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ABSTRACT Background: Caudal anesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants have been utilized with local anesthetic to prolong duration of post-operative analgesia of caudal block in pediatric patients, but with variable results. Aim and Objective: This study is conducted to evaluate the hemodynamics effects and surgical stress response of caudal magnesium sulfate with bupivacaine in children undergoing lower abdominal surgeries. Methods: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 children ASA classification I and II, aged 1 year to 6 years scheduled for lower abdominal surgeries randomized into one of two groups. after inhalation induction of general anesthesia, standard caudal block was done the participants were randomized into one of two groups either receive 1ml volume containing 50mg of magnesium sulfate (group Mg) added to 1ml /kg bupivacaine 0.25% or 1ml saline as placebo added to the same dose of bupivacaine in group (C). Postoperative pain assessed by FLACC score (acronym for Face, Legs, Activity, Cry and CONSOL ability) and duration of analgesia, postoperative sedation as well as hemodynamic parameters were compared between the two groups. Results: Group Mg had significantly lower FLACC score than group C in the first six postoperative hours. The sedation score was significantly higher only during the first postoperative hours in group Mg compared to group C. There was no statistically significant difference between groups about hemodynamic parameters at any time during the study period. Conclusion: Caudal magnesium sulfate 50mg enhance caudal block and prolongs duration of analgesia with bupivacaine in pediatric patient undergoing lower abdominal surgeries under general anesthesia with minimum adverse effects.

ABSTRACT Background: Caudal anesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants have been utilized with local anesthetic to prolong duration of post-operative analgesia of caudal block in pediatric patients, but with variable results. Aim and Objective: This study is conducted to evaluate the hemodynamics effects and surgical stress response of caudal magnesium sulfate with bupivacaine in children undergoing lower abdominal surgeries. Methods: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 children ASA classification I and II, aged 1 year to 6 years scheduled for lower abdominal surgeries randomized into one of two groups. after inhalation induction of general anesthesia, standard caudal block was done the participants were randomized into one of two groups either receive 1ml volume containing 50mg of magnesium sulfate (group Mg) added to 1ml /kg bupivacaine 0.25% or 1ml saline as placebo added to the same dose of bupivacaine in group (C). Postoperative pain assessed by FLACC score (acronym for Face, Legs, Activity, Cry and CONSOL ability) and duration of analgesia, postoperative sedation as well as hemodynamic parameters were compared between the two groups. Results: Group Mg had significantly lower FLACC score than group C in the first six postoperative hours. The sedation score was significantly higher only during the first postoperative hours in group Mg compared to group C. There was no statistically significant difference between groups about hemodynamic parameters at any time during the study period. Conclusion: Caudal magnesium sulfate 50mg enhance caudal block and prolongs duration of analgesia with bupivacaine in pediatric patient undergoing lower abdominal surgeries under general anesthesia with minimum adverse effects.

ABSTRACT Background: Caudal anesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants have been utilized with local anesthetic to prolong duration of post-operative analgesia of caudal block in pediatric patients, but with variable results. Aim and Objective: This study is conducted to evaluate the hemodynamics effects and surgical stress response of caudal magnesium sulfate with bupivacaine in children undergoing lower abdominal surgeries. Methods: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 children ASA classification I and II, aged 1 year to 6 years scheduled for lower abdominal surgeries randomized into one of two groups. after inhalation induction of general anesthesia, standard caudal block was done the participants were randomized into one of two groups either receive 1ml volume containing 50mg of magnesium sulfate (group Mg) added to 1ml /kg bupivacaine 0.25% or 1ml saline as placebo added to the same dose of bupivacaine in group (C). Postoperative pain assessed by FLACC score (acronym for Face, Legs, Activity, Cry and CONSOL ability) and duration of analgesia, postoperative sedation as well as hemodynamic parameters were compared between the two groups. Results: Group Mg had significantly lower FLACC score than group C in the first six postoperative hours. The sedation score was significantly higher only during the first postoperative hours in group Mg compared to group C. There was no statistically significant difference between groups about hemodynamic parameters at any time during the study period. Conclusion: Caudal magnesium sulfate 50mg enhance caudal block and prolongs duration of analgesia with bupivacaine in pediatric patient undergoing lower abdominal surgeries under general anesthesia with minimum adverse effects.

