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Papers by nahla amin

Research paper thumbnail of Inhalation of Sevoflurane Versus Intravenous Ketamine, Midazolam and Propofol For Sedation in Pediatrics Undergoing Upper Gastrointestinal Endoscopy

Zagazig University Medical Journal

Research paper thumbnail of Comparison between the effects of two enteral nutrition support algorithms on nutrition care outcome in critically ill adult patients

Research and Opinion in Anesthesia and Intensive Care, 2018

Background The use of enteral nutrition (EN) algorithm optimizes nutrition by increasing the inta... more Background The use of enteral nutrition (EN) algorithm optimizes nutrition by increasing the intake of calories in critically ill patients, but it does not compensate for loss of feeding time due to frequent interruptions as during fasting for operation or investigation.Aims were to compare implementation of enteral feeding support algorithm based on the SCCM/A.S.P.E.N guidelines and modifications to this algorithm (using a protocol that shifted from an hourly rate target goal to a twenty four hour volume goal). Settings and Design Case control study in the surgical ICU of zagazig university hospital. Methods and Material Patients of group1 were given caloric requirements as five bolus meals, patients of group 2 were given Fresubin by continuous infusion with hourly rate target goal and in Group 3 there was a Shift from hourly rate target goal to 24 hour volume goal and metoclopramide 10 mg I.V. q. 6 hours with the start of EN. Results There were statistically significant differences between groups regarding adequacy of caloric intake in 2nd, 3rd days and the overall adequacy of calories in all four days, where Group 2 provided more EN adequacy than Group 1 (P=0.02, 0.001, 0.01) respectively, and Group 3 provided more calories adequacy than Group1in 3rd day and overall adequacy (P=0.008 and 0.007) respectively. Also Patients in Group 2and 3 started accommodating EN earlier and had less episodes of vomiting than patients in group 1, (P value=0.043 and0.003 respectively). Conclusion The use of EN protocol provides more adequacy of calories and proteins from EN in comparison to bolus meals.

Research paper thumbnail of Comparison between three supraglottic airway devices as conduits for fiber-optic tracheal intubation

Background Securing the airway is a major task for anesthesiologists. Supraglottic airway devices... more Background Securing the airway is a major task for anesthesiologists. Supraglottic airway devices (SADs) are widely used nowadays. Fiber-optic endotracheal intubation (ETT) plays an important role in difficult-to-manage airways. The general purpose of a conduit is to provide a clear protected pathway for the expensive, sensitive, and fragile fiber-optic cable. Aimof the work To compare between three SADs as conduits for fiber-optic tracheal intubation. Patients and methods A prospective, randomized study involving 81 adult patients (American Society of Anesthesiologists I or II), of both sexes who were allocated into three groups (27 patients each): Air-Q group (group Q), intubating laryngeal mask airway (ILMA) group (group L) or I-Gel group (group G). Fiber-optic ETT through SADs was performed. The number of attempts and duration of insertion of SAD, laryngeal view grading, number of attempts, and duration of insertion of ETT were assessed. Complications were recorded. Results The ...

Research paper thumbnail of Palonosetron, Dexamethasone and their combination for prevention of postoperative nausea and vomiting after laparoscopic gynecological surgeries

Zagazig University Medical Journal

Background:Palonosetron is a 5HT3 receptor antagonist which is used to prevent postoperative naus... more Background:Palonosetron is a 5HT3 receptor antagonist which is used to prevent postoperative nausea and vomiting (PONV).Design:Prospective Randomized Double Blinded Controlled Clinical Trail. Patients and methods:A total of 200 female patients of ASA physical status class I and II scheduled for gynecological laparoscopic surgery were randomly allocated into four groups: Control group (group C) received 5 ml saline; Palonosetron group (group P) received 0.075 mg palonosetron; Dexamethasone group (group D) received 8 mg dexamethasone and combined Palonosetron/ Dexamethasone (group P/D) group received a combination of 0.075 palonosetron and 8 mg dexamethasone. Studied drugs were given intravenously(iv) immediately before induction of anaesthesia. Anaesthesia was induced with propofol and fentanyl and maintained with isoflurane/oxygen/air. Diclofenac sodium was given intramuscularly for postoperative analgesia. Metoclopramide was used as rescue antiemetic. Overall incidence, severities of PONV, number of patients who needed rescue antiemetic and side effects of the used drugs were recorded during 1st 24 hours postoperatively. Results:The overall incidences, severities of PONV and the number of patients who needed rescue antiemetic in group P, D and P/D were significantly lower than that in group C. Group P and P/D were comparable and significantly lower than that in group D. Side effects of the used drugs were minimal and comparable. Conclusion:Palonosetron and combined palonosetron with dexamethasone were comparable and superior to dexamethasone in reducing the incidence and severity of PONV and need to rescue antiemetic in gynecological laparoscopic surgery.

