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.
This study examines Agence France Presse’s (AFP) media treatment of the Great Return Marches in order to identify its contents, the issues it gave attention to, its sources, attitude, techniques, objectives, the journalistic forms used in covering events and the typographic elements used to highlight them.
This descriptive study employed the survey methodology through the use of content analysis method, and the methodology of mutual relations through the use of the case study method. The data was collected by means of a content analysis form. The study was based on the Agenda Setting Theory in the analysis of the study results.
The study sample included (116) news texts from AFP collected during the period from 20/3/2018 to
Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota
... Show MoreBackground: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.
Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.
Methods: A descriptive comparative des
... Show MoreBackground: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent
... Show MoreThe physicochemical behaviour of dodecyltrimethylammonium bromide (DTAB) in water and ethanol-water mixture in the presence and absence of ZnSO4 were studied by measuring the conductivity at 298.15 K. The pre-micellar (S1) and post-micellar slopes (S2) were obtained and calculated the degree of dissociation (α) and the critical micelle concentration (cmc). With an increase in ethanol content, the cmc and α of DTAB increased whereas, in the presence of ZnSO4, the cmc and α decreased. By using cmc and α, thermodynamic properties as the standard free energy of micellization ( ) were evaluated. With an increase in ethanol content, the negative values of are decreased indicating less spont
... Show MoreSalah Al-Din Provence is an active agriculture and population region. One of its primary water sources is groundwater, which suffers from a lack of information regarding water quality and hydrochemistry. In order to study those missing variables, 27 samples from wells of shallow tubes were collected for analyzing the relevant physicochemical indices that help to produce the Schoeller index, Piper diagram, and Gibbs plot. Piper diagram revealed a hydrochemistry behavior of different values along with the groundwater samples. The chemistry of wells was controlled primarily by the evaporation process according to the Gibbs plot. The values of the Schoeller index of the studied samples stated that 59% of
The specifications of lubricating oil are fundamentally the final product of materials that have been added for producing the desired properties. In this research, spherical nanoparticles copper oxide (CuO) and titanium oxides (TiO2) are added to SAE 15W40 engine oil to study the thermal conductivity, stability, viscosity of nano-lubricants, which are prepared at different concentrations of 0.1%, 0.2%, 0.5%, and 1% by weight, and also their pour point, and flash point as five quality parameters. The obtained results show that CuO nanoparticles in all cases, give the best functionality and effect on engine oil with respect to TiO2. With 0.1 wt. % concentration, the thermal conductivity of CuO/oil and TiO2/
... Show MoreThis study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 pati
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