Comparative study of levobupivacaine and bupivacaine for bilateral maxillary nerve block during pediatric primary cleft palate surgery: a randomized double-blind controlled study

Mohamed F. Mostafa,Ragaa Herdan,Mohamed Elshazly 대한마취통증의학회 2018 Korean Journal of Anesthesiology Vol.71 No.2

Background: Cleft lip and palate are common major congenital anomalies. Cleft palate (CP) repair causes pain and needs large doses of intravenous opioids. The risk of postoperative airway obstruction or respiratory depression is high, requiring continuous and vigilant monitoring. The primary outcome was to evaluate the efficacy of using different local anesthetics during bilateral maxillary nerve block (MNB) with general anesthesia on quality of recovery after primary CP repair. We hypothesized that levobupivacaine would be better than bupivacaine. Also, to investigate the potency of bilateral MNB in improving quality of postoperative analgesia. Methods: Sixty children undergoing primary CP repair surgery were enrolled in the study. Combined general anesthesia and regional bilateral MNB were used for all patients. Group L (n = 30): children received 0.15 ml/kg of 0.2% levobupivacaine, while in Group B (n = 30): children received 0.15 ml/kg of 0.2% bupivacaine. Results: Face, Legs, Activity, Cry, and Consolability pain score readings were 0 score in 7 cases of the Group L and 10 cases of Group B, 1 score in 14 cases of the Group L and 12 cases of Group B, and 2 score in 9 cases of the Group L and 8 cases of Group B. We found no statistically significant difference between the two study groups as regarding pain score or serious complications. Conclusions: Levobupivacaine is as effective and safe as bupivacaine to be used for MNB block with a lower incidence of complications. Bilateral suprazygomatic MNB is an effective, easy, and safe method for pain relief in children undergoing primary cleft palate repair surgeries.

Camellia sinesis leaves extract ameliorates high fat diet-induced nonalcoholic steatohepatitis in rats: analysis of potential mechanisms

Mohamed Safaa H.,Shahat Abdelaaty A.,Mohamed Mohamed Ragaa,Khalil Wagdy K. B.,Salem Ahmed M.,Farrag Abdel Razik H.,Ahmed Hanaa Hamdy 한국약제학회 2021 Journal of Pharmaceutical Investigation Vol.51 No.2

Purpose Our research aims to address and determine the effect of Camellia sinensis extract in the management of nonalcoholic steatohepatitis (NASH) in rats. Methods Forty adult female albino rats were divided into four groups. Group 1 (G1) served as the control group, while the other three groups received high-fat diet for 32 weeks to induce NASH and then were later assigned to the following groups: (G2) NASH-afflicted group which was left untreated, (G3) NASH-afflicted group treated with Camellia sinensis extract in a dose of 400 mg/kg, and (G4) NASH-afflicted group treated with Camellia sinensis extract in a dose of 200 mg/kg. Results Significant elevation in serum alanine aminotransferase, albumin, bilirubin (total and direct), cholesterol, low density lipoprotein, triglycerides, leptin, Cox-2, and CD40 values was recorded. Moreover, overexpression of hepatic tumor necrosis factor alpha and hepatocyte growth factor genes were recorded, whereas blood platelet count and serum high density lipoprotein concentration revealed significant depletion, which was paralleled by significant downregulation of hepatic adiponectin gene expression level in NASH group versus the control group. On the opposite side, treatment of NASH groups with two different doses of Camellia sinensis extract reversed the values of the measured biochemical parameters and the targeted gene expression levels when compared with the NASH group. Optical micrograph of liver tissue sections of rats treated with Camellia sinensis extract showed the observed improvement in the studied biochemical and genetic markers. Conclusion This study provides a clear evidence for the promising therapeutic potential of Camellia sinensis extract against NASH. This could be ascribed to its hepatoprotective activity, hypolipidemic effect, and anti-inflammatory potency.

Does intrauterine injection of low-molecular-weight heparin improve the clinical pregnancy rate in intracytoplasmic sperm injection?

