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.
HR Al-Hamamy, AA Noaimi, HA Salman, NAA Jabbar, American Journal of Dermatology and Venereology, 2013
This paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary
... Show MoreThe focus of this research revolves around the importance level of sialic acid in the reasoning of cases, including tumors and then evaluate the patient's response to treatment and its impact on the immune response there are a lot of evidence showing that parts Alkrbu ???????? in peptides sugary and glycoproteins play an important role in Alfalitin life and responsiveness
The main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study
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This research aims to investigate the role of quality management in enhancing the efficiency and effectiveness of settling accounts tax in terms of achieving satisfaction in charge of the hand and the increase of tax revenue on the other hand, by testing the main hypothesis of the study and the sub-hypotheses in the Income and Sales Tax Department in Jordan for the period 2000-20
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Background: Diabetes mellitus is a chronic metabolic disorder of the carbohydrate, protein and fat metabolism, resulting in increased blood glucose levels. Various complications of diabetes have been described with periodontitis being added as the sixth complication of diabetes mellitus. Matrix metalloproteinase-8 (MMP-8) has been identified as major tissue-destructive enzyme in periodontal disease. MMP-8 is released from neutrophils in a latent, inactive pro form and becomes activated during periodontal inflammation by independent and/or combined actions of host-derived inflammatory mediators .C-reactive protein is a systemic marker released during the acute phase of an inflammatory response. Subjects, materials and methods: Total samples
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The exercise of citizenship behaviors and their impact on customer loyalty (An analytical study from the perspective of workers in the National Insurance Company).
The Research aims to find out the degree of customers National Insurance company for customer citizenship behavior and its impact on the level oh loyalty from the perspective of employess in the company, as well as the statement of the differences in the answers of employees according to their personality traits. To achieve the goals of research has been the use of the questionnaire as a tool for the collection and distribution of data on a sample of (90) individuals, as was the use of statistical program (SPSS) in the process of statistical analysis methods (mean, sta
... Show MoreThe aim of the study is to reveal the effect of the constructivist learning Model on the achievement and reflective thinking of the fifth grade literary Preparatory students in History subject. A random sample was chosen which consisted of 64 students divided into experimental and control groups, each group consisted of 32 students. The experimental group was taught via the constructivist learning model, and the control group was taught via the traditional method. The experiment was lasted for Eight weeks, each week taught two lessons. The researcher adopted the experimental design with partial control. The two groups were equalized statistically. The researcher used two instruments, the achievement test and the reflective thinking test.
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