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
This article is devoted to the stylistic and educational characteristics of the language of Russian diplomacy. The article describes the stylistic and educational aspect of the appearance of the Russian protocol, its relation to universal diplomacy, the relationship between the diplomatic language and the business sub-style. Here the semantic features of the diplomatic vocabulary are determined and the factors influencing its formation and the emergence of new terms in the language of Russian diplomacy are considered. The article also examines the national and cultural identity of the language of Russian diplomacy, provides rules for drafting diplomatic documents and conducting negotiations, defines the concept of a document as a whole, giv
... Show MoreThis research aims to study a range of yet and future variables that can affect human resources in Iraq and public organizations that influence the size of each, and the extent of its contribution to the development of human resources through the National Investment Commission of Baghdad. The identified research problem in a set of questions was the most important, what are the variables that help in the development of human resources to the Investment Commission of Baghdad theme of the search, in order to achieve the goal of research and answer questions about the problem, applied research on both the research community's (55) individual executives and employees.
Researcher has identified a r
... Show MoreThis research discusses the logic of the balance of power in the field of International Relations. It focuses on the structural-systemic version of the theory because of its centrality to the realist research program within the field. The paper examines the conventional wisdom, which argues that balances of power, in a self-help system, will form regardless of the state’s motives (or intentions); It emerges as an unintended recurring consequence of the interaction of units in anarchy, which primarily seeks superior, not an equal power. This logic assumes that hegemony does not form (or fail) in a multi-state system, because its threats (actual or perceived) to the system instill fear and provoke counterbalancing behavior by other state
... Show MoreAutoimmunity is a philosophical term that enhances the fields of life-sciences, and links out to the unnatural behaviour of an individual. It is caused by the defenses of an organism that deceive its own tissues. Obviously, the immune system should protect the body against invading cells with types of white blood cells called antibodies. Nevertheless, when an autoimmune disease attacks, it causes perilous actions like suicide. Psychologically, Jacques Derrida (1930-2004) calls autoimmunity a double suicide, because it harms the self and the other. In this case, the organ disarms betraying cells, as the immune system cannot provide protection. From a literary perspective, Derrida has called autoimmunity as deconstruction for over forty years
... Show MoreThe phenomenon of child labor, any activity performed by a child and represents a contribution to the production, this phenomenon had been rife in Iraqi society, after that the proportion of child labor for the age group (6-14 years) amounting to 3% in 2006, became for the same age group of 8% in 2008*.
It is recognized that each phenomenon reasons, the phenomenon which our atten
... Show MoreThere is no doubt that development is a human necessity and an urgent technical imperative that science imposes on all aspects of societal life. Especially in the field of graphic design, as logos are among the most prominent graphic achievements of an interactive nature with the requirements of the technical and functional era to serve the recipient and the continuity of interaction with him through a visual message sent to him constantly to remind him of what he interacted with in advance, which is known as visual identity, and during the process of developing logos especially And by providing designs that suit the contemporary technical and functional development, we often see the logo lose its visual identity. Therefore, the research
... Show MoreThe study aims at showing the active role of the internal auditors through explaining what they should be obliged to in writing the reports and financial and non financial statements according to the international standards of accounting to be transparent and integral. It also aims at giving the independence that the auditors should enjoy through connecting them to an Auditing Commissions to submit additional services in addition to assessing the instrument of control to evaluate risks, give consultations and the services related to the governance and independence of Supervising Council.
... Show MoreBackground: Excessive crying in early
infancy is a common condition that causes a
great deal of concern to the parents and
physician.
Objective: The aim of this study is to find
the underlying etiology of excessive crying in
infancy and to determine how the history,
physical examination, and laboratory
investigations contribute to the final diagnosis.
Method: A prospective study done on 150
afebrile infants less than 4 months of age
visited Al-Elwia hospital for children
complaining of excessive crying of more than
two hours.
The study done over a one year period from
the first of January 2009 to the end of
December 2009.
All febrile infants and those with acute illness
preceding the
We try through this research to show the relationship between the crescent and the month in the Koran, and then their importance and their relationship to timing, and the timing of this relationship with people, and the significance of these timings, so we gathered verses that spoke about the family and the month, and we tried to study them in a detailed objective study, so this came The research of five subjects was the first topic introductory research and the time and month, while the remaining four detectives on the verses that talked about the timing of the month, and we have explained the relationship of this timing with people and the significance of these times.