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Under certain circumstances, flow in microchannels can exhibit compressibility effects even at Reynolds numbers (Re) around (below 2,300) and low Mach numbers (below 0.3). This is particularly true for gases, especially when the flow undergoes significant pressure changes or acceleration within the microchannel. This study investigates the compressibility effects encountered in two-parallel plates microchannels at these low Reynolds and Mach numbers, due to the high-pressure drop associated with the small scale of the microchannels. This uncommon flow is characterized by an exceptionally small channel diameter-to-length aspect ratio (∼10–3), resulting in a friction coefficient that deviates from the typical value for laminar flow between parallel plates (f = 96/Re). Both steady and transient effects on the flow field are examined under low Re subsonic flow, assuming continuum behavior. The ideal gas equation is used to model gas density, while the isothermal Tait-Murnaghan equation models liquid density. For gases, compressibility effects are observed primarily when the inlet pressure ratio exceeds 0.1. The results show that these effects are less pronounced for liquids, even at elevated inlet pressure ratios. Additionally, a flow delay across the channel exhibits a first-order transient response. For liquid flow, this effect depends on the channel resistance, the total fluid volume within the channel, and the liquid's bulk properties, rather than the inlet pressure ratio.

Objective: Different anaesthetists for sedation or monitored anaesthesia care have been used for colonoscopy. The target of this research was the ability to perform colonoscopy under a painless degree of sedation and the prevalence of undesired proceedings. Methods: A total of 60 patients were randomly divided into two groups: Group D received dexmedetomidine and Group PF received propofol-fentanyl. Patients in both groups received the same infusion ratio. The minimum infusion amount of dexmetatomidine is (0.1 to 0.4 μg kg-1 h-1) in Group D, whereas fentanyl is administered at a rate of 0.01 to 0.05 μg kg-1 min-1 in the PF group during the approximately 45-min colonoscopy. Results: Group D exhibited significantly lower modified Observer’s Assessment of Alertness/Sedation (OAA/S) scores at intraoperative time points T1-T12. Group D also exhibited significantly lower visual analog scale scores for pain at intraoperative time points T4 and T7. The mean arterial pressure was significantly lower in Group D at intraoperative times T6-T8 and T11-T12, as well as upon admission to the post-anaesthesia care unit (PACU) and 30 min after admission to the PACU. The results of the ANOVA tests revealed a significantly lower heart rate in Group D. The respiratory rate exhibited a notable decrease during time intervals T8 and T10 in the PF group. Conclusion: The administration of dexmetatomidine and propofol-fentanyl during colonoscopy was found to be safe. In addition, dexmetatomidine may present significant benefits in this context because of its lower occurrence of adverse respiratory events.

ABSTRACTBackground General anesthesia organizes the best option for controlled blood pressure during rhinoplasty surgery. The primary agent applied in controlling hypotension should have particular unique characteristics. The peripheral and central sympatholytic attainment of dexmedetomidine is usually indicated by low blood pressure and low heart rate. Magnesium sulfate is among the best agents used.Objective Determine the influence of both dexmedetomidine and magnesium sulfate on hemodynamic parameters for patients undergoing rhinoplasty surgeries after general anesthesia.Patients and methods This is a randomized prospective comparative study. Fifty-six patients got enrolled and divided into two categories. Group 1 (n = 28): Received a priming dose of dexmedetomidine 1 microgram/kg before induction then 0.4 µg/kg/h. Group 2 (n = 28): Received 30 mg/kg of magnesium sulfate as a priming dose before induction and then 10 mg/kg/h during the time of the procedure.Results No significant differences were seen between the two groups regarding the MAP. There were significant differences among the groups in heart rate (p

