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.
Zora Neale Hurston's (1891-1960) is an outstanding African American
novelist, playwright, autobiographer and essayists. Her work is considered as an
important part of the African American and Harlem Literature.**** It represents a
milestone and a keystone in the African-American literary canon because it breaks
from the style of the previous works and makes a beginning of a new style. Hurston
shifts from the black works that stick to racial themes and sheds the light on new
aspects and themes in blacks' life especially on feminist themes. Her exceptional fame
culminates in her novel Their Eyes Were Watching God (1937). 1
Their Eyes Were Watching God examines with a great deal of artistry
the struggle of a black
The research aims to shed light on the possibility of measuring the intellectual capital in the Iraqi insurance company using accounting models, as well as disclosing it in the financial statements of the company, where human capital was measured using the present value factor model for discounted future revenues and the intellectual value-added factor model for measuring structural capital It was also disclosed in the financial statements based on the theory of stakeholders. The research problem lies in the fact that the Iraqi insurance company does not carry out the process of measuring and disclosing the intellectual capital while it is considered an important source for the company’s progress in the labor market recently. T
... Show MoreFeedback on students’ assignments can be done in many different ways. Nowadays, the growing number of students at universities has increased the burden on the instructors to give feedback on students’ writings quickly and efficiently. As such, new methods of modern online automated feedback tools, such as Hemingway app and ecree,are used to assist and help instructors. Hence, this research is an explanatory study to examine the effect of using the online automated feedback on some Iraqi EFL learners’ writings at the university level. The study comprised 60 students enrolled in an English language course at the University of Anbar. They were divided randomly into two groups, experi
... Show MoreVarious theories have been proposed since in last century to predict the first sighting of a new crescent moon. None of them uses the concept of machine and deep learning to process, interpret and simulate patterns hidden in databases. Many of these theories use interpolation and extrapolation techniques to identify sighting regions through such data. In this study, a pattern recognizer artificial neural network was trained to distinguish between visibility regions. Essential parameters of crescent moon sighting were collected from moon sight datasets and used to build an intelligent system of pattern recognition to predict the crescent sight conditions. The proposed ANN learned the datasets with an accuracy of more than 72% in comp
... Show MoreThis paper investigates the effect of magnetohydrodynamic (MHD) of an incompressible generalized burgers’ fluid including a gradient constant pressure and an exponentially accelerate plate where no slip hypothesis between the burgers’ fluid and an exponential plate is no longer valid. The constitutive relationship can establish of the fluid model process by fractional calculus, by using Laplace and Finite Fourier sine transforms. We obtain a solution for shear stress and velocity distribution. Furthermore, 3D figures are drawn to exhibit the effect of magneto hydrodynamic and different parameters for the velocity distribution.
Objective: This study aims to assess the efficacy of CT-guided true-cut biopsy as a less invasive and cost-effective diagnostic technique for peripherally placed lung lesions. Methods: fourty patients with solitary lung nodule were involved in this study, true cut biopsies under Ct guide was taken then processed for routine H&E staining. Results: different pathological features can be identified with different pathological features giving primary diagnostic screening for lung cancer Conclusion: CT guided thoracic lesion biopsy is very efficient, cost-effective and less invasive technique when compared with the thoracic surgery
Periodontitis is one of the most prevalent bacterial diseases affecting man with up to 90% of the global population affected. Its severe form can lead to the tooth loss in 10-15% of the population worldwide. The disease is caused by a dysbiosis of the local microbiota and one organism that contributes to this alteration in the bacterial population is Prophyromonas gingivalis. This organism possesses a range of virulence factors that appear to contribute to its growth and survival at a periodontal site amongst which is its ability to invade oral epithelial cells. Such an invasion strategy provides a means of evasion of host defence mechanisms, persistence at a site and the opportunity for dissemination to other sites in the mouth. However, p
... Show MoreWith the increasing integration of computers and smartphones into our daily lives, in addition to the numerous benefits it offers over traditional paper-based methods of conducting affairs, it has become necessary to incorporate one of the most essential facilities into this integration; namely: colleges. The traditional approach for conducting affairs in colleges is mostly paper-based, which only increases time and workload and is relatively decentralized. This project provides educational and management services for the university environment, targeting the staff, the student body, and the lecturers, on two of the most used platforms: smartphones and reliable web applications by clo
Carnosol, a phenolic diterpene, is one of the effective anticancer agents naturally occurring in rosemary, sage, parsley, and oregano. The chemoresistance problem increased with the routinely used chemotherapy. Therefore, the efforts to find a substitute with safe and low cost have become crucial worldwide. The current study attempts to inspect the anticancer molecular mechanisms of Carnosol on modulating up- and down- regulation of multiple genetic carcinogenesis pathways. The cytotoxicity of Carnosol on Hela cells was evaluated by MTS assay. Flow cytometry was used to assess apoptosis and cell cycle arrest. The apoptotic morphological changes were obvious by dual apoptosis assay. The differential gene expression after treatment wi
... Show MoreThe research discusses the most important goals and means of IGAD in making peace in Sudan and then regional peace.