Variations of corneal hysteresis in myopic patients with normal pentacam findings

Background: hysteresis refers to the energy lost during the stress/strain cycle which is the result of viscous damping in the corneal tissue, is an indicator of corneal biomechanical properties. Refractive surgery currently uses corneal thickness as a basic qualification and planning parameter. However, corneal hysteresis may be more useful as a qualification factor for LASIK, a significant decrease in the IOP and biomechanical properties is found in eyes following LASIK surgery

Objective: this study aimed to reveal the variations of corneal hysteresis in patients with normal pentacam findings and to see if a correlation exists between corneal hysteresis, corneal resistance factor, mean keratometric reading, central corneal thickness and anterior chamber depth during the pre-operative assessment of myopic patients going for LASIK

Patients and Methods:in this study we did an analysis of corneal hysteresis in a group of myopic patients with normal pentacam findings undergoing evaluation for refractive surgery. In our study we included 50 eyes of 26 patients aged between 18 and 44

Results: this study included a mean keratometric reading of 44.108 D+/- 1.3243D, the mean central corneal thickness was 522.1um+/-38.416um, the mean anterior chamber depth was 3.2098mm+/-0.249mm the mean corneal hysteresis was 9.582 mmHg+/-1.4702 and the mean corneal resistance factor was 9.64 mmHg +/-1.9838

Conclusion: our data suggested that patients should get their corneal hysteresis tested as a part of their routine investigation portfolio before undergoing refractive surgery as it may play a role in determining patients that are at higher risk of developing ectasia after surgery

comparative study between magnesium sulphate and nitroglycerin with propranolol in controlled hypotensive anaesthesia during middle ear surgeries

Background: controlled hypotension is performed in order to reduce blood loss and the need for transfusion during the surgery and to improve visibility of the surgical site by decreasing the arterial pressure until hypotension is reached

Aim of the Work: to compare magnesium sulphate and nitroglycerin with propranolol during middle ear surgery in terms of regarding their efficiency in inducing deliberate hypotension and providing a better surgical field exposure during middle ear surgery. It also compared the influence of their use of postoperative pain and recovery time

Patients and Methods: forty adult patients undergoing middle ear surgery were included. Patients were randomly divided into two equal groups. Patients were assigned to receive magnesium sulphate [M group] and nitroglycerin with propranolol [N group] from the period of Jan 2018 to August 2018. ASA physical status I, age group ranged from 18 to 60

Results: the current study shows the ability of magnesium sulphate and nitroglycerin with propranolol to induce deliberate hypotension in patients undergoing middle ear surgery. Mean arterial pressure was successfully reduced to the target values in both groups. All drugs were equally successful to produce satisfactory surgical field

Conclusion: this study included forty adult patients age ranged 18 to 60 undergoing middle ear surgery was included. Patients were randomly divided into two equal groups. Patients were received magnesium sulphate [M group], or nitroglycerin and propranolol [N group]

Prophylactic use of parenteral ketamine versus ondansetron for prevention of shivering during spinal anesthesia in hernia surgeries

Background: Perioperative shivering is a common complication in modern anesthesia. It's usually defined as readily detectable fasciculation or tremors of the face, jaw, head, trunk or extremities lasting longer than 15 seconds

Aim of the work: Compare the anti-shivering effect of parentral low dose ketamine and ondansetron after spinal anesthesia during hernia surgery, as well as the anticipated side effects and complications

Patients and Methods: This study presents a prospective randomized single blinded study. After obtaining approval from the medical ethical committee of Ain Shams University, this study was conducted in Ain Shams University hospitals operating rooms. Study period was from January 2018 to May 2018

Results: Our results indicated that low dose ketamine and ondansetron were effective, with more extent to ketamine, in prevention of post spinal shivering in patients undergoing hernia surgery and these results agreed with other results of studies done before

Conclusion: Our results indicated that Prophylactic low dose ketamine [0.25mg/kg] and Ondansetron [4mg] significantly decreased shivering in patients undergoing spinal anesthesia without significant side effects. Ketamine found to be more effective in controlling post spinal shivering

Serum interieukin-4 and 5 as parameters of improvement of lower airway obstruction in children following early noninvasive ventilation

Childhood diseases such as bronchial asthma and acute bronchiolitis have both been linked to lower airway obstruction with the possibility of developing acute lung injury. Management usually necessitates the intervention of mechanical ventilation with its risks and complications. In addition, serum levels of lnterleukin-4 [IL-4] and Interleukin-5 [IL-5] have been found to be associated in the pathogenesis of this condition and are known to be elevated in these patients. This study was designed to evaluate the use of IL-4 and IL-5 as predictive factors and markers of inflammation for a successful response to non-invasive ventilation [NIV] in children with acute severe lower airway obstruction. This iia prospective study that included 40 cases presented with acute respiratory distress secondary to lower airway obstruction including acute exacerbations of asthma and acute bronchiolitis. Cases were classified randomly into two groups; Group A: patients who received NIV plus standard conventional therapy if needed, and Group B: control patients who received only standard conventional therapy without NIV. Serum IL-4 and IL-5 were measured in all patients on admission and after treatment. We have found that there was significant improvement of all the clinical parameters in addition to a reduction in the need of invasive ventilation. There were also a significant reduction in the serum levels of the studied interleukins 4 and 5 after the completion of therapy as indicated by p<.001 in both cytokines. This may give a key for the importance of the early use of NIV as a first line of treatment of severe cases of lower airway obstruction and highlights the importance of using serum IL-4 and IL-5 as parameters of improvement