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.
Background: Complete seal of the root canal system following its chemo-mechanical debridement plays a pivotal role for achieving successful endodontic treatment. This can be established by reducing the gaps between the core filling material and root canal wall. Aim: To assess and compare the dislocation resistance of root canals obturated with GuttaFusion® and TotalFill BC sealer versus single cone obturation technique and TotalFill BC sealer after instrumentation of the canals with WaveOne, ProTaper Next and ProTaper Universal system. Material and Method: Sixty extracted human permanent mandibular premolars were conducted in the current study. The teeth were decorated and left the root with 15mm length; the roots were divided randomly i
... Show MoreThis research deals with leverage and its impact on the profitability of Islamic banks in Iraq for the years (2015-2018), the research variables of leverage have been analyzed and measured as an independent variable, profitability as a dependent variable, and the research is based on a main hypothesis: there is a moral relationship of statistical significance. Between leverage and profitability at The Islamic Cooperation Bank for the period (2015-2018). The results of the research showed that there are moral (exorcist) relationships between the ratio of leverage and profitability indicators, as the higher the leverage ratio, the higher the profitability indicators. In addition, The Islamic Cooperation Bank has adopted a conservative poli
... Show MoreIdentify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think
... Show MoreThe added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).
The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi
... Show MoreGod Almighty put in his great book secrets that do not end, and wonders that do not expire, for he is the one from which the scholars are not satisfied, and he does not create due to the multitude of response, and it is the comprehensive and inhibitory book that God conceals to the worlds, and he challenged the two heavyweights to come up with something like it.
At all times, issues arise in the Noble Qur’an that fit the needs of the people of that time and their culture, for it is an eternal book, characterized by the ability to give, extend and respond to addressing the problems of the age and its variables, when the Arabs had little luck at the time of the message’s descent from the scientific culture, and their proficienc
... Show MoreThe Vulnerable Indian Roofed Turtle Pangshura tecta (Gray, 1831) (Testudines: Geoemydidae) occurs in the Sub-Himalayan lowlands of India, Nepal, Bangladesh, and Pakistan. Little is known about its natural history, no studies have been conducted revealing its natural predators. In this study, a group of Large-billed Crow Corvus macrorhynchos Wagler, 1827 (Passeriformes: Corvidae) was observed hunting and predating on an Indian Roofed Turtle carcass in the bank of river Kuakhai, Bhubaneswar, India. The first record of this predation behaviour is reported and substantiated by photographic evidence.
Purpose: To determine the impact of service encounter in stimulating voluntary customer behaviors.
- Approach / methodology: It was selected a sample of customers Bank Iraqi Trade (TBI) was (105) individual, using a questionnaire designed in the light of previous studies, was drafted scale and tested in the light of a group of statistical methods developed (reliability coefficient, reliability coefficient composite, convergence). Then test hypotheses through structural equation modeling.
- Results: The behaviors and characteristics of the service provider in effect urged bank customers to perform voluntary extra, as the service environment service encounter
In this paper, a theoretical study was introduced to discussion the Influence of donor senstizer on efficiency of solar cell with clear focusing on dye senstized solar cell DSSCs applications was presented. Use of donor as -sensitizer dye in solar cells was a viable contender in photovoltaics due to their spectrum of excited state to transfer more elkectrons to conduction band of semiconductor .In this study, two systems Alq3/ZnO and D149/ZnO devices taken with same two solvents .Transtion energy ,coupling strength and transtion parameters are used to calculate the electron current density , it uses to calculate the photovoltic characteristic I-V ,fill factor and the efficiency of th
... Show More