Background Pain relief after knee arthroscopy is very important for early recovery and rehabilitation. The study was conducted to evaluate the effects of adding dexamethasone (8 mg) to intra-articular morphine (10 mg) and bupivacaine (25 mg) combination on postoperative pain after knee arthroscopy. Results We enrolled 40 patients, 18–65 years-old of both sexes, ASA I and II scheduled for minor arthroscopic knee surgeries. The study group showed a lower visual analog score at rest and movement, prolonged postoperative analgesia, and decreased total analgesic consumption compared with the control group (P value < 0.05). Conclusions Adding dexamethasone to intra-articular combination of morphine and bupivacaine after knee arthroscopy prolongs the duration of analgesia, lowers pain scores, and decreases total analgesic consumption with no detected adverse effects.

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Background Evidence of various cardiac arrhythmias in septic patients has been demonstrated by multiple clinical reports and observations .Most cardiac arrhythmias in sepsis are new-onset and may be related to sepsis-induced myocardial dysfunction, autonomic dysfunction and, most likely also, by impairment and involvement of the cardiac conduction system. Aim of the Work to describe the incidence of NOAF and to determine the risk factors associated with its development, as well as its clinical course and its effect on the outcome of patients with sepsis admitted to the ICU. Patients and Methods A systematic search was conducted to retrieve articles that investigated the association of NOAF in patients diagnosed with sepsis. We identified potential Englishlanguage sources from the PubMed, Medline, and EMBASE databases. Keywords used were “atrial fibrillation” and (“sepsis” or “septic shock”). In addition, reference lists of any studies meeting inclusion criteria were reviewed manually to identify additional relevant publications. Results In our meta-analysis, we found that NOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Also, we found that NOAF in sepsis patients is significantly associated with increased risk of ICU. In hospital, and After hospital discharge mortality, as well as, increased risk of developing ischemic stroke. Conclusion NOAF is a common occurrence in critically ill patients with sepsis, and its incidence rises with increasing severity of disease. Our Meta-analysis suggests that it is independently associated with poor outcome. In view of these findings there is a need for better quality observational studies, because reliable identification of patients with sepsis who are prone for the development of AF may allow for early pharmacological interventions to prevent this complication.

Background this prospective comparative observational study, to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock, after approval of Ethical committee of critical care department on forty patients in general ICU divided into two groups of twenty patients each equal. Aim of the Work to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock. Patients and Methods this prospective comparative observational study, carried out in Maadi Military Force Hospital, to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock, after approval of Ethical committee of critical care department on forty patients in general ICU divided into two groups of twenty patients each equal. Results group A has higher values in SOFA score than in Group B, most probably due to toxins affected perfusion of organs and response to resuscitation, beside the poor cellular oxygen utilization, so clinical outcome among the two groups was twenty-four patients died in (sixteen patients in Group A and eight patients in Group B), so in our study there was a higher mortality in Group A patients (Septic shock) than Group B patients (Hypovolemic shock), The deceased patients had higher serum cTnI levels than survivors, this was concordant with Arlati and his colleagues, but there were no significant differences in cardiac troponin. Conclusion the incidence of myocardial infarction is increased in Group A (septic patients) more than Group B (hypovolemic patients), most probably due to the maldistribution of coronary blood flow which might produce, for a given level of hypotension, higher amounts of myocardial damage and, consequently, higher levels of troponin I than in hypovolemic shock.

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