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.
Buzurgan oil field suffers from the phenomenon of asphaltene precipitation. The serious negatives of this phenomenon are the decrease in production caused by clogging of the pores and decrease in permeability and wettability of the reservoir rocks, in addition to the blockages that occur in the pipeline transporting crude oil. The presence of laboratories in the Iraqi oil companies helped to conduct the necessary experiments, such as gas chromatography (GC) test to identify the components of crude oil and the percentages of each component, These laboratory results consider the main elements in deriving a new equation called modified colloidal instability index (MCII) equation based on a well-known global equation called colloidal in
... Show MoreSynthetic polymers such as polyurethane are used widely in the field of biomedical applications such as implants or part of implant systems.
This paper focuses on the preparation of base polymer matrix composite materials by (Hand Lay-Up) method, and studying the effect of selected grain size (32, 53, 63, 75, and 90) µm of (Reenia) particles on some properties of the prepared composite.
Mechanical tests were used to evaluate the prepared system (Tensile, Compression, Impact, and Hardness) tests, and a physical test of (Water absorption %), and all tests were accomplished at room temperature.
Where results showed tensile test (maximum tensile strength and modulus of elasticity) high at small grain size while
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All of us are indispensable for this rule (the most important and important) individuals, whether we were groups of leaders or followers of peoples or countries because the rule provides adequate guarantees for the correct positions and drawing the plan for successful decision-makers matching with the balances of Sharia without incompatibility between religious or worldly interests or legal positions and therefore in the framework of the most important appointment And distinguish it from the important from the interests or the appointment of the most important and distinguish from the important from the evils and through this rule we learn about the scientific and practical solutions t
... Show MoreCost estimation is considered one of the important tasks in the construction projects management. The precise estimation of the construction cost affect on the success and quality of a construction project. Elemental estimation is considered a very important stage to the project team because it represents one of the key project elements. It helps in formulating the basis to strategies and execution plans for construction and engineering. Elemental estimation, which in the early stage, estimates the construction costs depending on . minimum details of the project so that it gives an indication for the initial design stage of a project. This paper studies the factors that affect the elemental cost estimation as well as the rela
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The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s
... Show MoreThe study of the " Speech act " in grammatical codes reveals great efforts in the study of the elements of linguistic communication contained in their efforts, and is part of the study of the linguistics of heritage, and the research has been designed to identify the verbal act in the blog of Ibn al-Khabaz (guiding the shine) by studying its sections comprehensively; To the spirit of grammatical discourse as well as the combination of the concept of the semantic act already verbal according to Searle, and its response in the form of indirect verbal acts more than direct acts, as well as the pure formulas of the opinions of the violators in the speech of Ibn al-Khabaz other than the proven verbal formulas Approval and approval, the class
... Show MoreImam Ibn Abi Shaybah counted in his book classified twenty-five and a hundred recent and impact claimed that Abu Hanifa has violated the provisions required by apparent, and these conversations and effects including with regard to worship and transactions, including with regard to personal status, including with regard to borders and felonies, and collected by Sheikh Muhammad Zahid Al-Kothari in his book funny jokes in talking about the responses of Ibn Abu Shaybah on Abu Hanifa, and these issues we will study in our research.
Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
... Show MoreThe primary objective of the present research is to diagnose the most mportant imensions of quality of work life in a sample of individuals working in the Northern Gas Filling Company in Nynawa. The study sample consisted of 140 employees of the Northern Region Filling Company in even ,Through a questionnaire prepared for this purpose. The study concluded that there are five main factors that are considered to be measure of the quality of working life and are based on their importance: Empowerment, organizational health, internal work environment, motivation, development and training of workers. The study recommended that the organization should payattentio
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