbow trout, but that high stocking densities can negatively influence the growth and immune responses.

Effects of bamboo leaf extract intervention on the growth performance, antioxidant capacity, and hepatic apoptosis in suckling piglets.

This study investigated whether bamboo leaf extract (BLE) could improve the growth performance, antioxidant capacity, and inhibit hepatic apoptosis in suckling piglets. Sixty-four suckling piglets were orally gavaged with vehicle (CON group) or 100, 200, or 300 mg BLE/kg body weight (BL, BM, and BH groups) at 3 d of age for 21 d (n = 8). The results showed that BLE treatment had no effects on the growth performance (P > 0.05). Compared with the CON group, the BM and BH groups decreased (P < 0.05) the jejunal and hepatic malondialdehyde (MDA) contents. Supplementation with BLE increased antioxidant enzymes activities and the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and several targeted genes in the jejunum and liver of suckling piglets. The hepatic apoptosis rate was lower (P < 0.05) in BLE treatment than in the CON group. Compared with the CON group, the BLE groups showed increased (P < 0.05) mRNA levels of B-cell-lymphoma protein 2 (BCL-2), whereas decreased (P < 0.05) BCL-2-associated X (BAX) and cysteine aspartate specific protease-3 (caspase-3) mRNA levels. The results of protein expressions of BCL-2 and caspase-3 were consistent with those of mRNA levels. Altogether, our results indicated that BLE intervention can improve the antioxidant capacity and inhibit hepatic apoptosis in suckling piglets.

Effects of the Hand Massage and Back Massage on Comfort and Anxiety in Older People: A Randomızed Controlled Trial

With the advanced age, older people become less productive, experience decline in mental functions, delay to respond to new situations, weakening of the short-term memory and need others’ help to maintain activities of daily living, which cause them to experience loneliness and anxiety. The purpose of the present study was to investigate the effect of back massage and hand massage applications on comfort and anxiety of older people living in nursing homes. The population of this single-blind randomized controlled experimental study with a pretest - posttest control group comprised seniors living in two different nursing homes in Izmir, a province in western Turkey. The study sample consisted of 45 older people between October 15, 2015 and May 1, 2016 and met the sample selection criteria. They were assigned to BM (n = 15), HM (n = 15) and Control (n = 15) groups. The study data were collected using the Personal Information Form (PIF), State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ). BM and HM increased the comfort levels of the older adults living in nursing homes and reduced their anxiety levels, and the results were considered statistically significant (p&lt; .05). BM and HM have a positive effect on comfort and anxiety in older adults living in nursing homes. It was concluded that BM and HM were non- pharmacological nursing interventions with no side effects which nurses can include in nursing care confidently and can apply independently.

Effects of the potential probiotic Bacillus subtilis D1-2 on growth, digestion, immunity and intestinal flora in juvenile sea cucumber, Apostichopus japonicus

In the present study, a potential probiotic Bacillus subtilis D1-2 with antibacterial activity was isolated from the gut of Apostichopus japonicus. The purpose of this experiment was to assess the effect of B. subtilis D1-2 at different concentrations (C: 0 CFU/g, BL: 105 CFU/g, BM: 107 CFU/g and BH: 109 CFU/g) on the growth performance, digestive enzyme activity, immune ability and intestinal flora of A. japonicus. After the 56-day feeding trial, the final body weight and weight gain rate of juvenile sea cucumber A. japonicus fed B. subtilis D1-2 were significantly increased, especially in the BM group. Additionally, the lipase activity of the intestine was significantly increased in the BM and BH groups. Enhanced immunity was also found in sea cucumbers supplemented with B. subtilis D1-2. Alpha diversity indices showed that the B. subtilis D1-2-supplemented groups had higher intestinal microbial richness and diversity than the control group. The beta diversity analysis indicated that the bacterial communities in the B. subtilis D1-2-supplemented groups were quite similar but different from the bacterial communities in the control group. Dietary supplementation with B. subtilis D1-2 increased the relative abundance of some potential probiotic-related genera, including Lactobacillus, Clostridium, Lactococcus, Bifidobacterium and Streptococcus. In conclusion, dietary addition of B. subtilis D1-2 could effectively promote the growth of A. japonicus, improve its digestion and immunity capacity to a certain extent, and actively regulate the intestinal microflora of A. japonicus.

