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.
Background: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes. Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations. Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase type 2 (rs225013 and rs225014) and le
... Show MoreBackground: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes. Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations.
Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase t
... Show MoreThe changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external
... Show MoreThe parametric programming considered as type of sensitivity analysis. In this research concerning to study the effect of the variations on linear programming model (objective function coefficients and right hand side) on the optimal solution. To determine the parameter (θ) value (-5≤ θ ≤5).Whereas the result، the objective function equal zero and the decision variables are non basic، when the parameter (θ = -5).The objective function value increases when the parameter (θ= 5) and the decision variables are basic، with the except of X24, X34.Whenever the parameter value increase, the objectiv
... Show MoreCumhuriyet Üniversitesi Fen-Edebiyat Fakültesi Sosyal Bilimler Dergisi | Volume: 48 Issue: 2
The use analysis value chain such information in the provision as financial so information quality meet and satisfy the needs of users such information , particularly investors and lenders as the identification needs financial information and the knowledge as their behavior influenced by that information can be based on the accounting profession to focus on improving their function in order to achieve its goal that satisfying their needs and rationalize their decisions . In accounting thought discovered fertile ground for users preferences as one of the entrances theorising positive which is based on the need to include knowledge on accounting hypothesis that explain the
... Show MoreATTAPULGITE clay was modified in this study by the graphene oxide sheets and the clay was diagnosed before and after modification using several techniques (Fourier-transform infrared spectroscopy FT-IR, X-ray powder diffraction XRD, Scanning electron microscope SEM , energy dispersive spectroscopy EDX ) ,The surface of the attapulgite clay (before (Ata) after modification by graphene oxide (Ata-GO) ) was applied to adsorption of the Alizarin dye from its water solutions through the application of several kinetic models (pseudo first-order model , pseudo second -order model , intraparticle diffusion model ),It was found that the practical results follow pseudo second -order model. The process of modification on the surface of the mud has imp
... Show Moreالمقدمة :يعد سرطان المثانة من بين أكثر أنواع السرطانات انتشارًا في جميع أنحاء العالم، حيث تم الإبلاغ عن 549,393 حالة جديدة في عام 2018 وما يقرب من ٪3 من جميع تشخيصات السرطان الجديدة و ٪2.1 من جميع وفيات السرطان ناتجة عن سرطان المثانة البولية. الاهداف: تهدف هذه الدراسة إلى استكشاف كفاءة وظائف الجهاز البولي بواسطة اجراء اختبارات وظائف الكلى ومستويات الايونات لمرضى سرطان المثانة. المنهجية: تم تحديد جميع الافراد الم
... Show MoreThis paper investigated the fatigue life behavior of two composite materials subjected to different times of shot peening (2, 4 and 6 min).The first material prepared from unsaturated polyester with E-glass reinforcement by 33% volume fraction. While, the second one was prepared from unsaturated polyester with aluminum powder by2.5% volume fraction. The experimental results showed that the improvement in endurance limit was obtained (for the first material) at 2, 4 and 6 min shot peening times where the percentage of maximum improvement was 25% at shot peening time of 6 min. While, the endurance limit of the second material decreased at shot peening times of 2, 4 and 6 min where the percentage of maximum reduction was 29 % at shot peenin
... 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
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