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
This Research aims for harnessing critical and innovative thinking approaches besides innovative problem solving tools in pursuing continual quality improvement initiatives for the benefit of achieving operations results effectively in water treatment plants in Baghdad Water Authority. Case study has been used in fulfilling this research in the sadr city water treatment plant, which was chosen as a study sample as it facilitates describing and analyzing its current operational situation, collecting and analyzing its own data, in order to get its own desired improvement opportunity be done. Many statistical means and visual thinking promoting methods has been used to fulfill research task.
... Show MoreThe adsorption behavior of Bismarck brown (BB) dye from aqueous solutions onto graphene oxide GO and graphene oxide-g-poly (n-butyl methacrylate-co-methacrylic acid) GO-g-pBCM as adsorbents was investigated. The prepared GO and GO-g-pBCM were characterized by Fourier transform infrared spectroscopy FTIR, which confirmed the compositions of the prepared adsorbents. Adsorption of BB dye onto GO and GO-g-pBCM was explored in a series of batch experiments under various conditions. The data were examined utilizing Langmuir and Freundlich isotherms. The Langmuir isotherm was seen as increasingly reasonable from the experimental information of dye on formulating adsorbents. Kinetic investigations showed that the experimental data were fitted ve
... Show MoreTwo Schiff bases, namely, 3-(benzylidene amino) -2-thioxo-6-methyl 2,5-dihydropyrimidine-4(3H)-one (LS])and 3-(benzylidene amino)-6-methyl pyrimidine 4(3H, 5H)-dione(LA)as chelating ligands), were used to prepare some complexes of Cr(III), La(III), and Ce(III)] ions. Standard physico-chemical procedures including metal analysis M%, element microanalysis (C.H.N.S) , magnetic susceptibility, conductometric measurements, FT-IR and UV-visible Spectra were used to identify Metal (III) complexes and Schiff bases (LS) and (LA). According to findings, a [Cr(III) complex] showed six coordinated octahedral geometry, while [La(III), and Ce(III) complexes]were structured with coordination number seven. Schiff's bases a
... Show MoreLaboratory studies were conducted at the biological control unit, college of Agriculture, University of Baghdad to evaluate some biological aspects of the predator Chilocorus bipustulatus (Coleoptera: Coccinellidae), which is considered one of the most important predators on many insect pests, especially the scale insect, Parlatoria blanchardi, (Homoptera: Diaspididae) on date palms. The results showed that biological parameters of the predator were varied according to different degree of temperature. Egg incubation period was significantly different and reached to 7.5 and 5.44 day at 25 and 30°C respectively, Fertility was the same 100% at both temperature degrees. Larval growth periods were 17.41 and 16.12 day as well as the mortality du
... Show MoreBackground: This study was aimed to investigate the effect of three lingual button (Nickel free / rectangular base, Nickel free / round base and Composite) and bonding environment, wet and dry enamel surface, on: the shear bond strength (SBS) of light and self-cured Resin Modified Glass Ionomer Cements, and the debonding failure sites. Materials and method: One hundred twenty no-carious, free of cracks maxillary first premolar teeth were selected. Three types of orthodontic lingual buttons were used in this study: Nickel free / rectangular base, Nickel free / round base and Composite buttons. The teeth were divided into two groups of sixty teeth each. One group was used for testing the chemically cured GC Fuji Ortho Resin modified Glass Io
... Show MoreAbstract
The research aims to examine the relationship between psychological flow, psychological well-being, and self-management among a sample of fine artists in the Makkah region and its governorates. The research also aims to examine the mean group differences in psychological flow, psychological well-being, and self-management due to demographic variables (sex and years of practicing arts). The sample consists of (110) male and female fine artists. The descriptive correlational approach was performed to collect the data by using the psychological flow scale developed by Payne et al (2011), which was translated by the researcher, the Oxford happiness questionnaire developed by Hills and Argyle (2002), it has t
... Show MoreÖz
Arzı Kanber/Kamber hikayesi Anadolu, Rumeli, Azerbaycan, Türkmenistan ve Irak gibi Türk dünyasının birçok yerinde birden fazla varyantı bulunan, çok sevilen ve yaygın olarak anlatılan aşk ve dramatik maceralı bir halk hikayesidir. Türk halk hikayelerinin en popüler olanlarından biri sayılan Arzı Kanber/Kamber hikayesi, Anadolu'nun birçok yöresinde bilinmesine rağmen Irak Türkmenleri arasında daha çok sevildiği ve yaygın olarak anlatıldığı tespit edilen birden fazla varyantından da görülebilir. Irak Türkmenleri arasında günümüze kadar hikayenin iki varyantı tespit edilmi
... Show MoreThe research amid to find out the extent of Iraqi oil companies commitment to implement internal control procedures in accordance with the updated COSO framework. As the research problem was represented in the fact that many of the internal control procedures applied in the Iraqi oil companies are incompatible with most modern international frameworks for internal control, including the integrated COSO framework, issued by the Committee of Sponsoring Organizations of the Tradeway Committee. The research followed the quantitative approach to handling and analysing data by designing a checklist to represent the research tool for collecting data. The study population was represented in the Iraqi oil companies, while the study sample
... Show More