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
Abstract
The problem of the study is the main question (Can tourism planning address the phenomenon of unemployment in Iraq ?) , And the importance of the study in the fact that the tourism sector can become an effective development alternative in many countries, especially Iraq, as tourism contributes to diversify sources of income and stimulate other economic sectors , We know how important Iraq's qualifications are in the field of tourism and what it can generate on the public treasury, To confirm the current study on the need to pay attention to tourism planning for its role in providing employment opportunities that reduce the unemployment rate in the future.
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... Show MoreVarious literary studies have investigated the psychological, social and cultural effects of traumatic events. They give voice to traumatised victims and enable them to convey and confront their traumas. However, these studies present a one-sided view, concentrating largely on the presentation of trauma in the industrial societies of the Western world. Recently, increasing attention has been devoted to identifying and depicting the forms and types of trauma that have been experienced in marginalised and neglected societies, such as the Iraqi society. Iraq has witnessed the unexpected fall of a brutal dictatorship, Western invasion and an unprecedented rise of sectarian discourses. This extreme violence has deeply affected many aspec
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The conflict between the fundamentalist and news theory in the methodology that each of the two schools pursued with the Twelver Shi'a Imamiyyah in deriving the legal rulings from the sources of legislation, especially in the second source, which is the noble hadith and narration after the Holy Qur’an, which is the first source has gone through multiple and complex stages that led This struggle to excess, stress, exaggeration, negligence, neglect and indulgence by each of the two schools in dealing with the noble hadith and narration and in the manufacture of rules and laws and fundamentalist and juristic theories of the process of jurisprudential development of legal rulings where every school believed and proceed
... Show MoreThe development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i
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Abstract
This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que
... Show MoreHigh frequencies of multidrug resistant organisms were observed worldwide in intensive care units which is a warning as to use the only few effective antimicrobials wisely to reduce selective pressure on sensitive strains.
The aim of the current study is to asses the compliance of the currently followed antibiotic prescribing pattern in the intensive care unit in an Iraqi hospital with the international guidelines.A cross-sectional study was done in the intensive care unit (ICU) of the Surgical Specialties Hospital, Medical City in Bagdad from the 30th of November 2011 to the 5th of May 2012.Patients were followed until they were discharged or died to see any change in condition, response to drugs, devices u
... Show MoreThe study aims to reveal the degree of application of the alternative evaluation strategy in social studies in public education in the Kingdom of Saudi Arabia. It also aims to identify the opinions of experts on how to implement this. The study adopted the mixed methodology, which represented in the descriptive-analytical method, and qualitative methods through the grounded theory. The study used two tools namely: a questionnaire for assessments of social studies teachers and semi-structured interview questions. The results of the study showed a medium degree of appreciation for the application of alternative evaluation strategies by social studies teachers in general education with an average of (2.28). The results also showed that ther
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Research aims : The aim of the research is to evaluate the reality of the inspection teams' work in the health institutions belonging to Dhi-Qar health office .
Purpose: This research seeks to present a point of view based on knowing the extent of health service quality in Dhi-Qar governorate and discover the role of the inspection teams in enhancing the health service.
Design / Methodology/ Approach: The experimental method has been used and the questionnaire has also been used to collect data in order to develop a reliable and correct measurement model for the research's variables . The research's hypotheses have been tested through using some statistical treat
... Show MoreThe study of history has begun to become increasingly important for those interested in the field of education in general, and physical education and sports sciences in particular. It is a recent study of the past and relying on it. Therefore, studying the history of sports for people with disabilities and their development is of great importance, as it is one of the means to measure the extent of development of societies and their culture in this field. Weightlifting is a sport for people with motor disabilities, and the way to play is for the contestant to lie on the bench (ping bar) and most often the legs are tied to the bench to ensure that the hip and legs do not contribute to the lifting process with the arms, when the player grabs t
... Show MoreThis study aims to impact statement played by banking governance according to the decisions of the Basel Committee in achieving the strategic objectives of the banks, But order to achieve the this goal has been the adoption of two hypotheses in addition to the two main hypotheses as sub answered preliminary The study seeks to verify their health and two (no correlation relationship and impact between Banking governance and achieve strategic objectives), has been tested hypotheses. Study has reached
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