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
Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid supplement on oxidative stress parameters an
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The objective Effect of Internal and External Environment and its Psychological & Practical Reflection on the Political Decision-Making Process
Will address this research interaction and coordination between fiscal and monetary policies and the impact of this interaction and coordination on economic stability and growth، and how the financial implications of monetary policy may stimulate action monetary policy and treatment side effects and the nature of responsiveness and bounce between procedures both two policies and their impact on the balance of overall economic and explained in the folds of searchjustifications coordination and the extent necessary in order to address the imbalances in economic activity through twinning actions of monetary and fiscal، has embodied this coordination and interaction between policies and their impact m
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the films of cdse pure and doped with copper ratio glass substrate effect od cucomcentration technique thikness doped with copper is an anonmg and the density of state increases
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The aim of this research is analysis the effect of the changes in (GDA, g, inflation) at average and standard economic curriculum in composition of the models, depending on SPSS program in analysis, and according to available date from central bank of Iraq and during the period from 2003 to 2018 and by using OLS and estimate of the equation and the results showed a statistical significance relation in incorporeal level 5% and the R2 value equal to 92.1 refer to the changes in independent variables explain 92% of changes of unemployment and the independent variables effect are very limit depend on estimated parameters in the model and respectively (0.986,0.229,-0.060), the research recommended necessity to active the inve
... Show MoreThe promotion by its means lead a vital and important role at the level of all organizations, whether (industrial or service) in general, and financial markets in particular. The promotion is earns delved to be as one of the main operations which market uses it through various means of financial markets and companies which its shares listed in the aim of (finance or investment), with a view to the implementation and financing of public and private projects the one hand, or with a view to achieving profits through investment of speculative or... For other purposes, on the other hand.Accordingly, we find that the set of public and private goals joint between the financial markets and listed companies respectively, will serve the stra
... Show MoreThe aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.
The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava
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Abstract:
The research seeks to explain the role of the international auditing standard (3402) in the auditor's procedures, where the importance of the research stems from the adoption of international auditing standards in the Iraqi environment, including the standard (3402) of assurance engagements that the external auditor performs by submitting reports on the design of control tools and their operational effectiveness in a service facility that provides the beneficiaries with a service. To provide useful information for service organizations The control tools are of great benefit in rationalizing decisions, and many recommen
Background: Wound healing is a complex dynamical interaction between various cell types, the extracellular matrix, cytokines, and growth factors. osteoponetin is a substance that acts as an anti-inflammatory. Aims of study: The study was designed to identify the role of local exogenous applications of osteopontin on wound healing (in cheek skin). Materials and methods: Thirty adult male albino rats weighting an average of (250-300gm) used in this study, incisional wounds were made in the skin of the cheek of rat and they were divided into the following groups: A-Control group: 15 rats treated with 1µ l of normal saline B-Experimental groups: 15 rats treated with topical application of 1µl osteopontin. The scarification of animals we
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