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 current research seeks to achieve several objectives, including knowing the extent of the audit directorate of the Ministry of Construction, Housing and General Municipalities of the International Standard (ISO19011:2018) regarding determining the efficiency and evaluation of auditors and diagnosing the gap between requirements and application and knowing the reasons for not applying some of the items in the standard, starting from the problem, The field raised the following question (Does the audit directorate determine the efficiency and evaluation of auditors according to the standard ISO19011:2018?), and the importance of research lies in determining the return that can be achieved by the directorate through its application of stand
... Show MoreThe effect of using three different interpolation methods (nearest neighbour, linear and non-linear) on a 3D sinogram to restore the missing data due to using angular difference greater than 1° (considered as optimum 3D sinogram) is presented. Two reconstruction methods are adopted in this study, the back-projection method and Fourier slice theorem method, from the results the second reconstruction proven to be a promising reconstruction with the linear interpolation method when the angular difference is less than 20°.
Risk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has
... Show MoreBridging the Gap between Graphemes and Phonemes in the Phonetic Transcription
The Russian foreign policy of the post-cold-war era faced dilemmas in the light of the international and regional realities of the disintegration of the Soviet Union and the formation of a new unipolar international order led by the United States of America. Thus, Russian foreign policy-making was divided over the nature of the foreign policy to be followed. The achievement of the Russian goals, especially as the objectives of Russian foreign policy have been set within the framework of trying to regain the status and leading role, as well as the establishment of some fundamental changes to be consistent with the new international situation of the post-one The Russian Federation has adopted in the sphere of its foreign policy to the vari
... Show MoreIn his opus, Ted Hughes has annexed new and fresh territories of signification to the very notion of the literary animal. Building on the earlier modernist example of the Lawrencian legacy that dwells upon the question of animalism, Hughes seems to have stepped further into the terrain of the sheer struggle when, in his hands, the grotesquerie of survival and violence energizes the topos of the literary animal in his postmodern bestiary. In Hughes’s elemental poetic process this grotesquerie and violence stages the literary animal as a vital poetic device or motif that is finally restored to the primitive power of poetry. In his “Thrushes”, he thus defamiliarizes these tiny creatures’ acts of being to bring upfront into focus thi
... Show MoreRisk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has
... Show MoreThe aim of this research is to study the factors affecting drag coefficient (C d ) in
non-Newtonian fluids which are the rheological properties ,concentrations of non-
Newtonian fluids, particle shape, size and the density difference between particle and
fluid .Also this study shows drag coefficient (C d ) and particle Reynolds' number (Re
P ) relationship and the effect of rheological properties on this relationship.
An experimental apparatus was designed and built, which consists of Perspex pipe
of length of 160 cm. and inside diameter of 7.8 cm. to calculate the settling velocity,
also electronic circuit was designed to calculate the falling time of particles through
fluid.
Two types of solid particles were
In the spreading of the Internet, mobile smart devices, and interactive websites such as YouTube, the educational video becomes more widespread and deliberative among users. The reasons for its spread are the prevalence of technologies, cheap cost, and easy to use. However, these products often lack to the distinction in video production. By following videos of an educational channel on YouTube, some comments found to discuss the lack of the content presented to motivate the learners, which lead to reduce the viewers of the videos. Therefore, there is an important decision to find general standards for the design and production of educational videos. A list of standards has been drawn up to help those interested in producing educational
... Show MoreThis research include building mathematical models for aggregating planning and shorting planning by using integer programming technique for planning master production scheduling in order to control on the operating production for manufacturing companies to achieve their objectives of increasing the efficiency of utilizing resources and reduce storage and improving customers service through deliver in the actual dates and reducing delays.