A comparative study between magnesium sulphate and dexmedetomidine for deliberate hypotension during middle ear surgery

AbstractBackgroundThis study was designed to compare magnesium sulphate with dexmedetomidine, 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 on postoperative pain and recovery time.MethodsEighty-eight adult patients undergoing middle ear surgery were included. Patients were randomly divided into two equal groups. Patients were assigned to receive either magnesium sulphate (M group) or dexmedetomidine (D group). Anaesthesia was induced by propofol 2mg/kg iv and fentanyl 1μg/kg. Patients in the M group received an iv bolus of magnesium sulphate 50mg/kg in a total of 100ml saline over 10min followed by infusion of 15mg/kg/h until the end of surgery. Similarly, patients in the D group received dexmedetomidine 1μg/kg over 10min followed by 0.4–0.8μg/kg/h until the end of operation. The target MAP during operation was between 60 and 70mmHg. The surgeon who was blinded of the selected hypotensive agent was asked to assess the quality of the surgical field. In the postanaesthesia care unit (PACU), postoperative pain was assessed and recovery time was recorded.ResultsBoth study drugs succeeded to reach the target MAP. The quality of the surgical field was not different between the two groups. Postoperative pain was not different between the two group and only eight patients in the M group and seven patients in the D group required analgesics. Recovery time was significantly longer for the patients in group D (p<0.05).ConclusionWe concluded that both magnesium sulphate and dexmedetomidine successfully induced deliberate hypotension in patients undergoing middle ear surgery but magnesium sulphate was associated with shorter recovery time and earlier discharge from the PACU

Morphological and radiometrical study of the human intervertebral foramina of the cervical spine

Background: Degenerative changes of the cervical spine are an inevitable response to certain occupational status and aging processes. Compression of cervical nerve roots may result from disc degeneration, disc herniation or intervertebral foraminal stenosis. The precise and detailed anatomical knowledge of the intervertebral foramen of the cervical spine is essential for the diagnosis and management of cervical radiculopathy. The significance of the observations and findings of the present study was to elucidate the correlation between the morphology and disorders of the cervical intervertebral foramina in normal and pathological conditions especially at the level of C3-C4 to C6-C7 on both sides and in both sexes. Moreover, it will help greatly in the planning of both surgical and conservative strategies. Materials and Methods: In the present study, 5 formalin-fixed adult cadavers and radiological specimens of the cervical region of the vertebral column of 28 normal and 209 subjects suffering from cervical disorder from both sexes and different age groups. They subjected for morphological and radiometrical analysis. Results: All measurements of the present study of the cervical disorders in females were found to be 6% less than in males in all age groups, which is statistically significant (p &lt; 0.01) as compared with the control group (2%). The mean intervertebral foraminal areas in the control group of C5-C6 and C6-C7 are significantly greater than those of C3-C4 and C4-C5. Conclusions: The mean intervertebral foraminal area was greater in the lower cervical region than the upper in normal adult individuals. In pathological condition the affection of C3-C4 and C4-C5 intervertebral foramina was more due to narrower surface area. The pathology of cervical spine affecting the intervertebral foramina of female which complaint earlier than male due to narrower foramina

Incidence of variations in human cadaveric renal vessels

Background: Awareness of discrepancies of renal vasculature is crucial for some medical procedures. The present study investigated origin and course of aberrant and accessory renal vessels and any associated variations. Materials and methods: Renal blood vessels of 63 cadavers were examined. Number of renal veins and arteries, arrangement, location where the vasculature attached to the kidneys, and presence of variations were recorded. Incidence of renal vasculature variations was determined, and associations were tested with age at death, sex, and cause of death and whether variations were more common on a specific side. Results: Variations were found in 7 (11%; 95% confidence interval [CI] 5–22%) cadavers. For renal veins, double, triple, and quadruple veins unilaterally (5; 8%) and veins that drained the superior pole (1; 2%) or inferior pole only (5; 8%) were found. For renal arteries, double and triple arteries unilaterally (3; 5%) and arteries attached to the superior pole only (1; 2%) or inferior pole only (2; 3%) were found. Other variations (polycystic kidney, variations in the common iliac or gonadal veins) were observed. Only renal failure as a cause of death was different between those with or without variations (4/7 [57%] vs. 1/56 [2%]; p &lt; 0.001). Conclusions: The present study found many variations in renal vasculature. Awareness of such variations may be useful for physicians concerned with this region

Efficiency of selenium in attenuating epididymal histopathological changes in hypercholesterolaemic adult rat

Background: Studies on sperm maturation, epididymal histology, or epididymal tubule physiology are significant parts in reproductive researches. The present study was aimed to evaluate the effect of induced hypercholesterolaemia on the epididymis of adult albino rats and to clarify the possible protective role of selenium. Materials and methods: Forty adult albino Wistar rats were divided into four groups; untreated control group (group I), sham control (group II), group with induced hypercholesterolaemia (group III), group with induced hypercholesterolaemia treated with selenium 0.25 mg/kg/day (group IV). Results: Histological and ultrastructural examination of the epididymal epithelial cells of hypercholesterolaemic rats (group III) showed loss of cilia with many vacuolations, fatty degenerative changes and increased collagen fibres. Morphometrically significant increase (p &lt; 0.0001) in the per cent area of collagen fibres with no significant change in the optical density of periodic acid Schiff reaction (p &gt; 0.05). Selenium treated group (group IV) produced marked improvement in histological, ultrastructural and morphometric results as compared with group III. Conclusions: It could be concluded that hypercholesterolaemia produced deleterious effects to the epididymis and selenium could attenuate these effects

