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.
Pollution of the aquatic environment and the depletion of the natural resource cause imbalance in the natural balance of the river environment and contributes to the deterioration of life and the killing of living organisms. Most of the old and modern cities and urban centers were set up close to the rivers because water enters the main lifeblood and all its facilities. The proximity of cities to rivers caused environmental problems resulting from the dumping of residues of these cities to a large and continuous, these wastes include all uses of the city (industrial, agricultural, residential and commercial) and others. The accumulation of these wastes inside the rivers water kills life and makes them unsuitable for various uses to bury
... Show MoreSovereign wealth funds have attracted the attention of the governments of the oil and non-oil countries alike, with a variation of the size of those funds to those states, based on the size of the financial surpluses resulting from Alriadat oil or foreign reserves, or state revenues for other sovereign assets. Raj use these funds remarkably during the financial crises the world has seen, including the crisis of 2008-2007., And Iraq is a oil-producing countries, which has the third largest reserves of crude oil (Crude Oil) at the level of the Arab world and of 140 300)) million barrels after Saudi Saudi Arabia and the Islamic Republic of Iran, and the fourth reserves of crude oil in the world after issued Venezuela to the reserve
... Show MoreMethods of teaching plays an important vole in the educational process
because is the link between the teacher and the learner. The process of
teaching doesut fulfill the desirable results unless the methods of guiding and
teaching are provided and through a qualified educationalist capable of
communicating the syllabus to the students in an easy and clear way. In spite
of the diversity of the methods of teaching ,there is no one way suitable for all
the educational purposes , all the sciences ,all the subjects ,all the levels of
growth ,levels of teaching, maturity and intelligences ,all teachers and
educationalists and all the circum stances surrounding the teaching processes
.The teacher is the one who choos
Is the subject of the mind took a dimension in philosophy and psychology , and has cared psychologists this topic to a large extent , I started education institutions interest in the capabilities of intelligence since the early twentieth century , and the development of interest in them until he arrived to find Standards and Criteria to identify the degree IQ of any individual , and began to educational institutions interested in mental talent and talented .
The United States is the country chock first of these research projects , but they devoted all their attention on the wish talent mental and Gifted , until I got to the projects, the so-called time ( ( wars of the mind ) ) and projects Schools gifted
... Show MoreThe solar eclipse occurs at short time before the crescent birth moment when the moon near any one of moon orbit nodes It is important to determine the synchronic month which is used to find Higree date. The 'rules' of eclipses are:
Y= ± 0.997 of Earth radius , the solar eclipse is central and 0.997 < |Y| < 1.026 the umbra cone touch the surface of the Earth, where Y is the least distance from the axis of the moon's shadow to the center of the Earth in units of the equatorial radius of the Earth.
A new model have been designed, depend on the horizontal coordinates of the sun, moon, the distances Earth-Moon (rm), Earth-sun (rs) and |Y| to determine the date and times of total solar eclipse and the geogra
... Show MoreABSTRACT : Alzheimer’s disease (AD) is one of the most common inflammatory neurodegenerative diseases linked with dementia, it is characterized by the deposition of amyloid beta-peptide (Ab) in the brain. The present study aims to innovate a biochemical relationship between AD and interleukin 38 (IL-38) as an anti-inflammatory cytokine, expose novel mechanisms and concepts regarding other biochemical parameters studied previously or recently in AD patients and also examine the biochemical action of memantine (10 mg daily) on AD patients. Sixty (60) diagnosed AD patients participated in the present study and classified into four (4) groups: G3 were composed of (15) newly diagnosed males (52-78) years / without treatment, G4 composed of (15
... Show MoreBACKGROUND: Helicobacter pylori is an important gastrointestinal infective bacteria with many serious complications including gastric erosions and ulceration, duodenal ulcer, gastric carcinoma and MALT gastric lymphoma. The gastric biopsy is commonly performed in H. pylori-positive dyspeptic individuals, and many previous researchers studied the histopathological features of infected gastric biopsies however little previous studies focused on the histopathological findings in young population in comparison to the older one. AIM: To make a focus on the histopathological effects of H. pylori infection in young patients compared with the older one and predicts the need for endoscopy in this population, also to estimates the prevalence of
... Show MoreAbstract Background Hemoglobin A1c (HbA1c) is a widely used test for glycemic control. It is done for chronic kidney disease (CKD) patients. Renal disease is accompanied by thyroid abnormalities, which affect HbA1c, especially in those taking erythropoiesis-stimulating agents (ESAs). We aimed to find the effect of thyroid dysfunction on HbA1c in hemodialysis patients taking ESAs and those who do not. Materials and Method Fifty six patients were included in this study, which was done between September 2017 and June 2018, in Baghdad Teaching Hospital. Thyroid stimulating hormone, free T3, free T4 and HbA1c measurements were done. The patients were divided into 2 groups; those who took ESAs and those who did not, then they were subdivided into
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