Single brain metastasis versus glioblastoma multiforme: a VOI-based multiparametric analysis for differential diagnosis

PurposeThe authors’ purpose was to create a valid multiparametric MRI model for the differential diagnosis between glioblastoma and solitary brain metastasis.Materials and methodsForty-one patients (twenty glioblastomas and twenty-one brain metastases) were retrospectively evaluated. MRIs were analyzed with Olea Sphere® 3.0. Lesions’ volumes of interest (VOIs) were drawn on enhanced 3D T1 MP-RAGE and projected on ADC and rCBV co-registered maps. Another two VOIs were drawn in the region of hyperintense cerebral edema, surrounding the lesion, respectively, within 5 mm around the enhancing tumor and into residual edema. Perfusion curves were obtained, and the value of signal recovery (SR) was reported. A two-sample T test was obtained to compare all parameters of GB and BM groups. Receiver operating characteristics (ROC) analysis was performed.ResultsAccording to ROC analysis, the area under the curve was 88%, 78% and 74%, respectively, for mean ADC VOI values of the solid component, the mean and max rCBV values in the perilesional edema and the PSR. The cumulative ROC curve of these parameters reached an area under the curve of 95%. Using perilesional max rCBV > 1.37, PSR > 75% and mean lesional ADC < 1 × 10−3 mm2 s−1 GB could be differentiated from solitary BM (sensitivity and specificity of 95% and 86%).ConclusionLower values of ADC in the enhancing tumor, a higher percentage of SR in perfusion curves and higher values of rCBV in the peritumoral edema closed to the lesion are strongly indicative of GB than solitary BM.

Digital 3D "Heads-up" Cataract Surgery: Safety Profile and Comparison with the Conventional Microscope System.

The aim of this study was to compare the complication rates between surgery performed using digital heads-up 3Dsystem (3Dgroup) and a conventional binocular microscope-based system (BM group) in a large series of cataract operations performed by the same surgeon. This retrospective analysis included a consecutive series of 2,000 cataract operations. The 3Dgroup included n = 1,000 operations performed immediately following the introduction of a 3Dsystem (Alcon Ngenuity). For comparison, the last n = 1,000 operations performed with a binocular microscope were included in the BM group. The 3Dsystem was adapted to the existing microscope so that the microscope optics remained unchanged. The In both groups, the surgical techniques used were either phacoemulsification or femtosecond laser cataract surgery. Complications were recorded and analyzed retrospectively. The proportion of femto-laser cataract operations was 19.8% in the 3Dgroup and 18.6% in the BM group. Capsule rupture occurred in 10 eyes (3D: n = 4 (0.4%), anterior vitrectomy: n = 2, pars plana vitrectomy: n = 1; BM: n = 6 cases (0.6%), anterior vitrectomy: n = 4, pars plana vitrectomy: n = 1). A short-term iris prolapse occurred in 3 eyes (3D: n = 2, BM: n = 1). Zonulolysis occurred in 2 eyes (3D: n = 1, BM: n = 1). Overall, there was no statistically significant difference between the two groups (p > 0.5). There was no significant increase in the duration of surgery following the switch to the 3Dtechnique. In a large series of 2000 eyes, there was no significant difference between 3D and BM surgery in terms of the safety profile during cataract surgery. 3D surgery can, therefore, be used for cataract operations without additional risk.

