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.
Contemporary developments in various sciences and the impact of technological changes require an integrated vision of the activities and work of the organization in Iraq in light of the high costs of products and their low quality compared to imported products of high quality and low cost, and the need to use modern cost techniques based on a clear and specific philosophy that contributes to increasing the efficiency and effectiveness of management In the business environment and how it can contribute to reducing product costs and being environmentally friendly at the same time, it is no secret that the main goal of most organizations is to maximize profitability and reduce costs to the minimum, but this matter is not achieved autom
... Show Morethose affected by technological development risks within the scope of medical works. The unprecedented technological development the world witnesses nowadays has been providing brilliant medical service to the human being including examination, diagnosis and the treatment or follow up. However, such works hide behind potential risks threatening people's lives and such risks my be discovered within the limits of now – how and technical knowledge prevailing the time of rendering the medical service. Also this the question is raised on how to keep up between the safety of the patients and such risks are being unknown by the provider and questioning them contradicts the justices. subsequently, can the patients (affected) acquire the compensat
... Show MoreA substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T
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یعد والت وتمن شاعرا استثنائیا سواء أكان ذلك في المكانة التي یحتلھا في الأدب الأمریكي او في نمط
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To decrease the dependency of producing high octane number gasoline on the catalytic processes in petroleum refineries and to increase the gasoline pool, the effect of adding a suggested formula of composite blending octane number enhancer to motor gasoline composed of a mixture of oxygenated materials (ethanol and ether) and aromatic materials (toluene and xylene) was investigated by design of experiments made by Mini Tab 15 statistical software. The original gasoline before addition of the octane number blending enhancer has a value of (79) research octane number (RON). The design of experiments which study the optimum volumetric percentages of the four variables, ethanol, toluene, and ether and xylene materials leads
... Show MoreObjectives Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. Methods The novel agents were prepared using different concentrations of bromelain (10–40 wt. %), with and without 0.1–0.3 wt. % chloramine T or 0.5–1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficiency
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