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.
The objective of the investigation was to analyze the structure and administration of the political system in Iraq (post-ISIS). After 2003, the Iraqi political system suffered the fundamental problem of its failure to achieve the political and social inclusion that characterizes democratic systems, to guarantee the establishment of a "state for all", while respecting differences. Political representation has moved from the system of sectarian ethnic components, under the title of consensual democracy, to the representation of leaders and the realization of their interests and the interests of their parties at the expense of the groups that claim to represent them, which complicates the problem. In this sense, the new political syste
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The study aims to find out the impact of expectations and perceptions in determining the position of the customer service quality received by him. Represent the expectations and perceptions customer’s key of service quality determinants. The customer's requirements and needs main pivot, who must be built all events and activities and efforts of service organizations, including the hotel and organizations that operate in an environment known as highly competitive , intensification and complexity of the conditions set by the customer and increasing day after day. The study sample of three Luxury hotels in Kurdistan region of Iraq a model. The use of service quality m
... Show MoreBackground: The antimicrobial resistance is one of the most serious and expanding health problems world -wide in the last decades. The esbl escherichia coli. (extended – spectrum beta-lactamase e.coli) represents an important aspect of it .Objectives: To get an overview on the esbl e.coli prevalence profile in general. Also to assess the antibiotic sensitivity of esbl e. coli trying to specify the most effective antibiotics in combating this micro-organism.Methods: this study tries to focus on this problem in Iraq which through a prospective study approach by taking 35 clinical samples from various sources (urine, blood, abscess, eye ,vagina ,stool and others),and after confirming the presence of e.coli, the presence of esbl e.coli and
... Show MoreThe research is dedicated to study technical and dramatic recruitment of the clown character in Child's Theater Shows This research consist of four chapters ; first chapter is dealing with the problem of the research which defined by the following question :" Does the educational and dramatic recruitment of the clown character achieved in Child's Theater Shows?"The research is summarized in sets of points such as :•Make use of this research for the benefit of employees in the child's theater , especially directors, actors, technicians, workers and dress designers .•To benefit concerned educational institutions in the field of child's theater ; such as : child's culture house , theater & cinema office which are belonging to the ed
... Show MoreColor is one of the most important elements involved and contributing mainly to designs and visual works, whether they are fixed or mobile, for internal spaces through what color gives it the possibilities on the physical and intellectual level, if the process is linked to the functional performance or the aesthetic value, which is thus included within the system of processors and basic works in Designing the interior spaces and highlighting the functional and aesthetic aspects of them through the executed designs that are linked to certain techniques and mechanisms. Therefore, they are processed according to the references and pressure structures or the creation and modern dealing with materials and designs to implement operations in hi
... Show MoreThis research deals with shedding light on the issue of the poor understanding of students of Islamic sciences colleges for the subject of modern sciences; their causes and treatment, and it started with an introduction and an introductory research; The general weakness of the level of students of colleges of Islamic sciences in this article, and I detailed these reasons that relate to: the curriculum, the teaching staff, and students, and then concluded it with proposals and recommendations that would address this weakness.
This study was designed to investigate the effect of aqueous extract of ginger Zingiber officinale Roscoe on the histology of corpus luteum and the concentration of the hormones progesterone and estrogen during the first trimester of pregnancy (0 - 7) days from fertilization. 30 pregnant mice were divided into five experimental groups: control group (administrated with distilled water), and four groups treated at doses (284, 568, 1136,1420 mg / kg), orally administrated , daily with (0.1 ml). Microscopic examination results have shown histopathological changes in corpus luteum included: Pyknosis in some nuclei of granulosa cells, Karyorrhexis, Karyolysis in some granulosa cells, and necrosis in corpus luteum, with additional significant dec
... Show MoreThe current research examines the employment of indicators of stereotypes and the dimensions of organizational clarification to achieve planned organizational behaviour on a sample of employees in a number of departments of the Faculties of Engineering, University of Kufa, for a sample of (122) teaching staff. This research proposes the use of positive indicators of stereotypes for both the organization and employees and their awareness of what they want to obtain and what should be done for both parties and the removal of organizational clarity represented by the functional dimension that explores to what degree the employee's understanding of the internal strategy of the organization and the strategic dimension that searches fo
... Show MoreThe research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MorePraise be to Allah , and peace and blessings of God sent mercy to the worlds Muhammad
Amin and his family and his friends and followers to the Day of Judgement .
Savants Jews worked to distort the Torah calamity on the Prophet Moses ( peace be upon
him ) to achieve their goals and objectives , which are decorating sin to their followers , and
spreading corruption on earth, through the charge prophets Bmvassad , morality, as the
example and the example that emulate the human in the book of the Lord of the worlds and
their Prophet Lot, described the weak, and cheese, and lack of modesty, and disobedience ,
drinking alcohol , and his failure to raise his two daughters , Jews are corrupt in the ground .
Koran , which