Objective:Hypotension is the most frequent side effect of intrathecal anaesthesia, with an incidence of more than 80%. Following neuraxial anaesthesia, perioperative shivering is a serious complication affecting 40-60% of patients undergoing surgery. This study aimed to determine the effectiveness of low-dose ketamine on blood pressure in patients undergoing cesarean delivery after spinal anaesthesia.Methods:We included 126 female patients undergoing cesarean deliveries, American Society of Anesthesiologists (ASA)-(II and III), and aged 21-40 selected from the outpatient clinics of the anaesthesia department. Patients were randomized to two groups; Group K (63 patients), who received 0.3 mg kg-1 of ketamine IV diluted to 10 mL, followed by an infusion of 0.1 mg kg-1 h-1. Group C (Controlled) (63 patients) received 10 mL of normal saline, followed by an infusion of 0.1 mL kg-1 h-1, which started before spinal anaesthesia.Results:Compared with the saline group, the average heart rate, blood pressure, and level of sedation were significantly higher in the ketamine group (P < 0.05). The ketamine group reported a significantly lower incidence of shivering (P < 0.01). The ketamine groups exhibited significantly less mild or severe hypotension (P < 0.05). There was no significant difference between the two groups in terms of nystagmus, diplopia, hallucinations, or neonatal outcomes (P > 0.05).Conclusion:Ketamine decreases the incidence of hypotension and shivering in patients undergoing spinal anaesthesia during cesarean delivery. In addition, it resulted in improved sedation for the mother and prolonged postoperative analgesia without neonatal illness.

Abstract Background Local anesthesia and intrathecal narcotics are utilized to provide postoperative analgesia. IPACK (infiltration between the knee capsule and popliteal artery) is a new localized analgesic approach for knee surgery. This randomized study aimed to compare fentanyl-based spinal anesthesia and IPACK block-based spinal anesthesia for postoperative analgesia in patients undergoing arthroscopic meniscectomy. Results In group F, the VAS (visual analog scale) was higher than in group I, whereas the total amount of morphine was lower in group I (P

This study investigates numerically, with experimental verification, the performance of a hybrid multilayer microchannel heat sink with jet impingement. The three-dimensional fluid flow and heat transfer processes were solved using the finite volume method using Fluent CFD Solver. The surface temperature distribution and pressure drop across the system were monitored under a range of designs and operating conditions including different flow rates, channel aspect ratios, jet spacings, and distribution of the flow rate between the jets and the channels. Our results show that increasing the number of jets minimizes the pressure drop, yet, results in higher surface temperatures. Increasing channel height decreased the pressure drop and enhanced the temperature uniformity. Using a double-layer heat sink instead of a single-layer one resulted in a decrease of 7.5% in surface temperature with a considerable reduction in pressure drop. Nevertheless, adding copper fins/posts in the lower channel layer is essential to help conduct the heat to the top layer and improve the heat removal rate. We also studied dividing the total flow rate between the jets and the main cooling channel and found that it can reduce the average temperature on the hot surface even though it did not improve the temperature uniformity. We verified our simulation results with experimental measurement for a single-layer hybrid heat sink with jet impingement and results matched with a temperature difference below 5 °C. Based on our simulations, the DL-hybrid module can remove high heat fluxes while maintaining an acceptable pressure drop.

Reducing reliance on fossil fuels with clean and sustainable alternatives is essential for mitigating climate change and global warming-related environmental concerns. Previous researchers have studied the performance of choppers and crushers as separate units powered by diesel or gasoline engines. Nowadays, an increasing interest in producing Eco-friendly machines that stand out for being dual purposes, cost-effectiveness, and with lengths suitable for feeding ruminants are imperative to achieving economic and sustainable goals. Therefore, this study aims to solve these issues and gaps by developing and evaluating a dual-purpose forage machine for chopping and crushing operations to achieve both operations more efficiently and at a lower cost. The developed forage machine's performance was evaluated for chopping operation using maize stalks with four different rotational speeds of 1200, 1400, 1600, and 1800 rpm and four different moisture contents of 22.7, 43.3, 59.8, and 74.6% (w.b.). Also, the crushing operation was evaluated using maize ears with four different crusher speeds of 1200, 1400, 1600, and 1800 rpm and three different sieves with holes' diameters of 6, 8, and 10 mm. The results concluded that the highest efficiencies with values of 94.17 and 92.85% were obtained at 1800 rpm chopper rotational speed and 22.7% moisture content for the chopper and 1200 rpm crusher rotational speed and 10 mm sieve hole diameter for the crusher, respectively. At these proper operational parameters, the machine productivity of 2.44 and 0.31 ton.hr−1, the specific energy requirements of 3.22 and 4.50 kW h.ton−1, and the estimated production costs of 23.56 and 121.24 EGP.ton−1 (1.25 and 6.38 USD.ton−1) were obtained for chopper and crusher, respectively.

