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
Edward Albee (1928-2016) is an American dramatist who is notorious for his controversial works. Albee's plays generate a crisis of a restraint situation and a point of no return where characters trespass the limits and get caught up in a tragic cycle. The Goat or Who is Sylvia? )2000) is one of his controversial pieces, addressing (human-animal relations). This theatrical masterpiece unleashes man's wildest desires and ravaging behavior. Bestiality is a criminal offense placed in the domain of mental disorders attributed to the lack of emotional support, anxiety, depression, and psychological problems. It is also a serious moral infraction of communities' socio-religious traditions. In this play, Martin’s bestiality lead
... Show MoreThis study is qualitative, it illustrates H.G. Wells\\'s The Time Machine through the scientific and social framework of the Victorian Era. Wells\\'s portrayal of future societies examines the rapid technological progress and social changes of the 19th century. The analysis scrutinizes the division between the Eloi and the Morlocks, tracing the consequences of social division. To meet the objective of the study, Victorian frame of mind is utilized to examine the class struggle that is symbolized by the Eloi and the Morlocks. The analysis highlights the economic and social effects of industrialization and how Wells examines the capitalist system and its impact on human relationships and class division. The study also utilizes concepts from D
... Show MoreA case-control study was designed to find out the association between rs2234671 polymorphism of cxcr1 and rUTI in a sample of Iraqi women by polymerase chain reaction- sequence-specific primer (PCR-SSP) method. The current findings revealed that the genotype GC (OR= 7.86, 95% CI = 2.82-21.87, P= 7.7 × 10-5) and the C allele (OR= 3.93, 95% CI = 1.97 - 7.83, P = 9.8×10-5) are significantly associated with rUTI. However, the genotype GG played as a protective factor (OR= 0.12, 95% CI = 10.05 - 0.34, P = 4.0 ×10-5). Depending on these findings, the genotype GC is significantly associated with rUTI.
The calculation. of the nuclear. charge. density. distributions. ρ(r) and root. mean. square. radius.( RMS ) by elastic. electron. scattering. of medium. mass. nuclei. such. as (90Zr, 92Mo) based. on the model. of the modified. shell. and the use of the probability. of occupation. on the surface. orbits. of level 2p, 2s eroding. shells. and 1g gaining. shells. The occupation probabilities of these states differ noticeably from the predictions of the SSM. We have found. an improvement. in the determination. of ground. charge. density. and this improvement. allow. more precise. identification. of (CDD) between. (92Mo- 90Zr) to illustrate the influence of the extra
... Show MoreThe aim of this study is to investigate the sedimentation environments and diagenetic processes of the Ibrahim Formation (Oligocene-early Miocene) in Zurbatiya, eastern Iraq. The Ibrahim Formation is comprised mostly of clayey micrite and skeletal grains composed of planktonic foraminifera, calcispheres, radiolaria, and benthic foraminifera. Glauconite and pyrite were documented in some restricted zones of this formation; they reflect quiet and reducing conditions. Radiolaria were identified in Late-Oligocene which was not known previously at this age regionally in carbonate formations of the Arabian Plate (AP). Mudstone, wackestone, and planktonic foraminiferal wackepackstone are the main microfacies that are affected by dissolutio
... Show MoreManufacturing industries are at the beginning of the thinking of those who put economic policies in developed countries and also more in developing countries, where manufacturing is the engine of industrial and economic development through its performance and its effective role in the formation of GDP, as well as the great advantages that characterize this sector and affect Largely on sustainable development, as well as its importance in its influential role in protecting national industry through increased exports and reduced imports.
Iraq is one of the countries that rely on its oil economy to rely entirely on the provision of needs and requirements of the state, and this
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يجمع المختصون أن ليس من نقد إلا وكان مُرحِّلا لنظرية لسانية إلى فضائه، فكان أثر اللسانيات السوسيرية، ومن ثم اللسانيات التوليدية التحويلية معروفا، ولم يكن هذا الأثر محدودا باللسانيين أو نقاد الأدب فحسب، بل امتد إلى الشعراء والجماليين أيضا. وفي هذا البحث سنتوقف عند أثر اللسانيات الوظيفية، وهو ما لم يتوقف عنده إلا قلة من المختصين. ولن نقف عند نقد الوظيفيين للشعر، بل سنقف عند نقدهم للرواية، بقراءة
... Show MoreThe oil and gas production industry is considered the most important industries in the modern world because of its large relative significance among the group of energy recourses required for the world, where the natural resources represent the oil and natural gas fields, phosphate, gold, coal, forests and others. The most important advantage of the natural resources is its need for huge financial investments for a relatively long period of time from the beginning of the work until the start of extracting natural resources. Also, there are numerous cases where the natural source is not feasible exploited economically and is not discovered until after the passage of a long period of time from the start of work and paying relatively high a
... Show MoreIt has become clear to see the role of the small and medium enterprises in the economy, and for the continuity of these projects it is necessary to supply finance from the banks, How ever the latter suffers risk of lending.
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