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.
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This research sheds light on the major sins (fornication and sodomy) as two crimes that are prohibited by the divine laws, including its conclusion by the Islamic Sharia. Major sins so that life and the universe are organized, and the individual lives a life of chastity and purity free of filth and filth. The Islamic message included a set of preventive measures and remedial methods that, if the ummah were to apply them, they would live a decent life full of noble goals.
In this work, the pseudoparabolic problem of the fourth order is investigated to identify the time -dependent potential term under periodic conditions, namely, the integral condition and overdetermination condition. The existence and uniqueness of the solution to the inverse problem are provided. The proposed method involves discretizing the pseudoparabolic equation by using a finite difference scheme, and an iterative optimization algorithm to resolve the inverse problem which views as a nonlinear least-square minimization. The optimization algorithm aims to minimize the difference between the numerical computing solution and the measured data. Tikhonov’s regularization method is also applied to gain stable results. Two
... Show MoreHaemoproteus burhinus is described from the stone curlew, Burhinus oedicnemus saharae (Reichenow) from Al-Attariya, 45 km SE Baghdad city middle of Iraq. It is related to but differs from H. peireci in that it hypertrophied the erythrocyte and the erythrocyte nucleus is always laterally displaced in microgametocytes.
Criteria to be met in selecting the obtimal areas for generating alternative electric energy from wind
Alice Walker's novel The Color Purple1983, whose events take place in the rural Georgia and addresses the most important issues in the early 20thcentury; like male dominant society and women submission to men, weaves a mosaic picture of male-female relationships. Black men like Alphonso, Albert and Harpo are portrayed as oppressors, cruel and they exercise power and violence over their wives and daughters. Through the negative portrayal of black male characters, Walker is accused to be a men hating writer because she ''Views oppression as an essentially masculine activity which springs from the male's aggressive need to dominate. In the novel, man is the premium mobile, the one by whom and t
... Show MoreThe Paleocene benthic foraminiferal zonation of the Umm Er Rhadhuma Formation from the borehole (K.H 12/7), South Anah City (Western Iraq), has been re-studied and re-analyzed precisely based on the large benthic foraminifera (LBF). They are represented by two biozone Rotorbinella hensoni Partial Range Zone, recorded from the Lower and middle parts of the Umm Er Rhadhuma Formation and Lockhartia praehaimei Partial Range Zone determined Uppermost of this unit, and dated to be the Selandian – Thanetian stage. Almost all the biogenic (micro and macro) and non-biogenic constituents, including large benthic foraminifera, Algae, Echinoderm, Bryozoans, Oyster, Gastropod fragments, and peloids, in addition to lithofacies types, indicate t
... Show MoreThe research aims to identify the availability of some basic competencies that are required to be available to workers in digital agricultural Extension from the point of view of senior management, middle management, and, employees with Post-graduate education degrees, represented by the following: Transition to digital agricultural Extension for sustainable and smart family farms, benefiting from international expertise and experiences in applying for Digital agricultural Extension, preparing and implementing Extension messages through platforms, factors affecting the effectiveness of digital agricultural Extension and its platforms, following up and evaluating the activities and programs of the digital Extension platform. The research pop
... Show MoreThe addition of new reactive sites on the surface area of the inert sand, which are represented by layered double hydroxide nanoparticles, is the primary goal of this work, which aims to transform the sand into a reactive material. Cetyltrimethylammonium bromide (CTAB) surfactant is used in the reaction of calcium extracted from solid waste-chicken eggshells with aluminum prepared from the cheapest coagulant-alum. By separating amoxicillin from wastewater, the performance of coated sand named as "sand coated with (Ca/Al-CTAB)-LDH" was evaluated. Measurements demonstrated that pH of 12 from 8, 9, 10, 11, and 12, CTAB dosage of 0.05 g from 0, 0.03, 0.05, and 0.1 g, ratio of Ca/Al of 2 from 1, 2, 3, and 4, and mass of sand of 1 g/50 mL from
... Show MoreWheat straw was modified with malonic acid in order to get low cost adsorbent have a good ability to remove copper and ferric ions from aqueous solutions, chemical modification temperature was 120°C and the time was 12 h. Parameters that affect the adsorption experiments were studied and found the optimum pH were 6 and 5 for copper and iron respectively and the time interval was 120 min and the adsorbent mass was 0.1 g. The values for adsorption isotherms parameters were determined according to Langmuir [qmax were 54.64 and 61.7 mg/g while b values were 0.234 and 0.22 mg/l] , Freundlich [Kf were 16.07 and 18.89 mg/g and n were 2.77 and 3.16], Temkin [B were 0.063 and 0.074 j/mol and At were 0.143 and 1.658 l/g] and for Dubinin-Radushkev
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