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 rapid spread of novel coronavirus disease
(COVID19) throughout the world without available
specific treatment or vaccine necessitates alternative
options to contain the disease. Historically, children
and pregnant women were considered high-risk
population of infectious diseases but rarely have been
spotlighted nowadays in the regular COVID-19
updates, may be due to low global rates of incidence,
morbidity, and mortality. However, complications did
occur in these subjects affected by COVID-19. We
aimed to explore the latest updates of
immunotherapeutic perspectives of COVID-19
patients in general population and some added details
regarding pediatric and obstetrical practice.
Immune system boo
In this work, the geomagnetic storms that occurred during solar cycles 23 and 24 were classified based on the value of the Disturbance Storm Time index (Dst), which was considered an indicator of the strength of geomagnetic conditions. The special criterion of Dst >-50 nT was adopted in the classification process of the geomagnetic storms based on the minimum daily value of the Dst-index. The number of geomagnetic storms that occurred during the study period was counted according to the adopted criteria, including moderate storms with (Dst >-50 nT), strong storms with (Dst >-100 nT), severe storms with (Dst >-200 nT), and great storms with (Dst >-350 nT). The statistica
Roaming data is an important source of information about the political and social activities of a country. And this is true for Iraq situation after 2003 when the mobile companies started their business. In this paper, data of subscribers roamed onto foreign networks (inbound roamers) is collected; it consists of the name of the Radio Control Point, the counter dealing with this type of information, Mobile Network Code/Mobile Country Code tupel. This data is processed. Results obtained out of this process show the classification of the inbound roamers (according to their countries) during the occupation period (2008-2009). These results reflect the political situation of Iraq at that time. Information resulted from this proc
... Show MoreThe rapid spread of novel coronavirus disease(COVID19) throughout the world without availablespecific treatment or vaccine necessitates alternativeoptions to contain the disease. Historically, childrenand pregnant women were considered high-riskpopulation of infectious diseases but rarely have beenspotlighted nowadays in the regular COVID-19updates, may be due to low global rates of incidence,morbidity, and mortality. However, complications didoccur in these subjects affected by COVID-19. Weaimed to explore the latest updates ofimmunotherapeutic perspectives of COVID-19patients in general population and some added detailsregarding pediatric and obstetrical practice.Immune system boosting strategy is one of therecently emerging issue
... Show MoreBackground: Pregnancy is a stressful state of increased inflammatory activity, and pregnancy – associated hormone changes can influence periodontal tissues, these inflammatory activity lead to production of inflammatory mediators. Interleukin 1 beta (IL-1β) is a potent pro-inflammatory cytokines that is consistently associated with periodontal diseases. This study was designed to determine the periodontal health status and detect the serum level of IL-1β in the healthy pregnant women at first, second and third trimester and compare it with healthy non pregnant women, and determine its correlation with different clinical periodontal parameters. M
... Show MoreThe Ilkhanid Mongols (651-756 AH / 1253-1355 AD) were interested in urbanization and construction in keeping with civilized countries and to have an architectural imprint that competed with the neighboring nations. The Ilkhan Öljeitü Muḥammad Khudābandeh (703-716 AH / 1303-1316 AD), known for his love of building and construction, wanted to have a capital that would immortalize his name and history, so he ordered its construction to compete with contemporary cities, and he summoned workers and engineers from all over the world to contribute to its construction. The city has several educational and service institutions such as schools, ribats, khanqas, mosques, hospitals, markets, and baths, as well as a mausoleum for him, which
... Show MoreDiverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost
... Show MoreFor many years, the construction industry damages have been overlooked such as unreasonable consumption of resources in addition to producing a lot of construction waste but with global awareness growth towards the sustainable development issues, the sustainable construction practices have been adopted, taking into account the environment and human safety. The research aims to propose a management system for construction practices which could be adopted during constructing different types of sustainable buildings besides formulating flowcharts which clarify the required whole phases of sustainable buildings life cycle. The research includes two parts: theoretical part which generally ,handles the sustainability concepts at construction i
... Show MoreMeasurement of construction performance is essential to a clear image of the present situation. This monitoring by the management team is necessary to identify locations where performance is exceptionally excellent or poor and to identify the primary reasons so that the lessons gained may be exported to the firm and its progress strengthened. This research attempts to construct an integrated mathematical model utilizing one of the recent methodologies for dealing with the fuzzy representation of experts’ knowledge and judgment considering hesitancy called spherical fuzzy analytic hierarchy process (SFAHP) method to assess the contractor’s performance per the project performance pa