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.
EGFR-mutant non–small cell lung cancer (NSCLC) initially responds well to EGFR tyrosine kinase inhibitors (EGFR-TKIs), yet resistance is nearly inevitable and responses to immune checkpoint inhibitors (ICIs) remain limited. In a retrospective cohort of 57 patients with advanced EGFR-mutant NSCLC treated with nivolumab or pembrolizumab, the objective response rate was 12.3%, although responses were concentrated in a small subgroup with concurrent high PD-L1 expression and dense intratumoral CD8⁺ immune-cell infiltration. Emerging evidence links these outcomes to chemokine-network dysregulation that alters immune trafficking and spatial organization. Oncogenic EGFR signaling shifts chemokine networks away from effector T-cell recruitment
... Show MoreThe river water salinity is a major concern in many countries, and salinity can be expressed as total dissolved solids. So, the water salinity impact of the river is one of the major factors effects of water quality. Tigris river water salinity increase with streamline and time due to the decrease in the river flow and dam construction from neighboring countries. The major objective of this research to developed salinity model to study the change of salinity and its impact on the Al-Karkh, Sharq Dijla, Al-Karama, Al-Wathba, Al-Dora, and Al-Wihda water treatment plant along Tigris River in Baghdad city using artificial neural network model (ANN). The parameter used in a model built is (Turbidity, Ec, T.s, S.s, and TDS in)
... Show MoreRestoration of degraded lands by adoption of recommended conservation management practices can rehabilitate watersheds and lead to improving soil and water quality. The objective was to evaluate the effects of grass buffers (GBs), biomass crops (BCs), grass waterways (GWWs), agroforestry buffers (ABs), landscape positions, and distance from tree base for AB treatment on soil quality compared with row crop (RC) (corn [
The aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
... Show More(Thimma) in Arabic means compact, and immunity. (People of Thimma) are the free non-Muslim people under Muslim rule. This includes Heavenly Religions people, i. e., Christian and Jews).
They have been called (People of Thimma) because they had paid (Jizyah: tribute) so they became safe for their souls, honor, properties at the custody of Muslims.
Islamic law had posed (Jizyah: tribute) upon the Jews and Christians who were living under Muslim rule as a reaction of not embracing Islam Faith against securing their rights and freedom.
Freedoms secured by Islam for the (People of Thimma) had been many, including the right of faith, not coercing them to be Muslim, the right to live, to possess properties, protect and secure them, the
Background: Data on the impact of neonatal and total pediatric admissions volume on neonatal mortality are sparse. Objectives: This study is done to estimate the neonatal mortality in relation to neonatal admissions and to total hospital admissions in Al-Alwyia Pediatric Teaching Hospital through years 2005-2012 Type of the study: A retrospective study.Methods: statistical records of all cases admitted to APTH were studied during 2005-2012.Results: Neonatal mortality decreased to the nadir at last year of study period (2012) and reached 6.1% of neonatal admissions compared to 2005 level which was 9.7 %. Mortality rate among premature and low birth weight (LBW) infants decreased also. The study also reveals that neonatal mortality constit
... Show MoreComputer simulations were carried out to investigate the dependence of the main perturbation parameters (Sun and Moon attractions, solar radiation pressure, atmosphere drag, and geopotential of Earth) on the orbital behavior of satellite. In this simulation, the Cowell method for accelerations technique was adopted, the equation of motion with perturbation was solved by 4th order Runge-Kutta method with step (1/50000) of period to obtain the state vectors for position and velocity. The results of this simulation have been compared with data that available on TLEs (NORD data in two line elements). The results of state vectors for satellites (Cartosat-2B, Gsat-14 an