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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The present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%). After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL
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This paper is an attempt to investigate the syntactic and semantic features of the English phrasal verbs. In this paper, phrasal verbs were classified into subgroups according to their syntactic and semantic characteristics. After giving a survey of literature written on the meaning and definition of phrasal verbs, two sections have been devoted to tackle the most important issues in this category of English verbs. Section one sheds light on the basic definitions of the term ‘phrasal verb’ which are, according to the researcher’s point of view, sufficient to cover the area of the study. In addition, it studies the number and the importance of phrasal verbs in English. Section two deals with the syntactic and semantic features of Engli
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Аннотация
в статье рассматриваются проблемы преподавания русской литературы в иракской аудитории.. Использование литературы в преподавании иностранного языка, как правило, имеет две цели. Первая-чисто лингвистическая .. Вторая цель, однако, ассоциируется больше с экстралингвистикой и представляет собой ознакомление студентов с различными аспектами русской жизни, культуры,
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The aim of this paper is introducing the concept of (ɱ,ɳ) strong full stability B-Algebra-module related to an ideal. Some properties of (ɱ,ɳ)- strong full stability B-Algebra-module related to an ideal have been studied and another characterizations have been given. The relationship of (ɱ,ɳ) strong full stability B-Algebra-module related to an ideal that states, a B- -module Ӽ is (ɱ,ɳ)- strong full stability B-Algebra-module related to an ideal , if and only if for any two ɱ-element sub-sets and of Ӽɳ, if , for each j = 1, …, ɱ, i = 1,…, ɳ and implies Ạɳ( ) Ạɳ( have been proved..
A crucial area of research in nanotechnology is the formation of environmentally benign nanoparticles. Both unicellular and multicellular play an important role in synthesis nanoparticles through the production of inorganic materials either intracellularly or extracellularly. The agents (pigments, siderophores, cell extracted metabolites and reducing compounds) were used to prepare silver nanparticles with different sizes and shapes. The color variations (dark yellow, slightly dark yellow and golden yellow) arising from changes in the composition, size, and shape of nanoparticles, surrounding medium can be monitored using UV-visible spectrophotometer. These effects are due to the phenomena called surface plasmon resonance. The silver nanopa
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The objective of the current research is to find an optimum design of hybrid laminated moderate thick composite plates with static constraint. The stacking sequence and ply angle is required for optimization to achieve minimum deflection for hybrid laminated composite plates consist of glass and carbon long fibers reinforcements that impeded in epoxy matrix with known plates dimension and loading. The analysis of plate is by adopting the first-order shear deformation theory and using Navier's solution with Genetic Algorithm to approach the current objective. A program written with MATLAB to find best stacking sequence and ply angles that give minimum deflection, and the results comparing with ANSYS.