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: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability
... Show MoreThe Experiment was carried out to determine the level vibration transfer in three axes Horizontal X, Lateral Y and Vertical Z direction to seat driver tractor, Vector sum of vibration and Daily Vibration Exposure (8 hours) in seat driver tractor, and vibration in steering wheel tractor, Heart Rate, Systolic and Diastolic blood pressure and temperature were measure to all Drivers before and after used Chisel plow in operation tillage. Statistical analysis system was used, Split-Split Plot Design under Randomized Complete Block Design, Three factors were used in this experiment included Two types of Soil Moist and Dry soil which represented main plot, Three Velocity Tractor was second factor included 1.6,3.5 and 5.4 km/hr and Three Drivers Tr
... Show MoreIn this work, the annual behavior of critical frequency and electron density parameters of the ionosphere have been studied for the years (1989, 2001 and 2014) and (1986, 1996 and 2008) which represent the maximum and minimum of years in the solar cycles (22, 23 and 24) respectively. The annual behavior of (Ne, fo ) parameters have been investigated for different heights of Ionosphere layer (100 -1000) Km. The dataset was created both of critical frequency and electron density parameters by using the international reference ionosphere model (IRI-2016 model). This study showed result that during the maximum solar cycles the values of the (Ne) parameter change with
Background Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods A single arm clinical trial included 150 eligible women who attended Al-Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the ute
... Show MoreThe Dwelling is a Fundamental issue related to human beings; throughout time, man has always had to dwell in a place and build his house. Due to different styles and typologies appearing all over the world, all containing the character of privacy as the main element of human life in their dwellings. The present study aims to investigate the temporal shift in understanding privacy during the 20th and 21st centuries in Baghdadi houses, and what are the physical elements that are related to the meaning of privacy? The research methodology analyzed the concepts of privacy to extract the research indicators to be applied to (49) samples of individual houses in selected neighborhoods in two different periods. The data was collected from v
... Show MoreBackground: Pain and the usage of local anesthetic agents are still real problem in pediatric dentistry, for these reasons, the use of minimal invasive dentistry (MID) in regard to the patient comfort is important especially for children, anxious and uncooperative patients. Chemomechanical caries removal (CMCR) methods involve the selective removal of the carious dentine hence it avoided the painful removal of the sound dentine and the anxiety resulted due to the vibration of the hand piece which is also decreased thus it appears to be more acceptable and comfortable to the patient. Aims of this study: This study was conducted among group of children to assess and compare the anxiety rating scale (during and after treatment) between the
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