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Background : Plantar fasciitis or recently called plantar fasciopathy, generally observed with heel spurs because of the deposition of calcium, although the definite pathology is still unknown. Ultrasound-guided injection of conventional corticosteroids was the primary treatment modality, with other emerging substances (e.g. Ozone or Platelet Rich Plasma PRP). Aim of the study: This study was conducted to evaluate the effect of ultrasound-guided injection of local Ozone or Platelet Rich Plasma (PRP) versus conventional corticosteroid in the management of plantar fasciitis. Patient and methods: this a randomized Prospective comparative study has done Al-Azhar university hospitals (Al-Hussein and Sayed Galal), where fifty-one patients have been diagnosed to have plantar fasciitis were included and allocated into one of three groups (17 patients in each group) to receive an ultrasound-guided injection of corticosteroid (control group), platelet-rich plasma (PRP) or Ozone O2-O3. Clinical evaluation and ultrasonographic measurement of the plantar fascia thickness was done before, at one, three and six months next to the injection. Primary outcome included: pain score using the visual analogue score (VAS). While secondary outcomes were plantar fascia thickness and foot quality health status. Results: There was a highly significant decrease in VAS score and plantar fascia thickness, and an increase in foot pain domain of the foot health status (FHSQ) score in corticosteroid and Ozone groups (p < 0.01 respectively) in one month. Regarding 3-month results, there was a highly significant decrease in VAS score plantar fascia thickness, and an increase in FHSQ score in the corticosteroid group (p < 0.01 respectively). Regarding long-term 6-month results, there was a highly significant decrease in VAS score, plantar fascia thickness, and an increase in FHSQ score in the PRP group (p < 0.01 respectively). Conclusion:Corticosteroid and Ozone injections were effective at shortterm assessment, but PRP was more valuable at long-term assessment regarding pain management in plantar fasciitis patients.

Background: Thoracic epidural analgesia (TEA) was considered as the gold standard for postoperative analgesia in thoracic surgeries, particularly in bilateral procedures. However, it isn't routinely used as it is associated with some haemodynamic side effects. Erector spinae plane (ESP) block is recognized as a promising postoperative analgesia technique. Aim of the study: The primary outcome was to compare post-mastectomy pain control in TEA and ESP block groups, and secondary outcomes were to compare post-operative hypotension, number of morphine boluses, and patient satisfaction. Patient and Methods: Sixty female patients scheduled for elective mastectomy were enrolled in this study. Patients were allocated into 2 groups, 30 patients each. Group (TE) patients underwent ultrasoundguided single-shot TEA, while group (ES) were handled with ultrasoundguided single-shot ESP block. Peri-operative details, Post-operative hypotension, visual analog scale (VAS) assessment of pain, number of postoperative morphine boluses, and patient satisfaction were recorded. Results: Time needed to give block was shorter in the group (ES) (p<0.001). Group (ES) patients reported significantly lower pain scores according to VAS (P<0.001). Hypotension was more recorded in group (TE) patients, with statistical significance at 0 point (p<0.001). Required post-operative morphine boluses were significantly lower in the group (ES), as 3.3% of patients received 3 boluses compared to 27% in the group (TE) (p=0.01). More patients were highly satisfied with group ES (60%) than group TE (30%) (p=0.037). Conclusion: Ultrasound-guided ESP block is a choice with a better outcome in patients undergoing elective mastectomy as regards the lower frequency of hypotension, better efficiency, and patient satisfaction.

Background: Adequate analgesia post-operative is crucial to permit early mobilization and effective cough in order to decrease the respiratory system issues and complications. The usage of peripheral nerve blockage in conjunction with sonographic technology and neural stimulators have resulted in better fascial planes identification.Aim: To compare the analgesic effectiveness of sonographic -guided caudal epidural blockage versus sonographic -guided single-shot thoraco-lumber paravertebral blockage in pediatric cases undergoing lower abdominal surgeries such as herniotomy.Methodology: This is a prospective randomized interventional clinical research trial performed in Department of Anesthesiology, Samir Abbas Hospital 'Saudi Arabia to compare single-shot caudal Blockage to single-shot paravertebral blockage conducted on sixty pediatric cases. Categorized randomly into two equal numbered research groups: research Group C (caudal Blockade) and research Group P (paravertebral blockade). Results:Comparative statistical analysis of research group C (Caudal blockage research group) and research group P (paravertebral blockage research group) as regards Postoperative FLACC ( Face, Legs, Activity, Cry, Consolability) scoring level in which there was no statistical significant difference between both research groups at 0, 0.5, 1, 2, scoring levels p values =0.605, 0.192, 0.076, 0.130 consecutively) whereas there was statistical significant higher scoring levels among research group C study subjects in comparison to research group p study subjects at 3 rd , 6 th , 12 th and 24 th hours. (p values=0.031, 0.002, 0.000, 0.000 consecutively).Conclusion: analgesia after Sonographic-guided paravertebral blockade administering (bupivacaine 0.25 % 1mg /kg) is superior in analgesic effects in comparison to sonographic guided mode of caudal epidural blockade.

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