A comparative study of respiratory effects of erector spinae plane block versus paravertebral plane block for women undergoing modified radical mastectomy.

BACKGROUND: Inadequate acute postoperative pain control after modified radical mastectomy (MRM) can compromise pulmonary function. This work aimed to assess the postoperative pulmonary effects of a single-shot thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) in female patients undergoing MRM. METHODS: This prospective, randomized comparative trial was conducted on 40 female American Society of Anesthesiologists (ASA) II-III, aged 18 to 50 years undergoing MRM under general anesthesia (GA). Patients were divided into two equal groups (20 in each group): Group I received ESPB and Group II received TPVB. Each group received a single shot with 20 ml volume of 0.5% bupivacaine. RESULTS: Respiratory function tests showed a comparable decrease in forced vital capacity (FVC) and forced expiratory volume (FEV1) from the baseline in the two groups. Group I had a lower FEV1/FVC ratio than Group II after 6 h. Both groups were comparable regarding duration for the first postoperative analgesic request (P value = 0.088), comparable postoperative analgesic consumption (P value = 0.855), and stable hemodynamics with no reported side effects. CONCLUSION: Both ultrasound guided ESPB and TPVB appeared to be effective in preserving pulmonary function during the first 24 h after MRM. This is thought to be due to their pain-relieving effects, as evidenced by decreased postoperative analgesic consumption and prolonged time to postoperative analgesic request in both groups. GOV ID: NCT03614091 registration date on 13/7/2018.

Synchronous analysis of acetaminophen, codeine, and caffeine in human fluids employing graphite screen-printed electrodes.

A facile electrochemical approach is proposed for the synchronous determination of acetaminophen (ACP), codeine (COD) and caffeine (CAF) utilizing unmodified screen-printed electrodes (SPEs). The determination of ACP, COD and CAF has been explored across different supporting electrolytes including sulfuric acid (H2SO4), hydrochloric acid (HCl), phosphoric acid (H3PO4) and Briton Robinson (B.R) buffer solutions. It was found that a 0.05 mol L-1 sulfuric acid solution is an optimal supporting electrolyte utilized for voltammetric analysis of ACP, COD, and CAF with improved sensitivity, stability, and reproducibility. The electro-analytical sensing of ACP, COD and CAF was investigated using SPEs within linear concentration ranges of 3.0-35.0 µmol L-1, 10-160 µmol L-1 and 10-160 µmol L-1 and revealed competitively low limits of detection (3S/N) of 0.9, 4.8 and 6.3 µmol L-1 for ACP, COD and CAF, respectively. The results indicated the possibility of such a simple and quick electroanalytical protocol for online monitoring of pharmaceutical formulations comprising ACP, COD, and CAF drugs in human fluids with satisfactory recovery.

Geotechnical data compilation for evaporitic rocks in Abu Dhabi, UAE: A resource for engineers.

The durability and degradability of evaporitic rocks are always a critical concern in geological, civil, and geotechnical engineering applications, necessitating careful consideration for reliable, secure, and sustainable construction. This dataset is based on a comprehensive collection of geotechnical data involving both mechanical and physical properties as well as geochemical analyses for the evaporitic rocks in Abu Dhabi and its vicinity. The purpose of this dataset is to be an important source for construction professionals, engineers, and decision-makers in the region by providing basic insights into the challenges associated with building projects on and in evaporitic rocks. This data is obtained from extensive field investigations and laboratory analyses and will help to ensure that construction activities are carried out safely and efficiently when dealing with evaporitic rock formations. The prevalence of evaporitic rocks in Abu Dhabi highlights the importance of this geotechnical data compilation in facilitating informed decision-making and supporting safe construction.

Geochemistry and Sr, S, and O stable isotopes of Miocene Abu Dhabi evaporites, United Arab Emirates.

This study investigates for the first time the subsurface Miocene evaporite facies (Gachsaran Formation) in Abu Dhabi, United Arab Emirates. Forty-five evaporite rock samples were selected for petrographic, mineralogical, and geochemical investigations and stable isotope analyses to decipher their origin and constrain their age. Secondary gypsum with anhydrite relics dominates the investigated evaporitic rocks, with minor amounts of clays, dolomicrite, Fe/Ti oxides, and celestite. These samples are characterized by their excellent purity and low variability in geochemical composition. The distribution of trace element concentrations is significantly influenced by continental detrital intake. The main focus of the study is to determine the strontium, sulfur, and oxygen stable isotope compositions. The measured 87Sr/86Sr values of 0.708411-0.708739 are consistent with Miocene marine sulfates and indicate ∼21.12-15.91 Ma (Late Aquitanian-Burdigalian). The δ34S and δ18O values are 17.10‰-21.59‰ and 11.89‰-19.16‰, respectively. These values are comparable to those of Tertiary marine evaporites. The relatively low values of δ34S suggest that non-marine water possesses little influence on S distribution. The geochemical composition and Sr, S, and O isotope distributions of the Abu Dhabi gypsum facies from the Gachsaran Formation reveals that their source brines were marine (coastal saline/sabkha) with subordinate continental input.

