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.
Tigris River is the lifeline that supplies a great part of Iraq with water from north to south. Throughout its entire length, the river is battered by various types of pollutants such as wastewater effluents from municipal, industrial, agricultural activities, and others. Hence, the water quality assessment of the Tigris River is crucial in ensuring that appropriate and adequate measures are taken to save the river from as much pollution as possible. In this study, six water treatment plants (WTPs) situated on the two-banks of the Tigris within Baghdad City were Al Karkh; Sharq Dijla; Al Wathba; Al Karama; Al Doura, and Al Wahda from northern Baghdad to its south, that selected to determine the removal efficiency of turbidity and
... Show MoreMany people believe that diabetes appears after a psychological crisis, which is a misconception but it could be in them before having a crisis ore the crisis. But emotion increases the appearance of symptoms, and athletes are at risk of developing diabetes. Hypoglycemia is not unusual for athletes, and during physical activity the sugar level changes in the blood. Therefore, it is important to conduct tests for the measurement of sugar before and immediately after the activity, for the purpose of detecting the sharp drop in the sugar level and treating it, and the early detection is necessary to avoid the possibility of diabetes, the concept of psychological immunity in psychology is considered a positive concepts that maintain the balance
... Show MoreThe aim of this research to study.
The dimensions of organizational learning have been defined(learning dynamics, individuals empowerment, knowledge management and technology application) as well as the dimensions of learning organization have been defined (culture values, knowledge transfer, communication and employee characteristics), Asset completion questionnaire was used to collect data of this research from a purposely sample represent forty employees who works in Iraqi Planning Ministry at different positions. The research divided to four parts :
The first to the research methodology, the second to the theoretical review o
... Show MoreThis research evaluated the effect of (UV)(400-320A)Hz(320-220B)Hz on the patient with vitiligo , using it with our new combing therapy that include the oral (Psorlene ) topical , meladinine solution applied on the Vitiligiousns Lesions , In edition to the instralesnional injection in the Vitiligiousns Lesions by long acting steroid (kenacort-A ) by aprecentage of (5%) , after that we expose the patient to UV . The ruslets of this way of treatment more effective by using of the UV rays in the treatment of vitiligo , while the previous treatment that used the UV ray with or with out the psorlene , the results were not effective on controlling of the Vitiligio diseases comparing by the treatment used in this research as it stop’s the sp
... Show MoreThe tax is a financial amount collected from the taxpayer for the account of the public treasury.. and is the cornerstone of the close bond between members of the community and the country in which they live , as income tax is imposed on the profits and revenues achieved by people and often the constitution of most contemporary countries stipulate that the legislator is obligated to determine the sources of revenues and profits subjected to tax. Because the tax has a serious impact on people’s money because it is exposed to that money through direct deduction . Therefore, we note that the applicable income Tax Law stipulated that in order income to be subject to tax , it must be derived from one or more of the income sources st
... Show MoreBackground: Temporomandibular joint disorder (TMD) is a general term that describe a wide variety of conditions that include myogenic pain, internalderangement, arthritic problem, ankylosis of the joint and growth disorders. The aims of study was to evaluate the value of 3 Tesla magnetic resonance imaging in assessment of articular disc position and configuration in patients with temporomandibular joint disorders and to evaluate the correlations of these MRI findings with the clinical signs and symptoms. Materials and methods: A total forty six (30 study and 16 control) participants aged between18 and 49 years, were examined according to Helkimo anamnestic index (questionnaire for anamnesis) and clinical dysfunction index scoring criteria
... Show MoreBackground: Sclerotherapy is a simple treatment modality for treatment of infantile hemangioma and slow-flow vascular malformations; Polidocanol is a mild sclerosing agent that is traditionally used in treatment of varicose veins. This study aims to evaluate the effectiveness, treatment outcome, and complications of polidocanol foam sclerotherapy for infantile hemangioma and slow-flow vascular malformations. Materials and methods: Between March 2013 and December 2014, seventeen patients with infantile hemangioma and slow-flow vascular malformations treated with polidocanol 1% foam sclerotherapy. Foam was prepared by Tessari’s method. Injection performed under general or local anesthesia, injections were repeated (if necessary) on mon
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