Background Arrhythmia is a major complication of CABG and it happens in 30 % of patients after CABG . Arrhythmias represent a significant source of morbidity and mortality. Mainly have a benign course, it may prolong the icu stay and rarely may lead to mortaility. Postoperative arrhythmias (POAs) include atrial tachyarrhythmia's (ATs) and to a lesser extent ventricular arrhythmias (VAs) and Brady arrhythmias The outcome of arrhythmia depends on several factors like underlying cardiac function, patient’s comorbidities, arrhythmia duration, and ventricular response rate. So, POAs could be tolerated in some patients and a source of morbidity and mortality in others. Objective We aim to analyze the relationship between serum random blood sugar concentration (BS) and arrhythmias after CABG. Methodology We conducted a retrospective cohort study on 60 patients patients who underwent isolated elective on pump CABG divided in two groups group A arrhythmia group and group S non arrhythmia group patient clinical and procedure characters was notice and recorded Serum blood sugar. Results History of DM .insluin Intake, postoperative Mean AND Maximum BS and post operative drainage volume showed statistically significance (p-value < 0.05). Conclusion The predictors of postoperative Arrhythmias after CABG are hyperglycemia, history of Insluin intake and postoperative drainage volume. In particular, hyperglycemia and postoperative Arrhythmias after CABG were found to have a very strong association. Therefore, we believe that BS control should reduce the incidence of AF after CABG.

Background Interscalene approach for brachial plexus block is recognized as the gold standard technique for postoperative pain control after shoulder scope surgeries. However, it is associated with major adverse effects and patient discomfort due to paralysis of the hand muscles. The suprascapular nerve block is considered to be a safe and effective alternative to interscalene nerve block for shoulder surgery without affecting the motor function of the hand muscles and other serious complications of interscalene nerve block, especially in ambulatory surgery. The aim of this study is to compare interscalene and suprascapular nerve block in terms of postoperative pain, opioid consumption, and hand grip strength in shoulderscopic surgeries. This prospective, randomized trial was done in Ain Shams University Hospitals. A sample of 50 patients was divided into two groups; 25 patients in each group, namely Group ISB (interscalene approach of brachial plexus block) and Group SSNB (suprascapular nerve block). Visual analogue scale (VAS) was used to assess shoulder pain at rest and upon flexion in the first 24 h. The degree of hand motor power affection, the total amount of opioids used as rescue analgesia, and the incidence of complications were also recorded. Results The findings revealed no statistically significant difference between groups (P-value > 0.05) in pain control all over the 24 h by VAS score at rest and at arm flexion. SSNB received a larger total narcotic dose (60 ± 26.02) mg of pethidine than ISB (52 ± 22.73). However, there was no statistical difference between them throughout the 24 h regarding total narcotic consumption and 1st time for pethidine administration. The ISB group showed a statistically significant reduction in the hand power grip strength postoperatively (83.68 ± 4.75%). Conclusions The results of the present study favor SSNB as the first choice of pain control after shoulderscopic surgeries for a patient scheduled for early home discharge because of the complete recovery of the hand muscles’ motor power. Trial registration This study was registered on PACTR (www.pactr.org) database; identification number for the registry is PACTR202201840526231.

Background: We developed a multi-dimensional score which may help in predicting those patients, undergoing bariatric surgery, who may be in need for postoperative ICU admission and which may also help in avoiding unnecessary admission to the critical care units after bariatric surgery. Methods: We collected the data of 111patients who underwent either laparoscopic gastric sleeve or bypass and studied the association between some risk factors related to obesity and their postoperative ICU admission. Those factors found to be statistically significant are included in the final score. The cutoff value of our scoring system is determined by running a Receiver Operating Curve (ROC) analysis. Results: Forty patients (36%) were admitted to the ICU postoperatively. Our final score includes 7 independent variables; 6 found to be significantly related to post-bariatric surgery ICU admission; these are age, gender, BMI, ASA, obstructive sleep apnea and spirometry results, and the seventh is the history of venous thrombo-embolism. According to the ROC curve analysis, we set the score value of 10 as our cut-off value for the need of postoperative ICU admission. The score median value is 9. Males' odds to be admitted to the ICU after bariatric surgery are 11.9 times higher than females. Also, those with BMI above 50 kg m À2 have odds of 29.8 times higher than those below 50 kg m À2 . Conclusions: We propose a scoring system for risk stratification, in which some of the well-known predictor risk factors are included in a simple way to help identify those high-risk patients undergoing bariatric surgery.Conclusions: Trial registry number: NCT02976649.