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.
Background: The disc prolapse is a common condition especially in young adults. Different levels are affected in the lumber region; the L4/L5 disc is more susceptible to longitudinal load and is the most common site of lumbar disc prolapse. The L5/S1 disc is protected from torsion load by strong ilio-lumbar ligaments but it is more susceptible to axial compressive forces. Many factors affect the result and outcome of surgery in these levels.Objective: The aim of this study is to correlate operative data, short-term results, complications, and prognostic factors (age, gender, mobility, hospital stay, and level of pain) for one-level lumber discectomybetween different levels (L4–L5 vs. L5–S1).Methods In this prospective study, 32 patie
... Show MoreType 2 diabetes mellitus(T2DM) is a metabolic disease that is associated with an increased risk for atherosclerosis by 2-4 folds than in non- diabetics. In general population, low IGF-1 has been associated with higher prevalence of cardiovascular disease and mortality .This study aims to find out the relationship between IGF-1 level and other biochemical markers such as Homeostasis Model Assessment insulin resistance(HOMAIR) and Body Mass Index(BMI) in type 2 diabetic patients . This study includes (82) patients (40 females and 42 males) with age range (40-75) years,(34) non obese diabetic patients and (48) obese diabetic patients. The non obese individuals considered
... Show MoreVisceral leishmaniasis (VL) or kala-azar is one of the worlds most neglected tropical diseases in mortality and fourth in morbidity, rK39 dipstick was used to diagnose the suspected infected patients as cheapest simple technique which can differentiate recent from chronic infection, for disease out-coming, naïve T-lymphocyte cells should be differentiated into pathogen-specific immunity responses, such as T-helper 1(Th-1) or (Th-2). HLA-G is a special protein defined as nonclassical HLA class I molecule can suppress the immune system through prevention of T-cell function by foul all T-cell mechanisms. So, this study aimed to detect and evaluate the level of sHLA-G in the sera of patients infected with VL. The results showed that there was
... Show MoreObjectives: To assess the quality of life for adult patients with peptic ulcers in the city of Sulaimani.
Methodology: A descriptive study, using the assessment approach was conducted on patients with peptic ulcer
disease from January 12th, 2009 to September 30th, 2009. A purposive "non-probability" sample of (100) paƟents
(males and females) with peptic ulcers who attended Kurdistan Center for Gastroenterology and Hepatology were
selected for the study. A questionnaire was adapted from the World Health Organization quality of life questionnaire
(1998) for the purpose of the study. It is comprised of (3) parts that included sociodemographic characteristics form,
medical history form and adult peptic ulcers patients' qu
This study included 46 patients with liver hydatid cyst diagnosed clinically and surgically, control group consist of 22 were naïve from infection had been confirmed by specialist. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, were 33 and 13 respectively. Also it divided into primary and secondary hydatid cyst infection which were 30 and 16 respectively. The role of immunological response against hydatid cyst parasite, showed a significant increased in humoral immunoglobulins (IgG, IgA, IgM and IgE) which were significantly higher in the hydatid cyst infection than control. Also significant increased in immunoglobulins in secondary infection than primary infection, beside significa
... Show MoreEvolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl
... Show MoreAt present, the ability to promote national economy by adjusting to political, economic, and technological variables is one of the largest challenges faced by organization productivity. This challenge prompts changes in structure and line productivity, given that cash has not been invested. Thus, the management searches for investment opportunities that have achieved the optimum value of the annual increases in total output value of the production line workers in the laboratory. Therefore, the application of dynamic programming model is adopted in this study by addressing the division of investment expenditures to cope with market-dumping policy and to strive non-stop production at work.
In spite of increasing clinical cases which caused by enteroviruses transferred by water and no documents about entericviruses in the Iraqi water standards. The use of coliphages as an indicator of enteroviruses and fecal pollution were suggested two procedures were applied . The first is Two-Step Enrichment Method and the second is Single Agar Layer Method. Both methods gives good results in Identification of coliphages through testing fifty different water samples (Tap water, Surface water and Bottled water) the study shows the presence of coliphages in fourteen samples.
Objective: this search aims to test the correlation between job complexity and psychological detachment then stats how the burnout can affect in this relationship and dose the burnout can contribute in development of this relationship. Theoretical framework: the research adopted some questions like how can psychological detachment can make the employee keeping away from work and isolates himself from work environment and how can the job complexity enhance this behavior for employee ,and how can the burnout increase the correlation between job complexity and psychological detachment ?, then trying to extraction some of recommendations may contributes in enhancing practicing and adopting these three variables (job complexity, psych
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