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.
natural and non-natural disasters, is an environmental challenges the society and the economy as well as a direct and indirect economic affect, and the units are part of the system overlapping among themselves and thus affected by external indicators, directly or indirectly, these direct effects appear in the destruction or damage inflicted by disasters in property , infrastructure , superstructure , accounting information systems and indirectly in the outcome of future business, comes research problem through access to accounting treatments issued by the Federal Office of financial supervision to address the damage caused by the disasters and prepare the missing financial accounts it turns out us that there is negligence of a nu
... Show MoreIn this work, the effects of size, and temperature on the linear and nonlinear optical properties in InGaN/GaN inverse parabolic and triangular quantum wells (IPQW and ITQW) for different concentrations at the well center were theoretically investigated. The indium concentrations at the barriers were fixed to be always xmax = 0.2. The energy levels and their associated wave functions are computed within the effective mass approximation. The expressions of optical properties are obtained analytically by using the compact density-matrix approach. The linear, nonlinear, and total absorption coefficients depending on the In concentrations at the well center are investigated as a function of the incident photon energy for different
... Show MoreThe aim of this research is to construct a three-dimensional maritime transport model to transport nonhomogeneous goods (k) and different transport modes (v) from their sources (i) to their destinations (j), while limiting the optimum quantities v ijk x to be transported at the lowest possible cost v ijk c and time v ijk t using the heuristic algorithm, Transport problems have been widely studied in computer science and process research and are one of the main problems of transport problems that are usually used to reduce the cost or times of transport of goods with a number of sources and a number of destinations and by means of transport to meet the conditions of supply and demand. Transport models are a key tool in logistics an
... Show MoreThe insurance companies are one of the organizations that rely mainly on human capital to underwriting to insurable risks because most of risks have many variables, so the aim of the research is to show the level of interest of the researched company in human capital, the reality of the underwriting policy in it, and the relationships of correlation and effect between them, and the approach has been used Analytical descriptive, as books, research and other related sources were used for the purpose of completing the theoretical side, on the practical side, a questionnaire was prepared, which represents the main tool for collecting data and distributed to a random sample of 64 people from underwriting managers and employees in spec
... Show MoreThe accuracy of the Moment Method for imposing no-slip boundary conditions in the lattice Boltzmann algorithm is investigated numerically using lid-driven cavity flow. Boundary conditions are imposed directly upon the hydrodynamic moments of the lattice Boltzmann equations, rather than the distribution functions, to ensure the constraints are satisfied precisely at grid points. Both single and multiple relaxation time models are applied. The results are in excellent agreement with data obtained from state-of-the-art numerical methods and are shown to converge with second order accuracy in grid spacing.
This study comes as: The responsibility of the Iraqi newspapers in promoting the political culture inside society, an analytical study in newspapers: Al-Sabah, Al-Ittihad, Al-Aalam for 2/ 3/ 2013 to 31/ 3/ 2013 to spot light on the extent to which the three mentioned newspapers are compliance with the promotion of the political culture inside society which is seen as one of the essential requirements for the success and promotion of the democratic process inside society.
The study aims to: finding out the extent to which these newspapers are compliance with their responsibility in the promoting the political culture inside society; knowing the nature of their role in pr
... Show MoreThe problem of multi assembly line balancing appears as one of the most prominent and complex type of problem. The research problem of this dissertation is concerned with choosing the suitable method that includes the nature of the processes of the multi assembly type of the sewing line at factory no. (7). The State Company for Leather Manufacturing. The sewing line currently suffers from idle times at work stations which resulted in low production levels that do not meet the production plans. The authors have devised a flexible simulation model which uses the uniform distribution to generate task time for each shoe type produced by the factory. The simulation of the multi assembly line was based on assigni
... Show MorePhotos of the backwardness of the Muslims and their backwardness in creating
sustainable development policies have driven them to a state of civilization , which witnesses
Avckaddoha time ago and not disrupt the adversary is a phenomenon thought the youth to
exercise its role and duty in the construction and development of the state witnesses Mdanah
civilized nation.
The vigilance thought the youth of its slumber correct form could provide opportunities for
growth and development in the Arab and Islamic worlds, and both material and moral support
through the creation model youth Islamic social role models, but that the image of the model
, , - 1
230 stool samples were collected from 2 state homes for (males and females) to investigate
the infection of different intestinal parasites (pathogenic and non-pathogenic).
The infection rate was higher among males 15.7% than females 6%, these rates were
increased when concentration method was employed up to 54.8% for males and 8.7% for
females significantly.
Most infected orphans were found to harbor single parasite followed by double, triple
parasites.
The highest rate of infection was found among young age group (1-5) years old, while
the older age groups got lowest rates.
Of helminthes, the commonest parasite was Hymenolepis nana 5.7% and of protozoa, the
commonest intestinal parasite was Giardia lamblia