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.
Imam Ibn Abi Shaybah counted in his book classified twenty-five and a hundred recent and impact claimed that Abu Hanifa has violated the provisions required by apparent, and these conversations and effects including with regard to worship and transactions, including with regard to personal status, including with regard to borders and felonies, and collected by Sheikh Muhammad Zahid Al-Kothari in his book funny jokes in talking about the responses of Ibn Abu Shaybah on Abu Hanifa, and these issues we will study in our research.
Abstract:
The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s
... Show MoreThe current paper was designed to find the possible synergic effect of EBV infection with the HPV-16 in Iraqi women suffering from cervical carcinoma. This retrospective study involved paraffinized blocks of two groups. The research included 30 carcinomatous cervical tissues and 15 samples from normal cervical biopsies. After sectioning using positively charged slides, immunohistochemistry (IHC) was performed to detect anti-Epstein Barr Virus LMP1 and Human papillomavirus type 16 primary antibodies. Sixty-three percentage (19 out of 30) of the studies group showed positive overexpression as shown in with a significant association of the expression with cervical cancer with a significant association (p = 0). The co-infection of the EBV and H
... Show MoreThe 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 MoreThe 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
... Show MoreDifferent parameters of double pipe helical coil were investigation experimentally. Four coils were used; three with a curvature ratio (0.037, 0.031, and 0.028) and 11mm diameter of the inner tube while the fourth with 0.033 curvature ratio and 13 mm diameter of the inner tube. The hot water flow in the inner tube whereas the cold water flows in the annulus. The inlet temperatures of hot and cold water are 50 0C and 18 0C respectively. The inner mass flow rate ranges from 0.0167 to 0.0583 kg/s. The results show the Nusselt number increase with increase curvature ratio. The Nusselt number of the coil with 0.037 curvature ratio increases by approximately 12.3 % as compare with 0.028 curvature ratio. The results also r
... Show MoreHypertension is one of the main causes of heart disease; beta- blockers play a crucial role in the management of patients with essential hypertension. Bisoprolol is one of the widely used drugs for the treatment of hypertension. Bisoprolol tablets were prepared by two methods (direct and wet) using different proportion and types of diluents, different binder types and forms, then evaluated for, weight variation, hardness, friability, disintegration time and dissolution rate. The results were compared with a reference Bisoprolol tablet.
Both methods of preparation wet and direct compression method gave good results, which are consistent with the requirements of British Pharmacopeia and United States Pharmacopeia. It was found that
... Show MoreGas sensors are essential for detecting noxious gases that have a detrimental effect on people's health and welfare. Carbon quantum dots (CQDs) are the fundamental component of gas detectors. CQDs and graphene (Gr) were prepared using the electrochemical method. The gas sensitivity of these materials was evaluated at different temperatures (150, 200, 250 °C) to assess their effectiveness. Subsequently, experiments were conducted at different temperatures to ascertain that the combination of CQDs and Gr, with various percentages of Gr and CQDs, exhibited superior gas sensitization properties compared to CQDs alone. This was evaluated based on criteria such as sensitivity, recovery time, and reaction time. Interestingly, the combination was
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