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Walaa Y Elsabeeny, Nahla N Shehab, Mohamed A Wadod, Mostafa A Elkady Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, EgyptCorrespondence: Walaa Y ElsabeenyDepartment of Anesthesia and Pain Management, National Cancer Institute, Kasr Al Eini Street, Fom El Khalig, Cairo 11796, EgyptTel +20 1007798466Email walaa.Elsabeeny@nci.cu.edu.egPurpose: Various analgesic modalities are adopted for perioperative analgesia in breast cancer surgeries. This study aimed to compare the efficacy of intravenous morphine versus serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) in breast cancer surgeries.Patients and Methods: Seventy-five breast cancer patients undergoing modified radical mastectomy from January 2020 to June 2020 were randomly allocated into 3 groups; the morphine group received morphine 0.1 mg/kg, the SAPB group received ultrasound-guided SAPB with 25 mL bupivacaine 0.25% and the ESPB group received ultrasound-guided ESPB with 25 mL bupivacaine 0.25%. A visual analogue scale (VAS) 0– 10 was used to evaluate pain postoperatively, where 0 denotes no pain and 10 worst pain. If any patient in the 3 studied groups reported breakthrough pain with VAS ≥ 4 then a bolus of 3 mg morphine was given.Results: There was no difference in VAS scores between the 3 groups postoperatively. Morphine consumption was higher in the morphine group (9.19 ± 2.32 mg) than the SAPB group (4.00 ± 1.55 mg) and the ESPB group (4.20 ± 1.64 mg), respectively. First time to receive postoperative morphine was significantly longer for the ESPB and SAPB groups than the morphine group (20.40 ± 4.98 hours), (19.00 ± 5.9 hours), (5.00 ± 4.62 hours), respectively. Intraoperative hemodynamics and fentanyl consumption showed no difference between groups, whereas postoperative mean arterial blood pressure values at 2 and 4 hours were higher in the morphine group. Ramsay sedation score and postoperative nausea and vomiting values in the post anesthesia care unit were higher for the morphine group compared to the SAPB and ESPB groups. No complications related to the blocks were reported.Conclusion: SAPB and ESPB can be used as an effective and safe alternative to opioids with fewer side effects in breast cancer patients undergoing modified radical mastectomy.Trial Registration: This trial was prospectively registered at Clinical Trials.gov on 22 January 2020 with registration number NCT04248608 (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009JS5&selectaction=Edit&uid=U0004LIG&ts=7&cx=− 81xkwa).Keywords: modified radical mastectomy, morphine, serratus plane block, erector spinae block

Mixing performance is commonly assessed using the Villermaux– –Dushman protocol. Mixing in passive mixers may need to be at very low Reynolds number (Re). This study is aimed at comparing the mixing performances of T, Y and arrow-shaped micromixers using the Villermaux–Dushman protocol at Re < 100. The mixing performance test was run at flow rates of 500 to 1 mL h-1 with the pressure drop measurement. Based on UV absorbance values and experimental mixing times of mixed fluids from the three micromixers, the order of mixing performance at Re > 26.5 was Y < T < arrow-shaped micromixers. At lower Re values, the order of performance based on the absorbance and the experimental mixing times, became inconsistent. However, the comparison of mixing performance based on predicted mixing time gave consistent order of performance at all Re values. The instability in UV absorbance of mixed reagents in Villermaux–Dushman protocol was noted as the major cause of the reported inconsistency at very low Re. The inadequacy of Villermaux– –Dushman protocol at low Re was verified via facile solvent extraction test. A more reliable technique should be used to assess the mixing performance of micromixers at very low Re and on-line UV measurement should be adopted for the Villermaux–Dushman experiment.

Self-sensing cement-based composite was used to monitor the flow of traffic volume. Composite material was prepared with numerous percentages of carbon black (CB) and activated granulated ground blast furnace slag (GGBFS). This economical and concrete friendly material having piezo resistive properties helped to detect the wheel pressure induced by the vehicles passing over it. Initially, the pressure sensitivity of different mix designs was investigated in the laboratory and the samples having more sensitivity to applied load were used on the real road test for vehicle detection. Mechanical and microstructural properties of hydrated cement composite filled with CB and GGBFS as an active filler were also explored. Scanning electron microscopy/Electron dispersive spectroscopy (SEM/EDS) and X-ray diffraction (XRD) analysis were carried out to characterize the microstructure and hydration product development of different specimens at different curing ages. The tested cement composite gives a remarkable response to both compressive and vehicular loading with excellent mechanical and microstructural properties. The results also showed that the self-sensitive cement composite has a great potential to use as a device for traffic monitoring.