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 current research aims to show the impact of the international auditing standard IAS 540 in reducing income smoothing practices in Iraq. To achieve the objectives of the research, the researcher adopted a questionnaire for a sample of auditors in Iraq. Where 60 forms were distributed and after the questionnaire was retrieved and statistical analysis was done using the SPSS program, The research reached a number of results, the most important of which are: the existence of a statistically significant effect of the application of the international auditing standard IAS 540 in reducing income smoothing practices, The research recommended the necess
... Show MoreThe research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o
... Show MoreFrom a medical perspective, autoimmunity reflects the abnormal behaviour of a human being. This state is shaped when the defense of an organism betrays its own tissues. Allegedly, the immune system should protect the body against attacking cells. When an autoimmune disease attacks, it results in perilous actions like self-destruction. However, from a psychological perspective, the French philosopher Jacques Derrida (1930-2004) explains that autoimmunity harms both the self and the other. As a result, the organ disarms the betraying cells, as the immune system cannot provide necessary protection. From a literary perspective, Derrida has termed autoimmunity as deconstruction for almost forty years. Autoimmunity starts with the stage of a norm
... Show MoreCare and attention to the structure in the sixties of the last century replaced the mark, and if the structure of Ms. pampered in research and studies, it has become the mark is also a spoiled lady .. But the relationship between the structure and the mark was not a break and break, but the relationship of integration, His themes are structural analysis, and these are intellectual themes that can not be surpassed in contemporary research, especially since semiotics have emerged from the linguistic inflection.
We have tried to distinguish between text and speech, which is a daunting task, as it seems that whenever the difference between them is clear and clear, we come back to wonder whether the text is the same discourse, and is
... Show Morenouns , because deriving these names will lead to eternity which is impossible, and restrict the derivation only in agent nouns from their verbs, and the adjective names from their adjectives with the condition of truth in derivation.
The derivation of “Allah” names was denied due to a creed thoughts, because saying that “Allah” names is derived will not describe the eternal essence of “Allah”, and if it were derived this will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant the derivation of the agent nouns by preventing the derivation of “Allah” names because it will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant from
The research problem boils question is there in Riyadh organizational climate that enables them to do their work properly and whether there are differences between the government and private Riyadh depending on the organizational climate has sought Find measure: 1 regulatory climate for kindergarten 2. The difference between government and private Riyadh depending on the organizational climate. Limited research on the (200) parameter of the Riyadh government and private parameters for the year (20,142,015) In order to achieve the research objectives the researchers built a regulatory climate in accordance with the scientific steps to build a psychological scales measure After the formulation of climate regulation paragraphs of the (30) p
... Show MoreThis research deals with the concept of space in the theatrical performance and how the director works between two different spaces, the closed space and the open space. The question was how to use space according to the director's vision in the presentation. The problem of the research was whether the director of the Iraqi filmmaker could see the variable in the architectural space Or the place or space within the exhibition between open and closed, through the formation of the vision of the external components of intellectual and aesthetic and aesthetic, and impact on the relationship between the actor and the recipient to produce a new aesthetic space, and then the purpose of research and importance and limits and terminology The seco
... Show MoreThe research aims to identify the concept of green taxes and their role in reducing environmental pollution through the poll of Abnh of taxpayers and employees of the General Authority for taxes totaling 200 individual .autam adoption of the resolution as a tool head for the collection of data and information from the sample and analyzed their responses using a statistical program (spss - 10), and calculating the percentages and the arithmetic mean, standard deviation and research found to a number of conclusions, notably the lack of legislation with the challenges and the difficulty of the existence of a measure or a standard lack of planning for the application of environmental taxes that the state taxation application between the Gene
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