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.
This study is about awareness of teaching explanation difficulties in the Islamic university from the lecturers point of view. It discussed the difficulties and the traditional teaching methods of explanation. The study concentrated on teaching Islamic studies in general and teaching explanation in specific and set difficulties so as to be treated.
The study is of three chapters, the first contains the difficulties in several aspects like the educational goals, text contents, teaching methods and styles, students, educational techniques, educational aids and evaluation, it addition to the lecturers of Islamic university colleges in 2009-2
... Show MoreSome microorganisms can produce nanocellulose, which is known as bacterial nanocellulose (BNC); the most active bacterial producer is acetic acid bacteria (AAB), which is a gram-negative, motile and obligate aerobic belongs to the family Acetobacteraceae. Bacterial nanocellulose has excellent attention in medical (surgical domain), industrial and pharmaceutical fields because of its flexible properties, characteristics and advantages. So, in this study, the AAB (5AC) isolate was isolated from apple vinegar. The production of BNC was performed by using a natural medium called palm dates liquid medium, the produced bacterial Cellulose was purified by using the sodium hydroxide method; it was observed that the wet weight of the BNC was a
... Show MoreThe genus Larra Fabricius, 1793 (Hymenoptera: Crabronidae) is recorded for the first time from Vietnam. Three species and two subspecies belonging to this genus as follows: L. amplipennis (F. Smith, 1873); L. carbonaria (F. Smith, 1858); L. fenchihuensis Tsuneki, 1967; L. polita polita (F. Smith, 1858) and L. polita luzonensis Rohwer, 1919 are presented. Keys to both sexes of the three species and two subspecies reported here are provided.
Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (E
... Show MoreSaccharomyces Cerevisiae cells were immobilized in calcium alginate beads and activated charcoal for use in the
production of ethanol from batch fermentation of sugar beet waste. Treatment of the waste with NaOH to increase the
ability of lignocellulose material to hydrolysis by acid (2N H2SO4) to monosaccharide and disaccharide (mainly glucos).
The high reducing sugar concentration obtained was equal to 9.2gm/100ml (10Brix) after treatment. Fermentation
parameters, are (pH, glucose concentration (2.5-25 gm/100ml), immobilized agent concentration (2.5-25 gm/100ml)
were studied to find the optimum physiological condition. And the highest ethanol concentration obtained from the
fermentation in the presence of 20%(wt/v) ca
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children. |
Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (Ea
... Show More