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.
Pseudomonas aeruginosa is a common and major opportunistic human pathogen, its causes many and dangersinfectious diseases due to death in some timesex: cystic fibrosis , wounds inflammation , burns inflammation , urinary tract infection , other many infections otitis external , Endocarditis , nosocomial infection and also causes other blood infections (Bacteremia). thereforebecomes founding fast and exact identification of P. aeruginosafrom samples culture very important.However, identification of this species may be problematic due to the marked phenotypic variabilitydemonstrated by samples isolates and the presence of other closely related species. To facilitate species identification, we used 16S ribosomal DNA(rRNA) sequence data
... Show MoreThree types of extracts ( aquatic, alcoholic, and oily ) were prepared from the fruits of coconuts, and a series of chemical tests were conducted in addition to the use of the FTIR equipment to determine the active locations in the prepared extracts. The results indicated the presence of active compounds (tannins, saponins, flavonoids, turbines and steroids) in the extracts prepared from the fruits of coconuts, also the antimicrobial capability of these extracts were tested on pathogenic bacteria isolated from wounds and burns infections cases. The results proved that the concentration 80 mg/ml of the aquatic extract is the minimum inhibitory concentration for the microbes: Proteus vulgaris and Pseudomonas fluorescence, while the
... Show More(Social values) are of great importance in the lives of nations and peoples as they are the frame of reference that governs the relations of members of society to each other and regulates their life affairs.
And the Prophet of Islam (may God’s prayers and peace be upon him) has told about a group of (social values) such as: spreading peace, feeding food, being fair in dealing with others, and clarifying what a Muslim should have towards his Muslim brother from the safety of the chest and refraining from harming him with the tongue and hand, and so on. Ethics and behaviors that are directly and closely related to (social values).
The best book that abounds with these (social valu
... Show MoreIn a world of fierce competition companies of different activities strive to strengthen their competitiveness in order to be able to deliver greater value to their customers and gain a distinct sites in competition with other companies in the market at the local and international levels. Every company seeks to focus on one or more of the competitive capabilities in order to turn it into an obvious advantage or a number of competitive advantages to contribute in improving the performance and superiority over its competitors. Therefore, the management of companies no longer need only useful information for the internal aspects of the environment, but also need to include the external environment that includes various and constantly changin
... Show MoreIn this article the nanoparticles synthesis of ZnO (Nps) by using the precipitation method at concentrations range (0.5, 0.25, 0.125, 0.0625, 0.03125) mg/mL and then activity was examined against Streptococcus spp that causing dental caries in vitro by well diffusion method, find these concentrations effected in these bacteria and better concentration is 0.03125. ZnO Nps were characterization by EDS to prove this particles are ZnO, and also characterized by atomic force microscope (AFM), X-ray Diffraction (XRD) and TEM, from these technic found that the average size about 30.52 nm and hexagonal shape. The UV-visible result reveals that the large band is observed at 340.8 nm, Zeta potential show that the surface charge is 30.19 mv an
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