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.
AN Adil A, F Basman M, 2009
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.
The current rasearch which is entitled " The stylistic change in Kandinsky and Mondrian paintings – A Comparative Analytic study-" deals with the nature of change concept, its mechanisms and its constructive disciplines. The research has four chapters: The first chapter deals with the methodological Framework represented by the problem of the research which is concerned with the stylistic change and its role in activating formative disciplines. The research aims at, finding out the stylistic change in Kandinsky and Mondrian Paintings.&
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The most honorable of science was what was related to the book of God, the Almighty, the Constitution of this nation and the way of its guidance and method of advancement there is no life except for him and safety only by its application and it is no secret to the competent studies of the importance of the subjective studies in the Koranic studies to address issues of great importance enlighten the path of the nation and revive From here comes the importance of the topic covered by the research, which is "Intent in the Holy Quran meanings and semantics", and this topic features features that made it worthy of writing, including the importance of clarifying theories of Qur'anic character of a systematic nature, such as the theory of inten
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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
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Patch in transdermal drug delivery(TDDS) used to overcome the hypodermic drawback, but these patch also have absorption limitation for hydrophilic and macromolecule like peptide and DNA. So that micronized projection have the ability for skin penetration developed named as microneedle. Microneedle drug delivery system is a novel drug delivery to overcome the limitation of TDDS like skin barrier restriction for large molecule. Microneedle patch can penetrate through skin subcutaneous into epidermis, avoiding nerve fiber and blood vessel contact. There are many type of microneedle patch like solid, polymer, hallow, hydrogel forming microneedle and dissolving microneedle with different method of microfabrication
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