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 explored the impact of applying lean thinking With all that carries this term of goals, trends, principles, foundations and concepts, The possibility of applying it in institutions, including Ur public company, an industrial company, And the only one in Iraq specialized in the manufacture of cables, Electrical Wires and the aluminum industry ,Which has been applied to the curriculum of lean thinking , The problem of research is that the institutions, including the company (research sample), adopt and practice traditional administrative, financial and technical methods without relying on modern curricula and ideas, including the subject of our research, In order to achieve the research objectives, the research was divided int
... Show MoreBackground: It had been found that passive smoking may have the same harmful effect as tobacco cigarettes smoking. Aims: This study was conducted to determine the effect of passive smoking on salivary glutathione peroxidase and selenium in relation to dental caries severity. Settings and Design: The sample consisted of 120 children aged 5 years old, classified into four groups according to the number of cigarettes smoked by their fathers daily: Passive smoking children of 5-10 cigarettes, those of 10–15 cigarettes daily, those of 15–20 cigarettes daily and non-passive smoking children of no smokers indoor (the control group). The sample was further classified according to dental caries severity into three groups: mild (DMFS values <4
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The main problem of the study lies in the lack of a clear perception among the study sample about the impact of digital marketing tools on legal liquidity. Legal) of the International Development Bank for Investment and Finance and to achieve the objectives of the research, the method of observation and survey was used in measuring the dimensions of digital marketing. As for banking liquidity, the reports and financial statements of the bank were used as the research sample, as well as the use of the statistical analysis program SPSS in the statement of the relationship The study concluded, in summary, the following: Mar
... Show MoreModern trends have appeared recently in educational thought that call for the achievement of the outcomes of the educational process. Some of these trends are the development of individual thinking skills, considering the individual differences, and learning basic skills. The five-year learning cycle is one of these models. It is called as five-year learning cycle because it passes through five stages. These five stages are: (operate - discover - clarify - expand – Evaluate), which make the learner as the main axis for activating thinking processes. This can be done by organizing study materials through research, investigation, and identifying concepts by himself, as in learning sports skills that depend on motor performance and teamwork,
... Show MoreThe concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq
... Show MoreThe current research aims to identify "the impact of the round table strategies and the question of self-achievement and self-efficacy among students of the Faculty of Education in research methodology course.” The research sample consisted of (75) male and female-third stage students in the department of Life Sciences / College of Education for Pure Sciences / University of Dhi Qar for the academic year (2018-2019. The researcher adopted the experimental approach to achieving the study objectives. The researcher prepared two tools: the achievement test and the self-efficacy scale were applied to the collected sample to obtain the needed data. The result showed that there was a statistically significant difference at the level (0.05) b
... Show MoreAmino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve
... Show MoreBackground: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability. Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in anterior segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 i
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