Kamel, Ahmed Mohamed,El-Faissal, Yahia,Aboulghar, Mona,Mansour, Ragaa,Serour, Gamal I,Aboulghar, Mohamed The Korean Society for Reproductive Medicine 2016 Clinical and Experimental Reproductive Medicine Vol.43 No.4

Objective: Heparin can modulate proteins, and influence processes involved in implantation and trophoblastic development. This study aimed to assess the improvement of clinical pregnancy and implantation rates after local intrauterine injection of low-molecular-weight heparin (LMWH) in patients undergoing intracytoplasmic sperm injection (ICSI). Methods: A randomised case/control design was followed in women scheduled for ICSI. The study arm was injected with intrauterine LMWH during mock embryo transfer immediately following the ovum pickup procedure, while the control arm was given an intrauterine injection with a similar volume of tissue culture media. Side effects, the clinical pregnancy rate, and the implantation rate were recorded. Results: The pregnancy rate was acceptable (33.9%) in the LMWH arm with no significant reported side effects, confirming the safety of the intervention. No statistically significant differences were found in the clinical pregnancy and implantation rates between both groups (p= 0.182 and p= 0.096, respectively). The odds ratio of being pregnant after intrauterine injection with LMWH compared to the control group was 0.572 (95% confidence interval [CI], 0.27-1.22), while the risk ratio was 0.717 (95% CI, 0.46-1.13; p= 0.146). No statistical significance was found between the two groups in other factors affecting implantation, such as day of transfer (p= 0.726), number of embryos transferred (p= 0.362), or embryo quality. Conclusion: Intrauterine injection of LMWH is a safe intervention, but the dose used in this study failed to improve the outcome of ICSI. Based on its safety, further research involving modification of the dosage and/or the timing of administration could result in improved ICSI success rates.

Osteoblast-Based Therapy—A New Approach for Bone Repair in Osteoporosis: Pre-Clinical Setting

Mahmoud Nadia Samy,Mohamed Mohamed Ragaa,Ali Mohamed Ahmed Mohamed,Aglan Hadeer Ahmed,Amr Khalda Sayed,Ahmed Hanaa Hamdy 한국조직공학과 재생의학회 2020 조직공학과 재생의학 Vol.17 No.3

BACKGROUND: Osteoporosis is a metabolic bone disease characterized by low bone density resulting in increased fracture susceptibility. This research was constructed to uncover the potential therapeutic application of osteoblasts transplantation, generated upon culturing male rat bone marrow-derived mesenchymal stem cells (BM-MSCs) in osteogenic medium (OM), OM containing gold (Au-NPs) or gold/hydroxyapatite (Au/HA-NPs) nanoparticles, in ovariectomized rats to counteract osteoporosis. METHODS: Forty rats were randomized into: (1) negative control, (2) osteoporotic rats, whereas groups (3), (4) and (5) constituted osteoporotic rats treated with osteoblasts yielded from culturing BM-MSCs in OM, OM plus Au-NPs or Au/ HA-NPs, respectively. After 3 months, osterix (OSX), bone alkaline phosphatase (BALP), sclerostin (SOST) and bone sialoprotein (BSP) serum levels were assessed. In addition, gene expression levels of cathepsin K, receptor activator of nuclear factor-jb ligand (RANKL), osteoprotegerin (OPG) and RANKL/OPG ratio were evaluated using real-time PCR. Moreover, histological investigation of femur bone tissues in different groups was performed. The homing of implanted osteoblasts to the osteoporotic femur bone of rats was documented by Sex determining region Y gene detection in bone tissue. RESULTS: Our results indicated that osteoblasts infusion significantly blunted serum BALP, BSP and SOST levels, while significantly elevated OSX level. Also, they brought about significant down-regulation in gene expression levels of cathepsin K, RANKL and RANKL/OPG ratio versus untreated osteoporotic rats. Additionally, osteoblasts nidation could restore bone histoarchitecture. CONCLUSION: These findings offer scientific evidence that transplanting osteoblasts in osteoporotic rats regains the homeostasis of the bone remodeling cycle, thus providing a promising treatment strategy for primary osteoporosis.

