Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild systemic diseases) of ASA (American society of anesthetists) undergoing elective orthopaedic surgeries were randomly assigned in two groups and (both of them have general anesthesia); Group A (10patients) received local infiltration of 0.5% bupivacaine before closure of surgical wounds and group B (10 patients) received local infiltration of 0.9% of normal saline. We use uniform technique of anesthesia in both at rest and on passive mobilization by nurses and residents groups. Visual analogue pain scale scores were assessedblinded to analgesic treatment and we check the needs for analgesic drugs post-operative in both groups.Results: Group A showed a significant reduction inpostoperative pain at rest and on mobilization afterinfiltration of 0.5% bupivacaine with short hospital stay andonly 3 patients need for post-operative analgesia ,while allpatients in group B require at least single dose of analgesialike pethidine or non-steroidal anti-inflammatory drugs.Conclusion: The use of 0.5% Bupivacaine by wound infiltration is effective for post-operative pain relief, as it reduces the requirements for additional post-operative analgesia after total hip and knee replacements.
The laws of the three religions tend to extend the rules and foundations of coexistence, and this is achieved in achieving the values and principles that these laws have nourished in all societies.
Our research deals with a major problem that has broken out in our societies, namely (disturbing the balance of values and behavioral standard between people), and perhaps one of the greatest causes of the problem is to move away from the correct divine discourse and sound approach, as well as corruption of common sense and the violation of its rules and found principles in the hearts of people.
اليورانيوم المنضب واستخدامه امريكياً في العراق
Discourse markers are expressions used to connect sentences to what comes before or after and indicate a speaker's attitude to what he is saying.As linguistic items, they have important functions in discourses of various styles or registers. And being connective elements, discourse markers relate sentences, clauses and paragraphs to each other. "One of the most prominent function of discourse markers, however, is to signal the kinds of relations a speaker perceives between different parts of the discourse". (Lenk 1997: 2) Through political discourse, different types of discourse markers are used. This paper deals with the importance and functions of discourse markers and tries to shed light on the kinds of discourse markers used in polit
... Show MoreThe authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.
This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.
This architecture had been neglected and replaced by modern imported architecture which had collap
... Show More
Through the study of social work and social policy ( problems of marginalization and empowerment opportunities ) and taken a theoretically descriptive and analytical and highliyhed the role of social work in social policy its achieved only through community intraction and paamong all parties and according to social policies include of material resources and haman and integrated in to the planning and development framework with the aim of providing social services for allsegments of society and become the study in social work that include the introducation / and five chapters each chapter in cludes several detectives and each complements the other .
1 – The absence of social development projects on social policy .
2 – social pol
Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of
This study deals with the thems of "in-betweeness" in the modern Afro-American Drama, drawing upon the accumulated literature of the colonial and postcolonial studies. In-betweeness appears in these studies under the canopy of the terms mimicry, hybridity and liminality which refer to a transformative, in-between state of being. It also refers to themutual relations holdingbetween man and his cultural space.
This concept is fitting the Afro-American playwright Amiri Baraka's plays and his violent, revolutionary theatre. In his play Dutchman (1964), Clay, the protagonist, is a good example of the two-ness or in-betweeness. He finds difficulty choosing between the ethnocentric white culture and the black culture.He allows
... Show More