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.
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This paper examined accounting information systems (AIS) as a mediator between small and medium-sized enterprises (SMEs) strategies, including (finance source, administrative innovation, organizational culture, developing capabilities levels of SMEs, information source, development of business managers, and technological innovation) and organizational performance. In this quantitative study, 450 self-administered questionnaires were distributed to the managers and owners of SMEs using purposive sampling. Data were analyzed using the structural equation modeling (SEM) method via SmartPLS3 Software. The study offers empirical findings on the importance of AIS as a mediator, considers various factors, a
Cholinesterases are among the most efficient enzymes known. They are divided into two groups: acetylcholinesterase (AChE) involved in the hydrolysis of the neurotransimitter acetylcholine, and butyrylcholinesterase (BChE) of unknown function. Several crystal structures of the former have shown that the active site is located at the bottom of a deep and narrow gorge. Human BChE has attracted attention because it can hydrolyze toxic esters and nerve agents. Here we analyze the complexes of cholinesterase with soman by describing the 3D geometry of the complex, the active site, the changes happened through the inhibition and provide a description for the mechanism of inhibition. Soman undergoes degradation in the active site of the AChE and B
... Show Morethe shear strength parameters of the treated and untreated gypsum soil under the effect of four soaking and drying cycles has studied in this paper, moreover examined the effect of wetting and drying cycles on the collapse potential of the soil and comparing between the behavior of the treated and untreated gypsum soil under the effect of the two conditions. Gypsum soil sample brought from Sawa lake in Al Muthana governorate with the content of gypsum 65.5%, the polyurethane polymer (PP) was used with different percentages 3, 6, and 10% to enhance the mechanical properties of gypsum soil, model was prepared to achieve four soaking and drying cycle to the samples before testing, this model consists of an Aluminum plate base with dimensions 7
... Show MoreVocational stresses and their relation with the level of ambition among the lecturers of the university In general , vocational stresses affect the attention and the process of focusing making individual busy with solving of his daily problems instead of his job. The vocational stresses , anxiety and tension are factors effecting the physical and psychological ability of the individual. This study aims to measure the vocational stresses among the lecturers of the university , to measure the level of ambition among them, to identify the statistical differences significant among them according to sex variable, to identify the differences significant in level of ambition among them according to sex variable and to identify the correlation r
... Show MoreThe research aims at identifying the organizational performance of the kindergarten teachers and defines the educational environment of kindergarten children. To achieve the objectives of the research, the researcher adopted the organizational performance scale for (Saadi, 2016), which was applied to kindergarten teachers. The scale consists of (43) paragraphs, and has good reliability and validity, as the coefficient of reliability (84.0) in a retest method, and (87.0) using the formula Alpha Kronbach. Additionally, the researcher adopted the educational environment scale for (Radam, 2015); the scale consists of (66) paragraphs, and it enjoys a good reliability and validity, as the coefficient of reliability (89.0) method of reliability
... Show MoreThe habitat type and food availability always influence the population size of many
organisms. Bird’s feeding pattern should be abstracted to complete avian community structure
data. The agronomy main research farm of Orissa University of Agriculture and Technology
is a well-managed multi-crop agro-ecosystem which provides a suitable ground for ecological
research. In a multi-crop farmland, the association of Barn Swallow Hirundo rustica Linnaeus,
1758, with the Indian mustard Brassica juncea (L.) Czernajew, 1859 crops have been
recorded for the first time while hovering only on this field. A flock of Barn swallows was
recorded in 32 field visits while flying continuously over the Indian mustard field after
flow
The research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some
... Show MoreAfter about twelve months or maybe more, some people can’t achieve pregnancy. This might be a sign of infertility as a reproductive system disease. The following study was carried out to investigate the DAZ 1 gene methylation level and its association with azoospermia in Iraqi patients. One hundred and fifty human blood samples were collected from from different regions in Baghdad governorate, including (private medicals Labs and the high institute for infertility diagnosis assisted reproductive techniques and Kamal Al- Samara'ay IVF Hospital) from both fertile and infertile men. The control group consists of 50 samples ranging from 22 to 51 years old, while the patient (infertile group) consists of 100 samples ranging between 25 and 51 y
... Show MoreThe body of the actor and its expressive significance is an essential topic in studying acting . it is not only confined to the study of soul and body from philosophical aesthetic perspective , but also to study the conception and mechanism of such a dichotomy followed by theatre directors and theorists , who are highly concerned with the creativity of actors . The researchers believe that such a study would be of benefit for actors as well as others working in theatre .
The study falls into two sections . the first deals with the phi
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