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.
Linguistic research according to modern curricula:
It is one of the important matters that occupy the ideas of those concerned with linguistic studies, whether Arabic or otherwise. Recent years have witnessed the advancement of this methodological approach, and books and studies in Arabic have been written on important, multifaceted issues, of grammatical and linguistic origins, and their balance with new developments and ideas attracted mostly from Western studies.
The comparative approach - as they call it - is one of the modern approaches that is based on balancing a language with other sisters belonging to its family, to reach similarities and differences between them, and to know the c
The problem with research lies in hiding the Hanbali approach in building long and short travel provisions, as well as hiding some provisions relating to short travel that are not provided for by the jurists of Hanbali (in their books).
The research aims to demonstrate the approach and standards on which they based the long and short travel provisions, as well as to reflect the provisions of some of the issues that are silent on long and short travel, with evidence and significance.
The research included a preface and two researches, the researcher in the preface talked about the reality of long and short travel, in the first research on the approach of ha
... Show MoreGod Almighty set out to build mosques, and he commanded to seek their architecture, and the competition for them, and allocate them with types of worship that are not valid in others, and to preserve their sanctity and not to be degraded and taken for mundane purposes and special benefits, because they are considered one of the most prominent features of Islam and the rituals of Islamic society, so this research came to show the rule Sharia in various and contemporary issues that are needed by the imams of the mosques, their rulers, and those responsible for them. Among the issues in which they have examined comparative juristic research and reached the most correct opinion are:
Building mosques over or under buildings and factories i
Conflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s
... Show MoreThe aim of this research is to show the importance of the effective use
of the internet in academic libraries; to improve the services and to increase
the competence of librarians.
The research has given some recommendations to improve the quality
of services and the need for cooperative network among academic libraries.
Foreign direct investment is considered one of important bases to blind economy for many. Countries as if the main stage for developing national economy ,so for this ,many of countries give great prominence to the role of drivel foreign investment due to its importance as one of economic growth pillars in the developing countries. They offer a support for modern technology, organizational and managerial skills.
Dneto the importance of direct foreign investment on the economic growth, today, we discover that Iraq in need to rebnlid the in frastructuve and renew what has been destroyed during was in many production and export institutions . as wel
... Show Moreالضاد والظاء موطن تفرد العربية وفخرها ، الفت فيهما العشرات والعشرات من المصنفات الثرّة لكثرة ذرائع تلابسهما والخلط بينهما ، فهما متشابهان في هيكل البناء ، وإخراجهما متداخل على اللسان ، وألفاظهما متناظرة برحابة في الإملاء ، فضلاعن اشكالهما إلى حدّ الآن ، مما حثني على التفكير في وسائل تسهل المطروح وتمد جسراً بين أجزائه عسى أن تدنو قطافه في دفع الشبهة ومواراتها ، فتحصلت لي امور ادرتها بكلمتين مف
... Show MoreCovalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and leve
Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
... Show MoreBackground: ;Hepatitis C virus (HCV) is a major cause of chronic liver disease. Approximately 85% of patients acutely infected with HCV progress to chronic liver disease with persistence of HCV-RNA for more than 6 months Among patients with chronic HCV infection , 15-20% progress to end-stage liver disease main transmission methods of the virus is by : blood and blood products ; sharing needles and acupuncture .Objective: To evaluate Iraqi patients infected with chronic HCV, including their treatment, and factors that affect their response to treatment .Methods :This study was performed at Gastroenterology and Hepatology hospital in Baghdad from January 2011 to March 2012.The study enrolled 90 patients with HCV Antibody positive (Ab +ve)
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