ABSTRACT Background: Sodi-Pallares and colleagues first time introduced use of glucose-insulin and potassium (GIK) solution for myocardial protection. They used this solution in patients with acute myocardial infarction and concluded that GIK solution limited electrocardiographic changes in these patients. Objective: To investigate the effectiveness of the GIK solution regarding myocardial protection evaluated by postoperative creatine kinase MB (CKMB) and cardiac troponin I levels. Method: In this prospective, randomized clinical trial, sixty-four patients were assigned into two groups: GIK group, in which glucose-insulin and potassium infusion were given during surgery, and non-GIK group in which only saline infusion was given during the procedure. Results: All CK-MB values were lower in the GIK group than the Non-GIK group in the postoperative period (6, 12 and 24 hours’ samples) with statistically significant results. Troponin values were lower in the GIK group versus the Non-GIK group after 6 and 12 hours with statistical significance (P < 0.001 and 0.022 respectively). Conclusion: The addition of GIK infusion throughout the operation to standard myocardial protective techniques in patients undergoing on-pump coronary artery bypass graft (CABG) surgery attenuates myocardial ischemic injury.

ABSTRACT Background: Abdominal sepsis patients suffer from profound intravascular fluid deficit due to concomitant inflammatory response and capillary leakage. It is reported that anti-inflammatory properties of sedative agents can control inflammatory cascade in many experimental septic conditions. We aimed to investigate the best sedative drug for inflammatory responses and capillary leak in patients with abdominal sepsis. Methods: In this prospective randomized study, 60 patients with abdominal sepsis who underwent abdominal surgery and required post-operative sedation and mechanical ventilation were randomized into 3 groups in a 1:1:1 ratio. Group D (sedated with dexmedetomidine), group P (sedated with propofol), and group M (sedated with midazolam). This study was held in intensive care units of Assiut University Hospitals with primary outcome was serum IL-6 and IL-1β. Secondary outcomes were capillary leak index, lactate clearance, vasopressor requirements, total intake, total output, and fluid balance. Results: Dexmedetomidine significantly reduced levels of IL-6 and IL-1β through 48 hours compared to both midazolam and propofol. Dexmedetomidine caused a significant decline in capillary leak index (p < 0.05) through 48 hours and significant higher lactate clearance (p = 0.03) in first 24 hours compared to both midazolam and propofol. Dexmedetomidine group had a significantly lower intake in first 24 hours and comparable vasopressor requirements through 48 hours. Dexmedetomidine group had a significantly higher output, lower serum creatinine levels and lower positive fluid balance compared to propofol and midazolam. Conclusions: Dexmedetomidine reduced inflammatory response and capillary leak in mechanically ventilated patients with abdominal sepsis with better lactate clearance and less fluid intake.

Abstract

A B S T R A C T
Excessive iron accumulation is highly toxic to various tissues. Acetylated whey peptides (AWP) obtained from bovine milk have a powerful iron chelating and immunomodulation effect. This study was performed on iron overload (IO)-induced rats’ spleen model and announced that AWP can act as a potent prophylactic, natural, affordable, oral and safe iron chelator and can be used as an alternative to the current synthetic drugs. Moreover,
it can alleviate oxidative stress and downregulate the proinflammatory markers. The results showed that AWP significantly decreased serum iron, splenic ferritin, oxidative stress markers (ROS, iNOS, and HO-1), and inflammatory markers (IL-6, IL-1β, and NF-κB). Histopathological examination declared that AWP reduced splenic iron deposition and improved histopathological changes in iron-overloaded rats. Immunohistochemical examination showed a significant decrease in macrophage markers (CD68 and CD163) expressions. The efficacy of AWP was compared to that of N-Acetyl-L-cysteine (NAC) and both of them showed no significant difference.

Background

The Japanese quail is considered one of the most significant species in the poultry industry. However, the high male-to-female ratio results in the aggressive behavior of males. Dietary strategies that improve the properties of semen could reduce the number of males required to maintain optimal fertility and reduce aggressive behavior. Therefore, this study aims to provide insight into the possible improving efm fect of ginger roots on the reproductive aspects of Japanese male quails.

Results

To achieve this objective, powder of Ginger roots was administrated to 2 groups of quails (10, and 15 g/Kg feed) from 7 days until 70 days of age. Some males were reared singly in cages (n = 40 for each group) to assess sperm quality and other males (n = 32 for each group) were raised with females to assess fertility and sperm-egg penetration. Additionally, biochemical tests and histological examination were also performed. When compared to the control group, dietary inclusion of Ginger at a dose of 15 g caused more improvement in ejaculate volume, sperm concentration, motility, viability and sperm-egg penetration. Whereas, the motility and fertility percentages of sperms were equipotent in both doses. Dose-dependent increases were found in the cloacal gland area and volume, as well as foam production and weight. Both doses resulted in a significant reduction in plasma total cholesterol along with an elevation cin plasma testosterone and lipid peroxides. The comparison between all groups concerning nitric oxide, catalase, superoxide dismutase, and total antioxidant capacity revealed the absence of significant difference. Morphologically, the diameter of the seminiferous tubules and the height of germinal epithelium significantly increased especially in the higher dose of Ginger.

Conclusions

Ginger roots especially at a dose of 15 gm/kg feed was effective in improving male reproductive performance. These findings are of utmost importance in encouraging the addition of Ginger roots in ration formulation in male quails.

Background:

Having good exposure to the mitral apparatus during mitral valve replacement is a vital decision every cardiac surgeon must take. This study was conducted to compare the Simple Transseptal approach and the conventional Left Atrial approach for mitral valve procedures, to evaluate the safety and efficacy of the simple transseptal approach during open-heart mitral valve procedures, as the conventional left atrial approach may not provide optimal exposure, especially in unfavorable anatomical and operative situations.

Methods:

This is a retrospective chart review cohort study. It has been conducted on 140 patients who were diagnosed with heart diseases that required mitral valve replacement. Surgeries were performed in Cardiothoracic Surgery Department at Assiut University Hospital over the period from January 2016 to June 2021 by one surgeon. Mitral procedure was done through median sternotomy incision under general anesthesia on cardiopulmonary bypass machine with cold antegrade cardioplegia. Demographic data, preoperative diagnosis, intraoperative findings, hospital stay, complications, and mortality were documented and revised.

Results:

one hundred and forty patients were enrolled in this study with a median age of 39 years, and no significant differences as regards the baseline demographic data as age, sex, and BMI. 68 patients underwent mitral valve replacement through the simple transseptal approach and 72 patients through the conventional left atrial approach. Both studied groups had insignificant differences as regards bypass time, re-operation rate, postoperative complications, hospital stay, and mortality.

Conclusion:

Simple transseptal approach through the midpoint of fossa ovalis could be a safe and even favorable alternative to the traditional left atriotomy approach in certain difficult operative situations during mitral valve replacement surgery.