European Journal of Cardiovascular Medicine

Introduction: Emergence agitation is a common side-effect of Sevoflurane anaesthesia in children. Dexmedetomidine, a specific α2- receptor agonist, may be useful adjuvant during general anaesthesia by promoting hemodynamic stability and decreasing the doses of anaesthetics and analgesics. The purpose of our study was to test the effect of Dexmedetomidine in reducing emergence agitation in children undergoing Sevoflurane anaesthesia.

Material and Methods: 60 children aged 3 to 7 years scheduled to undergo superficial lower abdominal or genital surgeries were included in the study. Patients were randomly assigned to receive either Inj. Dexmedetomidine 0.3µg/kg (Group D) or Inj. Fentanyl 1µg/kg (Group F) i.v prior to induction. After induction with 8% Sevoflurane, a laryngeal mask airway was inserted. Anaesthesia was maintained with 1-2% Sevoflurane and 50% nitrous oxide on spontaneous ventilation. Postoperatively, caudal epidural block was given. At the end of anaesthesia, the time of response to verbal commands (TRVC) and characteristics of emergence were recorded.

Results: Mean postoperative behaviour score in Group D was 1.7 ± 0.79 while that in Group F was 2.96 ± 0.96. There was significant reduction in the VAS score from 5.7 ± 0.98 in Group F to 2.4 ± 0.89 in Group D. 13.33% patients in Group D and 43.33% in Group F showed agitation.

Conclusion: We conclude that Inj. Dexmedetomidine 0.3µg/kg i.v reduces postoperative emergence agitation after Sevoflurane anaesthesia in children

Hepatic tuberculosis is a rare form of extra-pulmonary tuberculosis The aim: to describe the clinical, morphological and evolutionary aspects of hepatic tuberculosis. Methods: The medical data of all cases of hepatic tuberculosis admitted to our department. Results: Among the 240 cases of abdominal tuberculosis, 6 patients had a hepatic location with a prevalence of 2.5%. They were 2 men and 4 women, with an average age of 38 years. The clinical and imaging manifestations were various. The diagnosis of tuberculosis was confirmed by the pathological study of the liver biopsies (4cases) or by the association of clinical, biologic and morphological arguments (2cases). The clinical and biological course was favorable in all patients under anti-tuberculosis protocol. Conclusion: Hepatic tuberculosis, although rare, should be considered in endemic countries. Its diagnosis is difficult to establish, because it simulates many pathologies.

Background: Acute appendicitis is one of the most common surgical presentations worldwide. Acute appendicitis is complicated with several sequels, of which the perforated appendicitis presents a major health concern. Perforated appendicitis is profoundly affected with method of wound closure which determines the incidence of wound infection. Methods: This is a prospective randomized study that included 360 patients presented with acute appendicitis. Intraoperative recording of the gross pathology of the appendix with assessment of the relation of wound infection and method of wound closure were performed. Moreover, record of the patients’ postoperative hospital stay period was assessed. Results: Postoperative assessment of appendectomy revealed that 18.8% was appendicitis negative, 63% was uncomplicated appendicitis and 18.2% was perforated appendicitis. We considered primary closure of wounds in 36.4% of patients, delayed wound primary closure in 18.2% of patients and partial closure of wounds in 45.4% of patients. Incidence of infected surgical wounds was 37.5%, 16.7% and 13.3% in primary, delayed primary and partial wound closure respectively. Delayed primary closure had the longest hospital stay (8 days) compared to primary wound closure (7 days) and partial wound closure (4 days). Conclusions: The study on hand provided an evidence on how superior the partial wound closure compared to primary wound closure and delayed primary wound closure in patients with appendicitis.

Background: The danger of chronic kidney disease (CKD) is rising quickly worldwide and has become a main health crisis and most of these patients die from cardiovascular disease (CVD) prior to progression to end stage renal disease (ESRD), therefore, Poor cardiovascular outcomes in CKD patients have encouraged nephrologists to search for biomarkers that may improve risk stratification in this population. The aim of this study was to assess serum brain natriuretic peptide (BNP) hormone and cardiac troponin T (cTnT) levels in CKD patients and to determine their involvement with cardiovascular diseases. Methods: This analytical case control study was conducted at Ibn sina and Military hospitals in the period from February 2016 to March 2019, (n = 150) clinically diagnosed CKD patients (age range between 22 - 76 years, 105 males and 45 females), and (n = 150) healthy subjects were included as controls. Serum BNP hormone and cardiac troponin T (cTnT), were estimated by Cobas E-411® fully automated analyzer, serum creatinine by Cobas C-311® fully automated analyzer, hemoglobin by Sysmix, glomerular filtration rate (GFR) was calculated by Cocroft-Gault formula and blood pressure was measured by using mercuric sphygmomanometer. Results: Serum BNP, cTnT, creatinine, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) were significantly higher in CKD patients than in controls, while hemoglobin and GFR were significantly lower. Moreover, serum BNP, cTnT, SBP and DBP were significantly higher in CKD patients with cardiovascular disease (CVD) than CKD patients without CVD. In addition, serum BNP, at cutoff level of 240 pg/ml, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 87%, 90%, 52% and 92%, respectively in relation to CVD, while serum cTnT, at cutoff level of 0.1 ng/ml, the sensitivity, specificity, PPV and NPV were 80%, 57%, 46% and 74%, respectively. Furthermore, there was an association between elevated BNP levels and CVD outcomes in patients with CKD, since it is a strong risk factor for CVD (OR: 1.48, p. value 0.031). Conclusions: BNP levels are significantly associated with cardiovascular events (left ventricular hypertrophy and systolic dysfunction) in patients who have CKD and are on maintenance hemodialysis (HD)

Described as the most common cause of gastric outlet obstruction and the most common surgical cause of vomiting in infants, Hypertrophic Pyloric Stenosis (HPS) is defined as a hyperplasia of smooth muscle fibers of the pylorus that is responsible for the narrowing of the pyloric canal and obstruction of gastric emptying. It occurs at a rate of 1–4 per 1000 live births with a male to female ratio 4:1. The classic presentation of HPS is nonbilious, projectile vomiting in a full-term neonate with a classic presentation at 3 to 4 weeks of age. We report in here a delayed presentation of HPS in an infant aged 4 months who presented with projectile nonbilious recurrent episodes of post prandial vomiting, where history, examination and investigations supported the diagnosis of HPS and Ramstedt's pyloromyotomy was curative.

Nutrition is a basic need for children and pregnant women; if a child is born malnourished s/he might not be the good asset for a country. We tried to assess the co relationship between nutritional intake and anthropometry among under five children. Purposively selected 100 mothers having under five children were interviewed for the study by using pretested questionnaire. The prevalence of malnutrition was found to be 43%. Majority of mothers had hygiene practice of hand washing during and after feeding their children. The study concludes that the nutrition status was unsatisfactory among under five children.