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: Difficulties arise when attempting to imagine the interpupillary line and comparing it with the Fox plane guide and not more difficult than holding any instrument over the movable pupils just to demonstrate the interpupillary line. The aim of this study was to introduce ear lobes as alternative landmarks for the interpupillary line during orientation of the occlusal plane. Also, the other aim was to compare the ear lobes with the pupils of the eyes to verify that they were indifferent as anatomical landmarks. Materials & methods: The alternative landmarks, ear lobes, were presented and the method for orienting the occlusal plane with these landmarks was introduced. Digital pictures of 30 subjects, who participated in the study,
... Show MoreThe research concern about the conceptual framework of crisis in the strategic view has become to mean opportunity to change not threat only. The research explains the multi stages of crisis & its characteristics that are difference from catastrophe and disaster. We rely on two criteria of classification of crisis (predictability & influence possibilities). Also there are sub crises with the main crisis; the important one is the Maida Crisis which is related with the informational dimension & the Psychological Crisis which is related with the Human dimension or the victim management. The current research aimed to develop crises management strategy according to Islamic perspective based on model of ( Augustine, 1995).&
... Show MoreThe research Was based to on a real problem and realistically of represented by that Iraqi Airways company does not have the electronic cost accounting system and therefore be the process of the pricing various services provided by a company sample research respecting air transport and air cargo and aviation fuel and services and catering are not properly especially in the presence of new data from the new companies entering competition in Iraqi aviation industry and therefore does not provide price flexibility in order to compete in getting market share, And then research this problem addressed through design an electronic cost Accounting system covers all the costs incurred by the compan
... Show MoreThe study was conducted from November 2021 to May 2022 at the three study sites within the Baghdad governorate. The study aims to identify the impact of human activities on the Tigris River, so an area free of human activities was chosen and represented the first site. A total of 48 types were diagnosed, 6204 ind/m3 spread over three sites. The following environmental indicators were evaluated: Constancy Index (S), Relative abundance index (Ra), Richness Index (between 17.995 and 23.251), Shannon Weiner Index (0.48-1.25 bit/ind.), Uniformity Index (0.124 -0.323). The study showed that the highest percentage recorded was for the phylum Annileda 34%; and the stability index shows that taxes (Stylaria sp., Aoelosoma sp., Branchinra sowerby, Ch
... Show MoreIn this paper, the finite element method is used to study the dynamic behavior of the damaged rotating composite blade. Three dimensional, finite element programs were developed using a nine node laminated shell as a discretization element for the blade structure (the same element type is used for damaged and non-damaged structure). In this analysis the initial stress effect (geometric stiffness) and other rotational effects except the carioles acceleration effect are included. The investigation covers the effect speed of rotation, aspect ratio, skew angle, pre-twist angle, radius to length, layer lamination and fiber orientation of composite blade. After modeling a non-damaged rotating composite blade, the work procedure was to ap
... Show MoreClimate change, together with terrorism, economic depressions, and mass-destructive weaponry, is a source of international phobia for many people. The advancement in technology increases the competition among world powers and economic systems to develop their industrial enterprises. The smoke that emits from the factories, the pollution caused by the industrial projects, the excessive use of green gas result in the increase of global warming and have catastrophic effects on the ecosphere of the planet. Besides, man’s wrong practices even in agricultural matters are exhausting the natural resources of the lands, and they badly affect the ecological diversity and the wellbeing of the humans and non-humans alike. Contemporary feminis
... Show MoreIn this paper the modified trapezoidal rule is presented for solving Volterra linear Integral Equations (V.I.E) of the second kind and we noticed that this procedure is effective in solving the equations. Two examples are given with their comparison tables to answer the validity of the procedure.
The research aims to characterize the strategic plan of the Educational Professional Development Center, to reveal the most important training needs for teachers from this center, to reveal the extent to which this center meets those needs, and to identify the differences between teacher responses about the degree of importance, availability of those needs according to variables of sex, specialization, and years of experience. This descriptive study adopted a questionnaire applied to (256) teachers in the K.S.A. The results of the study showed that all training needs ranged in the degree of importance from large to very large and that the most important were the skills associated with communicating with members of the learning community.
... Show MoreBac kground:: Septal deviation is one of the commonest anatomical deformities of the nasal skeleton, this deviation is usually accompanied by compensatory hypertrophy of the inferior turbinate on the concave side that will accentuate the severity of nasal obstruction.
Objectives: To evaluate the effect of septoplasty on the size of the inferior turbinate in patients with nasal septum deviation.
Methods: This is a prospective study of 25 patients attending the otolaryngological department at Al-Jirahat teaching hospital from September 2011 to November 2013, complaining mainly of nasal obstruction. Otolaryngological examination had shown nasal septum deviation. The cross sectional areas of inferior turbinates were measured with compu