Improving the engineering properties of A356 alloy is an appealing option for the automotive industry. This study aimed at refining and redistributing Si particles and the eutectic phase by applying T6 heat treatment to a semi-solid A356 alloy, followed by severe plastic deformation (SPD). Using a cooling-slope technique, the as-cast and rheocast samples were subjected to heat treatment prior to being processed using equal-channel angular pressing (ECAP) and high-pressure torsion (HPT) at room temperature. The results show that the brittle Si particles were effectively fragmented and redistributed in the homogenous microstructure. The grain size reduced from 170 μm to 23 μm in the as-cast sample after combining heat treatment and the cooling-slope. This was followed by the ECAP sample after six passes through route A (where the sample is not rotated between each pass), while it reduced to 160 nm after five turns of the HPT process in a heat-treated cooling-slope sample. The hardness of the heat-treated cooling-slope casting samples increased with the ECAP process; there was an increase from 61 HV to 134 HV for the as-cast alloy after six passes through route A. The hardness of the heat-treated cooling-slope sample improved with the HPT process to 211 HV after five turns.

This study investigates sequential segmentation as an active mixing technique inside microchannels. In sequential segmentation, the solvent and anti-solvent streams are divided into segments in the axial direction. Due to the non-uniform velocity profile exhibited in laminar flow, Taylor-Aris dispersion can improve mixing by several orders of magnitude as compared with pure molecular diffusion. We built a 3D numerical model using COMSOL Multiphysics® to optimize this technique. We studied the effect of segmentation frequency, duty cycle (DC), flow velocity, microchannel aspect ratio and configuration of the inlet branches on the concentration distribution. We found that channel aspect ratio (H:W) and segmentation frequency had the most significant effect on mixing efficiency. Increasing segmentation frequency was found to increase the mixing efficiency up to a certain limit beyond which mixing efficiency decreased. This decrease was due to the non-complete segmentation of both streams at high frequencies and the formation of continuous trailing stream of both the solvent and anti-solvent. These trailing streams, which mitigate the segmentation effect, also appear in low aspect ratio (i.e. wider) channels and, therefore, reduces the mixing efficiency. Unequal mixing ratios were achievable by changing the segmentation duty cycle without changing the mixing efficiency considerably. Changing the flow velocity did not cause considerable changes in the mixing efficiency. Our 3D model confirms that sequential segmentation can considerably improve mixing inside microchannels and introduces the channel aspect ratio, for the first time, as an important parameter affecting the segmentation mixing efficiency.

The Quseir Formation is an Upper Cretaceous (Campanian) deposit in the Kharga oasis of the Southwestern Desert (Egypt). This formation comprises a clastic sequence of bioturbated mudstone and sandstone intercalations, including rare scattered and fragmented vertebrate remains such as shark teeth, dinosaur remains, and turtle plates. These deposits indicate a supratidal marsh environment. A complete shell of a turtle discovered from the Quseir Formation, at the Kharga oasis, is attributed here to Bothremydini (Pleurodira, Bothremydidae), and determined as a new taxon: Khargachelys caironensis gen. et sp. nov. This form represents the only Bothremydini member currently identified in the Campanian record not only of Egypt but also of North Africa. Therefore, it helps fill the missing evolutionary gap from the Late Cretaceous pleurodires in Egypt and in North Africa.

