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 paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c
... Show MoreSelf-compacted concrete (SCC) considered as a revolution progress in concrete technology due to its ability for flowing through forms, fusion with reinforcement, compact itself by its weight without using vibrators and economic advantages. This research aims to assess the fresh properties of SCC and study their effect on its compressive strength using different grading zones and different fineness modulus (F.M) of fine aggregate. The fineness modulus used in this study was (2.73, 2.82,2.9& 3.12) for different zones of grading (zone I, zone II& marginal zone(between zone I&II)) according to Iraqi standards (I.Q.S No.45/1984).Twelve mixes were prepared, each mix were tested in fresh state with slump, V-Funnel and L-Box tests, then 72
... Show MoreSelf-compacted concrete (SCC) considered as a revolution progress in concrete technology due to its ability for flowing through forms, fusion with reinforcement, compact itself by its weight without using vibrators and economic advantages. This research aims to assess the fresh properties of SCC and study their effect on its compressive strength using different grading zones and different fineness modulus (F.M) of fine aggregate. The fineness modulus used in this study was (2.73, 2.82,2.9& 3.12) for different zones of grading (zone I, zone II& marginal zone(between zone I&II)) according to Iraqi standards (I.Q.S No.45/1984).Twelve mixes were prepared, each mix were tested in fresh state with slump, V-Funnel and L-Box tests, t
... Show MoreThe research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to non- observance of environmental requirements and the preservation of human health and protection of the environment.To achieve the goal of the research, the researchers re
... Show MoreThis research paper is about synoptic climate specifically with in the upper air layers
using upper air layers maps analysis which are maps of thickness for the level 1000 – 500
MB, that their high average ranges between 100 – 5600 M above surface. This research paper
focuses on studying special and temporal variations of the atmosphere thickness above Iraqaccording
to this study, it is concluded that atmosphere thickness above Iraq increases
towards south with an average of 100 M as compared with north of Iraq. Regarding the
temporal variations, it is concluded that atmosphere thickness during hot months. In July, for
example, the atmosphere thickness becomes thicker than in January with an average of
(250)M
Construction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreThe concept of power despite its implications unclear and unknown was one of the most standards in international relations ambiguity and lack of clarity, however was more standards important and influential in the conduct of international relations, and since that time until today since that ambiguity in the meaning of power and use it as a factor of international relations factors and drive the engines were very different and irony from case to case and from researcher to another, but it may be classified force as the international status enjoyed by the state in the international ocean and here is a structure formed of forces posed by the state, such as economic and political nature of the political system and military power and concept
... Show MoreIn the theory of cinema genre, horror films are at the forefront of the list. It is one of the oldest genres that saw the light with the early emergence of cinema, taking advantage of literary works, especially Gothic literature and it continues to this day, but the third millennium has seen a marked increase in the number of films and recipients alike. There were many types within the same genre and there are many authors and varied topics, all seeking to spread terror and panic and fear in the hearts of viewers who are passionate about the type of horror. Although the fear and horror have been, throughout the ages, a challenge to the psychological balance and stability, as well as being a rejection and an opposition to the aesthetic ta
... Show MorePraise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.
A study of the singlet and triplet states of two electron systems in the first excited state was performed using a simple quantum mechanical model, which assigns the 1s,and 2s orbital with two different variational parameters. Our results agree with a high level calculation used by Snow and Bills.