Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a left pure posteriorly directed PCoA aneurysm. In the surgery, through the left pterional approach, all intraoperative steps were carried out. Additional steps were performed as well. Three additional intraoperative steps were contemplated because a pure posteriorly directed PCoA aneurysm is not well appreciated and is often hidden behind the supra cliniold internal carotid artery (ICA). First, the extension of Sylvian fissure dissection to include the distal part and the proximal. Second, temporal pole mobilization is performed by cutting small anterior temporal veins. Third, a brain retractor is placed on the temporal lobe to gently tract the superficial part of the lobe. All these steps widened the surgical corridor to ensure the aneurysm's safe clipping. Conclusion: Surgical clipping is influenced by the aneurysmal dome projection. In a ruptured pure posteriorly directed PCoA aneurysm, further intraoperative steps may facilitate complete access and safe clipping of the aneurysm.
Background: Ankylosing spondylitis (AS) is inflammation of the sacroiliac joints and spine, associated with clinical symptoms such as pain and stiffness in the vertebral column, after which, in a considerable number of individuals, new bone growth occurs. Objective: The current research study attempted to find out whether the presence of SNPs in TNF receptor [TNFRSF1A (rs767455), TNFRSF1B (rs1061622)] encoding genes could influence patients' outcomes to etanercept in a specimen of Iraqi AS patients. Patients and methods: Sixty patients with established AS receiving only etanercept were selected to be enrolled in this research with a mean age of 40.75 ± 8.67 years, 51 patients of them were males and only 9 patients were females. Patients we
... Show MoreFinancial markets play an important role in the economy, as it contributes to the financial and economic system of the state stability, as it reduces the adoption of the companies on the loans granted by the banks, as financial markets contribute to attracting and channeling savings to small savers who will be able to buy a number of shares proportional to their savings, It also provides them the place of exchange, and play technology and information systems an important role in facilitating exchanges and increased market activity, in this research touched on the importance of information technology in effect on the activity of the financial markets. Research is divided into three demands of the first concept of eating and the importance
... Show MoreThe Noble Qur’an is the book of God, the Blessed and Exalted, in which is the teachings of God Almighty’s religion, which is Islam, in order for people to unite it and establish servitude to it. The individual and the society alike saw it appropriate to make my opinion alerting the seriousness of this matter, so the research was entitled (The Impact of Sins and Disobedience on the Individual and Society in the Holy Qur’an - Objective Study), knowing that we touched upon some of the effects, which we found it appropriate to mention in this research in the service of the good. Its details came in the Holy Qur’an without referring to others, noting their arrangement in the Holy Qur’an..
The human blood physiology is an active system that is closely connected with environmental and lifestyle changes, which affect such processes as erythropoiesis, coagulation, platelet activity, nitric oxide (NO) signaling system, and oxygen transport. It is a synthesis of evidence based on recent research (2020-2026) on four modulators that relate to each other physically: exercise, high-altitude hypoxia, climate change-induced high and low temperatures, and consumption of non-nutritive sugar substitutes such as erythritol. Adaptive changes that are generally observed in response to exercise and altitude are increased erythropoiesis and improved vascular functions, whereas maladaptive changes, including oxidative stress, inflammator
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The six Arab Gulf states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, UAE) play a vital role, especially with its geographical location and natural resources (oil and gas) as well as other cultural and civilizational elements, in achieving global economic balance and more specifically global energy security, naturally because of these countries have a comparative advantage in the field of fossil energy (oil and gas), thus this sector becomes more attractive for local and international investments alike. Being the energy sector a leader sector in the economic development process, and the basic factor to achieve savings and financial surpluses in thes
... Show MoreSocial responsibility has achieved tremendous attention by academicians and practitioners to focus on social responsibility accounting. However, many studies around the globe have been conduct to measure the outcomes of social responsibility accounting. This paper presents the impact of applying the supply chain strategy (SCS) on the agribusiness field to optimize productivity and decreasing cost which will have a direct impact on the net income of the organization. The inconclusive results of earlier studies stimulated this research to social responsibility accounting-financial performance. The equivocal results of this phenomenon urge this study to investigate the role of other factors in the relationship of social responsibility accounti
... Show MoreThis study aimed to recognize and understand the concept of strategic management accounting (SMA) and how it's the effect on the competitive advantage for industrial companies in Jordan. The study's importance arises due to the lack of Arab studies that dealt with this topic, in addition to the important and vital role of strategic management accounting on companies that represent the artery of the decision-making process, and to identify the benefits associated with SMA technology. The necessary data were collected through the literature review and theoretical study of the references that relevant to the study subject, in addition to a questionnaire developed for this purpose, the study used (124) out of (250) questionnaires tha
... Show MoreThe different crises and financial collapses place in many companies, particularly in developed countries as a result of administrative and financial corruption return aspects of the task to the role of the company and the external auditor, both in their emphasis on honesty and fairness of financial statements and the Provisions of accounting information and on the contrary to the truth, you may have to the loss of the rights of stakeholders, particularly existing investors, and the loss of confidence of prospective investors in the accounting information contained in the financial statements of these companies, which led to a crisis of confidence and credibility in the profession of accounting and auditing where the wonder of ma
... Show Moret-Self-Compacting Concrete (SCC) reduces environmental noise and has more workability. This research presents an investigation of the behavior of SCC under mechanical loading (impact loading). Two types of cement have been used to produce SCC mixtures, Ordinary Portland Cement (OPC) and Portland Limestone Cement (PLC), which reduces the emission of carbon dioxide during the manufacturing process. The mixes were reinforced with Carbon Fiber Reinforced Polymer (CFRP) which is usually used to improve the seismic performance of masonry walls, to replace lost steel reinforcements, or to increase column strength and ductility. Workability tests were carried out for fresh SCC. Prepared concrete slabs of 500×500×50mm were tested for lo
... Show MoreThe Sunnah of the Prophet has a great impact in building human behavior, and the formation of Islamic thought, has worked to spread science in all of Egypt, as it carried to the people of the eternal prophecy of the love of science, it was a source of knowledge and civilization. It is a generous source, a rich source of the Islamic nation, always tender, and renewed benefit, which is not only a source of legislation and language but is a source of guidance for thought and guidance of behavior, and the Hadith The importance is obvious In the integration of Islam, and show aspects of human integration in the personality of Mustafa , and the Muslims are interested in talking - collected and codification -, and made the effort of the cent
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