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.
Show the greatness of Allah Almighty when contemplating the benefits of trees and plants in
Life in general and trees mentioned in the Koran in particular, do not have to meditate that
He acknowledges the greatness of the Almighty Creator, and his preference over man, that he is prepared for his livelihood
And give him what he can do in this life to the fullest.
The study also stressed the need to urge people to this great blessing trees
By preserving them and wasteful wastefulness.
The study also pointed to the need to guide people towards the aesthetics and improvements of
Look through and enjoy the beauty of trees, flowers, greenery and fruits ..
Soil water retention curves (SWRCs) are crucial for characterizing soil moisture dynamics and are particularly relevant in the context of irrigation management. A study was carried out to obtain the SWRC, inflection point, S index, pore size distribution curve, macro porosity, and air capacity from samples submitted to saturation and re-saturation processes. Five different-texture disturbed soil samples Sandy Loam, Loam, Sandy Clay Loam, Silt Loam, and Clay were collected. After obtaining SWRC, each air-dried soil samples were submitted to particle size distribution and clay dispersed in water analyses to verify the soil lost clay. The experimental design was completely randomized with three replications using two processes of SWRC (saturat
... Show MoreAcid treatment is a widely used stimulation technique in the petroleum industry. Matrix acidizing is regarded as an effective and efficient acidizing technique for carbonate formations that leads to increase the fracture propagation, repair formation damage, and increase the permeability of carbonate rocks. Generally, the injected acid dissolves into the rock minerals and generates wormholes that modify the rock structure and enhance hydrocarbon production. However, one of the key issues is the associated degradation in the mechanical properties of carbonate rocks caused by the generated wormholes, which may significantly reduce the elastic properties and hardness of rocks. There have been several experimental and simulation studies regardi
... Show MoreBackground: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq.
Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women.
Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospita
... Show MoreThe construction project is a very complicated work by its nature and requires specialized knowledge to lead it to success. The construction project is complicated socially, technically and economically in its planning, management and implementation aspects due to the fact that it has many variables and multiple stakeholders in addition to being affected by the surrounding environment. Successful projects depend on three fundamental points which are cost-time, performance and specifications. The project stakeholder's objective to achieve best specifications and the cost-time frame stipulated in the contract.
The question is, was the optimum implementation accomplished? The provision for the success of the project
... Show MoreBackground: Laparoscopic cholecystectomy (LC) has become the standard treatment for symptomatic cholelithiasis. Bile duct injury and accidental gallbladder perforation with spillage of bile and stone are common complications of LC. This study was carried out to assess the early complications of gallbladder perforation during LC, and identify the risk factor of that perforation.
Objectives: to evaluate the early complications which may occur after the perforation of the gallbladder during laparoscopic cholecystectomy and to determine the risk factors which are associated with the perforation of the gall bladder.
Subjects and methods: A prospective comparative study o
... Show MoreBACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m
... Show MoreBackground: Preeclampsia occurs in 3-5% of
pregnancies and is a major cause (12-20 %) of
maternal mortality in developed countries. It is the
leading cause of preterm birth and intra-uterine
growth restrictions (IUGR).
Objective: The study was designed to determine and
demonstrate the ultra structural changes of
endothelial cells in placenta of women suffering from
hypertensive disease.
Patients & Methods: Placental samples were
obtained from two groups of pregnant women
groups (preeclamptic and normal pregnant women).
The specimens were fixed in 2.5% gluteraldehyde
and preceded for electron microscopic examination.
Results: Placenta of women with preeclampsia has
shown marked degenerative
Analyze the relationship between genetic variations in the MTHFR gene at SNPs (rs1801131 and rs1801133) and the therapy outcomes for Iraqi patients with rheumatoid arthritis (RA). The study was conducted on a cohort of 95 RA Iraqi patients. Based on their treatment response, the cohort was divided into two groups: the responder (47 patients) and the nonresponder (48 patients), identified after at least three months of methotrexate (MTX) treatment. A polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) technique was employed to analyze the MTHFR variations, specifically at rs1801133 and rs1801131. Overall, rs1801131 followed both codominant and dominate models, in which in
Background:In this study,TiO2 layer was thermally grown as a diffusion barrier on CP Ti substrate prior to electrophoretic deposition of HA coatings, to improve the coating’s compatibility also macro and micro pores in nano Hydroxyapatite dual coatings were created and their effect on the bond strength between the bone and implant was evaluated. Materials and methods: Electrophoretic Deposition technique (EPD) was used to obtain coatings for each one of four types of Hydroxyapatite(HA)on CP Ti screws (micro HA, nano HA, dual nano HA with micro pores, dual nano HA with macro pores) where carbon particles used as fugitive material to be removed by thermal treatment to create porosity.For examination of the changes occurred on the subs
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