Assessment of the Prognostic Value of Methylation Status and Expression Levels of FHIT, GSTP1 and p16 in Non-Small Cell Lung Cancer in Egyptian Patients

Haroun, Riham Abdel-Hamid,Zakhary, Nadia Iskandar,Mohamed, Mohamed Ragaa,Abdelrahman, Abdelrahman Mohamed,Kandil, Eman Ibrahim,Shalaby, Kamal Ali Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.10

Background: Methylation of tumor suppressor genes has been investigated in all kinds of cancer. Tumor specific epigenetic alterations can be used as a molecular markers of malignancy, which can lead to better diagnosis, prognosis and therapy. Therefore, the aim of this study was to evaluate the association between gene hypermethylation and expression of fragile histidine triad (FHIT), glutathione S-transferase P1 (GSTP1) and p16 genes and various clinicopathologic characteristics in primary non-small cell lung carcinomas (NSCLC). Materials and Methods: The study included 28 primary non-small cell lung carcinomas, where an additional 28 tissue samples taken from apparently normal safety margin surrounding the tumors served as controls. Methylation-specific polymerase chain reaction (MSP) was performed to analyze the methylation status of FHIT, GSTP1 and p16 while their mRNA expression levels were measured using a real-time PCR assay with SYBR Green I. Results: The methylation frequencies of the genes tested in NSCLC specimens were 53.6% for FHIT, 25% for GSTP1, and 0% for p16, and the risk of FHIT hypermethylation increased among patients with NSCLC by 2.88, while the risk of GSTP1 hypermethylation increased by 2.33. Hypermethylation of FHIT gene showed a highly significant correlation with pathologic stage (p<0.01) and a significant correlation with smoking habit and FHIT mRNA expression level (p<0.05). In contrast, no correlation was observed between the methylation of GSTP1 or p16 and smoking habit or any other parameter investigated (p>0.05). Conclusions: Results of the present study suggest that methylation of FHIT is a useful biomarker of biologically aggressive disease in patients with NSCLC. FHIT methylation may play a role in lung cancer later metastatic stages while GSTP1 methylation may rather play a role in the early pathogenesis.

The Role of Curcuma longa Against Doxorubicin (Adriamycin)-Induced Toxicity in Rats

Ragaa Hosny Mohamad,Amal Mohamad El-Bastawesy,Zekry Khalid Zekry,Hussain A. Al-Mehdar,Mohamad Gamil Abdel Monaam Al-said,Soaad Shaker Aly,Sabry Mohamed Sharawy,Mahmuod M. El-Merzabani 한국식품영양과학회 2009 Journal of medicinal food Vol.12 No.2

The major component, called curcumin, of turmeric (Curcuma longa L.) (Family Zingiberaceae) powder is responsible for its biological actions. The present study aimed to prove the protective effect of turmeric extract against doxorubicin (DOX)-induced cardiac, hepatic, and renal toxicity as evaluated in rats. Body weight and urine volume of the animal groups under investigation were recorded daily throughout the experimental period. Also, the cardiac, hepatic, and renal toxicities were determined by estimating the changes in serum activities of the enzymes lactate dehydrogenase (LDH) and creatine kinase (CK), serum levels of alanine aminotransferase, aspartate aminotransferase, nitric oxide, albumin, and calcium, and kidney and liver tissue activities of superoxide dismutase and glutathione peroxidase, as well as the contents of glutathione and malondialdehyde. Hyperlipidemia was also determined, and protein and albumin changes in urine were estimated. Biochemical and histopathological findings demonstrate that turmeric extract has multiple therapeutic activities that are beneficially protective, and it has an ameliorative effect against DOX-induced cardiac toxicity and hepatotoxicity and blocks DOX-induced nephrosis. Similarly, turmeric extract inhibited the DOX-induced increase in plasma cholesterol, LDH, and CK. The present findings conclude that the turmeric extract has multiple therapeutic activities that block the cardiac, hepatic, and renal toxicities induced by DOX, and it also possibly acts as a free radical scavenger.

