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.
Abstract
Background: Scabies is a skin infestation by the Sarcoptes scabiei mite. Scabies is transmitted through close personal contact. Settings like hospitals, prisons and childcare centers are at greater risk of outbreaks. Both male and female may be infected with scabies in any age groups. It is common in tropical climate countries poor people who live in rural areas and among displaced patients. It rises significantly among low economic status because skin diseases are significantly associated with a higher crowding index.
Objectives: To estimate the prevalence of scabies in Al- Daseem region and identify factors associated with an increased risk of scabies among pat
... Show MoreBACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The
... Show MoreThe article approaches the characteristics of Russian literature in the time of Khrushchev or the "thaw" period a very short period of Soviet history, characterized by the easing of the dictatorship of power and relaxation in various areas of people's lives. The interest in the research is focused on the importance of interpreting the family portrait in a short but distinct period in the development of Russian/Soviet literature. The research material is the story of Sholokhov's “The Fate of Man” 1956, the story of Panova “Serioga” 1955, and Abramov’s story “Fatherless” 1961. В статье рассматриваются особенности художественной литературы периода хруще
... Show MoreBackground: Study looking into cardiovascular disorders (CVD) medicines or analgesics cost-saving activities during dispensing process is lacking.
Aim: To determine differences in factors and costs associated with refused CVD medicines or analgesics during dispensing process
Method: This study was approved by Medical Research and Ethics Committee (MREC) (Registration number: NMRR-20-177-53153(IIR)). Participants receiving CVD medicines or analgesics during dispensing process were recruited via convenience sampling technique between February and March 2020 at the Specialist Pharmacy Department of Jerantut Hospital, Malaysia. Refusal to medications and its reasons were asked based on the questionnaire developed by the resea
... Show MoreThe ionospheric characteristics exhibit significant variations with the solar cycle, geomagnetic conditions, seasons, latitudes and even local time. Representation of this research focused on global distribution of electron (Te) and ion temperatures (Ti) during great and severe geomagnetic storms (GMS), their daily and seasonally variation for years (2001-2013), variations of electron and ion temperature during GMS with plasma velocity and geographic latitudes. Finally comparison between observed and predicted Te and Ti get from IRI model during the two kinds of storm selected. Data from satellite Defense Meteorological Satellite Program (DMSP) 850 km altitude are taken for Te, Ti and plasma velocity for different latitudes during great
... Show MoreObjectives of the study: To assess nurses knowledge regarding oxytocin administration during labor and
delivery in maternity hospitals, and to find out the relationship between nurses knowledge and studied
variables (age, level of education, work times (shift) experience year, training course in nursing field).
Methodology: Descriptive analytic study was conducted on non-probability sample (convenient) of (70) nurses
to assess nurse’s knowledge related to oxytocin administration. The study is conducted at Al- kut Hospital for
Gynecology Obstetrics and Pediatrics and Al- Zahraa Teaching Hospital during periods 5th February to 24th
April 2013, A questionnaire was used as a tool of data collection to fulfill with objecti
Objective: To assess the impact of anxiety and stress during pregnancy upon neonatal outcome Methodology: A descriptive purposive study was used to assess the impact of anxiety and stress during pregnancy upon neonatal outcome. The study was conducted from (22nd \ September \ 2020 to 15th \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labour wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the n
... Show MoreAPFS Mohammed, 2014
This work studies the impact of input machining parameters of Electrical Discharge Machining (EDM) on the machining process performance. Tool steel O1 was selected as the workpiece material, copper as the electrode material, and kerosene as the dielectric medium. Experimental runs have been carried out with a Design of Experiment (DOE) technique. Twenty tests are accomplished with the current range of (18 to 24 Ampere), a pulse duration range of (150 to 200 µs), and a pulse-off time range of (25 to 75 µs). Based upon the experimental study's output results, the EDM parameter's effect (voltage of power supply, discharge current, pulse duration, and pulse pause interval) on the responses of the process represented by sur
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