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.
Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas
... Show MoreBoth type 1 diabetes and type 2 diabetes have a genetic component, with over 60 chromosomal regions related to type 1 diabetes and over 200 connected with type 2 diabetes at significant genome-wide levels. Numerous single nucleotide polymorphisms in the RETN gene and genetic variables can account for up to 70% of the variations in circulating resistin levels. The RETN polymorphism has been linked in numerous studies to obesity, insulin sensitivity, type 2 diabetes, and cerebrovascular illness. Our objective is to compare this RETN gene 3ʹ-untranslated region polymorphism in type 1 diabetes and type 2 diabetes Iraqi patients. We choose 51 type 1 diabetes and 52 type 2 diabetes patients against 50 healthy subjects (control group) to investig
... Show MoreA new Schiff base, 2-N( 4- N,N – dimethyl benzyliden )5 – (p- methoxy phenyl) – 1,3,4- thiodiazol ,and their metal complexes Cu (Π) ,Ni (Π), Fe (III) , Pd (Π) , Pt (IV) , Zn(Π) ,V(IV) and Co (Π) , were synthesized. The prepared complexes were identified and their structural geometries were suggested by using flam atomic absorption technique , FT-IR and Uv-Vis spectroscopy, in addition to magnetic susceptibility and conductivity measurements. The study of the nature of the complexes formed in ethanol solution , following the mole ratio method , gave results which were compared successfully with those obtained from the isolated solid state studied. Structur
... Show MoreThis paper presents a comparison study on thermal performance conic cut twist tape inserts in laminar flow of nanofluids through a constant heat fluxed tube. Three tape configurations, namely, quadrant cut twisted tape (QCT), parabolic half cut twisted tape (PCT), and triangular cut twisted (VCT) of twist ratio= 2.93 and cut depth= 0.5 cm were used with 1% and 2% volume concentration of SiO2/water and TiO
... Show MoreObjective: To assess the functional outcome, time to union, shoulder pain, blood loss, operative time, iatrogenic radial nerve injury, hospitalization, and infection. Methodology: It is a prospective randomized study on 30 patients with mid-shaft humerus fracture according to AO classification (1.2A1, 2, 3 and 1,2B) with functioning radial nerve. They were randomly dividing into two groups. Group A were treated by a closed antegrade interlocking nail, and group B treated by open reduction and locked compression plate fixation. The follow-up was up to 6 months, including time to union, shoulder pain, intraoperative blood loss, operative time and iatrogenic radial nerve injury. Functional outcome was assessed by quick DASH score. Resu
... Show MoreThe goal of this study is to investigate the effects of heat transfer on a non-uniform inclined asymmetrical channel with couple stress fluids via a porous medium using incline magnetohydrodynamics. The governing equation is studied while using low Reynolds approximations and long-wavelength assumptions. Mathematical expressions for (pressure gradient), (temperature), (axial velocity), (heat temperature coefficient), and (stream function). A precise set of values for the various parameters in the present model has been used. The mathematical expressions for axial velocity, stream function, pressure gradient, and pressure rise per wavelength have been derived analytically. "MATHEMATICA" is used to present the computational result
... Show More