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
After the internal audit as a tool of internal control in any organization, and helps in the evaluation of all internal control activities, as a tool to ensure compliance with the plans and policies to achieve the goals of the institution as much as possible of the efficiency, effectiveness, and should have the Internal Audit full independence and is linked to senior management, and aims to get the credibility and accuracy of information and data, and keep abreast of modern developments.
The practical side includes the preparation of the questionnaire, which included a set of questions that fit the hypothesis of the research, was Tozeiha the research sample consisting of employees of the Internal Audit Department an
... Show MoreTheatrical performances began with the Greeks when the theatrical scenes and skeletal figures were encoded, where the large wall of the Alskina, which contains three doors, the middle of them with a high height, and the two sides took the natural size, where the middle door indicated a symbolism of the god or demigods, as we find the condensation of the symbol in the architecture of the theater, and the symbol was taken In the theatrical scene, the development semantically and aesthetically, and interpreting and interpreting the current day, where the laser light formed the symbolism of the contemporary virtual scene, and in order to identify the aesthetics of the symbol in the theatrical scene, the current research was evaluated into fo
... Show MoreThe study of this topic is not to underestimate the previous studies but to the great importance of the Sunnis of the report. The reasoning of the Hadiths of the report is a kind of invisibility in that the significance is not a phenomenon such as the emergence of reasoning in the words of words and deeds. With the introduction of all types of Sunnah and protest, there is no difference between them, and that the Sunnis argument like other Sunnah. What we will see in the research.
The research is aimed at dynamics the dynamics of the artistic form within the theater and the dynamics of this movement in the development of the form and the multiplicity of meaning. This research came to address a problem of great importance in the creation of the image and the form of theatrical presentation. The evolution and transformation within the display system requires a dynamic structure that enables the form of growth and growth. The aim of the research was to identify the dynamics of form in the Iraqi theater. The researcher then identified two terms: form and motor.
In the theoretical framework, it was divided into two sections: the first (the dynamics of the artistic form) and the second (the dynamics of the act of dir
The field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th
... Show MoreThe research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o
... Show MoreThe current research included (the evaluation of Information Security Management System on according to international standard (ISO / IEC 27001: 2013) in Iraqi Commission for Computers and Informatics), for the development of an administrative system for information security is considered a priority in the present day, and in the light of the organizations dependence on computers and information technology in work and communication with others. The international legitimacy (represented by the International Organization for standardization (ISO)) remains the basis for matching and commitment and the importance of the application of information Security Management System accordi
... Show MoreDiversity of the aspects of analyzing a specific linguistic issue is considered to be a
familiar phenomenon in learning Arabic in which – at different levels- various linguistic
aspects and phases – sometimes – are involved in a linguistic issue . In this paper , the
problematic issues during linguistic analysis are taken into an account. The Holy Quran
interpretation books include many Quranic expressions which have a lot of meaning described
by different interpreters , from them this paper has selected only one expression ( = كفاتا
receptacle ) from the verse "Have we not made the earth a receptacle " ( Al- Mursalat verse 25
) , this paper believes that this expression is sufficient display the interpret
The aim of this investigation is to study and analysis the role of governance in the evaluation of the and social performance of the economic units to be addressed through the concept of corporate governance and then to the social performance and its relationship to corporate governance.
The most important obtained results from this research is that the corporate governance of extreme importance, and derive their importance from being an essential tool to contribute to the transparency and fair disclosure of the financial results of economic units in the fight against financial and administrative corruption in economic units, thus providing protection and confidence of all parties, and the evaluating soci
... Show MoreThe Political Thinking Regarded as an important element for the formulation of the stat, weather in its formation, the structure of it s entity, its political system and it s governmental instruments .The political thinking can not act without determined strategy, So they intend to work hard to formulate a railed strategy that make them able to determine its directions to general issues.
The Study aimed to solve the problem through the following question:
1- What are the levels of Political Thinking and Strategic Analysis in the financial ministry?
2- What are the relation ship between the dimensions of Political T
... Show More