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.
The study sought to highlight the importance of applying the administrative control procedures which play an important role in assessing the performance of the employees of the tax administration and specifically the companies department by setting the standards and objectives of the department on the basis of which in the implementation of its work and identify deviations and errors and find appropriate solutions and evaluate the results according to appropriate solutions, The study of the problem of research, namely the extent to which the tax administration applied to the administrative control procedures in view of its importance in evaluating the performance of its employees and the extent of their application to the legislations an
... Show MoreThe current research contains four chapters. The first topic included the methodological framework that included the problem of research and the need for it, and then the importance of the research, and then the aim of the research, its limits and the definition of terms linguistically, conventionally and procedurally. The second chapter (the theoretical framework) contained two topics, the topic The first is titled: The Outward Vision in Child Theater Performances, while the second topic was titled: Presentation Technology in Child Theater, Chapter Four (Research Procedures), which organized the research community and analyzed its sample, and the fourth chapter contained research results, conclusions and recommendations. The prop
... Show MoreThe construction industry plays a crucial role in the countries' economy, especially in the developed country. This point encourages the concerned institution to use new techniques and integrate many techniques and methods to maximize the benefits. The main objective of this research is to evaluate the use of risk management, value management, and building information modeling in the Iraqi construction industry. The evaluation process aims at two objectives. The direct objective was to evaluate the knowledge in risk management (RM), value management (VM), and building information modeling (BIM). The indirect objective was to support the participants with information related to the main items mentioned. The questionnaire
... Show MoreThe present study was conducted to investigate the relationship between critical thinking, epistemological beliefs, and learning strategies with the academic performance of high school first-grade male and female students in Yazd. For this purpose, from among all first-grade students, as many as 250 students (130 females and 120 males) were selected by using multistage cluster sampling. The data needed were then collected through using California Critical Thinking Skills Test, Schommer's Epistemological Beliefs Questionnaire, Biggs’ Revised Two Factor Study Process Questionnaire. The findings indicated that there is a positive significant relationship between critical thinking and academic performance and achievement. Moreover, four fa
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This study highlights the importance of Iraq in the analysis of foreign trade and economic growth for the period (1980 - 2013) is an attempt to determine the equilibrium relationship long term and short term between these two variables were used ARDL model to explain the economic relationship between the two variables.
To achieve the objectives of the research has been the standard model estimate after testing the stability of exports X data series, and imports M, and GDP current prices, and exchange rate EXR, and verify the existence of a joint integration relationship between these variables.
In order to achieve the objectives of the research it
... Show MoreIn the present article, we implement the new iterative method proposed by Daftardar-Gejji and Jafari (NIM) [V. Daftardar-Gejji, H. Jafari, An iterative method for solving nonlinear functional equations, J. Math. Anal. Appl. 316 (2006) 753-763] to solve two problems; the first one is the problem of spread of a non-fatal disease in a population which is assumed to have constant size over the period of the epidemic, and the other one is the problem of the prey and predator. The results demonstrate that the method has many merits such as being derivative-free, overcome the difficulty arising in calculating Adomian polynomials to handle the nonlinear terms in Adomian Decomposition Method (ADM), does not require to calculate Lagrange multiplier a
... Show MoreThe primary components of successful engineering projects are time, cost, and quality. The use of the ring footing ensures the presence of these elements. This investigation aims to find the optimum number of geogrid reinforcement layers under ring footing subjected to inclined loading. For this purpose, experimental models were used. The parameters were studied to find the optimum geogrid layers number, including the optimum geogrid layers spacing and the optimum geogrid layers number. The optimum geogrid layers spacing value is 0.5B. And as the load inclination angle increased, the tilting and the tilting improvement percent for the load inclination angles (5°,10°,15°) are (40%,28%, and 5%) respectively. The reduction percent o
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