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.
المستخلص
يعد تقييم اداء العاملين احد اهم الركائز الاساسية التي يتوقف عليها نجاح أي منظمة تسعى بأن تتطور وتتميز بأنشطتها واداءها وبالأخص المنظمات التي لها خصوصية في عملها كالأجهزة الرقابية التي تعتمد في اداء انشطتها ومسؤولياتها على كفاءة مواردها البشرية, ومن هذا المنطلق يهدف هذا البحث الى تصميم انموذج ثلاثي المحاور (المؤهلات والقدرات، الاداء والانجاز، التعاون والالتزام الوظيفي) ثُماني المستويات
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The research investigates the term innovation and its role in elaborating architectural practice based on diffusion. The complexity of the architectural field compared with other fields shows a problem in explaining how innovations in architecture diffuse as a thought and act in a certain context of practice. Therefore, the research aims to build an intellectual model that explains the way personal thoughts resembled by unique models introduced by creative and innovator designers diffuse in a certain pattern elaborate these models into a state of prevailing thought resembled by the movement in architecture. The research will apply its model to the more comprehensive movement in architecture, which is the modern movement,
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This investigation was carried out to study the treatment and recycling of wastewater in the Battery industry for an effluent containing lead ion. The reuse of such effluent can only be made possible by appropriate treatment method such as electro coagulation.
The electrochemical process, which uses a cell comprised aluminum electrode as anode and stainless steel electrode as cathode was applied to simulated wastewater containing lead ion in concentration 30 – 120 mg/l, at different operational conditions such as current density 0.4-1.2 mA/cm2, pH 6 -10 , and time 10 - 180 minute.
The results showed that the best operating conditions for complete lead removal (100%) at maximum concentration 120 mg/l was found to be 1.2 mA/cm2 cur
يهدف البحث الى دراسة وتحليل الهندسة المتزامنة (CE) وتحسين التكلفة(CO)، واستعمال مخرجات الهندسة المتزامنة كمدخلات لتحسين التكلفة، وبيان دور الهندسة المتزامنة في تحسين جودة المنتوج، وتحقيق وفورات في وقت التصميم والتصنيع والتجميع وتخفيض التكاليف، فضلاً عن توظيف بعض النماذج لتحديد مقدار الوفورات في الوقت ومنها نموذج(Lexmark) ونموذج (Pert) لتحديد الوفورات في وقت التصميم وقت لتصنيع والتجميع. ولتحقيق اهداف
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This research seeks to determine the nature of the relationship that brought together writing and memories,These memories have given the play (Bells and Trains) a new life, and brought it from one mold to another , And she re-drawn and produced it through words and imagination, and since they are important dramatic keys, they gave the writer the ability to maneuver. This play embodies part of the writer's suffering and an important part of his life It represents a journey into memories of the past through which the writer tried to narrate events that he lived and knew from his friends and relatives, It is the events of the Holocaust and its repercussions on the psyche of the Jews. This play is like a journey in memory with many feelings of
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The study aimed to examine the sensitivity to stress and its relation to positive mood among educational supervisors. The researcher used the descriptive approach as more an appropriate method for the current study. The sample is composed of (200) educational supervisor. To collect study data, two scales have been used: one scale to measure the sensitivity to stress and the other to measure the positive mood. The results indicated that a high level of sensitivity to stress with low level of positive mood among educational supervisors, sensitivity to stress showed significant differences among the sample regarding to major. There is no correlation between sensitivity to stress and positive mood, and finally, there are no significant diffe
... Show MoreJeder Lernende, der in der Fremdsprache Deutsch kommunizieren möchte, wird sich auch mit der deutschen Aussprache beschäftigen (müssen). Wer eine gute Aussprache hat, wird nicht nur oft und zu Recht bewundert, er hat es auch leichter, die deutsche Sprache zu verstehen, und er wird gut verstanden. Aussprachefehler beeinträchtigen die Kommunikation, sie führen zur Unverständlichkeit von Namen, Wörtern und Äußerungen oder Mißverständnissen, sie bewirken Ermüdung und Konzentrationsverluste und beeinträchtigen die Sprachverarbeitung durch Assoziationen und Emotionen, die beim Hörer entstehen können.’’[1]
Diese vorliegende Forschung befasst sich mit der Wic
... Show MoreTheoretical and experimental investigations have been carried out on developing laminar
combined free and forced convection heat transfer in a vertical concentric annulus with uniformly
heated outer cylinder (constant heat flux) and adiabatic inner cylinder for both aiding and opposing
flows. The theoretical investigation involved a mathematical modeling and numerical solution for
two dimensional, symmetric, simultaneously developing laminar air flows was achieved. The
governing equations of motion (continuity, momentum and energy) are solved by using implicit
finite difference method and the Gauss elimination technique. The theoretical work covers heat flux
range from (200 to 1500) W/m2, Re range from 400 to 2000 an
Shooting skill in basketball is one of the most important offensive skills and the final stage of the team's attack and the culmination of all skills in which points are scored, including the skill of peaceful shooting. The research aims to prepare competitive exercises and understand the impact of competitive exercises on developing coordination and balance for basketball players under 18 years old. The researcher used the experimental method with the single experimental group approach, including the research community of female athletes in the public directorates of education in Baghdad, totaling (6) directorates and (72) players. The research sample was selected intentionally, consisting of female athletes in the sports activity of the D
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