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.
يعد هذا النص أحد النصوص المسمارية المصادرة التي بحوزة المتحف العراقي، ويحمل الرقم المتحفي (235869)، قياساته )12،7x 6x 2،5سم). يتضمن مدخولات كميات من الشعير،أرخ النص الى عصر أور الثالثة (2012-2004 ق.م) و يعود الى السنة الثالثة من حكم الملك أبي-سين (2028-2004 ق.م)،أن الشخصية الرئيسة في هذا النص هو)با-اَ-كا مسمن الماشية( من مدينة أري-ساكرك، ومقارنته مع النصوص المسمارية المنشورة التي تعود الى أرشيفه يبلغ عددها (196) نصاً تضمنت نشاطاته م
... Show MoreFever is a common illness in the pediatric age group ,the causes could be viral ,bacterial and fungal , this study was focused on bacterial pathogens as gram positive like Staphylococci, coagulase positive or negative ,Streptococci and gram negative like E-coli , Klebsialla ,Proteus, Pseudomonas, Burkhoderia , Acinetobacter and others like Pusturella ,E-alkalescendiaper, Haemophillus influenza and yeast like candida . Four thousand and seventy eight blood samples (4078)were collected in a period between January 2011 and the end of May 2012 at the child welfare hospital ,all the samples were cultured on suitable culture media and then biochemical tests were done using API-E 20 and sugar fermentation tests ,sensitivity
... Show MoreA new species, Hottentotta pooyani sp. nov. is described and illustrated using two female specimens collected from the Khuzestan Province in Iran. This species is compared with the closely species including H. khoozestanus Navidpour, Kovařík, Soleglad & Fet, 2008; H. pellucidus Lowe, 2010 and H. saxinatans Lowe, 2010 that were previously described in Iran and Oman.
The research aimed to determine the role of the agricultural extension in educating farmers about the legislation on the protection of the rural environment from pollution with chemical pesticides working in the Department of Agricultural Extension and Training and the Department of Agricultural Extension in the directorates of agriculture of Najaf and Qadisiyah, and to determine the role of the agricultural extension in the axis of farmers' use of the correct methods to protect the rural environment from pollution with chemical pesticides and the axis of the reasons that lead farmers to pollute the rural environment with chemical pesticides, and to achieve the objectives of this research prepared A questionnaire in the light of rev
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... Show MoreA survey to show the reality of educational guidance in schools in Baghdad Rusafa 3\ from the point of view of educational guides. It used the analytical descriptive technique. The research community consists of () male and female advisors in schools of Baghdad. The sample was haphazard( 51\.) The questionnaire was made and it consists (50) items. The research statistics have been analyzed by (SPSS), The questionnaires have been used in the first term in (2017-2018) and the results showed the relationship between the advisor and other teachers, the advisor and students fathers and the local society. According to the results, the research made some recommendations and suggestions.