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 problem of water scarcity is becoming common in many parts of the world, to overcome part of this problem proper management of water and an efficient irrigation system are needed. Irrigation with a buried vertical ceramic pipe is known as a very effective in the management of irrigation water. The two- dimensional transient flow of water from a buried vertical ceramic pipe through homogenous porous media is simulated numerically using the HYDRUS/2D software. Different values of pipe lengths and hydraulic conductivity were selected. In addition, different values of initial volumetric soil water content were assumed in this simulation as initial conditions. Different value
... Show MoreThis paper examines the change in planning pattern In Lebanon, which relies on vehicles as a semi-single mode of transport, and directing it towards re-shaping the city and introducing concepts of "smooth or flexible" mobility in its schemes; the concept of a "compact city" with an infrastructure based on a flexible mobility culture. Taking into consideration environmental, economical and health risks of the existing model, the paper focuses on the four foundations of the concepts of "city based on culture flexible mobility, "and provides a SWOT analysis to encourage for a shift in the planning methodology.
Fifteen local isolates of Pseudomonas were obtained from several sources such as soil, water and some high-fat foods (Meat, olives, coconuts, etc.). The ability of isolates to produce lipase was measured by the size of clear zone on Tween 20 solid medium and by measuring the enzymatic activity and specific activity. Isolate M3 (as named in this study) was found to be the most efficient for the production of the lipase with enzymatic activity reached 56.6 U/ml and specific activity of 305.94 U/mg. This isolate was identified through genetic analysis of the 16S rRNA gene. and it was shown that the isolate M3 belongs to Pseudomonas aeruginosa with 99% similarity. The DNA of isolate M3 was extracted and lipase gene was amplified through PCR tec
... Show MoreThe production of polyhydroxyalkanoates PHAs from biopolymer degrading bacteria was examined
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Some mechanical and thermal properties of mullite samples prepared by mixing different phases of alumina and silica powders have been studied according to ASTM methods the cold crushing strength of the sintcred bodies.With different porosity, at room temperature was in the range(18-54)Mpa
In this work, the nano particles of Na-A zeolite were synthesized by sol –gel method. The samples were characterized by X-ray diffraction (XRD), X-ray luorescence (XRF), Surface area and pore volume, Atomic Force Microscope (AFM) and Fourier Transform Infrared Spectroscopy (FTIR). Results show that the nano A zeolite is with average crystal size is 74.77 nm., Si/Al ratio 1.03, BET surface area was 581.211m2/g and the pore volume for NaA was found equal to 0.355cm3/g.