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.
Effective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
This paper aims to discuss and analyse the role and importance of implementing industrial Policy to promote industry and enhance economic development in developing countries. The paper discusses the economic justifications for using industrial policy as well as the criticisms leveled against it, for this purpose it analyses the ideas of two different approaches to industrial policy. The first held by the neo-liberals in the USA , who oppose the use of industrial policy and emphasise the role of the market in attaining economic development. The second, represented by many economists who support the use of industrial policy to promote industry and accelerate economic development, they justify their stand by pointing to the negative
... Show MoreThis research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo
The main objective of this paper is to determine an acceptable value of eccentricity for the satellites in a Low Earth Orbit LEO that are affected by drag perturbation only. The method of converting the orbital elements into state vectors was presented. Perturbed equation of motion was numerically integrated using 4th order Runge-Kutta’s method and the perturbation in orbital elements for different altitudes and eccentricities were tested and analysed during 84.23 days. The results indicated to the value of semi major axis and eccentricity at altitude 200 km and eccentricity 0.001are more stable. As well, at altitude 600 km and eccentricity 0.01, but at 800 km a
Election study included four sites for the waters in area of Youssifiyah south of Baghdad (river water, tank water, liquefactions water, and water filtrate and seethed and purifier by alum and chloride), the samples were collected during the month of June in 2007. Temperature, electrical conductivity and acidity are measured. Also , the concentration of chloride , sulphate , carbonate , nitrate , sodium , calcium , magnesium , hard total and total dissolved substances are determined , as well as heavy metals assess environmental risk (such as Cu, Pb, Zn, Fe). It was also a study of bacterial totals included both total Bacteria (TB) and Total Coliform Bacteria (TC) and Fecal Coliform (FC) and Fecal Streptococci (FS). The stu
... Show MoreThe research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o
... Show Moreيلعب القطاع الصناعي التحويلي في أي قطر دوراً هاماً في تحقيق التنمية الصناعية، اذ تتحد تاثيراته فيها على طبيعة الدور المرسوم له وعلى مدى فاعلية هذا القطاع الحيوي الذي يعد اتجاه نحو التعاظم المضطرد لمستويات الانتاجية " Levels of productivity"والتنويع الانتاجي والتدفق المستمر للتجديد التكنولوجي من اهم دلائله.
ويعد مؤشر الانتاجية بصفة عامة وانتاجيتي العمل وراس المال بصفة خاصة من الم
... Show MoreBased economic units to technology to add innovations that lead to contribute to customer satisfaction, under intense competition and rapid development in customer taste, the economic units tend to apply the concepts that contribute to customer satisfaction led by the introduction of artificial intelligence techniques. In the production prominent role in the contributing and responding to the rapid changes in customer tastes, and consequent impact this in achieving customer satisfaction. Search gained importance of relying on artificial intelligence techniques to achieve customer satisfaction through speed of response to changes in the tastes of customers and thus be able to increase its market share، and sales growth، and to achieve a
... Show MoreThe Na Bop-Pu Sap Pb-Zn ore bodies represent a typical vein-type lead-zinc deposit situated in the Cho Don area and are currently being extracted for their lead and zinc resources. This deposit is characterized by its significant scale and quality and is considered one of the prominent lead-zinc deposits in the Cho Don area. Despite its significance, this deposit has not received adequate attention, resulting in limited knowledge of its geology, mineralization, and deposit genesis model. To address this knowledge gap, our study utilized several methodologies, including field surveying, ore mineral analysis under a microscope, and S and Pb isotopic geochemistry. By employing these approaches, we were able to obtain specific insights
... Show MoreThe study aimed to identify the social support and its relation with death anxiety for
olds who are listed at the Palestinian ministry of social affairs in the Jerusalem governorate,
the researcher uses the descriptive method and she bases her research on two types of
criterion: the social support and the criterion of death anxiety, these two criterion are applied
on a stratified random sample, amounted to (184) of the elderly.
The results show no statistical differences in the level of social support for olds who
are listed at the Palestinian ministry of social affairs according to the variables of sex.
Whereas there are statistical differences in the level of social support for those olds according
to the variab