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.
Hypercholesterolemia is a predominant risk factor for atherosclerosis and cardiovascular disease (CVD). The World Health Organization (WHO), ) recommended reducing the intake of cholesterol and saturated fats. On the other hand, limited evidence is available on the benefits of vegetables in the diet to reduce these risk factors, so this research was conducted to compare the hypolipidemic effect between the extracts of two different types of Iraqi peppers, the fruit of the genus Capsicum traditionally known as red pepper extract (RPE), and Piper nigrum as black pepper extract (BPE), respectively, in different parameters and histology of the liver of the experimental animals. The red pepper was extracted by ethyl acetate, while the black pepp
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:
The research dealt with an important and critical era in the history of the Seljuk State of the Romans in Asia Minor, as that country, after the assumption of Sultan Ghiath al-Din Kehsaru II in the year 634 AH / 1236 CE, was subjected to the constant Mongol threat, so the research came marked with (the Seljuk State of Rome in Asia Minor and the Mongol invasion 634 - 708 AH / 1236 - 1308 AD) The research showed the succession of the Seljuk Sultans to the rulers whose rule after the death of Sultan Alaeddin Kikbad was weak and subject to the authority of the Mongols
Abstract
Agricultural Bank is an important source of funding Specialist His role in lending to farmers, it imposes a great job in providing the necessary head for any developmental process in the agricultural sector money. The ACB of ancient Iraqi banks, and that because of its importance to the advancement of the national economy and contribute to the development and regulation of the economic sector through the support and the assignment of the Iraqi agricultural sector in various agricultural activities because it is responsible
for the process of granting agricultural loans to farmers bank.
The aim of the internal control in the agricultural banks to
... Show MoreThis research aims to clarify the concept of doctrinal rules and adjust its basic terminologies. It further aims to lay down a map for the method of rooting this science by mentioning its rooted sources, in addition to drawing a miniature picture of its history, origin, formation and development. The paper ends with practical models to highlight its importance in rooting the science of nodal rules and facilitating the mentioning of its scattered discussions in a short and comprehensive phrase. The study further illustrates the pioneering role of doctrinal rules science in managing the doctrinal disputes, combining multiple sayings, and in bringing together opposing opinions. The study follows the inductive, descriptive and analytical app
... Show MoreA high percentage of existing buildings in Iraq are traditional buildings, yet there is approximately no such green building in Baghdad or other governorates. Most of these buildings require urgent upgrading to increase their performance (operationally, economically, and environmentally), also the building owners looking for identifying and implementing many of the green building measures to reduce the operational and maintenance costs of their buildings. The decision-makers need to support the possibility of achieving sustainable measures of existing building rating systems such as LEED or BREEAM, and that would require an optimization model. The goal of this study is to maximize the
The paper aims to measure the impact of monetary policy on price stability , by testing the causal relationship between the money supply, inflation rate and the exchange rate , In order to prove that the inflation is a monetary phenomenon in the Iraqi economy , and that the exchange rate is controlled in the money supply , the money supply as an endogenous variable continued we found by using the standard tests to the existence of a single co-integration between the money supply and the rate of inflation and the money supply and the parallel exchange rate, This confirms the existence of a long-term relationship between the variables , It also confirmed the results of the vector error correctio
... Show MoreThis study aimed at an analytical comparison of the Internal Auditing Standards issued by the Institute of Internal Auditors (IIA) and the Guidance Manual for Audit Units issued by the Federal Audit Bureau to show the compatibility and differences between them and the possibility of applying the IIA standards to economic units in Iraq. The guideline was generally not covered by all the internal audit units. There is a lack of keeping pace with changes in internal auditing at the international level and there is a need to strengthen the Guideline on Internal Auditing Standards II A), which is characterized by the preparation of an internal document containing the objectives, powers and responsibilities of the internal audit work as well a
... Show MoreStudent performance may influence by several factors in all his study levels such as primary school, intermediate school and even in his college; some of these factors are psychological factors, social factors, and the factors which correlate with student environment.
In this paper we study some of these factors to discover their influence by using canonical correlation analysis to analyze the data. Many conclusions are discovered to help who focuses student performance or to make it pest in future.
Each sport has its own energy requirements that differ from the energy requirements of other sports, and a different method is used in each of them, so the trainer must first rely on the principle of privacy in training first, that is, privacy according to the working energy system, that is, he defines the controlling energy system In that event, and how the muscles use the available energy to perform according to the energy production systems. As we find the serving skill is the first volleyball skill with which the team starts the match in order to be able to gain points directly, through knowledge it turns out that there is a weakness in the skill performance, especially the skill of serving and being The key to victory for volle
... Show MoreThis study aimed at identifying the trend to applying the Joint Audit as an approach to improve the financial reports quality with all their characteristics (Relevance, Reliability, Comparability, Consistency), as well as enclose the difficulties that faced the auditors in the Gaza Strip in implementing the Joint Audit. In order to achieve the study aims, a measure was used to identify the trend to apply the Joint Audit and it was distributed to the study sample which is consisting of (119) individuals and retrieved thereof (99) valid for analysis, approximately (83.2%), (69) of them are Auditors, (30) financial managers and accountants. The researcher used the analytical descriptive method, and after analyzing the results, the s
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