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.
Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and pol
... Show MoreIs to obtain competitive advantage legitimate objective pursued by all organizations to achieve, because they live today in environments of rapid change and dynamic in order to meet the demands of the customer changing as well as intense competition between the organizations, which requires them to get the location of competitive markets in order to do this will remain to do the building and strengthening competitive advantage to be able to achieve, but that this feature is not easy and is not only through the identification and use of a successful strategy for a competitive standard and then manage it successfully. Hence the research problem of determining the sources of differentiation strategy and its impact on the dimensions of compe
... Show MoreBackground: planter fasciitis is a common condition
seen in adults and sport men, it is characterized by dull
pain in the heel, especially when getting up and
standing on the foot in the morning or after sitting for a
long time.
Recently low level laser therapy is used as a method of
treatment.
Objective: to evaluate the benefit of laser therapy in
treatment of planter fasciitis.
Methods: Out of twenty five patients with planter
fasciitis exposed to laser therapy. Laser used is (diode
type) given in two cessions per week for four weeks,
time for each cession is about (12 minutes).
Results: complete recovery seen in (32%) of patients,
moderate improvement in (16%), mild improvement in
(24%), no
The research includes a clinical study of Preptin with other parameters. The normal value of preptin in hypothyroidism (2638.4±280.0) in female while (2960.4±256.6) in male, in hyperthyroidism (589.0±90.1) in male, while in female (993.2±103.9), diabetes (2465.6±282.4) in female, in male (2085.5±282.8), in diabetes & hypothyroidism (3314.3±177.3) in male,(3179.4±265.7) in female, but control group in female (427.8±60.4), in male (384.7±62.4) at age (20-45) years they were divided into five groups: group one (G1) consisted of 30 hypothyroidism. The two group (G2) consisted of 30 patients with hyperthyroidism. And three group (G3) consisted of 30 healthy group, four group (G4) consisted of 30 patient with diabetes, and five group (G
... Show MoreBackground: Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation that is preventable but not curable. It is associated with persistent symptoms that cause a considerable burden on individual productivity at work, and daily activities, and reduced quality of life, also burdening the healthcare system and society. Objectives: The study aims to measure the burden of COPD on patients in terms of daily activities and work productivity. It also seeks to investigate some inflammatory biomarkers' levels and their correlation with selected outcomes. Patients and Methods: A cross-sectional study on 120 stable COPD patients who were diagnosed and treated according to the GOLD guidelines at Kirkuk General Hospital's
... Show MoreIn the midst of the public narrative film , we discussed the issue of dealing with the current narrative more specialized which its future dimension form shift and twist on the level of construction narrative film in some of its diverse and renewable trends in its two ways theoretical and practical and non-give important implications for the modes of operation of the renewable narrative structures and the fact that the cinema is an arts which always open to ideas in neighboring fields and this come naturally as a result of the continuing intellectual and knowledge sharing between cinema and other science . our current research has already begun to address the issue in a stream of consciousness narrative structure film based on all that t
... Show MoreThe relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,
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