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
We discussed the proper preparation, directing, and implementation of physical education lessons, and clarification of the duties that fall upon the physical education teacher in addition to his physical and skill duties, which is the duty of the physical education lesson. The problem of the research lies in the fact that interactive harmonic exercises are not implemented accurately by physical education teachers because they require great experience, exceptional efforts, and accuracy in performance. The research aims to identify the level of some physical and motor abilities and intelligence among students aged (9-10) years, and to know the effect of some harmonic exercises. Interactivity at the level of some physical and motor abi
... Show MoreThe importance of this research is to clarify the nature and the relationship between the indicators of financial policy and banking stability in Iraq, as well as to find a composite index reflects the state of banking stability in Iraq in order to provide an appropriate means to help policymakers in making appropriate decisions before the occurrence of financial crises.
Hence, the problem of research is that the fiscal policy has implications for the macro economy and does not rule out its impact on banking stability. Moreover, the central bank does not possess a single indicator that reflects the stability of the banking system, rather than the scattered indicators that depend o
... Show MoreBackground: Change in palatal vault shape and Reinforcement of high impact acrylic denture base resin may in turn affect the dimensional accuracy of acrylic resin and affecting the fitness of the denture.This study evaluated tostudy the effect of fiber reinforcement for high-impact acrylic resin denture base with different palatal vault shapes on adaptation or gap space between the denture base and the stone cast and compare with non-fiber reinforcement and effect of palatal vault shapes on adaptation of non-reinforced and fiber reinforced high impact denture base acrylic resin Material and method: Three different palatal vault shapes were prepared on standard casts using CNC (computer numerical control) machine. 60 samples of heat polymeri
... Show MoreBackground: The PMMA polymer denture base materials are low mechanical properties, adaptation of the denture base to underlying tissue is important for retention and stability of denture. The aim of the study was toevaluate the effect of mixtureZrO2-Al2O3 nanoparticles on impact strength, transverse strength, hardness, roughness, denture base adaptation of heat cured acrylic resin denture base material. Materials and methods: One hundred (100) specimens were prepared, the specimens were divided into five groups (20 specimens to each) according to the test type, each group was subdivided in to two subgroups (control and experimental) each subgroup consist of 10 specimens, the experimental group included mixture of 2% (ZrO2-Al2O3ratio2:1) b
... Show MoreBackground: Change in palatal vault shape and Reinforcement of high impact acrylic denture base resin may in turn affect the dimensional accuracy of acrylic resin and affecting the fitness of the denture. The aim of study is to evaluate the effect of fiber reinforcement for high-impact acrylic resin denture base with different palatal vault shapes on linear dimensional change and effect of palatal vault shapes on linear dimensional changes of non-reinforced and fiber reinforced high impact denture base acrylic resin Material and method: Three different palatal vault shapes were prepared on standard casts using CNC (computer numerical control) machine. 60 samples of heat polymerized high impact acrylic resin maxillary denture base were fabri
... Show MoreThis paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary
... Show MoreThe focus of this research revolves around the importance level of sialic acid in the reasoning of cases, including tumors and then evaluate the patient's response to treatment and its impact on the immune response there are a lot of evidence showing that parts Alkrbu ???????? in peptides sugary and glycoproteins play an important role in Alfalitin life and responsiveness
The main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study
... Show MoreThe research aims to apply one of the techniques of management accounting, which is the technique of the quality function deployment on the men's leather shoe product Model (79043) in the General Company for Textile and Leather Industries by determining the basic requirements of the customer and then designing the characteristics and specifications of the product according to the preferences of the customer in order to respond to the customer's voice in agreement With the characteristics and technical characteristics of the product, taking into account the products of the competing companies to achieve the maximum customer satisfaction, the highest quality and the lowest costs. Hence, the importance of research has emerged, which indicat
... Show MoreThe exercise of citizenship behaviors and their impact on customer loyalty (An analytical study from the perspective of workers in the National Insurance Company).
The Research aims to find out the degree of customers National Insurance company for customer citizenship behavior and its impact on the level oh loyalty from the perspective of employess in the company, as well as the statement of the differences in the answers of employees according to their personality traits. To achieve the goals of research has been the use of the questionnaire as a tool for the collection and distribution of data on a sample of (90) individuals, as was the use of statistical program (SPSS) in the process of statistical analysis methods (mean, sta
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