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
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Non-prismatic reinforced concrete (RC) beams are widely used for various practical purposes, including enhancing architectural aesthetics and increasing the overall thickness in the support area above the column, which gives high assurance to services that this will not result in the distortion of construction features and can reduce heights. The hollow sections (recess) can also be used for the maintenance of large structural sections and the safe passage of utility lines of water, gas, telecommunications, electricity, etc. They are generally used in large and complex civil engineering works like bridges. This study conducted a numerical study using the commercial finite element software ANSYS version 15 for analysing RC beams, hol
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Endophytic fungi live inside plants or any part of them without creating any visible pathogenic signs. Endophytic fungi are found within medicinal plants and have shown strong biologic activity, such as anticancer and antioxidant activities, as well as producing extracellular enzymes. In this study, different fungal strains were isolated from the leaves of the medicinal plant Ziziphus spina, including Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Cladosporium sp., Rhizopus sp., and Mucor sp. Extracellular enzymes have been quantified using agar plate-based methods in which fungi were grown in specified growth media to detect the enzymes produced. The results showed that A. niger has the highest ability to produce amy
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A new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever
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The incorporation of recycled concrete aggregate (RCA) into asphalt concrete supports circular economy goals by reducing reliance on virgin materials and minimizing construction waste. However, RCA’s inherent limitations, such as high porosity, microcracking, and poor interfacial bonding, compromise the structural integrity and durability of asphalt mixtures. This study introduces sugarcane molasses (SCM), a naturally derived, carbohydrate-rich byproduct of sugarcane refining, as a novel and eco-friendly surface treatment for RCA aimed at enhancing its compatibility with asphalt binders. SCM was applied at 5-6% by weight of RCA replacing coarse aggregate at varying levels (0-100%) to assess its effect on asphalt mixture performance. A com
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This paper aims to study the second-order geometric nonlinearity effects of P-Delta on the dynamic response of tall reinforced concrete buildings due to a wide range of earthquake ground motion forces, including minor earthquake up to moderate and strong earthquakes. The frequency domain dynamic analysis procedure was used for response assessment. Reinforced concrete building models with different heights up to 50 stories were analyzed. The finite element software ETABS (version 16.0.3) was used to analyze reinforced concrete building models.
The study reveals that the percentage increase in buildings' sway and drift due to P-Delta effects are nearly constant for specific building height irrespective of the seism
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