Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery

This study was designed to evaluate the effect of intravenous dexmedetomidine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6, cortisol and blood glucose level. It also assessed its effect on recovery profile and postoperative pain. Thirty adult ASA I-III patients admitted to the surgery department of the Alexandria Main University Hospital scheduled for elective major abdominal surgery under general anaesthesia were included. They were randomly classified into two equal groups of 15 patients each, dexmedetomidine group [Group D] received intravenous dexmedetomidine infusion and placebo group [Group P] received intravenous infusion of normal saline. Haemodynamic parameters were recorded intra- and postoperatively. Interleukin-6, cortisol and blood glucose levels were measured. Recovery profile, postoperative pain score and analgesic requirement postoperatively were assessed. Heart rate and mean arterial pressure were significantly lower in group D relative to group P during most of the intra- and postoperative periods. Postoperatively, the levels of interleukin-6, cortisol and blood glucose were significantly lower in group D relative to group P. Recovery time was longer in group D than group P but with no significant difference. Postoperative pain score was significantly less in group D relative to group P during the early postoperative period with smaller amount of analgesic requirements in group D. Dexmedetomidine is safe and effective in blunting the postoperative rise of the proinflammatory cytokine interleukin-6 and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose. Dexmedetomidine also reduces the postoperative pain score without delaying recovery from anaesthesia

Diagnostic value of beta-HCG, estradiol, and progesterone in ectopic pregnancy versus normal-intrauterine pregnancy

To evaluate the diagnostic value of rising level of serum beta subunit human chorionic genadotrophin, single measurement of progesterone, and estradiol in early diagnosis of ectopic pregnancy. A case control study was conducted on 40 women with ectopic pregnancy and 40 women with normal intrauterine pregnancy from Shatby University Maternity Hospital. Blood samples for the measurement of beta subunit human chorionic genadotrophin [beta-hCG], estradiol [E2], and progesterone were drawn in all the women upon admission. Extra blood sample was drawn for measurement of beta-hCG 24 hours after admission. The mean serum levels of beta-hCG, progesterone, and estradiol in patients with ectopic pregnancies [969.0 +/- 302.1, 7.9 +/- 2.83, 621.9 +/- 131.4 respectively] were significantly lower than these levels in normal intrauterine pregnancies [3186.8 +/- 649.2, 23.5 +/- 5.3, 1853.6 +/- 508.4 respectively]. The average rate of beta-hCG rising was [8%] for 24 hours in patients with ectopic pregnancy and [31%] in normal intrauterine pregnancies. Single measurement of serum progesterone level has the greatest sensitivity [97%] and specificity [90%] in the diagnosis of early ectopic pregnancy

Evaluation of the role of thrombophilia associated factors in pre-eclampsia

To evaluate the role of thrombophilia associated factors in pre-eclamptic pregnant women. A case control study was conducted on 30 severe pre-eclamptic pregnant women [group A], and 30 normotensive pregnant women [group B] from Shatby University Maternity Hospital. Routine laboratory tests, protein C, protein S, antithrombin III, factor V Leiden and anticardiolipin antibodies [IgM, IgG] were measured for both groups. Informed consent of the patients was taken. There was not any significant difference in the values of factor V Leiden, protein C, protein S, antithrombin III, and anticardiolipin IgG between pre-eclamptic and normotensive pregnant women. However, anticardiolipin IgM was shown to be significantly higher in the pre-eclamptic patients. Severe pre-eclamptic patients were 3.5 times more likely to develop elevated levels of anticardiolipin IgM. Routine screening for inherited thrombophilia disorders is not recommended in pre-eclamptic females

Factor XII deficiency and habitual abortion: the Haegman connection

To evaluate the role of factor XII deficiency in cases of habitual abortions. A case control study was conducted on 50 women with history of three or more consecutive first-trimester abortions [group A] of unexplained nature from outpatient clinic of Shatby Maternity University Hospital, and 25 healthy women with no history of recurrent miscarriage, thrombotic disease or adverse pregnancy outcomes [group B]. Blood sample was taken from each patient to assay the following parameters: protein S [PS], protein C [PC], antithrombin III [ATIII], and coagulation factor XII [FXII]. The subsequent miscarriage rate with abnormal FXII is significantly higher than that with normal FXII. However, there were no statistically significant differences in the subsequent miscarriage rates between normal and abnormal PC, PS and ATIII values. Factor XII deficiency might play a role in recurrent miscarriages

Evaluation of fine needle aspiration cytology [FNAC] in diagnosis of head and neck swellings in Bab Elsheria Hospital

FNAC is believed to be of great benefit as an alternative diagnostic approach to lesions in Head and Neck region. This study aims at evaluating the results of FNAC undertaken in Otorhinolaryngology, Head and Neck Surgery Department, Bab Elsheria Hospital in relation to the International big series. This is a retrospective study of 42 cases with FNACs performed between September 2004 and April 2006. All patients had both FNAC and Histology done. Patients were classified into 3 groups according to the site of their swellings: [parotid, thyroid and others]. The origin of the swellings in this series was 48% from the parotid gland, 19% from the thyroid gland and 33% from other sites. The first FNAC was only diagnostic in 21 patients [50%]. While the 2nd FNAC was diagnostic in 8 patients out of 15 [53.3%]. The majority of swellings with positive findings on FNAC in 29 patients had matched the histology results [68.9%]. So, the chances of getting diagnosis were about 50% in either first or second FNAC. The FNAC sensitivity was 69% and its specificity was 80%, which lags behind the International big series. We need to improve our FNAC results to be compared with the results of International big series