SAFETY AND EFFICACY OF ORAL MELATONIN WHEN COMBINED WITH THORACIC EPIDURAL ANALGESIA IN PATIENTS WITH BILATERAL MULTIPLE FRACTURE RIBS

Ahmed M Fetouh Abdelrahman,1 Amany Faheem Abdel Salam Omara,1 Alaa Ali M Elzohry2 1Anesthesia and Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University, Assiut, EgyptCorrespondence: Alaa Ali M ElzohryDepartment of Anesthesia, ICU and Pain Re

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Abstract The morbidity of aneurysmal subarachnoid hemorrhage (aSAH) remains high, particularly because of secondary cerebral lesions that significantly aggravate the primary lesions.The main type of secondary lesions is delayed cerebral ischemia (DCI), in which platelets (PLT) appear to play a key role.Mean platelet volume (MPV) is an indirect mark

Abolishing the inhibitory signal of intracellular cAMP is a prerequisite for effector T (Teff) cell function.The regulation of cAMP within leukocytes critically depends on its degradation by cyclic nucleotide phosphodiesterases (PDEs).We have previously shown that PDE8A, a PDE isoform with 40-100-fold greater affinity for cAMP than PDE4, is selecti