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 depends on sheding some litgt on the characteristics of political
relations between the arab and the Persian during the reign of sassane kings.
"Ardashir the first, shahbour the first, shahbour the second, Bahram the fifth; kisra
Anushrwan and kisrah abruis"
And who rulled the Persian before the Islamic conquest and were adopted in this studym
as a model. It was possible to get some information from invaluable refereces in order to
arrive at a clear image as regards the nature of these relations. These relations were
differently political according to the circumstances of ruling, interests and the personality
of those kings.
Drug consultation is an important part of pharmaceutical care. mobile phone call or text message can serve as an easy, effective, and implementable alternative to improving medication adherence and clinical outcomes by providing the information needed significantly for people with chronic illnesses like diabetes and hypertension particularly during pandemics like COVID-19 pandemic.
Applying a well-performing heat exchanger is an efficient way to fortify the relatively low thermal response of phase-change materials (PCMs), which have broad application prospects in the fields of thermal management and energy storage. In this study, an improved PCM melting and solidification in corrugated (zigzag) plate heat exchanger are numerically examined compared with smooth (flat) plate heat exchanger in both horizontal and vertical positions. The effects of the channel width (0.5 W, W, and 2 W) and the airflow temperature (318 K, 323 K, and 328 K) are exclusively studied and reported. The results reveal the much better performance of the horizontal corrugated configuration compared with the smooth channel during both melti
... Show MoreThe inhibition of mild steel corrosion in 1.0M HCl by 1-propanol and the synergistic effect of potassium iodide (KI) was investigated using weight loss and polarization techniques in the temperature range (30 ‒ 50) ̊ C. A matrix of Doelhert to three factors was used as the experimental design, adopting weight loss results as it permits the use of the response surface methodology which exploited in determination of the synergistic effect as inhibition on the mild steel. The results were confirmed using electrochemical polarization measurements. Experimental results showed that the inhibition efficiency (IE%) increases with increase in concentration of inhibitor and with increasing of temperature. The addition iodide ions t
... Show MoreThere is no doubt that Agricultural Policy is the main responsible for the degrading in Agricultural sector in Iraq during the period 2003-2013, and that was very clear from magnitude of indicators because of little sharing of each of agricultural product in GDP because it was (9.38%) in average during the study period and the annual changing of it was negative (-5.82%), and there is increasing in deficit of trade balance in Agriculture during the study period about (4185.73) million US$, and the percentage of agricultural exports from total exports was (0.14%) in average only. The foreign trade policy in Agricultural products also cannot determine map of Revealed Comparative Advantage (RCA) of Agricultural products and crops. The study sh
... Show MoreThis study aims to analyze the messages of a number of global news outlets on Twitter. In order to clarify the news outlets tactics of reporting, the subjects and focus during the crisis related to the spread of the Covid-19 virus. The study sample was chosen in a deliberate manner to provide descriptive results. Three news sites were selected: two of the most followed, professional and famous international news sites: New York Times and the Guardian, and one Arab news site: Al-Arabiya channel.
A total of 18,085 tweets were analyzed for the three accounts during the period from (1/3/2020) to (8/4/2020). A content analysis form was used to analyze the content of the news coverage. The results indicate an increase in th
... Show MoreBackground: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a
... Show MoreBackground: Anaemia is a major public health concern and is one of the most prevalent health issue in women within reproductive age group.
Objective: to assess maternal knowledge related to anaemia during pregnancy.
Type of the study: A cross –sectional study.
Method: The study including 200 mothers who attended selected primary health care centres, Baghdad during November and December 2015, they completed a previously prepared questionnaire coveringsocio-demographic characteristics and knowledge regarding anaemia in 4 main domains. The responses were analysed by using frequency, percentage and percent score for each statement a
... Show MoreStick- slip is the continuous stopping& release of the Bit/BHA due to the irregular down-hole rotation prompted by the existing relationship between the friction torque and the torque applied from the surface to free the bit.
Friction coefficient between BHA and wellbore is the main player of stick slip amount, which can be mitigated by support a good lubricators as additives in drilling mud.
Mathematical (or empirical) solves should be done through adjusting all parameters which supposed to reduce stick- slip as low as possible using different models, one of the main parameters is drilling mud. As per Nanoparticles drilling fluid is a new technology that offers high performance
... Show MoreIrisin is a novel myokine and adipokine, its role during pregnancy and its association with some metabolic risk factors especially pre-pregnancy body mass index (pre-BMI) need more evaluation. The aim of the study is to find whether the pre-BMI could predict irisin levels during normal pregnancy and to clarify associations of irisin with some pathological parameters.
Irisin levels were estimated by ELISA in sera of 59 normal pregnant women who enrolled from December 2016 to May 2017 at Maternity Hospital, Zakho city, Kurdistan region (Iraq). Thirty-two normal-weight pregnant (pre-BMI≤24.9 kg/m2, Age=24.03 mean±3.7standard deviation) and 27 overweight/obese-pregnant (pre-BMI>25 kg/m2, Age=27.6 mean±3.9
... Show More