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
Zora Neale Hurston's (1891-1960) is an outstanding African American
novelist, playwright, autobiographer and essayists. Her work is considered as an
important part of the African American and Harlem Literature.**** It represents a
milestone and a keystone in the African-American literary canon because it breaks
from the style of the previous works and makes a beginning of a new style. Hurston
shifts from the black works that stick to racial themes and sheds the light on new
aspects and themes in blacks' life especially on feminist themes. Her exceptional fame
culminates in her novel Their Eyes Were Watching God (1937). 1
Their Eyes Were Watching God examines with a great deal of artistry
the struggle of a black
The principal objective of this study is to demonstrate how green quality management and product life cycle costing may help an organization gain a competitive advantage. Green quality management's influence on increasing product quality and meeting environmental criteria, as well as tracking the activities of product life cycle before, during, and after production, is demonstrated. Orienting these activities toward the production of eco-friendly products that fulfill the needs of customers, hence increasing organization's market share. We found from our study that proposed framework can help organizations improve their competitiveness. Green quality management contributes to environmental protection and the provision of high-qualit
... Show MoreSummary This research, entitled (Distinguishing Voice Features of Qalqales Voices and their Expressive Values in the Holy Quran), aims to shed light on five of the voices that are characterized by strength and intensity, whose pronunciation requires loud vocal tone, great effort and semantic dimensions.The research consists of two topics .in the first topic. We talked about the voices of Alqalqal , their definition, their degrees, their ranks, and the opinions of scholars about them.
In the second topic, titled Expressive Values for Weak Voices in the Holy Qur’an, we talked about the relationship between sound and meaning, and we clarified in it the expressive values of Qalqa
... Show MoreIn this paper, we deal with a dynamical system that can demonstrate a chaotic attractor of Rossleroscillator. We simulate the Rosslerequations numerically then we investigate the model experimentally. Numerically, the Rossler parameter a and b were fixed and c was changed.The evolution of the system exhibits period, period-doubling, second period doubling, and chaos when control parameters are changed. This evolution can be seen by analyze the time series, the bifurcation diagrams and phase space. Experimentally, the evolution of the system exhibited the same numerical behavior by changing the resistance (Rv) in Rossler circuit that represent as control parameter.
To determine the relationship between chronic hepatitis B virus and autoimmune celiac disease, seventy five patients with chronic hepatitis B virus of ages (8-70) years have been investigated and compared with 50 healthy individuals. All the studied groups were carried out to measure antiGliadin antibodies IgA and IgG by ELISA test and anti-reticulin antibodies IgA and IgG by IFAT. There were significant elevation (P<0.05) in the concentration of AGA IgA and IgG antibodies compared to control group. The prevalence of AGA antibodies IgA and IgG was 8% and 9.33% respectively. There were a highly significant differences (P<0.01) between studies groups. The prevalence of antireticulin antibodies ARA IgA and IgG was 6.67% and 4.0% respectively i
... Show MoreThe purpose of this study was to determine the impact of added soy protein humidifier concentration of different ratios of bovine Alberkr mix that was to bring the old chicken shop pure beef in five ratios
Forecasting is one of the important topics in the analysis of time series, as the importance of forecasting in the economic field has emerged in order to achieve economic growth. Therefore, accurate forecasting of time series is one of the most important challenges that we seek to make the best decision, the aim of the research is to suggest employing hybrid models to predict daily crude oil prices. The hybrid model consists of integrating the linear component, which represents Box Jenkins models, and the non-linear component, which represents one of the methods of artificial intelligence, which is the artificial neural network (ANN), support vector regression (SVR) algorithm and it was shown that the proposed hybrid models in the predicti
... Show MoreThe research aims to determine the impact of Human Resources Accounting (HRA) on employee’s performance. The research’s problem was embodied in the lack of interest in HRA, which was reflected on the performance of employees in the Ministry of Education; the research adopted the descriptive-analytical approach, and the research community included the directors of departments and people at the headquarters of the Ministry of Education. The sample size was (224) individuals from the total community of 533. The questionnaire was adopted as the main tool for collecting data and information, as well as the interviews that were conducted by the researcher. In order to analyze t
... Show MoreWomen are considered important characters and subjects of discussion in the Glorious Qur’an. Some are portrayed in a positive light while others are condemned . Most women in the Glorious Qur’an are represented as either the mothers or wives of certain leaders and prophets. But the lexical items “Imra’a” امراة and “zawj” زوج occur in the Glorious Qur’an with different meanings depending on the context where they occur.
Translation of the Glorious Qur'an has always been a problematic and difficult issue. Since the Glorious Qur'an is regarded as miraculous and inimitable (i'jaz al-Qur'an), Muslims argue that the Qur'anic text should not be separated from its
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