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.
Conclusion :
The conflict between the fundamentalist and news theory in the methodology that each of the two schools pursued with the Twelver Shi'a Imamiyyah in deriving the legal rulings from the sources of legislation, especially in the second source, which is the noble hadith and narration after the Holy Qur’an, which is the first source has gone through multiple and complex stages that led This struggle to excess, stress, exaggeration, negligence, neglect and indulgence by each of the two schools in dealing with the noble hadith and narration and in the manufacture of rules and laws and fundamentalist and juristic theories of the process of jurisprudential development of legal rulings where every school believed and proceed
... Show MoreThe utilization of targeted therapy for programmed death ligand 1 (PD‑L1) has emerged as a prominent focus in contemporary clinical trials, particularly in the context of immune checkpoint inhibitors. The prognostic significance of the expression of PD‑L1 in invasive mammary cancer remains a subject of discussion in clinical oncology, requiring further exploration, despite its recognition as a biomarker for responsiveness to anti‑PDL1 immunotherapy. The present study was conducted to investigate the immunohistological expression of PD‑L1 in women with triple‑negative breast cancer (TNBC), with a particular focus for searching for the associated clinical and pathological characteristics. The present retrospective study examined the
... Show MoreHypertension is identified as one of the most significant risk factors for cardiovascular diseases (CVDs). There is growing evidence showing that oxidative stress plays a major role in hypertension. Increased production of reactive oxygen species and decrease bioavailability of antioxidant have been demonstrated in experimental and human hypertension. The present study was directed to determine the beneficial effect of the antioxidant vitamin C in patients with essential hypertension treated with the calcium channel blocker (amlodipine) or with the angiotensin converting enzyme inhibitor (enalapril). Ninety six patients (50 females and 46 males) with essential hyp
... Show MoreBackground: Acute radiodermatitis is a common side effect during and after radiotherapy course in breast cancer patients treated by radiotherapy. This study assess the frequency of acute radiodermatitis and record the predictive factors for acute radiodermatitis. Patients and Methods: A descriptive case series study conducted at Baghdad, Iraq from August 2020 to September 2021. 70 female scheduled for radiotherapy sessions enrolled in this study. sociodemographic data were recorded and Skin examination before radiotherapy and weekly till the end of the radiotherapy sessions was done to report the frequency, risk factors, clinical picture and grades of acute radiodermatitis based on The National Cancer Institute’s Common Terminology Crite
... Show MoreAcute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), follow
... Show MoreThe research depth and dimensions of the problem of environmental pollution resulting from the combustion of fuel used in electric power generators, especially in the summer and you are the national electric power supplied by almost non-existent state where this problem is a local phenomenon that has serious dimensions to human health, as well as the possibility of using a the tax system tools of b (environmental taxes) to reduce these pollutants, so the search is aimed at the types of gases emitted from burning fuel electric generators operating in the province of Baghdad and then measure the amount of environmental pollution as well as compared to the amount of some of these gases, which is more risk to humans with permitted by the Wor
... Show MoreBackground: Small cardamom or green cardamom is the dried fruit of the tall perennial herbaceous plant, Elettaria cardamomum Maton belonging to the family Zingiberaceae. The major use of small cardamom on world wide is for domestic culinary purpose and in medicine. This study was conducted to test the effect of small cardamom extracts on Mutans streptococci and Candida Albicans in comparison to 0.2% chlorhexidine gluconate and de-ionized water in vivo. Materials and Methods: Mutans streptococci and Candid Albicans were isolated, purified and diagnosed according to morphological characteristic and biochemical test. In this experiments, the effect of control agents and small cardamom extracts as a mouth rinses was tested on the saliva
... Show MoreIn order to select the optimal tracking of fast time variation of multipath fast time variation Rayleigh fading channel, this paper focuses on the recursive least-squares (RLS) and Extended recursive least-squares (E-RLS) algorithms and reaches the conclusion that E-RLS is more feasible according to the comparison output of the simulation program from tracking performance and mean square error over five fast time variation of Rayleigh fading channels and more than one time (send/receive) reach to 100 times to make sure from efficiency of these algorithms.
Methotrexate (MTX) is one of the most effective medications to treat rheumatoid arthritis (RA).Aserum of 60 Iraqi male patients suffering from RA as (G1) was newly diagnosis and the same patient in G1 after taking MTX as G2 and 40 Iraqi male healthy control as G3. Nesfatin-1 (Nf-1) is belong to the adipokine family withpleiotropic effect. Nf-1 has been found in different tissues, including stomach, pancreas, bone cells, cartilage and heart. Retinol binding protein (RBP4) was known as transpoter of retinol from its storage sites in the liver to the extrahepatic tissues. Moreover, RBP4 acts as adipokine and contributes in the pathophsyology of prototypic inflammatory disease, rheumatoid arthritis (RA). The results showed a significant increas
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