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 EFFECT OF SPREACL of KNOWLEDGE ON ETHICS
The capital in the bank is the important element in establishing it, because it maintains the banking sector in the event of exposure to losses or risks In addition to contributing to the provision of liquidity And protection of depositors' money from potential and unexpected losses. There is also a relationship between the prices of shares and the indicators of the durability of the capital owned, considering that the shares are the components of the bank capital The study limited the indicators of capital to assets and capital to deposits, capital to loans and financial investments Where the most important conclusions are the damage to the detriment of shareholders in contrast to the depositors in the case of increasing the propo
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Abstract : This research is concerned with studying the best type and method of irrigation as well as the best cultivated area to reduce the cost of producing dunums of wheat crop in Iraq , and was based on data taken from the Ministry of Planning / Central Statistical Organization About cost of wheat crop production for (12) Iraqi governorates except Kurdistan, Nineveh, Salah al-Din, Anbar) and the sample size (554) according to the cost survey carried out by the Ministry of Planning / Central Statistical Organization for 2017, The results of the research showed that there are significant statistical differences between production costs when using t
... Show MoreThe (NiTsPc) thin films operating by vacuum evaporation technique are high recital and good desirable for number of applications, were dumped on glass substrates at room temperature with (200±20nm) thickness and doped with Al at different percentage (0.01,0.03) besides annealing the sample with 200˚C for 1 hours . The stimuluses of aluminum dopant percentage on characterization of the dropped (Ni Ts Pc) thin films were studied through X-ray diffraction in addition from the attained results, were all the films have polycrystalline in nature, as well the fallouts of XRD aimed at film illustrations polycrystalline, depending on the Al ratio doping, the results, SEM exposed the surface is regularly homogeneous. Utilizing first-ideolog
... Show MoreThere is a set of economic factors that affect the rationalization of decisions on unexploited resources within the economic unit and here determines the problem of the search for the question of what economic factors cause the emergence of asymmetric costs, and aims to identify these factors in the costs of adjustment to resources, change in The size of the activity of the economic unit, the general trend of sales change in the previous period, and the economic level of the country. Rh measure the impact of these factors on economic unity, and taking into consideration the impact when formulating decisions.
The work of this paper is an investigation to improve the condenser performance of the automobile air conditioning system by enhancing the air-side heat transfer from the condenser through the use of an air guide net installed in front of the condenser face which is basically an aluminum plate having a circular entrance shape for the air passage. The A/C system was examined under two types of test. The first test was conducted the air guide net, while the second was done with the air guide net. The performances of the A/C system under these tests were compared. For the second type of test, the experiment was carried out with three different size of air guide net, three different circular diameters (2, 3 and 3.5 cm) a
... Show MoreThis study includes the direct influence of (single & multi) dose of Cold Atmospheric Plasma (CAP) on the no. of platelets for mice for different exposure time (15, 30, 60, and 120) sec. the influence of CAP on mice was measured after 1, 2, 3, 7, and 14 day from exposure.
The results obtained in this study indicate that the effect of low doses of CAP on platelets was stimulatory effect in the first few hours from exposure (1day) but the high dose was inhibitory, It was found that after two weeks of exposure that the number of platelets became normal comparable to the control one, and this indicates that plasma effect was removed after this period.
The importance of internal audit in the growing demand for services in the public and private economic units, and in the rapid growth of its systems professional, has also been recognition of the importance of internal audit quality and the quality of information provided in a long time, as well as the importance of achieving the greatest possible quality in his work to reduce accounting risks of financial reports misleading or fraudulent, which is one of the important features of the audit.
The internal audit quality are linked with the ability of auditors to detect errors in the financial statements, and their willingness to express an opinion technical neutral and non-aligned based on the results of th
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