Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
In this paper, a theoretical study to the effect of journal misalignment on the static characteristics of oil filled porous journal bearing when lubricated with couple stress fluid has been carried out.
The analytical model used through this work is for a bearing with isotropic permeability. Considering isotropic permeability the Reynolds' equation for the oil film is modified to include a so – called filter term and the effect of fluid coupled stress. The pressure equation for the porous medium is obtained from Darcy's law and continuity equation. The equation which was used to evaluate the oil film thickness was modified to include the effect of possible misalignment in longitudinal and transverse directions. The governing eq
... Show MoreTwisted tape insertion in smooth plain tube is one of types of passive methods that is used to enhance heat transfer. Swirl fluid flow inside tube and related heat transfer characteristics are very complex. ANSYS FLUENT (V 16.1) and ASPEN industrial program are used in analyzing this technique for enhancement heat transfer. A circular plain tube has length L=8534mm and 17 mm inner diameter with twisted tape has twist ratio of y = (H/D) = (150/17) =8.8 along with a plain tube were considered for this study. Eight Reynolds numbers (Re) of 784, 1000, 2000, 3000, 4000, 5000, 6000 and 7000 are used to analyze the response of thermal performance. Crude oil API 28 exit temperature, film heat transfer coefficient, Nusselt number
... Show MoreIn this article, the influence of group nano transition metal oxides such as {(MnO2), (Fe2O3) and (CuO)} thin films on the (ZnO-TiO2) electric characteristics have been analyzed. The prepared films deposited on glass substrate laser Nd-YAG with wavelength (ℷ =1064 nm) ,energy of (800mJ) and number of shots (400). The density of the film was found to be (200 nm) at room temperature (RT) and annealing temperature (573K).Using DC Conductivity and Hall Effect, we obtained the electrical properties of the films. The DC Conductivity shows that that the activation energies decrease while the σRT at annealing temperature with different elements increases the formation of mixed oxides. The Hall effect, the elec
... Show MoreThe research aims to measure the effect of sensory marketing (visual marketing, audio marketing, olfactory marketing, taste marketing, tactile marketing) in enhancing customer loyalty (behavioral loyalty, situational loyalty, perceptual loyalty) and the mediating role of marketing knowledge (product knowledge, price knowledge, promotion knowledge knowledge of distribution, knowledge of employees, knowledge of physical evidence, knowledge of the process) in a group of large single market markets in Baghdad and the researcher chose it because of the challenges faced by large single market in satisfying the customer and maintaining it as a permanent visitor and enhancing his loyalty, and the research problem was identified with a main
... Show MoreA study were conducted to examinate the effect of organic and aqueous (Hot, Cold) Extracts from leaves of Duranta repens on the growth and activities of the following types of Bacteria:- Staphylococcus aureus,Streptococcus pyogens ,Escherichia coli,Klebsilla pneumonia, in addition to the yeast Candida albicans and the fungi Aspergullis niger ,Aspergulls flavus.The result showed that gram Positive Bacteria is more sensitive to the extracts than gram negative bacteria with Minimum inhibitory concentration (MIC) value (50,25,50,100)% and Minimum Bactericidal Concentration (MBC) value (100,50,200,100)% for all types Bacteria respectively . The most active extract against A.niger ,A,flavus was cold and hot aqueous extract from the leaves with d
... Show MoreThe path and its nodal purposes
Abstract
This study has come to indicate the doctrinal purposes of faith in this path، It was composed of an introduction and four demands، as follows:
The first requirement: the intentions of distinguishing between the ranks of people according to divine justice، as those who pass by him are different. Some of them are safe by his work، surviving from the fire، and some of them are not peace، he falls into the fire of Hell، and all of them are different in their ranks in a manner consistent with the justice of God Almighty and the works they have given themselves.
The second requirement: the purposes of divine mercy in honoring the Prophet and his nation on the path and embodying their
Walt Whitman adds a poetic twist to the relationship of man’s body, soul with the universe. His inspiration in writing his elegy, "When Lilacs Last in the Dooryard Bloom'd," draws on aesthetico-political resources. Major amongst these is his leaning towards the American Transcendentalist idea of the "Over-Soul". The basic topoi in his poems is thus his identification of nature with the soul of man. The idea of the Over-Soul sheds light on the three stages of human loss: suffering, despair, and compensation. Whitman witnessed two political events, the outbreak of the civil war and Abraham Lincoln's death, which were of a particular importance to his life and work: they helped him shape a form and thematic concerns of his own. Buil
... Show Moreيجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي
... Show MoreDescribed the Arabic language being of genius sets by top models of eloquence , rhetoric and clarity of sounds and developments Moreover , it is an important element of our existence and our identity and our survival . That my methods and best in teaching Arabic language what has pursued the easiest ways to learning and teaching and helped learners to be aware of the function linguistic information , and they need it and its impact on their lives , and contributed to unleashing the potential of activism and led them to make the effort to apply them in the form of examples and uses of new life , as well as fits are the capabilities and tendencies of different learners , so the goal of current research into the importance of the curriculum
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