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 exchange rate is of great importance at the global and local levels alike, as this importance increases with the increasing rates of development of economic relations between countries of the world due to openness and integration into the global economy, expressed by the expansion of the volume of trade and financial relations between countries. The Central Bank of Iraq has set the need to stabilize this price as a goal to reduce inflation rates and reduce them to the internationally accepted rates by using the foreign currency sale window to achieve a balance between the forces of supply and demand for foreign currency and to preserve the value of the Iraqi dinar. The research concluded that the central bank was It has a maj
... Show MoreThis research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
... Show MoreThe importance of physical and nonphysical architectural design values made architectural designers need good experience to be experts of architectural values reasonably without neglecting any value in the design process. The importance of such values made that ignoring any values and mistakes occurs in the design process. Simultaneously, architectural designers' different nature and the difference in their experiences are causing different understandings of the design values, thus causing architectural mistakes. The research problem appears from the randomly propagating of mistakes in contemporary architecture, which is about to become a phenomenon in Al Sulaymaniyah city. The research aims to find the main reason
... Show MoreA new benzylidene derivative, namely N-benzylidene-5-phenyl-1,3,4-thiadiazol-2-amine (BPTA), has been synthesized and instrumentally confirmed with Elemental Analysis (CHN), Nuclear Magnetic Resonance (NMR), and Fourier Transform Infrared Spectroscopy (FT-IR). Titanium Dioxide (TiO2) nanoparticles (NPs) were synthesized and characterized by X-ray. The mutualistic complementary dependence of BPTA with TiO2 nanoparticles as anti-corrosive inhibitor on mild steel (MS) in 1.0 M hydrochloric acid has been tested at various concentrations and various temperatures. The methodological work was achieved by gravimetric measurement methods complemented with surface analysis. The synthesized inhibitor concentrations were 0.1 mM to 0.5 mM and the temper
... Show MoreThe study was conducted out at the Ministry of Agriculture's Poultry Research Station/Animal ResourcesDepartment/Agricultural Research Center. To see how body weight (BW) and leptin hormone (LEP) levels inbreeder blood affect fertility and hatchability. 140 Iraqi local laying chickens (120 females + 20 males) aged 28weeks were used in the study. Following the numbering of The experiment was divided into three periods,each lasting 28 days, during which the breeder's live body weight was recorded and divided into two categories(greater than 1.5 kg and less than 1.5 kg), and blood samples were collected at the end of each period todetermine the concentration of leptin hormone in the breeders' blood. For comparison between mothers'performance,
... Show MoreThe study aims to investigate the effect of the Six Thinking Hats Strategy on the achievement of essay writing skills among third-year students in Arabic Language and Literature who are Persian speakers enrolled in the course of Essay Writing (III) at Shiraz University for the academic year 2019-2020. The sample of the study consisted of (15) male and female students who were taught according to the pre-posttest, using the quasi-experimental approach. After applying the statistical analysis on the scores of the post-test, the results showed that there are statistically significant differences in the average of students' achievement in the skills of essay writing in terms of using the Six Thinking Hats Strategy. The results also proved th
... Show MoreST segment, T wave changes, QT interval changes, and QTc dispersion are among the parameters used to diagnose ischemic heart disease. The increase in the QT dispersion can be caused by myocardial ischemia, among other heart diseases, whereas cardiac diseases such as coronary artery disease (CAD) can be diagnosed by observing an abnormally high QTc dispersion. This study aimed to evaluate the variations in the QTc dispersion (depolarization and repolarization) of surface electrocardiography as a result of percutaneous coronary intervention (PCI) in patients with chronic total occlusion. This study took place in the Iraqi Center for Heart Disease from October 2020 to February 2021. 110 patients who suffered from chronic occlusion of t
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