Evaluation of intrathecal midazolam (2mg) as an adjuvant to bupivacaine (0.5%) for spinal anaesthesia in orthopaedic surgery: A case control study

Spinal anaesthesia is being routinely used for lower abdominal and lower limb surgeries. Bupivacaine is the commonly used anaesthetic agent because of its longer duration of action. Various intrathecal adjuvants like midazolam are sometimes added to enhance the anaesthetic effects and increase the duration of analgesia. We, hereby evaluated the effects of intrathecal midazolam 2mg as an adjuvant to bupivacaine during spinal anaesthesia in orthopaedic surgery. A total of 60 patients of age 20-50 years were randomly divided into two groups: BM-who received 3.2ml bupivacaine and 0.4ml(2mg) midazolam; and BS-who received 3.2 ml bupivacaine and 0.4ml normal saline. Mean duration of analgesia was prolonged in the midazolam group (429.33+/-59.54 min) as compared to controls (252+/-42.22 min) (p=0.00). The number of injection diclofenac as rescue analgesic were also significantly less in BM group. Time to achieve maximum sensory level(T4) was also significantly less in BM group. Time to two segment regression and the duration of motor block were more in the midazolam group. Intrathecal midazolam as an adjuvant significantly prolongs the duration of analgesia and decreases the requirement of rescue analgesia when combined with bupivacaine during spinal anaesthesia. The dose of 2mg seems to safe and effective to achieve the desired results.

Impact of different fixed dental prostheses on radiation dose in helical tomotherapy as measured with metal oxide semiconductor field-effect transistor dosimetry

This ex vivo study evaluated the effects of different fixed dental prostheses and protective materials on scattered radiation during radiation therapy (RT). Natural teeth (group NT) and 4 types of prostheses (group BL: bilayer lithium disilicate glass-ceramic; group MZ: monolithic zirconia ceramic; group BZ: bilayer zirconia-based all ceramic; and group BM: bilayer metal-ceramic restorations) were examined in maxillary and mandibular arch phantoms. All groups were divided into 3 subgroups: (1) without protective material over the prostheses; (2) protected with a soft acrylic night guard; and (3) protected with polyvinylsiloxane putty. All groups were irradiated with helical RT at 2 Gy and 6 MV photon energy. Doses were measured internally and externally 3 times on each phantom. Results were significant at P < .05. No statistically significant differences in doses were found between groups NT and BL in either phantom, but these groups were different from the others. The differences between groups BZ and MZ were insignificant. Doses in group BM were significantly larger than all other groups. No significant differences existed between doses with and without protective material. Doses increased significantly due to scattered radiation from the prostheses with increasing material density. Protective materials had no significant effect on dose.

Study of Analgesic Effect of Magnesium Sulphate with Bupivacaine in Ultrasonogram Guided Transversus Abdominis Plane Block for Post-Operative Analgesia in Lower Uterine Cesarean Section

Background: Transversus abdominis plane (TAP) block has proven to be an effective component of postoperative pain management for different abdominal procedures particularly in Lower uterine cesarean section (LUCS) done under Sub arachnoid block. Magnesium sulphate (MgSO4) is a N-methyl-D-aspartate receptor antagonist has the potential to act as an adjuvant in TAP block. For this reason this study was planned to assess the role of Magnesium Sulphate as an adjuvant to bupivacaine in ultrasound-guided transverse abdominis plane (TAP) blocks for postoperative analgesia in patients undergoing LUCS after regression of block of Sub arachnoid block.&#x0D; Methods: This was a hospital based randomized controlled trial which was conducted in Dhaka Medical College Hospital (DMCH) at the department of Anaesthesia, Analgesia, Palliative &amp; Intensive Care Medicine for 2 years of period. Formal ethical approval was taken from the Ethical Review Committee (ERC) of DMC. Patients having LUCS were approached for the study. A total of 60 patients of LUCS under Sub arachnoid block were selected in the study among them 30 patients received TAP block with bupivacaine 0.25% with saline, and the other 30 received bupivacaine 0.25% with 150 mg Magnesium Sulphate immediately following surgery. Primary outcome was focused on duration of analgesia, pain score, time of first need of rescue analgesic and total opioid consumption. Pre-block and immediately post block Visual analog pain scores (VAS) (0–10) were obtained. After pre-anesthetic checkup &amp; discussion about study procedures written informed consent was taken from the patient. Separate case record form was used in each case. Data analysis was done by SPSS version 22.&#x0D; Observation and Results: Mean age of group B (GB) and group-BM (GBM) patients were 25.57± 2.76 &amp; 25.9 ± 3.17SD (years). No significant difference demographic profile was observed (p&gt;0.05). Mean duration of analgesia was significantly prolonged in Group BM compared to Group B (263.13 ± 34.39) min vs. 222.23 ± 30.58 min; P-value &lt;0.001) which was evident by increased VAS score at 16th hour postoperatively in magnesium sulphate group than normal saline group. Total postoperative requirement of opioid was also lower in Group BM (p&lt;0.05).&#x0D; Conclusion: Magnesium Sulphate could be used as an adjuvant with bupivacaine in ultrasound guided transversus abdominis plane (TAP) blocks for management of post-operative analgesia in LUCS patient.&#x0D; CBMJ 2021 January: vol. 10 no. 01 P: 09-17

