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.
The study aimed to identify the effect of Total Quality Management on enhancing competitiveness through the opinions of employees of the front- rows of customer service in local Palestinian banks, the researcher adopted an analytical descriptive method through developing a special questionnaire to accomplish the study’s objectives and answer its questions. The study involved all the Palestinian local banks, with their scattered branches in West Bank. The study sample consisted of 3470 executive employees for banking services out of 4753 employees, in the rate of 73%, and the study sample reached (485) employees who were randomly selected working in the front -rows to provide services in the local Palestinian banks during the ye
... Show MoreAbstract: The research covered five chapters: So, the first chapter definition of the research is from the introduction to the research and its importance, as the importance of the research lies in an expression of the reality of e-learning as it is one of the new patterns of the educational process and its role in enhancing communication and interconnectedness between the learners from the students ’point of view Physical Education and Sports Sciences for Girls, University of Baghdad, as for the problem The research was, and through the researcher’s acquaintance with many previous studies, references and sources, and being a student at the College of Physical Education and Sports Sciences - University of
... Show MoreThe open hole well log data (Resistivity, Sonic, and Gamma Ray) of well X in Euphrates subzone within the Mesopotamian basin are applied to detect the total organic carbon (TOC) of Zubair Formation in the south part of Iraq. The mathematical interpretation of the logs parameters helped in detecting the TOC and source rock productivity. As well, the quantitative interpretation of the logs data leads to assigning to the organic content and source rock intervals identification. The reactions of logs in relation to the increasing of TOC can be detected through logs parameters. By this way, the TOC can be predicted with an increase in gamma-ray, sonic, neutron, and resistivity, as well as a decrease in the density log
... Show MoreThis study was designed to investigate the capability of gram-negative bacteria that isolated form wound and burn infection to production of Biofilm which included (32) isolates, which have multi – drug resistant to antibiotics. The isolates included (10) Pseudomonas aeruginosa, (9) Klebsiella pneumoniae, (6) Escherichia coli, (5) Proteus mirabilis and (2) Enterobacter cloacae. The method used method links the crystal violet with biofilm and reading by ELISA which was adopted on the values of optical density of violets that linked to the mass of biofilm at the wavelength of (620) nm, the test results showed variation of biofilm composition for all bacterial species depending on the optical density value while th
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The international organizations showed their interest in the marketable public relations, with their activities, means and strategies, they play a crucial role in marketing products, services and ideas of the institution. They are considered to be the link between the company and its public, They are responsible for presenting the institution to the public, with honest transmission of the information. This gives a good impression to the institution, in a way the institution and its products become consistent with the needs and interests of the public. Based on this, the research aims to identify the strategies used by the marketable public relations internationally. The r |
The coronavirus-pandemic has a major impact on women's-mental and physical-health. Polycystic-ovary-syndrome (PCOS) has a high-predisposition to many cardiometabolic-risk factors that increase susceptibility to severe complications of COVID-19 and also exhibit an increased likelihood of subfertility. The study includes the extent of the effect of COVID-19-virus on renin-levels, glutathione-s-transferase-activity and other biochemical parameters in PCOS-women. The study included 120 samples of ladies that involved: 80 PCOS-patients, and 40 healthy-ladies. Both main groups were divided into subgroups based on COVID-19 infected or not. Blood-samples were collected from PCOS-patients in Kamal-Al-Samara Hospital, at the period between Decembe
... Show MoreAlkaloids are regarded as important nitrogen-containing chemical compounds that serve as a rich source for discovering and developing new drugs where most plant-origin alkaloids have antiproliferation effects on different kinds of cancers. Alkaloids’ continence of Calotropis procera leaves are detected by two biochemical alkaloid reagents. Also GC-MS analysis for leaf alkaloid extract was done that showed the existence of one type of alkaloid compound at retention time12.8min detected as colchicine (C22H25N06( by comparing it with colchicine standard reference (Sigma Aldrich) with M.wt 399g/mol and percentage area 7.1%. Furthermore, identification, separation, and purification
... Show MoreA newly developed analytical method characterized by its speed and sensitivity for the determination of metformin-HCl via the formation of complex for metformin-HCl-OH--copper(II) ion from the gel bead system by continuous flow injection analysis. The method is based on the imbedded copper(II) ion in the gel bead structure can be used in the reaction for the formation of red –magneta colour complex(λmax. =530nm) formed by direct reaction of the drug with the released copper (II) ion from the gel bead in alkaline medium. Linear dynamic range for the absorbance versus metformin concentration was 0.001-1 mmol.L-1 while C.O.D was (r2% =95.33%) . The L.O.Q was 0.868mmol.L-1.L.O.D (S/N=3)=0.5μmol.L-1 from the step wise dilution for the min
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The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
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