This study fabricated a thixoformed Al-7% Si alloy using the cooling slope technique and subjected it to heat treatment before processing with severe plastic deformation to determine the effect of this combination method on the microstructure refinement and hardness of Al-Si alloys (300 Series). Each as-cast and thixoformed Al-Si alloy sample was subjected to equal-channel angular pressing (ECAP) and high-pressure torsion (HPT) individually at room temperature before and after heat treatment. ECAP was conducted in a mould with a 120° channel angle via route A, and HPT was applied with 0.75 and 5 turns. The heat-treated thixoformed Al-Si alloy subjected to the HPT process had an ultra-fine grain microstructure and showed a fine and homogeneous redistribution of the eutectic phase in the Al matrix. For the as-cast alloy, the hardness of the heat-treated thixoformed Al-7% Si alloy increased from 63 HV to 124 and 215 Hv after two ECAP passes and five turns of HPT due to the reduced and redistributed eutectic phase in the Al matrix. Subjecting the Al-7% Si alloy to a combination of semisolid and heat treatment processes before subjecting it to severe plastic deformation resulted in microstructural refinement and improved the hardness of the Al-Si alloy. The results indicate that HPT is a more effective method than ECAP for increasing the hardness of the thixoformed Al-Si alloy due to microstructure refinement.

This study aimed to produce healthy mayonnaise with a protective effect against cardiovascular diseases, containing omega-3 fatty acids (FA), using flaxseed oil (FXO), which includes a high percentage of alpha-linolenic acid (ALA, C18:3n-3). The mayonnaise was prepared by replacing soybean oil with FXO at 20, 30, and 40% levels. The effect on the organoleptic, physical, and chemical quality was studied compared to a control, prepared only with soybean oil (70%). The oxidative and microbial stability during 12 weeks of storage at 25 and 7 °C was also evaluated. The results showed that the use of FXO in mayonnaise (20, 30, and 40%) led to an increase in TUFA (from 79.37 (control) to 82.48, 85.49, and 87.66%, respectively), particularly in PUFAn-3, due to the rise of ALA (from 6.5 to 18.38, 24.02 and 37.87%, respectively) and a decrease in TSFA (from 20.63 to 17.52, 14.51 and 12.34%, respectively). The panelists did not perceive significant differences in the sensory characteristics of the “new” mayonnaise. A decrease in the oxidation rates of the “new” mayonnaise during the storage period was observed. A significant effect on microbial growth was not reported, although the permissible limits were not exceeded after 12 weeks of storage, even at 25 °C.

A356 aluminium alloy is subjected to heat treatment and high-pressure torsion (HPT) processing to investigate the impact of the combined treatments on the alloy’s microstructure refinement, corrosion resistance and hardness. The high-pressure torsion process was performed at room temperature for 0.75 and 5 turns. Subjecting the A356 Al alloy to a heat treatment and subsequent HPT processing produced a more refined microstructure, which has the effect of enhancing the alloy hardness and corrosion resistance under fragmentation and the homogenous redistribution of the intermetallic compounds and the Si particles. The results of the treatment show that there is a marked increase in hardness when imposing a strain from 61 HV to 198 HV on the A356 Al alloy, which has been HPTed and heat-treated for five turns. The polarisation curves show that there is a considerable improvement in the corrosion resistance rate of the alloy from 0.043 mm·year−1 for the A356 Al alloy sample to 0.003 mm·year−1 after five turns of HPT. In this work, the microstructure refinement resulted in the improvement of both the mechanical strength and corrosion resistance of the aluminium 356 alloy after heat treatment in comparison to the untreated alloy.

