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 research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio
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This study identified the developing of a range of students' geography learning skills and the change in their attitudes toward fieldwork as a consequence of leaning experiences that occurred within a field trip. The sample of the study consisted of (27) students within a special topic course enrolled in Geography Department at Umm Al-Qura University in Saudi Arabia in semester 2, 2018. A range of students' geography learning skills were measured by the skills questionnaire that consisted of 12 geography skills after completing field work. Changes in students' at
... Show MoreThe compliance is considered
This study aimed to deduce the net atrioventricular compliance which is affected the trans mitral blood flow.
This study focuses on study group of 25 patients (15 males
The aim of this study is to calculate the ene expenditure from fatty substance contents of the
frog. Rana ridibunda during its hibernation. It was found that, almost, all frogs enter
hibernation during the last week of December and emerge from hibernation during the first
week of March. Hence, January and February are considered the hibernation period.
December is the pre-hibernation period and March is the post-hibernation period. The
reduction in percent of body lipid during the hibernation period was 4.8% in males and 7.7%
in females. The reduction in percent of lipid of fat bodies during the hibernation period was
2.758% in males and 0.733% in females.
The calorific value of R. ridibunda lipid amounted to 1233
Amino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve
... Show MoreBackground: Oral cancer is a highly lethal and disfiguring disease. Squamous cell carcinoma of the oral cavity constitutes about 90% of all oral malignancies. The aims of the study was to achieve an epidemiological description of the oral squamous cell carcinoma in Iraq in general and in Iraqi governorates except Kurdistan region retrospectively during period 2001-2013 Materials and Methods: Data were collected from department of oral and maxillofacial pathology, college of dentistry, university of Baghdad, Nuclear medicine and radiotherapy hospital, Iraqi cancer registry center, Main hospitals in Baghdad and Iraqi governorates, Private labs. for histopathological examinations. The descriptive and inferential statistical methods were used
... Show MoreBackground: The immune system of the oral cavity suffers alterations due to fixed orthodontic treatment which act as potent stimulus for oral secretory immunity. The aims of this study are to estimate the effect of fixed orthodontic appliance on the level of salivary sIgA at different time intervals, and to verify the gender difference. Materials and method: The patient's history, clinical examination, and fixed orthodontic appliances were placed for 30 Iraqi orthodontic adult patients had class II division 1 and/ or class I malocclusion (15 males and 15 females) aged 18-25 years old. The unstimulated whole saliva was collected from each sample immediately before wearing fixed appliance (control group T0 as base line), and after 2 weeks (T1
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
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