Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
The research aims to Applied Study in the nature of the impact of information asymmetry for brokerage firms in the common stock trading, The research included the theoretical concepts associated with each of the brokerage firms ,information asymmetry and common stock trading, It used the financial methods on the practical side of the information asymmetry for brokerage firms based in the sector as well as trading volume and spread for common stock , The community of the research included the Iraq Stock Exchange,the sample of research the companies listed which have been trading on its stock for the period August 2015 until December 2015 as well as brokerage firms
amounting to 47 brokerage firm. The resea
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Allah legislated marriage and made it dwelling, fellowship and mercy between
the two couples, Prophet Moh'd (peace of Allah and blessing be upon him) ordered a
husband to look after his wife, treat her with full charity and make love with here
every kindly. On the other hand, he ordered a wife to obey her husband and respect
him deeply, nevertheless, some obstacles may sometimes be appeared within the life
of their marriage, this may be caused by either a husband or a wife. This problem is
called lifely disobedience (AL-Noshooz).
In the other words, this means that a wife begins to hate her husband, refuse his orders
and not obey him.
In brief, they hate each other which leads to some marks appear in their
m
Three-dimensional nonlinear thermal numerical simulations are conducted for the friction stir welding (FSW) of AA 7020-T53. Three welding cases with tool (rotational and travel) speeds of 900rpm-40mm/min, 1400rpm-16mm/min and 1400rpm-40mm/in are analyzed. The objective is to study the variation of transient temperature in a friction stir welded plate of 5mm workpiece thickness. Based on the experimental records of transient temperature at several specific locations during the friction stir welding process for the AA 7020-T53, thermal numerical simulation is developed. The numerical results show that the temperature field in the FSW process is symmetrically distributed with respect to the welding line, increasing travel speed decreasing tran
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The reality of teaching the Arabic language rules is not satisfactory, as the pedagogical methods used do not help students develop their mental skills, especially critical thinking skills. They are often traditional in terms of teaching students, who are passive, passive, often passive, active, and often active, their listening task, and the teacher's task of narrating facts and judgments. It is a blind simulation student, a dependency on others, and a weak spirit of creativity, innovation, and opinion. The opinions of educators and teachers almost agree on the reasons for students' weakness in learning the rules of Arabic, and that the reason lies in the way of teaching. The difficulty or the ease of the rules of Arabic does not lie in th
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In cooling water systems, cooling towers play a critical role in removing heat from the water. Cooling water systems are commonly used in industry to dispose the waste heat. An upward spray cooling water systems was especially designed and investigated in this work. The effect of two nanofluids (Al2O3/ water, black carbon /water) on velocity and temperature distributions along reverse spray cooling tower at various concentrations (0.02, 0.08, 0.1, 0.15, and 0.2 wt.%) were investigated, beside the effect of the inlet water temperature (35 ,40, and 45 ͦ C) and water to air flow ratio (L/G) of 0.5, 0.75, and 1. The best thermal performance was found when the working solution contained 0.1 wt.% for each of Al2
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Background: Directly observed therapy-short course (DOTS) had been adopted by World Health Organization (WHO) as hopeful strategy for treatment of tuberculosis (TB) since early nineties. Iraqi health authorities started DOTS implementation since 2001 in Baghdad. Coverage expanded gradually till 100% in 2004. War and unstable security condition hit Iraq since March 2003. Objective: The objective of this study was To evaluate the DOTS implementation program in Baghdad in different periods including 2 unstable periods for proper assessment of war and instability on treatment of TB. Patients and methods: This study had been conducted in Baghdad during four different periods (before and during 2003 war, after war; without and with DOTS). Dire
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