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 research aims to determine the role of green human resource management dimensions of (employment Green, training and development, green, performance evaluation Green, compensation and green bonuses) in the performance leadership of the organization dimensions of (advance planning, efficiency, effectiveness, index pioneering, renovation and modernization), Search of paramount importance because it addresses an important and modern issue in performance leadership, namely green management of human resources, aware of the importance of the subject and expected results of the company under study, an analysis of the data obtained through field visits in
... Show MoreThis study Studied Ministry of Hamdy Al-Buchachy(the first)and explain the features of
this Ministry in a critical time in the history of Iraq. The second world war had began and its
end had reached .The political situation in Iraq is so complicated. The Ministry had made
many things. The Ministry had situated in internal and external complicated time. The
situation in Iraq was so difficult, therefore the recommendor (Abdul-Ilah)asked Hamdy Al-
Bachachy to make be the head of the new governments Al-Bachachy had made irrelevant
government, thus it didn’t last more than three months and the British governorate and of
direct in terference in Iraq who worked to reduce the Iraqi army and the Minister of Defence
refus
The tourism industry has undergone exponential transformation, reshaped by online travel agencies (OTAs), shifting consumer preferences, and technological advancements. Established OTAs like TripAdvisor and Travelocity face pressures to adapt their strategies to capitalize on these disruptive landscape changes. This research involves a comparative analysis examining the key challenges confronting TripAdvisor and Travelocity, with a focus on opportunities to leverage artificial intelligence (AI) in enhancing personalization and the traveler experience. The study utilizes publicly available data on the companies and academic literature on AI innovation diffusion. Findings reveal that while TripAdvisor has actively developed AI-based trip plan
... Show MoreThe Yemen Kings and gaverners allered notable services to the pilgrims, who
were in their way to perform the pilgrimage to Mecca. Among them Al-Hysen Ibn
Salama (dead 384, Aih). The governer of Al- Zeadiea state, who concern about
pilgrimage route from its beginning at Hudrumot to its end at Mecca Al Makruma, the
distant was estimated by 60th days to pass the way he also eastablished asystem of
water “artesian wells” as long as the pilgrimage way also setting up large Mosqeses
and Marking out the way of the caravans of pilgrimage to save these caravans from
lossing the right way, he setting up under ground water chanal started from Arafat to
holy Mecca in order to ensure water supplies for the erea. This proje
Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries
... Show MoreThis study aims mainly to identify the role of the use of blockchain technology in improving the quality of digital financial reports, answering questions and testing the hypothesis of the study, the researchers relied on the descriptive analytical approach, and to obtain the necessary data a questionnaire was distributed after evaluation to the study community.
The results of the study have shown that the use of blockchain technology helps to provide a high degree of reliability in digital financial reports published to banks over the Internet, ensure the speed of completion and completion, and maintain the privacy and confidentiality of the information contained in the digital financial reports of banks
... Show MoreThe Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
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