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.
Background: Ruptured uterus is a catastrophic event to both
mother and her fetus. Apart from maternal and fetal mortality
rates, the incidence of rupture of uterus is often taken as an
index of the standard of obstetric care.
Objective: To determine the frequency, causes, management
outcome of ruptured uterus at Al Batool maternity hospital.
Method: The study was conducted in the department of
obstetrics and gynecology at Al Batool maternity hospital
Mosul-Iraq over a period of three years from October 1st 2002
to August 30th 2005. All the cases of uterine rupture presented
during the study period were recorded and managed in the
department. Data was recorded on designed forms.
Results: Thirty nine cas
Abstract:
In light of globalization and internationalization of financial markets, issues arising from financial crises have become increasingly serious and fundamental, creating a lot of debate among experts around the world. So, many studies have attempted to investigate what measures can be taken to detect and prevent crises before they devastate the economies.
Therefore, this paper examines the Effectiveness of the Monetary Policy (MP) to Avoid, Reduce or Treat the Financial Crisis in Malaysia. Scholars have yet to agree on the issue
... Show MoreA localized stenosis or aneurysm is a discontinuity that presents the pulse wave produced by the contracting heart with a reflection site. However, neither wave speed ( c) in these discontinuities nor the size of reflection in relation to the size of the discontinuity has been adequately studied before. Therefore, the aim of this work is to study the propagation of waves traversing flexible tubes in the presence of aneurysm and stenosis in vitro. We manufactured different sized four stenosis and four aneurysm silicone sections, connected one at a time to a flexible ‘mother’ tube, at the inlet of which a single semi-sinusoidal wave was generated. Pressure and velocity were measured simultaneously 25 cm downstream the inlet of th
... Show MoreBackground: laparoscopic cholccystectomy (LC) gained a wide acceptance as treatment of choice for acute cholccyslitis (AC) as early in 72 hours of admission or after interval of 8-12 weeks after the patient treated by medical treatment.
Background: genital herpes simplex virus infection in pregnancy poses a major risk to the fetus and it has been associated with bad obstetric out come causing preterm labor, intrauterine growth retardation and spontaneous abortion. This study was conducted to determine if premature rupture of membranes before 37 weeks of gestational age are observed with subclinical shedding of herpes simplex virus (HSV).
Patients and methods: Cervical swabs were taken from 75 women with a history of preterm premature rupture of membranes before 37 weeks of gestation, and 20 women with normal
obstetrical history for the presence of HSV antigen using Enzyme linked Immuno Sorbent Assay (ELISA) method.
Results: HSV ant
Background: The COVID-19 pandemic has an immense effect not only on the social and economic lives of people but also on the surgical lives of surgeons, residents, nursing staff, and patients as well as ground level staff. Amidst this COVID pandemic, emergency surgeries were being done but at a decreased rate, whereas elective cases depended on the will of hospitals, surgeons, and patients. Study aims to promulgate a "Neo–Surgical Check Box" by amalgamating the WHO surgical checklist and the results obtained from the questionnaires.
Subjects and Methods: After receiving ethical clearance from the Institute Ethical Committee, an online questionnaire with 50 questions divided into
... Show MoreBack ground: Colorectal cancer is one of the leading causes of death allover the world especially in the developed countries. Each year approximately one million veterans aged 50 and older will develop colorectal cancer over the remainder of their lives and nearly 433,000 will die from it. Because most cancers are diagnosed after local or regional spread, nearly half of all patients diagnosed with colorectal cancer will die lWarly detection and management definitely decrease mortality.
Patient and methods: This is a prospective study on fifty patients with colorectal cancer admitted at the first surgical unit in Baghdad teaching hospital since March 2000 till March 2003 The data collected from those fifty patients were analyzed accor
PM3 and Unrestricted Hartree Fock (UHF) quantum mechanical methods are carried out for the estimation of reaction path for the breakage of (R-O) bond rupture energies, for twelve ampicillin ester prodrugs derivatives, at their calculated equilibrium geometries, in addition to some physical properties such as heat of formation, total energy, dipole moment and the energy difference of EHOMO and ELUMO (ΔEHOMO-LUMO) energy levels, using the Gaussian-03 program. Comparisons were done between the total energies of the reactants, products, activation energies and transition states. The results show non possible use of some substituted organic groups as a carrier linkage for acidic ampicillin drug, whereas others show possible use as a carrier
... Show MoreA pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
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