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 paper attempts to develop statistical modeling for air-conditioning analysis in Jakarta, Indonesia, during an emergency state of community activity restrictions enforcement (Emergency CARE), using a variety of parameters such as PM10, PM2.5, SO2, CO, O3, and NO2 from five IoT-based air monitoring systems. The parameters mentioned above are critical for assessing the air quality conditions and concentration of air pollutants. Outdoor air pollution concentration variations before and after the Emergency CARE, which was held in Indonesia during the COVID-19 pandemic on July 3-21, 2021, were studied. An air quality monitoring system based on the IoT generates sensor data
... 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 MoreThe 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
Background: 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 MoreRoaming 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 MoreBackground: Pregnancy is a crucial time to promote health thus good antenatal care can promote mother and new born health &links mother with formal health system with increasing chance of using a skilled attendant at birth while inadequate care during this time increases mortality & morbidity of mother & new born.
Objectives: Assessment of Antenatal Care Services in relation with Iron deficiency anemia during pregnancy.
Patients and Methods; A descriptive study was carried out in 12 health centers , which were chosen randomly in Behri area (part of Khartoum City) in Sudan that (300) available pregnant females in 3rd trimester were interviewed (using non probability convenience sampling) by using a questionnaire paper du
The emergence of COVID-19 has resulted in an unprecedented escalation in different aspects of human activities, including medical education. Students and educators across academic institutions have confronted various challenges in following the guidelines of protection against the disease on one hand and accomplishing learning curricula on the other hand. In this short view, we presented our experience in implementing e-learning to the undergraduate nursing students during the present COVID-19 pandemic emphasizing the learning content, barriers, and feedback of students and educators. We hope that this view will trigger the preparedness of nursing faculties in Iraq to deal with this new modality of learning and improve it should t
... 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 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