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 study was carried out to measure the percentage of heavy metals pollution in the water of the Diyala river and to measure the percentage of contamination of these elements in the leafy vegetables grown on both sides of the Diyala river, which are irrigated by the contaminated river water (celery, radish, lepidium, green onions, beta vulgaris subsp, and malva). Laboratory analysis was achieved to measure the ratio of heavy element contamination (Pb, Fe, Ni, Cd, Zn and Cr) using flame atomic absorption spectrophotometer during the summer months of July and August for the year 2017. The study showed that the elements of zinc, chromium, nickel and cadmium were high concentrations and exceeded. The maximum concentration of these
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The scope of the humanitarian tragedies in the Arab region has widened after the conflicts that erupted over the past years, exacerbation to include educational, cultural, and social dimensions, economic and moral aspects of the displaced families, especially after the emergence of terrorist organizations and sectarian conflicts which overthrew human and led to various political and demographic changes, forcing citizens to leave their homes, fleeing with their families from the danger of murder, terrorism, and violation to other safer areas inside or outside their countries. Women and children were the vast majority of the displaced who were subjected to great pressures, The host communities bore the pro
... Show MoreOften there is no well drilling without problems. The solution lies in managing and evaluating these problems and developing strategies to manage and scale them. Non-productive time (NPT) is one of the main causes of delayed drilling operations. Many events or possibilities can lead to a halt in drilling operations or a marginal decrease in the advancement of drilling, this is called (NPT). Reducing NPT has an important impact on the total expenditure, time and cost are considered one of the most important success factors in the oil industry. In other words, steps must be taken to investigate and eliminate loss of time, that is, unproductive time in the drilling rig in order to save time and cost and reduce wasted time. The data of
... Show MoreThe goal of this study is to build an application that can be used in difficult cases and sudden circumstances during the pandemic and post-disaster state, which can be the development of digital risk management and mitigating the difficult impact of the epidemic through the improvement of IT and IoT that can be fine by finding initial solutions and make the world like a digital city that could be managed by the network. We provide this study to gain an overview of reasons for delayed and exceeded costs in a select of thirty Iraqi case projects by controlling the time and cost. The drivers of delay have been investigated in multiple countries/contexts. however, there is little country data available under the conditions that have ch
... Show Moreلقد تسبب انتشار الإرهاب في العالم وكذلك الحروب الأهلية والصراعات في أوائل القرن الحادي والعشرين في جميع أنحاء العالم في الكثير من الأضرار وخلفت ضحايا جسيمة. أدت الهجمات الإرهابية على النساء، مثل اختطاف بوكو حرام لأكثر من 270 تلميذة في نيجيريا وتقارير عن انتشار الاغتصاب والاعتداء الجنسي في المناطق التي مزقتها الحرب، إلى إنتاج العديد من العروض المسرحية في الولايات المتحدة التي تصور خواص الجناة وكذلك الضحا
... Show MoreIntroduction: In recent decades, the endovascular treatment of cerebral arteriovenous malformations (AVMs) has advanced. However, it still carries risks of unanticipated complications. Coil migration is a reported complication of aneurysmal coiling procedures. Herein, we report a case of early intraprocedural coil migration during pressure cooker technique embolization of right thalamic AVM, discussing the management and potential explanations. The literature showed no report of coil migration after the pressure cooker technique in the form of coil-augmented Onyx injection technique (CAIT). Case description: An otherwise healthy 26-year-old female suddenly developed a severe headache with no loss of consciousness. Computed tomograp
... Show MoreThis article investigates the relationship between foot angle and jump stability, focusing on minimizing injury risk. Here are the key points: Importance: Understanding foot angle is crucial for improving jump stability, athletic performance, and reducing jump-related injuries like ankle sprains. Ideal Foot Angle: Research suggests a forward foot angle of around 15 degrees might be ideal for many people during jumps. This angle distributes forces evenly across the foot, lowers the center of gravity, and provides more surface area for pushing off the ground. Factors Affecting Ideal Angle: The optimal angle can vary depending on the type of jump (vertical vs. long jump), fitness level, and personal preference. Incorrect Foot Angles: Landing w
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