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.
Gastro oesophageal reflux disease is due to involuntary gastric contents reflux into the esophagus from stomach, causing heartburn and acid regurgitation symptoms. Genetic and environmental factors are important factors in the causation of disease. Human Leukocyte antigens considered as an excellent marker for population genetics analysis and disease association. This study aimed to investigate the association between HLA-DRB1-DQB1 haplotype that inherited in linkage and its association with gastro oesophageal reflux disease (GERD). Patients and healthy controls were prospectively recruited from gastrocolonoscope unit at Al-Kindy Teaching Hospital (Baghdad-Iraq) between January and July 2016. Forty Iraqi Arab Muslims patients with a history
... Show MoreThe prostheses sockets use normally composite materials which means that their applications may be related with the human body. Therefore, it was very necessary to improve the mechanical properties of these materials. The prosthetic sockets are subjected to varying stresses in gait cycle scenario which may cause a fatigue damage. Therefore, it is necessary or this work to modify the fatigue behavior of the materials used for manufacturing the prostheses sockets. In this work, different Nano particle materials are used to modify the mechanical properties of the composite materials, and increase the fatigue strength. By using an experimental technique, the effect of using different volu
The banks mobilize savings and channel them to the economy, whether commercial or Islamic banks and thus both contribute to increasing financial depth, the objective of this paper is to measure the contribution of the Islamic banks in increase financial depth in Iraq, and compared the role played by private commercial banks in contributing to increasing financial depth in Iraq. The paper has been applying the most used indicators of financial depth that used widely in the literatures, especially those applicable with the Iraqi economy.
The paper found via using the Autoregressive Distributed Lag Model (ARDL) that Islamic banks did not contribute to increasing financial depth in Iraq, as well as for the p
... Show MoreThe research aims at clarifying the relationship between innovative marketing skills and broad recommendation as a vital and important issue for organizations in general and service organizations in particular to demonstrate how innovative marketing skills contribute to broad adoption and to determine the relationship between interdependence and the impact of innovative marketing skills on the broad recommendation. Some questions are posed by the research problem. Is there a clear awareness among individuals in the company about the concept of marketing marketing skills and how do innovative marketing skills affect the broad recommendation of the surveyed company? How innovative marketing skills relate to the broad recommendation
... Show MoreHigh smoke emissions, nitrogen oxide and particulate matter typically produced by diesel engines. Diminishing the exhausted emissions without doing any significant changes in their mechanical configuration is a challenging subject. Thus, adding hydrogen to the traditional fuel would be the best practical choice to ameliorate diesel engines performance and reduce emissions. The air hydrogen mixer is an essential part of converting the diesel engine to work under dual fuel mode (hydrogen-diesel) without any engine modification. In this study, the Air-hydrogen mixer is developed to get a homogenous mixture for hydrogen with air and a stoichiometric air-fuel ratio according to the speed of the engine. The mixer depends on the balance between th
... Show MoreThis paper deals with two preys and stage-structured predator model with anti-predator behavior. Sufficient conditions that ensure the appearance of local and Hopf bifurcation of the system have been achieved, and it’s observed that near the free predator, the free second prey and the free first prey equilibrium points there are transcritical or pitchfork and no saddle node. While near the coexistence equilibrium point there is transcritical, pitchfork and saddle node bifurcation. For the Hopf bifurcation near the coexistence equilibrium point have been studied. Further, numerical analysis has been used to validate the main results.
Background: Chronic suppurative otitis media (CSOM) is the result of aninitial 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.Methods. 1. To get an overview on the bacterial ear infection profile in general 2. 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... A cross sectional study was done which included 405 patient of CSOM patients196 (48%) case were males ,209 (52
... Show MoreThe media guide is a small-sized printed medium, whose importance is highlighted through the specific information it carriesThe task of the guide lies in the clarity of these indications and making a positive impact on the recipient with understanding so it is a means for the purpose of reaching the effect and effectiveness of the message symbols from the movements of lines in which elements that are supposed to be equal in the performance of their functions and the purpose of their existence gather to achieve the mental response of perception, understanding and enjoyment. It must be in an objective unity based on the balance in this distribution. To form a formal organizational unit and an integrated system, the result of which is to gi
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