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: Since its introduction to musculoskeletal imaging in the early 1980, magnetic resonance imaging (MRI) has revolutionized diagnostic imaging of the knee. It is therefore become the examination of choice in the evaluation of internal joint structures of the knee like menisci, cruciate ligaments, and articular cartilage.Objectives: to describe the MRI finding in various knee injuries.Patients and methods: A cross sectional study was done on 130 patients with history of knee injury in MRI unit at institute of radiology and al-Shaheed Ghazi Al-Hariri Hospital in medical city complex - Baghdad, from October 2011 to February 2013 includes 103 men, 27 women; the mean age was 33.86 years. MR imaging studies of the knee performed using
... Show MoreBackground: Systemic sclerosis (SSc) is a chronic autoimmune illness, which is consider by three main features: Sclerotic changes in the skin and internal organs, Vasculopathy of small blood vessels, Particular autoantibodies (1). The most important autoantibodies appeared significantly in SSc patients are anti-topoisomerase I autoantibody (Scl-70), anti-centromere autoantibody (ACA), and anti-RNA polymerase III autoantibody (RNAP3) (2). Anti-centromere antibodies (ACA) are infrequent in rheumatic conditions and in healthy persons but occur commonly in limited systemic sclerosis (CREST syndrome), and rarely appeared in the diffuse form of systemic sclerosis (3). Anti-Ro/SSA and antiLa/SSB, antibodies directed against Ro/La ribonucleoprot
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The multiple linear regression model of the important regression models used in the analysis for different fields of science Such as business, economics, medicine and social sciences high in data has undesirable effects on analysis results . The multicollinearity is a major problem in multiple linear regression. In its simplest state, it leads to the departure of the model parameter that is capable of its scientific properties, Also there is an important problem in regression analysis is the presence of high leverage points in the data have undesirable effects on the results of the analysis , In this research , we present some of
... Show MoreWith a great diversity in the curriculum contemporary monetary and visions, and development that hit the graphic design field, it has become imperative for the workers in the contemporary design research and investigation in accordance with the intellectual treatises and methods of modern criticism, because the work design requires the designer and recipient both know the mechanics of tibographic text analysis in a heavy world of texts and images varied vocabulary and graphics, and designer on before anyone else manages the process of analysis to know what you offer others of shipments visual often of oriented intended from behind, what is meant, in the midst of this world, the curriculum Alsemiae directly overlap with such diverse offer
... Show MoreAbstract The research investigates in detail the fascinating story of its title character, which may work as an allegory for Africa itself in its past. Ama Ata Aidoo is miscellaneous writers who wrote in different literary genre like drama , short stories novel and , poetry and criticism . She is also an active feminist. Aidoo is against the colonial practice and its influence on African minds. Aidoo's play Anowa confronts painful issues in Africa's past, mostly those of the slave trade. She goes further to tackle issues of patriarchal domination and African feminism, like the relationships between individuals and society, women and motherhood, men and women, husbands and wives, mothers and daughters, and above all the future invasion
... Show MoreBackground: Cluster of differentiation 14 (CD14) is a serum/cell surface glycoprotein; and it is a pattern recognition receptor. CD14 expressed on the surface of various cells, or it found soluble in saliva and other body fluids. It has been proposed that soluble CD14 (sCD14) may play a protective role by controlling Gram negative bacterial infections through its capacity to bind lipopolysaccharide. This study was conducted to assess the level of soluble CD14 in saliva of patients with different periodontal diseases and healthy subjects and determine its correlation with clinical periodontal parameters. Materials & Methods: A total of 80 subjects, age ranged (25-50) years old, divided into three main groups, group ? consisted of 45 chronic
... Show MoreThe present study took up the different ways to cultivate the species Epipremnum aureum by two habitat water and soil and comber the anatomical features of the root, stem, and leaf. The results showed amazing significant anatomical features to the ecosystem. The root and stem anatomy showing decrease in all characters that studied but the leaf anatomy showing increase of palisade, spongy tissue thickness, midrib thickness, number of vessels in the xylem also the long and width of stomata of the soilless plants than soil ones. The upper epidermis empty from the stomata for the two treatment and the stoma diffuse in the lower epidermis, the type of it paracytic type. Also the total of flavonoids in the plant that were growth in soil reached 1
... Show MoreThere is no doubt that the advertisement picture and the written text play a key role in the formation of the language of the communicative discourse as the main pillars of the design of commercial advertising and the main entrance for the advertising message awareness... Hence the researcher chose the title of her research (Integrative Relationship between the Picture and the Written Text in the Printed Commercial Advertisement) starting from following questions: What is the relationship between the picture and the written text in the printed commercial declaration? Is there functional, aesthetic and interactive integration between them?
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... Show MoreThis study relates to the estimation of a simultaneous equations system for the Tobit model where the dependent variables ( ) are limited, and this will affect the method to choose the good estimator. So, we will use new estimations methods different from the classical methods, which if used in such a case, will produce biased and inconsistent estimators which is (Nelson-Olson) method and Two- Stage limited dependent variables(2SLDV) method to get of estimators that hold characteristics the good estimator .
That is , parameters will be estim
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