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
Besides the role of state institutions that come in the forefront of their priorities and obligations to provide security and development of the economy and reduce the unemployment rate and the reduction of inflation and improving education, health and others, the Community Partnership At frames what has become known as the institutions of society civil-with the state does not eliminate the role, but rather complements its role ; it is the role of civil society partner and an extension of the role of the state in the face of challenges and crises, but it may be sometimes a race role in addressing social, political and economic issues of the role played by the state, not complementary.
The highlighting the specificity of the relationsh
The current research aims to provide a philosophical and knowledge framework to explain the issue of organizations dealing with Paradox phenomena by focusing on five main aspects. The first deals with the concept of paradox, and the second aspect deals with the types of forces paradox. While the third aspect regards subject of the philosophy of paradox in organization theory and the fourth side deals with methods of solving the paradox. Finally, the last side is exposed to the subject of the paradoxes of the three provided by the study (L
... Show MoreCurrent research sought to evaluate the performance and results of employees in accordance with normative to people and people result for the European model of excellence EFQM 2013 quality management Foundation in the Inspector General's Office/Ministry of health, so as to pursue a modern and advanced management methods in evaluating performance and the performance of the Office's relationship with a citizen's life, since it takes him beyond the accepted service capabilities today, but it became budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and continuous improvement and development as well as The primary role of the
... Show MoreBreast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o
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Current research has sought to apply the criteria of potential for altmizalaorbi model EFQM 2013 in assessing the performance of the Inspector General's Office/Ministry of health, so as to keep up with a modern and advanced management methods in the evaluation of performance, as well as to link performance to a citizen's life, and it takes him beyond the accepted service capabilities today, but of budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and development, as well as the constant quest for continuous improvement, is the spirit of the principle underpinning the European Foundation Quality managemen
... Show MoreOur research addresses one of the aspects of nostalgia for one of the most well-known Israeli writers of Iraqi origin (Sami Michael) who spent his childhood in Baghdad. The Israeli government has also been forced to emigrate with its family as a result of the Zionist propaganda that the Zionist institutions have followed since the early decades of this century in the Arab unrest and massacres. The fact that the homeland is like a mother is A fact that is compelling and something of an expatriate human being; the homeland is a fact that remains in the person's consciousness to be the image of the mother: The lover, love, safety, identity. The language that is formulated, and the memories that make its past, present and future, are all concep
... Show Morethe researchers pointed that the poet relied on several means in the form of poetic images, including analogy, and the metaphor with its various elements, The chromatic component has also been used in the formation of its poetic image,and resorted to the correspondence of the senses and the symbol of two types:Self-code, public code : And we find a variety of symbolic stems from different sources, from these symbols, what is religious, including what is historical and what is legendary, and such symbols, which resorted to the rare places of his poems confined to the myths contained in the Bible, His use of the general symbols was ineffective in the poetic picture, relying on the metaphor and metaphor.
God Almighty has imposed on us obligations and set limits on us, and among these obligations is the prayer, which is considered a pillar of Islam. And recently on the statement of its importance, and through extensive explanations, they elaborated on the statement of its pillars, its obligations, its Sunnahs, its rituals, and its bodies, and it is known that the imam in prayer is an important part of the parts of prayer. Whoever assumes this responsibility must be aware of these conditions, the most important of which is jurisprudence in religion, and there has been a disagreement between the jurists, especially the owners of the four schools of thought, about who is qualified to lead the imamate, and this is within many and wide details
... Show MoreTerrorist crime is considered a serious act that outweighs all other crimes in terms of impact and result, because it has a wide range on societies, and it also contains a great thing of danger represented in its purpose, and here describing terrorism as a crime is a description that does not give the full right to this behavior or that it It abbreviates it and does not show its actual reality, given that terrorism contains several different crimes and the roles of its contributors, and these roles are necessary to reach the result or the end. In which each episode is complementary to the other, it is not a single act, but rather several joint and complex actions that in turn all lead to the result, and the agreement in the terrorist pro
... Show MoreThe manufacturing industry in Iraq has faced, during the time stages, several obstacles that have had devastating effects on the Iraqi economy. These obstacles are represented by political events and wars that have led to the depletion of most human and material resources and the suspension of most vital industrial facilities from working, And the occurrence of this major deviation in the process of economic development, For the same reasons, the contributions of the manufacturing sector to the gross domestic product varied fluctuatingly, indicating instability in the growth rates of this sector, On the other hand, the supremacy of the belief that the dominance of oil resources as a main source for creating economic growth and achieving a h
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