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 study investigates the Linguistic and Conceptual equivalence of Conner’s Revised Scales when applied on a Sudanese sample. Sudanese parents and teachers completed behavior-rating scales on a stratified sample of 200 children. These instruments were based on Conner’s parent -48 and teacher-28 questionnaires. Following a reliable translation into Sudanese Arabic the test-retest reliability of the items and the internal consistency of the original Conner’s' revised scales were explored. The associations between scale scores and between parents and teachers scores were also examined. Both instruments displayed good reliability and the original Conners scales had satisfactory internal consistency. The inter-correlation sugg
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This research aims to the relationship and the effect of concurrent engineering dimensions analyze (product design, process design, and supply chain design) on the dimensions of strategic performance (efficiency, and effectiveness) The research was conducted in public Zora Electrical Industries Company, on a sample of departments and officials, engineers, managers and people in the company amounted to (45) . A questionnaire was used for the purpose of data collection which has been adopted, with the use of statistical methods via computerized system (spss) for processing data , identifying them and testing the research hypotheses. The research
... Show MoreKA Hadi, AH Asma’a, IJONS, 2018 - Cited by 1
Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were mal
... 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 MoreLanguage always conveys ideologies that represent an essential aspect of the world we live in. The beliefs and opinions of an individual or community can be organized, interacted with, and negotiated via the use of language. Recent researches have paid attention to bullying as a social issue. They have focused on the psychological aspect of bullying rather than the linguistic one. To bridge this gap, the current study is intended to investigate the ideology of bullying from a critical stylistic perspective. The researchers adopt Jeffries' (2010) critical stylistics model to analyze the data which is five extracts taken from Hunt’s Fish in a Tree (2015). The analysis demonstrates
... Show MoreOne of the most important problems that would continuously face the Higher education organizations is how to improve the service level presented by them, and how this can lead to increase demand for services of this organizations.As this issue has exhausted many organizations pushed some of them to withdraw from the market Because of weaknesses in their services. Here lies the importance of this matter to be given more attention in order to maintain the organization competitive position. According to that, The selection of the research title (The Impact of Quality on the Level of the University Service Request) which seeks to measure the impact of service quality on the level of demand, At a time when world&
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