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 behavior of thinking is consider one of the modern concepts that appear in the last 20 years, this concept has attracted the attention of psychologists and researchers for thinking has a great role in many fields like teaching ,educational,economical,cultural and social fields.
One of thinking manner is imaginal thinking that has a great role in human civilization. imaginal thinking lead to innovation ,poems, inventions and arts. imaginal thinkingled to highscores in talented schools by escalating their thinking range and solving problems that consider one of organized and free assumption thinking.
The development of problems thinking strategies reflect the development of organized brain process ability.
That studies assumes
The interplay of predation, competition between species and harvesting is one of the most critical aspects of the environment. This paper involves exploring the dynamics of four species' interactions. The system includes two competitive prey and two predators; the first prey is preyed on by the first predator, with the former representing an additional food source for the latter. While the second prey is not exposed to predation but rather is exposed to the harvest. The existence of possible equilibria is found. Conditions of local and global stability for the equilibria are derived. To corroborate our findings, we constructed time series to illustrate the existence and the stability of equilibria numerically by varying the different values
... Show MoreAbstract Drug addiction is considered a criminal behavior, which led the Iraqi legislator to prohibit and criminalize it, imposing penalties on those who use or even approach it. This aims to limit its presence in Iraq and reduce unethical behaviors, leveraging the divine prohibition to curb it. The legislator also encourages media organizations to raise awareness about the dangers of this substance, which has contributed to reducing the phenomenon of drugs in Iraq.
« The emergence of satellite channels has led to fundamental changes in the supposed role of television, making it a center of culture and an important tributary to social upbringing and influencing the attitudes and values of individuals and in making public opinion regarding various issues, some television programs target ordinary people at home by virtue of the nature of their subjects, where there is a large audience of viewers, who consume and absorb what is offered to them from the cultural production of those satellite channels that play with the aspirations of groups of society to find metaphysical or magic solutions to their social problems or psychological delusions. The media, through its various messages, contributes to brin
... Show MoreThe aim of this study is to develop a novel framework for managing risks in smart supply chains by enhancing business continuity and resilience against potential disruptions. This research addresses the growing uncertainty in supply chain environments, driven by both natural phenomena-such as pandemics and earthquakes—and human-induced events, including wars, political upheavals, and societal transformations. Recognizing that traditional risk management approaches are insufficient in such dynamic contexts, the study proposes an adaptive framework that integrates proactive and remedial measures for effective risk mitigation. A fuzzy risk matrix is employed to assess and analyze uncertainties, facilitating the identification of disr
... Show MoreIn the present research a new test rig has been proposed to be suitable for different cyclic loads such as cyclic bending, cyclic torsion, proportional and non proportional loads. In this work the efforts were concentrated on the cyclic bending loads concerning cracked pipes with or without internal pulsing pressure to study crack propagation in small bore pipes (up to 1'') for transverse or inclined cracks. The rig simulates the real service conditions under different stresses by means the least dangerous case will be suggested, so the experiments were considered for copper pipe, and the results have been tabulated and drawn to demonstrate the crack growth behavior as well as to justify the outcomes practically, consequently the durabil
... Show MoreThe study investigates the relationship between the volatility of the Iraqi Stock Exchange Index (ISX), and the volatility of global oil prices benchmarks, Brent and West Intermediate Texas (WTI), in additional to the Iraqi Oil, Basra Crude Light (BSL) which represents the most exported Iraqi oil and the major influential factor on the Iraqi governmental revenues. Using monthly data covering the period: 1/2005-12/1205, econometrical and technical tools represented by Co-incretion, Vector Error Correction Model – VECM, Granger Causality, and Bollinger band were employed in order to explore the relationship between the variables.
The econometric analysis revealed the impact of the oil prices volatility on
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