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.
Background: myocardial ischemia-reperfusion (I/R) injury may occur in a variety of clinical settings and this remains a significant problem. Oxygen free radicals, produced on reperfusion have been shown to play a major role in myocardial I/R injury. Various therapeutic effects have been described for Crataegus. Additionally, it has been presented that Crataegus has protective effect against ischemia reperfusion induced myocardial injuries to various organs. Therefore, it seems possible that the administration of Crataegus might protect the heart against the ischemia reperfusion injury.
Objectives: I detected the chemical components and trace elements of the aqueous extract of Crataegus leaves and determine whether Crataegus extract pr
Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea
... Show MoreBackground: Pain due to muscular cramp during hemodialysis is one of the most common problems experienced by patient undergoing hemodialysis, and is associated with poor outcomes of patients. The main aim of this study was to comparing the effects of lavender oil and olive oil massage on Pain due to muscular cramp during hemodialysis.
Methods: In this random clinical trial, 60 hemodialysis patients were enrolled randomly and allocated to two groups with 30 members in Lordegan and Brojen hospitals, Shahrekord, Iran. The intervention included flora massage on the lower leg muscles so that the first group received olive oil massage (10 drops) and the second group received lavender oil massage (10 dr
... Show MoreThe research aims at a statement Internal Debt options during shocks and the impact of this borrowing in the volume of the foreign reserve, using induction and deduction with available data analysis. During the period (2004-2013) did not require the use of borrowing across (financial institutions, discounted transfers, bonds); it was only sufficient by transfer with commercial banks that can finance of temporary budget deficits: rose and decline of volume of foreign reserve according to the changes of oil prices and the volume of purchases and sales of the Central Bank of Iraq. Central Bank of Iraq (CBI) has significantly contributed to Internal Debt through bond and discounted transfers in the secondary market; thus, funding the
... Show MoreThis study is concerned with the comparison of the results of some tests of passing and dribbling of the basketball of tow different years between teams of chosen young players in Baghdad. Calculative methods were used namely (Arithmetic mean, Value digression and T.test for incompatible specimens). After careful calculative treatments, it has been that there were abstract or no abstract differences in the find results of chestpass, highdribble and cross-over dribble. The clubs were: (Al-Khark, Air defence, Police and Al-Adamiyah) each one separate from the other for the year (2000-2001). After all that many findings were reached such as the lack of objective valuation (periodical tests) between one sport season and the other. In the light
... Show MoreThis 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
... Show MoreThis study explored the preservative effects of the alcoholic leaves’ extract of Ficus carica plant on beef refrigerated for 15 days. Phytochemical analysis showed that the plant extract contained terpenoids, flavonoids, tannins, saponins, and alkaloids. Furthermore, the alcoholic extract of plants significantly reduced the total viable counts of psychrotrophic bacteria, pathogenic bacteria (Proteus, Salmonella typhimiurum, Escherichia coli, and Staphylococcus aureus), and yeasts (Candida kruse, Candida lambica, and Zygosaccharomyces) isolated from meat samples, particularly at 100 and 200 mg/ml concentrations.
The antioxidant activity of the extract was det
... Show MoreAbstract
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 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