Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production,occurs most prominently at skin sites with a high density of sebaceous glands such as the face,chest, and back. Survivin is an evolutionarily conserved eukaryotic protein that is essential for cell division , can inhibit cell death, Normally it is only expressed in actively proliferating cells. Survivin has been found to be increased in keratinocyte proliferative and inflammatory states, which are deeply involved in the pathogenesis of the acne lesions.Foxo1 is considered to be a representative member of the FoxO family, and has key transcription regulatory activities FoxOs are homeostatic factors in healthy skin and in skin disorders,Foxo1 a master regulatory factor for gluconeogenesis and glycogenolysis, as well as a positive regulator of the expression of insulin, is part of signaling axes related to the control of epidermal morphogenesis and the pathogenesis of acne ,The study was a case –control design which conducted in dermatology Al-Musayyab General Hospital and Al Imam Sadiq Hospital,Murjan Teaching Hospital. with 45 patients with Acne volgaris and 45 healthy controls, the level of serum survivin and Foxo1 were measured using an enzyme-linked immunosorbent assay (ELISA).
Hormonal stress response due to manipulation of the upper and lower respiratory tracts occurring during rigid bronchoscopy represents a potentially great hazard to safeanesthesia.There were many attempts to attenuate these adverse effects.Dexmedetomidine is highly selective, short-acting central alpha 2 agonist. It has increasingly gained popularity among anesthesiologists as adjuvant to general and regional anesthesia techniques. This study was conducted to compare the efficacy of administrating fentanyl, dexmedetomidine or lidocaine on control of hormonal changes in response to rigid bronchoscopy in pediatric patients. Ninety ASA I-II children aged 2-12 year were randomly assigned to 3 groups: fentanyl (F), dexmedetomidine (D) and lidocaine (Z). cortisol, ACTH and vasopressinlevels were measured and recorded. Results revealed that patients in the D group showed less elevation of ACTH levels in in response to the insertion of the rigid bronchoscope compared with the other groups, cortisol levels increased significantly after bronchoscopy in the lidocaine group, meanwhile, changes in vasopressin levels were not significant between the groups We concluded that dexmedetomidine can be used safely and effectively to attenuate the hormonal responses to rigid bronchoscopy in pediatric patients.
Bronchoscopy entails significant manipulation of the upper and lower respiratory tracts with marked hemodynamic response and therefore represents a potentially greater hazard to safe anesthesia.There have been many attempts to attenuate these adverse effects. Dexmedetomidine is highly selective, short-acting central alpha 2 agonist. It has increasingly gained popularity among anesthesiologists as adjuvant to general and regional anesthesia techniques. This study was conducted to compare the efficacy of administratingfentanyl, dexmedetomidine or lidocaine on control of hemodynamic changes to rigid bronchoscopy in pediatric patients. Ninety ASA I-II children aged 2-12 year were randomly assigned to 3 groups: fentanyl (F), dexmedetomidine (D) and lidocaine (Z). HR, SAP, MAP, DAP and SPO2 were measured and recorded. Results revealed that patients in the D group showed minimal changes in hemodynamic parameters in response to the procedure of rigid bronchoscopy. We concluded that dexmedetomidine can be used safely and effectively to attenuate the hemodynamic responses to rigid bronchoscopy in pediatric patients.
Background:This is a prospective, randomized, double blind study to evaluate the postoperative analgesia following ultrasound guided supraclavicular brachial plexus block with Tramadol or Midazolam as an admixture to bupivacaine in upper extremity surgery. Patientsand methods:Total 60 patients of ASA I and II undergoing upper extremity surgery under ultrasound guided brachial plexus block with Bupivacaine were randomly divided in to two groups; one group received Tramadol (1mg/kg) and the other group received midazolam (0.05mg/kg) as an admixture to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score. Results: The mean duration of postoperative analgesia in the Midazolam group was 650±47.49 minutes while in the tramadol group it was 508±30.44 minutes. Conclusion: We concluded that midazolamwith local anaesthetic prolongs postoperative analgesiasignificantly than Tramadol (P<0.0001) when used as admixture to local anaesthetic inUltrasound guided brachialplexus block in upper extremity surgery.
AIM: The aim of this work is to know the pathophysiological mechanism of critically ill obese patients and to recognize the new requirements for their management in the critical-care-setting. The obese patient's category is still increasing in many westernized countries especially the united states (USA). As a result, the peri-operative management of obese patients became routine care. As obese patients are now liable for all types of procedures, it is essential and very important for all anesthesiologists, surgeons, perioperative-health care providers to understand their different multi-organ physiology so as to safely prepare those obese patients perioperatively. A good assessment of those patients pre-operatively can decrease the risk of postoperative complications later on …, in this manuscript, we mention the major considerations for the preoperative assessment of morbidly obese patients. Obesity now became the main cause of increased morbidity and mortality because of acute and chronic medical diseases, like diabetes mellitus, hypertension, cardiovascular problems, renal disorders, arthritis, and certain types of cancer (Mokdad et al. 2003). Obese patients, particularly morbidly ones, have a higher percentage of resource utilization, intensive care unit entrance, respiratory diseases, and respiratory distress syndrome, than do nonobese patients (Westerly and Dabbagh2011). also, obese patients are at higher danger for postoperative complications
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