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.
This study aimed at an analytical comparison of the Internal Auditing Standards issued by the Institute of Internal Auditors (IIA) and the Guidance Manual for Audit Units issued by the Federal Audit Bureau to show the compatibility and differences between them and the possibility of applying the IIA standards to economic units in Iraq. The guideline was generally not covered by all the internal audit units. There is a lack of keeping pace with changes in internal auditing at the international level and there is a need to strengthen the Guideline on Internal Auditing Standards II A), which is characterized by the preparation of an internal document containing the objectives, powers and responsibilities of the internal audit work as well a
... Show MoreOver the last two decades, several sustainability assessment methods have developed as key accelerators for the development and improvement of sustainable industrial buildings. Some of these systems, like as LEED or BREEAM, are considered international, whereas others, such as Pearl Rating Systems (PRS), are local. Although they all share similar goals, they can lead to the construction of green buildings or the improvement of the efficiency of existing conventional buildings. Each technique has its structure, certification process, and weighting norms. The inequalities have prompted various questions about whether global assessment systems appropriately consider the country’s national settings. This study aims to compare the Pear
... Show MoreToxoplasmosis is a widespread infection usually caused by Toxoplasma gondii (T. gondii) parasite. It occurs in humans and other warm blooded animals, causing severe problems. It was found that there is an alteration in the trace elements concentrations levels associated with some human diseases. This study aimed to investigate the changes in the concentrations of some trace elements (Mg, Fe , Zn, and Cu) in the sera of 60 immunocompetent patients with chronic toxoplasmosis and 82 healthy individuals as a control group. Measuring the serum level of seropositivity rate of anti-T. gondii antibodies was done by Enzyme Linked Immunosorbent Assay (ELISA) Kit, while the concentrations of trace elements were measured by absorption spectrophotometry
... Show MoreThe image of television dominates the cognitive and artistic motivations. It is the formulation of ideas and visions along with its documentary ability. It is the main element in television work as it is a story that is narrated in pictures. Therefore, attention to image building is a major point of gravity in the work structure as a whole. On the image is the element carrying all aesthetic and expressive values of news and information directly to the hints that work to stimulate and stir the imagination of the recipient to evoke mental images added to the visual images to deepen the meanings.
All visual arts carry elements and components that follow in a particular pattern to give special meanings and specific connotations. However,
Background: Urinary tract infections (UTIs) and their complications such as Bladder cancer (Bl. C.) are a health growing problem worldwide. Objective: To shed light on this subject, present study was done to investigate relationship between recurrent urinary tract infection (RUTI) due to Escherichia coli (E. coli) and Bl. C.Type of study: Cross-sectional study. Methods: This study included 130 patients with RUTI, 50 patients with Bl. C. and 50 control of both sexes (aged 7-85 years) attending Al-Zahra Teaching Hospital in Al-Kut/Wassit governorate and Al-Harery Teaching Hospital of specialized surgeries/Baghdad. The patients were divided into two groups: the first group (n=130) included those who were suffering from recurrent UTI without
... Show MoreConstitute the relationship between the director and actor mainstay chock done to show art in film and television , both of which occupy what a big role in the mission accomplishment . The leadership of the director of the artwork in various joints require two features two important ( creativity and administration ) , The capabilities director of creative serves as an added intellectual and aesthetic saturated sensation that leaves its impact on all the technical elements involved in done. Either trait administration and leadership it is what requires multiple skills in dealing on according to technical standards and moral and humanitarian allow the transfer of ideas , concepts and visions to those elements to embody and implement the ki
... Show MoreBackground: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
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