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: Rehabilitation of the carious tooth to establish tooth structure integrity required cavity design that show a benign stress distribution. The aim of this study was to investigate the influence of the cavity position on the stress values in the reamining tooth structure restored with amalgam or resin composite. Materials and methods: Seven 2-D models of maxillary first premolar include class I cavity design was prepared, one sound tooth (A) 3 composite (B1, B2, and B3) and 3 amalgam (C1, C2, and C3). In design (BI and C1) the cavity position is in the mid distance between bacc-lingual cusp tip, design (B2 and C2) and (B3 and C3) shifted toward the buccal cusp and the lingual cusp for 0.5 mm respectively. One hundred N vertical
... Show MoreThe aim of this paper to study the effect of the implicit factors on the entrepreneurial spirit of the students of the Algerian university. Our structural model was proposed based on the model (Shapiro et Sokol, 1982) and the model (Ajzen, 1991). We tested it on a sample of 163 university students at the University of Algiers 3. The model consists of a set of variables (the intention of contracting as a dependent variable, structural and social educational support as independent variables). The results showed that educational and social support factors affect the entrepreneurial spirit of students more than structural support. The Applied Impacts are the enhancing of knowledge capacities of university stu
... Show MoreAtheists have spread in the modern era, so that atheism has become a bad phenomenon in the world in general and in Islamic societies in particular, so the research aims to study the individual and social effects left by atheism on the atheists themselves, and the research included multiple axes: atheism linguistically and idiomatically, atheism in the Qur’an Noble and Modern (and Contemporary) Atheism Statistics: and the reasons for atheism: Studying the phenomenon of atheism in Iraq as a model, then studying the effects of atheism: on the individual first, then atheism and its impact on society, then the conclusion, recommendations, sources and references
So I present in the hands of the honorable reader what God Almighty has made easy for me in terms of what I dealt with in the rule (the principle of permissive things) and what branches from it and what is related to it.
This research was divided into an introduction, a preface, three demands, and a conclusion.
The preamble is to explain the meaning of the rule in language and terminology and the definition of the legal rule and what is related to it. The first requirement is to explain the rule that we have in our hands and the words related to its text - and is it a fundamentalist or jurisprudential rule? .
As for the second requirement - in the difference of scholars and their opinions in whether the origin of things is permi
The impact of management control systems (MCS) on organizations performance empirical research has been the subject of numerous studies during the past decade in developed and emerging economies. In the contemporary competitive, complex and changing global business environment, firms are being challenged to adopt business models that enable them to address the strategic uncertainties and risks they face in their business environments. The main issue of this study is that management accounting researchers argue that one of the ways firms can continually rejuvenate themselves to survive and succeed in these complex and uncertain environments is to understand the role of management control systems in Formulating a b
... Show MoreObjective: to assess the risk factors of coronary artery disease patients.
Methodology: A non-probability (purposive) sample of (100) patients. The study population consisted of
a sample of adults from both genders whose ages were 30 years and more, and was newly diagnosed as
having CAD by coronary angiography in the cardiac catheterization unit of An Nasiriyah heart center.
Results: The result of the study showed that the most common modifiable risk factors were low HDL-C
levels (58%), smoking (53%), hypertension (46%), diabetes mellitus (34%), obesity (30%), high
triglycerides (19%), hypercholesterolemia (17%), and high LDLC (14%). All these factors were positively
and significantly associated with the development
Background: Imaging has a critical role in the diagnosis and evaluation of cardiac diseases, beginning with chest radiography and fluoro-scopy and progressing to coronary angio-graphy, echocardiography, nuclear medicine and recently multidetector computed tomo-graphy (MDCT) as well as magnetic resonance (MR) imaging
Objective: To highlight the role of Multi-detector CT in the evaluation of coronary artery disease and its importance of being noninvasive diagnostic technique.
Methods: A cross sectional study for 20 patients. Patients were asked to fast 6 hours prior to the examination and the patients with heart rates above 65 beats per minute were given cardio-
... Show MoreThis research aims at identifying the commitment of satellite news channels in Arabic to the set of important standards that reflect their credibility in dealing with the media material, and considering that these channels give special importance to events in Iraq, as well as the Arab region and the world, decide to choose them and study them with a problem The research was a question about the level of credibility of Iraqi media. This research is descriptive research, which used the survey method on an objective sample of 245 items, while the questionnaire was used as a data collection tool. Seven channels were selected in Arabic for the study. The three most watched channels were chosen. These channels included the channels of Russia t
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