Research paper thumbnail of A Comparative Study between Transmuscular Quadratus Lumborum Block and Oblique Subcostal Transversus Abdominis Plane Block for Analgesia Following Upper Abdominal Surgeries

Zagazig University Medical Journal

Research paper thumbnail of Combined femoral and sciatic nerve blockade for lower limb surgeries: ultrasound guidance versus nerve stimulation

Zagazig University Medical Journal

Background: Comparison between nerve stimulator guided and ultrasound guided femoral-sciatic nerv... more Background: Comparison between nerve stimulator guided and ultrasound guided femoral-sciatic nerve block, to find out the method of best outcome and least side effects. Methods: The study was performed in Zagazig University Hospital (ZUH), eighty ASA classes I and II adult cooperative patients of both sexes were scheduled for below or at knee level surgery. They anesthetized under femoral-sciatic nerve block. They were randomly allocated into two equal groups, ultrasound guided nerve block (US) group and nerve stimulator group (NS) group (40 patients each) according to the used method for nerve localization. Results: It was found that there was a statistically significant difference between US and NS groups (P=0.001) regarding the "performance": technique time, the number of attempts of skin puncture, the onset time for complete motor and sensory block, incidence of hematoma formation and the incidence of painful paresthesia during nerve localization. Conclusion: The ultrasound guided lower limb block was superior to nerve stimulator guided for localization of femoral and sciatic nerve with less performance time, accurate needle placement, less failure rate and less incidence of complications.

Research paper thumbnail of Inhalation of Sevoflurane Versus Intravenous Ketamine, Midazolam and Propofol For Sedation in Pediatrics Undergoing Upper Gastrointestinal Endoscopy

Zagazig University Medical Journal

Research paper thumbnail of Comparison between the effects of two enteral nutrition support algorithms on nutrition care outcome in critically ill adult patients

Research and Opinion in Anesthesia and Intensive Care, 2018

Background The use of enteral nutrition (EN) algorithm optimizes nutrition by increasing the inta... more Background The use of enteral nutrition (EN) algorithm optimizes nutrition by increasing the intake of calories in critically ill patients, but it does not compensate for loss of feeding time due to frequent interruptions as during fasting for operation or investigation.Aims were to compare implementation of enteral feeding support algorithm based on the SCCM/A.S.P.E.N guidelines and modifications to this algorithm (using a protocol that shifted from an hourly rate target goal to a twenty four hour volume goal). Settings and Design Case control study in the surgical ICU of zagazig university hospital. Methods and Material Patients of group1 were given caloric requirements as five bolus meals, patients of group 2 were given Fresubin by continuous infusion with hourly rate target goal and in Group 3 there was a Shift from hourly rate target goal to 24 hour volume goal and metoclopramide 10 mg I.V. q. 6 hours with the start of EN. Results There were statistically significant differences between groups regarding adequacy of caloric intake in 2nd, 3rd days and the overall adequacy of calories in all four days, where Group 2 provided more EN adequacy than Group 1 (P=0.02, 0.001, 0.01) respectively, and Group 3 provided more calories adequacy than Group1in 3rd day and overall adequacy (P=0.008 and 0.007) respectively. Also Patients in Group 2and 3 started accommodating EN earlier and had less episodes of vomiting than patients in group 1, (P value=0.043 and0.003 respectively). Conclusion The use of EN protocol provides more adequacy of calories and proteins from EN in comparison to bolus meals.

