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.
Abstract Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com
... Show MoreMany studies and researches related to the audio and visual medium have shed light on the creative process that has taken place through them as well as the aesthetic and artistic creation and have dealt with many fields of knowledge and creativity in this field of art, which managed to study and follow its intellectual and technical tools for creating achievements through this medium, in its forefront come the elements of the cinematic language, which is characterized by possessing multiple features of aesthetic and semantic employment to reach the recipient as it is a tool of the artistic expression that gives the material it deals with aesthetic and intellectual dimensions from various aspects. "The artistic expression cannot be achiev
... Show MoreA polycrystalline PbxS1-x alloys with various Pb content ( 0.54 and 0.55) has been prepared successfully. The structure and composition of alloys are determined by X-ray diffraction (XRD), atomic absorption spectroscopy (AAS) and X-ray fluorescence (XRF) respectively. The X-ray diffraction results shows that the structure is polycrystalline with cubic structure, and there are strong peaks at the direction (200) and (111), the grain size varies between 20 and 82 nm. From AAS and XRF result, the concentrations of Pb content for these alloys were determined. The results show high accuracy and very close to the theoretical values. A photoconductive detector as a bulk has been fabricated by taking pieces of prepared alloys and polished chemic
... Show MoreOver the years, the issue of inclusion of students with special educational needs (SEN) in mainstream schools is controversial worldwide. Evidence from research argues that without a positive teachers’ attitude towards the inclusion of students with SEN in mainstream schools, the successful implementation of inclusion is most likely doubtable. The aim of this paper is to understand teachers’ attitudes towards the inclusion of students with SEN in mainstream schools from different perspectives and from different contexts. The conclusion drawn in this review can be that teachers’ attitude is the most important key towards the appropriate inclusion implementation in mainstream schools. The disparity of teachers’ attitudes towards th
... Show MoreIntroduction: An aneurysmal bone cyst are enigmatic lesion of unknown cause and presentation and are difficult to distinguish from other lesions, it is a benign, but expansible tumor like lesion that generally occurs in the long bones. An aneurysmal bone cyst arising from the flat bone like clavicle is rare . Case presentation: We report a 12-year-old girl child with an aneurysmal bone cyst of the lateral third of left clavicle treated with enblock resection. The pathologic findings confirmed the diagnosis of aneurysmal bone cyst. The patient has been followed up for one year with no evidence of recurrence . Conclusion: En bloc resection can be curative and provide good results for this rare type of clavicle tumour.
The research problem consisted in answering the question that revolves around what is the impact of localizing employees’ salaries on bank deposits, and did it lead to an increase in their size? The research also aimed to nominate some initial solutions to improve the role of salary localization, in terms of reviewing the concept of electronic payment systems, its tools and channels, and then identifying the concept of salary localization, its importance, objectives and obstacles to its application, and then analyzing the reality of the state of localization of salaries and bank deposits to banks, the research sample for the period (2017- 2021), and the use of the statistical program (SPSS V25) to test the research hypotheses. The stud
... Show MoreBackground : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults
Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome.
Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ul
The researchers reached many conclusions, the most important of which was the distinction of practitioners of sports activity with high degrees in the trait (social). At the same time, it was low in the trait (aggression –restraint-desisting) and non-practitioners were distinguished by sports activity with high degrees in the trait (aggression –restraint-desisting). In contrast, the degree was low in the trait (social), and there were significant differences in favor of practitioners of the activity of the athlete, Through the conclusions, the researchers recommend the need for university students to practice sports activities because of their positive impact on their health in general and on the deve
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