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.
ABSTRACTBackground Subclinical hypothyroidism is mild thyroid hormone deficiency, defined by elevation of serum thyroid-stimulating hormone concentration despite a normal free T3, free T4 level, can be distinguished by clinical and circumstantial observations from other conditions that cause this constellation of laboratory findings. The aim is to find the prevalence, anthropologic, and metabolic changes associate subclinical hypothyroidism(SH) in adult patients presented to obesity research and therapy unit (ORTU Objective: To find the prevalence of subclinical hypothyroidism (SH) in adult obese patients presented to obesity research and therapy unit (ORTU) in AL-Kindy College of medicine and to describe the anthropologic and metabolic
... Show MoreBackground: Various studies conducted in many parts of the world suggest that there is lack of public awareness and knowledge of various aspects related to diabetes. With proper education, awareness, earlier detection and better care, many complications and co-morbidities can be reduced in diabetic population.Objectives: to evaluate the level of awareness of diabetes mellitus type 2 patients regarding their disease and its' complications.Methods: Cross – sectional survey was conducted during November and December 2011, in the Medical centers of Al Baladiat, Mustansyria and Zuafranya, including 145 type 2 diabetic patients (58.6 % males, 41.4% females) who were subjected to self–structured questionnaires regarding different aspects of
... Show MoreBackground Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders. Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients. Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and
... Show MoreTwo groups of chronic hepatitis B and C virus patients were divided into Pre-treated patients (25 CHB patients with positive HBs Ag for more than 6 months and 40 CHC patients), and post-treated patients [12 CHB patients (4, 6, and 2 were treated with lamivudine, IFN-? and combination of LMV + IFN-? respectively), and 27 patients for CHC (3, 13 and 11 patients were treated with Ribavirin, IFN-? and combination therapy (RBV+ IFN-?) respectively].These patients were followed up for 6 months. By using ELISA technique, levels of IL-6, IL-10, IFN-? and TNF-? were measured in vivo and in vitro (supernatant of PBMCs stimulated with PHA) and compared with healthy control. The mean level of IL-6, IL-10 and TNF-? in CHB patients showed significant dif
... Show MoreThe relation between anemia and inflammatory immune response has lately had much attention. This research was conducted from October 2018 until April 2019, including (110) children below 12 years from both gender in some Hospitals, Primary Health care centers, Public Primary Schools and Kindergarten in Baghdad, Iraq. The objective of this study is to determine the possible correlation between iron deficiency anemia and inflammatory immune response among children infected with Entamoeba histolytica or Giardia lamblia. Blood samples were taken from all groups to measure hemoglobin level, serum iron, total iron binding capacity (TIBC), mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration
... Show MoreRouting protocols are responsible for providing reliable communication between the source and destination nodes. The performance of these protocols in the ad hoc network family is influenced by several factors such as mobility model, traffic load, transmission range, and the number of mobile nodes which represents a great issue. Several simulation studies have explored routing protocol with performance parameters, but few relate to various protocols concerning routing and Quality of Service (QoS) metrics. This paper presents a simulation-based comparison of proactive, reactive, and multipath routing protocols in mobile ad hoc networks (MANETs). Specifically, the performance of AODV, DSDV, and AOMDV protocols are evaluated and analyz
... Show MoreThe use of non-parametric models and subsequent estimation methods requires that many of the initial conditions that must be met to represent those models of society under study are appropriate, prompting researchers to look for more flexible models, which are represented by non-parametric models
In this study, the most important and most widespread estimations of the estimation of the nonlinear regression function were investigated using Nadaraya-Watson and Regression Local Ploynomial, which are one of the types of non-linear
... Show MoreSoftware-defined networking (SDN) presents novel security and privacy risks, including distributed denial-of-service (DDoS) attacks. In response to these threats, machine learning (ML) and deep learning (DL) have emerged as effective approaches for quickly identifying and mitigating anomalies. To this end, this research employs various classification methods, including support vector machines (SVMs), K-nearest neighbors (KNNs), decision trees (DTs), multiple layer perceptron (MLP), and convolutional neural networks (CNNs), and compares their performance. CNN exhibits the highest train accuracy at 97.808%, yet the lowest prediction accuracy at 90.08%. In contrast, SVM demonstrates the highest prediction accuracy of 95.5%. As such, an
... Show MoreSustainable crop production in a coarse soil texture is challenging due to high water permeability and low soil water holding capacity. In this paper, subsurface water retention technology (SWRT) through impermeable polyethylene membranes was placed at depth 35 cm below ground surface and within the root zone to evaluate and compare the impact of these membranes and control treatment (without using the membranes) on yield and water use efficiency of eggplant inside the greenhouse. The study was conducted in Al-Fahamah Township, Baghdad, Iraq during spring growing season 2017. Results demonstrated the yield and water use efficiencies were 3.483 kg/m2 and 5.653 kg/m3, respectively for SWRT treatment p
... Show MoreThe problematic of the current research marked (style between alienation and westernization in contemporary painting) is demonstrated by the fact that the stylistic forms in art are full of the influx of subjective and emotional impressions, as well as administrative and borrowing techniques, as well as their contextual meaning, whether cultural, social and political, which gives them an alien dimension at one time or another. The aim of the research is: Define the style between alienation and alienwesternization in contemporary painting. The research included six axes dealing with the first axis: an introduction to the concept of alienation, and the second axis dealing with the style in romanticism. The third dealt with: the method in i
... Show More