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.
T.V photo in modern shows has emerged with special characteristics and signs that have developed in cope with the development of medium and technique. This leads to adding a variety of aesthetic dimensions which are capable of attracting audience because of its communicative elements that have an important role in increasing of T.V show Watching. As a result, the research is limited to methodological Framework as the problem. The problem of the research deals with emerging the aesthetic dimensions of T.V photo. The major question is (what are the aesthetic and communicative dimension of T.V Photo?). The research aims at finding out the aesthetic dimensions of T.V photo in modern artworks. The significance of the research on the presented
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The primary focus of the study factor reverse polymerization styrene polymer kinetics and distribution weight Aljaia in Blma Aldhur free reverse The study was conducted wi Mamahakah and using the Monte Carlo method
The Civil Rights era has been an era of struggle for the African American in the
Unites states. Thus, many writers devoted their writing to reflect the racism and
discrimination that many have suffered from, among them is Ralph Ellison.
Ralph Ellison is a 20th century African-American writer and scholar best known for
his renowned, award-winning novel Invisible Man. He illustrates the powerful
social and political forces that conspire to keep black Americans in their place,
denying them the right to life, liberty, and the pursuit of happiness guaranteed to all
Americans. Invisible Man is a 1952 novel that addresses many of the social and intellectual
issues facing African-Americans in the twentieth century. It exa
Rheumatoid arthritis (RA) is a systematic autoimmune disorder with chronic inflammation changes of unknown etiology. Various synovial inflammatory and proliferative alterations may contribute to the cartilaginous tissues and invasive bony tissues, leading to destructive joints and malformed bones. This disease is mostly due to infective microorganisms or genetic susceptibility causing immune system disturbances through triggering both T-cells and B-cells. Furthermore, different immune cells may secret cytokines, which are responsible for some RA pathogenesis activity. From ninety individuals, serum sample was collected; thirty of them were normal and sixty cases were patients with RA attended a privet medical clin
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We presented here a 25years old lady with a multiple hatdtid cysts in lung and liver and spleen in large number in each organ. Which regarded inoperable and difficult to treared.We use medical treatment with antihelimenthes drugs in new regime and follow-up over 1year clinically, laboratory investigations, U/s and CT.scan. There was good disappearance of liver and spleen cysts with very good response in lungs.
The Islamic religion approach Rabbani urges and seeks to bring happiness to people, as Allah says: ((We sent thee not all people glad tidings and a warner, but most people do not know)) Spa: State 28
Islam looks at the concept of educational values through positive behavior derived emerging through formal and informal education. The Islamic approach works on the basis of a systematic and clear rule in the form of an integrated system includes multiple areas. As the lead actor role as the desired position.
Although
اليورانيوم المنضب واستخدامه امريكياً في العراق
This study aimed to clarify the legal provisions concerning the senses and their role in financial transactions, in the light of the definition of all the vocabulary presented by this study (senses - the definition of senses apparent: they are hearing - sight - smell - taste - touch) in the first section. The study deals with the second topic of the reference and writing denominator phrase and includes two requirements, the first requirement: the establishment of the denominator of the phrase, which has two branches: Section I: signal Akhras. Section II: Signal of the Spokesman.
The second requirement is that writing takes the place of the phrase in financial transactions. The owners argue that the sale of the blind is correct a
Abstract
The research aims to verify the dimensions of tax justice that exist in Iraq, and to determine their impact on tax compliance. Through a revised model of tax justice based on the literature of tax justice according to the classification of the studies of (Saad, 2009), (Wenzel, 2002), by using a questionnaire as an experimental measurement tool designed to be in line with perceptions of tax justice in Iraq. To define the dimensions of tax justice (the independent variable) with eight dimensions (Distributive justice, Exchange justice, Vertical justice, Horizontal justice, Retributive justice,
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