A comparative study between magnesium sulfate and dexmedetomidine as adjuvants to bupivacaine using ultrasound-guided lumbar-plexus block in lower abdominal surgeries

Background and aim Pain international association of described pain as an unpleasant sensory and emotional practice accompanied with actual or potential tissue injuries. Opioid administrations remain the cornerstone of postoperative pain relief, but it may cause significant side effects, including sedations, nausea, vomiting, and urinary retention. We aimed to compare the efficacy of ultrasound-guided lumbar-plexus block through adding magnesium sulfate and dexmedetomidine (DEX) to bupivacaine on postoperative analgesia and thereafter surgical operation. Patients and methods This prospective, randomized, double-blinded, controlled research was performed on Al-Azhar University Hospitals. A total of 75 cases of both sexes, age between 21 and 65 years, American Society of Anesthesiologists class I– II, were listed for elective lower-abdomen surgical operation underneath general anesthesia. Results Pain scores were decreased significantly in the study groups for 12 and 18 h in BM and BD, respectively, also, there was a significant decrease at 2, 4, 6, 8, and 12 h in the BD group lesser than the BM group postoperatively. The time to the initial analgesic appeal was significantly extended in the BD group (11.9±1 h) than the BM group (10.6±0.7 h). Conclusion Posterior lumbar-plexus block utilizing 22 ml of bupivacaine 0.5% with DEX 1 μg/kg decreases pain score, opioid consumption, prolongs duration of analgesia, better hemodynamics stability, and perfect outcome of cases’ satisfaction postoperatively compared with posterior lumbar-plexus block using 22 ml of bupivacaine 0.5% with magnesium sulfate 150 mg. DEX provides faster onset time and longer periods of MB and extended period of analgesia with smaller consumptions of postoperative rescue analgesia.

Comparison of LMA Supreme, i-gel, and Baska Mask for Airway Management during Laparoscopic Cholecystectomy: A Prospective Randomized Comparative Study from North India.

Background:The supraglottic airway device (SAD) has proved to be an appropriate alternative to endotracheal intubation in laparoscopic surgeries owing to various advantages, namely, decreased airway manipulation and stable hemodynamics.Aims:We compared the efficacy in terms of oropharyngeal leak pressure (OLP) and safety of laryngeal mask airway (LMA)-Supreme (LMA-S), i-gel, and Baska mask in patients undergoing laparoscopic cholecystectomy.Settings and Design:Ninety patients posted for elective laparoscopic cholecystectomy were selected for a prospective randomized comparative study in a tertiary care center.Materials and Methods:The study comprised three groups of 30 each based on the different SADs used Group-LS with LMA-Supreme, Group-IG with i-gel, and Group-BM with Baska mask. The secondary objectives were device insertion time, ease of insertion, changes in the peak airway pressure (PAP), heart rate, mean arterial pressure, and airway complications (sore throat, dysphagia. dysphonia, lip/tongue or dental injury, etc.) between three groups.Statistical Analysis:The quantitative data were analyzed using the one-way analysis of variance test and Bonferroni post hoc multiple comparison test. Qualitative data were compared using Chi.squared testResults:OLP was significantly higher (P = 0.005) in the Baska mask than i-gel and LMA-S groups just after insertion and during carboperitonium. There was no significant difference in time for device insertion, number of attempts, ease of insertion, and use of manipulation (P > 0.05). However, the gastric tube insertion time was significantly lower in Group BM (9.59 ± 2.78) than Group IG with 12.79 ± 3.47 and Group LS with 10.84 ± 3.68 (P < 0.05). There were no significant differences between the groups with regard to changes in the PAP, heart rate, mean arterial pressure at different time intervals, and complications.Conclusion:Baska mask provided a significantly higher OLP compared to i-gel and LMA-S without significant airway morbidity in laparoscopic surgeries.