Introduction: Failure of effective treatment of epithelial carcinoma of the ovary necessitates searching factors that lead to resistance to chemotherapy and recurrence. Cancer stem cell theory hypothesis provides an explanation of how small group of cells inside the tumour remain resistant to treatment. CD44 has been considered as cancer stem cell marker in multiple malignancies but its role in Ovarian Serous Carcinoma (OSC) is still controversial. Aim: To investigate the expression of stem cell marker CD44 and proliferative activity using Ki67 immunostaining in serous ovarian carcinoma and their relation to clinical and pathological variables and outcome of the patients. Materials and Methods: The present study was a prospective study done on 45 patients with serous ovarian tumours, the ovarian sections obtained from the patients were immunostained by CD44 and Ki67 immunohistochemical markers. The Overall Survival (OS), Disease Free Survival (DFS) and response to treatment were investigated and analysed. Results: Both CD44 and Ki67 were positive in patients with increased grade and advanced stage and the difference was highly statistically significant (p=0.001 and p

Objective: Programmed cell death ligand-1 interacts with the immune receptors on the surface of CD8+ tumor infiltrating lymphocytes and PD-1, thereby blocking its anti-tumor activity. Therapeutics suppression of this interaction will show a promise in the treatment of non-small cell lung cancer by restoring the functional anti-tumor T-cell activity. We aimed to evaluate the association between the immunohistochemical expression of PD-L1, stromal CD8+ tumor infiltrating lymphocytes and p53 with the clinicopathological characteristics, response to chemotherapy, progression-free-survival, and overall survival. Material and Method: We examined the immunohistochemical expression of PD-L1, stromal CD8+ TILs, and p53 expression in 50 patients with advanced stage (III&IV) non-small cell lung cancer. Results: PD-L1 was expressed in 56% of the studied cases. PD-L1 expression was related to unfavorable response to the therapy without significant difference. PD-L1 expression was significantly associated with disease progression, poor progression-free-survival & overall survival. CD8+ TILs were high in 32% of the cases. Tumors with high CD8+ TILs showed a partial response to therapy and had a better progression-free-survival and overall survival. p53 expressed in 82% of the studied cases. There was a significant negative association between PD-L1 and CD8+ TILs (p=0.009), while a non-significant association was found between p53 and PD-L1 (p=0.183). Conclusion: PD-L1 overexpression is an unfavorable prognostic marker, while the high CD8 + TILs is a good prognostic marker in non-small cell lung cancer. PD-L1 immunohistochemical assessment may be used for the selection of patients legible for treatment with anti-PD-L1 therapy.

As-cast and semisolid casting using a cooling slope A356 alloy were processed by equal channel angular pressing (ECAP) for Si and grain refinement. The ECAP was conducted at room temperature in a mold, with a channel angle of 120°, and this resulted in a significant size reduction of grain and Si particles from 170.5 and 4.22 to 23.12 and 0.71 µm, respectively, after six passes of heat-treated cooling slope casting, using the ECAP process. The hardness increased with ECAP processing, from 61 HV, for the as-cast alloy, to 134 Hv, after six passes of heat-treated cooling slope casting. The corrosion resistance of the alloy improved, from 0.042 to 0.0012 mmy−1, after the ECAP process. In this work both the strength and corrosion resistance of the ECAPed A356 alloys were improved with the application of the cooling slope process than without (i.e., from the as-cast condition).

