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.
In order to obtain a mixed model with high significance and accurate alertness, it is necessary to search for the method that performs the task of selecting the most important variables to be included in the model, especially when the data under study suffers from the problem of multicollinearity as well as the problem of high dimensions. The research aims to compare some methods of choosing the explanatory variables and the estimation of the parameters of the regression model, which are Bayesian Ridge Regression (unbiased) and the adaptive Lasso regression model, using simulation. MSE was used to compare the methods.
The research aims to reveal the impact of developmental leadership in its dimensions (ideal model, interest in employees, inspiration and motivation) as an independent variable in achieving adaptive performance in its dimensions (Creative problem solving, learning and motivation, Training efforts, adaptability, work stress management, dealing with crises and emergencies) as a dependent variable, and the research aims to enhance the quality of developmental leadership in the research sample through this leadership style, which is a modern style and is still under research and study with a focus on the benefit of adaptive performance From a psychological and organizational research sample consisting of (106) respondents from the middle adm
... Show MoreBackground: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted t
Abstract:
This research seeks to test the influence of intellectual capital as an explanatory variable and its components (human capital, structural capital, relational capital) and sustainable competitive performance as a responsive variable and its components (reducing service delivery cycle time, rapid response to market demand, increasing customer satisfaction, providing better Quality of service, increasing market share)” through a field study, and here the research problem was diagnosed in an attempt to answer the following question: Is there awareness among the senior management within the private colle
... Show MoreA comprehensive practical study of typical mechanical properties of welded Aluminum alloy AA7020-T6 (Al-Mg-Zn), adopting friction stir welding (FSW) technique and conventional metal inert gas (MIG) technique, is well achieved in this work for real comparison purposes. The essences of present output findings were concentrated upon the FSW samples in respect to that MIG ones which can be summarized in the increase of the ultimate tensile strength for FSW was 340 MPa while it was 232 MPa for MIG welding, where it was for base metal 400 MPa. The minimum microhardness value for FSW was recorded at HAZ and it was 133 HV0.05 while it was 70 HV0.05 for MIG weld at the welding metal. The FSW produce 2470 N higher than MIG welding in the bending t
... Show MoreThis 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
The success of any media work in our contemporary life is based on proper planning. Television in Iraq is like any media outlet that adopts clear planning and programming in order to achieve the goals set in the news, entertainment, education. Iraq TV relies on four programming plans in one year (short term), but we often receive central instructions directly from the Minister of Information ordering to cancel the program plan and what was scheduled for broadcast to be finally replaced by alternative or emergency program associated with an incident, occasion or important news, these programs are all called (emergency programs).
In this present research we will be dealing with these programs as well as the extent of their impact o
... Show MoreThe aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe
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