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.
Employee Stealing or internal theft is considered from the passive practices that can’t be denied or be hidden, In spite of the hospital privacy as a serving organization that works 24\7 and deleing with human lives, they weren’t infallible from that kind of practice. To prevent or reduce this practice, it was important to search for the organizational and behavioral factors influencing internal thefts. The study problem briefly is to reach the most organizational and behavioral factors influencing internal theft, in governmental hospitals in Baghdad Rusafa Health district, this was done by analyzing (20) administrative cases of thefts occurred in the District, also a sample of (60) specialist Doctor’s opinion work, in (3) hospital
... Show MoreThe liver of marsh harrier grossly appeared as large, bi-lobed organ divided into left and right lobes, which are approximately equal in size and not divided into secondary lobes. Histologically, the liver of marsh harrier was found to contain numerous lobules which are not well defined by the connective tissue of the septa except that surrounded the portal triads. The parenchyma of liver composed of irregular branching cords of hepatocytes organized in double rows alternating with tortures path sinusoids which are lined with flattened endothelial cells and large, irregular outlined kupffer cells. Hepatic cords arranged in a radial pattern around the central vein of the liver lobule while in a subscapsular region they run parallel to the ca
... Show MoreThis paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c
... Show MoreThe love of the world and its lusts are the head of sins and the corruptors of religion, and the one who loves and loves them who prefers them over the hereafter is one of the most pitiful of creation, and the least intelligent of them, as he prefers imagination over reality, sleep over wakefulness, fleeting shadow over eternal bliss and the mortal abode over the eternal abode, and he sold the life of eternity for the most luxurious life. In life, it is dreams and sleep or as a fleeting shadow, and as it was said: The intelligent person is not deceived.
The reason for choosing this topic is due to two things:
The first: When I contemplated the reasons for the differences and conflicts that afflicted our wounded and occupied country
The integration of AI technologies is revolutionizing various aspects of the apparel and textile industry, from design and manufacturing to customer experience and sustainability. Through the use of artificial intelligence algorithms, workers in the apparel and textile industry can take advantage of a wealth of opportunities for innovation, efficiency and creativity.
The research aims to display the enormous potential of artificial intelligence in the clothing and textile industry through published articles related to the title of the research using the Google Scholar search engine. The research contributes to the development of the cultural thought of researchers, designers, merchants and the consumer with the importance of integ
Approaching the turning of the millennium, the American theatre witnessed an arousing
interest much shown in patients suffering of severe diseases as a subject matter to drama. In a
discussion of Margaret Edson's Wit, the light is shed on how far such patients, who were literally
involved in secular visions during their life-time, become apt to create a different one on their
death beds. The vision newly blossomed becomes much rooted in the spiritual life; it is a
redemptive vision that can amend what those patients' hearts and minds have long ignored.
Further, the human touch that has been ignored during man's healthy secular life is ultimately
needed for the time being. It helps to enhance man's vision towards the
The research addressed an analytical field investigation of the locality of meander, the factors responsible of the locality of the meander at certain points of the stream other than others, and the role sequence of these factors in the formation process.
The research revealed that the location of forming the meander was associated closely with the scale structural composition of the bank materials from which the first stage of forming the curved stream, for the inhomogeneous or non-identical opposite banks in their scale structural composition saw an activity of differential corrosion, while the homogeneous and identical opposite banks in their scale structural composition saw an identical corrosion activity in its intensity at both
Increased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th
... Show MoreThe products of the surrealist school since its inception to this day have greatly influenced art in the world, so we find many artists around the world invested in their visual texts the forms generated by surrealism, and here the researcher raises several questions: What are the formal vocabulary that directly or indirectly refers to Self-used by the surrealist painter? Was the surrealist form understood as intended by the movement? In these questions, the research problem is summarized. The importance of it lies in identifying the references to the form of the human self, which are related to the psychological field in the works of the surrealists, especially Salvador Dali. Then the researcher chose his research community from the wor
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