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 main aim of this research study is to point out the vital importance of high-quality exterior audits to limit discretionary accounting, as it could distort a company’s commercial results. The research introduces a well-founded hypothesis on the preventive powers of high-quality audits, as it can act as a strong exterior control. The research focuses on testing the complex relationship between earnings management and investors’ behavior within the public-listed companies from the food industry. The research gathers credible annual comprehensive data from thirty-five publicly-listed firms from the United States. It encompasses the twenty years prior to 2024, as it includes the twenty years prior to 2024. Additionally, the gathered dat
... Show MoreIncreased epidemic when Akbari in his book Explanation in the expression of the Koran
Disabled people are among the most important groups that need attention, care, and financial and moral care. They cannot fulfill the requirement of life normally without care from a person to meet their special needs. The disability is either mental or physical. The Iraqi government has paid attention to this category by adopting a law for this category, represented by Law No. (38) for the year (2013), which keeps their rights and duties in Iraqi society by establishing institution of persons with disabilities and special needs of the Ministry of Labor and Social Affairs to create a modern society politically, socially, culturally or economically. In view of the importance of this group in society, the media reinforces the communit
... Show MoreThe volatility of the financial markets and the oil market plays a major role in influencing macroeconomic activity, as well as the high interaction between the both markets and the remarkable sensitivity to their each other fluctuations which cause the undesirable impact on other economic sectors as an expected result due the mentioned interaction.
The study aimed to analyze the relationship between the volatility of the major US market indices represented by the DJIA index, S & P500, due to their comprehensiveness of the financial market, as they summarize the performance of the entire US market which is the largest economy in the world, as well as the difference in the calculation mechanism, and oi
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The Aims of this research is to describe the concept of risk, its type and method of measurement, and to clarify the impact of these risks on the expected cash flow statement and the preparation of the target cash flow statement that takes these risks into consideration. Because the local economic environment is exposed to many risks, Therefore, this list will be predictive, which will help the economic unit to make administrative decisions, especially decisions related to operational, investment and financing activities. Therefore, the research problem is based on the fact that most of the local economic units are the list of flows According to the actual basis and not according to the discretionary basis (bud
... Show Moreالضاد والظاء موطن تفرد العربية وفخرها ، الفت فيهما العشرات والعشرات من المصنفات الثرّة لكثرة ذرائع تلابسهما والخلط بينهما ، فهما متشابهان في هيكل البناء ، وإخراجهما متداخل على اللسان ، وألفاظهما متناظرة برحابة في الإملاء ، فضلاعن اشكالهما إلى حدّ الآن ، مما حثني على التفكير في وسائل تسهل المطروح وتمد جسراً بين أجزائه عسى أن تدنو قطافه في دفع الشبهة ومواراتها ، فتحصلت لي امور ادرتها بكلمتين مف
... Show MoreThe study aims detection teaching modalities adopted relationship in Jerash University exactly the classroom, and to achieve the goal of the study was to develop a questionnaire consisting of (39) items, and was achieving validity and reliability have, then sent to a sample of professors made up the university from (122) university professor of the total (172) professor, and they study population.
Study found a relationship between the teaching methods of the four their strategies with classroom management, and as a result the overall average level, while Hspt critical thinking at the highest correlation with classroom discipline management relationship strategy, while the relatio
... Show MoreForeign direct investment is considered one of important bases to blind economy for many. Countries as if the main stage for developing national economy ,so for this ,many of countries give great prominence to the role of drivel foreign investment due to its importance as one of economic growth pillars in the developing countries. They offer a support for modern technology, organizational and managerial skills.
Dneto the importance of direct foreign investment on the economic growth, today, we discover that Iraq in need to rebnlid the in frastructuve and renew what has been destroyed during was in many production and export institutions . as wel
... Show MoreBuilding Information Modeling (BIM) and Lean Construction (LC) are two quickly growing applied research areas in construction management. This study focuses on identifying the most essential benefits and analyzing the most affecting constraints on the construction sector that construction players face as they attempt to combine BIM-LC in Iraqi construction. Experts assessed 30 benefits and 28 constraints from examining the previous literature, and a two-round Delphi survey formed the responses. Expert consensus analysis was utilized to elaborate and validate responses after descriptive statistical checks had been used for data processing.
According to the study's findings, the benefits include ensuring the most ef
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