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 reform process is a dynamic process going on, especially the administrative and financial reform, which contributes to the work and directing operations towards success and continuous development, which requires determining the validity and the responsibility and the rights and duties of all officials in the school settings (within the formations educational institutions) for the purpose of reducing the administrative and financial corruption, and then ensure management efficient and effective way by taking advantage of the physical, financial and human resources available to achieve the greatest benefit at the lowest cost to the fact that the follow-up performance on an ongoing basis in accordance with the specific of powers
... Show MoreMultimedia is one of the most important elements of modern educational media and must be used in educational websites in order to disseminate knowledge on a large scale and should be used to provide scientific information to all, as the current research tried to explore the possibilities of employing them in the design of educational websites and highlight their role in promoting the scientific aspects of the user. This study included four axes, the first of which was devoted to the introduction which includes the problem of research, its importance, objectives and its objective, temporal and spatial limitations, which were limited to the study of the main pages of Arabic educational websites published in 2019. The second axis contained th
... Show MoreThis study aimed to prepare a program (physical-nutritional) for women with polycystic ovary, as well as to identify the effect of this program on some body measurements and the incidence of polycystic ovarian syndrome in the research sample. A total of 12 women (aged 20-25 years) with Polycystic Ovary Syndrome (PCOS) participated in the randomized controlled trial design. They were divided equally into two groups (experimental and control group). The experimental group received the physical-nutritional program accompanying the treatment program, while the control group received only the instructions of the specialist doctor and the treatment program prepared by them. The two researchers applied their nutritional progr
... Show MoreA field experiment was conducted during the autumn of 2021 at the Agricultural Research Department station / Abu Ghraib to evaluate the soil moisture, water potential distribution, and growth factors of maize crops under alternating and constant partial drip irrigation methods. In the experiment, two irrigation systems were used, surface drip irrigation (DI) and subsurface irrigation (SD); under each irrigation system, five irrigation methods were: conventional irrigation (CI), and 75 and 50% of the amount of water of CI of each of the alternating partial irrigation APRI75 and APRI50 and the constant partial irrigation FPRI75 and FPRI50 respectively. The results showed that the water depth for conventional irrigation (C1) was 658.3
... Show MoreThe first section of this research discussed the manner of the research from many sides like the problem it faces, importance of it , its targets ,boundaries, the way to collect and get information's and its assumption.
When the second chapter discussed the press – manufacturing and the development ,importance and types of newspapers, also its merits and weaknesses.
The third chapter talked about the scientific side and how to choose an assumption for the research . as it talked also about the apparent honest and stability tests that help in analyzing the research until getting results and so the right assumption for the research will be chosen.
And finally, the fourth chapter put highlight on the be
... Show MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
ABSTRACT
The research aims to know the reality of a two examined variables at the organization studied identifying the relationship between managerial processes reengineering and organizational citizenship behavior. The research applied on the Electronic Manufacturing Company encompassing a sample of managers and employees consisted of (100) individuals. A questionnaire is the main instrument for data gathering, which has been included (45) questions as well as personal interviews to support the questionnaire's questions and to achieve greater realism for collecting information.
Answers were analyzed to reach the final results through the use of a number of statistical methods via
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