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.
the contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa
Seventy five E. coli isolates were collected from urine of patients with urinary tract infections in AL-Kadhimia and AL-Yarmook teaching hospitals in Baghdad for a period between 22/11/2009 to 15/3/2010, from these samples twenty five isolates were selected according to their pattern of the highest resistance as these showing multi-drug resistances and tested to specify their minimum inhibitory concentration for (meropenem, gentamicin and amikacin), meropenem was found having the lowest MIC comparing with others. This study also includes in vitro effects of various combinations of three types of antimicrobials (meropenem, gentamicin and amikacin) against twenty five E. c
... Show MoreMetabolic dysregulation and obesity are associated with many metabolic alterations, including impairment of insulin sensitivity and dyslipidemia. Recent studies highlight the key role of phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchange proteins (PREX proteins) in the pathogenesis of obesity, advocating further elucidation of their potential therapeutic implications. The present study aimed to estimate the serum level of PREX proteins and its potential association with insulin resistance markers and plasma lipids level in obese and overweight non-diabetic patients. The study included 30 persons classified as obese, 30 as overweight, and 30 healthy individuals of similar age and gender. The levels of PREX1 and PREX2 were
... Show MoreThe term discourse is one of the terms that have attracted the attention of learners because it is indicative of the speech that is directly related to the addressee and the addressee through a common message between them. In the story of the study and the importance of research can be a widespread method, and then the choice of this story the story of Joseph (peace be upon him) in particular did not come The research presented in the introduction and the preamble and three topics, dealt with the definition of discourse, and the role of discourse in modern Quranic and linguistic studies, and in the first section dealt with the definition of the style of command language, terminology and command formu
... Show MoreBackground: The disc prolapse is a common condition especially in young adults. Different levels are affected in the lumber region; the L4/L5 disc is more susceptible to longitudinal load and is the most common site of lumbar disc prolapse. The L5/S1 disc is protected from torsion load by strong ilio-lumbar ligaments but it is more susceptible to axial compressive forces. Many factors affect the result and outcome of surgery in these levels.Objective: The aim of this study is to correlate operative data, short-term results, complications, and prognostic factors (age, gender, mobility, hospital stay, and level of pain) for one-level lumber discectomybetween different levels (L4–L5 vs. L5–S1).Methods In this prospective study, 32 patie
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The research aims to identify the nature of the relationship between the level of debt used and economic value added of companies listed on the Iraq Stock Exchange under the Contrast sizes of these companies , The research addressed the theoretical concepts associated with each of the debt financing , economic added value and Organization size With the use of financial techniques in the practical side to measure these variables, The research community Represent of the shareholding companies listed on the Iraq Stock Exchange with a choice of intentionally sample of 24 joint stock companies representing 
... Show MoreIn any language there is some amount of difference between written language (planned) and spoken language (spontaneous). Since planned speech could be considered a form of written language, it could be inferred that there are also differences between planned speech and spontaneous speech. Some of these differences are very clear in terms of syntax, lexis, phonology and discourse. These differences are highlighted in order to make a clear distinction between spontaneous and planned speech.
This paper is an attempt to show the differences between the two forms of a language (written & spoken English) as far as number of linguistic features are tackle
... Show MoreAbstract:
The achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.
Thus, this paper aims to analysis the n
... Show MoreObjective: this search aims to test the correlation between job complexity and psychological detachment then stats how the burnout can affect in this relationship and dose the burnout can contribute in development of this relationship. Theoretical framework: the research adopted some questions like how can psychological detachment can make the employee keeping away from work and isolates himself from work environment and how can the job complexity enhance this behavior for employee ,and how can the burnout increase the correlation between job complexity and psychological detachment ?, then trying to extraction some of recommendations may contributes in enhancing practicing and adopting these three variables (job complexity, psych
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