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
The irony pushes us to inquire about what is in the text of contradiction, irony, suspense, and other acts of paradox, as well as a departure from what is logical, or familiar, that attracts the attention of the addressee, and this is what drives us to introspect the text and interrogate it in order to get to know the intended product of the text or its real or metaphorical intent. On the other hand, the irony is more in the literary text than in the scientific texts. Therefore, critics add the word literature to it in their definition.
As it is represented by the paradox, we will seek to study the paradox of the title and the problematic that it may pose as the beginning of the text, and i
... Show MoreBaghdad Lake Touristic is suffering from a lake of tourism and entertainment services
efficiency provided to their visitors , knowing that this type of services as they are the basics
to achieve economic and socialist development because of their indicators where their goal is
to serve human in city as they represent lungs which population breathe within .
The Parks are resorted as human usually in search of quiet and funny places , away from
the noise of the city and its complex , as well as they give the city a beauty manifestations ,
that give happiness.
The study reached that there is deficiencies in service present, inability to provide
services and inadequate for the population and bad distribution. So the s
Our research subject (environmental impact in the cultural output of the civilizations of ancient East) the environmental impact on human civilization and how her and adapted to serve in various cultural aspects especially in ancient cultures whether punches or sculptures and other addresses as well as tracing precious stones and raw materials. It was the environment of the civilizations of Mesopotamia and Egypt and another effective impact in drawing ancient history through human interaction and responsiveness. The Iraqi environment was marked by poverty and cruelty on the one hand and on the other cultural elements contributed to the civilization in General and research dealing with technical and product sourcing raw materi
... Show MoreThis study examines the species composition, biodiversity, zoogeography, and ecology of freshwater gastropods of 12 springs in Andijan region of Uzbekistan. The study used generally accepted malacological, faunistic, ecological, analytical, and statistical methods. As a result of research in the springs, 14 species of freshwater gastropods belonging to 2 subclasses, 5 families, and 10 genera were recorded. 7 of them are endemic to Central Asia. When indicators of biodiversity of mollusks were analyzed according to the Shannon index, it was found that the highest value was recorded in the springs besides the hills. According to the biotope of distribution and bioecological features, they were divided into cryophilic, phytophilic, pelophil
... Show MoreThe aim of this study is to investigate the effect of environmental management accounting information (EMAI) on the design process of environmental and sustainable products of Iraqi industrial companies. This process has five different sub-processes: research process, analysis process, conceptual design process, detailed design process and design production process. The study uses the quantitative approach as the questionnaire was designed and distributed to 87 quality managers, production managers, design managers and financial managers. The MANOVA analysis shows that EMAI has a positive and significant effect on three of these processes, namely research process, analysis process and detailed design process, while EMAI has an insi
... Show MoreThe added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).
The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi
... Show MoreBiomedical alloy 316L stainless steel enhancing to replace biological tissue or to help stabilize a biological structure, such as bone tissue, enhancing were coated with deposition a thin layer of silver nanoparticles as anti-bacterial materials by using DC- magnetron sputtering device. The morphology surface of The growth nanostructure under the influence of different working pressure were studied by atomic force microscope. The average grain size decrease but roughness of the silver thin layer was increased with‖ ―increasing the working pressure. The thickness of silver thin layer was increased from 107 nm at 0.08 mbar to 126 nm at 1.1 mbar. Antimicrobial activity of silver thin layers at different working pressure were studied. Th
... Show MoreA total of 215 sheep and 87 goats were carefully searched for ixodid ticks from January to December 2015 at different regions of the middle and south of Iraq. The detached ticks count 1533 ticks from sheep with intensity of 8.4 and count 332 ticks from goats with intensity of 6.8. Tick species recovered from sheep and their incidence rates were: Rhipicephalus turanicus (39%), Hyalomma anatolicum (28%), R. (Boophilus) annulatus (11%), Hyalomma sp. (9%), H. turanicum (6%), H. excavatum (6%) and R. leporis (1%) while the tick species recovered from goats and their incidence rates were: R. turanicus (64%), H. anatolicum (24%)
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