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
In this paper a prey-predator-scavenger food web model is proposed and studied. It is assumed that the model considered the effect of harvesting and all the species are infected by some toxicants released by some other species. The stability analysis of all possible equilibrium points is discussed. The persistence conditions of the system are established. The occurrence of local bifurcation around the equilibrium points is investigated. Numerical simulation is used and the obtained solution curves are drawn to illustrate the results of the model. Finally, the nonexistence of periodic dynamics is discussed analytically as well as numerically.
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The research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreThe COVID-19 pandemic has profoundly affected the healthcare sector and the productivity of medical staff and doctors. This study employs machine learning to analyze the post-COVID-19 impact on the productivity of medical staff and doctors across various specialties. A cross-sectional study was conducted on 960 participants from different specialties between June 1, 2022, and April 5, 2023. The study collected demographic data, including age, gender, and socioeconomic status, as well as information on participants' sleeping habits and any COVID-19 complications they experienced. The findings indicate a significant decline in the productivity of medical staff and doctors, with an average reduction of 23% during the post-COVID-19 period. T
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Knowledge management contribute to the overall private university libraries to develop libraries for the purpose of creating human and technological resources by investing research and development, as well as education and training for life.
This study followed the methodology of the descriptive and historical pillars of knowledge management for the years 1990 to the present day in 2017, depending on statistical figures obtained by the researchers from the General Secretariat of the Central Library at the University of Baghdad, and the Human Resources Division, which specialized human resources training after 2004 (and before those years from 1982 until 2002, where the continuing education was committee of the fixed committees are wor
تناولنا في هذه الدراسة التأكيد على تطوير المناهج الدراسية بأتجاه تنمية قيم التسامح والتعايش السلمي ، لان ثقافة التسامح باتت من الضرورات الملحة التي يفرضها الواقع الراهن لمواجهة العنف المجتمعي ، مما يوجب الحرص على ترسيخ القيم الانسانية ، لان التسامح من الصفات التي تحبها النفوس وتنجذب اليها القلوب .
والقيم الاخلاقية والسلوكية كالتسامح وغيرها ، من الامور الرئيسية لعمليتي التربية والتعليم في المدارس وال
... Show MoreFast economical developments in the US. in second half of nineteenth century contained many social results, such as increasing of stealing and killing crimes and expand of Labor strikes, which resulted in violence actions, and presented acceptable reason for emergence specialist security agencies, first of them "Pinkerton Agency". which played important role in all of that, besides that .. its role in American Civil War such as discovering an attempt to kill elected republican president Abraham Lincoln. This research studied all that aspects, focused on period of 1850 - 1899 of agency's history.
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The study aimed to identify the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the relationship of statistical significance between the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the differences of statistical significance in the relationship between psychological counseling skills and the strength of the ego in the guides according to the gender variable(male, Females), the number of sample (100) guides, including (50) males and (50) females from the area of Atifiya and Qadissiya and Ameriya in the Directorate of Education Karkh / 1, the researcher adopted a scale of psychological counseling skills prepared b
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