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
Recent studies agree that the democratic system in a country can only be established in an atmosphere of political and religious freedom. However, the term democracy and the term freedom have become controversial because their concepts remain multiple and different. Karl Popper is one of the most prominent philosophers in modern Western political thought, and one of the defenders of democracy as opposite to dictatorship. It has defined its function by its ability to restrain the ruling elite and to enforce it to prevent their tendency to tyranny. This can be achieved only in the context of the close relationship between democracy and freedom, so, if there is democracy in the absence of absolute freedom, democracy is a gateway to expandin
... Show MoreThe current environment is witnessing several developments as a result of the changes taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading of these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension. &
... Show MoreThe aim of the current study is to identify the effectiveness of cognitive conflict strategy in comprehending reading among literary fifth students in literature and literature texts. The researcher uses experimental method with partial control. The sample consisted of (80) students distributed into control and experimental groups. The scientific material, the behavioral goals, the teaching plans, and the instrument of the research have been prepared (reading comprehension test) by the researcher.
The instrument's validity and reliability have been calculated and then applied to the sample. After treating the data statistically by using SPSS, the results have revealed that there is a statistically significant difference at the si
... Show MoreAfter its 35-year occupation of Japan and the US occupation, Korea has set its sights on a long-term goal of building its country and establishing its foundations, unobtrusive and unchecked by the problems and wars that have stood in the way of its goal, surpassing all odds and achieving the best results. The most powerful Asian and global economies, which gained the respect of the world and its appreciation of the experience has become referred to as boys
Iraqi legislator taxation married women in charge of the income tax treatment of the man in charge of tax and the application of the principle of equality of individuals to bear public burdens. The factor legislator women in charge of special treatment in some cases, taking into account the circumstances family allow tax in the case of whether she was married to a man is unable to completely work and does not have a resource, as well as giving the legislator allow for her children. it observed that the amount of allowing still little is notcommensurate with the high cost of living in addition to limiting the tax allowances granted within the limits of the taxpayer and his immediate family did not take the legisla
... Show MoreHyperbole is an obvious and intentional exaggeration in the sense that it takes things to such an extreme that the audience goes too far and then pulls itself back to a more reasonable position, i.e. it is an extravagant statement or figure of speech not intended to be taken literally. This paper focuses on the formal and functional perspectives in the analysis of hyperbole which American candidates produce in their speeches in electoral campaigns, for it is hypothesized that candidates in their electoral campaigns use hyperbolic expressions excessively to persuade voters of the objectives of their electoral campaign programs. Hence, it aims to analyze hyperbole in context to determine the range of pragmatic func
... Show MoreThis research concerns the fact of the school garden and how can we tackle this issue. The research starts with a question forwarded to those who are interested in the ministry of education matters; the question is that how is the extent of interest in the school garden project? And how it is activated in the Iraqi Educational Institution program? In addition, the analysis reveals the importance of the school garden since we, as teachers and students, suffer from seeing the view of the trashes, the wastes of school furniture, the stinking water and the weeds and how it is accumulated in the back yard of the school. To add fuel to the fire, the increase in number of the students; year after year. This increase leads to adding more classes
... Show MoreIschemic heart disease is a major causes of heart failure. Heart failure patients have predominantly left ventricular dysfunction (systolic or diastolic dysfunction, or both). Acute heart failure is most commonly caused by reduced myocardial contractility, and increased LV stiffness. We performed echocardiography and gated SPECT with Tc99m MIBI within 263 patients and 166 normal individuals. Left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured. For all degrees of ischemia, there was a significant difference between ejection fraction values measured by SPECT and echo
Background: White-spot lesion is one of the problems associated with the fixed orthodontic treatment. The aims of this in-vitro study were to investigate enamel damage depth on adhesive removal when the adhesive were surrounded by sound, demineralized or demineralized enamel that had been re-mineralized prior to adhesive removal using 10% Nano-Hydroxy apatite and to determine the effect of three different adhesive removal techniques. Materials and methods: Composite resin adhesive (3M Unitek) was bonded to 60 human upper premolars teeth which were randomly divided in to three groups each containing ten sound teeth and ten teeth with demineralized and re-mineralized lesions adjacent to the adhesive. A window of 2 mm was prepared on the bucca
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