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
This study presents experimental and numerical investigations on seven one-way, reinforced concrete (RC) slabs with a new technique of slab weight reduction using polystyrene-embedded arched blocks (PEABs). All slabs had the same dimensions, steel reinforcement, and concrete compressive strength. One of these slabs was a solid slab, which was taken as a control slab, while the other six slabs were cast with PEABs. The main variables were the ratio of the length of the PEABs to the length of the slab (lp/L) and the ratio of the height of the PEABs to the total slab depth (hP/H). The minimum decrease in the ultimate load capacity was about 6% with a minimum reduction in the slab weight of 15%. In contrast, the maximum decrease in the
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Phase change materials (PCMs) such as paraffin wax can be used to store or release large amount of energy at certain temperature at which their solid-liquid phase changes occurs. Paraffin wax that used in latent heat thermal energy storage (LHTES) has low thermal conductivity. In this study, the thermal conductivity of paraffin wax has been enhanced by adding different mass concentration (1wt.%, 3wt.%, 5wt.%) of (TiO2) nano-particles with about (10nm) diameter. It is found that the phase change temperature varies with adding (TiO2) nanoparticles in to the paraffin wax. The thermal conductivity of the composites is found to decrease with increasing temperature. The increase in thermal conductivity ha
... Show MoreThe present work concerns with simulating unsteady state equilibrium model for production of methyl oleate (biodiesel) from reaction of oleic acid with methanol using sulfuric acid as a catalyst in batch reactive distillation. MESHR equations of equilibrium model were solved using MATLAB (R2010a). The validity of simulation model was tested by comparing the simulation results with a data available in literature. UNIQUAC liquid phase activity coefficient model is the most appropriate model to describe the non-ideality of OLAC-MEOH-MEOL-H2O system. The chemical reactions rates results from EQ model indicating the rates are controlled by chemical kinetics. Several variables was studied such as molar ratio of methanol to oleic acid 4:1, 6:1
... Show MoreBackground: The stethoscope is a tool that doctors use daily in the examination of patients and it can take part in the transmission of health care-associated infections. In a single day it may come in direct contact with multiple patients and the intra hospital environment may be contaminated by various type of bacteria and possibly transmit to others.
Objective:- The study was to know the attitude and knowledge about the stethoscope hygiene behavior among physicians and to determine the types of bacterial agents that can contaminate stethoscopes.
Type of the study: The study was a cross-sectional study
Metho
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Aneurysms of the cortical branches of the middle cerebral artery (MCA) are rare. They usually are secondary to traumatic or infectious etiologies and are rarely idiopathic. The specific characteristics of idiopathic aneurysms in such location are not well defined in the literature. The authors report a rare case of a ruptured giant idiopathic cortical MCA aneurysm with review of the available literature on this clinical entity.
A 24-year-old female presented with headache, disturbed level of consciousness, and right-sided weakness. Imaging studies showed a left frontoparietal intracer
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Fabrication of porous clay refractory insulating specimens from Iraqi kaolin with different percentage of Expanded Polystyrene (EPS) waste crumbs additions were investigated. After mixing and forming by hand molding, the specimens was dried and fired at 1300 oC. The structural, physical, mechanical and thermal properties of the refractory insulating products were measured. Maximum addition of EPS (1.25 wt%) lead to reduce the linear shrinkage to less than 1.7% and increased apparent porosity up to 50 %. As well as, the density, Modulus of rupture and thermal conductivity were reduced to 1.39 g/cm3, 4.1 MPa and 0.21 W/m.K, respectively. The final outcome, addition of EPS showed good results in the formation of pores without distorting the
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