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
The researcher focused on the importance of the physical abilities of the tennis game, as this game is one of the games that are characterized by its specificity in performance as this game is characterized by continuous movement and dealing with different elements, so this game requires the development of muscle strength, which plays an important role in Performance skills in the game of tennis. There are several methods to develop strength, including flat hierarchical technique, which is one of the most common forms of training in the development of muscle strength. As for the research problem, the researcher found a method that has an effect on the development of force. Therefore, the researcher tried to diversify a
... Show MoreCu-Al-Ni shape memory alloy specimens has been fabricated using powder metallurgy technique with tube furnace and vacuum sintering environment , three range of Nb powder weight percentage (0.3,0.6,0.9)% has been added. Micro hardness and sliding wear resist has been tested followed by X-ray diffraction, scanning electron microscope (SEM) and energy dispersive X-ray spectroscope (EDX) for micro structure observation. The experimental test for the samples has showed that the increase of Nb powder weight percentage in the master alloy has a significant effect on increasing the hardness and decreasing the wear resist therefore it will enhance the mechanical properties for this alloy.
The researcher focused on the importance of the physical abilities of the tennis game, as this game is one of the games that are characterized by its specificity in performance as this game is characterized by continuous movement and dealing with different elements, so this game requires the development of muscle strength, which plays an important role in Performance skills in the game of tennis. There are several methods to develop strength, including flat hierarchical technique, which is one of the most common forms of training in the development of muscle strength. As for the research problem, the researcher found a method that has an effect on the development of force. Therefore, the researcher tried to diversify a
... Show MoreLanguage is essential for politics, for producing, disseminating, engaging with, and reacting to political discourse. The pragmatics of political speeches is crucial to the development of effective political communication tactics. Thus, speech is situated at the intersection of rhetoric, linguistics, and politics. In communication, intent is a pragmatic factor that plays a crucial role at the time of the communication process. Speech is of paramount importance to the social and political domains. Through the use of concepts and the relationship between language and politics, the study analyzes the function of language in communication and interpretation of intentions. The study of the relationships between language and the situations in whi
... Show MoreTurkey Consider Tigris and Euphrates rivers as a national rivers, and not an a International rivers, so that . It insists on its absolute sovereignty on that resources. The block ( levee ) which Turkey established should not create International problems.
The All International agreements and laws in this sect warrant the rights of all the states that located in river stream to use it without any consider to the regional absolute right.
During the 1980s, Turkey construct water projects, started with GAP, project which is one of the greatest project in the world, in spite of the plane of construct of the keep an levee on the Euphrates was pre of that project. The
... Show MoreThe importance of the heritage of the Iraqi heavy symbolism and connotations where contacted habits rights and beliefs from antiquity to the present, in addition to being represented with data aesthetic it is an expression philosophical concepts associated implications incentives cultural aesthetic of the content of the intellectual including contents of semantics and symbols and the dimensions of the meanings Sayings , to turn form a legacy popularly moving window to communicate worth studying its details and search function on the character and identity and origins . Where have emerged in recent years, a phenomenon characterized by inventing new designs by modernist styles that have entered into technical system design and effectivenes
... Show MoreThe aim of the research is to explain the nature of the relationship between the dimensions of the strategic recovery of the service represented by (compensation, speed of response, apology, initiative (defining the problem) and the strategic goals of the company represented in (profitability, growth, community service, employee satisfaction) in the National Insurance Company, it has been approved The questionnaire as a tool to collect data and information from the sample of (58) who are in (department manager, M. department director, division official, unit official) and the statistical program (spss) was used in calculating (arithmetic mean, standard deviation, coefficient of variation, coefficient of Correlation, t-test, varia
... Show MoreThe research topic is summarized in the importance of studying the measuring the extent of the university youth’s exposure in the Emirati Society to those series and the resulting achieved satisfaction. The most important results and recommendations of the study are as follows: a high rate of the respondents’, sample individuals, exposure to the dubbed Turkish series since it is evident that almost three-fourths of the study individuals watch the dubbed Turkish series,.”. The most significant positive aspects of the dubbed Turkish series are: “they focus on the most important tourist attractions in Turkey” and “ improving the audience›s knowledge and information on the traditions of the Turkish society”. The most apparent
... Show MoreThis study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper
... Show MoreAbstract:
This research emerged due to the needs of Iraqi social sector for diagnosing the problems ,finding the appropriate solutions,and exploiting the social opportunities to solve these problems .The research problem focused on raising the following question: "Were Iraqi Managers in the Ministry of Labor and Social Affairs able to use their qualifications as social entrepreneurs in the ministry to improve the quality of life of the disadvantaged groups?", In light of that, the importance and objectives of the study were determined, and this research derives its importance from trying to address social problems by measuring the degree of meeting the subjective and objective needs of the custo