MUSLIM BROTHERHOOD IN EUROPE: BETWEEN RELIGION AND POLITICS.

The article examines the reasons that prompted the governments and expert circles of many EU countries to pay increased attention in the past two years to the activities of the Muslim Brotherhood (BM) religious and political association within the EU. According to the author, this is due not only to the terrorist attacks of Islamists in France and Austria in 2020, but also to the manifestations of the growing influence of this category of Muslim organizations and groups on the social and political life of the countries of the Old World. The article focuses on the analysis of the means, methods and mechanisms characteristic of the groupings associated with the structures of the Muslim Brotherhood in Europe, on their differences from similar organizations in the Middle East. The author turns to the history of the emergence and growth of the influence of the «brothers» in Europe in order to more thoroughly examine the phenomenon of today: while the authority and influence of the BM are noticeably falling in the Arab countries, in the Old World the situation is different for the «brothers» – in many cases they manage to hide their Islamist essence under the cover of left, «progressive» rhetoric, which allows them to fit into the current political and ideological discourse in the host countries. However, with the aggravation of intercivilizational relations in Europe, BM groups are increasingly forced to leave their traditional «hiding places», publicly claiming the status of «defenders of discredited Muslims», but in fact trying to legalize their radical views and positions. The resulting scale of their presence and influence in European societies noticeably frightens the establishment and the population of these countries. The author comes to the conclusion that at the current stage, an aggravation of the confrontation between the political elites in the EU countries and the BM structures is inevitable

Decellularized Whole-Organ Pre-vascularization: A Novel Approach for Organogenesis.

Introduction: Whole-organ decellularization is an attractive approach for three-dimensional (3D) organ engineering. However, progress with this approach is hindered by intra-vascular blood coagulation that occurs after in vivo implantation of the re-cellularized scaffold, resulting in a short-term graft survival. In this study, we explored an alternative approach for 3D organ engineering through an axial pre-vascularization approach and examined its suitability for pancreatic islet transplantation. Methods: Whole livers from male Lewis rats were decellularized through sequential arterial perfusion of detergents. The decellularized liver scaffold was implanted into Lewis rats, and an arteriovenous bundle was passed through the scaffold. At the time of implantation, fresh bone marrow preparation (BM; n = 3), adipose-derived stem cells (ADSCs; n = 4), or HBSS (n = 4) was injected into the scaffold through the portal vein. After 5 weeks, around 2,600 islet equivalents (IEQs) were injected through the portal vein of the scaffold. The recipient rats were rendered diabetic by the injection of 65 mg/kg STZ intravenously 1 week before islet transplantation and were followed up after transplantation by measuring the blood glucose and body weight for 30 days. Intravenous glucose tolerance test was performed in the cured animals, and samples were collected for immunohistochemical (IHC) analyses. Micro-computed tomography (CT) images were obtained from one rat in each group for representation. Results: Two rats in the BM group and one in the ADSC group showed normalization of blood glucose levels, while one rat from each group showed partial correction of blood glucose levels. In contrast, no rats were cured in the HBSS group. Micro-CT showed evidence of sprouting from the arteriovenous bundle inside the scaffold. IHC analyses showed insulin-positive cells in all three groups. The number of von-Willebrand factor-positive cells in the islet region was higher in the BM and ADSC groups than in the HBSS group. The number of 5-bromo-2′-deoxyuridine-positive cells was significantly lower in the BM group than in the other two groups. Conclusions: Despite the limited numbers, the study showed the promising potential of the pre-vascularized whole-organ scaffold as a novel approach for islet transplantation. Both BM- and ADSCs-seeded scaffolds were superior to the acellular scaffold.

