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The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo. Methods: One hundred children aged (7-12) years were randomly allocated in four groups) n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative. Results: The mean time to first request for rescue analgesics was prolonged in K-N1(400.9±60.5 min, 95% CI 375.9-425.87) and K-N2 (455. 5±44.6 min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5±86.1 min, 95% CI 282.9-354.1) and Group C (68.3±21.9 min, 95% CI 59.5-77.1; p 0.001), with a significant difference between K-N1 and K-N2 Groups(p 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced in Group K-IV (672.6±272.8 mg, 95% CI 559.9---785.2), Group K-N1 (715.6± 103.2 mg, 95% CI 590.4-840.8) and Group K-N2 (696.6±133.3 mg, 95% CI 558.8-834.4) compared with Control Group (1153.8±312.4 mg, 95% CI 1024.8-1282.8; p 0.001). With no difference between intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p 0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects Conclusion: Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine.

The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo. Methods: One hundred children aged (7-12) years were randomly allocated in four groups) n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative. Results: The mean time to first request for rescue analgesics was prolonged in K-N1(400.9±60.5 min, 95% CI 375.9-425.87) and K-N2 (455. 5±44.6 min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5±86.1 min, 95% CI 282.9-354.1) and Group C (68.3±21.9 min, 95% CI 59.5-77.1; p 0.001), with a significant difference between K-N1 and K-N2 Groups(p 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced in Group K-IV (672.6±272.8 mg, 95% CI 559.9---785.2), Group K-N1 (715.6± 103.2 mg, 95% CI 590.4-840.8) and Group K-N2 (696.6±133.3 mg, 95% CI 558.8-834.4) compared with Control Group (1153.8±312.4 mg, 95% CI 1024.8-1282.8; p 0.001). With no difference between intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p 0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects Conclusion: Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine.

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This study aimed to assess the impact of high-fat diet (HFD) and vitamin D3 supplementation on cardiac apoptosis, inflammation, oxidative stress, and cardiac uncoupling proteins (UCPs) 2&3 expression. Forty rats were fed either (45%) or (10%) fat diet with or without vitamin D3 (500 U/kg/day) for 6 months, then cardiac tissue expression of Bax, Bcl2, Fas, Fas-L (markers for apoptotic pathways), TNF-α, MDA7, GPX1 (inflammatory and oxidative markers) and UCP 2&3 were assessed. Results revealed the enhancement of intrinsic and extrinsic cardiomyocyte apoptosis cascades and increased inflammatory and oxidative burdens on the heart in HFD rats. Downregulation of UCP2 and upregulation of UCP3 gene expression at 6 months. After vitamin D3 supplementation with HFD, cardiac apoptotic, inflammatory and oxidative markers were mitigated and expression of UCP3 was downregulated and UCP2 was

Objective: The aim of our study is to assess the clinico-electrophysiological profile of children with Guillain–Barré syndrome (GBS) in Upper Egypt and to compare the efficacy of plasmapheresis versus other treatment modalities. Patients and methods: This was a retrospective study of children from January 2010 to October 2014 diagnosed as GBS. It included 62 cases. Results: Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the most prevalent type of GBS in our locality. As regards the treatment, 32 cases received plasmapheresis while 30 patients received intravenous immunoglobulin. We found a significant decrease in the duration of hospitalization and a significant increase in the number of children with complete recovery in cases treated with plasmapheresis. Conclusion: GBS is not uncommon in children of Upper Egypt, with AIDP the most prevalent type. Plasmapheresis is the best treatment modalities for GBS as it reduces the duration of hospital stay and hastens the recovery of those children.