Dexmedetomidine during suprazygomatic maxillary nerve block for pediatric cleft palate repair, randomized double-blind controlled study

Mohamed F. Mostafa,Fatma A. Abdel Aal,Ibrahim Hassan Ali,Ahmed K. Ibrahim,Ragaa Herdan 대한통증학회 2020 The Korean Journal of Pain Vol.33 No.1

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 µg/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children’s hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 μg/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

Camel Milk as an Adjuvant Therapy for the Treatment of Type 1 Diabetes: Verification of a Traditional Ethnomedical Practice

Ragaa Hosny Mohamad,Zekry Khalid Zekry,Hussain A. Al-Mehdar,Omar Salama,Siad Ebrahim El-Shaieb,Amany A. El-Basmy,Mohamad Gamil Abdel Monem Al-said,Sabry Mohamed Sharawy 한국식품영양과학회 2009 Journal of medicinal food Vol.12 No.2

There is a traditional belief in the Middle East that regular consumption of camel milk may aid in prevention and control of diabetes. The aim of this work was to evaluate the efficacy of camel milk as an adjuvant therapy in young type 1 diabetics. This 16-week randomized study enrolled 54 type 1 diabetic patients (average age 20 years) selected from those attending the outpatient diabetes clinic of the Menofia University Hospital, affiliated with Egypt's National Cancer Institute. Subjects were randomly divided into two groups of 27 patients: one received usual management (diet, exercise, and insulin), whereas the other received 500 mL of camel milk daily in addition to standard management. A control group of 10 healthy subjects was also assessed. The following parameters were evaluated at baseline and at 4 and 16 weeks: hemoglobin A1c (HbA1c), human C-peptide, lipid profile, serum insulin, anti-insulin antibodies, creatinine clearance, albumin in 24-hour urine, body mass index, and Diabetes Quality of Life score. The following parameters were significantly different between the usual-management group versus the camel milk group after 16 weeks: fasting blood sugar (227.2 ± 17.7 vs. 98.9 ± 16.2 mg/dL), HbA1c (9.59 ± 2.05[%] vs. 7.16 ± 1.84[%]), serum anti-insulin antibodies (26.20 ± 7.69 vs. 20.92 ± 5.45 μU/mL), urinary albumin excretion (25.17 ± 5.43 vs. 14.54 ± 5.62 mg/dL/24 hours), daily insulin dose (48.1 ± 6.95 vs. 23 ± 4.05 units), and body mass index (18.43 ± 3.59 vs. 24.3 ± 2.95 kg/m2). Most notably, C-peptide levels were markedly higher in the camel milk group (0.28 ± 0.6 vs. 2.30 ± 0.51 pmol/mL). These results suggest that, as an adjunct to standard management, daily ingestion of camel milk can aid metabolic control in young type 1 diabetics, at least in part by boosting endogenous insulin secretion.

Camel Milk as an Adjuvant Therapy for the Treatment of Type 1 Diabetes: Verification of a Traditional Ethnomedical Practice

Al-Tahtawy, Ragaa Hosny Mohamad,Zekry, Zekry Khalid,Al-Mehdar, Hussain A.,Salama, Omar,El-Shaieb, Siad Ebrahim,El-Basmy, Amany A.,Al-said, Mohamad Gamil Abdel Monem,Sharawy, Sabry Mohamed The Korean Society of Food Science and Nutrition 2009 Journal of medicinal food Vol.12 No.2

