A comparative study between ultrasound-guided interscalene and ultrasound-guided suprascapular nerve blocks in postoperative pain and hand motor power affection in shoulder scope surgeries

Abstract Background Interscalene approach for brachial plexus block is recognized as the gold standard technique for postoperative pain control after shoulder scope surgeries. However, it is associated with major adverse effects and patient discomfort due to paralysis of the hand muscles. The suprascapular nerve block is considered to be a safe and effective alternative to interscalene nerve block for shoulder surgery without affecting the motor function of the hand muscles and other serious complications of interscalene nerve block, especially in ambulatory surgery. The aim of this study is to compare interscalene and suprascapular nerve block in terms of postoperative pain, opioid consumption, and hand grip strength in shoulderscopic surgeries. This prospective, randomized trial was done in Ain Shams University Hospitals. A sample of 50 patients was divided into two groups; 25 patients in each group, namely Group ISB (interscalene approach of brachial plexus block) and Group SSNB (suprascapular nerve block). Visual analogue scale (VAS) was used to assess shoulder pain at rest and upon flexion in the first 24 h. The degree of hand motor power affection, the total amount of opioids used as rescue analgesia, and the incidence of complications were also recorded. Results The findings revealed no statistically significant difference between groups (P-value > 0.05) in pain control all over the 24 h by VAS score at rest and at arm flexion. SSNB received a larger total narcotic dose (60 ± 26.02) mg of pethidine than ISB (52 ± 22.73). However, there was no statistical difference between them throughout the 24 h regarding total narcotic consumption and 1st time for pethidine administration. The ISB group showed a statistically significant reduction in the hand power grip strength postoperatively (83.68 ± 4.75%). Conclusions The results of the present study favor SSNB as the first choice of pain control after shoulderscopic surgeries for a patient scheduled for early home discharge because of the complete recovery of the hand muscles’ motor power. Trial registration This study was registered on PACTR ( www.pactr.org ) database; identification number for the registry is PACTR202201840526231

Photodynamic therapy for hair removal

Background: Unwanted hair is one of the most common medical problems affecting women of reproductive age inducing a lot of psychological stress and threatening their femininity and self-esteem. Old methods of removing unwanted hair include shaving, waxing, chemical depilation, and electrolysis, all of which have temporary results. However laser-assisted hair removal is the most efficient method of long-term hair removal currently available. It is desirable to develop a reduced cost photodynamic therapy (PDT) system whose properties should include high efficiency and low side-effects. Method: Mice skin tissues were used in this study and divided into six groups such as controls, free methylene blue (MB) incubation, liposome methylene blue (MB) incubation, laser without methylene blue (MB), free methylene blue (MB) for 3 and 4 h and laser, liposome methylene blue (MB) for 3 h and laser. Methylene blue (MB) was applied to wax epilated areas. The areas were irradiated with CW He-Ne laser system that emits orange-red light with wavelength 632.8 nm and 10 mW at energy density of 5 J/cm2 for 10 min. The UV-visible absorption spectrum was collected by Cary spectrophotometer. Results: Methylene blue (MB) is selectively absorbed by actively growing hair follicles due to its cationic property. Methylene blue (MB) untreated sections showed that hair follicle and sebaceous gland are intact and there is no change due to the laser exposure. Free methylene blue (MB) sections incubated for 3 h showed that He:Ne laser induced destruction in hair follicles, leaving an intact epidermis. Treated section with free methylene blue (MB) for 4 h showed degeneration and necrosis in hair follicle, leaving an intact epidermis. Liposomal methylene blue (MB) sections incubated for 3 h showed He:Ne laser induced destruction in hair follicles with intradermal leucocytic infiltration. Conclusion: Low power CW He:Ne laser and methylene blue (MB) offered a successful PDT system in selectively damaging hair follicles, leaving an intact epidermis. The current PDT system provides better outcome than hair destruction through laser heat transfer procedures and laser-mediated hair removal, due to complete destruction of hair follicles.qscienc

Virulence profiles of some Pseudomonas aeruginosa clinical isolates and their association with the suppression of Candida growth in polymicrobial infections.

Pseudomonas aeruginosa is an opportunistic pathogen that can cause a variety of diseases especially in the hospital environment. However, this pathogen also exhibits antimicrobial activity against Gram-positive bacteria and fungi. This study aimed to characterize different virulence factors, secreted metabolites and to study their role in the suppression of Candida growth. Fifteen P. aeruginosa isolates were tested for their anticandidal activity against 3 different Candida spp. by the cross-streak method. The effect on hyphae production was tested microscopically using light and scanning electron microscopy (SEM). Polymerase chain reaction was used in the detection of some virulence genes. Lipopolysaccharide profile was performed using SDS-polyacrylamide gel stained with silver. Fatty acids were analyzed by GC-MS as methyl ester derivatives. It was found that 5 P. aeruginosa isolates inhibited all tested Candida spp. (50-100% inhibition), one isolate inhibited C. glabrata only and 3 isolates showed no activity against the tested Candida spp. The P. aeruginosa isolates inhibiting all Candida spp. were positive for all virulence genes. GC-Ms analysis revealed that isolates with high anticandidal activity showed spectra for several compounds, each known for their antifungal activity in comparison to those with low or no anticandidal activity. Hence, clinical isolates of P. aeruginosa showed Candida species-specific interactions by different means, giving rise to the importance of studying microbial interaction in polymicrobial infections and their contribution to causing disease

Pathology, bacteriology and molecular studies on caseous lymphadenitis in Camelus dromedarius in the Emirate of Abu Dhabi, UAE, 2015-2020.

Caseous lymphadenitis (CLA) or pseudotuberculosis is a chronic zoonotic bacterial disease caused by Corynebacterium pseudotuberculosis, which affects livestock and humans. This study aimed to describe the pathology, bacteriology and confirm the identity of the pathogen by 16S rRNA gene sequencing in Camelus dromedarius. A total of 12 camels with suspected CLA in three regions of Abu Dhabi Emirate (Abu Dhabi, Al Ain and Al Dhafra), United Arab Emirate (UAE) were subjected to clinical and postmortem examinations from January 2015 to December 2020. Clinically, camels were emaciated and showed the presence of external caseous abscesses suggestive of CLA. Postmortem examination showed multiple abscesses of variable sizes with caseous material encapsulated by fibrous tissue in the liver, lungs, muscle, and lymph nodes. Following clinical and postmortem examination, blood, pus and different tissue samples were collected for subsequent analysis. Histopathological examination of all organs stained with Hematoxylin and Eosin (H&E) indicated a central caseo-necrotic core that was admixed with bacterial colonies and infiltration of chronic inflammatory cells, surrounded by a pyogenic membrane, and an outer fibrous connective tissue capsule. Bacterial culture identified the isolates of Corynebacterium pseudotuberculosis biotype ovis strain, and these isolates were shown to be sensitive to all antibiotics tested (penicillin, ampicillin, Co-trimoxazole, enrofloxacin and tetracycline). Moreover, the identity of the isolates was confirmed by partial sequencing of the 16S rRNA gene which showed a 100% identity to Corynebacterium pseudotuberculosis. Phylogenetic analysis based on 16S rRNA gene sequence clearly differentiates Corynebacterium pseudotuberculosis from other species of Corynebacterium. Briefly, this study provided the basic information for infection of Corynebacterium pseudotuberculosis in Camels and will help in controlling of this pathogen in the region