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.
Domesticated translation has been for a long time the norm in cultural communication between nations all over the world. The texts are translated mainly into English (being the dominant language) in terms dictated principally by the requirements of the target language (English). The claim has been that fluency, readability, and immediate intelligibility can be guaranteed as far as the reader of the target language is concerned (English). The foreignness of the text (of the culture which produced it) would be not preserved. Not only this. Being the language of predominant cultures, English has become number one among languages into which texts are translated. The imbalance has been noticeable between the volumes of works translated from a
... Show MoreBegging is an ancient social phenomenon since the Man's creation. It was simple at its beginning to get a living and the family needed, but presently, this simple social phenomenon converted to a big phenomenon which controlled by competent groups away from the values and principles. Their doings are far from humanity representing by the cutting of a hand or a foot and facial distortion or removed eye as a way of attracting people's emotions to get material and incorporeal helps; these doings became a trade which is exchanged by slave traders. Furthermore, different illegal and greedy methods were followed as a way of blackmailing others; contrariwise other cases of begging are doing by a people who real poor and needy. In this case, the
... Show MoreMost countries in the world particularly developing countries, including Iraq, facing extremely dangerous problem with social and political dimensions, which is the emergence of the food crisis problem ,the decrease in domestic food production in Iraq isn't meet the needs of its population food, due to the fact that the agricultural sector suffers from multiple natural ,economic and human problems .It is still below the level required to meet the needs of the population of food ,since food at the forefront of priorities needed by the human . This represents indispensable basic necessity , so the responsibility of its availability permanently in appropriate&nb
... Show MoreThis research discusses one of the most important means of reducing corruption in public sector companies and government departments, a relationship of cooperation and coordination between the external auditor and internal auditor, in the light of ISA (610), the recommendations of the International Organization of Supreme Audit Institutions (INTOSAI) and the National Strategy to combat corruption. The research was based on two assumptions: the first was weak relationship of cooperation and coordination between the external auditor and internal auditor leads to weakne
... Show MoreIncreasingly, public organizations in the federal state are required to work together, as well as to work with others to achieve their objectives. In Iraq there are two levels of organizations, including federal and local, and these organizations have been forced to work for many years in an environment in which the responsibility for service delivery is shared between policy makers and service providers, and between local governments and the federal government. It is sometimes difficult to manage the relationship between these organizations (federal and local) and do not always provide the best possible outcome of this relationship. This paper reviews how to manage the relationship between local administrations and
... Show MoreDiabetic kidney disease is an illness of the glomerulus that interferes with the glomerular filtration barrier (GFB), which is worked to enable kidney to selective purification of water and solutes in addition to limiting the movement of large macromolecules such as albumin. In the glomerular endothelium, mesangial cells, foot cells, and the brush border of the proximal tubules, ACE-2 is expressed and that the kidneys represent the highest-expressing region of this enzyme. Thus, the current study aimed to evaluate ACE-2 level in this case compared to healthy condition. The study Conducted with 120 male and female ranging in age (30-65) years old. Ninety patients with type 2 diabetes subdivided into three groups on the basis of A
... Show MoreThis paper introduces a non-conventional approach with multi-dimensional random sampling to solve a cocaine abuse model with statistical probability. The mean Latin hypercube finite difference (MLHFD) method is proposed for the first time via hybrid integration of the classical numerical finite difference (FD) formula with Latin hypercube sampling (LHS) technique to create a random distribution for the model parameters which are dependent on time [Formula: see text]. The LHS technique gives advantage to MLHFD method to produce fast variation of the parameters’ values via number of multidimensional simulations (100, 1000 and 5000). The generated Latin hypercube sample which is random or non-deterministic in nature is further integ
... Show MoreBackground: The posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion shows significant flattening. This study aimed to correlate between the flattening of the posterior slope of the articular eminence, with dental status, age, genders, on both sides using computed tomography. Materials and Methods: The sample of the present study was a total of 117 Iraqi subjects, who admitted to the maxillofacial department at Al-Sadr Teaching Hospital in Al-Najaf city. The examination was performed on CT scanner; the eminence inclination was measured in two methods using sagittal section. Results: Clinically, the inclination of articular eminence was higher in edentulous subjects than i
... Show MoreThis paper studies the investment project evaluation under the condition of uncertainty. Evaluation of investment project under risk and uncertainty is possible to be carried out through application of various methods and techniques. The best known methods are : Risk-adjusted discount rate , certainty equivalent method , Sensitivity analysis and Simulation method The objective of this study is using the sensitivity analysis in evaluation Glass Bottles project in Anbar province under the condition of risk and uncertainty.
After applying sensitivity analysis we found that the glass bottles project sensitive to the following factors (cash flow, the cost of investment, and the pro
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