Comparative study between intravenous and intraperitoneal magnesium sulphate as adjuvant to general anesthesia for pain management in laparoscopic cholecystectomy

Background: numerous researches have proved the benefits of laparoscopic cholecystectomy compared to the open method, mainly because of less metabolic response to stress, maintenance of diaphragm and pulmonary function, less postoperative complications, lower incidence of postoperative ileus, early mobilization, shorter hospital stay, and a more cosmetic. The main presentation of postoperative pain is somatic, whereas visceral pain is less present, and thus the pain is less in the patients operated by laparoscopic method

Aim of the Work: to compare intravenous Magnesium Sulphate with intra peritoneal Magnesium Sulphate as adjuvant to general anesthesia for pain management in laparoscopic cholecystectomy

Patients and Methods: this prospective randomized double blind clinical study using closed envelopes method was carried out on 100 adult patients, Undergoing laparoscopic cholecyctectomy in Bab-Alshaeria University Hospital, faculty of medicine, Al-Azhar University. After approval by the Institutional Ethical Committee, and informed written consent obtained from the patients, we randomly divided the patients into two groups 50 patients each

Results: the pain scores of group II [intra-peritoneal group] were significantly lower than group I [intravenous group], the total opioid consumption postoperatively in group II[intra-peritoneal group] was highly significant lower than group I [intravenous group]. Also there was a significant reduction in opioid-related side effects such as postoperative nausea and vomiting

Conclusion: the intraperitoneal administration of magnesium sulphate is a safe and effective method in the management of acute postoperative pain after laparoscopic cholecystectomy more than intravenous administration of magnesium sulphate

Takayasu arteritis: the role of multimodality imaging

Takayasu arteritis is a rare, chronic granulomatous inflammatory disease of the large arteries. The disease mainly affects females of reproductive age. Patients present with a wide range of non-specific symptoms. Diagnosis mainly relies on imaging features as laboratory investigations are non-specific. We present a case of a 31-year-old Indian female who presented with chest pain and uncontrolled hypertension. Chest X-ray revealed aneurysmal thoracic aorta, which prompted further diagnostic investigations and was ultimately diagnosed as type V Takayasu arteritis

Super-selective hepatic angioembolization for traumatic hepatic artery laceration in a child

The liver is commonly injured through blunt abdominal trauma in children. Transaction of the hepatic artery and subsequent angioembolization is well reported in the adult population; however, the evidence of its effectiveness is lacking in pediatrics. We report a case of a child who sustained a grade 3/4 liver injury with contrast blush as evidenced on CT scan. The case was treated by super-selective angioembolization with no major or minor complications. To our knowledge, this is the first case report of pediatric hepatic angioembolization in the Middle East

Prostatic artery embolization as a treatment for benign prostatic hyperplasia

Benign prostatic hyperplasia [BPH] is a common problem affecting elderly males, causing symptoms of lower urinary tract obstruction. The medical and surgical treatment modalities have their complications and limitations. Recently, prostatic artery embolization [PAE] was proven to be a safe, effective treatment modality for BPH

We report a case of a 55-year-old male with severe urinary obstructive symptoms and prostatic volume of 128 gm on magnetic resonance imaging. The patient underwent successful bilateral prostatic artery embolization without any short-term minor or major complications after ten months follow-up

Juvenile nasopharyngeal angiofibroma: imaging characteristics and pre-operative embolization

Juvenile nasopharyngeal angiofibroma [JNA] is a benign highly vascular tumor. It almost exclusively affects male adolescents and young adults. Nasal blockage and recurrent epistaxis are the classic symptoms. Cross-sectional imaging is vital for accurate diagnosis and operative planning. Pre-operative embolization is frequently performed to decrease blood loss and has especially facilitated endoscopic resection. A sixteen-year-old male presented with one-month complaint of unilateral nasal blockage and frequent epistaxis. Angiofibroma was diagnosed by CT and MRI. Angiography followed by embolization was performed 24 hours prior to endoscopic surgical resection. The reported blood loss was less than 50 ml. No complications were encountered

Rapid diagnosis of spontaneous bacterial peritonitis by use of leukocyte esterase reagent strips

Spontaneous bacterial peritonitis [SBP] is a serious complication in cirrhotic ascitic patients. That is why, its early diagnosis and treatment is important for prevention of further complications as hepatorenal syndrome or encephalopathy. Leukocyte Esterase reagent strips have been used successfully for many years for diagnosing urinary tract infections, being accurate, safe, rapid, available and cheap. The aim of our study was to assess the diagnostic accuracy of these leukocyte esterase reagent strips for diagnosing spontaneous peritonitis. One hundred ascitic cirrhotic patients were tested by leukocyte esterase strips and also by bedside culture of ascitic fluid using blood culture bottles. The study showed high sensitivity [98.4 %] and specificity [87.2 %] of the leukocyte esterase [LE] strips in diagnosis of spontaneous bacterial peritonitis