Background: Impaired pulmonary function in patients on hemodialysis may be caused by an underlying pulmonary disease, however the effects of hemodialysis treatment and kidney transplantation are not well understood. Aim of the work: The aim of this study was to evaluate pulmonary function among patients with chronic renal failure (CRF) undergoing hemodialysis and patients with kidney transplant. Patients and methods: This study was conducted on 60 subjects. They were classified into 3 groups: Hemodialysis group (HDG) included 20 patients with end stage renal disease (ESRD) on regular hemodialysis for at least six months and were clinically stable. Transplant group (TG) included 20 patients who had undergone kidney transplant at least six months earlier and were also clinically stable. Control group (CG) included 20 apparently healthy subjects. All subjects underwent pulmonary function testing; including resting spirometry included flow volume loop and Maximal Voluntary Ventilation (MVV), measurement of lung volumes and diffusing capacity for carbon monoxide (DLCO) using single breath technique, Six Minute Walking Test (6MWT) and arterial blood gases (ABG). Results: There was a significant difference between HDG, TG and CG regarding FVC% of predicted, FEV1% of predicted, FEF 25–75% of predicted, PEFR% of predicted and MVV% of predicted. Also there was a statistically significant difference between HDG, TG and CG regarding RV% of predicted, TLC% of predicted and RV/TLC%. Although FVC% of predicted and FEV1% of predicted were within the normal range in the 3 studied groups, there was a statistically significant reduction in these spirometric parameters in HDG more than that in the TG and CG, also reduction in TG more than CG. FEF 25–75% of predicted was less than normal in HDG and was within the normal range in TG and CG, also RV% of predicted and TLC% of predicted were increased in HDG more than that in TG and CG. Regarding DLco% of predicted we found significant differences between the 3 studied groups. It was lower in HDG than in TG and CG. Also the same results we found regarding Dlco/VA% of predicted. There were statistically significant differences among the studied groups regarding 6MWT. Regarding ABG although all values were within normal levels, Pao2 in HDG was less than that in TG and CG. Conclusion: There is impairment of lung function in patients with CRF undergoing hemodialysis. The main changes are small airway obstruction, reduction in carbon monoxide transfer and diminished 6MWT that were not completely improved in the kidney transplant patients.

Cryopreservation is a key technology in biology and clinical practice. This paper presents a digital microfluidic device that automates sample preparation for mammalian embryo vitrification. Individual micro droplets manipulated on the microfluidic device were used as micro-vessels to transport a single mouse embryo through a complete vitrification procedure. Advantages of this approach, compared to manual operation and channel-based microfluidic vitrification, include automated operation, cryoprotectant concentration gradient generation, and feasibility of loading and retrieval of embryos.

Background: Exploring a biomarker with enhanced sensitivity and specificity for tissue perfusion may facilitate the timely identification of circulatory collapse, and enable more precise resuscitation efforts. Objective: The objective of this study was to ascertain the correlation between whole blood lactate versus plasma renin concentration being a biomarker of tissue perfusion and predictor of mortality among hypotensive critically ill patients. Methods: This prospective, observational cohort study enrolled 84 hypotensive critically ill patients. Plasma renin concentration and blood lactate were measured at enrollment, 24, 48, and 72 hours. The primary outcome is the correlation between the recorded renin, lactate concentrations and mortality rate during hospitalization. Results: The mean plasma renin concentration at enrollment was 61.95 pg/ml in survivors, and 104.45 pg/ml in non-survivors (p = <0.001). The non-survivors exhibited a significant boost in plasma renin concentration after 48 and 72 hours, opposed to the survivors (112 vs 40.89, and 106.64 vs 28.85 pg/ml) respectively. There was a significant positive correlation between plasma renin, blood lactate concentrations and patient mortality (r = 0.389 & 0.601) respectively. Conclusion: Plasma renin and whole blood lactate had positive correlation to mortality, yet plasma renin revealed superior diagnostic accuracy over blood lactate for mortality prediction in hypotensive critically-ill patients. Trial registration: The protocol of this study can be obtained on ClinicalTrials.gov with the id NCT05810415. [ABSTRACT FROM AUTHOR]

The article evaluates the effectiveness of mivacurium in modified rapid sequence intubation (RSI) for emergency surgeries. Topics include the comparison of intubating conditions between two doses of mivacurium, the earlier onset of muscle relaxation with the higher dose, and the longer recovery time associated with the 0.4 mg/kg dose.

