Biomedical subjects
M El-Naggar
Publications and source records attributed to M El-Naggar.
Sodium nitroprusside and lidocaine in the anaesthetic management of pheochromocytoma.
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The airway smooth muscles in asthma. Part I. Recent advances.
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Studies on reproduction in camels (Camelus dromedarius) VIII. The electrophoretic pattern and the amino acid content of the seminal plasma protein.
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What we now know about ventricular fibrillation.
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Smooth muscles of the airway in asthma: recent advances in anatomy, physiology and biochemistry.
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Studies on reproduction in camels (Camelus dromedarius). VII. The acid and the alkaline phosphatase activities of the seminal plasma.
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The use of a small endotracheal tube in bronchoscopy.
The use of the standard 4-mm cuffed endotracheal tube to deliver manually or mechanically interrupted jets of oxygen or nitrous oxide and oxygen into the trachea allowed bronchoscopy and other related procedures to be performed with advantage to the patient, the surgeon and the anawsthetist. This paper describes the equipment used and the advantages obtained.
Ketamine as an induction agent and an adjunct to nitrous oxide-oxygen curare anaesthesia sequence.
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Effect of ketamine in the blood pressure and pulse rate (a comparison with thiopental and fentany).
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Jet ventilation for microlaryngoscopic procedures. A further simplified technique.
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Changes in the hemodynamic, ventilatory and respiratory parameters following saline, isoproterenol and racemic epinephrine aerosol therapy in patients on IPPV.
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Factors influencing choice between tracheostomy and prolonged translaryngeal intubation in acute respiratory failure: a prospective study.
One of the problems of prolonged ventilatory therapy in acute respiratory failure (ARF) is the need to choose between tracheostomy after 48 to 72 hours of translaryngeal (TL) tracheal intubation or the continuous use of the TL tube for a period of 10 days. Too often the choice has been based on retrospective studies or personal preference. To investigate this problem prospectively, 52 adults in ARF were divided sequentially into 2 groups on their 3rd day of TL intubation. Patients in group I (G-I) retained the TL tube for a total of 11 days; those in group II (G-II) were tracheostomized on the 3rd day. The following factors ere used to evaluate the efficiency and complications in each group: patient's epidemiologic variables, daily pulmonary functions, severity of respiratory infections, and scores of post-intubation airway lesions. No consistent statistically significant differences between the two procedures were seen in the pulmonary functions or the range of individual patient variables. However, with an early tracheostomy, there was an eightfold greater incidence of contamination of the airway by new organisms, airway lesions were more frequent and severe, and the need for the tracheal tube was extended. To identify the epidemiologic variables and the pulmonary functions that discriminate between patients with serious airway lesions and those with mild lesions, and to evaluate the ability of these variables to differentiate the patients who died from those who survived, the distribution of all factors was compared in the two categories. The epidemiologic variables separated the patients according to their airway lesions only, while the difference in pulmonary functions was statistically significant only between the patients who died and those who survived.
Administration of ketamine or Innovar by the microdrip technic: a double blind study.
This study of 40 healthy adults undergoing elective gynecologic procedures was undertaken to evaluate the microdrip technic of administering ketamine or Innovar slowly to induce anesthesia and to supplement N2O anesthesia. All patients were managed by the same anesthetist and surgeons and received 10 mg of diazepam and 0.4 mg of atropine IM for premedication. After injection of 10 mg of diazepam, anesthesia was induced by infusions containing either ketamine (2 mg/ml) or Innovar (0.1 ml/ml), at an average rate of 10 ml/min. The infusions were assigned to the patients randomly and their nature was disguised from the staff. After tracheal intubation, ventilation was mechanically supported and anesthesia maintained with N2O-O2 (2:1), by drip at a rate adjusted to the patient's vital signs, and by intermitten injections of 3 to 6 mg of d-tubocurarine. Special forms coded to suit computer use were used to collect data during induction, maintenance, and recovery, and standard mathematical tests were used for analysis. Results showed that (a) ketamine effects could not be differentiated clinically from those of Innovar; (b) ketamine dosage could be reduced to 0.3 to 0.5 the recommended bolus dosage; (c) pulse rates and incidence of mental aberrations during induction or recovery were equal in both groups; (d) blood pressure showed a modest but significant increase (10% from basal values) until 20 minutes of tracheal intubation only in the ketamine group; (e) mean Pao2 determined 30 minutes after tracheal intubation was significantly higher in the ketamine group; (f) ketamine administration by the slow (20 mg/min) microdrip technic reduces the incidence of side effects.