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 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
... Show MoreStatistical methods of forecasting have applied with the intention of constructing a model to predict the number of the old aged people in retirement homes in Iraq. They were based on the monthly data of old aged people in Baghdad and the governorates except for the Kurdistan region from 2016 to 2019. Using Box-Jenkins methodology, the stationarity of the series was examined. The appropriate model order was determined, the parameters were estimated, the significance was tested, adequacy of the model was checked, and then the best model of prediction was used. The best model for forecasting according to criteria of (Normalized BIC, MAPE, RMSE) is ARIMA (0, 1, 2).
Each phenomenon contains several variables. Studying these variables, we find mathematical formula to get the joint distribution and the copula that are a useful and good tool to find the amount of correlation, where the survival function was used to measure the relationship of age with the level of cretonne in the remaining blood of the person. The Spss program was also used to extract the influencing variables from a group of variables using factor analysis and then using the Clayton copula function that is used to find the shared binary distributions using multivariate distributions, where the bivariate distribution was calculated, and then the survival function value was calculated for a sample size (50) drawn from Yarmouk Ho
... Show MoreThe platforms of social networking sites, with their distinctive communication and technological features, create a social movement that led to the establishment of a new pattern of communication in a modern context. This allows the users on the internet to carry out many social interactions based on the interests and commonalities among them. Algerian women have a share of this digital presence by representing their views and discussing their issues on several sites like Facebook, for example.
In this research, we have analyzed the pages of Algerian women on Facebook site to find out the most important issues addressed by Algerian women so that we can organize their concerns in the digital channels and discover their different orie
Cultivation of the green seaweed Enteromorpha compressa was performed under natural laboratory spring environmental conditions of temperature, light intensity and photoperiod to study the salinity tolerance of this intertidal green macroalga. Cultivation was carried out under artificial seawater (ASW) of different concentrations (18, 35, 53 and 106 g/l sea salt) compared to the control using natural seawater (NSW). Growth rate and pigment content of the cultivated alga were recorded at regular intervals during the experimental duration. Antioxidant activity of the crude ethanolic extract and its fractions (petroleum ether, chloroform, ethyl acetate and acetone) was performed against DPPH radical scavenging assay and compared to
... Show MoreLiposomal amphotericin B (Amph B) has been used effectively to treat leishmaniosis, in spite of its high toxicity appeared in some patients. In our study, Amph B was administered in Leishmania donovani that infected BALB/c male mice using different concentrations to evaluate its efficacy challenge against infection as well as its effect in modulating immunity of the host. We observed that low doses with short duration of Amph B as a therapy regime significantly enhanced the induction of Th1 cytokine (INF-γ), but suppressed Th2 cytokine (IL-10) production. Groups of mice infected with L. donovani and treated with Amph B showed clearly increasing in INF-γ level and reduction in IL-10 level in concentration (3, 4, 5 mg/ml/kg) with best resul
... Show MoreThe marine collagens are biocompatible and biodegradable materials that are considered as a biomimetic approach for tissue regeneration. This study evaluated the effect of daily consumption of marine collagen supplement drink on enamel white spot lesions (WSLs), comparing the results against Regenerate system and Sylc air abrasion methods. Fifty human enamel slabs were allocated into five groups (n = 10 per group): non-treated (sound); non-treated (WSLs, 8% methylcellulose gel with 0.1 M lactic acid (pH 4.6) at 37 °C for 21 days); and three treated surfaces with marine collagen; Regenerate system; and Sylc air abrasion. The treatment lasted for 28 days followed by four weeks’ storage in artificial saliva (pH = 7.0, 37 °C). Evalu
... Show MoreBackground: In recent years, the prevalence of obesity has climbed sharply. Still, only a few safe and effective medications are approved as weight-loss drugs. Objective: This study aims to assess the knowledge and practice of community pharmacists in Iraq regarding the use of Liraglutide and Semaglutide as weight-loss medications. Method: A cross-sectional survey was implemented using a validated questionnaire and a convenient sample of Iraqi community pharmacists from different governorates. The questionnaire was created after conducting a literature review of the most important articles about liraglutide and semaglutide. The questionnaire consists of three sections. The first part was used to collect demographic information. The second a
... Show MoreConstructed wetlands (CWs) are simple low-cost wastewater treatment units that use natural process to improve the effluent water quality and make it possible for its reuse.in this study used the horizontal flow system for the tertiary treatment of wastewater effluent from secondary basins at Al-Rustamiya wastewater treatment plant / old project / Baghdad / Iraq. the Phragmites Australis plant was used for wastewater treatment and the horizontal subsurface flow system was applied. the experimental study was carried out in February 2020 to October 2020. the parameters were monitored for a period of five weeks, Concentration-based average removal efficiencies for HSSF-CW were COD,53% [NO
Twisted tape insertion in the smooth plain tube is one of the types of passive methods that are used to enhance heat transfer. Swirl fluid flow inside the tube and related heat transfer characteristics are very complex. ANSYS FLUENT (V 16.1) and ASPEN industrial program are used in analyzing this technique for enhancement heat transfer. A circular plain tube has length L=8534mm and 17 mm inner diameter with a twisted tape of twist ratio of y = (H/D) = (150/17) =8.8 along the plain tube were considered for this study. Eight Reynolds numbers (Re) of 784, 1000, 2000, 3000, 4000, 5000, 6000 and 7000 are used to analyze the response of thermal performance. Crude oil API 28 exit temperature, film heat transfer coefficient, Nus
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