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.
August Wilson’s major concern is to communicate the African American cultural awareness; to establish a counter-culture based on self-confidence and assertiveness. He advocates an encouraging attitude to elevate the African Americans’ spiritual consciousness and to teach them how to sublimate their aims in life. He aspires to win the everlasting battle against racial discrimination, oppression, injustice, and identity confusion. Sublimation, as a defense mechanism, will be Wilson’s new ammunition to re-read and to re-interpret the psychic constitution of his people, to help them get out of their self-imposed fences and this is the core of Wilson’s new culture. Sublimation is the process in which the psyche directs the negative drive
... Show MoreSecurity reflects a permanent and complex movement that complies with international and societal needs and developments in all its dimensions, interactions and levels. To constitute a universal demand for all States, communities and individuals. The question of security is one of the most important motivations and motivations that govern the behavior, and even the objectives of those societies and States. These groups or individuals have always sought to avoid fear and harm, and to provide stability, safety and security. In the light of this, security studies have been among the important fields of study in the field of international and strategic relations. The field witnessed many theoretical efforts, from the traditional perspective,
... Show MoreThe main aim of conducting this research is to identify the applications of Smart libraries in the Arab world. The Researcher relied on the documentary and Survey approach to collect information and data through the Internet, and to get to know these libraries. Then the Research came in three sections dealing with the first topic: The general framework of the study. The second topic deals with: introducing Smart libraries and indicating their types and characteristics. The Third topic dealt with the requirements of Smart libraries'application by identifying the basic components of it (Smart building, Smart Librarian , Smart devices, systems and software, Smart information sources,and Smart beneficiaries), and dealt with Smart libraries appl
... Show MoreIn the last period there have been rapid developments and increased interest in the integration of the environment into urban planning. It has occupied a large part of the world’s most economically and economically important concerns, emphasizing the need to adopt the concepts of green urban construction as a basis for future cities. Both human and nature to continue and stay. Hence, the importance of research in building a base on the planning and design principles of the eco-friendly city for the purpose of local adoption”, thus facing the problem of” lack of application of knowledge on the basis of planning and design eco-friendly city. The hypothesis that “the development
Contrary to deconstruction and its destructive pursuit, the concept of undermining the familiar seeks to refute the constants and its known limitations. It is done through the process of receiving and what is imposed by the formation of the word or text or the structural and design structure in general, along with the Arabic calligraphy in particular. This is based on the recipient's understanding and interpretation of the dual phenomenon and the content's manifestation. More accurately, the disclosure of its reality through its expressive phenomenology; for that sake, the research was devoted to studying “undermining the familiar and embodiment content in Arabic calligraphy” including four chapters. The first chapter comprised
... Show Moreيشكل السياق جانبا مهماً في فهم الخطاب والمقصود هنا العرض المسرحي، من خلال ما يمده السياق للمتلقي من مؤشرات، يتم الاعتماد عليها في استكمال المعنى الظاهر بالمعنى المستتر، فالسياق يعتمد في الاصل على المحيط المادي الاجتماعي الذي يتم فيه التواصل وفيه يتعرف المرسل والمتلقي أحدهما على الآخر وتتبلور الصورة التي يحملها الطرفان أحدهما عن الآخر، الى جانب كونه يمثل الاحداث التي سبق لهما أن عاشاها والتبادل القولي
... Show MoreOur life is a test and the eternal life in the afterlife. So we must work well in our life even win paradise, must always remember the death and there is a life after this death and we will be responsible for everything we've done in our life. God did not create us vain but for reward, punishment, for this we must have to well prepare for this great day and we have to think about what to do in order to win the paradise.
Keywords: paradise, surat al-rahman, preparation.
Corruption is one of the barriers to economic growth and investment opportunities, and after the most serious security and stability, that corruption plagued the Iraqi economy is striking and has roots since the eighties of the last century to the present day.
The study aimed to identify practical impact of corruption on investment in the Iraqi economy and revealed the possibilities and obstacles to investment in Iraq and clarify the investment opportunities at the level of Iraq and the impact of corruption on investments.
The focus will be on the statement of the extent of corruption and investment in Iraq and the adoption of the style of economic measurement using cross-section
... Show MoreDigital literacy is crucial in the modern workforce, where technology plays an integral role in daily operations. This abstract explores the significance of digital literacy in enhancing productivity, efficiency, and competitiveness in the workplace. Digital literacy encompasses the ability to use and navigate digital tools and platforms effectively, including software, applications, and online communication tools. In today's digital age, employers increasingly value candidates with strong digital skills, as they are better equipped to adapt to rapidly evolving technologies. This abstract highlights the importance of digital literacy in empowering employees to perform tasks more efficiently, collaborate seamlessly, and innovate effecti
... Show MoreThe Colour is one of important aspect of human activity, especially in General arts and press, and also is one of the essential elements to achieve and build the idea of design technology in the appropriate places, according to the space of designs work.
In a view of the colour and its relationship with the Semiotics, we can find that the objectives goals at the point of visual formats that’s «oral or written”. In last years, the intellectual concerns of Semiotics through eye contact methods, that’s meaning contact methods for get messages of sense of sight.
The semiotics term Can be defined into: (the sequential feature or network system has relations according agreed language rules, in a particular environment, also is a g