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 impact of management control systems (MCS) on organizations performance empirical research has been the subject of numerous studies during the past decade in developed and emerging economies. In the contemporary competitive, complex and changing global business environment, firms are being challenged to adopt business models that enable them to address the strategic uncertainties and risks they face in their business environments. The main issue of this study is that management accounting researchers argue that one of the ways firms can continually rejuvenate themselves to survive and succeed in these complex and uncertain environments is to understand the role of management control systems in Formulating a b
... Show MoreIn the postmodern era, the graphic design styles showed a new visualization method when the graphic designers had changed the traditional conditions by using design elements with new technics for photos, collage and comics illustration. The researcher assumes that the graphic design styles were affected by the art's movement at that period throw the same perspective of view for the concept presented in the art pieces and their entire message. Therefore, the researcher chooses field was the period of 1945-1970 in the USA for the (pop-art and conceptual-art) and explored the main visual effects that expressed the visual dialogue and compared them with the most common design styles ant the same period and location, the results of selected e
... Show MoreThe current study has sought to identify the levels of the compound thinking among secondary school students basing and relying on the opinions of Lipman who sees that the compound thinking consists of creative thinking and critical thinking, In accordance with this point of view, researchers have resorted to build scale of the critical thinking in its final form of (28) item additionally to the adoption of Torrance for the creative thinking which was translated by sayed. Khairallah in 1981 after confirming psychometric Properties Of both scales and then collect scores of both scales and be the final score represented the level of the compound thinking that has been shown by the results of secondary school students they have no skill of
... Show MoreThe current research deals with studying the aesthetics of symbolic values in the design of internal spaces and their connotations through their existence as a material value, as well as the symbolic meanings and their connotations that touch the spiritual and emotional side of the human being as an intangible value, and the research included four chapters, so the research problem was embodied by the following question (What is the role of values Symbolism and aesthetics in the design of interior spaces)? Therefore, the aim was to clarify the role of symbolic values and their aesthetics in the design of internal spaces. The first chapter included the importance of research, the need for it, the limits of the research and its terminology.
... Show MoreAbstract:
The achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.
Thus, this paper aims to analysis the n
... Show MoreBackground: Breast cancer is the most common
malignancy affecting females worldwide. The association
of Epstein-Barr virus (EBV) with this cancer is a longstanding
interest to this field.
Aim: to investigate the presence of EBV in breast tumor
tissue in relation to age.
Patients and Methods: Paraffin-embedded tissue blocks
from 45 female patients with breast tumors (ranged in age
from 28 to 85 years) were retrieved. The cases were
grouped into two categories: group (A): included 30 cases
with breast carcinoma and group (B): included 15 cases
with benign breast diseases as a control group .The
expression of EBV protein was examined
immunohistochemically.
Results: Twelve (40%) of the 30 breast canc
The History of Multi Parties and its Effect on Political System in India
Fingerprint recognition is one among oldest procedures of identification. An important step in automatic fingerprint matching is to mechanically and dependably extract features. The quality of the input fingerprint image has a major impact on the performance of a feature extraction algorithm. The target of this paper is to present a fingerprint recognition technique that utilizes local features for fingerprint representation and matching. The adopted local features have determined: (i) the energy of Haar wavelet subbands, (ii) the normalized of Haar wavelet subbands. Experiments have been made on three completely different sets of features which are used when partitioning the fingerprint into overlapped blocks. Experiments are conducted on
... Show MoreThe nature and intensity of the association of myasthenia gravis (MG) with distinct human leukocyte antigen (HLA) haplotypes differ between ethnic populations, so this study determined the association of HLA class II antigens with myasthenia gravis (MG) in Iraq.The study included Iraqi patients diagnosed with MG and two control groups the first of 54 insulin dependent diabetes mellitus patients and the second of 237 subjects as a normal control group. The test used was microlymphocytotoxicity test.The work was done in the Teaching Laboratories/Medical City/Baghdad.Results: positive associations were observed (etiological risk factors) as follows: 1. HLA-DR locus showed one positively associated allele when compared to healthy control and th
... Show MoreThe transportation model is a well-recognized and applied algorithm in the distribution of products of logistics operations in enterprises. Multiple forms of solution are algorithmic and technological, which are applied to determine the optimal allocation of one type of product. In this research, the general formulation of the transport model by means of linear programming, where the optimal solution is integrated for different types of related products, and through a digital, dynamic, easy illustration Develops understanding of the Computer in Excel QM program. When choosing, the implementation of the form in the organization is provided.