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 labeled research deal with (Entrepreneurship Organizations In the framework of strategic leadership practices: Field research in the Ministry of Oil), Search over the possibility of the influence of the practices of strategic leadership Which include
(Determine the strategic direction, The discovery of the fundamental estimators and maintain it, The development of the human capital, and Maintaining of an organizational culture influential, and Find a balanced regulatory Control) In a Entrepreneurship in its dimensions and its (innovation, risk, pre-emptive and independence) On group of heads of departments and authorities
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The current study aims to demonstrate the role of strategic renewal in enhancing organizational immunity through strategic renewal mechanisms represented by (Reanimating, Rejuvenation, Venturing, and restructuring). The main idea of this study relates to the extent to which organizations’ immunity is achieved through strategic Renewal mechanisms, by measuring these dimensions with Organizational immunity represented by organizational learning, organizational memory, and organizational DNA. The study population was the headquarters of the Iraqi Ministry of Education, and the sample included (330) individuals from the upper, middle, and lower leadership levels. Several statistical methods were used to deal with the results of the questionna
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The aim of the current research is to identify the level of administrative applications of expert systems in educational leadership departments in light of the systems approach. To achieve the objectives of the research, the descriptive-analytical and survey method was adopted. The results showed that the level of availability of the knowledge base for expert systems in educational leadership departments (as inputs) was low. The level of availability of resources and software for expert systems in educational leadership departments (as transformational processes) came to be low, as well as the level of availability of the user interface for expert systems in educational leadership departments (as outputs
... Show MoreThe current research aims to find out the effect of strategic sensitivity in enhancing organizational immunity at the leadership levels in the Iraqi Ministry of Education, as the strategic sensitivity variable includes two dimensions (strategic foresight and strategic Insight), and the organizational immunity variable addresses three dimensions (organizational learning, organizational memory and organizational DNA). The main purpose of this research was related to the extent to which the Ministry’s immunity was achieved through the role played by strategic sensitivity. A sample of (349) individuals was selected . The questionnaire was relied upon to collect data, and the number of questionnaires suitable for analysis was (330). Re
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This study aimed at highlighting the role of small and medium enterprises in bringing about economic development in Jordan. The study examined the impact of the number, size of investment and the number of jobs provided by these enterprises on the rate of growth in gross domestic product (GDP) as an indicator for economic development. To achieve its objectives, the study adopted descriptive and quantitative analysis. A linear multi regression model was developed with a growth rate of GDP as dependent variable and the number of institutions, size of investment, and the number of job opportunities as independent variables. The study concluded that each increase by one small or medium enterprise lead to an increase in the rate of gr
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أن كرة السلة بما تتضمنه من مهارات حركية متنوعة تتطلب من ممارسيها امتلاك عدد من القدرات الحركية الخاصة وبشكل خاص التوافق العضلي العصبي والرشاقة والقوة المميزة بالسرعة، فضلاعن قدرات الإدراك الحس- حركي (إدراك المكان وقوة دفع الكرة سواء بالطبطبة العالية أو الواطئة .... الخ ) لذا تكمن أهمية البحث في إيجاد الطرق والوسائل التي تطور قدرة الطالبة على إدراك قوة دفع الكرة والإحساس بها أثناء تعلم وتدريب الطبطبة بأنواعها ب
... Show MoreThe research aims to reveal the availability of skills to develop the tax assessor when carrying out the tax examination process. The study was conducted in the branches of the General Tax Authority in the province of Baghdad (the General Authority for Taxes, Adhamiya branch, the General Authority for Taxes, Rusafa branch, Al-Bayaa branch, New Baghdad tax branch) was approved The descriptive approach to achieve the research objectives represented by answering the following two questions: 1- What are the necessary skills that should be available in the performance of the tax examiner? 2- Are the skills of developing a tax evaluator available? The two researchers used the closed questionnaire as a tool for their research. The quest
... Show MoreAlopecia (Baldness) is very usual trouble in current time. It is accompanied by an intensive weakening of the scalp's hair and follows a specific pattern. Hereditary predisposition plays a very important role in alopecia despite not completely understood. Alopecia can be typed to various categories according to etiology, may be due to hereditary factors, autoimmune disease, and drugs or chemicals. There are many options of strategies of treatment according to the type and causes of alopecia. Chemical or synthetic medications apply for the management of hair loss are accompanied by a wide range of undesirable effects. Naturally occurring drugs also play important role in alopecia management with minimal side effects.
This study included the estimation of growth rate, viability and morphological changes in different culture media (NNN, P-Y, RPMI- 1640, and Panmed). Promastigotes cultured in RPMI-1640 showed maximal growth rate after (2, 4, 6) days of cultivation (27.26 ± 0.05), (172.20 ± 0.1) and (343.81 ± 1.48) million parasites / ml for each day respectively, while P-Y media gave the highest mean of growth rat after (8 and 10) days of cultivation (307.16 ± 1.67) and (303.5 ± 4.96) million parasites / ml for each day respectively. P-Y medium showed the maximal percentage of viability after (2, 4, 6, 8, and 10) days of cultivation (99.76 ± 0.5) %, (98.30 ± 0.17) %, (96.1 ± 0.1) %, (92.5 ± 0.52) % and (87.26 ± 0.05) % for each day respectively.
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