There is a traditional belief in the Middle East that regular consumption of camel milk may aid in prevention and control of diabetes. The aim of this work was to evaluate the efficacy of camel milk as an adjuvant therapy in young type 1 diabetics. This 16-week randomized study enrolled 54 type 1 diabetic patients (average age 20 years) selected from those attending the outpatient diabetes clinic of the Menofia University Hospital, affiliated with Egypt's National Cancer Institute. Subjects were randomly divided into two groups of 27 patients: one received usual management (diet, exercise, and insulin), whereas the other received 500 mL of camel milk daily in addition to standard management. A control group of 10 healthy subjects was also assessed. The following parameters were evaluated at baseline and at 4 and 16 weeks: hemoglobin A1c (HbA1c), human C-peptide, lipid profile, serum insulin, anti-insulin antibodies, creatinine clearance, albumin in 24-hour urine, body mass index, and Diabetes Quality of Life score. The following parameters were significantly different between the usual-management group versus the camel milk group after 16 weeks: fasting blood sugar ($227.2\;{\pm}\;17.7$ vs. $98.9\;{\pm}\;16.2\;mg/dL$), HbA1c ($9.59\;{\pm}\;2.05$[%] vs. $7.16\;{\pm}\;1.84$[%]), serum anti-insulin antibodies ($26.20\;{\pm}\;7.69$ vs. $20.92\;{\pm}\;5.45\;{\mu}U/mL$), urinary albumin excretion ($25.17\;{\pm}\;5.43$ vs. $14.54\;{\pm}\;5.62\;mg/dL$/24 hours), daily insulin dose ($48.1\;{\pm}\;6.95$ vs. $23\;{\pm}\;4.05$ units), and body mass index ($18.43\;{\pm}\;3.59$ vs. $24.3\;{\pm}\;2.95\;kg/m^2$). Most notably, C-peptide levels were markedly higher in the camel milk group ($0.28\;{\pm}\;0.6$ vs. $2.30\;{\pm}\;0.51\;pmol/mL$). These results suggest that, as an adjunct to standard management, daily ingestion of camel milk can aid metabolic control in young type 1 diabetics, at least in part by boosting endogenous insulin secretion.

The Role of Curcuma longa Against Doxorubicin (Adriamycin)-Induced Toxicity in Rats

Al-Tahtawy, Ragaa Hosny Mohamad,El-Bastawesy, Amal Mohamad,Zekry, Zekry Khalid,Al-Mehdar, Hussain A.,Al-said, Mohamad Gamil Abdel Monaam,Aly, Soaad Shaker,Sharawy, Sabry Mohamed,El-Merzabani, Mahmuod The Korean Society of Food Science and Nutrition 2009 Journal of medicinal food Vol.12 No.2

The major component, called curcumin, of turmeric (Curcuma longa L.) (Family Zingiberaceae) powder is responsible for its biological actions. The present study aimed to prove the protective effect of turmeric extract against doxorubicin (DOX)-induced cardiac, hepatic, and renal toxicity as evaluated in rats. Body weight and urine volume of the animal groups under investigation were recorded daily throughout the experimental period. Also, the cardiac, hepatic, and renal toxicities were determined by estimating the changes in serum activities of the enzymes lactate dehydrogenase (LDH) and creatine kinase (CK), serum levels of alanine aminotransferase, aspartate aminotransferase, nitric oxide, albumin, and calcium, and kidney and liver tissue activities of superoxide dismutase and glutathione peroxidase, as well as the contents of glutathione and malondialdehyde. Hyperlipidemia was also determined, and protein and albumin changes in urine were estimated. Biochemical and histopathological findings demonstrate that turmeric extract has multiple therapeutic activities that are beneficially protective, and it has an ameliorative effect against DOX-induced cardiac toxicity and hepatotoxicity and blocks DOX-induced nephrosis. Similarly, turmeric extract inhibited the DOX-induced increase in plasma cholesterol, LDH, and CK. The present findings conclude that the turmeric extract has multiple therapeutic activities that block the cardiac, hepatic, and renal toxicities induced by DOX, and it also possibly acts as a free radical scavenger.