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.
Background: The insertion torque (IT) values and implant stability quotient (ISQ) values are the measurements most used to assess primary implant stability. This study aimed to assess the relationship between ISQ values and IT. Materials and methods: This study included 24 patients with a mean (SD) age of 47.9 (13.64) years (range 25-75 years). The patients received 42 dental implants (DI), 33 in the mandible and 9 in the maxilla. The DI were installed using the motorized method with 35 Ncm torque, When DI could not be inserted to the requisite depth by the motorized method, a hand ratchet was used and the IT was recorded as ˃ 35 Ncm. Implant stability was measured utilizing Osstell® ISQ. The secondary stability was measured after 16
... Show MoreThe aim of this paper is to estimate the concentrations of some heavy metals in Mohammed AL-Qassim Highway in Baghdad city for different distances by using the polynomial interpolation method for functions passing from the data, which is proposed by using the MATLAB software. The sample soil in this paper was taken from the surface layer (0-25 cm depth) at the two sides of the road with four distances (1.5, 10, 25 and 60 m) in each side of the road. Using this method, we can find the concentrations of heavy metals in the soil at any depth and time without using the laboratory, so this method reduces the time, effort and costs of conducting laboratory analyzes.
The thermal and electrical performance of different designs of air based hybrid photovoltaic/thermal collectors is investigated experimentally and theoretically. The circulating air is used to cool PV panels and to collect the absorbed energy to improve their performance. Four different collectors have been designed, manufactured and instrumented namely; double PV panels without cooling (model I), single duct double pass collector (model II), double duct single pass (model III), and single duct single pass (model IV) . Each collector consists of: channel duct, glass cover, axial fan to circulate air and two PV panel in parallel connection. The temperature of the upper and lower surfaces of PV panels, air temper
... Show MoreThe aim of the research is to identify the adequacy of accounting disclosure in granting bank financing in explaining the role of accounting disclosure in granting bank financing by linking the concepts of full, comprehensive and adequate disclosure to bank financing. The impact of full accounting disclosure on granting bank financing, the existence of an impact of comprehensive accounting disclosure on granting bank financing, the existence of an impact of adequate accounting disclosure on granting bank financing, and the research relied on the descriptive approach, the deductive and inductive approach, the inferential analytical approach, a
... Show MoreSports skills in some individual games require physical and motor qualities to facilitate the process of skill performance and also require the instructor or trainer to use more than one strategy, method and way to bring the performance to the level of mastery and avoid injury. The aim of the research is to know the effect of using special exercises using tools and their effect on teaching the skill of a front shoulder circle. The research hypothesis is that using special exercises with tools has a positive effect on teaching the skill of a front shoulder circle on the rings apparatus. Research method: - The researchers used the experimental method by designing two equal groups, the control and the experimental, to suit the research
... Show MoreThe current research studies the aesthetic framework for the dialectical development of the functions of the contemporary theater director in an aesthetic approach to the mechanisms of functional overlap between the dramaturgy and direction functions, and scenography and direction, the detection of the controversial structure of that overlap, and what can be summed up in the following question: (what are the aesthetic approaches of the dialectical development in the function of the contemporary theatre director?). The research is determined by a pivotal aim which is (knowing the aesthetic nature of the dialectical development in
The research aims to form a clear theoretical philosophy and perceptions about strategic Entrepreneurship through the relationship between high Involvement management practices, the basis in creating that leadership and high-performance work systems as a support tool in achieving them according to the proposals (Hitt et al, 2011), in an attempt to generalize theoretical philosophy and put forward how to apply it within The Iraqi environment, and on this basis the problem of the current research was launched to bridge the knowledge gap between the previous proposals and the possibility of their application, aiming to identify the practices of high Involvement management and the possibility of high-performance work systems and thei
... Show MoreAl comentar un texto literario no se llega solamente mediante el estudio de su Historia. Ese estudio sería vano, se convertiría en una simple memorización de datos, creo yo.
Comentar un texto supone comprobar las características generales de un movimiento, estilo de un autor... en otras palabras comprender con profundidad el texto literario en s
The present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur
... Show MoreCurrent search problem manifested and widows who community harsh to bear hardships and pains، The goals of continuing the sustainability of life and take responsibility, and especially in light of the difficult circumstances in which Iraq is going through, and the displacement of murder and terrorism, which generated huge numbers of widows and orphans Because of the loss of a breadwinner and which became women and children are the most harm to the victim and as a result of wars and armed tendencies So this research is an important and vital topic opens our horizons important for overlapping roles of women widows and their impact on the achievement and status of Iraqi women and that as long as aptly characterized and their ability to end
... Show More