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
Construction is the opening of the important pillars of the construction of the film as a whole for this, we find that the first of any narrative of my film begin at the borders of this construction is the window that we look through the contents tale and puzzle narrative is of significance that degrade traveler when reservoirs expression later in reasoning and find justifications ills that came by those initiation, this initiation may be the window that lead us to the core, understanding the story through signals received to the recipient to sail because of the paths of pickling what is which is encoded, but this initiation may serve as keys that understanding the be puppies and signals that beset and surrounded to what He holds inevita
... Show MoreEarthquakes in the Holy Qur’an and the Hadith of the Noble Prophet, an intellectual approach
Every researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.
The person who wants to learn. The history of Bab’is will notice a very
starnge phenomenon that they (Babis and Baha’is) resort to visions to prove their
delusion.
The believers usually reach to each other by their visions. This phenomenon
are shared among them from Al- Ahsa’ai time till the last phase of their propaganda
which is the Baha’is propaganda, and this is due to their ignorance and under
development in doctrine of islam which was widespread in Iran and the Islamic world.
The whole secrets of Babis and Baha’is movement were restricted among
particular group, most of them were Al- Rashti’s students and knew the basic
principles of their movement which deperding or (the principles) declarati
An in-depth experimental study of the matrix effect of antifreeze (ethylene glycol) and water contamination of engine oil through FT-IR spectroscopy. With a comparison of the percent by volume concentration of contaminated fresh 15W-40 engine oil, there appeared to be a noticeable reduction in the O–H stretching signal in the infrared spectrum when ethylene glycol based antifreeze was included as a contaminant. The contaminants of distilled water, a 50/50 mixture of water and commercial ethylene glycol antifreeze, and straight ethylene glycol antifreeze were compared and a signal reduction in the O–H stretch was clearly evident when glycol was present. Doubling the volume of the 50/50 mixture as compared to water alone still res
... Show MoreThe evaluation of banks plays an important role in maintaining the interests of customers with the bank as well as providing continuous supervision and control by the Central Bank. The Central Bank of Iraq conducted an assessment of the Iraqi banks through the implementation of the CAMEL model during a certain period. This evaluation did not continue. The research provides continuity to the Central Bank's assessment and as a step to continue the evaluation process for all banks through the use of the CAMEL model. ROA and ROE by using the regression model for four Iraqi banks registered in the Iraqi market for securities during the period 2010-2016. The results showed that the capital and profitability indicators have a significan
... Show MoreThis study examined the phenomenon of unemployment in Iraq and the extent of the contribution of these loans granted by banks to finance small and medium enterprises in reducing their rates. The temporal boundaries of the study included the period between (2012-2018). The spatial boundaries consisted of random sampling of six Iraqi banks) Where the government banks included (Rafidain, Rasheed and industrial), private banks included (the Iraqi Islamic Bank and the Gulf Commercial Bank and the Bank of the Middle East). In order to achieve the objective of the research in the light of the hypotheses drawn up, the research divided into three topics, the first section highlighting the reality of small and medium enterprises in Iraq and the lo
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تدور الدراسة في علم الاقتصاد المنزلي حول احتیاجات الانسان الضروریة لاستمرار الحیاة ومواقف في محیط
الاسرة وتفاعل مع ظروف البیئة المحیطة بھ .والتي تكون دائمة التغییر لذلك یمكن تعریف علوم وفنون الاقتصاد
المنزلي وفنونھ انھا عبارة عن مجموعة منظمة من المعارف والعلوم تتركز في محور الاسرة والمنزل حیث ینمو
ویتطور الانسان بالعلاقات الانسانیة والنواحي الاقتصادیة والاجتماعیة من جھة والنواحي العلمیة وا
The liver of marsh harrier grossly appeared as large, bi-lobed organ divided into left and right lobes, which are approximately equal in size and not divided into secondary lobes. Histologically, the liver of marsh harrier was found to contain numerous lobules which are not well defined by the connective tissue of the septa except that surrounded the portal triads. The parenchyma of liver composed of irregular branching cords of hepatocytes organized in double rows alternating with tortures path sinusoids which are lined with flattened endothelial cells and large, irregular outlined kupffer cells. Hepatic cords arranged in a radial pattern around the central vein of the liver lobule while in a subscapsular region they run parallel to the ca
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