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The complement system is a fundamental part of the innate immune system that plays a key role in the battle of the human body against invading pathogens. Through its three pathways, represented by the classical, alternative, and lectin pathways, the complement system forms a tightly regulated network of soluble proteins, membrane-expressed receptors, and regulators with versatile protective and killing mechanisms. However, ingenious pathogens have developed strategies over the years to protect themselves from this complex part of the immune system. This review briefly discusses the sequence of the complement activation pathways. Then, we present a comprehensive updated overview of how the major four pathogenic groups, namely, bacteria, viruses, fungi, and parasites, control, modulate, and block the complement attacks at different steps of the complement cascade. We shed more light on the ability of those pathogens to deploy more than one mechanism to tackle the complement system in their path to establish infection within the human host. [ABSTRACT FROM AUTHOR]

A large number of pediatric patients undergoing congenital heart disease corrective procedures receive peri-operative corticosteroids, aiming to reduce post-operative inflammation and capillary leak following cardiopulmonary bypass (CPB). This study aimed to compare the effect of different doses of methylprednisolone on inflammatory mediators' production and effect on myocardium. A trial was conducted on pediatric patients undergoing surgical correction for congenital acyanotic lesion needing CPB machine. Patients were divided into 3 groups: group A patients received 10 mg/kg methylprednisolone (MP) after induction, group B received 30 mg/kg MP and group C patients received placebo. Serial measurement of serum troponin, IL6 and random blood sugar showed no differences in the 3 studied groups at the first measurement, and random blood glucose at ICU admission and hour-24 were highest in the high-dose group (IL6 was lowest) with P value <0.001. Troponin showed no difference at ICU admission, while at hour-24, it was lowest in the high-dose group with p value<0.001, followed by the low-dose group and the highest in control. The ejection fraction (EF) at hour-6 was highest in the high-dose group with p value<0.001, followed by the low-dose group and lowest in control. The vasoactive inotrope score was lowest in high-dose followed by low-dose groups followed by control. As regards complications, there was no different significance between groups. High-dose MP (30 mg/kg) given to pediatric patients undergoing surgical correction of congenital acyanotic heart disease showed better outcomes such as less elevation of inflammatory mediators, lower level of troponin, vasoactive score and higher ejection fraction, with no additional complications recorded. [ABSTRACT FROM AUTHOR]

Background: One of the main objectives of anesthesia is to alleviate the patient's pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for extended analgesia without any side effects to achieve this goal. Objective: To assess the analgesic efficiency and safety of both Modified Pectoral Nerve Block versus Serratus Block in cases of modified radical mastectomy (MRM). The duration of analgesia and effect on hemodynamic parameters were evaluated. Moreover, undesirable side effects were studied. Patients and Methods: The purpose of this study was to evaluate the effect of both PECS II block versus and Serratus anterior block in patients undergoing modified radical mastectomy surgery. The duration of analgesia and effect on hemodynamics parameters were evaluated. Moreover, undesirable side effects were studied. forty patients were randomly allocated into two equal groups (20 patients): group (A) and group (B). Group (A): received a PECSII block with 30 mL of bupivacaine 0.25%. Group(B): received a serratus anterior plane block (SAPB) using the same volume of 30 ml bupivacaine 0.25%. Results: This study demonstrated that PECSII and serratus blocks have comparable analgesic properties in patients undergoing modified radical mastectomy. Both blocks were associated with reduced postoperative pain intensity and morphine consumption, intraoperative fentanyl requirement, and prolonged analgesia. The two blocks were associated with hemodynamic stability and absence of major complications characterizes both blocks. Conclusion: This study confirms that PECSII and serratus blocks provide similarly adequate analgesia following modified radical mastectomy. [ABSTRACT FROM AUTHOR]

The success of complete dentures is highly dependent on the anatomy of the oral cavity. Several conditions can affect the final denture fit. Disorders of the soft tissues, such as denture hyperplasia, denture stomatitis and mucosal pathology may play a role. There are also difficulties related to the shape of the bone, including excessively large undercuts/bony exostoses, tori, enlarged tuberosities and flabby ridges and other factors, such as xerostomia to be considered. The aim of this article is to help diagnose these conditions and to suggest ways of overcoming the individual problems with which patients present before starting denture construction. CPD/Clinical Relevance: The diagnosis of several oral conditions and their appropriate management may help achieve an optimal outcome when constructing complete dentures. [ABSTRACT FROM AUTHOR]

Background: Interscalene approach of brachial plexus nerve 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. Aim of the work: 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. Patients and Methods: This prospective, randomized trial was done in Ain Shams University Hospitals. A sample of 50 patients; 25 patients in each group, namely Group ISB (interscalene approach of brachial plexus block) and Group SSNB (supra-scapular nerve block). Visual Analogue Scale (VAS) was used to assess Shoulder pain at rest and upon flexion in the first 24 hours. 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 hours by VAS score at rest and at arm flexion. SSNB received a larger total narcotic dose (60626.02) mg of pethidine than ISB (526 22.73). However, there was no statistical difference between them throughout the 24 hours 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 (83.6864.75 %). Conclusions: The results of the present study favour 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. [ABSTRACT FROM AUTHOR]

Introduction : Infective endocarditis is a serious infection of the heart endothelium and valves. It carries long-term health risks and compromises the heart condition. However, this condition has been rarely observed since the introduction of appropriate antibiotic prophylaxis. Dentists play a major role in preventing infective endocarditis in susceptible patients. In this study, we assessed the levels of awareness about antibiotic prophylaxis for infective endocarditis among students and young dentists at King Abdulaziz University, Jeddah, Saudi Arabia. Methods : This cross-sectional study included 367 dental students and dental interns who answered a questionnaire designed to assess their awareness levels; it included questions pertaining to demographic information and questions examining the general knowledge of the participants with regard to antibiotic prophylaxis for infective endocarditis. Results : An average of 50% of the participants clearly lacked knowledge regarding the conditions that require antibiotic prophylaxis, while an average of 65% provided correct answers pertaining to the conditions that do not require prophylaxis. Regarding dental procedures that require prophylaxis, the majority of responses were correct with an average of 71.2%. With regard to the type of antibiotic to be prescribed, 63.5% of the participants chose to prescribe 2 g of amoxicillin as a first-line antibiotic. Conclusion : The results of this study showed that the levels of awareness about antibiotic prophylaxis for infective endocarditis are below 100%. Awareness is essential because of the cardiac risks associated with the lack of appropriate treatment. Up-to-date and accurate knowledge is mandatory for all dental students and interns who see and treat patients on a daily basis.