A COMPARISON BETWEEN INSTILLATION OF INTRAPERITIONEAL BUPIVACAINE &amp; MORPHINE vs. BUPIVACAINE ALONE IN ANALGESIA AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract Background Pain after laparoscopic cholecystectomy remains a challenging issue to this relatively less invasive surgery, In this study we try to tackle this problem through intraperitoneal injection of drugs particularly morphine and bupivicaine to reduce post-operative pain. Objectives The Aim of this study is to assess postoperative pain in laparoscopic cholecystectomy by comparing between administering intraperitoneal bupivacaine alone versus intraperitoneal bupivacaine with intravenous morphine; Using the VAS scale and measuring time for rescue analgesic administration. Methods and material This prospective double blinded randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent laparoscopic cholecystectomy were included in the study their ages range between 18 and 60 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization into two groups 30 patients in each (n = 30), Group BM received 30 ml of mixture of bupivacaine and 2 mg morphine while group BO received bupivacaine only Results This study showed that Morphine bupivacaine admixture had made dramatic decline in shoulder and abdominal pain VAS scores specifically at the 18th and24th hour; 15 patients in the BM group had either VAS score zero or 1 when compared to BO group whom their scores at the 18th and 24th hour was between 4 and 8. Also, there was more decrease in postoperative analgesic consumption in BM group. Conclusions We conclude that intraperitoneal instillation of 2 mg to bupivacaine 0.5% in elective LC significantly reduced post-operative shoulder pain and analgesic requirement when compared to bupivacaine 0.5% alone.

A Comparative Study of Analgesic Efficacy of Intrathecal Bupivacaine with Ketamine Versus Bupivacaine with Magnesium Sulphate in Parturients Undergoing Elective Caesarian Sections.

Background and Aims:Spinal anaesthesia is the most preferred technique of anaesthesia in parturient, undergoing lower segment caesarean sections (LSCS) which provides effective pain relief during intra operative and early postoperative period. However, recent studies demonstrate that about 50%–70% of patients experience moderate to severe pain after LSCS indicating that postoperative pain remains poorly managed. The aim of our study was to compare intrathecal magnesium sulphate (Mgso4) and ketamine as adjuvants to hyperbaric bupivacaine in parturients posted for elective caesarean sections under spinal anaesthesia to determine their effectiveness in extending the duration of analgesiaMaterials and Methods:After institutional ethical committee approval, 82 parturient undergoing elective LSCS were enrolled into the prospective randomized double blinded study. Group BK (n = 41) received intrathecal ketamine (25 mg) as additive to hyperbaric bupivacaine and group BM (n = 41) received magnesium sulphate (75 mg) as additive to hyperbaric bupivacaine. Time of onset of sensory analgesia, motor blockade, duration of analgesia was noted down. Intraoperative hemodynamics and any adverse effects of study drugs were noted.Results:The mean duration of analgesia in group BK was significantly longer (P < 0.05) than in Group BM. The onset of sensory and motor blockade was significantly early in Group BK compared to Group BM. Hemodynamics was better maintained in Group BK with less requirement of ephedrine compared to Group BM. The visual analog scale scores were significantly lower without side effects in both the groups.Conclusion:The present study demonstrated that the duration, quality of analgesia, hemodynamic stability was better with intra thecal ketamine as an adjuvant to bupivacaine compared to intrathecal MgSo4 without any significant side effects on mother and child.

Addition of intrathecal atropine for prevention of postoperative nausea and vomiting in patients received intrathecal bupivacaine / morphine in lower limb surgeries

Abstract Background Intrathecal opioids administration is an attractive analgesic technique since the opioids is injected directly into the cerebrospinal fluid providing safe and effective postoperative analgesia for up to 24 hours. The most common adverse effects after intrathecal morphine are postoperative nausea, vomiting and pruritus. We evaluated the effect of intrathecal atropine on prevention of postoperative nausea and vomiting in patients receiving intrathecal hyperbaric bupivacaine and morphine in lower limb surgeries and on its effect on duration of postoperative analgesia. Methods 80 patients undergoing lower limb surgeries under spinal anesthesia were randomized into two groups. BM group Received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + Normal saline (0.1ml). BMA group received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + 100 mcg preservative-free atropine sulphate (0.1ml). Follow-up of both nausea and vomiting episodes was done during the first 24 hours postoperatively. Results Nausea and vomiting were noticed in 17 patients (42.5%) in group BM and 7 patients (17.5%) in group BMA, with significant differences (p = 0.015). As regards postoperative analgesia, there was no significant differences between BM and BMA group. Conclusions Intrathecal atropine has antiemetic effect after spinal anesthesia using bupivacaine and morphine for lower limb surgeries without affecting postoperative analgesia.

