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.
In this research, a number of the western al-Anbar clays (red iron clays, Attapulgite) were modified by treating them thermally with a temperature of 650oC. After that, these clays reflux with sodium hydroxide 5% for 1 hour by using microwave as a power supply. The research included fractionation alqayaira crude oil the fractionation included removing the asphaltene by precipitation from the crude using a simple paraffin solvent (normal hexane) as a non-soluble substance. After that it was filtered using the ash-free filter paper 42, the dissolved part, maltinate, was taken, drying a temperature of 75oC and weight, and to find the percentage of the two parts. Malatine was divided into three main parts (paraf
... Show MoreThe research aims to identify the impact of the teaching methods Breathe test and imperative training method in learning some basic skills in Volleyball. The sample included 30 students of the first intermediate level from Al-Tawaia for boys / the public directorate of the education of Baghdad province – Al-Rasafa /2 ( The second). The samples are chosen randomly and divided into three groups : The systematic (Imperative method), first experimentary (training method), second experimentary (training method). Ten students are chosen for each group . The syllabus of the ministry of education is adopted on the systematic group while educational unites, which are prepared by the researcher, are used for the first and second experimenting group
... Show MoreA case-control study was designed to find out the association between rs2234671 polymorphism of cxcr1 and rUTI in a sample of Iraqi women by polymerase chain reaction- sequence-specific primer (PCR-SSP) method. The current findings revealed that the genotype GC (OR= 7.86, 95% CI = 2.82-21.87, P= 7.7 × 10-5) and the C allele (OR= 3.93, 95% CI = 1.97 - 7.83, P = 9.8×10-5) are significantly associated with rUTI. However, the genotype GG played as a protective factor (OR= 0.12, 95% CI = 10.05 - 0.34, P = 4.0 ×10-5). Depending on these findings, the genotype GC is significantly associated with rUTI.
This study examines the syntactic and semantic functions of the conscience of the chapter and the grammatical disagreement in its diagnosis between two famous linguists: Sibuyh and fur. Also, the conscience of the chapter occupies an important synthetic space in the construction of the Arabic sentence, identified by the Arab scientists, as linguistic analysts, have a strong sense of language and careful observation, they revealed it in their linguistic composition through the analysis of nominal structures, and found that it I come in specific syntactic patterns and grammatical templates that have certain characteristics that are unique to them because of the conscience of separation in their compositional space.
In this paper, customers’ expectations are continually shifting due to the business environment’s growing competition and substantial changes. As a result, organisations no longer viewed it as a static objective but as an ever-evolving aim. From this vantage point, the research has explored the accounting literature in search of novel approaches to addressing the strategic dimensions of quality, cost and time. Getting them to respond positively to the customer’s requests also requires recognising their needs and controlling their impact on these dimensions. With the removal of operations that do not contribute any value to the product’s value chain and a reduction in manufacturing costs through continuous improvement, the ou
... Show MoreThe entrance process re-engineering one of the main entrances of administrative and technology appropriate to keep pace with scientific progress and the continuing changes in business environment and for the purpose of achieving the goal sought by the organizations in the pursuit of rapid developments and renewable energy in the market competition by changing its operations and activities of the radical change which contributes to an effective contribution to reducing the cost of product or service taking into account the quality improvement in the management of change to keep the increase value and speed of placing on the market to meet customer needs and desires to achieve a
... Show MoreIn the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil
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The current research aims to identify the level of partnership between school and community agencies to improve secondary school outcomes for students with intellectual disabilities and develop strategies that help enhance community partnerships between schools and agencies. The researcher used the qualitative research approach; he utilized the interviews as a tool for data collection. The sample of research included (12) participants: three female school leaders, three male-school leaders, three female-school supervisors, and three male-school supervisors in schools that have programs for students with intellectual disabilities in Riyadh. The results of the study showed that the level of partnership bet
... Show MoreBackground: Multiple myeloma (MM) is characterized by clonal proliferation of malignant plasma cells within the bone marrow. In most patients, monoclonal immunoglobulin heavy chains or light chains are produced and are associated with organ dysfunction. The growth factor B-cell activating factor (BAFF) plays an important role in the pathogenesis of multiple myeloma due to its ability to promote B-cell survival, expansion, and differentiation. Objective: to measure the circulatory level of B-cell activating factor in multiple myeloma patients in relapsed and remission states and explore its possible correlations with the clinical staging, β2-microglobulin, and interleukin-6. Methods: This cross-sectional study was performed on 60
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