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.
Abstract The purpose of this paper is to preparing small games for fifth graders. And to identify the impact of these small games in developing some concepts of traffic safety for fifth graders. The two researchers used the experimental method to solve the research problem, and the research community was identified with students. The fifth grade of primary school in the province of Baghdad and a sample was chosen from the private Baghdad Primary School, which numbered (60) male and female students. They were distributed equally into two groups by simple random method (experimental and control groups). As for the most important conclusions reached by the two researchers, it is the presence of an effect of small games in developing some conce
... Show MoreBackground: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr
... Show MoreGalantamine was isolated from the bulb part of Narcissus jonquilla L. plant cultivated in Iraq. The compound was identified by different chemical analysis like: Fourier Transforms Infrared spectra (FTIR), High Performance Liquid Chromatography (HPLC) and mass spectroscopy and 1H-NMR.
Pseudoephedrine (PSE) or (Sudafed) is one of the sympathomimetic group of drugs (ephedrine, PSE and amphetamines) which effects cardiovascular system, respiratory system, and gastrointestinal tract. However, only little researches had supported its effect on solid abdominal organs. This study aims to investigate the effects of different doses of Sudafed in the liver and kidney of albino mice. The current study included 18 albino mice grouped into 2 groups: control (3 mice), and acute group (15 mice). The acute group was further subdivided into 5 subgroups, each subgroup of 3mice wasgiven a lonely intaperitonial injection of 0.3ml of the following conc. (500mg/kg, 250mg/kg, 125mg/kg, 62.52mg/kg, and 31.24mg/kg) for 24hrs. After the m
... 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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