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.
The research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
... Show MoreThe subject of the strategic vision is of great importance to all companies because they live in an environment of rapid change in various areas of life. Supports the performance of its operations in a better way, towards appropriate strategic growth and achieving success. The research aims to determine the level of interest of the researched company in the research variables (strategic vision and growth strategy), and the importance of the research came in being an attempt to provide the theoretical and scientific foundations for the research variables (strategic vision and growth strategy). As for the research method, it was relied on the descriptive analytical method, relying on the questionnaire as a means of obtaining data from the
... Show MoreBackground: Blood group system and the ability to taste phenylthiocarbamide (PTC) are the most studied traits in human genetics which have been extensively used in describing genetic variations among human populations around the world that may had an effect on dental caries. The aims of present study were to investigate the caries experience among students with different bitter taste threshold in relation to blood type. Materials and Methods: The sample of present study includes dental students female aged19-21 years. The diagnosis of dental caries was done according to the criteria of Manjia et al, 1989 recording decayed lesion by severity (D1-4) MFS. Furthermore, bitter taste sensitivity was measured according to PTC (phenylthiocarbamid
... Show MoreThis study aims to determine the reasons for the increase in the frequency of sand and dust storms in the Middle East and to identify their sources and mitigate them. A set of climatic data from 60 years (1960–2022) was analyzed. Sand storms in Iraq are a silty sand mature arkose composed of 72.7% sand, 25.1% silt, and 2.19% clay; the clay fraction in dust storms constitutes 70%, with a small amount of silt (20.6%) and sand (9.4%). Dust and sand storms (%) are composed of quartz (49.2, 67.1), feldspar (4.9, 20.9), calcite (38, 5), gypsum (4.8, 0.4), dolomite (0.8, 1.0), and heavy minerals (3.2, 6.6). Increasing temperatures in Iraq, by an average of 2 °C for sixty years, have contributed to an increase in the number of dust storm
... Show MorePoly(ethylene oxide) is a promising material for solid-state lithium batteries due to its safety, ease of processing, and compatibility with lithium. However, conventional linear PEO falls short of practical requirements due to its limited ionic conductivity, a consequence of the high crystallinity of its ethylene oxide chains. This crystallinity hinders the movement of lithium ions, limiting its performance in solid-state battery applications. In this study, we successfully prepared the plasticized solid polymer electrolytes (PSPEs) based on poly(ethylene oxide) (PEO)/ tetracyanoethylene (TCE) complexed with lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) salt and studied the effect of TCE on structural, mechanical, electrical and elec
... Show MoreOne of the scientific education aims, preparing a student able to keep up with the scientific developments and innovations around him and make him contribute, adapt, investment and continue development. The concepts of nanotechnology from scientific innovation open up an important area of thinking and intervention in the field of chemistry applications in daily life, the technological changes lead to social, political and economic changes which result that the students to have the knowledge, understanding, awareness, appreciation and sense in applications of modern technology for their use optimally, in order to cope with these scientific and technological changes. The research aims at finding out the correlation between the acquisi
... Show MoreBackground: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.
Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw
... Show MoreAbstract:
Recently, there is a widespread attention about the service at the level of each of the research and academic studies, and at the organizational level as well. The subject of orientation towards the service aspect is starting to be of this attention being of the modern subjects, relatively, which appeared at the end of the last century, as well as the link of this subject with the relationship between the organization and its customers, and how to provide high quality services to get their satisfaction. Thus, the specialists from researchers were interested in this field to develop an appropriate scale to measure the organizational orientation toward service, and it was the most prominen
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