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.
It must be emphasized that media is amongst human studies fusing older and more recent sciences together, and that its disclosures are the physics of the new communication. Michio Kaku, a theoretical physicist, in his book “ Visions”, confirms this fact when he says :” As a research physicist, I believe that physicists have been particularly successful at predicting the broad outlines of the future .Professionally, I work in one of the most fundamental areas of physics, the quest to complete Einstein's dream of a "theory of everything." As a result, I am constantly reminded of the ways in which quantum physics touches many of the key discoveries that shaped the twentieth century. “ He then got to the fact that the physical disclo
... Show MoreAbstract: Consumer protection in electronic contracts is of great importance in Iraqi law, as there are detailed legislations that enhance consumer rights and provide mechanisms for compensation when necessary. In Iraq, the Consumer Protection Law of 2010 regulates these rights and ensures the availability of sufficient and clear information to consumers.
A field experiment was conducted to grow the wheat crop during the fall season 2020 in Karbala province, north of Ain Al-Tamr District in two locations of different textures and parent materials. The first site (calcareous soil) with a sandy loam texture, is located at (44° 40′ 37′) east longitude and (32° 41′ 34′) north latitude, at an altitude of 32 m above sea level, and an area of 20 hectares. As for the second location (gypsum soil) with a loam texture, it is located at a longitude (45° 41′ 39′) east and a latitude (33° 43′ 34′ north) and at an altitude of 33 m above sea level and an area of 20 hectares. To find out the effect of different tillage systems on water productivity and wheat yield under center pivot irri
... Show MoreMost pathological effects of lead on the body are due to ability of lead to bind with important cellular molecules of various tissues and organs leading to formation abnormal molecules and thus to emergence of pathological conditions. To evaluation the risk to the health status of Iraqi workers who work in the batteries industry, expression of three types of calmodulin related genes were examined. Blood samples were collected from worker working in Iraqi industry of batteries (located in Al-Waziriya), then RNAs extraction were done thereby gene expression for Calcium/Calmodulin- dependent protein kinase2 (CaMKK2), C-X-C Chemokine receptor 4 (CXCR4) and mitogen activated protein kinase kinase 6 (MAP2K6) was done for each sample by using RT-q
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Background: Polymethylmethacrylate (PMMA) is the most ‎commonly used mâ€aterial in denture construction. This material is ‎far from ideal in fulfilling the‎ mechanical requirements, like low impact and transverse strength and poor thermal conductivity are present in this material. The purpose of this study was to study the effect of addition a composite which include 1%wt silanized silicone dioxide nano fillers (SiO2) and 1wt% oxygen plasma treated polypropylene fiber (PP) on some properties of heat cured acrylic resin denture base material (PMMA). Materials and methods: One hundâ€red (100) prepared specimens were divided into five groups according to the tests, each group consisted of 20 specimens and t
BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m
... Show MoreThe bodies responsible for the organization of accounting in the world seek to keep abreast of repaid development, by provide the information required by users, which they need to make efficient decision that return them to the desired benefits, and avoid the risks they could face if they made their decision based on misleading information, or insufficient, or not accurate, Hence, the IASB has undertaken to review the standards, and make the necessary adjustment and clarifications to remove the ambiguities that some of the paragraphs may have in IFRS issued.
And the Iraqi Central Bank obliges banks to convert from local accounting standards to apply IFRS only a step towards keeping pace with developments
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