The Scientific Journal of Medical Scholar最新文献

{"title":"Driving Pressure During Mechanical Ventilation of Acute Respiratory Distress Syndrome","authors":"Ali Mohamed Ali Abdelhameed, Abo-bakr Helal Al-Asmar, Ezzat Atwa Ali, Atef Wahdan Saleh","doi":"10.55675/sjms.v3i3.90","DOIUrl":"https://doi.org/10.55675/sjms.v3i3.90","url":null,"abstract":"Background: Driving pressure has been identified as a more accurate indicator of mortality risk than low tidal volume (VT) and pulmonary compliance (Ppl). It was also noted that when this pressure surpasses the 18 cm H2O mark, there is a significant elevation in the relative risk of death. This study aimed to evaluate the effect of driving pressure guided ventilation in acute respiratory distress syndrome (ARDS).   \u0000Patients and Methods: The study included 64 subjects selected from the respiratory intensive care unit (RICU) of Al-Azhar University Hospital (Damietta). All participants received management through a protective lung strategy that was informed by driving Pressure. The study outcomes included 1). Determination of weaning categories; 2). Adverse events; 3). Length of ICU stay and duration of mechanical ventilation; 4). Mechanical Ventilation-free days, and 5). Organ/s dysfunction.\u0000Results: The commonest cause of admission was pneumonia (36%), and least percentage was septic shock (1.6%). The median ICU stay was 7 days (4 to 25 days) and weaning success rate was 76.6% with mortality rate of 23.4%. The severity was mainly severe (40.6%) and moderate (31.2%). Driving pressure at day 1 of ≤ 21 had sensitivity of 97.96%, specificity of 80.0% and area under curve (AUC) of 0.952. The driving pressure was significantly increased in cases with failure weaning than the success weaning (24.67 ± 1.05 vs 16.86 ± 1.24, respectively). In addition, it was significantly increased in died than alive patients. There was progressive significant increase of driving pressure from mild to moderate to severe cases. Pneumothorax was recorded among 9.4% and pleural effusion was recorded for 7.8% of patients.  \u0000Conclusion: Use of driving pressure guided ventilation in patients with ARDS improves lung compliance, decreases the duration of mechanical ventilation and the length of ICU stay. Driving pressure < 21 can predict mortality.","PeriodicalId":486005,"journal":{"name":"The Scientific Journal of Medical Scholar","volume":"110 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Guided Measurement of Inferior Vena Cava Diameter, Common Carotid Artery Diameter versus Central Venous Pressure for Estimation of Intravascular Volume Status in Septic Shock Patients","authors":"Ayman Adel Abbas Ali, Osama Mofreh Salem, Mohamad Mohamad AbdElhamed Elghonimy, Mohamad Samy Mohamad Sharaf","doi":"10.55675/sjms.v3i3.91","DOIUrl":"https://doi.org/10.55675/sjms.v3i3.91","url":null,"abstract":"Background: In critically ill patients, the fluid resuscitation is crucial and is the first step in treatment protocol. Invasive CVP measurement was used to guide fluid resuscitation. However, it is time consuming and invasive maneuver. Ultrasound measurement of inferior vena cave and common carotid arteries are suggest to predict the fluid response as well as CVP or even better. The current work designed to compare inferior vena cava diameter and common carotid artery diameter with central venous pressure for estimation of intravascular volume status in septic shock.   \u0000Patients and Methods: The study included 60 subjects with septic shock who received vasopressor support. CVP and ultrasound were performed before and after fluid challenge test. Values of inferior vena cava and common carotid arteries were documented and compared to CVP values.  This was performed after full clinical assessment by detailed clinical examination and laboratory workup.\u0000Results: The MAP was significantly increased and HR decreased after than before procedure.  In addition, CVP, (inferior vena cava), ICVmax, ICV min and common carotid artery diameter (CCAD) were significantly increased, IVC CI (%) was significantly reduced after procedure than basal values. There was significant decrease of IVCmax, IVCmin and CCAD while there was significant increase of IVC CI% with lower (<8) than higher (> 8) CVP values.   CVP was positively and significantly correlated with IVCmax, IVCmin and CCAD, while it was inversely correlated with IVC CI%. The AUC was over 0.75 for IVCmax, IVCmin and CCAD for prediction of CVP while it was lower than 0.7 for IVC CI%. These data reflected the better predictive power of IVCmax, IVCmin and CCAD. The best cutoff value was 1.35, 1.25, 10.45 and 4.15 for IVCmax, IVCmin, IVC CI% and CCAD successively. \u0000Conclusion: IVC and CCA diameters measurement by US may replace CVP measurement for estimation of intravascular volume status in septic shock patients.","PeriodicalId":486005,"journal":{"name":"The Scientific Journal of Medical Scholar","volume":"122 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amikacin once every other day versus Daily Meropenem for Treatment of Urinary Tract Infection with Escherichia Coli","authors":"Abdel-Moneim Ghorab, Saied A.A. Mostafa, Sultan Hamdan Alsakran","doi":"10.55675/sjms.v1i6.77","DOIUrl":"https://doi.org/10.55675/sjms.v1i6.77","url":null,"abstract":"Background and Aim: Urinary tract infection (UTI) is a common medical challenge, especially in the light of increased antibiotic resistance. This work aimed to compare between amikacin (3 doses, once each other day) with a daily dose of meropenem (once daily for seven days) for the treatment of urinary tract infection caused by Escherichia Coli.   \u0000Patients and Methods:  70 patients with confirmed UTI infection by E. Coli were included and divided for two groups. The first was treated by amikacin 15mg/kg once every 48 hours for seven days. The second group was treated by meropenem 1 g three times daily for one week. Then, urinary culture and sensitivity was re-performed and tested against the commonest panel of antibiotics. The clinical manifestations were documented before treatment and one week after treatment. \u0000Results:  There was no significant difference between groups regarding patient demographics or manifestations of UTI. 54.3% in amikacin and 65.7% in meropenem groups reported previous UTI. The clinical manifestations of UTI include dysuria, frequent urination, flank pain, abdominal pain, fever and suprapubic pain. The treatment was associated with eradication of E. Coli in 60.0% and 54.3% in Amikacin and meropenem respectively, with no significant differences between groups at the end of the first week and at that time, the most sensitive drugs were nitrofurantoin (34.3%) followed by meropenem (22.9%) and amikacin (18.6%). However, the highest resistance was registered for cefepime and cefotaxime (41.4%) followed by ceftazidime-clavulanic acid (40.0%). Clinical manifestations of UTI were significantly reduced in both groups one week after treatment with no significant differences between groups. \u0000Conclusion: Amikacin could be considered as is an effective and safe alternative to meropenem for treatment of UTI due to E. Coli.","PeriodicalId":486005,"journal":{"name":"The Scientific Journal of Medical Scholar","volume":"11 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Vitamin D Supplementation for Non-Diabetic Elder Egyptians: Effects on Glycemic Indices and Lipid Profile","authors":"Yasser El Kerdasy, El Sayed Abouzid Ibrahim","doi":"10.55675/sjms.v2020i2.86","DOIUrl":"https://doi.org/10.55675/sjms.v2020i2.86","url":null,"abstract":"Background and aim: Elderly populations are a susceptible group for many health risks. Vitamin D deficiency is a common health problem among elderly populations. It is associated with different harmful effects, especially increased insulin resistance and liability for development of diabetes mellitus. The value of vitamin D supplementation on glycemic indices produced heterogenous results. This work aimed to evaluate the value of vitamin D supplementation (10000 IU, three times a week for six months) on glycemic indices, mainly insulin resistance. \u0000Methodology: This study included 100 apparently healthy elder subjects. They were randomly divided into two equal groups, the intervention and the control groups. The intervention group received vitamin D supplementation by 10000 IU three times a week for 6 months. However, the control (placebo) group, received a placebo at the same time for the same period. Laboratory values (vitamin D, fasting blood glucose and insulin, insulin resistance indicator (HOMA-IR) and lipid profiles) were measured at inclusion in the study and after 6 months of treatment. In addition, demographic characteristics were documented. \u0000Results:  At basal point, both intervention and control groups were comparable regarding patient demographics and all laboratory workup values. There was slight increase of males than females in both groups. The mean age was 68.32±3.93 and 69.60±3.75 years in intervention and control groups respectively. After the six months of vitamin D supplementation, the intervention group had significantly higher levels of vitamin D than the control group (28.48±3.58 vs 12.42±1.99 ng/ml, respectively). However, the values of fasting glucose, fasting insulin, HOMA-IR and total cholesterol were significantly reduced in the intervention than the control group. In the intervention group, all laboratory work-up values showed significant changes at the end of the study duration than basal values. For example, vitamin-D values were increased from 11.66±2.20 to 28.48±3.58 ng/ml. \u0000Conclusion: Supplementation with cholecalciferol for 6 months is associated with improvement of vitamin D status, insulin resistance indicator (HOMA-IR), overall glycemic indices and lipid profile in healthy elder Egyptians.    ","PeriodicalId":486005,"journal":{"name":"The Scientific Journal of Medical Scholar","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141221947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Renal Protective effects of Matricaria Chamomilla Extract in Streptozotocin-Induced Diabetic Rats","authors":"F. M. Abou Galala, M.K. Ayoub, A. M. Yousef, Ahmed H. Abd El-Slam","doi":"10.55675/sjms.v2020i2.72","DOIUrl":"https://doi.org/10.55675/sjms.v2020i2.72","url":null,"abstract":"Background and aim: Diabetes mellitus is a chronic disease with significant burden on the patient, his/her family and overall healthcare system due to its complications. Herbs of medicinal use played an important role in many diseases and chamomile is one of these herbs. The current worm aimed to investigate potential ameliorative effects of chamomile against diabetic changes in rat model. \u0000Methodology: Fourty rats were used in the current work and divided into four equal groups. The first (negative control) received nothing except water; the second received chamomile extract in a similar dose in the fourth group (300mg/kg/bodyweight/day). The third group included diabetic rats and the fourth one included diabetic rat who received chamomile extract after induction of diabetes. Rats completed the study duration (6 weeks). Then blood samples were collected for laboratory investigations and after sacrificing, the pancreatic and renal tissues were fixed and prepared for microscopical examination. \u0000Results:  The use of chamomile was associated with significant reduction of diabetic indices (serum glucose, insulin and glycated hemoglobin) and significant improvement in renal function markers (blood urea and creatinine). However, this did not reach the normal values. The diabetic groups showed histological alterations of renal and pancreatic tissues, mainly necrosis and lymphocytic infiltration. The changes which reduced with the use of chamomile. \u0000Conclusion: Chamomile (300mg/kg/bodyweight daily) have ameliorating effects against diabetic changes in a rat model. This was evident on biochemical and histopathological levels. ","PeriodicalId":486005,"journal":{"name":"The Scientific Journal of Medical Scholar","volume":"356 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141228181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}