Stress-induced changes in the aged-rat adrenal cortex. Histological and histomorphometric study

Background: Stress exposure exerts direct effects on the morphology and functionality of the adrenal cortex. In addition, ageing effects growth, differentiation, apoptosis and cellularity of the cortex. The missing data is the combined effect of stress and ageing on the adrenal cortex. The aim of this study was to demonstrate the structural changes in the adrenal cortex following the exposure to stress in the adult and aged albino rats.   Materials and methods: Forty rats were divided into groups I and II (adult and senile). Each group was further subdivided into subgroups a and b (control and stressed). Light and electron microscopic studies were done. Area per cent of collagen fibres (Masson’s trichrome-stained sections), number of proliferating cells (optical density immunoreactivity in the Ki67 stained sections) and thickness of the three adrenal zones were also measured.   Results: Lamellar separation of the capsule with subcapsular spindle cell hyperplasia and areas of ghost cells were observed in zona glomerulosa (ZG) and zona fasciculata (ZF) in group I-b. Separation and indentation of the capsule with its lamellar separation were observed in group II-a with the existence of multiple scattered degenerative foci in ZF and zona reticularis (ZR). Similar and aggressive was the architectural pattern of ZF in group II-b with the presence of areas of homogenous degeneration. The nuclei of ZG had marginated chromatin in group I-b and were pyknotic with deformed irregular outlines in group II-b. Multiple lysosomes and vacuolar degeneration mitochondria were also seen in group I-b. The nuclei of ZF were irregular with condensed marginated heterochromatin in group I-b, irregular with scattered chromatin in group II-a and indented with areas of chromatin destruction in group II-b. Mitochondria with disrupted cristae and cristolysis were also detected in group I-b. Numerous lipofuscin granules and dilated smooth endoplasmic reticulum were revealed in group II-b. The mean collagen fibre area per cent and the mean number of the proliferating cells in group II-b were significantly higher by 39% and 23%. The thickness of ZG decreased significantly by 20% in group I-b. Contrary, the thickness of both ZF and ZR increased significantly by 10% in group I-b.   Conclusions: Histological alterations occurred in the adrenal cortex in response to stress, especially when coupled with the advance of age. This was accompanied by increase in the area per cent of collagen fibres and increase in the mean number of the proliferating cells in the adrenal cortex

The Photovoltaic Performance of CdS/Cu2S (QD) Co-Sensitized Solar Cell

The performance of CdS/Cu2S co-sensitized quantum dot solar cell (QDSSCs) is studied. CdS quantum dots (QDs) were adsorbed onto TiO2 using Successive Ionic Layer Adsorption and Reaction (SILAR) method for different cycles (2, 4, 6, 8 and 10). The Cu2S QDs were deposited onto TiO2/CdS10 cycle photoanodes using the same method. The FTO counter electrodes were coated with platinum, while the electrolyte containing polysulfide redox species was sandwiched between the two electrodes. The current density- voltage (J-V) characteristic curves of the assembled QDSSCs were measured at different cycles and AM 1.5 simulated sunlight. The value of current density (Jsc) and conversion efficiency (η) of TiO2/CdS/Cu2S are 252% larger than the TiO2/CdS values. The maximum values of Jsc and η are 3.56 mA/cm2 and 1.21% respectively corresponding to CdS10/Cu2S for 6 cycles of Cu2S

Serum Islet Cell Autoantibodies During Interferon α Treatment in Patients With HCV-Genotype 4 Chronic Hepatitis

Chronic hepatitis C virus (HCV) infection is a leading cause of end-stage liver disease worldwide and HCV genotype 4 (HCV4) is predominant in African and Middle Eastern countries. It is well established that interferon-α (IFNa) treatment for HCV may trigger serum autoantibodies against pancreatic islet cells (ICA) in a subgroup of patients. Available data on the incidence of ICA during IFNa therapy for chronic HCV4 infection are not conclusive. We investigated the appearance of ICA in 40 naïve Egyptian patients (38 males, 32 ± 6 years) with histologically defined chronic HCV4 infection undergoing IFNa treatment at a dose of 9-million U/week for 24 weeks. Serum samples were collected at baseline and following IFNa therapy and ICA were detected using indirect immunofluorescence. Baseline evaluation indicated that 2/40 (5%) patients had detectable serum ICA. After the completion of the treatment scheme, 12/38 (32%) previously ICA negative patients became ICA positive; however, no patient developed impaired glucose tolerance (IGT) or diabetes during follow-up. In conclusion, we submit that IFNa treatment for chronic hepatitis C (CHC) may induce serum ICA in one-third of Egyptian patients with HCV4. These autoantibodies, however, do not lead to alterations in glucose metabolism