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
Approaching the turning of the millennium, the American theatre witnessed an arousing
interest much shown in patients suffering of severe diseases as a subject matter to drama. In a
discussion of Margaret Edson's Wit, the light is shed on how far such patients, who were literally
involved in secular visions during their life-time, become apt to create a different one on their
death beds. The vision newly blossomed becomes much rooted in the spiritual life; it is a
redemptive vision that can amend what those patients' hearts and minds have long ignored.
Further, the human touch that has been ignored during man's healthy secular life is ultimately
needed for the time being. It helps to enhance man's vision towards the
Abstract The study aimed at reviewing translation theories proposed to address problems in translation studies. To the end, translation theories and their applications were reviewed in different studies with a focus on issues such as critical discourse analysis, cultural specific items and collocation translation.
Increased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th
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Abstract
Islam has been concerned with preserving and maintaining rights, so the provisions in which it is preserved are legislated. Among that is the testimony that made it a way to prove the truth and obliges its bearer to fulfill right in order to preserve the right and establish justice and prevent injustices by defying conflict, and tyranny .
And while acknowledging that divine absolute wisdom that is the cause and origin of legal rulings is sufficient, it is obligatory to abide by its provisions and imposes obedience, surrender, contentment and work in accordance with its controls.
However, the realization of the defects behind the legislation in a comprehensive way that realizes the dev
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Abstract
The aim of the research is to clarify the requirements of the qualification of the external auditor in Iraq and the extent of their impact on the quality of the professional performance of the audit process. The research was based on analyzing the results of the questionnaire prepared for the impact of qualifications on the quality of professional performance. The researcher has reached a number of conclusions, the most important of which is that a highly qualified and unethical auditor has a greater negative impact on the quality of professional performance than those with low qualifications. The most important recommendations of the research were the need to pay
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The research addressed an analytical field investigation of the locality of meander, the factors responsible of the locality of the meander at certain points of the stream other than others, and the role sequence of these factors in the formation process.
The research revealed that the location of forming the meander was associated closely with the scale structural composition of the bank materials from which the first stage of forming the curved stream, for the inhomogeneous or non-identical opposite banks in their scale structural composition saw an activity of differential corrosion, while the homogeneous and identical opposite banks in their scale structural composition saw an identical corrosion activity in its intensity at both
The Logic of Freezers and Animals in the Holy Quran
The research reviews how the national economy contributes to building community confidence and strengthening national identity, explaining that sustainable economic development leads to improving the standard of living and creating job opportunities, which enhances citizens ' sense of stability and belonging. The research indicates that state investments in infrastructure and public services contribute to strengthening trust between individuals and state institutions. The research discusses the interactive relationship between economic stability and national identity, and how economic policies can strengthen this relationship, drawing on local and international examples to support development strategies . In Iraq, attempts to develop agricu
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