OTHR-03. Brain Metastasis Among Ovarian Cancer Patients

BackgroundBrain metastasis (BM) are uncommon among ovarian cancer (OC) patients. Their frequency, risk factors and clinical repercussions are not well described. We assessed OC patients who developed BM, the role of BRCA status and survival implications.MethodsStudy cohort included OC patients treated at our center, from 2002–2020. We retrospectively evaluated clinical parameters, risk for BM development and association with survival data.ResultsAmong 972 OC patients, 28 (2.9%) were diagnosed with BM. Comparing the BM to non-BM group, median age of 60 across both groups, stage III-IV at diagnosis was more common among BM group (96.4% vs. 84.8%, p=0.0065) while platinum sensitivity was similar (92.3% in BM vs. 80.8% in non-BM, p=0.2193). Out of 658 patients tested for BRCA, 33.6% (n=221) were BRCA mutation carriers (BRCA+). Of the patients with BM, 22 tested for BRCA, 13 were carriers. BRCA+ was significantly higher in the BM group compared to the non-BM group (59.1% vs. 32.9%, p=0.0123). Among BRCA+ the rate of BM was higher than among BRCA- (5.8% vs. 2.1%, p=0.0123, HR=3.029; 95%CI: 1.4–6.5). Median time from OC diagnosis to BM and from disease recurrence to BM, was longer for BRCA+ compared to BRCA- (44.3mo vs. 32.3mo and 11.8mo vs. 0.7mo, respectively). Median survival (mOS) was not significantly different among patients with BM compared to those without BM (59.4mo vs. 71.2mo, p=0.36). Following diagnosis of BM, mOS was 20.6mo among BRCA+ and 12.3mo among BRCA- (p=0.4266). No correlation was demonstrated with PARP inhibitors or bevacizumab treatment and subsequent development of BM.ConclusionBM are an infrequent event among OC patients. However, the risk is three-folds higher among BRCA+. Interestingly, BM do not significantly alter survival among OC patients. Our work suggests that the higher rate of BM in BRCA+ may be related to longer survival. Another hypothesis requiring further evaluation, is possible higher brain tropism among this population.

Baska Mask is non-inferior to tracheal tube in preventing airway contamination during controlled ventilation in elective nasal surgeries: A randomised controlled trial.

Background and Aims:Baska Mask, a newly designed third-generation supraglottic device, has a sump where the pharyngeal secretions can collect and be suctioned out continuously. We aimed to study the effectiveness of Baska Mask in preventing airway contamination during nasal surgeries. Our primary objective was to assess airway soiling using fibreoptic bronchoscopy. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were the secondary objectives.Methods:Eighty-four participants undergoing nasal surgeries were randomised to either have their airway maintained with Baska Mask (Group-BM) or Endotracheal tube (Group-TT). Fibreoptic bronchoscopy was performed at the end of the surgery and the airway was inspected for signs of contamination. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were also assessed. Unpaired Student's t test was used for parametric data and Chi-square test for nonparametric data. One-way analysis of variance (ANOVA) was used for the intra-group analysis of haemodynamic data.Results:Tracheal contamination was not observed in any patient in either group. Time taken for device insertion (Group TT: 24.24 ± 6.86 s vs. Group BM: 24.22 ± 7.3 s; P = 0.97) was similar in both the groups. The total airway manipulation time was 2 min longer in Group-TT (P = 0.000) due to additional time taken for insertion of throat pack. Haemodynamic parameters during device insertion were stable and post-operative oro-pharyngeal morbidities were fewer with Baska Mask when compared to Tracheal tube.Conclusions:Baska Mask is non-inferior to tracheal tube in preventing tracheal contamination in patients undergoing nasal surgeries.