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.
Ureteric obstruction is rarely noted in cases of gastric cancer. Its involvement by distant metastasis from gastric adenocarcinoma without direct invasion is an exceptionally unusual occurrence. This is the story of a 58-year-old man who arrived at the emergency department with acute flank pain and fever. He was initially diagnosed with obstructive pyelonephritis after the discovery of a new onset, complete ureteric obstruction on the left side. Subsequent investigations and follow-up revealed the presence of gastric adenocarcinoma with possible ureteric metastasis bilaterally, flank pain and hydronephrosis were the first and only presentations of gastric cancer. The rarity of the condition and the unusual presentation encouraged us to r
... Show MoreThe research paper aims to highlight the impact of electronic governance in improving the quality of auditing through accounting disclosure and how to make use out of it in resolving many of the problems by economic units in general and in particular the financial problems in particular. It focuses on the most important financial information of the loss of confidence and credibility in the financial information of the economic units, This study has been carried out through the use and application of many of the principles and rules contained in the electronic governance, The most important Which is the accounting disclosure, and hence the dimensions of accounting for electronic governance through the achievement of ac
... Show MoreBackground: Maxillary canines are important aesthetically and functionally, but impacted canines are more difficult and time consuming to treat, the aim of this study is to investigate with multi-detector computed tomography the correlation between the bone density and the upper canine impaction. Material and method: A sample of Unilaterally impacted maxillary canines from 24 patients (19 female, 5 male) who were referred to accurately localize the impacted canines at al- Karkh general hospital were evaluated by a volumetric 3-d images by the multi-detector computed tomography to accurately measure the bone density of the maxillary cortical palate of the maxillary impacted canine side and compare it with the other side of the normally erupt
... Show MoreThe research dealt with the issue of strategic information systems and its impact on the global marketing channel. As the research aims to know the strategic information systems used in the cement company. Which support the senior management in supporting decisions taken in the process of global orientation and moving to foreign markets by choosing the marketing channel that will suit the company. Product and competition with it. With other companies' products. The problem of the study focused on how to move to global markets, and any marketing channel that can be followed to move the cement product globally, what are the strategic information systems used in the company and how will it contribute to supporting senior management dec
... Show MoreThe transportation model is a well-recognized and applied algorithm in the distribution of products of logistics operations in enterprises. Multiple forms of solution are algorithmic and technological, which are applied to determine the optimal allocation of one type of product. In this research, the general formulation of the transport model by means of linear programming, where the optimal solution is integrated for different types of related products, and through a digital, dynamic, easy illustration Develops understanding of the Computer in Excel QM program. When choosing, the implementation of the form in the organization is provided.
A substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T
... Show MoreThe term ‘photometry’ refers to the accurate determination of the apparent brightness of an astronomical object. Until roughly 1980, nearly all astronomical photometry was done by means of analog measurements of photographic plates, or by analog or digital (photon-counting) techniques with photomultipliers. These photometers produced brightness readings which were typically displayed on dials, plotted on strip charts or printed on strips of paper, and it was often quite practical to analyse these raw data with pencil, paper and a slide rule or table of logarithms. However, during the late 1970s electronic area detectors for astronomy became more advanced: first, for a brief period, television-type cameras were employed, but these were s
... Show MoreThis work describes the weathering effects (UV-Irradiation, and Rain) on the thermal conductivity of PS, PMMA, PS/PMMA blend for packaging application. The samples were prepared by cast method at different ratios (10, 30, 50, 70, and 90 %wt). It was seen that the thermal conductivity of PMMA (0.145 W/m.K), and for PS(0.095 W/m.K), which increases by PS ratio increase up to 50% PS/PMMA blend then decreased that was attributed to increase in miscibility of the blend involved. By UV-weathering, it was seen that thermal conductivity for PMMA increased with UV-weathering up to (30hr) then decreased, that was attributed to rigidity and defect formation, respectively. For 30%PS/PMMA, there results showed unsystematic decrease in thermal conduct
... Show MoreThe study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the mo
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