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.
This work investigates experimentally the effect of using a skirt with a square foundation of 100 mm width resting on dry gypseous soil (i.e., loose soil with 33% relative density), and subjected to an inclined load. Previous works did not study the use square skirted foundation rested on gypseous soil and subjected to inclined load. The investigated soil was brought from Tikrit city with 59% gypsum content. Standard physical and chemical tests on selected soil were carried out. Model laboratory tests were carried out to determine the effect of using a skirt with a square foundation on the load-settlement behavior of gypseous soil and subjected to inclined load with various Skirt depth (Ds) to foundation width (B) ratio
... Show MoreBackground: Disinfection and shaping of the canal with a combination of chem¬ical agents and endodontic instruments play an important role in the success of endodontic therapy. Eliminating the microorganisms within the pulp space is a critical and important objective in treating a tooth with apical periodontitis. This study was conducted to evaluate the antibacterial properties of herbal alternatives (Green tea and siwak extracts) as possible irrigants during endodontic treatment compared with the conventional irrigation solutions. Materials and methods: Salvadora Persica (siwak) and Green Tea solutions were prepared.An agar diffusion test was performed on Mueller-Hinton agar using the well diffusion method. The tested solutions (5.25% N
... Show MoreThe raw material soil of Al-Sowera factory quarry (quarry soil and mixture) used for building brick industry was tested mineralogically, geochemically and geotechnically. Mineral components of soil are characterized by Clay minerals (Palygoriskite and chlorite) and nonclay minerals like calcite, quratz, feldspar, gypsum and halite. The raw material is deficient in SiO2, Al2O3, K2O, Fe2O3 and MgO, while enriched in CaO. Loss on ignition and Na2O are in suitable level and appear to be concordant with the standard. Grain size analyses show that the decreasing sand and clay, and increasing silt ratio in both quarry soil and mixture caused decreasing in strength of brick during molding and after firing. The quarry soil is characterized by high p
... Show MoreSAIs has a pivotal role in enhancing public sector performance through its quest to achieve the greatest possible efficiency and effectiveness in its, so it has to adopt applied framework for abilities building, the research aims to shed light on the role of SAIs and the nature of their work, and the definition for its abilities building, and to prepare a proposal for abilities building applied to work with the SAI in the Republic of Iraq (of the Federal Board of Supreme Audit ),the Researchers reached conclusions, namely: abilities building is the outcome of the interaction between the reality of all of the employees of the SAI and the institution itself and the environment and the specific requirements of the de
... Show MoreThis study aims to highlight the role of financial control in the development of government performance through the use of "GFS" system and its application in the service of government units, which will help them in how to use financial resources efficiently through the quality of accounting information provided by this system in the financial statements that reflect the predictability in that fiscal policy of the state through government programs and activities fee as well as to identify weaknesses and address them quickly in order to avoid wastage and loss of public money, which leads to the possibility of utilization of available financial resources of the state to effectively and efficiently, has been reached that the failure of gove
... Show MoreObjective :To evaluate elderly's environmental practices concerning fall prevention at governmental elderly care homes in Baghdad city. Methodology: A quazi- Experimental study was carried out in governmental elderly care homes at Baghdad city, during the period 1st, June 2014 to 30th November, 2014 , selected a purposive " Non – probability " sample of (40) elderly men and women aged (60) years old and over who were resident in governmental elderly care homes " Al Ceelakh and Al Sader elderly care homes", the data was collected through the use of constructed questionnaire that consist of (23) items,
To evaluate the efficiency and effectiveness of three minimally invasive (MI) techniques in removing deep dentin carious lesions. Forty extracted carious molars were treated by conventional rotary excavation (control), chemomechanical caries removal agent (Brix 3000), ultrasonic abrasion (WOODPECKER, GUILIN, China); and Er, Cr: YSGG laser ablation (BIOLASE San Clemente, CA, USA). The assessments include; the excavation time, DIAGNOdent pen, Raman spectroscopy, Vickers microhardness, and scanning electron microscope combined with energy dispersive X-ray spectroscopy (SEM–EDX). The rotary method recorded the shortest excavation time (p < 0.001), Brix 3000 gel was the slowest. DIAGNOdent pen va
Acute appendicitis is the most common surgical abdominal emergency. Its clinical diagnosis remains a challenge to surgeons, so different imaging options were introduced to improve diagnostic accuracy. Among these imaging modality choices, diagnostic medical sonography (DMS) is a simple, easily available, and cost effective clinical tool. The purpose of this study was to assess the accuracy of DMS, in the diagnosis of acute appendicitis compared to the histopathology report, as a gold standard. Between May 2015 and May 2016, 215 patients with suspected appendicitis were examined with DMS. The DMS findings were recorded as positive and negative for acute appendicitis and compared with the histopathological results, as a gold standard
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