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.
Abstract
The common types of movement disorders are ; dystonia which is a syndrome of repetitive muscle contractions. While , Huntington disease is autosomal dominant progressive neurodegenerative disorder, which is characterized by involuntary movements (“chorea”).
Tetrabenazine therapy has been shown to effectively control this movements compared with placebo.
Design the proper dosing approach for patients treated with tetrabenazine with genotype polymorphisms and their hepatic effect on patients.
A prospective case controlled study was carried on 50 patients whom divided into 2 groups :first group involved 25 patients who had cho
... Show MoreThe determination hardness in water raised to rivers caused several problem in the validity of the water used depends on where determination ions concentration calcium and magnesium in salts carbonate and sulfate , this possibility of separation between of these ions and the resulting impact on concentration and determination the degree of hardness water and appreciation between the insolvent water quality . It study the effect of the impact of concentration magnesium ion in determination the quality of the water has turned out to be Mg concentration more than 60% of the total content of hardness is borderline in hardness effect the determination. Adopted in this research determination the ions in two method titration by EDTA solution and
... Show MoreImage classification is the process of finding common features in images from various classes and applying them to categorize and label them. The main problem of the image classification process is the abundance of images, the high complexity of the data, and the shortage of labeled data, presenting the key obstacles in image classification. The cornerstone of image classification is evaluating the convolutional features retrieved from deep learning models and training them with machine learning classifiers. This study proposes a new approach of “hybrid learning” by combining deep learning with machine learning for image classification based on convolutional feature extraction using the VGG-16 deep learning model and seven class
... Show MoreImage classification is the process of finding common features in images from various classes and applying them to categorize and label them. The main problem of the image classification process is the abundance of images, the high complexity of the data, and the shortage of labeled data, presenting the key obstacles in image classification. The cornerstone of image classification is evaluating the convolutional features retrieved from deep learning models and training them with machine learning classifiers. This study proposes a new approach of “hybrid learning” by combining deep learning with machine learning for image classification based on convolutional feature extraction using the VGG-16 deep learning model and seven class
... Show MoreThe research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right
... Show MoreSurvival analysis is one of the types of data analysis that describes the time period until the occurrence of an event of interest such as death or other events of importance in determining what will happen to the phenomenon studied. There may be more than one endpoint for the event, in which case it is called Competing risks. The purpose of this research is to apply the dynamic approach in the analysis of discrete survival time in order to estimate the effect of covariates over time, as well as modeling the nonlinear relationship between the covariates and the discrete hazard function through the use of the multinomial logistic model and the multivariate Cox model. For the purpose of conducting the estimation process for both the discrete
... Show MoreBack ground: Diabetic nephropathy is rapidly becoming the leading cause of end-stage renal disease (ESRD). The onset and course of DN can be ameliorated to a very significant degree if intervention institutes at a point very early in the course of the development of this complication.
Objective: The aim of this study was to characterize risk factors associated with nephropathy in type I diabetes and construct a module for early prediction of diabetic nephropathy (DN) by analyzing their risk factors.
Methods: Case control design of 400 patients with type I diabetes mellitus (IDDM), aged 19-45 years. The cases were 200 diabetic patients with overt protein urea while the controls were 200 diabetic patients with no protein urea or micr
Background: Beta thalassemia major (β-TM) is an inheritable condition with many complications, especially in children. The blood-borne viral infection was proposed as a risk factor due to the recurrent blood transfusion regimen (hemotherapy) as human parvovirus B19 (B19V). Objective: This study investigated the B19V seroprevalence, DNA presence, B19V viral load, and B19V genotypes in β-TM patients and blood donors. Methods: This is a cross-sectional study incorporating 180 subjects, segregated into three distinct groups each of 60 patients, namely control, β-TM, and β-TM infected with Hepatitis C Virus (HCV). For the B19V prevalence in the studied group, the ELISA technique and real-time PCR were used. The genotyping was follo
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