Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anesthesiologists (ASA) 2 / 3/4 patients between 25 and 85 years who underwent elective and emergency lower limb surgeries randomly allocated into two group, each group has 50 patients by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine with 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (20mg) of Nefopam in the second group (Group BN). The onset time, duration time of both sensory and motor blocking were seen and compared between the two groups.
Results : The onset time of both sensory and motor blockade was shorter in Group BN (bupivacaine with nefopam) when compared to Group BS (bupivacaine and normal saline) (p<0.0001). The duration of both sensory and motor blockade was longer in Group BN when compared to Group BS (p<0.0001). There were no significant hemodynamic changes (PR, BP,SPO2) in both groups. Also there is no any side effect or any complication.
Conclusion Nefopam when mixed with Bupivacaine in Sciatic nerve block and femoral nerve block in below knee surgeries shortens the onset time and prolongs the duration of action of both sensory and motor blockade without any systemic side effects and give excellent intra and postoperative analgesia.
Knowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
The present study was conducted to investigate the relationship between critical thinking, epistemological beliefs, and learning strategies with the academic performance of high school first-grade male and female students in Yazd. For this purpose, from among all first-grade students, as many as 250 students (130 females and 120 males) were selected by using multistage cluster sampling. The data needed were then collected through using California Critical Thinking Skills Test, Schommer's Epistemological Beliefs Questionnaire, Biggs’ Revised Two Factor Study Process Questionnaire. The findings indicated that there is a positive significant relationship between critical thinking and academic performance and achievement. Moreover, four fa
... Show MoreThe authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.
This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.
This architecture had been neglected and replaced by modern imported architecture which had collap
... Show MoreTheater is a renewed art until this moment, and it does not stray from its components from life and its spaces in general, but rather is derived from them according to characteristics and directions intended to differ based on finding other, more effective solutions, Therefore, the research entitled (Extractive treatments of the space between tradition and contrast in contemporary theater) consists of four chapters. The first chapter came under the title (the methodological framework). Where he dealt with the research problem and then the importance of the research and the goal of the research as well as the objective, temporal and spatial limits of the research, In addition to defining the terminology and then finding the procedural ter
... Show MoreThe meniscus has a crucial function in human anatomy, and Magnetic Resonance Imaging (M.R.I.) plays an essential role in meniscus assessment. It is difficult to identify cartilage lesions using typical image processing approaches because the M.R.I. data is so diverse. An M.R.I. data sequence comprises numerous images, and the attributes area we are searching for may differ from each image in the series. Therefore, feature extraction gets more complicated, hence specifically, traditional image processing becomes very complex. In traditional image processing, a human tells a computer what should be there, but a deep learning (D.L.) algorithm extracts the features of what is already there automatically. The surface changes become valuable when
... Show MoreAbstract Objectives: to determine efficiency and safety of three misoprostol regimens for 2nd trimester pregnancy termination in individuals with two or more cesarean section scars. Methods: a cross-sectional study included 100 pregnant ladies at 13th-26th weeks gestation with previous two cesarean sections (CSs) who were scheduled for pregnancy termination using misoprostol. Patients were conveniently assigned to 100µg/3h, 200µg/3h or 400 µg/3h regimens. Primary outcome was time to abortion, secondary outcomes were side effect and complications. Results: a significant association was found between number previous CSs and longer time to abortion (p=0.01). A highly significant association was identified between earlier gestatio
... Show MoreBackground Radiotherapy is one of the main modalities in the management of cancer along with chemotherapy and surgery. Despite its great benefit it has many side effects on many systems and organs including the skin. Objective To record the frequency, grades and types of acute cutaneous side effect in patients with pelvic tumors treated with radiotherapy, in order to report the risk factors and to find appropriate strategies for prevention and management. Patient and methods. Methods A prospective observational study was carried out in Baghdad Radiation and Nuclear Medicine Centre between August 2020 and August 2021.A total 70 patients were enrolled in this study.All patients had full history and full baseline skin exam and were ass
... Show MoreThe current study was carried out to investigate the correlation of gene expressions of ADA1 and ADA2 genes with the development of autoimmune thyroid disease (AITD) in a sample of Iraqi females. One hundred patients with AITD and 80 controls were included. Quantitative real time polymerase chain reaction (qRT–PCR) was utilized for investigation of ADA1 and ADA2 gene expression among patients and controls. The correlation of age and body mass index (BMI) with AITD occurrence comparing with controls was studied. Based on the results of this study, there is high expression level of ADA1 and ADA2 genes in patients compared with healthy controls; also, the gene expression fold (2-ΔΔCT) of ADA1 and ADA2 among AITD patients was recorded and a
... Show MoreT-cell activation and alteration of cytokine levels are involved in the pathogenesis of asthma. However, the profile of circulating T-lymphocyte subsets and related cytokines during asthmatic attacks is still unclear. We compared the serum concentrations of proinflammatory cytokines Interleukine-18( IL-18) and Interleukine-12(IL-12), T-helper 2 (Th2) cytokine Interleukine-13(IL-13 ) and Immunoglobuline-E ( IgE) in 27 asthmatic children and 21 sex and age matched healthy control subjects. Serum cytokines and IgE concentrations were measured by enzyme-linked immunosorbent assay. Serum IL-13 , IL-18 and IgE concentrations were significantly higher in asthmatic patients than normal control subjects ( IL-13: median 9.73 versus 4.43 pg/ml, P&l
... Show More