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.
The research aims to indicate the relationship between lean production tools included seven {constant improvement , and Just in time (JIT), and the production smoothing , and quality at the source, and standardized work, Visual management, and activities 5S } and Mass Customization strategy for the model (Pine & Gilomer, 1997) {collaborative, adaptive, cosmetic, transparent}, as well as providing a conceptual framework and applied for variables search to clarify how they will choose a Mass Customization strategy through the lean production tools, , and recognize the reality of the practices of Iraqi industries in such a field. Moreover, aims to highlight the positive aspects that accrue to companies a
... Show MoreThe purpose of this study is to compare the influence of three teaching methods, as represented by problem-based learning (PBL), the PBL with lecture method, and the conventional teaching on undergraduate physics students' group work skills among bachelor’s degree physics students. In this study, the pre- and post-test were done and the instruments were administered to the students for data collection. The actual sample size comprises of 122 students, who were selected randomly from the physics department, college of education in iraq. Overall, the statistical results rejected null hypothesis of this study. Thus, using the PBL without or with lecture method enhances the skills of the group work among the bachelor’s degree physics studen
... Show MoreThis study showed that liver of Passer domesticus bilobed the right lobe is cardiac shape while the left is elliptical and the liver colour is brown. It is occupying most of anterior and middle parts of abdominal cavity. The liver is surrounded by Glison capsule which is represented by a thin layer of connective tissue with septum extend peripherally in liver tissue. The liver tissue is formed from polyhedral hepatocyte arrange as irregular hepatic cord surrounded the central vein. Each cell contains one or two nucleus with one or more nucleolus. The blood sinusoid appeared between the liver cells .The hepatic cord arranged radially around the central vein. The portal area is clear and surrounded by connective tissue. Gallbladder is almost
... Show Morehe study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the models (Al-
... Show MoreIn this study ZnS thin film was prepared by using thermal evaporation vacuum technique under the pressure (10-6) Torr on glass substrate at room temperature and annealing at 523 K Samples were irradiated to CO2 laser of power (1 watt) and wave length (10.6) μm at distance 10 cm from the source during (5 sec). The absorbance spectra was recorded by using UV-visible spectrophotometer and used to calculated some of optical properties investigated including their transmittance, reflectance spectra, energy gap, and extinction coefficient. From the result of thin films samples at room temperature and at 523 K, we conclude that the irradiation by laser causes a decrease in the transmittance and increasing in reflection and extinction coeffic
... Show MoreThe present study deals with the effect of acute exposure of different salt concentrations of NaCl on male and female of IU.FOBRJMOPNARJ, which belongs to Class Copepoda, Order Cyclopoida by calculating lethal concentration killing 50% (LC50), lethal concentration killing 100% (LC100) and safe concentration (LC0). The results showed that LC50 values were 3.80ppt, 2.75ppt and 2.29 ppt for males during 24,48 and 72 hrs. exposure respectively while LC50 values were 2.45ppt, 2.18ppt and 1.77ppt for females for the same periods of exposure. The lethal concentration (LC100
... Show MoreThe radial wave function R(r) and the radial distribution function P(r) as a function of (r), for the Hydrogen atom was calculated for several atomic state (1s,2s,2p,3s,3p,3d) The results were compared with Hydrogen like atom(He+,Li+2,Be+3).
Photo citation request in examples Of ascetic poetry in the first Abbasid era
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.
Environmental pollution is regarded as a major problem, and traditional strategies such as chemical or physical remediation are not sufficient to overcome the problems of pollution. Petroleum-contaminated soil results in ecological problems, representing a danger to human health. Bioremediation has received remarkable attention, and it is a procedure that uses a biological agent to remove toxic waste from contaminated soil. This approach is easy to handle, inexpensive, and environmentally friendly; its results are highly satisfactory. Bioremediation is a biodegradation process in which the organic contaminants are completely mineralized to inorganic compounds, carbon dioxide, and water. This review discusses the bioremediation of petroleum-
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