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
BACKGROUND: Genetic skeletal abnormalities are a heterogeneous group of genetic disorders frequently presenting with disproportionate short stature. AIM OF THE STUDY: To give an idea about the frequency of genetic skeletal abnormalities, and to find out whether these disorders are really increasing in the last 16 years or not. METHODS: During the period extending from (Jan, 1st 2003-April, 1st 2007), all cases of genetic skeletal disorders referred to the Genetic Counseling Clinic, Medical City – Baghdad who were born after 1991 were included in this study as the post-war group; the pre-war group, included all cases of skeletal disorders referred prior to 1991 (Jan., 1st 1987-Jan., 1st 1990). The demographic parameters, family history of
... Show MoreTwo field experiments were conducted during the season 2021-2022 in central Iraq represented by the Al-Muthanna governorate - Al-Majd District and Al-Qadisiyah governorate / Al-Nouriah Research Station to determine the productivity of the Baghdad 3 cultivar from spray foliar fertilization of Macro and Micro elements with alcoholic sugars and half the fertilizer recommendation for addition floor, three treatments were used for fertilization: T1 as the control treatment and T2 with alcoholic sugar fertilization at a concentration of 20 g.L-1 + the fertilizer combination of Macro and Micro elements, and T3 with alcoholic sugar fertilization at a concentration of 40 g.L-1 + the fertilizer combination of Macro and Microelements, at irrigation 55
... Show MoreWe have provided in this research model multi assignment with fuzzy function goal has been to build programming model is correct Integer Programming fogging after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.
The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the
... Show MoreThe impact of the auditor's personal judgment starts from the beginning of the audit process to the formation of the final opinion and the issuance of the report, and because of the possibility of bias in the auditor's judgment for various reasons that may relate to the auditor himself or the circumstances surrounding it, which requires assessing the current reality of the auditor's personal judgments In the local environment and determining their determinations. To clarify the concept and determinants of the auditor's personal judgments when implementing the audit work, prepare the report and determine the role of the international auditing standards in rationalizing the auditor's personal judgment when conducti
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The changes that happened in the environment of business have great effects upon organizations with different activities specially the banks which requires the existence of an able opinion resources can adapt with the changes . Accordingly importance put upon intellectual capital which become one of the basic resources for organizations and one of success and growth elements with the availability of expertise , skills and capability of making essential changes in different process due to the presentation of innovations and creations of the to support banks activities .Therefore the intellectual capital represents the more r
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The main problem of the study lies in the lack of a clear perception among the study sample about the impact of digital marketing tools on legal liquidity. Legal) of the International Development Bank for Investment and Finance and to achieve the objectives of the research, the method of observation and survey was used in measuring the dimensions of digital marketing. As for banking liquidity, the reports and financial statements of the bank were used as the research sample, as well as the use of the statistical analysis program SPSS in the statement of the relationship The study concluded, in summary, the following: Mar
... Show MoreOf the importance of the concept of ownership of real estate as the basic basis from which various projects are launched in various economic, tourism, and urban areas .... The need to research the diagnosis of real estate reality went astray in the difficulties, which played a decisive role in the process of urban development.
This leads us to the research problem of the difficulty of implementing urban development plans in many cases due to the absence of a clear methodology for organizing and modernizing the ownership of real estate and its coordination with the management of urban land and to achieve the objective
... Show MoreThe article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show MoreThe objective of this research is to determine the relationship between the performance evaluation process and the training programs for the employees, to identify the extent of the organization's commitment to perform the performance evaluation process for its employees and to use the results of this process in determining the appropriate training programs. Performance evaluation, functional analysis, evaluation method used, dependent variable (training programs) and its dimensions, type of programs, program objectives, program curriculum, And the application of the field research methodology and the questionnaire, which included 146 individuals to know their views and analyz
... Show MoreText science presented a set of criteria to make the text essentially a project to create
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Albulagjun Arabs on the semantic consistency between the text components, as reflected in
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