Ultrasound-guided fascia iliaca block versus quadratus lumborum block for perioperative analgesia in patients undergoing hip surgery. A randomised controlled trial.

INTRODUCTION: Femoral neck fractures are common orthopaedic fractures, especially in old age, and they represent a life-threatening condition requiring surgical intervention. In this study, we aimed to compare 2 regional techniques used to decrease perioperative pain. MATERIAL AND METHODS: In this parallel group randomized controlled clinical trial we enrolled 68 patients from both sexes scheduled for hip surgery after femoral neck fractures. The patients were randomly allocated to 2 equal groups with one receiving ultrasound- guided supra-inguinal fascia iliaca block (FIB) and the other receiving ultrasound- guided anterior quadratus lumborum block (QLB). Our primary outcome was the duration of postoperative analgesia. The secondary outcome was measuring the Visual Analog Scale (VAS) during patient positioning while applying the neuraxial block, the total analgesic requirement in the postoperative period, patient satisfaction in the postoperative period, and the frequency of adverse effects. RESULTS: The group receiving supra-inguinal FIB had a significantly longer time of postoperative analgesia 18 (4-24), compared to the group receiving anterior QLB 2 (1-24), P = 0.005. They consumed less morphine throughout 24 hours postoperatively, 5.3 ± 0.9 mg compared to 6.9 ± 1.87 mg (95% CI: 6.45-3.92, P = 0.008), and they showed less pain during positioning for spinal anaesthesia. CONCLUSIONS: Supra-inguinal FIB provides prolonged postoperative analgesia compared to anterior QLB in patients undergoing hip surgery. It was associated with less pain during positioning in spinal anaesthesia and decreased total morphine consumption.

Fast resolution and good outcomes of isolated traumatic intraventricular haemorrhage: a case report.

The location and the size of intracranial haemorrhage play an important role in determining the time for the hematoma resolution. Without surgical intervention, it takes at least a few weeks for the whole hematoma to resolve spontaneously. Despite that the rapid and spontaneous resolution of intracranial haemorrhage is well described in the literature, it is considered rare. Moreover, we could identify only one case of rapid spontaneous resolution of isolated traumatic intraventricular haemorrhage (ITIVH) in the literature. Herein, we report a rare case of ITIVH that disappeared rapidly without surgical intervention. Our case supported the hypothesis that the cerebrospinal fluid (CSF) and its circulation are major players in the rapid resolution of ITIVH.

Seed Priming Boost Adaptation in Pea Plants under Drought Stress.

In the present investigation, we study the effect of Bacillus thuringiensis MH161336 (106-8 CFU/cm3), silicon (25 mL L-1), and carrot extract (75 mL L-1) as seed primers, individually or in combination, on morphological, physio-biochemical and yield components of drought-stressed pea plants (Master B) during 2019/2020 and 2020/2021 seasons. Our results indicated that drought causes a remarkable reduction in plant height, leaf area, number of leaves per plant, and number of flowers per plant in stressed pea plants during two seasons. Likewise, number of pods, pod length, seeds weight of 10 dried plants, and dry weight of 100 seeds were decreased significantly in drought-stressed pea plants. Nevertheless, seed priming with the individual treatments or in combination boosted the morphological, physio-biochemical, and yield characters of pea plants. The best results were obtained with the Bacillus thuringiensis + carrot extract treatment, which led to a remarkable increase in the number of leaves per plant, leaf area, plant height, and number of flowers per plant in stressed pea plants in both seasons. Moreover, pod length, number of seeds per pod, seeds weight of 10 dried plants, and dry weight of 100 seeds were significantly increased as well. Bacillus thuringiensis + carrot extract treatment led to improved biochemical and physiological characters, such as relative water content, chlorophyll a, chlorophyll b, regulated the up-regulation of antioxidant enzymes, increased seed yield, and decreased lipid peroxidation and reactive oxygen species, mainly superoxide and hydrogen peroxide, in drought-stressed pea plants.

Development of an efficient in vivo cell-based assay system for monitoring hepatitis C virus genotype 4a NS3/4A protease activity.

BACKGROUND: Hepatitis C virus (HCV) represents a serious worldwide healthcare problem. No protective vaccines against HCV have been developed yet due to the fact that HCV is rapidly mutable, allowing the virus to escape from the neutralizing antibodies. Understanding of HCV was initially hampered by the inability to achieve viral replication in cell culture. Given its essential roles in viral polyprotein processing and immune evasion, HCV NS3/4A protease is a prime target for antiviral chemotherapy. We aimed to establish in vivo cell-based assay system for monitoring the activity of NS3/4A protease from HCV genotype 4a, the predominant genotype in Egypt, and the Middle East. Furthermore, the developed system was used to evaluate the inhibitory potency of a series of computer-designed chemically-synthesized compounds against NS3/4A protease from HCV genotype 4a. MATERIALS AND METHODS: Native as well as mutant cleavage sites to NS3/4A protease were cloned in frame into ß-galactosidase gene of TA cloning vector. The target specificity of HCV NS3/4A was evaluated by coexpression of ß-galactosidase containing the protease cleavage site with NS3/4A protease construct in bacterial cells. The activity of ß-galactosidase was colorimetrically estimated in the cell lysate using orthonitro phenyl ß-D-galactopyanoside (ONPG) as a substrate. RESULTS AND CONCLUSIONS: We successfully developed an efficient cell-based system based on the blue/white selection of bacterial cells that are able to express functional/nonfunctional ß-galactosidase enzyme.

Comparison of dexamethasone or intravenous fluids or combination of both on postoperative nausea, vomiting and pain in pediatric strabismus surgery.

BACKGROUND: Strabismus surgery is perhaps a pediatric surgical procedure that has the strongest evidence of postoperative nausea and vomiting (PONV) risk. This randomized controlled blind study was designed to evaluate the efficacy of combined therapy of dexamethasone and intraoperative superhydration vs their monotherapy on the incidence and severity of PONV and on pain intensity after pediatric strabismus surgery. METHODS: A total of 120 children aged 6 to 12 years undergoing strabismus surgery were randomized to equally 3 groups to receive 0.15 mg/kg dexamethasone (dexamethasone group) or intraoperative superhydration of lactated Ringer's solution in a dose of 30 mL/kg per fasting time (superhydration group), or a combination of dexamethasone and intraoperative fluid in the same strategy (combination therapy group). The incidence and severity of PONV and pain using visual analog scale score, and need for supplemental antiemetic and analgesic therapy and their consumptions were assessed and compared in the 3 studied groups for 24 hours postoperatively. RESULTS: The incidence of PONV and postoperative vomiting was significantly lower (P> .001) in the combination therapy group (5% and 5% respectively) compared with the dexamethasone group (35% and 30%) and superhydration group (32.5% and 35%). There was no significant difference among patients in the superhydration group and dexamethasone group in the cumulative incidences of PONV in the whole 24 hours postoperatively. Postoperative aggregated visual analog scale pain score and total acetaminophen consumption showed a significant reduction (P> .05) in the combination therapy group together with significant prolongation of time to the first analgesic request compared with both the superhydration group and the dexamethasone group. CONCLUSION: Combined therapy of 0.15 mg/kg dexamethasone 1 minute before induction and intraoperative fluid superhydration is an effective and safe way to reduce PONV and pain better than monotherapy of dexamethasone, or intraoperative superhydration separately for pediatric strabismus surgery.