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.
Ubikh is one of the most important tribes of the Northwest Caucasus and has a long history. Naturally, rebukes are an integral part of the Caucasus region. Their people were able to confront the Russian invasion of their lands like the rest of the Caucasus tribes to defend their existence, freedom and the right to build their independent state, but they were not able to resist the great Russian military progress they achieved on all sides. For the territory that belonged to Persia and the Ottoman Empire and ended the resistance of the Meridian movement in the Northeast Caucasus, the Russians left only the weak resistance of the tribes of the Northwest Caucasus led by the rebuke after Russia managed to eliminate all resistance movements i
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The study aims to identify the level of health services provided in private suites to government hospitals from the perspective of the recipi
... Show MoreThis investigation was designed to determine the occurrence of intestinal parasites in fresh
vegetables(Apium graveolense, Lepidium aucheri and Allium porrum), from different markets
as a primary effort in Iraq. Eight genera and species of intestinal parasites appear in
vegetables, they were as follow: Echinococcus sp. 50%,Oxyuris equi 45%,Habronema sp.
45%,Parascaris equroum 31.6%,Strongyloides westrei 30%,Toxocara sp. 18.3%,Ascaris
lumbricoides 11.6% and Hymenolepis sp. 8.3% .The scarcity of fresh water has meant that
urban gardeners are increasingly irrigating their plots with wastewater. This poses a threat to
public health in addition of roaming dogs in open farms. All studied areas showed high rates
of eggs
This study focuses on how tax administrations in Iraq use Artificial Intelligence (AI) techniques to monitor tax evasion for individuals and companies to achieve Tax Compliance (TC). AI was measured through four dimensions: Advanced Data Analytics Techniques (ADAT), Explainable AI (EAI), Machine learning (ML), and Robotic Process Automation (RPA). At the same time, TC was measured through registration, accounting, and tax payment stages. We relied on the questionnaire form to measure the variables. A sample of employees in the General Tax Authority in Iraq was selected, and a questionnaire was distributed to 132 people. The results indicated that the dimensions of AI affect achieving TC at all stages. This study provides evidence of using A
... Show MoreSaccharomyces Cerevisiae cells were immobilized in calcium alginate beads and activated charcoal for use in the
production of ethanol from batch fermentation of sugar beet waste. Treatment of the waste with NaOH to increase the
ability of lignocellulose material to hydrolysis by acid (2N H2SO4) to monosaccharide and disaccharide (mainly glucos).
The high reducing sugar concentration obtained was equal to 9.2gm/100ml (10Brix) after treatment. Fermentation
parameters, are (pH, glucose concentration (2.5-25 gm/100ml), immobilized agent concentration (2.5-25 gm/100ml)
were studied to find the optimum physiological condition. And the highest ethanol concentration obtained from the
fermentation in the presence of 20%(wt/v) ca
Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (E
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children. |