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.
The evolution of thought, planning for Urban Communities in the second half of the twentieth century, through several successive stages. He was thought of planning urban communities depends on identifying the general plan for land uses of the project area as a basis for drawing charts the physical, social, economic, and put the general plan for land uses based on the terms of reference set by the number of experts in the ministries and agencies. I have lived cities in the Arab-Muslim region, during the transition period the natural and historic environment, urban, sophisticated balanced ways mentioned in the cultural, social, inspired by the teachings of Islam and the customs and traditions of the Arab social, put forth a set of
... Show MorePurpose: The aim of this study is to examine knowing the real role and impact of manufacturing flexibility on competitiveness through operations management practices, which is to determine the role and impact of manufacturing flexibility on competitiveness directly in the General Company for the Battery Industry. On the other hand, identifying the indirect role of flexible manufacturing systems in enhancing competitiveness. Theoretical framework: The main purpose of the theoretical framework is to identify all the dimensions and variables included in the current study, and thus form a deep scientific view of the study and its variables. Design/methodology/approach: field coexistence, personal interviews, and classification of
... Show MoreBackground: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav
... Show MoreBackground:The technology of nanoparticles has been expanded to many aspects of modern life. Titanium dioxide nanoparticles were of many nanomaterials utilized in biomedical applications. The interactions between nanoparticles and proteins are believed to be the base for the biological effect of the nanoparticles. The oxidation reaction of many substances is catalyzed by oxidizing enzymes called peroxidases. The activity of salivary peroxidase is elevated with periodontal diseases. the aim ofthis study is to examine the action of titanium dioxide nanoparticles on salivary peroxidase activity.Material and method75 participants were enrolled in this study—Periodontitis group with 44 participants and the non-periodontitis group with 31 pa
... Show MoreBackground: This study aimed to find whether there is a relation between the mesio-distal crown diameters of the deciduous second molars and the permanent first molars in an Iraqi sample from Baghdad city. Material and methods: The sample consisted of 54 Iraqi children aged 8-9 years at the mixed dentition stage. The measurements included the mesio-distal crown width of the deciduous second molars and the permanent first molars on the study casts using digital sliding vernier. Results: The results revealed absence of the side difference of the widths of teeth measured. High significant gender difference was detected for the permanent first molars and the deciduous second molars except mandibular permanent first molar. On the other hand, hig
... Show MoreThe purpose of this study was to measure serum levels of insulin-like growth factor-binding protein (IGFBP7), Insulin-like Growth Factor 1 (IGF-1), Growth Hormone (GH), Interleukin 6 (IL-6) and insulin in acromegaly patients and healthy controls. The acromegaly group had 60 patients, while the population group had 30 people who had never had acromegaly before. The concentration of IGFBP7, IGF-1, GH, IL-6, and insulin were determined. The results of the present study indicate that IGFBP7 level in the acromegaly group was significantly lower (1.690.07 ng/mL vs. 2.740.12 ng/mL, respectively, p = 0.001). IGF-1, GH, IL-6, and insulin concentrations were also significantly higher in acromegaly patients. The diagnostic accuracy (2.194) was exce
... Show MoreThe right of the patient to know the medical risks surrounding the medical intervention is one of the most prominent rights based on the principle of "physical safety", which has undergone several stages of development until it reached the development of the patient's independence in making medical decision without relying on the doctor, The patient's prior informed consent is informed of his / her medical condition. We will study this development in accordance with the French March 4, 2002 legislation on the rights of patients in the health system, whether it was earlier and later. We will highlight the development of the patient's right to "know the medical risks surrounding medical intervention" The legislation and its comparison with th
... Show MoreObjective: This study aims to assess the awareness of patients suffering from cardiovascular
diseases.
Methodology: A descriptive design was applied in this study. A purposive sample consisted of
(100) patients with cardiovascular disease in the Mosul's hospitals were interviewed to achieve study
objectives. A questionnaire was used for data collection after tested for validity and reliability by pilot
study.
Results: The study results showed the mean of patients awareness are (1.78) cut point of (3) and
the majority of patients84% were aged more than 50 years or above. Slightly increase proportion of
male more than females. Most of them are married81%, retired, smokers, and a period of developing
the disease a
Under aerobic and anaerobic conditions, two laboratory-scale reactors were operated. Each reactor
was packed with 8.5 kg of shredded synthetic solid waste (less than 5 cm) that was prepared according to an
average composition of domestic solid waste in the city of Kirkuk. Using an air compressor, aerobic
conditions were created in the aerobic reactor. This study shows that the aerobic reactor was more efficient in
COD and BOD5 removal which were 97.88% and 91.25% while in case of anaerobic reactor, they were
66.53%and 19.11%, respectively.