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: Mental health is integrated into PHC as a strategy of WHO to fill the gap in mental health treatment. Part of this strategy needs a level of task shifting so that mental health care is provided by different level of PHC workers and not only specialists such as psychiatrists and psychologists.
Objectives: To assess the knowledge and attitudes of family doctors regarding the provision of psychological health in PHCC and if there is an association between the certificates of these family doctors and their Knowledge and attitudes to psychological health.
Subjects and Methods: A cross-sectional descriptive study with analytic elements was conducted in 8 famil
... 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 MoreBackground: 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 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
Objective: This study aims to assess the awareness of patients suffering from cardiovascular
diseases.
Methodology: A descriptive design was applied in this study. A purposive sample consisted of
(100) patients with cardiovascular disease in the Mosul's hospitals were interviewed to achieve study
objectives. A questionnaire was used for data collection after tested for validity and reliability by pilot
study.
Results: The study results showed the mean of patients awareness are (1.78) cut point of (3) and
the majority of patients84% were aged more than 50 years or above. Slightly increase proportion of
male more than females. Most of them are married81%, retired, smokers, and a period of developing
the disease a
Atherosclerosis is the most common causes of vascular diseases and it is associated with a restriction in the lumen of blood vessels. So; the study of blood flow in arteries is very important to understand the relation between hemodynamic characteristics of blood flow and the occurrence of atherosclerosis.
looking for the physical factors and correlations that explain the phenomena of existence the atherosclerosis disease in the proximal site of LAD artery in some people rather than others is achieved in this study by analysis data from coronary angiography as well as estimating the blood velocity from coronary angiography scans without having a required data on velocity by using some mathematical equations and physical laws. Fif
... 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
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 MoreSo 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
Background: despite the rise in the incidence of renal cell carcinoma attributed to availability of medical imaging, a considerable decline in mortality is an association. Morbidity-wise, the shift from radical nephrectomy to partial nephrectomy is the trend for now. Multiple scoring systems have been introduced over the past decades to help surgeons choose between radical and partial nephrectomy. One commonly used system is the RENAL nephrometry score that was first introduced by Kutikov and Uzzo in 2009.
Objective: to evaluate the role of RENAL nephrometry scoring system in predicting the surgical technique to use to resect renal masses and associated perioperative outcomes.
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