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.
Thyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.
Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because
... Show MoreGrabisch and Labreuche have recently proposed a generalization of capacities, called the bi-capacities. Recently, a new approach for studying bi-capacities through introducing a notion of ternary-element sets proposed by the author. In this paper, we propose many results such as bipolar Mobius transform, importance index, and interaction index of bi-capacities based on our approach.
This research was carried out to reveal the the technique of the recitation in this story including a preface, introduction, two chapters and the conclusion. the introduction consisted of the problem, significance , purpose and limitations of research. The preface included two paragraphs. The first included a meta-recitation of terminology and semantic. The second paragraph devoted to show the cultural identity of Hussein Rahim. The first chapter aimed to reveal the reality and the imaginary in the story of Na'lat Al Hakawaty (storyteller's curse). The second chapter aimed to study the strange arguments in the story. The research concluded the conclusion by presenting the results for attaching them with the margins, and the references
... Show MoreGraphite Coated Electrodes (GCE) based on molecularly imprinted polymers were fabricated for the selective potentiometric determination of Risperidone (Ris). The molecularly imprinted (MIP) and nonimprinted (NIP) polymers were synthesized by bulk polymerization using (Ris.) as a template, acrylic acid (AA) and acrylamide (AAm) as monomers, ethylene glycol dimethacrylate (EGDMA) as a cross-linker and benzoyl peroxide (BPO) as an initiator. The imprinted membranes and the non-imprinted membranes were prepared using dioctyl phthalate (DOP) and Dibutylphthalate (DBP) as plasticizers in PVC matrix. The membranes were coated on graphite electrodes. The MIP electrodes using
... Show MoreThe plant decorative arts field full of decorative Baltnoat from diversity in the design structure of vocabulary and whether units sepals, vase Aogsnah or written and what their catalog decorative hearts in Kadhimiya holy threshold of diversity in shapes and measurements and sizes.It is during the field visit of the researcher found that there are variations in the overall appearance and internal padding and this researcher has formulated the discussion by asking the following problem:(What is the diversity of designs decorative hearts in Kadhimiya holy threshold?)The importance of research in it:Research contributes to open the horizons of knowledge for researchers and scholars concerned with the teaching of the decorative arts, as well
... Show MoreIn this paper, point estimation for parameter ? of Maxwell-Boltzmann distribution has been investigated by using simulation technique, to estimate the parameter by two sections methods; the first section includes Non-Bayesian estimation methods, such as (Maximum Likelihood estimator method, and Moment estimator method), while the second section includes standard Bayesian estimation method, using two different priors (Inverse Chi-Square and Jeffrey) such as (standard Bayes estimator, and Bayes estimator based on Jeffrey's prior). Comparisons among these methods were made by employing mean square error measure. Simulation technique for different sample sizes has been used to compare between these methods.
This study reveals the impact of critical reading on viewers understanding and astatic judgment at artworks. And aims to find out the reasons and motives behind their issuing of these judgments towards artworks.
The study adopts the qualitative method as two pre and post interviews were conducted and analysed according to a thematic analysis method.
The results show that critical reading contributes to their understanding of the content of artworks and the message that the artist would like to convey to the recipient audience. and directs them towards the aesthetic judgment that is based on full understanding of the philosophical contents of the artwork, which, in turn, contributes to the development of artistic culture and a
The study aims to analyze computer textbooks content for preparatory stage according to the logical thinking. The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea during the analysis process. One of the content analysis tools which was designed based on mental processes employed during logical thinking has utilized to figure out the study results. The findings revealed that logical thinking skills formed (52%) in fourth preparatory textbook and (47%) in fifth preparatory textbook.
The objective of this research is to analyze the content of science textbook at the elementary level, according to the dimensions of sustainable development for the academic year (2015-2016). To achieve this goal has been to build a list with dimensions of sustainable development to be included in science textbooks in primary school, after seeing the collection of literature and research and studies, as has been reached to the list of the dimensions of the three sustainable development and social, economic and environmental in the initial image consisted of (63) the issue of sub-divided the three-dimensional, the menu and offered a group of arbitrators and specialists in curriculum and teaching methods, and thus the menu consiste
... Show MoreThe research aims to find out the impact of cognitive strategies in the mathematical competence of the students of the fourth scientific in the preparatory mahmoudiyah in the Directorate General of The Education of Karkh 2. A post-test of the mathematical competence prepared by (Jassim, 2018) was applied to the sample of (65) students, distributed into two groups of (33) students as experimental group and (32) students as a control group. The results found there are significant differences between the experimental group and the control group in testing the mathematical competence of students for the experimental group.