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.
Background. Colorectal cancer, ranking second place in global cancer mortality, arises from diverse causes. There is growing recognition of the substantial involvement of the epigenetic modifications of histones at the DNA level in the occurrence of CRC. Aim. To assess the expression of p53, HDAC1, and HDAC3 proteins in a cohort of CRC patients and to analyze potential relationship between their expression and the stages of CRC progression. Materials and Methods. The retrospective investigation was carried out on 95 paraffin-embedded CRC tissue samples. The expression of p53, HDAC1, and HDAC3 was assessed immunohistochemically. Results. Notably, the expression of the p53 protein in CRC tissue samples exhibited a prominent correlatio
... Show MoreThe logistic regression model is one of the oldest and most common of the regression models, and it is known as one of the statistical methods used to describe and estimate the relationship between a dependent random variable and explanatory random variables. Several methods are used to estimate this model, including the bootstrap method, which is one of the estimation methods that depend on the principle of sampling with return, and is represented by a sample reshaping that includes (n) of the elements drawn by randomly returning from (N) from the original data, It is a computational method used to determine the measure of accuracy to estimate the statistics, and for this reason, this method was used to find more accurate estimates. The ma
... Show MoreWe have provided in this research model multi assignment with fuzzy function goal has been to build programming model is correct Integer Programming fogging after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.
The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the
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The subject of this research is the study of the formal alienation of contemporary English sculpture, by comparing the most important sculptors of the new contemporary generation. This research problem is to look for the important factors in the formation of the contemporary sculptural structure of the exotic, and what is the mechanism of formation and output of these forms. The research seeks to explore (Alienation in contemporary sculpture between the works of Anthony Caro and Tony Cragg) in a comparative study. The importance of the research is to identify the concept of alien forms in contemporary British sculpture, especially in the cases of Anthony Caro and Tony Cragg that this research is considered a know
The issue of peaceful coexistence between societies is the topic of the hour, as it is one of the important issues in this era, especially in days when conflicts and conflicts abound, and even wars in the name of religion, gender, race, language, and the like. The world, so that single-mindedness and adherence to one opinion and intolerance to it became the method of dialogue in our world today, as writing in the field of peaceful coexistence, peace-building, tolerance, pluralism, and acceptance of the other is one of the new fields of knowledge in Iraq in general and in Nineveh Governorate in particular, as peaceful coexistence is one of the basic needs And necessary for the presence of individuals in societies, and it requires the achi
... Show MoreThe mutagenic effect of some crucifers widely consumed Lepiduim sativum (Garden cress) and Arugula (Eruca sativa) was studied in comparison to carrot (Daucus carota), using bacterial mutagenic system composed of three bacterial isolates; (Bacillus spp)G3 (Arthrobacter spp)G12, and (Brevibacterium spp)G27 ,. Treatment of isolates with plant extracts led to reduction in survival fraction (Sx)at different levels except that Aurgula extract did not show any inhibitory effect in isolates G12 and G27. Crucifers extracts induced streptomycin resistant mutants in G12 at higher level than G3 , but not in G27. No resistance to rifimpacin was detected in all isolates.
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This study is concerned with the estimation of constant and time-varying parameters in non-linear ordinary differential equations, which do not have analytical solutions. The estimation is done in a multi-stage method where constant and time-varying parameters are estimated in a straight sequential way from several stages. In the first stage, the model of the differential equations is converted to a regression model that includes the state variables with their derivatives and then the estimation of the state variables and their derivatives in a penalized splines method and compensating the estimations in the regression model. In the second stage, the pseudo- least squares method was used to es
... Show MoreReliability analysis methods are used to evaluate the safety of reinforced concrete structures by evaluating the limit state function 𝑔(𝑋𝑖). For implicit limit state function and nonlinear analysis , an advanced reliability analysis methods are needed. Monte Carlo simulation (MCS) can be used in this case however, as the number of input variables increases, the time required for MCS also increases, making it a time consuming method especially for complex problems with implicit performance functions. In such cases, MCS-based FORM (First Order Reliability Method) and Artificial Neural Network-based FORM (ANN FORM) have been proposed as alternatives. However, it is important to note that both MCS-FORM and ANN-FORM can also be time-con
... Show MoreTo get access into the orbital floor 3 paths are commonly used which are transconjunctival, subciliary and subtarsal approaches. Each one of these approaches has its advantages and disadvantages. The study assessed the outcomes of the transconjunctival retroseptal approach, which reflects our experience in this type of surgery. Along 8 years, 26 patients received in the emergency room diagnosed with pure isolated orbital floor fractures, all of them admitted to the maxillofacial surgery department and approached by transconjunctival incision without lateral canthotomy. Three types of complications occurred: laceration of the lower eyelid, injury to the lacrimal system and entropion. All of these complications were managed accordingly with n
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