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.
The Voluntary Obedience has great importance for the modern taxes systems and its management and this is meant the taxpayer whom in charge to pay of his taxes obligations voluntarily , he is very known of himself whereas he prepared his finishing accountings and present them as samples prepared by taxes management and settle the tax sum directly according to specified income , which has an impact to find end to tax evasion as result lead to increase the tax income and achieve the justice for the taxpayer and the state treasury
At different stages of the evolution of the modern Iraqi state ears last century did not receive the industrial sectors importance in great domestic production (GDP) and that the limited resources available in the initial stage and the dominance of public sector industry in the late stage , so the continued decline in the contribution of the private industrial sector in GDP , and this is why imbalance in the labor market and reduced demand for manpower in this sector despite the high rates of labor supply and the various skills and levels of investments, their human and the different geographical distribution , and direction of labor to other economic sectors most requested of the l
... Show MoreThe research aims to test the correlation relationships between wise leadership, and the business model, and to demonstrate its influence (wise leadership) on the business model. Therefore, two main hypotheses were put forward. The research was applied to a sample consisting of (87) managers and deputy managers, some of them are members on the board of directors of the researched company. The questionnaire was adopted as a basic tool for collecting data, in addition to personal interviews. A number of statistical methods were used to analyze the data and obtain results. The researcher showed a set of results, including: There is a significant correlation between wise leadership and business model. There is an influence of wise leadership on
... Show MoreMost of the cinema and television production relies on the use of modern digital technologies, which today become the as ideal as the artistic expressive style that sends aesthetic values through the use of electronic elements of the language of cinema and television to achieve aesthetic dazzling, and design the digital production for the purpose of persuasion, as well as the use of digital effects and graphics to activate the aesthetic pleasure. The research tries to subject all these aspetcs to study and apply them to a modern sample in order to get the results that confirm this technical and artistic aesthetic synergy that leads to the emergence of a cinema and television achievement the leas
... Show MoreABSTRACT: BACKGROUND: Left ventricular hypertrophy is a significant risk factor for cardiovascular complications such as ischemic heart disease, heart failure, sudden death, atrial fibrillation, and stroke. A proper non-expensive tool is required for detection of this pathology. Different electrocardiographic (ECG) criteria were investigated; however, the results were conflicting regarding the accuracy of these criteria. OBJECTIVE: To assess the accuracy of three electrocardiographic criteria in diagnosis of left ventricular hypertrophy in adult patients with hypertension using echocardiography as a reference test. PATIENTS AND METHODS: This is a hospital-based cross sectional observational study which included 340 adult patients with a his
... Show MoreThe electro-optic coefficient r63 and r41 are determined in congruent KDP crystals, using an experimental method based upon the direct measurement of material. Sénarmont system for electro-optic coefficient measurement and characterization of crystals was modified. This modification allowed us to obtain on the frequency dispersion dependence of the electro-optic coefficients within a frequency range up to 20 MHz and on a new version of modulation depth method. To the best of our knowledge, by using this system, the electro-optic coefficients r63 and r41 in different configurations (transverse and longitudinal) have been measured for the first time within a frequency range up to 20 MHz. The measurements have been investigated as a functi
... Show MoreThe productivity of oil wells may be improved by determining the value of enhancing well productivity and the likely reasons or sources of formation damage after the well has been recognized as underperforming. Oil well productivity may be improved, but the economics of this gradual improvement may be compromised. It is important to analyze the influence of the skin effect on the recovery of the reserve.
The acid treatment evaluated for the well AD-12, primarily for the zone Mi4; using a license of Stimpro Stimulation Software to validate the experimental work to the field scale, this software is considered the most comprehensive instrument for planning and monitoring matrix acid treatments and utilizing actual data to prov
... Show MoreThe Umm Al-Naaj Marsh was chosen in Maysan province, and it is one of the sections of Mar Al-Hawza, which is one of the most prominent Iraqi marshes in the south. The marshes are located between latitudes 30 35 and 32 45 latitudes and longitudes 13 46 and 48 00. The area of the study area is 76479.432142 hectares to evaluate soil quality and health index and their spatial distribution based on measuring physical, chemical, biological and fertility traits and calculating the total quality index for those characteristics. Using an auger drilling machine, we collected 50 randomly selected surface samples, evenly distributed across the study region, from Al-Aq 0.0–0.30 m, noting their precise locations along the way. Soil health and quality w
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