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
The cement industry is considered one of the strategic industries, because it is directly related to construction work and cement is used as a hydraulic binder. However, it is a simple industry compared to major industries and depends on the availability of the necessary raw materials. This study focuses on optimizing and coordinating the location of raw materials needed for the cement manufacturing in Wasit Governorate in Iraq. Field works include detailed reconnaissance, topographic work, and description and sampling of 24 lithological sections that represent the carbonate deposits, which crop out in the area. The investigated area has the following specifications: The weighted aver
Cardiovascular disorders are refer to the class of diseases that involve the heart or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system. Cholesterol is classified as a sterol (a contraction of steroid and
... Show MoreHarriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong wille
... Show MoreThis paper studies the investment project evaluation under the condition of uncertainty. Evaluation of investment project under risk and uncertainty is possible to be carried out through application of various methods and techniques. The best known methods are : Risk-adjusted discount rate , certainty equivalent method , Sensitivity analysis and Simulation method The objective of this study is using the sensitivity analysis in evaluation Glass Bottles project in Anbar province under the condition of risk and uncertainty.
After applying sensitivity analysis we found that the glass bottles project sensitive to the following factors (cash flow, the cost of investment, and the pro
... Show MoreHarriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong w
... Show MoreIn this study, a cholera model with asymptomatic carriers was examined. A Holling type-II functional response function was used to describe disease transmission. For analyzing the dynamical behavior of cholera disease, a fractional-order model was developed. First, the positivity and boundedness of the system's solutions were established. The local stability of the equilibrium points was also analyzed. Second, a Lyapunov function was used to construct the global asymptotic stability of the system for both endemic and disease-free equilibrium points. Finally, numerical simulations and sensitivity analysis were carried out using matlab software to demonstrate the accuracy and validate the obtained results.
Nimodipine (NMD) is a dihydropyridine calcium channel blocker useful for the prevention and treatment of delayed ischemic effects. It belongs to class ? drugs, which is characterized by low solubility and high permeability. This research aimed to prepare Nimodipine nanoparticles (NMD NPs) for the enhancement of solubility and dissolution rate. The formulation of nanoparticles was done by the solvent anti-solvent technique using either magnetic stirrer or bath sonicator for maintaining the motion of the antisolvent phase. Five different stabilizers were used to prepare NMD NPs( TPGS, Soluplus®, HPMC E5, PVP K90, and poloxamer 407). The selected formula F2, in which Soluplus
has been utilized as a stabilizer, has a par
... Show MoreAbstract:
The issues related to foreign trade is a broad field for discussions and captures the interest of economists for their contribution to the process of economic development in the economies of the countries, especially developing ones. The imports of goods and services in foreign trade constitute an important part of the local by which the economy gets goods and services that the economy cannot produce because of the incompetent base of production. Further, the demand function of imports occupied a good deal of the attention of researchers in the field of international economics for which agricultural imports constitute an important part. The reason for the interest in the subject is due to its im
... Show MoreSuffer most of the facilities of the high cost of inventory , which affects the high cost of the product and thus affects many administrative decisions , as well as suffer the facilities of the systems developed by the provisions of inventory control , and this problem is exacerbated in the construction sector where the inventory in the form of Construction spin of the Year for another it becomes difficult to control the cost effectively , and is the research problem in question follows: What are the implications of the use of the system in time inventory accounting system for the contracting company does kills Alrkaah to the provisions of the cost of inventory and what is the optimal approach to inventory control ? Find assumed
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