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.
Abstract
The aim of the current research is to identify the level of administrative applications of expert systems in educational leadership departments in light of the systems approach. To achieve the objectives of the research, the descriptive-analytical and survey method was adopted. The results showed that the level of availability of the knowledge base for expert systems in educational leadership departments (as inputs) was low. The level of availability of resources and software for expert systems in educational leadership departments (as transformational processes) came to be low, as well as the level of availability of the user interface for expert systems in educational leadership departments (as outputs
... Show MoreThe current research aims to know the complementary use of the paper book and the digital book by defining the paper book and the digital book and knowing the methods and methods of obtaining each of them and indicating the extent of their use and for what purpose and knowing the difficulties that researchers face in using each of them and which is better using the paper book or the digital book in preparing research Studies and for no reason. The research relied on the descriptive approach and the questionnaire as a tool for data collection, and it was distributed to professors and students of Iraqi universities. The research sample reached (219) individuals and reached a set of results, the most important of which are: Preference for the
... Show MoreThe research aims to shed light on the importance of Natural gas as a National wealth is not being used optimally to be a financial resource is important to Iraq in addition to Oil, as well as could be used as an important Source of Energy, instead of burning gas is a waste of wealth and Contribute to the contamination of the environment. Research Reviews the importance of Natural gas, where is currently about a quarter of global energy consumption. Then deals with the reality of the gas industry in Iraq and winning because of the volume of waste incineration, which reached a rate (45%) of the gas Associated with oil, where Iraq is fourth globally in Terms of the amount of gas Burned. Finally, this paper discusses the future of n
... Show MoreAbstract The relative pronoun in Hebrew language is an important pronoun use anciently and recently, it developed and it's usage and meanings differed so, it was not confined to the particle "אֲשֶׁר" as a relative pronoun, but beside it appeared other pronouns giving the relative meaning. Hence, the topic of this research was on this basis through studying the relative pronouns in old and modern Hebrew, the way of using them and their connection with preposition particles, as well as studying the relative clause.
The reciprocal relationship between the text and the mask in the printed product is one of the most important relationships that frame the level of communication between the appearance and the interior, although it is not cared for by some designers and publishing institutions. Therefore, the problem of research is determined by the following question (What is the dialectical relationship between the text and the mask in the literary books covers design?). The research aims to shed light on this problematic relationship at the level of reception and aesthetics at the same moment. The theoretical framework included two sections: the first (mask and text ... the concept and the mutual relationship), while the second section (trends in the
... Show MoreBackground:- Cholesterol is high in ascetic fluid due
to malignancy and other causes of exudates.
Objective:-To use cholesterol as a marker to
differentiate between exudative and transudative
ascetic fluid and to compare that with other routine
parameters.
Methods:-Twenty eight patients were included in this
study 17 females with mean age of 41.9 years, 11
males with mean age of 48.2 years. The patients were
divided in group I suspected transudate, and group II
suspected exudate according to history and clinical
examination.
Ascetic fluid samples were sent for total protein,
albumin, and cholesterol measurement blood samples
were sent for serum protein and albumin measurement.
Results:-In this
In the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil
... Show MoreA case-control study was designed to find out the association between rs2234671 polymorphism of cxcr1 and rUTI in a sample of Iraqi women by polymerase chain reaction- sequence-specific primer (PCR-SSP) method. The current findings revealed that the genotype GC (OR= 7.86, 95% CI = 2.82-21.87, P= 7.7 × 10-5) and the C allele (OR= 3.93, 95% CI = 1.97 - 7.83, P = 9.8×10-5) are significantly associated with rUTI. However, the genotype GG played as a protective factor (OR= 0.12, 95% CI = 10.05 - 0.34, P = 4.0 ×10-5). Depending on these findings, the genotype GC is significantly associated with rUTI.
In this paper, customers’ expectations are continually shifting due to the business environment’s growing competition and substantial changes. As a result, organisations no longer viewed it as a static objective but as an ever-evolving aim. From this vantage point, the research has explored the accounting literature in search of novel approaches to addressing the strategic dimensions of quality, cost and time. Getting them to respond positively to the customer’s requests also requires recognising their needs and controlling their impact on these dimensions. With the removal of operations that do not contribute any value to the product’s value chain and a reduction in manufacturing costs through continuous improvement, the ou
... Show MoreThis study examines the syntactic and semantic functions of the conscience of the chapter and the grammatical disagreement in its diagnosis between two famous linguists: Sibuyh and fur. Also, the conscience of the chapter occupies an important synthetic space in the construction of the Arabic sentence, identified by the Arab scientists, as linguistic analysts, have a strong sense of language and careful observation, they revealed it in their linguistic composition through the analysis of nominal structures, and found that it I come in specific syntactic patterns and grammatical templates that have certain characteristics that are unique to them because of the conscience of separation in their compositional space.