Effects of groundwater and distilled water on the durability of evaporitic rocks.

Evaporitic rock durability induced by groundwater cause several construction challenges, but representative experimental studies to evaluate such conditions are still missing. Therefore, this study intended to provide better and more realistic degradability features of evaporites with groundwater besides a comparison with distilled water as slaking fluids. Forty-eight evaporitic rock blocks were collected from Abu Dhabi area, United Arab Emirates. 96 slake durability index (SDI) tests were performed, 48 with each of the slaking fluids; groundwater and distilled water, and their textural, mineralogical, and geochemical attributes were also examined before and after the SDI tests. In comparison to mineralogical and textural modifications, slaking fluid had a greater impact on the chemical composition of evaporitic rock. The study shows that the degradability of evaporites with groundwater and distilled water indicates a wide range from very low to high. The mean weight loss values after four cycles with groundwater and distilled water vary from 11 to 77 and from 4 to 81 wt.%, respectively. Consequently, slaking with groundwater illustrates a wide range compared to the slaking with distilled water. This could be due to quick interactions between groundwater and evaporites and fast hydration-dehydration process than distilled water due to the chemical composition of the groundwater. It is recommended to investigate the attributes of evaporitic rocks as well as groundwater geochemistry for safe, cost-effective, and sustainable structures.

Resource Oriented Decision Making for Treatment of Metastatic Colorectal Cancer (mCRC) in a Lower-Middle Income Country: Egyptian Foundation of Medical Sciences (EFMS) Consensus Recommendations 2020.

PURPOSE: Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and the second cause of cancer related mortality. Treatment options for patients with metastatic CRC (mCRC) expanded during the last two decades, with introduction of new chemotherapeutic and targeted agents. Egypt is a lower middle-income country; Egyptian health care system is fragmented with wide diversity in drug availability and reimbursement policies across different health care providing facilities. We report the results of consensus recommendations for treatment of patients with metastatic colorectal cancer developed by Egyptian Foundation of Medical Sciences (EFMS), aiming to harmonize clinical practice through structured expert consensus-based recommendations consistent with the national status. EFMS recommendations could be utilized in other countries with similar economic status. METHODS: EFMS recommendations were developed using a modified Delphi process, with three rounds of voting till the final recommendations were approved. A non-systematic review of literature was conducted before generating the provisional statements. Content experts were asked to vote on some recommendations in two different resource groups (restricted resources and non-restricted resources). External review board of experts from a low income and lower-middle countries voted on the applicability of EFMS recommendations in their countries. RESULTS: The current recommendations highlighted the discrepancy in health care between restricted and non-restricted resources with expected survival loss and quality of life deterioration. Access to targeted agents in first line is very limited in governmental institutions, and no access to agents approved for third line in patients who failed oxaliplatin and irinotecan containing regimens for patients treated in restricted resource settings. CONCLUSION: Management of mCRC in developing countries is a challenge. The currently available resource-stratified guidelines developed by international cancer societies represent a valuable decision-making tool, adaptation to national status in each country based on healthcare system status is required.

Simultaneous Voltammetric Determination of Acetaminophen and Isoniazid (Hepatotoxicity-Related Drugs) Utilizing Bismuth Oxide Nanorod Modified Screen-Printed Electrochemical Sensing Platforms.

To overcome the recent outbreaks of hepatotoxicity-related drugs, a new analytical tool for the continuously determination of these drugs in human fluids is required. Electrochemical-based analytical methods offer an effective, rapid, and simple tool for on-site determination of various organic and inorganic species. However, the design of a sensitive, selective, stable, and reproducible sensor is still a major challenge. In the present manuscript, a facile, one-pot hydrothermal synthesis of bismuth oxide (Bi2O2.33) nanostructures (nanorods) was developed. These BiO nanorods were cast onto mass disposable graphite screen-printed electrodes (BiO-SPEs), allowing the ultrasensitive determination of acetaminophen (APAP) in the presence of its common interference isoniazid (INH), which are both found in drug samples. The simultaneous electroanalytical sensing using BiO-SPEs exhibited strong electrocatalytic activity toward the sensing of APAP and INH with an enhanced analytical signal (voltammetric peak) over that achievable at unmodified (bare) SPEs. The electroanalytical sensing of APAP and INH are possible with accessible linear ranges from 0.5 to 1250 µM and 5 to 1760 µM with limits of detection (3σ) of 30 nM and 1.85 µM, respectively. The stability, reproducibility, and repeatability of BiO-SPE were also investigated. The BiO-SPEs were evaluated toward the sensing of APAP and INH in human serum, urine, saliva, and tablet samples. The results presented in this paper demonstrate that BiO-SPEs sensing platforms provide a potential candidate for the accurate determination of APAP and INH within human fluids and pharmaceutical formulations.