ABSTRACT : A total of 150 buffalo’s ocular muscle samples were examined for the presence of sarcosporidians in Assiut Governorate. These samples included 80 males less than 2 years old and 70 females more than 5 years old. Sarcocystis spp. were detected in 55 (36.66%) of examined animals. The incidence of infection in males was 15.0% and in females was 61.42%. Two species of Sarcocystis were detected in the present work: S.fusiformis was detected in 9.33% of examined animals, where in males it was 1.25% and in females was 18.57%. S.levinei was detected in 34.66% of examined animals, in males it was 15.0% and in females was 57.14%. Mixed infection with the two species was detected in 11 (7.33%) of examined animals. The morphological characters and the ultrastructure of each species were described.The present data showed that ocular muscles are a preferreble site for Sarcocystis especially S.levinei. It is ,therefor recommended that Sarcocystis cysts showed be looked for in ocular muscles of humans complaining of ocular muscle disease.

ABSTRACT : A total of 150 buffalo’s ocular muscle samples were examined for the presence of sarcosporidians in Assiut Governorate. These samples included 80 males less than 2 years old and 70 females more than 5 years old. Sarcocystis spp. were detected in 55 (36.66%) of examined animals. The incidence of infection in males was 15.0% and in females was 61.42%. Two species of Sarcocystis were detected in the present work: S.fusiformis was detected in 9.33% of examined animals, where in males it was 1.25% and in females was 18.57%. S.levinei was detected in 34.66% of examined animals, in males it was 15.0% and in females was 57.14%. Mixed infection with the two species was detected in 11 (7.33%) of examined animals. The morphological characters and the ultrastructure of each species were described.The present data showed that ocular muscles are a preferreble site for Sarcocystis especially S.levinei. It is ,therefor recommended that Sarcocystis cysts showed be looked for in ocular muscles of humans complaining of ocular muscle disease.

Vitamin D deficiency has been recognized as a worldwide epidemic, affecting even healthy population. The awareness and practices of primary health care physicians regarding vitamin D needs to be highlighted, as improving the knowledge of physicians will improve the knowledge of the public as a whole. This study aimed to address the knowledge, attitude and practice of primary health care physicians regarding vitamin D in Riyadh city, KSA. A cross-sectional study was conducted using a self-administered questionnaire among primary care physicians; currently working in Riyadh city, KSA. Descriptive statistics: mean, standard deviation, frequencies, percentage were calculated. Of the 158 eligible participants, there were 43.7% male. The mean participant's age of was 40.7 ± 9.6 years. Of all the participants; 51.3% showed good knowledge regarding vitamin D, while 48.7% showed poor knowledge; 55.1% had positive attitude. Participants were asked about patient features that would alert them to vitamin D status. Fatigue was shown to alert more male than female physicians participants (75.4% vs. 58.4%, p = 0.026). Participants were asked about ways of managing vitamin D deficiency. Nutrition advice was mostly given by older physicians (p = 0.044) and non-Saudis (p = 0.003). In conclusion, this survey identified a gap in knowledge and practice among Primary Health Care physicians. The confusion could be partly attributed to different guidelines and sources of information. This study showed that continuous medical education and online sources were the most common sources of information about vitamin D among physicians.

Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges. The patient was premedicated with midazolam 1 mg and general anesthesia was induced with fentanyl 2 μg/kg body weight, propofol 2 mg/kg and rocuronium bromide 0.6 mg/kg to facilitate tracheal intubation. Anesthesia was maintained with inhalation of isoflurane 1.0–1.5 % in 40 % oxygen-enriched air and 25 μg boluses of fentanyl. The patient did not require any additional rocuronium throughout surgery which was finished after 4 h. The patient most probably had preoperative simvastatin-inducedmyotoxicity. This potentiated the muscle relaxant effect of rocuronium bromide and was the reason for patient unresponsiveness and delayed postoperative recovery. We can conclude that anesthesiologists should preoperatively identify statin myotoxicity and to avoid neuromuscular blocking drugs for statin-treated patients. Also, preoperative adjustment of statin dosage may be recommended.