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 current study aimed to explore the mediation effects of mother's mental health symptoms between marital adjustment and child development aspects. (666) participants of mothers and their children were the sample of the study. The researchers used the marital adjustment scale prepared by Manson, Morse, Lerner, Arthur, as well as, a package of tests for some aspects of growth Kindergarten children prepared by Kenawi and Mohamed (1999). In addition, theyemployed a list of modified symptoms (Symptom Checklist-90- Revised (SCL) -90-, prepared by Derogatis, Lipman and Lipogun & Cov (1976), The results of the current study showed there is a statistically significant relationship between marital adjustment and the symptoms of mental diso
... Show MoreThis study aims to identify the level of quality of Islamic banking services in the Kingdom of Saudi Arabia. It also investigates the importance of the various dimensions of the quality of banking services. The sample of the study included 69 clients of Al Rajhi Bank and Al-Bilad Bank. The study concluded that the overall level quality of services that Islamic banking offer is high. However, their relative importance varies from one dimension to another. The security, confidence and physical aspects are very high which this is a good point. On the other hand, the application aspects do not get the same importance. These aspects include the customer's wishes, helping them to improve the services offered to them,
... Show MoreAbstrct The Turkish political system has undergone exceptional and unprecedented circumstances, represented by a series of security and political unrest that has cast its shadow over the Turkish state and regional and international challenges. It has never been a pretext or pretext for continuing the comprehensive reform process. The constitutional amendments of the 1982 Constitution, Justice and development, whether political, economic or social, is not a reaction to a difficult reality; it is a system of governance and a national option stemming from within. It promotes national unity and enshrines democracy and the concept of public rights and freedoms.
The research aims to identify the academic problems of family counseling diploma students at Saudi Universities. In addition, to identify the differences in these problems according to gender, marital status, place of study, academic specialization, and GPA. The sample consisted of (491) students. The researcher has used one questionnaire for academic problems prepared by the researcher. The research revealed the following results: There were academic problems among family counseling diploma students at Saudi Universities, the most problems were related to the systems and administrations of the university, then the field training, the buildings, classrooms and campus facilities, then the academic courses, after that the exams, then
... Show Moreالتعددية السياسية بين الرفلض والقبول دراسة نظرية لأبرز الاتجاهات الاسلامية المعاصرة
Sliver / Sliver chloride is as old used from human but the sliver / sliver chloride nanoparticles have only recently been recogenized. They have used in medicin and agiculture. In the present study have been investigation the effecte biosynthesis Sliver / Sliver chloride nanoparticles as antibacterial by demonstrated that Ag / AgCl NPs arrest the growth of many bacterial: S.typhimurium, k. pneumonia. S. aureus, L.monocytogenes, B. Anthracis, E. coli, C. frundi, S. Pneumonia, P. Aeruginosa. The elements compestion and crystallization panal of biosynthesized nanoparticles were chracterazated by FTIR, XRD and SEM. From XRD, It is confirmed the synthesized nanoparticles contain Sliver / Sliver chloride elements. Synthesized Ag / AgCl NPs showed
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The research aims to study the importance of applying lean accounting techniques and the tools and methods they contain, the most important of which is the “value path costs” technique and its impact on rationalizing and controlling costs, as well as reducing production costs in general and reducing quality costs in a way Special by reducing or eliminating waste and waste in both time and resources and meeting customer requirements. In order to achieve this goal, the researcher relied on the application of lean accounting tools by obtaining data related to the mill, in addition to that, the information obtained as a result of field coexistence in the mill and being able to view the records of the mill in the research sample. From the
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