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.
In this research, the semiparametric Bayesian method is compared with the classical method to estimate reliability function of three systems : k-out of-n system, series system, and parallel system. Each system consists of three components, the first one represents the composite parametric in which failure times distributed as exponential, whereas the second and the third components are nonparametric ones in which reliability estimations depend on Kernel method using two methods to estimate bandwidth parameter h method and Kaplan-Meier method. To indicate a better method for system reliability function estimation, it has be
... Show MoreThe main objective of resources management is to supply and support the site operation with necessary resources in a way to achieve the required timing in handing over the work as well as to achieve the cost-realism within the budget estimated. The research aims to know the advantage of using GIS in management of resources as one of the new tools that keep pace with the evolution in various countries around the world also collect the vast amount of spatial data resources in one environment easily to handled and accessed quickly and this help to make the right decision regarding management of resources in various construction projects. The process of using GIS in the management and identification of resources is of extreme importance in t
... Show MoreBackground: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
... Show MoreFever is a common illness in the pediatric age group ,the causes could be viral ,bacterial and fungal , this study was focused on bacterial pathogens as gram positive like Staphylococci, coagulase positive or negative ,Streptococci and gram negative like E-coli , Klebsialla ,Proteus, Pseudomonas, Burkhoderia , Acinetobacter and others like Pusturella ,E-alkalescendiaper, Haemophillus influenza and yeast like candida . Four thousand and seventy eight blood samples (4078)were collected in a period between January 2011 and the end of May 2012 at the child welfare hospital ,all the samples were cultured on suitable culture media and then biochemical tests were done using API-E 20 and sugar fermentation tests ,sensitivity
... Show MoreBackground: Folic acid (vitamin B9) is one of the important vitamins that are necessary for growth and development of the embryo and preventing the occurrence of congenital malformations which are one of the important health problems in the developing countries and the world as it has a direct effect on the affected babies, their families and the community. It affects an estimated 3% of newborns worldwide.Periconceptional supplementation with folic acid (before conception and during the first 12 weeks of pregnancy) was found to decrease many important types of these anomalies. Objectives: The aim of this study is to assess knowledge, attitude and practice of periconceptional use of folic acid in pregnant women who are attending antenatal
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