Introduction. Intraoperative rupture (IOR) of an aneurysm is a frightful complication that causes significant morbidity and mortality worldwide. IOR can be attributed to various parameters, including hypertension, increased intracranial pressure (ICP), fragility of the vessels, and inadequate anaesthesia. IOR due to insufficient anaesthesia is scarcely reported in the literature. Here, we describe a re-ruptured anterior communicating artery (ACoA) after incomplete clipping of the neck during craniotomy closure due to unintended early wake-up from anaesthesia with a discussion about the management. Case description. A 38-year-old male suddenly developed a severe headache, a brief loss of consciousness, and vomiting. Computed tomography (CT) scan showed a subarachnoid haemorrhage in the basal cistern. CT angiography showed a bilobed right ACoA aneurysm with a wide neck and Murphy's teat. The patient was considered for surgery. Clipping of the aneurysm neck was done through two curved clips. During craniotomy closure, the patient started coughing and gagging then a huge IOR was encountered. These events can be mainly attributed to unintended inadequate anaesthesia, particularly muscle relaxants. The bleeding ceased after two suction catheters were inserted, temporary clips were applied, and the readjustment of permanent clips. After surgery, the patient showed a left-sided weakness. His postoperative CT scan showed a right distal anterior cerebral artery (ACA) territory infarction. The weakness improved in the follow-up period. Conclusion. Delayed IOR due to early awaking from anaesthesia should be considered a potential source of complications and bad outcomes in aneurysm surgery.
Arabic prose poem and the antithesis of contrast: poetry _ prose and West _ East
Abstract:
The achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.
Thus, this paper aims to analysis the n
... Show MoreThe construction industry in Iraq suffers from many problems, perhaps the most important of which is the delay in time and the increase in costs. Therefore, it was necessary to try to adopt a new methodology that would help in overcoming these problems. It was suggested to combine building information modeling with the agile management approach because this technique and methodology is modern and helps in reducing time and cost and improving quality. This paper aims to know the status of using Building Information Modeling (BIM) and Agile Project management (APM) in Iraq and to shed light on the merging of this integration, explaining the benefits, difficulties, and workflow practices, finding the most influencing factors on the tim
... Show MoreThe present paper is an experimental study to improve the productivity of the conventional solar still. This done by modifying conventional still in a way that the distilled basin is larger than distillation basin, thus providing an increase in the condensation surface and speeding up the condensation process. Moreover, increase in the dimensions of the distilled base helps coupling reflective panels to the distilled base to reflect incident solar radiation to the distillation basin. For this purpose , two solar stills were made, one conventional designand another made according to the proposed design. The two solar stills were tested during the period from February to July 2009 under varying weather conditions of Basra, Iraq (latitude o
... Show MoreThe goal of this work is demonstrating, through the gradient observation of a of type linear ( -systems), the possibility for reducing the effect of any disturbances (pollution, radiation, infection, etc.) asymptotically, by a suitable choice of related actuators of these systems. Thus, a class of ( -system) was developed based on finite time ( -system). Furthermore, definitions and some properties of this concept -system and asymptotically gradient controllable system ( -controllable) were stated and studied. More precisely, asymptotically gradient efficient actuators ensuring the weak asymptotically gradient compensation system ( -system) of known or unknown disturbances are examined. Consequently, under convenient hypo
... Show MoreInfection with cryptosporidiosis endangers the lives of many people with immunodeficiency, especially HIV patients. Nitazoxanide is one of the main therapeutic drugs used to treat cryptosporidiosis. However, it is poorly soluble in water, which restricts its usefulness and efficacy in immunocompromised patients. Surfactants have an amphiphilic character which indicates their ability to improve the water solubility of the hydrophobic drugs. Our research concerns the synthesis of new cationic Gemini surfactants that have the ability to improve the solubility of the drug Nanazoxide. So, we synthesized cationic Gemini surfactants. N1,N1,N3,N3-tetramethyl-N1,N3-bis(2-octadecanamidoethyl)propane-1,3-diaminium bromide (CGSPS18) and 2,2‘-(etha
... Show MoreThe electrical activity of the heart and the electrocardiogram (ECG) signal are fundamentally related. In the study that has been published, the ECG signal has been examined and used for a number of applications. The monitoring of heart rate and the analysis of heart rhythm patterns, the detection and diagnosis of cardiac diseases, the identification of emotional states, and the use of biometric identification methods are a few examples of applications in the field. Several various phases may be involved in the analysis of electrocardiogram (ECG) data, depending on the type of study being done. Preprocessing, feature extraction, feature selection, feature modification, and classification are frequently included in these stages. Ever
... Show MoreThe current study aims to identify soil pollutants from heavy metals The study utilized 40 topsoil (5 cm) samples, which adapted and divided into seven regions lies in Baghdad governorate, included (Al-Husainya,(Hs) Al-Doura (Do), Sharie Al-Matar (SM), Al-Waziria (Wz), Nharawan (Nh), Abu Ghraib (Abu) and Al-Mahmoodyia (Mh)). Spatial distribution maps of Nickel (Ni), Manganese (Mn), Lead (Pb) and Zinc (Zn) were created for Baghdad city using Geographic Information Systems (GIS). The concentrations of four heavy metals in the soil of different area of Baghdad were measured and observed using XRF instrument. The result found highest values of Pb and Zn at the middle of the Baghdad in (Wz