Research paper thumbnail of Comparison between three supraglottic airway devices as conduits for fiber-optic tracheal intubation

Background Securing the airway is a major task for anesthesiologists. Supraglottic airway devices... more Background Securing the airway is a major task for anesthesiologists. Supraglottic airway devices (SADs) are widely used nowadays. Fiber-optic endotracheal intubation (ETT) plays an important role in difficult-to-manage airways. The general purpose of a conduit is to provide a clear protected pathway for the expensive, sensitive, and fragile fiber-optic cable. Aimof the work To compare between three SADs as conduits for fiber-optic tracheal intubation. Patients and methods A prospective, randomized study involving 81 adult patients (American Society of Anesthesiologists I or II), of both sexes who were allocated into three groups (27 patients each): Air-Q group (group Q), intubating laryngeal mask airway (ILMA) group (group L) or I-Gel group (group G). Fiber-optic ETT through SADs was performed. The number of attempts and duration of insertion of SAD, laryngeal view grading, number of attempts, and duration of insertion of ETT were assessed. Complications were recorded. Results The ...

Research paper thumbnail of Palonosetron, Dexamethasone and their combination for prevention of postoperative nausea and vomiting after laparoscopic gynecological surgeries

Zagazig University Medical Journal

Background:Palonosetron is a 5HT3 receptor antagonist which is used to prevent postoperative naus... more Background:Palonosetron is a 5HT3 receptor antagonist which is used to prevent postoperative nausea and vomiting (PONV).Design:Prospective Randomized Double Blinded Controlled Clinical Trail. Patients and methods:A total of 200 female patients of ASA physical status class I and II scheduled for gynecological laparoscopic surgery were randomly allocated into four groups: Control group (group C) received 5 ml saline; Palonosetron group (group P) received 0.075 mg palonosetron; Dexamethasone group (group D) received 8 mg dexamethasone and combined Palonosetron/ Dexamethasone (group P/D) group received a combination of 0.075 palonosetron and 8 mg dexamethasone. Studied drugs were given intravenously(iv) immediately before induction of anaesthesia. Anaesthesia was induced with propofol and fentanyl and maintained with isoflurane/oxygen/air. Diclofenac sodium was given intramuscularly for postoperative analgesia. Metoclopramide was used as rescue antiemetic. Overall incidence, severities of PONV, number of patients who needed rescue antiemetic and side effects of the used drugs were recorded during 1st 24 hours postoperatively. Results:The overall incidences, severities of PONV and the number of patients who needed rescue antiemetic in group P, D and P/D were significantly lower than that in group C. Group P and P/D were comparable and significantly lower than that in group D. Side effects of the used drugs were minimal and comparable. Conclusion:Palonosetron and combined palonosetron with dexamethasone were comparable and superior to dexamethasone in reducing the incidence and severity of PONV and need to rescue antiemetic in gynecological laparoscopic surgery.

Research paper thumbnail of A Comparative Study between Transmuscular Quadratus Lumborum Block and Oblique Subcostal Transversus Abdominis Plane Block for Analgesia Following Upper Abdominal Surgeries

Zagazig University Medical Journal

Research paper thumbnail of Combined femoral and sciatic nerve blockade for lower limb surgeries: ultrasound guidance versus nerve stimulation

Zagazig University Medical Journal

Background: Comparison between nerve stimulator guided and ultrasound guided femoral-sciatic nerv... more Background: Comparison between nerve stimulator guided and ultrasound guided femoral-sciatic nerve block, to find out the method of best outcome and least side effects. Methods: The study was performed in Zagazig University Hospital (ZUH), eighty ASA classes I and II adult cooperative patients of both sexes were scheduled for below or at knee level surgery. They anesthetized under femoral-sciatic nerve block. They were randomly allocated into two equal groups, ultrasound guided nerve block (US) group and nerve stimulator group (NS) group (40 patients each) according to the used method for nerve localization. Results: It was found that there was a statistically significant difference between US and NS groups (P=0.001) regarding the "performance": technique time, the number of attempts of skin puncture, the onset time for complete motor and sensory block, incidence of hematoma formation and the incidence of painful paresthesia during nerve localization. Conclusion: The ultrasound guided lower limb block was superior to nerve stimulator guided for localization of femoral and sciatic nerve with less performance time, accurate needle placement, less failure rate and less incidence of complications.