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.
Hyperprolactinemia is a common endocrine abnormality caused by physiological factors like pregnancy and lactation, drug-induced factors like antipsychotics, pituitary adenomas that secrete prolactin, or stalk compression or section that reduces dopamine inhibition. Dopamine agonists cure most prolactinomas.
To assess response to treatment in micro versus macroprolactinoma.
The purpose of this research is to improve the organizational performance of the Oil Projects Company by adopting an approach to strategic change، and finding appropriate solutions to the problems facing the company. The researcher adopted in designing his research by conducting a survey of previous literature that dealt with approaches to strategic change، as the results of the survey showed that most researchers agree on the approach of renewal and modernization، Which formed a starting point for the researcher to identify the extent of the company's management interest in renewal and modernization to improve its level of performance، and the quality of the procedures followed on the ground that is related to
... Show MoreCovalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and leve
The problem with research lies in hiding the Hanbali approach in building long and short travel provisions, as well as hiding some provisions relating to short travel that are not provided for by the jurists of Hanbali (in their books).
The research aims to demonstrate the approach and standards on which they based the long and short travel provisions, as well as to reflect the provisions of some of the issues that are silent on long and short travel, with evidence and significance.
The research included a preface and two researches, the researcher in the preface talked about the reality of long and short travel, in the first research on the approach of ha
... Show MoreIn this research, a number of the western al-Anbar clays (red iron clays, Attapulgite) were modified by treating them thermally with a temperature of 650oC. After that, these clays reflux with sodium hydroxide 5% for 1 hour by using microwave as a power supply. The research included fractionation alqayaira crude oil the fractionation included removing the asphaltene by precipitation from the crude using a simple paraffin solvent (normal hexane) as a non-soluble substance. After that it was filtered using the ash-free filter paper 42, the dissolved part, maltinate, was taken, drying a temperature of 75oC and weight, and to find the percentage of the two parts. Malatine was divided into three main parts (paraf
... Show MoreThe Iraqi economy has suffered for a long period of inflation because of the Iraq war and the resolutions and the sanctions that were imposed on Iraq, this phenomenon overshadowed at various aspects of the economy including the tax revenue that the State seeks to optimize the total income for the budget, the research covers the years 1990-2010, these years have been divided according to the country's economic variables.
The research adopted on econometrics analysis that is based on the information and data available on topics and has been using statistical methods to test functions are formulated.
Research concluded that rates of inflation and GDP impact is limited to direct taxation and indirect in current prices a
... Show MoreLinguistic research according to modern curricula:
It is one of the important matters that occupy the ideas of those concerned with linguistic studies, whether Arabic or otherwise. Recent years have witnessed the advancement of this methodological approach, and books and studies in Arabic have been written on important, multifaceted issues, of grammatical and linguistic origins, and their balance with new developments and ideas attracted mostly from Western studies.
The comparative approach - as they call it - is one of the modern approaches that is based on balancing a language with other sisters belonging to its family, to reach similarities and differences between them, and to know the c
Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
... Show MoreThe residual limb within the prosthesis, is often subjected to tensile or fatigue stress with varying temperatures. The fatigue stress and temperatures difference which faced by amputee during his daily activities will produces an environmental media for growth of fungi and bacteria in addition to the damage that occurs in the prosthesis which minimizingthe life of the prosthetic limb and causing disconfirm feeling for the amputee.
In this paper, a mechanical and thermal properties of composite materials prosthetic socket made of different lamination for perlon/fiber glass/perlon, are calculated by using tesile test device under varying temperatures ( from 20oC to 60oC), also in this paper a device for measuring rotational bendin
... Show MoreBackground: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) are bidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of α amylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of both diseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patients with poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlate between biochemical, physical and clinical periodontal parameters of each study and control groups. Materials and Methods: 80 males, with an age range of (35-50) years were divide
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