Objective: Different anaesthetists for sedation or monitored anaesthesia care have been used for colonoscopy. The target of this research was the ability to perform colonoscopy under a painless degree of sedation and the prevalence of undesired proceedings. Methods: A total of 60 patients were randomly divided into two groups: Group D received dexmedetomidine and Group PF received propofol-fentanyl. Patients in both groups received the same infusion ratio. The minimum infusion amount of dexmetatomidine is (0.1 to 0.4 µg kg-1 h-1) in Group D, whereas fentanyl is administered at a rate of 0.01 to 0.05 µg kg-1 min-1 in the PF group during the approximately 45-min colonoscopy. Results: Group D exhibited significantly lower modified Observer's Assessment of Alertness/Sedation (OAA/S) scores at intraoperative time points T1-T12. Group D also exhibited significantly lower visual analog scale scores for pain at intraoperative time points T4 and T7. The mean arterial pressure was significantly lower in Group D at intraoperative times T6-T8 and T11-T12, as well as upon admission to the post-anaesthesia care unit (PACU) and 30 min after admission to the PACU. The results of the ANOVA tests revealed a significantly lower heart rate in Group D. The respiratory rate exhibited a notable decrease during time intervals T8 and T10 in the PF group. Conclusion: The administration of dexmetatomidine and propofol-fentanyl during colonoscopy was found to be safe. In addition, dexmetatomidine may present significant benefits in this context because of its lower occurrence of adverse respiratory events. [ABSTRACT FROM AUTHOR]

Improving the engineering properties of A356 alloy is an appealing option for the automotive industry. This study aimed at refining and redistributing Si particles and the eutectic phase by applying T6 heat treatment to a semi-solid A356 alloy, followed by severe plastic deformation (SPD). Using a cooling-slope technique, the as-cast and rheocast samples were subjected to heat treatment prior to being processed using equal-channel angular pressing (ECAP) and high-pressure torsion (HPT) at room temperature. The results show that the brittle Si particles were effectively fragmented and redistributed in the homogenous microstructure. The grain size reduced from 170 μm to 23 μm in the as-cast sample after combining heat treatment and the cooling-slope. This was followed by the ECAP sample after six passes through route A (where the sample is not rotated between each pass), while it reduced to 160 nm after five turns of the HPT process in a heat-treated cooling-slope sample. The hardness of the heat-treated cooling-slope casting samples increased with the ECAP process; there was an increase from 61 HV to 134 HV for the as-cast alloy after six passes through route A. The hardness of the heat-treated cooling-slope sample improved with the HPT process to 211 HV after five turns. [ABSTRACT FROM AUTHOR]

Objective: Hypotension is the most frequent side effect of intrathecal anaesthesia, with an incidence of more than 80%. Following neuraxial anaesthesia, perioperative shivering is a serious complication affecting 40-60% of patients undergoing surgery. This study aimed to determine the effectiveness of low-dose ketamine on blood pressure in patients undergoing cesarean delivery after spinal anaesthesia. Methods: We included 126 female patients undergoing cesarean deliveries, American Society of Anesthesiologists (ASA)-(II and III), and aged 21-40 selected from the outpatient clinics of the anaesthesia department. Patients were randomized to two groups; Group K (63 patients), who received 0.3 mg kg-1 of ketamine IV diluted to 10 mL, followed by an infusion of 0.1 mg kg-1 h-1. Group C (Controlled) (63 patients) received 10 mL of normal saline, followed by an infusion of 0.1 mL kg-1 h-1, which started before spinal anaesthesia. Results: Compared with the saline group, the average heart rate, blood pressure, and level of sedation were significantly higher in the ketamine group (P < 0.05). The ketamine group reported a significantly lower incidence of shivering (P < 0.01). The ketamine groups exhibited significantly less mild or severe hypotension (P < 0.05). There was no significant difference between the two groups in terms of nystagmus, diplopia, hallucinations, or neonatal outcomes (P > 0.05). Conclusion: Ketamine decreases the incidence of hypotension and shivering in patients undergoing spinal anaesthesia during cesarean delivery. In addition, it resulted in improved sedation for the mother and prolonged postoperative analgesia without neonatal illness. [ABSTRACT FROM AUTHOR]