Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anesthesiologists (ASA) 2 / 3/4 patients between 25 and 85 years who underwent elective and emergency lower limb surgeries randomly allocated into two group, each group has 50 patients by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine with 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (20mg) of Nefopam in the second group (Group BN). The onset time, duration time of both sensory and motor blocking were seen and compared between the two groups.
Results : The onset time of both sensory and motor blockade was shorter in Group BN (bupivacaine with nefopam) when compared to Group BS (bupivacaine and normal saline) (p<0.0001). The duration of both sensory and motor blockade was longer in Group BN when compared to Group BS (p<0.0001). There were no significant hemodynamic changes (PR, BP,SPO2) in both groups. Also there is no any side effect or any complication.
Conclusion Nefopam when mixed with Bupivacaine in Sciatic nerve block and femoral nerve block in below knee surgeries shortens the onset time and prolongs the duration of action of both sensory and motor blockade without any systemic side effects and give excellent intra and postoperative analgesia.
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 MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
The authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.
This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.
This architecture had been neglected and replaced by modern imported architecture which had collap
... Show MoreThis study was designed to evaluate the effect of major surgery on thyroid hormones and thyrotropin in patient undergoing major lower abdominal surgery. The study included fifty patients scheduled for elective major lower abdominal surgery, the serum levels of T3, T4 and TSH were determined one day preoperatively, intraoperative, one day postoperatively, two days postoperatively, and rT3 was determined one day preoperatively, and one day postoperatively. We observed that the levels of (T3, T4, TSH) increased significantly (P<0.05) intraoperatively, one day postoperatively the levels of T3 and T4 reduced significantly (P<0.05), while TSH reduced not significantly (P>0.05), and two days postoperatively T4 and TSH returned to increase si
... Show MoreTheater is a renewed art until this moment, and it does not stray from its components from life and its spaces in general, but rather is derived from them according to characteristics and directions intended to differ based on finding other, more effective solutions, Therefore, the research entitled (Extractive treatments of the space between tradition and contrast in contemporary theater) consists of four chapters. The first chapter came under the title (the methodological framework). Where he dealt with the research problem and then the importance of the research and the goal of the research as well as the objective, temporal and spatial limits of the research, In addition to defining the terminology and then finding the procedural ter
... Show MoreEvolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl
... Show MorePeripheral artery disease (PAD) is associated with increased oxidative stress and impaired endothelial function. Ticagrelor treatment improves antioxidant properties in addition to its antiplatelet effects. This study investigated the impact of Ticagrelor treatment on serum superoxide dismutase (SOD) levels and other biochemical parameters in PAD patients. It also evaluated the potential diagnostic accuracy and clinical utility of specific biomarkers based on receiver operating characteristic (ROC) analysis. Seventy individuals were categorized into healthy control (n=40), baseline PAD patients not on Ticagrelor (B-PAD, n=30), and same PAD patients after treated with Ticagrelor (A-PAD, n=30). Parameters measured included SOD concent
... Show MoreBACKGROUND: Acute appendicitis (AA) remains a complex case even for experienced surgeons. Rate of negative appendectomy is 5–40% and delayed intervention result in perforated appendicitis in 5–30% of cases. AIM: The aim of the study was to evaluate NPT as a marker for the diagnosis of AA concerning its severity. And compare the diagnostic value of it with the ALV scoring system. METHODS: One hundred twenty patients presented with signs and symptoms of AA and underwent appendectomy, only 84 patients proved to be AA by histopathological examination, were included in the study. Blood samples for neopterin (NPT) estimation and Alvarado (ALV) score was calculated. Control group consists of 45 healthy individual. RESULTS: NPT levels were s
... Show MoreIntroduction and Aim: Graves ophthalmopathy is one of the pandemic public health disorders in Iraq. The current investigation attempts to determine the variation in the complete total blood cells on the recovery of individuals with Graves' ophthalmopathy following low and high-dose Radioactive Iodine 131 (RI-131) exposures. Materials and Methods: The complete blood CBC level in people with Graves' illness and healthy, normal controls were quantitatively identified using the CBC counter. Thyroid stimulating hormone was utilized to compare the recovery of ophthalmopathy patients in comparison to a control group. Results: In comparison to healthy controls, patients with Graves' ophthalmopathy disease who received 10 mci of RAI-
... Show MoreThe purchase of a home and access to housing is one of the most important requirements for the life of the individual and the stability of living and the development of the prices of houses in general and in Baghdad in particular affected by several factors, including the basic area of the house, the age of the house, the neighborhood in which the housing is available and the basic services, Where the statistical model SSM model was used to model house prices over a period of time from 2000 to 2018 and forecast until 2025 The research is concerned with enhancing the importance of this model and describing it as a standard and important compared to the models used in the analysis of time series after obtaining the
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